Holly Smith poses a challenging moral problem. She offers examples that appear to show that the moral significance of promising can be nefariously exploited. Her leading example is this.

Pursuing Justice in Africa focuses on the many actors pursuing many visions of justice across the African continent--their aspirations, divergent practices, and articulations of international and vernacular idioms of justice. The essays selected by editors Jessica Johnson and George H. Karekwaivanane engage with topics at the cutting edge of contemporary scholarship across a wide range of disciplines. These include activism, land tenure, international legal institutions, and post-conflict reconciliation. Building on recent work in sociolegal studies that foregrounds justice over and above (...) concepts such as human rights and legal pluralism, the contributors grapple with alternative approaches to the concept of justice and its relationships with law, morality, and rights. While the chapters are grounded in local experiences, they also attend to the ways in which national and international actors and processes influence, for better or worse, local experiences and understandings of justice. The result is a timely and original addition to scholarship on a topic of major scholarly and pragmatic interest. Contributors: Felicitas Becker, Jonathon L. Earle, Patrick Hoenig, Stacey Hynd, Fred Nyongesa Ikanda, Ngeyi Ruth Kanyongolo, Anna Macdonald, Bernadette Malunga, Alan Msosa, Benson A. Mulemi, Holly Porter, Duncan Scott, Olaf Zenker. (shrink)

We argue that if evidence were knowledge, then there wouldn’t be any Gettier cases, and justification would fail to be closed in egregious ways. But there are Gettier cases, and justification does not fail to be close in egregious ways. Therefore, evidence isn’t knowledge.

The expectation used to be that men would be masculine and women would be feminine, and this was assumed to come naturally to them in virtue of their biology. That orthodoxy persists today in many parts of society. On this view, sex is gender and gender is sex. -/- A new view of gender has emerged in recent years, a view on which gender is an 'identity', a way that people feel about themselves in terms of masculinity or femininity, regardless (...) of their sex. On this view, sex is dismissed as unimportant, and gender is made paramount. -/- In the rush to celebrate this new view of gender, we have lost sight of a more powerful challenge to the traditional orthodoxy, namely the feminist sex/gender distinction according to which sex is biological and gender is social. On this view, gender is something done to people on the basis of sex. Women are socialised to conform to norms of femininity (and sanctioned for failure), and masculinity and femininity exist in a hierarchy in which femininity is devalued. This view helps us to understand injustice against women, and what we can do about it. -/- Holly Lawford-Smith introduces and defends gender-critical feminism, a theory and movement that reclaims the sex/gender distinction, insists upon the reality and importance of sex, and continues to understand gender as a way that men and women are made to be, rather than a way they really are. (shrink)

When a liberal-democratic state signs a treaty or wages a war, does its whole polity do those things? In this article, we approach this question via the recent social ontological literature on collective agency. We provide arguments that it does and that it does not. The arguments are presented via three considerations: the polity's control over what the state does; the polity's unity; and the influence of individual polity members. We suggest that the answer to our question differs for different (...) liberal-democratic states and depends on two underlying considerations: the amount of discretion held by the state's officeholders; the extent to which the democratic procedure is deliberative rather than aggregative. (shrink)

Does ?ought? imply ?can? for collectives' obligations? In this paper I want to establish two things. The first, what a collective obligation means for members of the collective. The second, how collective ability can be ascertained. I argue that there are four general kinds of obligation, which devolve from collectives to members in different ways, and I give an account of the distribution of obligation from collectives to members for each of these kinds. One implication of understanding collective obligation and (...) ability in the proposed way is that a group can be blameworthy for failing to realize its obligation even when no member of the group is blameworthy for failing to realize her obligation. (shrink)

The objective of this paper is to explain why certain authors - both popular and academic - are making a mistake when they attribute obligations to uncoordinated groups of persons, and to argue that it is particularly unhelpful to make this mistake given the prevalence of individuals faced with the difficult question of what morality requires of them in a situation in which there's a good they can bring about together with others, but not alone. I'll defend two alternatives to (...) attributing obligations to uncoordinated groups. The first solution has us build better people, who will coordinate their actions willingly and spontaneously when the occasion arises. The second solution has us build better groups, so that when the occasion arises, there is a framework in place for coordinating members into action. (shrink)

