Taking Ourselves Seriously and Getting It Right is written in a manner that is accessible to all. Frankfurt’s arguments are, as usual, clear and persuasive. Korsgaard’s, Bratman’s, and Dan-Cohen’s comments are thought provoking. There are, however, two main areas in which Frankfurt’s arguments need clarification (the notion of wholehearted identification, and the concept of ambivalence), and there are misunderstandings of Frankfurt at work in Korsgaard’s (relationship between the self and the will, and concept of the will for Frankfurt) and Bratman’s (...) (meaning of "necessity" for Frankfurt) comments. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:Beyond Slavery: Overcoming Its Religious and Sexual Legacies Edited by Bernadette J. BrootenEboni Marshall TurmanBeyond Slavery: Overcoming Its Religious and Sexual Legacies EDITED BY BERNADETTE J. BROOTEN New York: Palgrave Macmillan, 2010. 352 pp. $30.00In her introduction to this edited collection of essays, Bernadette Brooten asserts that religion has long been complicit in the construction and practice of the logic of human enslavement. She provocatively claims that religion (...) and the racial and sexual norms that emerge from religious inquiry have historically [End Page 236] designated women and other bodies that defy white male normativity as inherently “slaveable.” She further contends that the religious and sexual legacies of slavery are not relegated to a moment in time, now past and gone. Rather, contemporary society is the heir of a flesh-and-blood hierarchy that continues to shape its “social values, religious thought, and economic realities” (3). The remnants of enslavement persist among human communities not only as a lived reality that, as Mende Nazer suggests in the epilogue, continues to threaten the lives and life chances of poor women and children throughout the world, but also as a blood memory—a recollection that runs so deep into the social fabric of our theopolitical worlds that in spite of slavery’s superficial obscurity, it remains as the pulse of human everydayness, lurking beneath the surface of daily exchanges.The insidious legacies of slavery that emerge from bigoted God-talk promote dehumanizing racial-sexual stereotypes, dictate the quality of marriage and intimate relationships, corrupt and exploit sexual expression, and drive the development of public policy and law in ways that disproportionately marginalize and disempower women and girls. Consequently, this volume proposes resistance and calls readers to communal action that renounces slavery in all its forms.In parts 2, 3, and 4, the essays detail the racial, religious, and sexual character of slavery by focusing on the experience of black women’s oppression in America. This focus on the varieties of black women’s enslavement—from legal chattel slavery and social-political bondage to incarceration—provides the groundwork for the volume’s subsequent engagement of Christian, Jewish, and Islamic law, which demonstrates how slavery and its concomitant assignment and rationalization of embodied inferiority has been primarily cultivated by sacred texts. In her essay, for example, Sheila Briggs explicitly connects religious belief and dehumanizing practices; she ingeniously links religious textual interpretation with the sexual violence of early Christian gladiatorial practices in ancient amphitheaters.In parts 5 and 6, the volume reintroduces the substance of slavery’s legacies by way of a historical survey that connects enslavement across social contexts. In linking Debra Blumenthal’s discussion of slavery in late medieval Spain and Catherine Clinton’s analysis of the racial hypocrisies of Thomas Jefferson and Strom Thurmond to the problem of the Bible and the oppression it yields for sexual minorities as uncovered by Sylvester Johnson, Brooten exposes the vast and prevailing scope of slavery that affects all of us—women and girls, men and boys, sexual minorities, and even those who dare to fall in love across racial boundaries. In parts 7 and 8, Frances Smith Foster and Dwight Hopkins directly engage the “herstories” of black women who are marked by the legacies of slavery and yet who have consistently resisted in creative and effective ways (271). [End Page 237]Undoubtedly, this volume is a critical contribution to the field insofar as it uncovers an enduring social issue that continues to influence how we engage each other across differences of race, gender, class, and sexuality. The breadth of its disciplinary scope proves to be overwhelming at times. Nonetheless, Brooten’s constructive method serves well to emphasize the titanic complexity of enslavement and the challenge of its demolition.Eboni Marshall TurmanDuke Divinity SchoolCopyright © 2014 Society of Christian Ethics... (shrink)

