Many survivors of the Holocaust have carried feelings of shame related to having survived this horrific event. This paper traces a genealogy of shame by exploring the sources of shame that have haunted survivors, and how these have manifested themselves in their lives and the lives of their children. Arguing that the intergenerational transmission of shame has reinforced a culture of silence among survivors and their children, this paper calls for a reconceptualizing of the afterlife of the Holocaust, which leverages (...) shame as a powerful piece of remembering and understanding the Holocaust. (shrink)

Relational quantum mechanics (RQM) is an interpretation of quantum mechanics based on the idea that quantum states do not describe an absolute property of a system but rather a relationship between systems. There have recently been some criticisms of RQM pertaining to issues around intersubjectivity. In this article, we show how RQM can address these criticisms by adding a new postulate which requires that all of the information possessed by a certain observer is stored in physical variables of that observer (...) and thus is accessible by measurement to other observers. This makes it possible for observers to reach intersubjective agreement about quantum events that have occurred in the past. We suggest a possible ontology for a version of RQM employing this postulate; this ontology upholds the principle that quantum states are always relational, but it also postulates a set of quantum events that are not strictly relational. We show that the new postulate helps address the preferred basis problem in RQM. (shrink)

Dementia patients in the moderate-late stage of the disease can, and often do, express different preferences than they did at the onset of their condition. The received view in the philosophical literature argues that advance directives which prioritize the patient’s preferences at onset ought to be given decisive moral weight in medical decision-making. Clinical practice, on the other hand, favors giving moral weight to the preferences expressed by dementia patients after onset. The purpose of this article is to show that (...) the received view in the philosophical literature is inadequate and is out of touch with real clinical practice. I argue that having dementia is a cognitive transformative experience and that preference changes which result from this are legitimate and ought to be given moral weight in medical decision-making. This argument ought to encourage us to reduce our confidence in the moral weight of advance directives for dementia patients. (shrink)

Recently there have emerged an assortment of theorems relating to the ‘absoluteness of emerged events,’ and these results have sometimes been used to argue that quantum mechanics may involve some kind of metaphysically radical non-absoluteness, such as relationalism or perspectivalism. However, in our view a close examination of these theorems fails to convincingly support such possibilities. In this paper we argue that the Wigner’s friend paradox, the theorem of Bong et al and the theorem of Lawrence et al are all (...) best understood as demonstrating that if quantum mechanics is universal, and if certain auxiliary assumptions hold, then the world inevitably includes various forms of ‘disaccord,’ but this need not be interpreted in a metaphysically radical way; meanwhile, the theorem of Ormrod and Barrett is best understood either as an argument for an interpretation allowing multiple outcomes per observer, such as the Everett approach, or as a proof that quantum mechanics cannot be universal in the sense relevant for this theorem. We also argue that these theorems taken together suggest interesting possibilities for a different kind of relational approach in which _interaction_ states are relativized whilst observed events are absolute, and we show that although something like ‘retrocausality’ might be needed to make such an approach work, this would be a very special kind of retrocausality which would evade a number of common objections against retrocausality. We conclude that the non-absoluteness theorems may have a significant role to play in helping converge towards an acceptable solution to the measurement problem. (shrink)

The laws of nature have come a long way since the time of Newton: quantum mechanics and relativity have given us good reasons to take seriously the possibility of laws which may be non-local, atemporal, ‘all-at-once,’ retrocausal, or in some other way not well-suited to the standard dynamical time evolution paradigm. Laws of this kind can be accommodated within a Humean approach to lawhood, but many extant non-Humean approaches face significant challenges when we try to apply them to laws outside (...) the time evolution picture. Thus for proponents of non-Humean approaches to lawhood there is a clear need for a novel non-Humean account which is capable of accommodating these sorts of laws. In this paper we propose such an account, characterizing lawhood in terms of constraints, which are understood as a form of modal structure. We demonstrate that our proposed realist account can indeed accommodate a large variety of laws outside the time evolution paradigm, and describe some possible applications to important philosophical problems. (shrink)

