In 1998, the Labour government introduced legislation broadening British sentencing powers in relation to crimes aggravated by the offender's hostility towards the victim's actual or perceived race, religion, sexual orientation or disability. Gender is a notable omission from this list. Through a survey of eighty-eight stakeholders working in the violence against women (VAW) sector, this paper explores both the potential benefits and possible disadvantages of adding a gender-based category concerned with VAW to British hate crime legislation. The majority of participants (...) believed that a hate crime approach would offer significant benefits, especially in terms of the symbolic power of the law to send a message to society that VAW is unacceptable. However, most also recognised that the addition of a VAW category to current legislation would involve major practical and conceptual difficulties, not least those resulting from problematic assumptions about the nature of hate crimes versus VAW, and a general unwillingness on the part of policy-makers to address the socio-cultural inequalities that underpin VAW. Overall, the fact that the majority of participants favoured inclusion, on the basis that the possible symbolic benefits were likely to outweigh the potential practical disadvantages, is significant: it speaks to the power of hate crime legislation to challenge many forms of inequality and discrimination still endemic in British society. (shrink)

In her rich and engaging new book, Elinor Mason argues that blameworthiness has three varieties—ordinary, detached, and extended—each of which corresponds to a distinct way of acting wrongly. In ex...

As Christian List (2021) has recently argued, the increasing arrival of powerful AI systems that operate autonomously in high-stakes contexts creates a need for “future-proofing” our regulatory frameworks, i.e., for reassessing them in the face of these developments. One core part of our regulatory frameworks that dominates our everyday moral interactions is blame. Therefore, “future-proofing” our extant regulatory frameworks in the face of the increasing arrival of powerful AI systems requires, among others things, that we ask whether it makes sense (...) to extend our blaming practices to these systems. In the paper, we argue for the admittedly surprising thesis that this question should be answered in the affirmative: contrary to what one might initially think, it can make a lot of sense to blame AI systems, since, as we furthermore argue, many of the important functions that are fulfilled by blaming humans can also be served by blaming AI systems. The paper concludes that this result gives us a good pro tanto reason to extend our blame practices to AI systems. (shrink)

Critics currently argue that applied ethics approaches to artificial intelligence (AI) are too principles-oriented and entail a theory–practice gap. Several applied ethical approaches try to prevent such a gap by conceptually translating ethical theory into practice. In this article, we explore how the currently most prominent approaches of AI ethics translate ethics into practice. Therefore, we examine three approaches to applied AI ethics: the embedded ethics approach, the ethically aligned approach, and the Value Sensitive Design (VSD) approach. We analyze each (...) of these three approaches by asking how they understand and conceptualize theory and practice. We outline the conceptual strengths as well as their shortcomings: an embedded ethics approach is context-oriented but risks being biased by it; ethically aligned approaches are principles-oriented but lack justification theories to deal with trade-offs between competing principles; and the interdisciplinary Value Sensitive Design approach is based on stakeholder values but needs linkage to political, legal, or social governance aspects. Against this background, we develop a meta-framework for applied AI ethics conceptions with three dimensions. Based on critical theory, we suggest these dimensions as starting points to critically reflect on the conceptualization of theory and practice. We claim, first, that the inclusion of the dimension of affects and emotions in the ethical decision-making process stimulates reflections on vulnerabilities, experiences of disregard, and marginalization already within the AI development process. Second, we derive from our analysis that considering the dimension of justifying normative background theories provides both standards and criteria as well as guidance for prioritizing or evaluating competing principles in cases of conflict. Third, we argue that reflecting the governance dimension in ethical decision-making is an important factor to reveal power structures as well as to realize ethical AI and its application because this dimension seeks to combine social, legal, technical, and political concerns. This meta-framework can thus serve as a reflective tool for understanding, mapping, and assessing the theory–practice conceptualizations within AI ethics approaches to address and overcome their blind spots. (shrink)

The present volume brings Arendt's notes for these lectures together with other of her texts on the topic of judging and provides important clues to the likely direction of Arendt's thinking in this area.