Individuals have various kinds of obligations: keep promises, don’t cause harm, return benefits received from injustices, be partial to loved ones, help the needy and so on. How does this work for group agents? There are two questions here. The first is whether groups can bear the same kinds of obligations as individuals. The second is whether groups’ pro tanto obligations plug into what they all-things-considered ought to do to the same degree that individuals’ pro tanto obligations plug into what (...) they all-things-considered ought to do. We argue for parity on both counts. (shrink)

Many of the items that humans consume are produced in ways that involve serious harms to persons. Familiar examples include the harms involved in the extraction and trade of conflict minerals (e.g. coltan, diamonds), the acquisition and import of non- fair trade produce (e.g. coffee, chocolate, bananas, rice), and the manufacture of goods in sweatshops (e.g. clothing, sporting equipment). In addition, consumption of certain goods (significantly fossil fuels and the products of the agricultural industry) involves harm to the environment, to (...) future persons, and to current persons in low-lying and developing countries, by way of their impacts on climate change. When it comes to such large-scale harms, it's easy for the individual to feel helpless. Even if she sincerely wishes things were otherwise, she may wonder what she could possibly do to make them so. In this paper I briefly explore several promising avenues for generating duties in individuals to consume ethically, and develop one in particular: that an individual ought to signal her commitments to others, as a first step in collectivizing to act against unjust global labour practices. (shrink)

Online digital archives have allowed researchers to explore the past as never before. Arguably without the search technology offered by online digital archives the lives of many individuals would have remained in obscurity. Furthermore, the level of detail that can be quickly gleaned about individuals from the past, particularly when multiple digital archives are accessed, raises ethical questions. For example, when reporting findings researchers could be disclosing personal information that is unknown to descendants, and if it relates to a sensitive (...) topic then there is the potential for the researcher to cause distress. However, the rapid growth in digital archives has meant there has been little consideration of what ethical concerns digital archives might generate. This article reflects upon research using one digital archive and the importance of the researcher’s relationship with the material they retrieve when searching this type of source. (shrink)

Climate change appears to be a classic aggregation problem, in which billions of individuals perform actions none of which seem to be morally wrong taken in isolation, and yet which combine to drive the global concentration of greenhouse gases (GHGs) ever higher toward environmental (and humanitarian) catastrophe. When an individual can choose between actions that will emit differing amounts of GHGs―such as to choose a vegan rather than carnivorous meal, to ride a bike to work rather than drive a car, (...) or to take a reusable bag to the supermarket rather than send another plastic bag to landfill―does she have any reason to choose the lower-emitting actions? In this chapter I'll reject the claim that individuals don't make a difference when it comes to climate change. I first discuss making a difference with every action, as a way of getting clearer about how individuals' actions impact causally on the harms resulting from climate change, making a distinction so far overlooked in the climate ethics discussion between 'macro' thresholds like ice-cap melt, and 'micro' thresholds like severe weather events. I set aside making a difference with every action as implausible, and then move on to discuss both low probability of major difference, and high probability of minor difference. I argue that both of these are plausible characterizations of individuals' causal contributions to climate change. I conclude by noting some policy implications of having (probabilistic) individual difference-making back in play. (shrink)

When payment is offered for controlled human infection model research, ethical concerns may be heightened due to unfamiliarity with this study design as well as perceptions—and misperceptions—regarding risk. Against this backdrop, we commend Grimwade et al 1 for their careful handling of the relevant issues, coupling empirical and conceptual approaches. We agree with foundational elements of the authors’ analysis, including the acceptability of payment for research risk.1 However, in our view, it is preferable to treat payment for risk as a (...) discretionary incentive to achieve adequate recruitment and retention, rather than compensation owed as a matter of fairness. Grimwade et al 1 note that although their ‘Payment for Risk Model’ was ‘created specifically in the context of CHIM research, it has the potential to inform payment in other areas of medical research.’ We agree and would go further: we do not need a special payment framework for CHIMs because there is nothing so novel about them compared with other types of research as to demand a distinct approach. Any successful payment framework must address the following ethical issues: preserving informed consent ; treating participants fairly ; encouraging adequate recruitment and retention; avoiding deception by participants; and preserving public trust.2 Some of these issues may have particular salience in the context of CHIMs, but this study design does not demand consideration of entirely distinct ethical factors when evaluating offers of payment.2 We also agree with Grimwade et al 1 about several other key points.2 Given the burdens involved and …. (shrink)