In this article we set out to understand the significance of the process matrix formalism and the quantum causal modelling programme for ongoing disputes about the role of causation in fundamental physics. We argue that the process matrix programme has correctly identified a notion of ‘causal order’ which plays an important role in fundamental physics, but this notion is weaker than the common-sense conception of causation because it does not involve asymmetry. We argue that causal order plays an important role (...) in grounding more familiar causal phenomena. Then we apply these conclusions to the causal modelling programme within quantum foundations, arguing that since no-signalling quantum correlations cannot exhibit causal order, they should not be analysed using classical causal models. This resolves an open question about how to interpret fine-tuning in classical causal models of no-signalling correlations. Finally we observe that a quantum generalization of causal modelling can play a similar functional role to standard causal reasoning, but we emphasize that this functional characterisation does not entail that quantum causal models offer novel explanations of quantum processes. (shrink)

The Politics of Method in the Human Sciences provides a remarkable comparative assessment of the variations of positivism and alternative epistemologies in the contemporary human sciences. Often declared obsolete, positivism is alive and well in a number of the fields; in others, its influence is significantly diminished. The essays in this collection investigate its mutations in form and degree across the social science disciplines. Looking at methodological assumptions field by field, individual essays address anthropology, area studies, economics, history, the philosophy (...) of science, political science and political theory, and sociology. Essayists trace disciplinary developments through the long twentieth century, focusing on the decades since World War II. Contributors explore and contrast some of the major alternatives to positivist epistemologies, including Marxism, psychoanalysis, poststructuralism, narrative theory, and actor-network theory. Almost all the essays are written by well-known practitioners of the fields discussed. Some essayists approach positivism and anti-positivism via close readings of texts influential in their respective disciplines. Some engage in ethnographies of the present-day human sciences; others are more historical in method. All of them critique contemporary social scientific practice. Together, they trace a trajectory of thought and method running from the past through the present and pointing toward possible futures. Contributors. Andrew Abbott, Daniel Breslau, Michael Burawoy, Andrew Collier , Michael Dutton, Geoff Eley, Anthony Elliott, Stephen Engelmann, Sandra Harding, Emily Hauptmann, Webb Keane, Tony Lawson, Sophia Mihic, Philip Mirowski, Timothy Mitchell, William H. Sewell Jr., Margaret R. Somers, George Steinmetz, Elizabeth Wingrove. (shrink)

Institutional Review Board decisions hinge on the availability and interpretation of information. This is demonstrated by the following well-known historical example. In 2001, 24-year-old Ellen Roche died from respiratory distress and organ failure as a result of her participation in a study at Johns Hopkins Asthma and Allergy Center. The non-therapeutic physiological study, “Mechanisms of Deep Inspiration-Induced Airway Relaxation,” was designed to examine airway hyperresponsiveness in healthy individuals in order to better understand the pathophysiology of asthma. Participants inhaled hexamethonium, a (...) chemical ganglionic blocker that was not FDA-approved for use as specified in the experimental protocol. Risks of inhaling hexamethonium, including lung damage, had been reported in the 1950s and ‘60s. An investigation conducted after Roche's death determined that the study's principal investigator had failed to adequately search the medical literature; the protocol submitted for IRB review cited articles indexed in online literature databases that went back only as far as the 1970s. (shrink)

Physicists are increasingly beginning to take seriously the possibility of laws outside the traditional time-evolution paradigm; yet many popular definitions of determinism are still predicated on a time-evolution picture, making them manifestly unsuited to the diverse range of research programmes in modern physics. In this article, we use a constraint-based framework to set out a generalization of determinism which does not presuppose temporal evolution, distinguishing between strong, weak and delocalised holistic determinism. We discuss some interesting consequences of these generalized notions (...) of determinism, and we show that this approach sheds new light on the long-standing debate surrounding the nature of objective chance. (shrink)

In the target article “Promoting Ethical Payment in Human Infection Challenge Studies,” Fernandez Lynch et al. call for more information sharing about research payment amounts to study parti...

