We can imagine a world in which ectogenesis provides a safe gestating space that eliminates maternal morbidity and mortality while maximising healthy outcomes for babies. In this world, women, no longer physically—and visibly—pregnant, are no longer economically, socially or physically disadvantaged due to the potential for pregnancy and birth. Because everyone can access the same technology, women are able to work without fear of pregnancy-related discrimination or restrictions, and health disparities among individuals in gestation and birth based on socioeconomic status (...) are eliminated. This imagining allows us to explore the ethical and social underpinnings of such a world, and consider how to achieve it in our current paradigm. Having explored the freedom and equality that is possible in an ideal hypothetical where all have equal access to such technologies, we can now imagine that same world without ectogenesis: women, no longer economically, socially or physically disadvantaged due to pregnancy and birth, despite still becoming pregnant. Such is the potential political perspective and provocation that can be spurred on by discussion of ectogenesis. As Cavaliere argues, the technological reality of ectogenesis may not achieve the freedom and equality that …. (shrink)

Given the enduring debate over what constitutes quality, and therefore appropriate training, in clinical ethics consultation, it is unsurprising that there is variation in the structure and content of clinical ethics fellowship programs. However, this variation raises questions about the value of fellowship training when the ethicists that emerge from these programs might be quite different. The specifics of fellowship programs are largely internal. As such, the extent of variation and whether such variation is problematic remains unclear. In this article, (...) we summarize lessons learned from discussions between fellows, their mentors and program directors at the 2020 Clinical Ethics UnConference, and outline some possible ways to advance the conversation about variation in fellowship programs and training. We argue for the more open sharing of training specifics in order to help break down the siloed nature of fellowship programs. Greater transparency could, firstly, allow for more robust reflection on and refinement of training practices and, secondly, allow us to better balance professionally appropriate consistency with unavoidable or desirable variation based on local norms, culture and leadership. (shrink)

Contraception works by preventing fertilization of an egg or preventing implantation of a fertilized embryo. For those who believe pregnancy begins at implantation, contraceptives preventing implantation are not abortifacient. However, for those who assert that pregnancy begins at fertilization, any agent causing the intentional loss of an embryo, even prior to implantation, is abortifacient, both morally and for lack of a different term to describe the postfertilization, preimplantation loss. In the debate on this topic, much of the discourse on both (...) sides wrongly focuses on the opposing side's perceived ignorance in denying scientifically proven definitions rather than on the substance of the conflict. Indeed, both sides accuse the other of prioritizing its “subjective” views over “objective” facts. In this essay, we unpack the scientific, cultural, and religious factors that underlie this debate. We argue that the only way to move forward is to clarify our terminology and engage with the substance of the argument, rather than merely the rhetoric. (shrink)

Gestational surrogacy relies on a legal agreement between the surrogate and the intended parents to define the roles and responsibilities of the parties, including explicit consent by the surrogate to allow the physician to release all pregnancy-related medical information to the intended parents. In the event of surrogate misconduct, however, physicians may feel conflicted if the surrogate asks the physician to withhold information about potentially dangerous behaviour in pregnancy from the intended parents. While the American Society for Reproductive Medicine guidelines (...) may support disclosure over the objections of the surrogate, the authors argue that such disclosure is a violation of the surrogate’s rights and the physician’s ethical and professional duties. A surrogate’s confidentiality must be maintained as it is an essential element of the physician–patient relationship. (shrink)

With the growth and evolution of the field of clinical ethics, the one constant has been its variation. Resolving ethical issues at the bedside is done differently across the country based on one’s...

What were once considered private domains of life have become more public in the last 20 years with the rise of social media. Illness narratives of patients with chronic, severe, or terminal condit...

McCarthy et al. have made an important contribution to the field of ethics by identifying the important similarities between Christian and secular bioethics that can be drawn on to further s...

The Discourse on the All-embracing Net of Views: the Brahmajala Sutta and its Commentaries translated from the Pali by Bhikkhu Bodhi. Buddhist Publication Society, Kandy 1978. xiii-359pp. Rs. 75, £5.00.