It is not uncommon for multiple clinical trials at the same institution to recruit concurrently from the same patient population. When the relevant pool of patients is limited, as it often is, trials essentially compete for participants. There is evidence that such a competition is a predictor of low study accrual, with increased competition tied to increased recruitment shortfalls. But there is no consensus on what steps, if any, institutions should take to approach this issue. In this article, we argue (...) that an institutional policy that prioritises some trials for recruitment ahead of others is ethically permissible and indeed prima facie preferable to alternative means of addressing recruitment competition. We motivate this view by appeal to the ethical importance of minimising the number of studies that begin but do not complete, thereby exposing their participants to unnecessary risks and burdens in the process. We then argue that a policy of prioritisation can be fair to relevant stakeholders, including participants, investigators and funders. Finally, by way of encouraging and helping to frame future debate, we propose some questions that would need to be addressed when identifying substantive ethical criteria for prioritising between studies. (shrink)

Individuals sometimes pass their duties on to collectives, which is one way in which collectives can come to have duties. The collective discharges its duties by acting through its members, which involves distributing duties back out to individuals. Individuals put duties in and get (transformed) duties out. In this paper we consider whether (and if so, to what extent) this general account can make sense of states' duties. Do some of the duties we typically take states to have come from (...) individuals having passed on certain individual duties? There are complications: states can discharge their duties by contracting fulfilment out to non-members; states seem able to dissolve the duties of non-members; and some of states' duties are not derived in this way. We demonstrate that these complicate, but do not undermine, the general account and its application to states. And the application has an interesting upshot: by asking which individuals robustly participate in this process of duty transfer-and-transformation with a given state, we can begin to get a grip on who counts as a member of that state. (shrink)

The politics of climate change is marked by the fact that countries are dragging their heels in doing what they ought to do; namely, creating a binding global treaty, and fulfilling the duties assigned to each of them under it. Many different agents are culpable in this failure. But we can imagine a stylised version of the climate change case, in which no agents are culpable: if the bad effects of climate change were triggered only by crossing a particular threshold, (...) and it was reasonably, but mistakenly, believed by each country that insufficiently many other countries were willing to cooperate in order for that threshold to remain uncrossed, no country would be required to make a unilateral contribution. Yet even without culpability, we can diagnose a moral ill: the world has gone other than it should have. If not for the mistaken beliefs, there would have been a global climate treaty, and all the avoidance of future suffering that would come with it. In this article I argue that this moral ill has implications for the non-culpable agents, in that it generates duties to disgorge actual holdings over and above the counterpart holdings in the relevant counterfactual: those holdings the agents would have had, were the world to have gone as it should. (shrink)

In her ‘On the apparent paradox of ideal theory’, Laura Valentini combines three supposedly plausible premises to derive the paradoxical result that ideal theory is both unable to, and indispensable for, guiding action. Her strategy is to undermine one of the three premises by arguing that there are good and bad kinds of ideal theory, and only the bad kinds are vulnerable to the strongest version of their opponents’ attack. By undermining one of the three premises she releases ideal theorists (...) from the paradox, which is as follows. (1) Any sound theory of justice is action-guiding. (2) Any sound theory of justice is ideal. (3) Any ideal theory fails to be action-guiding. Here I shall respond to Valentini in two ways. First, I shall show that both (1) and (2) are false. The falsity of either is sufficient to release ideal theorists from the paradox. Second, I shall show that Valentini’s response to (3) can be extended, because her bad kinds of ideal theory do not necessarily fail to guide action. The cumulative effect of my arguments further strengthens Valentini’s support of ideal theory. I will deal with premises (1) and (2) in Sections I and II, and (3) in Section III. (shrink)