In recent years the quantum foundations community has seen increasing interest in the possibility of using retrocausality as a route to rejecting the conclusions of Bell’s theorem and restoring locality to quantum physics. On the other hand, it has also been argued that accepting nonlocality leads to a form of retrocausality. In this article we seek to elucidate the relationship between retrocausality and locality. We begin by providing a brief schema of the various ways in which violations of Bell’s inequalities (...) might lead us to consider some form of retrocausality. We then consider some possible motivations for using retrocausality to rescue locality, arguing that none of these motivations is sufficient to show that local retrocausal theories should always be preferred to nonlocal retrocausal theories, and therefore there is no clear reason to focus research efforts entirely on seeking local retrocausal models. Next, we examine several different conceptions of retrocausality, concluding that ‘all-at-once’ retrocausality is more coherent than the alternative dynamical picture. We then argue that since the ‘all-at-once’ approach requires probabilities to be assigned to entire histories, locality is not playing any crucial role within this picture. Thus we conclude that using retrocausality as a way to rescue locality may not be the right route to retrocausality. Finally, we demonstrate that accepting the existence of nonlocality and insisting on the nonexistence of preferred reference frames leads naturally to the acceptance of a form of retrocausality, albeit one which is not mediated by physical systems travelling backwards in time. We argue that this is the more natural way to motivate retrocausal models of quantum mechanics. (shrink)

Belief polarization occurs when subjects who disagree about some matter of fact are exposed to a mixed body of evidence that bears on that dispute. While we might expect mutual exposure to common evidence to mitigate disagreement, since the evidence available to subjects comes to consist increasingly of items they have in common, this is not what happens. The subjects’ initial disagreement becomes more pronounced because each person increases confidence in her antecedent belief. Kelly aims to identify the mechanisms that (...) underlie this phenomenon and assess whether these processes undermine the justification of polarized beliefs. He concludes that given evidentialism, justification is not undermined by the polarizing mechanisms. I take on board Kelly’s description of the polarizing mechanisms, but challenge his conclusion. I argue that on plausible versions of evidentialism, the beliefs that result from these routes to polarization are not justified. (shrink)

I argue that the Oxford school Everett interpretation is internally incoherent, because we cannot claim that in an Everettian universe the kinds of reasoning we have used to arrive at our beliefs about quantum mechanics would lead us to form true beliefs. I show that in an Everettian context, the experimental evidence that we have available could not provide empirical confirmation for quantum mechanics, and moreover that we would not even be able to establish reference to the theoretical entities of (...) quantum mechanics. I then consider a range of existing Everettian approaches to the probability problem and show that they do not succeed in overcoming this incoherence. (shrink)

In this article, I offer an analysis of what it is to take offense and what doing so is like, on which a more nuanced and positive appraisal of this emotion becomes possible as compared to its popular reputation. First, I survey the shortfalls of the limited discussion of offense by philosophers, before proposing an alternative analysis. Second, I distinguish offense from nearby emotions, like anger, disgust, and pride. Third, I examine the implications not only for how we conceptualize offense (...) but also how we regard those who take it. On my account, offense tends to be a smaller-scale, more everyday emotion than those making claims about its threats to society suppose, and one ripe for a moral reassessment. While offense sometimes appears excessive, that is likely only in limited cases: namely, those requiring symbolic withdrawal or proxy forms of estrangement. Even there, the appearance of excess may be illusory, with the grander gestures of offense appropriate given the distance between the offended and offending parties. Furthermore, on my account, to take offense is to resist affronts to one's standing, rather than merely a reflection of hurt feelings. Concluding, I sketch a defense of this resistance as a sometimes valuable response to injustice. (shrink)

This book provides in-depth analyses of a wide range of topics surrounding ethical issues in community and patient stakeholder–engaged health research, and highlights where consensus exists, is emerging, or remains elusive. Topics in this book cover the history of stakeholder engagement in health research; how codes of ethics and regulations have (or have not) addressed stakeholder engagement; how to promote equitable collaboration; the ethical perspectives of different stakeholders; and the unique challenges posed by stakeholder- engaged research to the protection of (...) human research participants and the research ethics review process. The book includes discussion of unique issues that arise in stakeholder engagement relevant to different populations, settings, and research designs. This book is relevant for anyone with a role or interest in stakeholder-engaged research, including patient and community research partners; academic researchers; research ethics scholars and educators; and funders. (shrink)

ABSTRACT There has been extensive debate among various disciplines about the nature and value of play. From these discussions it seems clear that play is a phenomenon with more than just one dimension: as a specific type of activity, as a form or structure, as an ontologically distinctive phenomenon, as a type of experience, or as a stance or an attitude towards a particular activity. This article focuses on the importance of the playful attitude in sport. It begins by attempting (...) to describe the underpinning features of a playful attitude, and its relation to Suits’ lusory attitude and the concept of gamification. Finally, it considers and critically evaluates the relationship between play and sport and the importance of the playful attitude in sporting activities. The purpose of this paper is a far deeper analysis of the playful attitude and its relationship to sport than has been previously provided, and a more precise definition as to what the playful attitude is. This will ultimately help to answer questions about the value of sport and how sport ought to be played. (shrink)