Evolving Clinical Ethics: A Working UnConference, held 5 through 7 February 2020 in Houston, Texas, brought together 91 participants from a variety of institutions, many of whom are engaged in clinical ethics work. The event followed the success of the first Clinical Ethics UnConference hosted by the Cleveland Clinic Center for Bioethics in 2018, and offered an opportunity for ethicists to share both their challenges and their solutions to clinical ethics issues. In this article we explore the emerging themes of (...) the second UnConference and identify the top 10 questions currently faced by the field. We address both unresolved issues and areas of agreement and highlight new collaborations that have been developed to work toward greater standardization in our field. (shrink)

Efforts to professionalize the field of bioethics have led to the development of the Healthcare Ethics Consultant-Certified (HEC-C) Program intended to credential practicing healthcare ethics consultants (HCECs). Our team of professional ethicists participated in the inaugural process to support the professionalization efforts and inform our views on the value of this credential from the perspective of ethics consultants. In this paper, we explore the history that has led to this certification process, and evaluate the ability of the HEC-C Program to (...) meet the goals it has set forth for HCECs. We describe the benefits and weaknesses of the program and offer constructive feedback on how the process might be strengthened, as well as share our team’s experience in preparing for the exam. (shrink)

The OpenNotes (ON) mandate in the 21st Century Cures Act requires that patients or their legally authorized representatives be able to access their medical information in their electronic medical record (EMR) in real time. Ethics notes fall under the domain of this policy. We argue that ethics notes are unique from other clinical documentation in a number of ways: they lack best-practice guidelines, are written in the context of common misconceptions surrounding the purpose of ethics consultation, and often answer questions (...) of a different nature than other documentation. Thus, we believe the clinical ethics community would benefit from clarification on when the withholding of ethics notes is justified. We provide recommendations for excluding information from ethics documentation based on the likelihood and magnitude of harm that may occur with particular disclosures and suggest approaches to decrease the potential harms that may occur. We define and explain six types of reasons to exclude information from ethics notes based on significant harms that are not addressed in the ON policy: (1) harmful revelations from a protected chart note; (2) negative emotional effects on patients or families; (3) the purpose of the consultation is undermined by harmful consequences; (4) avoidable negative impact on interpersonal dynamics; (5) inappropriate labeling or disclosure of medical, social, or financial information; and (6) inclusion of biasing or otherwise unfair information. We also suggest approaches to mitigate harm when excluding, including, reframing, or delaying release of information that is perceived to be relevant to an ethics case. Overall, we hope our analysis and recommendations will initiate a much-needed discussion about the impact of the ON mandate on clinical ethics documentation. (shrink)