AI systems, like self-driving cars, healthcare robots, or Autonomous Weapon Systems, already play an increasingly important role in our lives and will do so to an even greater extent in the near future. This raises a fundamental philosophical question: who is morally responsible when such systems cause unjustified harm? In the paper, we argue for the admittedly surprising claim that some of these systems can themselves be morally responsible for their conduct in an important and everyday sense of the term—the (...) attributability sense. More specifically, relying on work by Nomy Arpaly and Timothy Schroeder (In Praise of Desire, OUP 2014), we propose that the behavior of these systems can manifest their ‘quality of will’ and thus be regarded as something they can be blameworthy for. We develop this position in detail, justify some of its crucial presuppositions, and defend it against potential objections. (shrink)

Imagination comes with varying degrees of sensory accompaniment. Sometimes imagining is phenomenologically lean (cognitive imagining); at other times, imagining involves or requires sensory presentation such as mental imagery (sensory imagining). Philosophers debate whether contradictions can obtain in fiction and whether cognitive imagining is robust enough to explain our engagement with fiction. In this paper, I defend the Principle of Poetic License by arguing for the Permissive View of fictional truth: we can have fictions in which a contradiction is true, everything (...) is true, or nothing is true. I show that imagination-based worries about impossible, unlimited, and empty fictions can be shown to be about sensory imagination and that sensory imagination isn’t necessary for fictional truth. (shrink)

When people lose capacity to make a medical decision, the standard is to assess what their preferences would have been and try to honor their wishes. Dementia raises a special case in such situations, given its long, progressive trajectory during which others must make substituted judgments. The question of how to help surrogates make better‐informed decisions has led to the development of dementia‐specific advance directives, in which people are given tools to help them communicate what their preferences are while they (...) are still able. Such directives allow the perspective of the person to play a clearer role in guiding decisions about their care. Dementia directives can never serve as rigid algorithms. Rather, they can be used to help inform conversations, to help surrogates make decisions that are better aligned with the preferences the person would have had. This essay lays out the proposed utility of dementia‐specific directives and addresses some of the criticisms raised about them. (shrink)

Recent years have seen a surge of interest in the topic of moral responsibility for ‘non-ideal’ agents. And yet, one important type of ‘non-ideal’ agent, the narcissistic agent, has not received much attention. In this paper, I seek to fill this gap. My focus is on psychological entitlement, a feature that has been largely overlooked. I argue that this feature impairs narcissistic agents’ moral competence. This is because it both causes them to form distorted moral assessments in a wide range (...) of situations and impairs their ability to use feedback from others to correct these distortions. I conclude that narcissistic agents have mitigated responsibility owing to their impaired moral competence. As I furthermore show, this does not entail that we simply need to accept the damage they do. Rather, we may take steps to protect ourselves against the destructive effects of narcissistic entitlement, both on a personal and on a societal level. (shrink)

Karl Marx, as distinguished from the true and not the imagined sources of the Nazi ideology of racism, clearly belongs to the tradition of Western political thought. As an ideology Marxism is doubtless the only link that binds the totalitarian form of government directly to that tradition; apart from it any attempt to deduce totalitarianism directly from a strand of occidental thought would lack even the semblance of plausibility.

In this article, I aim to do two things: first, introduce Juche, the official philosophy of the Democratic People’s Republic of Korea (“North Korea”), and second, defend Juche against Alzo David-West’s allegation that it is a nonsensical philosophy. I organize David-West’s complaints into two major strands—that Juche’s axiom is too vague to be of philosophical use and that Juche makes too stark a distinction between human vs. everything else—and offer responses to both strands. My goal isn’t to defend the regime, (...) but to present its ideology in the most charitable way so its merits and demerits can be seen more clearly in future engagements. (shrink)