I suggest that the current situation in quantum field theory (QFT) provides some reason to question the universal validity of ontological reductionism. I argue that the renormalization group flow is reversible except at fixed points, which makes the relation between large and small distance scales quite symmetric in QFT, opening up at least the technical possibility of a non-reductionist approach to QFT. I suggest that some conceptual problems encountered within QFT may potentially be mitigated by moving to an alternative picture (...) in which it is no longer the case that the large supervenes on the small. Finally, I explore some specific models in which a form of non-reductionism might be implemented, and consider the prospects for future development of these models. (shrink)

Aesthetic theoriesmayclaim universality, but they are normally conditioned by the aesthetic issues and debates of their own times. Plato and Aristo- tle were motivated both to account for the Greek arts of their day and to connect aesthetics to their general metaphysics and theories of value. Closer to our time, asNo¨el Carroll observes, the theories of Clive Bell and R.G. Collingwood can be viewed as “defenses of emerging avant-garde practices— neoimpressionism, on the one hand, and the mod- ernist poetics of (...) Joyce, Stein, and Eliot on the other.”1 Susanne Langer can be read as provid- ing a justification for modern dance, while the ini- tial version of George Dickie’s institutional the- ory “requires something like the presupposition that Dada is a central form of artistic practice” in order to gain intuitive appeal. The. (shrink)

This essay explores how the distinctively anthropological concept of culture provides uniquely valuable insights into the workings of science in its cultural context. Recent efforts by anthropologists to dislodge the traditional notion of culture as a homogenous, stable whole have opened up a variety of ways of imagining culture that place power differentials, flux, and contradiction at its center. Including attention to a wide variety of social domains outside the laboratory, attending to the ways nonscientists actively engage with scientific knowledge, (...) and focusing on the complex interactions that flow both into and out of research laboratories are ways the activities of both scientists and nonscientists can be situated in the heterogeneous matrtx of culture. Three images—the citadel, the rhizome, and the string figure—allow us to picture the discontinuous ways science both permeates and is permeated by cultural life. (shrink)

Offered here is an interpretation of the ancient Confucian philosopher Mengzi's (372–289 B.C.E.) method of cultivating moral feelings, which he calls "extension." It is argued that this method is both psychologically plausible and an important, but often overlooked, part of moral life. In this interpretation, extending our moral feelings is not a project in logical consistency, analogical reasoning, or emotional intuition. Rather, Mengzi's method of extension is a project in realigning the human heart that harnesses our rational, reflective, and emotional (...) capacities in order to extend the feelings we already have to the appropriate objects for these feelings. It is argued that there are three main features of Mengzi's account that make it an attractive explanation of the cultivation of moral feelings. The first is the way Mengzi sees reasoning and philosophical reflection as an aid to, rather than the foundation for, moral development. The second is Mengzi's precision regarding the relationship between the basic moral feelings we start with (the "sprouts") and their corresponding virtues. The method of extension acts as a well-designed bridge between feelings and virtues. Third, Mengzi's account, unlike that of the Mohist Yi Zhi, whom he criticizes, pays special attention to the complexities and limitations of human psychology. In conclusion it is shown how a Mengzian understanding of the relationship between feelings and morality can answer some traditional challenges, especially Kantian ones, regarding the proper role of emotion in moral life. (shrink)

Wallace has recently argued that a number of popular approaches to the measurement problem can’t be fully extended to relativistic quantum mechanics and quantum field theory; Wallace thus contends that as things currently stand, only the unitary-only approaches to the measurement problem are viable. However, the unitary-only approaches face serious epistemic problems which may threaten their viability as solutions, and thus we consider that it remains an urgent outstanding problem to find a viable solution to the measurement problem which can (...) be extended to relativistic quantum mechanics. In this article we seek to understand in general terms what such a thing might look like. We argue that in order to avoid serious epistemic problems, the solution must be a single-world realist approach, and we further argue that any single-world realist approach which is able to reproduce the predictions of relativistic quantum mechanics will most likely have the property that our observable reality does not supervene on dynamical, precisely-defined microscopic beables. Thus we suggest three possible routes for further exploration: observable reality could be approximate and emergent, as in relational quantum mechanics with the addition of cross-perspective links, or observable reality could supervene on beables which are not microscopically defined, as in the consistent histories approach, or observable reality could supervene on beables which are not dynamical, as in Kent’s solution to the Lorentzian classical reality problem. We conclude that once all of these issues are taken into account, the options for a viable solution to the measurement problem are significantly narrowed down. (shrink)