Constraining collective cell migration in vitro using different types of engineered substrates such as microstructured surfaces or adhesive patterns of different shapes and sizes often leads to the emergence of specific patterns of motion. Recently, analogies between the behavior of cellular assemblies and that of active fluids have enabled significant advances in our understanding of collective cell migration; however, the physiological relevance and potential functional consequences of the resulting migration patterns remain elusive. Here we describe the different patterns of collective (...) cell migration that have been reported in vitro in response to geometrical constraints, explore the in vivo pertinence of the in vitro systems used to impose the geometrical constraints, and discuss the potential physiological ramifications of the collective migration patterns that emerge as a result of physical constraints. We conclude by highlighting key upcoming challenges in the exciting field of constrained collective cell migration. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:A Pragmatist in Paris: Frédéric Rauh’s “Task of Dissolution”Richard HornerIntroductionRichard Rorty has suggested that we think of “pragmatism in the professorial sense” as “just a repudiation of the quest for certainty and foundations.” 1 In other words think of a pragmatist as someone who links the quest for privileged method with the quest for foundational knowledge and gives up both. As Rorty explained several years ago,If one believes, as (...) I do, that the traditional ideas of “an absolute (‘objective’) conception of reality” and of “scientific method” are neither clear nor useful, then one will see the interlocked questions “What should be the method of the social sciences?” and “What are the criteria of an objective moral theory?” as badly posed. 2Pragmatists not only give up the quest for grounding, foundations, or essences, then, but they also understand that the dissolution of essences leads in turn to “the dissolution of inquiry into a self-reweaving web of beliefs.” If this “seems wacky to you,” Rorty notes, “consider that such a dissolution is a natural and [End Page 289] easy consequence of a generalized antiessentialism.” 3 Whether he speaks in terms of foundations or essences, Rorty’s message remains the same: pragmatists not only let go of the quest for foundations, they also let go of the quest for privileged method.Perhaps the principle difficulty with this way of defining pragmatism is that not very many people seem to qualify as pragmatists. What Rorty has been able to do with remarkable consistency, others have been less willing and less able to do. There are, of course, still numerous foundationalists among us who are explicit about their commitment to the quest for foundations and to the quest for method that accompanies it. While anti-foundationalism may be all the rage, “it would be too much to say that the foundationalist argument lies in ruins. It is in fact remarkably resilient and resourceful in the face of attacks against it.” 4 Furthermore, even where the “death of foundationalism” is a given, 5 the quest for method continues to hold interest. To cite only one notable example among many, Jürgen Habermas may have successfully resisted the seductive attraction of the quest for Letzbegründung or ultimate foundations, but he clearly remains committed to “a metahermeneutical analysis” of communication, the purpose of which is “to identify universals and thus to produce a type of theoretical knowledge.” 6 This kind of “anti-foundationalist theory hope,” 7 can be found among Deweyan pragmatists as well. While many of them let go of the quest for foundations with relative ease, they find it difficult to abandon the quest for method 8 or to allow the epistemological enterprise to succumb to Rorty’s “vulgar pragmatism.” 9 Furthermore, in doing so they believe that Dewey would have sided with them rather than with Rorty.Given the difficulty in identifying pragmatists who have consistently abandoned both quests, it is especially striking to discover Frédéric Rauh practicing “pragmatism in the professorial sense” in the philosophy section of the Faculté [End Page 290] des lettres of the Sorbonne and Ecole normale supérieure during the first decade of the twentieth century. While this period of French history certainly produced intellectuals who were sympathetic to the American pragmatists, these intellectuals were, as Durkheim noted, “far from subscribing to all their theses.” 10 Renouvier, for instance, remained, in James’s own words, “too classic in the general rationalism of his procedure.” 11 Similarly, James’s good friend Boutroux, though “simpatico” toward American pragmatism, also “betrayed... a philosophical inheritance quite foreign to that of James.” 12 Ralph Barton Perry, comes to a similar conclusion with regard to Bergson, writing that Bergson and James “exchanged salutations and gifts, and then proceeded on their way. In no sense did they coincide either as systems or in their particular theorems.” 13 Apparent alliances, then, emerge finally as “misalliances,” showing that “what has passed as pragmatism in European philosophical thought has not been distinctive of the essential and most important features of American pragmatism.” 14 Whatever their affinities with pragmatism may have been and whatever their contributions to dissolving the... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:How I Hate You, CancerClaire YarMigraine. That’s what we thought. They run in my family, so why not? My beautiful, bright, extroverted ten–year–old daughter’s neurological exam was unremarkable, but she had a bad headache and was vomiting in the early morning hours. Migraine didn’t seem that much of a stretch. Our savvy pediatrician had a gut feeling that it was more than a migraine and sent her for an (...) MRI.We had not even left the children’s hospital before I received a voicemail to call our pediatrician. When I returned the call, on our way to pick up Ellie’s younger brother from school and already running late I heard the words that no parent wants to hear, “I have bad news. We found a brain tumor and it’s rather large”. This conversation would turn our lives into a frenzy of fear and leave unanswered (unanswerable?) questions. I was told to bring her to the ER where we would be met by a neurosurgeon and oncologist. I could not process this information. My initial fears were too scary to utter. Was she going to die? Do children survive brain surgery “intact”? Is it operable? Oncologist = scary cancer, doesn’t it? Did we do something to cause it? What if our insurance doesn’t cover the best treatment?Clinging to the life I knew before—needing to stay in the “before,” not even pulling the car over, I reached backwards, held Ellie’s leg and spoke the words out loud for the first time. That’s what a brain tumor diagnosis does to your family. It breaks up time into “before” and “after”. Her reaction was a terrified wail and then, oddly, hysterical laughter. Is that what shock looks like? My own reaction to the call was of stunned silence. The sound of my heartbeat and the blood rushing in my ears meant I could not ask the questions I had in that moment.Ellie has always been exceptional. She is a bright light in any room. At only ten–years–old, she spoke like a teenager; had the vocabulary of an adult. Never again would I be able to take this for granted. In every waking moment that our lives were unoccupied with the practicalities of a brain tumor diagnosis, the questions I couldn’t think of or say out loud during that terrible phone call continually flooded my thoughts. Your child’s brain is everything after all; it’s what makes them “them.”An avid horse rider, she had been off her favorite horse’s back for a few weeks saying that the bouncing hurt her neck. I had kept her off school for several days, but we had seen marked improvement in [End Page E12] the day or two leading up to that devastating D–Day of diagnosis, and she had been back at school doing well. Only a week before, Ellie had been dancing at a party with friends. How could she have a brain tumor?We rushed home and hurriedly packed our bags for “at least a week”—and I recall that life seemed to be both in slow motion and traveling at the speed of light. I desperately wanted to turn the clock back to the innocence we had known a few hours before. This was way too much news to hear in one day. Even when I heard the diagnosis, I was surprised that we would have to go to the hospital that day. Now! Don’t people get time to process or plan and get second opinions? We had no time to tell family and friends or ask for help. We didn’t have the luxury of time. Time is another thing I no longer take for granted.Upon arrival at the large children’s hospital we felt as if we were given so much information, but looking back, I now know that these angels are trained in giving parents only what they can handle—in tiny pieces, nibble by nibble. You don’t (can’t) hear half of it anyway. Our families live far from us, and trying to gather and figure out... (shrink)