Bioethicists often draw sharp distinctions between hope and states like denial, self-deception, and unrealistic optimism. But what, exactly, is the difference between hope and its more suspect cousins? One common way of drawing the distinction focuses on accuracy of belief about the desired outcome: Hope, though perhaps sometimes misplaced, does not involve inaccuracy in the way that these other states do. Because inaccurate beliefs are thought to compromise informed decision making, bioethicists have considered these states to be ones where intervention (...) is needed either to correct the person’s mental state or to persuade the person to behave differently, or even to deny the person certain options. In this article, we argue that it is difficult to determine whether a patient is really in denial, self-deceived, or unrealistically optimistic. Moreover, even when we are confident that beliefs are unrealistic, they are not always as harmful as critics contend. As a result, we need to be more permissive in our approach to patients who we believe are unrealistically optimistic, in denial, or self-deceived—that is, unless patients significantly misunderstand their situation and thus make decisions that are clearly bad for them, we should not intervene by trying to change their mental states or persuade them to behave differently, or by paternalistically denying them certain options. (shrink)

In some views, philosophy’s glory days in bioethics are over. While philosophers were especially important in the early days of the field, so the argument goes, the majority of the work in bioethics today involves the “simple” application of existing philosophical principles or concepts, as well as empirical work in bioethics. Here, we address this view head on and ask: What is the role of philosophy in bioethics today? This paper has three specific aims: (1) to respond to skeptics and (...) make the case that philosophy and philosophers still have a very important and meaningful role to play in contemporary bioethics, (2) to discuss some of the current challenges to the meaningful integration of philosophy and bioethics, and (3) to make suggestions for what needs to happen in order for the two fields to stay richly connected. We outline how bioethics center directors, funders, and philosopher bioethicists can help. (shrink)

Just last week (October 4, 2022), the U.S. White House released a blueprint for an A.I. Bill of Rights, consisting of “five principles and associated practices to help guide the design, use, and de...

Little is known about the consequences of moral distress. The purpose of this study was to identify clinical situations that caused nurses to experience moral distress, to understand the consequences of those situations, and to determine whether nurses would change their practice based on their experiences. The investigation used a descriptive approach. Open-ended surveys were distributed to a convenience sample of 204 critical care nurses employed at a university medical center. The analysis of participants’ responses used an inductive approach and (...) a thematic analysis. Each line of the data was reviewed and coded, and the codes were collapsed into themes. Methodological rigor was established. Forty-nine nurses responded to the survey. The majority of nurses had experienced moral distress, and the majority of situations that caused nurses to experience moral distress were related to end of life. The nurses described negative consequences for themselves, patients, and families. (shrink)

The COVID-19 pandemic will generate vexing ethical issues for the foreseeable future and many journals will be open to content that is relevant to our collective effort to meet this challenge. While the pandemic is clearly the critical issue of the moment, it’s important that other issues in medical ethics continue to be addressed as well. As can be seen in this issue, the Journal of Medical Ethics will uphold its commitment to publishing high quality papers on the full array (...) of medical ethics. At the same time, JME aims to be a premiere home for ground-breaking scholarship on the ethical issues raised by COVID-19. Toward this end, we have a number of papers that are freely available online and for which production has been fast-tracked.1–5 A challenge for authors who want to write about the pandemic is the rapidly evolving nature of the situation and the time it takes for journal content to be reviewed and published, even when fast-tracked. For that reason, all authors who would like to submit a paper on the pandemic can also submit a post to the JME blog prior to submitting a full paper to the journal. Those interested in writing for the JME blog should contact one of its editors, Hazem Zohny or Mike King. Over the last 3 weeks, 30 high-quality commentaries on the pandemic have been posted to the blog. These posts are circulated widely via the JME Twitter and Facebook feeds and have stimulated significant …. (shrink)

The application of machine learning in health care holds great promise for improving care. Indeed, our own team is collaborating with experts in machine learning and statistical modeling to bu...