We argue that the temporal asymmetry of influence is not merely the result of thermodynamics: it is a consequence of the fact that modal structure of the universe must admit only processes which cannot give rise to contradictions. We appeal to the process matrix formalism developed in the field of quantum foundations to characterise processes which are compatible with local free will whilst ruling out contradictions, and argue that this gives rise to ‘consistent chaining’ requirements that explain the temporal asymmetry (...) of influence. We compare this view to the perspectival account of causation advocated by Price and Ramsey. (shrink)

This paper suggests that the contemporary feminist debate on relational autonomy is best understood as an attempt at ameliorative inquiry—the concept of autonomy is defined in order to secure political and theoretical advantages. Most theorists adopt some sort of constructionist, or relational, account precisely because of the political and theoretical advantages relational accounts are meant to offer. But there are also significant drawbacks to this approach. I argue that there are reasons to be skeptical of ameliorative inquiries into the concept (...) of autonomy: first, the goals of inquiry have not been made explicit and may not be shared; second, because ameliorative inquiries are guided by unclear and unshared goals, the debate will continue to pull feminists in conflicting directions; and finally, the normative and aspirational nature of ameliorative inquiry unacceptably threatens the exclusion of some women from the category of autonomous agents. (shrink)

Exploring the intimate tie between body movement and space and time, Lee begins with the position that body movement generates space and time and explores the ethical implications of this responsibility for the situations one’s body movements generate. Whiteness theory has come to recognize the ethical responsibility for situations not of one’s own making and hence accountability for the results of more than one’s immediate personal conscious decisions. Because of our specific history, whites have developed a particular embodiment and body (...) movement that generates places that can only be characterized as more comfortable and more enabling to whites. (shrink)

Long histories and entrenched habits of inattention among advantaged groups mean that even minor challenge and concession can provoke subjective perceptions of victimization. How, in such conditions, might claims of structural injustice break through? Drawing on field work with practitioners across conflict mediation, therapy, education, and performance – four sectors that facilitate listening in fraught contexts yet are undertheorized in politics – this article makes the case that among the most overlooked and powerful resources for cultivating receptivity and responsiveness among (...) advantaged groups are the arts of listening. Practices of engagement across these sectors establish listening as potent rather than passive, given the extent to which it constitutes the field of encounter and shapes what emerges within it, both in terms of expression and, more significantly in this context, receptivity of those to whom one listens. Yet this also means that how one listens is a pivotal consideration – particularly when listening might serve to reinforce and normalize unjustly dominant positions. In contrast to progressive politics’ emphasis on finding more forceful forms of voice and conventional reliance on direct communicative practices, this article explores how specific comedic, theatrical, and embodied tactics can generate ‘oblique forms of listening’ potentially useful to social justice struggles. (shrink)

In the Philebus, Socrates maintains two theses about the relationship between pleasure and the good life: the mixed life of pleasure and intelligence is better than the unmixed life of intelligence, and: the unmixed life of intelligence is the most divine. Taken together, these two claims lead to the paradoxical conclusion that the best human life is better than the life of a god. A popular strategy for avoiding this conclusion is to distinguish human from divine goods; on such a (...) reading, pleasure has merely instrumental value, and it benefits human beings only as a result of their imperfect nature. I argue that certain ‘pure’ pleasures are full-fledged, intrinsic goods in the Philebus, which are even worthy of the gods . This positive evaluation of pure pleasure results from a detailed examination of pleasure, which reveals that different types of pleasures have fundamentally different natures. (shrink)

Over the last several decades there has been an increase in the amount of research conducted concerning academically dishonest behaviors at the undergraduate level. However, this research and subsequent interventions are based on the assumptions that there exists a clear understanding of what constitutes academic dishonesty. In an attempt to address this gap in the current literature, a concept synthesis of students’ perceptions of academic behavior was completed. The end result was 18 categories of potentially dishonest academic behaviors. Definitions and (...) examples are explored. Inter-rater reliability was completed and Kappa values are reported as well as implications for teaching and future research. (shrink)