Background: Notwithstanding near-universal agreement on the theoretical importance of truthfulness, empirical research has documented gaps between ethical norms and physician behaviors. Although prior research has explored situations in which physicians may not be truthful with patients, it has focused on contexts within specialty practice. In this article, we report on a qualitative study of truthfulness in primary care. Methods: We conducted a qualitative study during December 2014–March 2015 involving both focus groups and in-depth, semistructured interviews with 32 primary care physicians (...) from the Boston, MA, and Baltimore, MD, metro areas in three specialties: internal medicine, family practice, and pediatrics. Interviews and focus groups were led using a semistructured guide, which explored situations in which primary care physicians find it difficult to be honest with patients; factors shaping truthfulness; and rationales for truthful and untruthful communication. Results: While physicians described outright lying to patients as rare, other deviations from truthfulness were not uncommon, including slanting and deliberately withholding information. Physicians described a range of factors as influencing truthfulness, from patient-level characteristics such as educational background to societal considerations including avoiding unnecessary tests and procedures. Physicians described truthfulness as an ethical requirement, deviations from which required further justification. Perceived justifications included promoting patient well-being and avoiding harm. Conclusions: Our results suggest a potential need to augment opportunities for training in “everyday ethics” challenges, such as the appropriateness of deception in response to patient requests for inappropriate tests or pain medications. Furthermore, they indicate that, in various circumstances encountered in primary care, physicians perceive other moral duties as potentially in conflict with the duty of truthfulness. Further ethical analysis should focus on identifying when deviations from complete truthfulness do and do not serve patients' interests, to guide physicians in striking a reasonable balance among principles of medical ethics that may conflict with one another. (shrink)

While one of the arguments against religious belief relates to its apparent irrationality, it can be shown phenomenologically that there is a different kind of rationality at work in religious knowledge, undermining the sharp distinction between sacred and secular that enables theology to be marginalised as irrational. Approaching Christianity through the category of revelation, that is, as a way of living and believing that draws not only on founding narratives of revelation but on the ongoing ‘experience’ of transcendence in unveiling (...) truth, I seek to examine how the possibility of truth itself can inspire hatred and so open onto violence. ‘Religious’ violence typically emerges from a hatred directed at otherness. Hatred of what truth reveals is a powerful motivation for violence, but it cannot be shown that this is specifically religious. Nevertheless, otherness is characterised by an excess that resists objectification and may be revelatory of truth. Violence may be religious precisely to the extent that it is directed against the otherness before which each person stands accused. (shrink)

I define 'skim semantics' to be a Davidson-style truth-conditional semantics combined with a variety of deflationism about truth. The expressive role of truth in truth-conditional semantics precludes at least some kinds of skim semantics; thus I reject the idea that the challenge to skim semantics derives solely from Davidson's explanatory ambitions, and in particular from the 'truth doctrine', the view that the concept of truth plays a central explanatory role in Davidsonian theories of meaning for a language. The fate of (...) skim semantics is not determined by the fate of the truth doctrine, so rejecting the truth doctrine does not in itself open the way to skim semantics. I establish my thesis by showing that some recently proposed versions of skim semantics fail because of truth's expressive role. I also discuss the conditions that might permit skim semantics. (shrink)