The primary purpose of Institutional Review Boards (IRBs) is to protect the rights and welfare of human research participants. Evaluation and measurement of how IRBs satisfy this purpose and other important goals are open questions that demand empirical research. Research on IRBs, and the Human Research Protection Programs (HRPPs) of which they are often a part, is necessary to inform evidence-based practices, policies, and approaches to quality improvement in human research protections. However, to date, HRPP and IRB engagement in empirical (...) research about their own activities and performance has been limited. To promote engagement of HRPPs and IRBs in self-reflective research on HRPP and IRB quality and effectiveness, barriers to their participation need to be addressed. These include: extensive workloads, limited information technology systems, and few universally accepted or consistently measured metrics for HRPP/irb quality and effectiveness. Additionally, institutional leaders may have concerns about confidentiality. Professional norms around the value of participating in this type of research are lacking. Lastly, obtaining external funding for research on IRBs and HRPPs is challenging. As a group of HRPP professionals and researchers actively involved in a research consortium focused on IRB quality and effectiveness, we identify potential levers for supporting and encouraging HRPP and IRB engagement in research on quality and effectiveness. We maintain that this research should be informed by the core principles of patient- and community-engaged research, in which members and key stakeholders of the community to be studied are included as key informants and members of the research team. This ensures that relevant questions are asked and that data are interpreted to produce meaningful recommendations. As such, we offer several ways to increase the participation of HRPP professionals in research as participants, as data sharers, and as investigators. (shrink)

In the recent literature on causal and non-causal scientific explanations, there is an intuitive assumption according to which an explanation is non-causal by virtue of being abstract. In this context, to be ‘abstract’ means that the explanans in question leaves out many or almost all causal microphysical details of the target system. After motivating this assumption, we argue that the abstractness assumption, in placing the abstract and the causal character of an explanation in tension, is misguided in ways that are (...) independent of which view of causation or causal explanation one takes to be most accurate. On major accounts of causation, as well as on major accounts of causal explanation, the abstractness of an explanation is not sufficient for it being non-causal. That is, explanations are not non-causal by dint of being abstract. (shrink)

During Aang's intermingling with Fire Lord Ozai, the voice of a Lion Turtle hints at the reason why Aang prevails. “In the era before the Avatar, we bent not the elements but the energy within ourselves. To bend another's energy, your own spirit must be unbendable or you will be corrupted and destroyed.” -/- We use ideas from Buddhist philosophy to answer four questions about the world of Avatar: (1) What is it for a spirit to be unbendable? (2) What (...) is it to bend another's energy? (3) Does Aang's ability to bend Ozai's spirit refute Ozai's accusation that Aang is weak? (4) What does Aang's ability indicate about what it means to be powerful? (shrink)

Do consumers’ ordinary actions of purchasing certain goods make them complicit in global labour injustice? To establish that they do, two things much be shown. First, it must be established that they are not more than complicit, for example that they are not the principal perpetrators. Second, it must be established that they meet the conditions for complicity on a plausible account. I argue that Kutz’s account faces an objection that makes Lepora and Goodin’s better suited, and defend the idea (...) that consumers are complicit in at least two of the ways distinguished by the latter. In the final section of the paper, I consider whether consumers’ responsibility for complicity in global labour injustice is likely to be as strong as responsibility from another source, namely benefiting from that injustice. (shrink)

What should we do when we won't do as we ought? Suppose it ought to be that the procrastinating professor accept the task of reviewing a book, and actually review the book. It seems clear that given he won't review it, he ought not to accept the task. That is a genuine moral obligation in light of less than perfect circumstances. I want to entertain the possibility that a set of such obligations form something like a 'practical morality'; that which (...) we ought to do given that we're unlikely or unwilling to do much of what ideal morality demands. If it is possible to give a coherent account of these kinds of obligations, then it is possible to entertain the idea that these obligations are in fact what morality demands. The conceptual truths about justice (good, right, fairness) that come from ideals are one thing; the actions that morality demands of people given their actual circumstances are quite another. In this paper I will ask about the kinds of facts that can be used to establish a more circumscribed set of obligations than we get from the orthodox view about moral obligation. (shrink)

‘Intersectionality’ is one of the rare pieces of academic jargon to make it out of the university and into the mainstream. The message is clear and well-known: your feminism had better be intersectional. But what exactly does this mean? This paper is partly an exercise in conceptual clarification, distinguishing at least six distinct types of claim found across the literature on intersectionality, and digging further into the most philosophically complex of these claims—namely the metaphysical and explanatory. It’s also partly a (...) reply to Sara Bernstein, who argued recently that the best interpretation of the metaphysical claim is explanatory priority. We’ll argue that duly clarified, it’s far from obvious that feminism had better be intersectional. At the very least, it had better not be only intersectional. (shrink)