The rule of rescue describes the moral impulse to save identifiable lives in immediate danger at any expense. Think of the extremes taken to rescue a small child who has fallen down a well, a woman pinned beneath the rubble of an earthquake, or a submarine crew trapped on the ocean floor. No effort is deemed too great. Yet should this same moral instinct to rescue, regardless of cost, be applied in the emergency room, the hospital, or the community clinic? (...) -/- In health care, the desire to save lives at any cost must be reconciled with the reality of resource scarcity. As one example, the estimated cost for prophylactic Factor VIII to treat one patient with hemophilia for one year is $300,000. Costs of this magnitude have been accepted by public and private insurers in the developed world, even though, in principle, these sums could provide greater overall health benefit if allocated to pay for the unmet health care needs of many other patients. Looking forward, however, broad application of the rule of rescue will be increasingly untenable. But the moral instinct will remain: the desire to help those weakest among us, especially when their small numbers allow us to see them as unique individuals. What, then, is the ethical framework that can guide coverage and reimbursement decisions for orphan drugs into the future? (shrink)

Only somewhat recently has a specific literature emerged focused on the ethics of engaging patient and community stakeholders in health research. This literature is informed by a broad range of disciplinary frameworks and norms. It also overlaps with – and diverges from – traditional research ethics scholarship in interesting and important ways. This volume is an effort to bring together, in one place, important perspectives on the ethics of stakeholder engagement in health research. Here, ethics, patient and community stakeholders, and (...) health-related research are all conceptualized broadly. (shrink)

Volume 20, Issue 5, June 2020, Page 28-30.

We discuss some difficulties that arise in attempting to interpret the Page–Wootters and Internal Quantum Reference Frames formalisms, then use a ‘final measurement’ approach to demonstrate that there is a workable single-world realist interpretation for these formalisms. We note that it is necessary to adopt some interpretation before we can determine if the ‘reference frames’ invoked in these approaches are operationally meaningful, and we argue that without a clear operational interpretation, such reference frames might not be suitable to define an (...) equivalence principle. We argue that the notion of superposition should take into account the way in which an instantaneous state is embedded in ongoing dynamical evolution, and this leads to a more nuanced way of thinking about the relativity of superposition in these approaches. We conclude that typically the operational content of these approaches appears only in the limit as the size of at least one reference system becomes large, and therefore these formalisms have an important role to play in showing how our macroscopic reference frames can emerge out of wholly relational facts. (shrink)

Recently, some work in feminist epistemology has received more uptake from mainstream western analytic epistemology than it had in the past. There has been recognition of the importance of topics like epistemic injustice, standpoint epistemology, and epistemologies of ignorance, for instance. But these discussions are often seen as orthogonal to core epistemic theorizing - they have not received uptake as fundamental contestations of the ways we understand epistemic value, or core normative epistemic concepts. I suggest that one reasons for this (...) is the perception that insofar as feminist theorizing is responsive to moral and political concerns, it is not doing epistemology because it is not theorizing about epistemic value. This assumes a specific kind of epistemic value monism - a view whose popularity, I argue, derives at least partly from features of the methodologies that are popular in mainstream epistemology. I show that by using a different type of methodology - ameliorative inquiry - we see that there is a principled reason to doubt epistemic value monism. We can thus understand feminist theorizing in ways that are richer, more accurate, and that contribute to our understanding of the ways in which our practical, moral, and epistemic agency are intertwined. (shrink)

In the Buddhist ethical traditions, equanimity along with love, compassion, and sympathetic joy form what are called the four boundless qualities, which are affective states one cultivates for moral and spiritual development. But there is a sense in which equanimity seems very unlike the three others: love, compassion, and sympathetic joy all imply an emotional investment in others, whereas equanimity seems to imply an absence of such investment. This observation has provoked debate as to how to properly understand the relationship (...) between equanimity and the other three qualities. In this paper, I propose that equanimity - like love, compassion, and sympathetic joy - is itself a virtue of good intimate relationships and not in conflict with such virtues. (shrink)