Patients in the United States have been subject to an evergrowing “avalanche” of unwanted medical treatment. This is economically, ethically, and legally wrong. As one advocacy campaign puts it: “Patients should receive the medical treatments they want. Nothing less. Nothing more.” First, unwanted medical treatment constitutes waste (and often fraud or abuse) of scarce healthcare resources. Second, it is a serious violation of patients’ autonomy and self-determination. Third, but for a few rare exceptions, administering unwanted medical treatment contravenes settled legal (...) rules and principles. This “Legal Briefing” describes a central and growing role for the law. Specifically, courts and agencies have increasingly imposed penalties on healthcare providers who deliberately or negligently disregard advance directives and DNR (donot-resuscitate) orders. I group these legal developments into the following five categories: 1. Five Types of Unwanted Medical Treatment2. State and Federal Duties to Follow Advance Directives3. Doctors Hospital of Augusta v. Alicea4. Other Lawsuits for Ignoring Advance Directives5. Administrative Penalties for Ignoring Advance Directives. (shrink)

This issue’s “Legal Briefing” column covers legal developments pertaining to conscience clauses and conscientious refusal. Not only has this topic been the subject of recent articles in this journal, but it has also been the subject of numerous public and professional discussions. Over the past several months, conscientious refusal disputes have had an unusually high profile not only in courthouses, but also in legislative and regulatory halls across the United States.Healthcare providers’ own moral beliefs have been obstructing and are expected (...) to increasingly obstruct patients’ access to medical services. For example, some providers, on ethical or moral grounds, have denied: (1) sterilization procedures to pregnant patients, (2) pain medications in end-of-life situations, and (3) information about emergency contraception to rape victims. On the other hand, many healthcare providers have been forced to provide medical treatment that is inconsistent with their moral beliefs.There are two fundamental types of conscientious objection laws. First, there are laws that permit healthcare workers to refuse providing — on ethical, moral, or religious grounds — healthcare services that they might otherwise have a legal or employer-mandated obligation to provide. Second, there are laws directed at forcing healthcare workers to provide services to which they might have ethical, moral, or religious objections. Both types of laws are rarely comprehensive, but instead target: (1) certain types of healthcare providers, (2) specific categories of healthcare services, (3) specific patient circumstances, and (4) certain conditions under which a right or obligation is triggered. For the sake of clarity, I have grouped recent legal developments concerning conscientious refusal into eight categories: 1. Abortion: right to refuse2. Abortion: duty to provide3. Contraception: right to refuse4. Contraception: duty to provide5. Sterilization: right to refuse6. Fertility, HIV, vaccines, counseling7. End-of-life measures: right to refuse8. Comprehensive laws: right to refuse. (shrink)

Written by some of the leading experts in the field, the essays in this volume will be a fascinating resource for students and scholars of ancient philosophy, ...

An informed consent and voluntary assent in biomedical research with adolescents is contingent on a variety of factors, including adolescent and parent perceptions of research risk, benefit, and decision-making autonomy. Thirty-seven adolescents with asthma and their parents evaluated a high or low aversion form of a pediatric asthma research vignette and provided an enrollment decision; their perceptions of family influence over the participation decision; and evaluations of risk, aversion, benefit, and burden of study procedures. Adolescents and their parents agreed on (...) research participation decisions 74% of the time, yet both claimed ultimate responsibility for the participation decision. Both rated most study procedures as significantly more aversive than risky. Parents were more likely to rate aspects of the hypothetical study as beneficial and to provide higher risk ratings for procedures. Disagreements concerning research participation decisions and decision-making autonomy have implications for the exercise of voluntary assent in biomedical research. (shrink)

ABSTRACTEmotion differentiation refers to the precision with which people can identify and distinguish their emotions and has been associated with well-being in adults. This study investigated ED and its relation with emotional well-being in adolescents. We used an experience sampling method with 72 participants to assess adolescents’ positive and negative emotions at different time points over the course of two weekends and a baseline questionnaire to assess emotional well-being. Differentiating negative emotions was related to less negativity intensity and propensity, and (...) to the belief that emotions are malleable. Differentiating positive emotions was not related to any of the assessed well-being variables. Together, these results suggest that a detailed awareness of one’s negative emotional states is an important dimension of well-being, also in adolescence. (shrink)

A chapter in an edited volume discussing philosophy and Ted Chiang's short stories. In this chapter, I show how philosophical debates about imaginative resistance and what can/can't be fictionally true influence our interpretation of "Division by Zero.".