A recent article argued for the immorality of abortion regardless of personhood status by comparing the impairment caused by fetal alcohol syndrome to the impairment caused by abortion. I argue that two of the premises in this argument fail and that, as such, one cannot reasonably attribute moral harms to abortion on the basis of the moral harms caused by fetal alcohol syndrome. The impairment argument relies on an inconsistent instantiation, which undermines the claim that personhood is irrelevant, and it (...) does not fulfill its own ceteris paribus clause, which demands that no additional benefit be gained from abortion that would not be gained from causing fetal alcohol syndrome. (shrink)

Individual differences in children's talk about inner states are striking, but how should they be interpreted? This study used transcripts of preschoolers’ conversations with siblings and best friends to address this question in two ways. Our first aim was to elucidate the exact nature of individual differences by contrasting categories (emotion/desire vs. cognitive state) and referents (own vs. other/shared) of inner state talk. Our second aim was to compare performance vs. competence views of inner state talk by exploring (i) the (...) stability of individual differences in inner state talk across different relationships and (ii) the cognitive correlates of inner state talk. A sample of 44 children (mean age = 4 years 3 months) was observed for 20 minutes at home playing with a sib and for 20 minutes at school playing with a best friend. Videos were transcribed and coded for the frequency and form of inner state talk (e.g., talk about different categories of inner state, or about own vs. others’ inner states). During the school visits, children completed a set of tasks tapping theory-of-mind skills and verbal ability. Individual differences in inner state talk (especially reference to others’ inner states) were stable across relationships. There was no association between individual differences in talk about cognitive vs. emotion/desire states, although both categories of inner state talk were significantly associated with individual differences in children's theory-of-mind skills. (shrink)

Visual artists and scientists frequently employ the labour of assistants and technicians, however these workers generally receive little recognition for their contribution to the production of artistic and scientific work. They are effectively “invisible”. This invisible status however, comes at the cost of a better understanding of artistic and scientific work, and improvements in artistic and scientific practice. To enhance understanding of artistic and scientific work, and these practices more broadly, it is vital to discern the nature of an assistant (...) or technician’s contribution to the production of a work, which is difficult as it is uncommon to discuss these workers. To address this, I investigate how different kinds of parallel working arrangements in collective artistic and scientific practices affect the creative potential of individuals involved. Different working arrangements permit different degrees of autonomy for individuals involved in these practices. Significantly, a lack of autonomy precludes the opportunity to act spontaneously and so exercise, what I term, “creative agency”. Evaluating the contribution of an assistant or technician based on the degree of autonomy that they are granted in the production of a work is an approach that I show can be used to precisely determine the nature of their contribution to the production of a work and accordingly, what kind of recognition an agent should receive for this. Importantly, this approach has the advantage of explaining the artistic and epistemic significance of different kinds of contribution to the production of artistic and scientific work. (shrink)

A consideration of the differences between Shakespearean comedy and tragedy in light of the historically particular inflection of dramatic irony in the English Reformation. The essay compares classical and humanist understandings of literary response and then proposes that we consider that response as a function of knowledge with respect to (and hence feelings about) a protagonist and his plight. The essay compares the structures of suspense in Sophocles’ and Seneca’s Oedipus plays, and then goes on to examine the ways in (...) which two early modern versions of Seneca’s play demonstrate different manners of crafting an audience’s affective relation based on epistemological advantage. The author argues that the peculiarities of these repsonses, and their difference from Shakespeare’s handling of dramatic irony, can be illuminated by the English response to Calvin’s understanding of predestination as a matter of being known about. The analysis concludes with examples from Much Ado About Nothing and Othello that demonstrate the different affective charge of privileged information. (shrink)

Two experiments examined similarities and differences in the effects of consciously and unconsciously perceived rewards on the active maintenance of goal-relevant information. Participants could gain high and low monetary rewards for performance on a word span task. The reward value was presented supraliminally or subliminally at different stages during the task. In Experiment 1, rewards were presented before participants processed the target words. Enhanced performance was found in response to higher rewards, regardless whether they were presented supraliminally or subliminally. In (...) Experiment 2, rewards were presented after participants processed the target words, i.e., during maintenance. Performance increased in response to relatively high rewards when they were presented subliminally, but decreased when they were presented supraliminally. We conclude that both consciously and unconsciously perceived rewards boost resources supporting the maintenance of task-relevant information. Conscious processing of rewards can, however, heavily interfere with an ongoing maintenance process and impair performance. (shrink)