Madison Kilbride recently argued that insurance ) should cover in vitro fertilisation with preimplantation genetic testing services for couples at high risk of having a child affected with a genetic condition. She argues that IVF-PGT meets CMS’s definition of ‘medically necessary care’, where such care includes ‘services or supplies needed to diagnose or treat an illness, injury, condition, disease or its symptoms’. Kilbride argues that IVF-PGT satisfies this definition in two ways: as a diagnostic tool and as a treatment. Contradicting (...) Kilbride, however, I argue that IVF-PGT provides neither diagnosis nor treatment under CMS’s definition. Thus, as long as we accept CMS’s definition of medically necessary care—which Kilbride does, explicitly—it follows that IVF-PGT does not count as medically necessary care. Still, there may be other reasons to conclude that IVF-Preimplantation genetic testing should be covered, and so, it would be a mistake to reject Kilbride’s conclusion altogether. The problem is simply that Kilbride’s argument—that the procedure should be covered because it is medically necessary per CMS’s definition—is not sound. I conclude by discussing a number of other genetic services that are not currently being covered despite the fact that they do seem to satisfy CMS’s definition of ‘medically necessary diagnosis or treatment’. These services, I argue, should be provided under CMS before we consider expanding coverage to include elective procedures such as IVF-PGT. (shrink)

This article provides a conceptual and normative framework through which we may understand the potentially ethically significant roles that information generated by neurotechnologies about our brains and minds may play in our construction of our identities. Neuroethics debates currently focus disproportionately on the ways that third parties may (ab)use these kinds of information. These debates occlude interests we may have in whether and how we ourselves encounter information about our own brains and minds. This gap is not yet adequately addressed (...) by most allusions in the literature to potential identity impacts. These lack the requisite conceptual or normative foundations to explain why we should be concerned about such effects or how they might be addressed. This article seeks to fill this gap by presenting a normative account of identity as constituted by embodied self-narratives. It proposes that information generated by neurotechnologies can play significant content-supplying and interpretive roles in our construction of our self-narratives. It argues, to the extent that these roles support and detract from the coherence and inhabitability of these narratives, access to information about our brains and minds engages non-trivial identity-related interests. These claims are illustrated using examples drawn from empirical literature reporting reactions to information generated by implantable predictive BCIs and psychiatric neuroimaging. The article concludes by highlighting ways in which information generated by neurotechnologies might be governed so as to protect information subjects’ interests in developing and inhabiting their own identities. (shrink)

This article analyzes the rise and fall of a public health ‘fact’ in the US: the assertion that gay men’s Viagra use is inherently recreational and increases STD risk. Extending the science studies argument that drug development and marketing entail the construction of new publics, this article shows how strategic drug marketing silences can also constitute new populations of users. It shows how Viagra marketing’s silence about gay users, which facilitated legitimization of the drug as an aid for companionate heterosexuality, (...) created a cultural space for the development of health discourse about gay men as illegitimate, recreational and risky Viagra users. Using Susan Leigh Star’s concepts of ‘simplification’ and ‘complexification’, this article traces the construction and deployment of this public health fact, as well as its subsequent contestation. Using an arena analysis approach, this article demonstrates how marketing discourse and public health fact-making came together in the case of gay Viagra use to refresh long-standing and politically harmful American cultural associations between gay sex and sickness. (shrink)

Bioethics, Volume 36, Issue 3, Page 298-304, March 2022.

The authors conducted a qualitative analysis of thirty-seven issues of The DDU Review, a newsletter produced by residents of the Dual Diagnosis Unit, a residential unit for people who had diagnoses of developmental disability and serious mental illness in the Central State Hospital. The analysis of the newsletters produced between September 1988 and June 1992 revealed three major themes: 1) the mundane; 2) good behavior; and 3) advocacy. Contrary to the authors’ expectations, the discourse of medicalization—such as relations with physicians, (...) diagnoses, and medications—receive little attention. Instead, the patient-journalists focus on prosaic aspects of institutional life. The patients used their writing as a form self-definition and advocacy. The authors argue that even though it is tempting to consider the patients’ emphasis on good behavior as evidence of institutional control, internalized discipline, and medicalization, a more nuanced interpretation, which focuses on how the patients’ understood their own experiences, is warranted. Researchers must also recognize the ways in which The DDU Review reveals the patient-journalists’ experience of an institutional life that includes non-medical staff, varied social relationships among patients, and negotiated freedoms. (shrink)