Part of a book symposium for Peter Langland-Hassan's Explaining Imagination (2020).

It is intuitive to think that fiction is more imaginative or creative than nonfiction, and that creating or engaging with fiction involves the imagination in ways creating or engaging with nonfiction doesn't. However, philosophers debate whether imagination has a special connection to fiction. This chapter will argue that fiction is intimately connected to creativity and that creativity's connection to imagination produces the impression that fiction and imagination also share an intimate connection. The key ingredient of fiction that connects fiction to (...) creativity is fabrication. The chapter will also discuss how an author can produce fiction that is creative in content and form, how readers and critics use imagination in a creative manner when engaging with works, and how metaphysical debates about fiction affect the kind of creativity we may attribute to authors. (shrink)

This issue’s “Legal Briefing” column covers recent legal developments involving total brain failure. Death determined by neurological criteria (DDNC) or “brain death” has been legally established for decades in the United States. But recent conflicts between families and hospitals have created some uncertainty. Clinicians are increasingly unsure about the scope of their legal and ethical treatment duties when families object to the withdrawal of physiological support after DDNC. This issue of JCE includes a thorough analysis of one institution’s ethics consults (...) illustrating this uncertainty. This experience is not unique. Hospitals across the country are seeing more DDNC disputes. Because of the similarity to medical futility disputes, some court cases on this topic were reviewed in a prior “Legal Briefing” column. But a more systematic review is now warranted. I categorize recent legal developments into the following nine categories: 1. History of Determining Death by Neurological Criteria2. Legal Status of Determining Death by Neurological Criteria3. Legal Duties to Accommodate Family Objections4. Protocols for Determining Death by Neurological Criteria5. Court Cases Seeking Physiological Support after DDNC6. Court Cases Seeking Damages for Intentionally Premature DDNC7. Court Cases Seeking Damages for Negligently Premature DDNC8. Court Cases Seeking Damages for Emotional Distress9. Pregnancy Limitations on DDNC. (shrink)

We consider the long-term evolution of science and show how a ‘contagion of disrespect’ – an increasing dismissal of research in subfields associated with marginalized groups – can arise due to the dynamics of collaboration and reputation (versus, e.g., preconceived notions of the field’s worth). This has implications both for how we understand the history of science and for how we attempt to promote diverse scientific inquiry.

Although it seems commonsensical to say that one cannot merely have too little, but also too much self-control, the philosophical debate has largely focused on failures of self-control rather than its potential excesses. There are a few notable exceptions. But, by and large, the issue of having too much self-control has not received a lot of attention. This paper takes another careful look at the commonsensical position that it is possible to have too much self-control. One key insight that will (...) emerge is that there are certain important confusions surrounding this view. Once these are removed, however, we are led to the conclusion that there need not be anything intrinsically problematic about being a paragon of self-control. (shrink)

A capacitated pregnant woman has a nearly unqualified right to refuse a cesarean section. Her right to say “no” takes precedence over clinicians’ preferences and even over clinicians’ concerns about fetal health. Leading medical societies, human rights organizations, and appellate courts have all endorsed this principle. Nevertheless, clinicians continue to limit reproductive liberty by forcing and coercing women to have unwanted cesareans. This “Legal Briefing” reviews recent court cases involving this type of obstetric violence. I have organized these court cases (...) into the following six categories: 1. Epidemic of Unwanted Cesareans2. Court-Ordered Cesareans3. Physician-Coerced Cesareans4. Physician-Ordered Cesareans5. Cesareans for Incapacitated Patients6. Cesareans for Patients in a Vegetative State or Who Are Brain Dead. (shrink)

In the United States, authoritative legal guidance remains sparse on whether or when clinicians may stop life-sustaining treatment without consent. Fortunately, several significant legislative and judicial developments over the past two years offer some clarity. We group these legal developments into the following seven categories: 1. Lawsuits for Damages 2. Amendments to the Texas Advance Directives Act 3. Constitutional Attack on TADA 4. Legislation Prohibiting Clinicians 5. Legislation Authorizing Clinicians 6. Cases from Canada 7. Cases from the United Kingdom.