The revival of virtue ethics is largely inspired by Aristotle, but few---especially Christians---follow him in seeing virtue supremely exemplified in the “magnanimous” man. However, Aristotle raises a matter of importance: the character traits and type of psychological stance exemplified in those who aspire to acts of extraordinary excellence. I explore the accounts of magnanimity found in both Aristotle and Aquinas, defending the intelligibility and acceptability of some central elements of a broadly Aristotelian conception of magnanimity. Aquinas, I argue, provides insight (...) into how Christian ethics may appropriate central elements of a broadly Aristotelian conception of extraordinary virtue. (shrink)

In this paper I argue that forecasting presents us with a paradox. Our ability to make reasonable and accurate medium to long term social and technological forecasts is demonstrably dismal. The gap between what actually happens and what was predicted is usually huge. Promoters and technological forecasters continue to provide us with wide varieties of technological futures. The paper introduces a tentative typology of technology futures as a framework for empirical work on failed technology futures. Sociological, psychological and historical explanations (...) are considered for the forecasting paradox. But primarily I argue this is an ethical question. Forecasting is akin to promising and it is in this light it ought to be assessed. Forecasters are accountable for their forecasts in the same way I may be held accountable for my promises. (shrink)

This article examines the artistic potential of forms of image-making that involve registering the features of real objects using mind-independent processes. According to skeptics, these processes limit an agent’s intentional control over the features of the resultant “automatic images,” which in turn limits the artistic potential of the work, and the form as a whole. I argue that this is true only if intentional control is understood to mean that an agent produces the features of the work by their own (...) bodily movements alone. Not only is this an unrealistic standard to uphold, but I show that a definition of intentional control based on the skeptic’s position does not prohibit an agent from realizing the features of an image by means beyond their own actions. An agent can exercise intentional control over the features of an image if they successfully anticipate the effect that the remote consequences of their actions will have on these. This, I argue, entails that to exert intentional control over the features of an image is to exercise “creative agency,” which is a species of executive agency. Consequently, I defend the idea that the origin of automatic images in creative agency grounds their artistic significance. (shrink)

It is often argued that the combination of deflationism about truth and the truth-conditional theory of meaning is impossible for reasons of circularity. I distinguish, and reject, two strains of circularity argument. Arguments of the first strain hold that the combination has a circular account of the order in which one comes to know the meaning of a sentence and comes to know its truth condition. I show that these arguments fail to identify any circularity. Arguments of the second strain (...) hold that the combination has a circular explanation of the ideas or concepts of meaning and truth. I show that these arguments identify a genuine, but acceptable, circularity. (shrink)

It is well-documented that the alteration of portrait photographs can have a negative impact on a viewer’s self-esteem. One might think that providing written disclaimers warning of alteration might help to mitigate this effect, yet empirical studies have shown that viewers continue to feel like what they are seeing is real, and thus attainable, despite knowing it is not. I propose that this cognitive dissonance occurs because disclaimers fail to show viewers how to look at the contents of a photographic (...) image differently. Consequently, viewers have the same perceptual experience, where the picture appears to faithfully resemble a direct visual experience of the subject, which conflicts with their changing sense of warrant. However, I argue that the degree of perceived similarity, and so contact, may be subject to change depending on what a viewer is attentive to during their viewing of an image, including subtle but unrealistic signs of alteration. (shrink)

My comments on this pioneering book by Russ Hurlburt and Eric Schwitzgebel do not focus on the descriptions of experiences that it includes, but on the very process of description, which seems to me insufficiently highlighted, described and called into question. First I will rely on a few indications given by Melanie herself, the subject interviewed by the authors, to highlight an essential difficulty which the authors only touch upon: the not immediately recognized charac-ter of lived experience. Then I will (...) look for clues about what Melanie does to come into contact with her experience and recognize it. These clues -- completed by elements of description of this act collected through explicitation interviews -- provide criteria enabling a more precise evaluation of what the authors do to guide Melanie in the real-ization of this act, and therefore the accuracy of Melanie's descrip-tions. I will defend the idea that the description of the very process of becoming aware and describing is an essential condition for the understanding, refinement, teaching, and evaluation of introspection methods, as well as for the reproducibility of their results. (shrink)