As the COVID-19 pandemic rages on, this June 2021 issue of the JME contains several articles addressing pandemic-related ethical issues, including, discrimination against persons with disabilities,1 collective moral resilience,2 and stress in medical students due to COVID-19.3 It also contains a critical appraisal of the most recent WHO guidance document on the management of ethical issues during an infectious disease outbreak.4 This June issue of JME also addresses several important clinical ethics issues: covert administration of medication in food,5 educational pelvic (...) exams under anesthesia,6 consent to cancer screening,7 care of critically ill newborns when the birth mother is unwell,8–10 and ethical considerations related to recruiting migrant workers for clinical trials.11 Perhaps what is most unique about this issue is its Feature …. (shrink)

In Why Some Things Should Not Be for Sale, philosopher Debra Satz takes a penetrating look at those commodity exchanges that strike most of us as problematic. What considerations, she asks, ought to guide the debates about such markets? What is it about a market involving prostitution or the sale of kidneys that makes it morally objectionable? How is a market in weapons or pollution different than a market in soybeans or automobiles? Are laws and social policies banning the (...) more noxious markets necessarily the best responses to them? Satz contends that categories previously used by philosophers and economists are of limited utility in addressing such questions because they have assumed markets to be homogenous. Accordingly, she offers a broader and more nuanced view of markets--one that goes beyond the usual discussions of efficiency and distributional equality--to show how markets shape our culture, foster or thwart human development, and create and support structures of power. (shrink)

Introduction: why the De anima commentaries? This book will concentrate on interpretations of the De anima in late antiquity, and what we can learn from ...

The People of Plato is the first study since 1823 devoted exclusively to the identification of, and relationships among, the individuals represented in the complete Platonic corpus. It provides details of their lives, and it enables one to consider the persons of Plato's works, and those of other Socratics, within a nexus of important political, social, and familial relationships. Debra Nails makes a broad spectrum of scholarship accessible to the non-specialist. She distinguishes what can be stated confidently from what (...) remains controversial and--with full references to ancient and contemporary sources--advances our knowledge of the men and women of the Socratic milieu. Bringing the results of modern epigraphical and papyrological research to bear on long-standing questions, The People of Plato is a fascinating resource and valuable research tool for the field of ancient Greek philosophy and for literary, political, and historical studies more generally. In discrete sections, Nails discusses systems of Athenian affiliation, significant historical episodes that link lives and careers of the late fifth century, and their implications for the dramatic dates of the dialogues. The volume includes a rich array of maps, stemmata, and diagrams, plus a glossary, chronology, plan of the agora in 399 B.C.E., bibliography, and indices. (shrink)

In the article “Informed Consent: What Must be Disclosed and What Must be Understood?” Joseph Millum and Danielle Bromwich argue that informed consent requires satisfaction of certain disclosure an...

In this article, Satz critiques "both Pogge's use of the causal contribution principle as well as his attempt to derive all of our obligations to the global poor from the need to refrain from harming others.".

In bioethics, the predominant categorization of various types of influence has been a tripartite classification of rational persuasion (meaning influence by reason and argument), coercion (meaning influence by irresistible threats—or on a few accounts, offers), and manipulation (meaning everything in between). The standard ethical analysis in bioethics has been that rational persuasion is always permissible, and coercion is almost always impermissible save a few cases such as imminent threat to self or others. However, many forms of influence fall into the (...) broad middle terrain—and this terrain is in desperate need of conceptual refining and ethical analysis in light of recent interest in using principles from behavioral science to influence health decisions and behaviors. This paper aims to address the neglected space between rational persuasion and coercion in bioethics. First, I argue for conceptual revisions that include removing the “manipulation” label and relabeling this space “nonargumentative]influence,” with two subtypes: “reason-bypassing” and “reason-countering.” Second, I argue that bioethicists have made the mistake of relying heavily on the conceptual categories themselves for normative work and instead should assess the ethical permissibility of a particular instance of influence by asking several key ethical questions, which I elucidate, that relate to (1) the impact of the form of influence on autonomy and (2) the relationship between the influencer and the influenced. Finally, I apply my analysis to two examples of nonargumentative influence in health care and health policy: (1) governmental agencies such as the Food and Drug Administration (FDA) trying to influence the public to be healthier using nonargumentative measures such as vivid images on cigarette packages to make more salient the negative effects of smoking, and (2) a physician framing a surgery in terms of survival rates instead of mortality rates to influence her patient to consent to the surgery. (shrink)