There is ongoing debate on whether Juche (주체/主體), the North Korean state ideology, is indigenous, Marxist-Leninist, or Confucian—or if it’s a real philosophy at all. In this article, I introduce Juche and show how characteristics that philosophers identify to be unique or pronounced in premodern Korean philosophy can be found in Juche as well. Intellectual adaptation, pragmaticism, and an emphasis on continual improvement are prominent in both premodern Korean thought and Juche. Juche should be understood as a politically inflected outgrowth (...) that is embedded within the larger context of Korean philosophy. (shrink)

This volume is the result of a collaborative endeavor to advance debates on environmental citizenship, while simultaneously and systematically addressing broader theoretical and methodological questions related to the particularities of ...

This book is about an emotion constantly present in human culture and history: fear. It is also a book about literature and medicine, two areas of human endeavour that engage with fear most acutely. The essays in this volume explore fear in various literary and medical manifestations, in the Western World, from medieval to modern times. It is divided into two parts. The first part, Treating Fear, examines fear in medical history, and draws from theology, medicine, philosophy, and psychology, to (...) offer an account of how fear shifts in Western understanding from the Middle Ages to Modern times. The second part, Writing Fear, explores fear as a rhetorical and literary force, offering an account of how it is used and evoked in distinct literary periods and texts. This coherent and fascinating collection will appeal to medical historians, literary critics, cultural theorists, medical humanities' scholars and historians of the emotions. (shrink)

This issue’s “Legal Briefing” column covers recent legal developments involving medical decision making for incapacitated patients who have no available legally authorized surrogate decision maker. These individuals are frequently referred to either as “adult orphans” or as “unbefriended,” “isolated,” or “unrepresented” patients. The challenges involved in obtaining consent for medical treatment on behalf of these individuals have been the subject of major policy reports. Indeed, caring for the unbefriended has even been described as the “single greatest category of problems” encountered (...) in bioethics consultation. In 2012, JCE published a comprehensive review of the available mechanisms by which to make medical decisions for the unbefriended. The purpose of this “Legal Briefing” is to update the 2012 study. Accordingly, this “Legal Briefing” collects and describes significant legal developments from only the past three years. My basic assessment has not changed. “Existing mechanisms to address the issue of decision making for the unbefriended are scant and not uniform.” Most facilities are “muddling through on an ad hoc basis.” But the situation is not wholly negative. There have been a number of promising new initiatives. I group these developments into the following seven categories: 1. Increased Attention and Discussion 2. Prevention through Better Advance Care Planning 3. Prevention through Expanded Default Surrogate Lists 4. Statutorily Authorized Intramural Mechanisms 5. California Litigation Challenging the Team Approach 6. Public Guardianship 7. Improving Existing Guardianship Processes. (shrink)

This issue’s “Legal Briefing” column covers the recent decision by the Centers for Medicare and Medicaid Services (CMS) to expand Medicare coverage of advance care planning, beginning 1 January 2016. Since 2009, most “Legal Briefings” in this journal have covered a wide gamut of judicial, legislative, and regulatory developments concerning a particular topic in clinical ethics. In contrast, this “Legal Briefing” is more narrowly focused on one single legal development. This concentration on Medicare coverage of advance care planning seems warranted. (...) Advance care planning is a frequent subject of articles in JCE. After all, it has long been seen as an important, albeit only partial, solution to a significant range of big problems in clinical ethics. These problems range from medical futility disputes to decision making for incapacitated patients who have no available legally authorized surrogate. Consequently, expanded Medicare coverage of advance care planning is a potentially seismic development. It may materially reduce both the frequency and severity of key problems in clinical ethics. Since the sociological, medical, and ethical literature on advance care planning is voluminous, I will not even summarize it here. Instead, I focus on Medicare coverage. I proceed, chronologically, in six stages: 1. Prior Medicare Coverage of Advance Care Planning 2. Proposed Expanded Medicare Coverage in 2015 3. Proposed Expanded Medicare Coverage in 2016 The Final Rule Expanding Medicare Coverage in 2016 4. Remaining Issues for CMS to Address in 2017 5. Pending Federal Legislation. (shrink)