Since the beginning of the AIDS epidemic, the proportion of AIDS cases among women has continued to rise. Women constituted 23 percent of the AIDS cases reported to the Centers for Disease Control and Prevention in 1995, and 81 percent of these women were of childbearing age. It was not until 1991, however, that epidemiological studies of women were initiated. By comparison, the representation of HIV-infected women in clinical trials gradually has grown. Undoubtedly, a consequence of the increased numbers of (...) women in clinical and epidemiological research is the earlier identification of and more appropriate treatments for HIV-related syndromes when women present in the clinical setting. Despite this expanded focus on women, however, clear information to guide the treatment of HIV-infected women who are pregnant is still lagging behind. (shrink)

A limiting factor in ethics education in medical training has been difficulty in assessing competence in ethics. This study was conducted to test the concept that content analysis of pediatric residents’ personal reflections about ethics experiences can identify changes in ethical sensitivity and reasoning over time. Analysis of written narratives focused on two of our ethics curriculum’s goals: 1) To raise sensitivity to ethical issues in everyday clinical practice and 2) to enhance critical reflection on personal and professional values as (...) they affect patient care. Content analysis of written reflections was guided by a tool developed to identify and assess the level of ethical reasoning in eight domains determined to be important aspects of ethical competence. Based on the assessment of narratives written at two times (12 to 16 months/apart) during their training, residents showed significant progress in two specific domains: use of professional values, and use of personal values. Residents did not show decline in ethical reasoning in any domain. This study demonstrates that content analysis of personal narratives may provide a useful method for assessment of developing ethical sensitivity and reasoning. (shrink)

To ensure that the information resulting from research is relevant to patients, the Patient‐Centered Outcomes Research Institute eschews the “traditional health research” paradigm, in which investigators drive all aspects of research, in favor of one in which patients assume the role of research partner. If we accept the premise that patient engagement can offer fresh perspectives that shape research in valuable ways, then at least two important sets of questions present themselves. First, how are patients being engaged—and how should they (...) be engaged? Second, which patients are being engaged—and which patients should be? This set has received relatively less attention, and the neglect is surprising, given that the “who” question is conceptually prior to the question of “how.”This article focuses attention on the “who” of patient engagement in research. First, we provide background on the rationale for patient engagement, underscoring the importance of ensuring the representativeness of engaged patients. Second, we present what little is known about patients engaged in PCORI‐funded research. Third, we identify and discuss the ethical implications of ways in which current practices of patient identification and recruitment may lead to a lack of representativeness. These practices include reliance on the well‐connected and well‐informed, reliance on patients who are not well trained or well‐informed, and reliance on patient advocacy organizations. Finally, we consider several strategies for addressing these pitfalls in order to maximize the positive goals of patient engagement. Patient engagement is intended to address the inability of researchers, funders, and others to fully represent patient views and priorities, but without sufficient attention, the patients selected for this role may still leave important gaps. (shrink)

How can we ensure that players in the National Football League receive excellent health care they can trust from providers who are as free from conflicts of interest as realistically possible? NFL players typically receive care from the club's own medical staff. Club doctors are clearly important stakeholders in player health. They diagnose and treat players for a variety of ailments, physical and mental, while making recommendations to the player concerning those ailments. At the same time, club doctors have obligations (...) to the club, namely to inform and advise clubs about the health status of players. While players and clubs share an interest in player health—both of them want players to be healthy so they can play at peak performance—there are several areas where their interests can diverge, and the divergence presents legal and ethical challenges. The current structure forces club doctors to have obligations to two parties—the club and the player—and to make difficult judgments about when one party's interests must yield to another's. None of the three parties involved should prefer this conflicted approach. We propose to resolve the problem of dual loyalty by largely severing the club doctor's ties with the club and refashioning that role into one of singular loyalty to the player-patient. The main idea is to separate the roles of serving the player and serving the club and replace them with two distinct sets of medical professionals: the Players' Medical Staff and the Club Evaluation Doctor. We begin by explaining the broad ethical principles that guide us and that help shape our recommendation. We then provide a description of the role of the club doctor in the current system. After explaining the concern about the current NFL player health care structure, we provide a recommendation for improving this structure. We then discuss how the club medical staff fits into the broader microenvironment affecting player health. (shrink)