Dissecting Bioethics, edited by Tuija Takala and Matti Hayry, welcomes contributions on the conceptual and theoretical dimensions of bioethics. The department is dedicated to the idea that words defined by bioethicists and others should not be allowed to imprison people’s actual concerns, emotions, and thoughts. Papers that expose the many meanings of a concept, describe the different readings of a moral doctrine, or provide an alternative angle to seemingly self-evident issues are particularly appreciated. To submit a paper or to discuss (...) a suitable topic, contact Tuija Takala [email protected].:This article examines some of the assumptions and implications associated with the Belmont era context in which the concept of therapeutic misconception was forged. We argue that the justification of therapeutic misconception should be reconsidered based on less paternalistic and more participatory models of research. Finally, we identify conceptual and practical approaches that might better reflect contemporary research practice. (shrink)

Chapter 1 Welcome to A Kids Mensch Handbook What is a mensch, anyway? How can I be someone people respect? What's A Kid's Mensch Handbook all about? ...

In their article “The Concept of Voluntary Consent,” Robert Nelson and colleagues (2011) argue for two necessary and jointly sufficient conditions for voluntary action: intentionality, and substantial freedom from controlling influences. They propose an instrument to empirically measure voluntariness, the Decision Making Control Instrument. I argue that (1) their conceptual analysis of intentionality and controlling influences needs expansion in light of the growing use of behavioral economics principles to change individual and public health behaviors (growing in part by the designation (...) of “The Science of Behavior Change” as a new National Institutes of Health [NIH] Roadmap Activity); and (2) that their measure of voluntariness that relies on self-perceived intentionality and extent of control is unreliable, given findings from behavioral economics and cognitive science that show that our perceptions about the intentionality and control of our own and others’ decisions and actions are remarkably skewed and un-insightful. (shrink)

The idea of a ‘right to mental integrity’, sometimes referred to as a ‘right against mental interference,’ is a relatively new concept in bioethics, making its way into debates about neurotechnological advances and the establishment of ‘neurorights.’ In this paper, we interrogate the idea of a right to mental integrity. First, we argue that some experts define the right to mental integrity so broadly that rights violations become ubiquitous, thereby trivialising some of the very harms the concept is meant to (...) address. Second, rights-based framing results in an overemphasis on the normative importance of consent, implying that neurointerventions are permissible in cases where people consent to have their mental states influenced or read off, a confidence in consent that we argue is misguided. Third, the concept often collapses the ethics of brain inputs and brain outputs, potentially resulting in a loss of important conceptual nuance. Finally, we argue that the concept of a right to mental integrity is superfluous—what is wrong with most violations of mental integrity can be explained by existing concepts such as autonomy, manipulation, privacy, bodily rights, surveillance, harm and exploitation of vulnerabilities. We conclude that bioethicists and policy-makers ought to either make use of these concepts rather than arguing for the existence of a new right, or they need to avoid making rights violations ubiquitous by settling on a narrower and more rigorous definition of the right. (shrink)

While the bioethics literature demonstrates that the field has spent substantial time and thought over the last four decades on the goals, methods, and desired outcomes for service and training in bioethics, there has been less progress defining the nature and goals of bioethics research and scholarship. This gap makes it difficult both to describe the breadth and depth of these areas of bioethics and, importantly, to gauge their success. However, the gap also presents us with an opportunity to define (...) this scope of work for ourselves and to help shape the broader conversation about the impact of academic research. Because of growing constraints on academic funding, researchers and scholars in many fields are being asked to demonstrate and also forecast the value and impact of their work. To do that, and also to satisfy ourselves that our work has meaningful effect, we must understand how our work can motivate change and how that change can be meaningfully measured. In a field as diverse as bioethics, the pathways to and metrics of change will likewise be diverse. It is therefore critical that any assessment of the impact of bioethics research and scholarship be informed by an understanding of the nature of the work, its goals, and how those goals can and ought to be furthered. In this paper, we propose a conceptual model that connects individual bioethics projects to the broader goals of scholarship, describing the translation of research and scholarly output into changes in thinking, practice, and policy. One of the key implications of the model is that impact in bioethics is generally the result of a collection of projects rather than of any single piece of research or scholarship. Our goal is to lay the groundwork for a thoroughgoing conversation about bioethics research and scholarship that will advance and shape the important conversation about their impact. (shrink)