This issue’s “Legal Briefing” column covers recent legal developments involving informed consent. We covered this topic in previous articles in The Journal of Clinical Ethics. But an updated discussion is warranted. First, informed consent remains a central and critically important issue in clinical ethics. Second, there have been numerous significant legal changes over the past year. We categorize recent legal developments into the following 13 categories: 1. Medical Malpractice Liability2. Medical Malpractice Liability in Wisconsin3. Medical Malpractice Liability in Novel Situations4. (...) Enforcement by Criminal Prosecutors5. Enforcement by State Medical Boards6. Enforcement through Anti-Discrimination Laws7. Statutorily Mandated Disclosures Related to End-of-Life Counseling8. Statutorily Mandated Disclosures Related to Aid in Dying9. Statutorily Mandated Disclosures Related to Abortion10. Statutorily Mandated Disclosures Related to Telemedicine11. Statutorily Mandated Disclosures Related to Other Interventions12. Statutorily Mandated Gag and Censorship Laws13. Informed Consent in the Research Context. (shrink)

What, if anything, makes a life meaningful? Consequentialist theories about meaning in life maintain that the consequences of that life confer meaning upon it. This article advances one such theory: welfarism about meaning in life. According to this view, a life is conferred meaning if, and only if, and then only insofar as, it promotes or protects the well‐being of other welfare subjects. The purpose of this article is to show why welfarism about meaning in life is the most plausible (...) theory about meaning in life. (shrink)

This issue’s “Legal Briefing” column, one product of a Greenwall Foundation grant, reviews recent developments concerning compulsory reporting duties.1 Most licensed clinicians in the United States are “mandated reporters.” When these clinicians discover certain threats to the safety of patients or the public, they are legally required to report that information to specified government officials. Over the past year, several states have legislatively expanded the scope of these reporting duties. In other states, new court cases illustrate the vigorous enforcement of (...) already existing duties. I have organized all these legal developments into the following eight categories: 1. Overview of Mandatory Reporting Duties 2. Controversy over the Benefits of Mandatory Reporting 3. New and Expanded Duties to Report 4. Criminal Penalties for Failing to Report 5. Civil Liability for Failing to Report 6. Disciplinary Penalties for Failing to Report 7. Legal Immunity for Good-Faith Reporting 8. Protection against Employers’ Retaliation. (shrink)

This paper interrogates the concept of luck in cancer diagnosis. I argue that while it might have some utility for individuals, at the clinical and research level, the concept impedes important prevention efforts and misdirects sources of blame in a cancer diagnosis. Such use, in fact, has the possibility of harming already vulnerable efforts at ameliorating social determinants of health and should therefore be eliminated from research and clinical contexts.

We discuss how writing assignments that center students’ personal experience can help to promote inclusive pedagogy and significant learning. These assignments lend themselves to less formal, more colloquial language that allow students to do the hard work of understanding, analyzing, and assessing complex philosophical content without also having to navigate a specialized form of academic writing—a struggle for many first generation and ESL students. Inviting students to make connections between philosophical content and their own lives rewards diversity of experience, which (...) can encourage students from underrepresented backgrounds to see their lived experience as relevant to philosophy and assure them that they belong, and can succeed, in philosophy. Significant learning is promoted for all students by addressing the key learning goals of integration, the human dimension, and caring and by helping build classroom community. We present the prompts, our reflections, and conclude by addressing potential worries. (shrink)