Increasingly, artists describe the feeling of creating images with generative AI systems as like working with a “collaborator”—a term that is also common in the scholarly literature on AI image-generation. If it is appropriate to describe these dynamics in terms of collaboration, as I demonstrate, it is important to determine the form and nature of these joint efforts, given the appreciative relevance of different types of contribution to the production of an artwork. Accordingly, I examine three kinds of collaboration that (...) can be found in the philosophical literature on artistic authorship—collective authorship, co-creatorship, and co-production—to determine whether human-AI interactions comprise joint efforts as per such kinds. As I find, collaboration is a concept that invokes rich psychological terms and so one to used be with care in relation to generative AI, which does not yet meet the conditions to count as an artistic collaborator in the senses derived from the literature. To progress discussions on ethical and legal issues that are raised by image-making practices involving generative AI, and further research into the distinctive qualities afforded by interactions with these systems, I argue that we ought to frame their contributions to the production of visual artworks in terms of a “generative” contribution and describe the interactions between humans and generative AI systems as “AI-assisted production”. (shrink)

The impact of postmodernism on research methodology: implications for nursingThis article considers what have been referred to as die two major crises in research methodology: (i) the crisis of legitimation (to what extent are the notions of reliability and validity still meaningful in the light of a posture that is said to approach an ’anything goes’ standpoint); and (ii) the crisis of representation (to what extent is it possible to represent the world view of ‘the odier’ without it being merely (...) a construction of the researcher). These are discussed in order to identify aspects of a continuing debate that is of relevance to nurses for they are integral to graduate research and the ongoing application of research in hospital or community contexts. Educating nurses in research requires that they learn a repertoire of research skills such as literature critiques, developing research questions, interviewing, analysing techniques and computer‐assisted analysis. However, postmodern debates can also be beneficial by facilitating their understanding of contemporary research issues so that they can critically integrate such reflexive thinking into dieir own research practices and go on to explore new ways to undertake research. (shrink)

Reading Nietzsche’s many remarks on freedom and free will, we face a dilemma. On the one hand, Nietzsche levels vehement attacks against the idea of the freedom of the will in several places throughout his writing. On the other hand, he frequently describes the sorts of people he admires as ‘free’ in various respects, as ‘free spirits’, or as in possession of a ‘free will’. So does Nietzsche think that we are or perhaps could be free, or not? I argue (...) that we ought to read these seemingly conflicting claims as part of one unified project, which is to try to understand what true freedom would look like. Nietzsche’s attacks on ‘free will’, I suggest, are not intended to establish that we are not free, but rather to show that a certain tempting picture of freedom is confused and totally inadequate for purpose. The positive half of Nietzsche’s project, then, should be read as his attempt to do a better job – to provide an account of freedom that better articulates what we were trying, via the confused picture, to get at. (shrink)

This article offers a critique and reformulation of the concept of empathy as it is currently used in the context of medicine and medical care. My argument is three pronged. First, that the instrumentalised notion of empathy that has been common within medicine erases the term’s rich epistemological history as a special form of understanding, even a vehicle of social inquiry, and has instead substituted an account unsustainably structured according to the polarisations of modernity. I suggest that understanding empathy by (...) examining its origins within the phenomenological tradition, as a mode of intersubjective understanding, offers a different and profitable approach. Secondly, I argue that the appropriation of empathy in medicine means that, ironically, empathy can function as a technique of pastoral power, in which virtue, knowledge and authority remain with the doctor. And thirdly, empathy is in danger of being resourced as a substitute for equity and funding within health systems. I conclude however with hope for the productive possibilities for empathy. (shrink)

Supererogatory actions must go beyond duty not only by being optional, but also by being good to do. Understanding the evaluative condition that supererogatory actions must meet is vital in order to understand the very concept of supererogation. I argue for two key features of the goodness of supererogatory actions: firstly, that they are comparative, and secondly, that they are relative. Specifically, I argue that an action meets the evaluative condition of supererogation if and only if it is (i) better (...) than some permissible alternative and (ii) better than (or at least as good as) all permissible alternatives that are (a) as costly or (b) less costly; where the sense in which it is better is relative to a particular beneficiary. Seeing why this is so reveals the complexity of our notion of the supererogatory and captures our intuitions on core and complex cases. Furthermore, it makes room for supererogation’s mirror: the suberogatory. (shrink)