An analysis of the identity issues involved in facial allograft transplantation is provided in this paper. The identity issues involved in organ transplantation in general, under both theoretical accounts of personal identity and subjective accounts provided by organ recipients, are examined. It is argued that the identity issues involved in facial allograft transplantation are similar to those involved in organ transplantation in general, but much stronger because the face is so closely linked with personal identity. Recipients of facial allograft transplantation (...) have the potential to feel that their identity is a mix between their own and the donor’s, and the donor’s family is potentially likely to feel that their loved one ‘‘lives on’’. It is also argued that facial allograft transplantation allows the recipients to regain an identity, because they can now be seen in the social world. Moreover, they may regain expressivity, allowing for them to be seen even more by others, and to regain an identity to an even greater extent. Informing both recipients and donors about the role that identity plays in facial allograft transplantation could enhance the consent process for facial allograft transplantation and donation. (shrink)

“Made for Learning” is the result of 60 years of research and theory building by Australian educator Brian Cambourne, articulated and described with abundant classroom examples by American educator Debra Crouch. This book describes a Discourse of Meaning-Making and explain and illustrate how to make that discourse the dominant language of the classroom. When the Conditions of Learning are coupled with four Processes That Empower Learning, an extension of the theory in the last three decades, teacher decision-making promotes the (...) active participation of learners in their own literate journey. How that active learning looks, sounds, and feels becomes tangible in the multitude of classroom examples found throughout the book. These classroom examples bring the Conditions of Learning to life and are unpacked to explore and analyze the specific teaching decisions leading to student learning. The authors offer educators concrete tools to use the Conditions of Learning as a framework to explore their own practices to strengthen learning experiences for every student. (shrink)

An original examination of the relevance of behavioral economics for the practice of medical ethics.

ArgumentDuring the two decades before the turning point in Copernicus's personal and scientific development in 1510, he had experience of political activity which has been largely ignored by the existing Copernicus literature but part of which is reconstructed in outline in this paper. Given the close linkage between politics and astrology, Copernicus's likely reaction to astrology is re-examined here. This reconstruction also suggests that the turning point in 1510, when Copernicus left his post as secretary to his uncle Lucas Watzenrode (...) the prince-bishop of Warmia, was not only linked to Copernicus's first version of his heliocentric theory in theCommentariolus, but also to major political setbacks being experienced by Watzenrode during these years, and with the publication of Copernicus's translation of theLettersof Theophylactus Simocatta. Some of these considerations contribute to maintaining the view that Copernicus and his work were in several respects exceptional. (shrink)

Howard Minkoff, Raaga Unmesha Vullikanti and Mary Faith Marshall argue that the U.S. Supreme Court ruling in Dobbs v. Jackson Women’s Health Organization not only undermines the right to abortion b...

Cognitive scientists have identified a wide range of biases and heuristics in human decision making over the past few decades. Only recently have bioethicists begun to think seriously about the implications of these findings for topics such as agency, autonomy, and consent. This article aims to provide an overview of biases and heuristics that have been identified and a framework in which to think comprehensively about the impact of them on the exercise of autonomous decision making. I analyze the impact (...) that these biases and heuristics have on the following dimensions of autonomy: understanding, intentionality, absence of alienating or controlling influence, and match between formally autonomous preferences or decisions and actual choices or actions. (shrink)

In an April 2023 article in JAMA Pediatrics, ‘Life Support System for the Fetonate and the Ethics of Speculation’, authors De Bie, Flake and Feudtner critique bioethicists for practising what they call ‘speculative ethics’. The authors refer to a 2017 article that they published on the Extra-uterine Environment of Neonatal Development (EXTEND) system. This system was able to keep fetonatal (newborn, but in a fetal physiological state) lambs alive outside of the parent lamb’s womb for 4 weeks. The article has (...) been accessed almost 300 000 times and received significant media attention. It also resulted in an explosion in the bioethics literature about ‘the ethics of the artificial womb’. However, the authors bemoan, these ethics discussions focused largely on unrealistic use cases of the new technology—from elective shortening of pregnancies to complete ectogenesis. The authors dubbed these discussions as ‘a technically and developmentally naive, yet sensationally speculative, pipe dream’. The use case of the EXTEND technology that is most realistic involves supporting extremely premature newborns (23–24 weeks). Other probable uses include supporting infants in later gestational ages (25–28 weeks) with pathological conditions, potentially allowing for surgeries or other therapeutics to be delivered without imposing risks on pregnant patients. To …. (shrink)

Whether as New Year's resolutions, birthday wishes, or daily promises, most everyone vows at some point to make a major life change. But change is easier said than done, especially when it comes to better managing our wellness amidst the chaos of everyday living. Fortunately, wellness coach and award-winning writer Brett Blumenthal has devised a way to inspire and motivate her readers to live healthier and make positive changes in their lives. Although Blumenthal's method is not a quick (...) fix, it is a surprisingly simple one: make one small change per week, for fifty-two weeks, and at the end of a year, you'll be happier and healthier. After all, it is the small changes that are the most realistic, instead of trying to overhaul your lifestyle all at once. 52 Small Changes addresses all areas of wellbeing, including nutrition, exercise, stress management, mental wellness, and even the health of one's home environment. By guiding readers through these changes at an easy, manageable pace, Blumenthal provides an engaging roadmap to lasting results and "happier, healthier you."'. (shrink)

This paper argues that neurolinguistics has the potential to yield insights that can feed back into corpus-based Cognitive Linguistics. It starts by discussing how far the cognitive realism of probabilistic statements derived from corpus data currently goes. Against this background, it argues that the cognitive realism of usage-based models could be further enhanced through deeper engagement with neurolinguistics, but also highlights a number of common misconceptions about what neurolinguistics can and cannot do for linguistic theorizing.

The concept of ‘accounts’ (Scott and Lyman, 1968) – or linguistic strategies for neutralizing the negative social meanings of norm violation – has a long history in sociology. This work examines British and American women's accounts of cosmetic surgery. In the medical literature, feminist writings and the popular press, aesthetic plastic surgery has been associated with narcissism, psychological instability and self-hatred. Given these negative connotations, cosmetic surgery remains a practice requiring justification even as its popularity increases. Drawing on interview data, (...) I argue that respondents' efforts to account for cosmetic surgery vary according to the ‘repertoires of evaluation’ (Lamont and Thévenot, 2000) made available by their own nation and, particularly, by its healthcare culture. In the market-based US healthcare system, women justify cosmetic surgery by referring to their personal and financial ‘investments’ in physical attractiveness and well-being. Such explanations are less legitimate in Britain, where healthcare is considered a social right rather than a consumer good. In the latter context, women employ narratives that medicalize the pre-surgical body by stressing the physical pain and emotional distress that it caused. (shrink)

Clinical trials are a central mechanism in the production of medical knowledge. They are the gold standard by which such knowledge is evaluated. They are widespread both in the United States and internationally; a National Institute of Health database reports over 106,000 active industry and government-sponsored trials (National Institutes of Health n.d.). They are an engine of the economy. The work of trials is complex; multiple people with diverse interests working across multiple settings simultaneously participate in them, and they are (...) underwritten by multiple organizational structures and diverse funding mechanisms. In the past several years, concern about the ethics of clinical trials has spiked dramatically .. (shrink)

In his article “Nudging and Informed Consent,” Shlomo Cohen (2013) argues, among other things, that 1) “to the extent that the nudge-influenced decision making is rational—in whatever sense,” there...

Agora, Academy, and the Conduct of Philosophy offers extremely careful and detailed criticisms of some of the most important assumptions scholars have brought to bear in beginning the process of (Platonic) interpretation. It goes on to offer a new way to group the dialogues, based on important facts in the lives and philosophical practices of Socrates - the main speaker in most of Plato's dialogues - and of Plato himself. Both sides of Debra Nails's arguments deserve close attention: the (...) negative side, which exposes a great deal of diversity in a field that often claims to have achieved a consensus; and the positive side, which insists that we must attend to what we know of these philosophers' lives and practices, if we are to make a serious attempt to understand why Plato wrote the way he did, and why his writings seem to depict different philosophies and even different approaches to philosophizing. From the Preface by Nicholas D. Smith. (shrink)