Which of the two dominant arguments for duties to alleviate global poverty, supposing their premises were generally accepted, would be more likely to produce their desired outcome? I take Pogge's argument for obligations grounded in principles of justice, a "contribution" argument, and Campbell's argument for obligations grounded in principles of humanity, an "assistance" argument, to be prototypical. Were people to accept the premises of Campbell's argument, how likely would they be to support governmental reform in policies for international aid, or (...) to make individual contributions to international aid organizations? And I ask the same question, mutatis mutandis, for Pogge's argument. (shrink)

The Idea of Disability in the Eighteenth Century is a wide-ranging collection of essays that explores philosophy, biography, and texts about and by disabled people living in the eighteenth century. The book, which introduces and affirms the notion that disability studies predates most United States and United Kingdom findings by more than a hundred years, will be of interest to philosophers, historians, sociologists, and literary scholars.

The Cooperative Extension System serves as the conduit through which scientific knowledge generated by the 130 land-grant colleges and universities in the United States is translated and delivered directly to its constituents. Since its inception over 100 years ago, Extension has been integral in developing, delivering, and applying cutting-edge knowledge in agriculture and natural resources, youth development, family and consumer sciences, and community and rural development. Today, more than ever, Extension will need to lead the way in building and maintaining (...) sustainable partnerships across disciplines and with organizations at the local, state, and national levels to tackle complex issues considering diminishing resources. Bringing together leading and emerging scholars, this volume discusses how Extension is addressing issues and opportunities relevant to children, youth, families, and communities across the country both now and in the future. Topics include Extension's role in supporting childcare, social media use, entrepreneurship, rural communities, and underserved audiences. (shrink)

Law and racism are intertwined, with legal tools bearing the potential to serve as instruments of oppression or equity. This Special Issue explores this dual nature of health law, with attention to policing in the context of mental health, schools, and substance use disorders; industry and the environment in the context of food advertising, tobacco regulation, worker safety, and environmental racism; health care and research in the context of infant mortality, bias in medical applications of AI, and diverse inclusion in (...) research; and anti-racist teaching and practice in the context of building an interprofessional curriculum and medical-legal partnerships. (shrink)

Aang is unwilling to kill Ozai in order to secure peace. The Lion Turtle's remark indicates that Aang's alternative strategy involves bending Ozai's energy, and that Aang is victorious because his spirit is unbendable while Ozai's presumably is bendable. Buddhist teachings identify five fundamental hindrances that foster duhkha. Aang struggles with all five hindrances, but he ultimately overcomes them and has a true heart. The first hindrance concerns sensory desire, longing for pleasure through the bodily senses. The second hindrance is (...) ill will. The third hindrance is dullness and drowsiness. The fourth hindrance is restlessness and remorse. The fifth and final hindrance is doubt. By virtue of overcoming emotional hindrance and delusion, Aang becomes a person who embraces obstacles and strives to overcome them through compassion rather than control. (shrink)

Is the state a collective agent? Are citizens responsible for what their states do? If not citizens, then who, if anyone, is responsible for what the state does? Many different sub-disciplines of philosophy are relevant for answering these questions. We need to know what “the state” is, who or what it's composed of, and what relation the parts stand in to the whole. Once we know what it is, we need to know whether that thing is an agent, in particular (...) a moral agent capable of taking moral responsibility for its actions. We have to know what it takes for it to be capable of moral responsibility, e.g., what the functional equivalents in groups are of knowledge, intention, foreseeability, recklessness, and so on. And once we've established that it is an agent, and is responsible for what it does, we have to explain whether and in what way this implicates members, i.e., whether state responsibility distributes to the members of states, whoever they may be. Answers to these questions come from metaphysics, social ontology, action theory, epistemology, political theory, and ethics. In what follows, we'll give an outline of some different ways of answering these questions. (shrink)

From a radical feminist perspective, gender is a cage. Or to be more precise, it’s two cages. If genders are cages, then surely we want to let people out. Being less constrained in our choices is something we all have reason to want: theorists in recent years have emphasized the importance of the capability to do and be many different things. At the very least, we should want an end to sex-based oppression. But what does this entail, when it comes (...) to gender? In this paper, I’ll compare four ‘transitional pathways’, with a view to considering how each relates to the ultimate end of ending sex-based oppression. Should we open the doors to the cages, so that people can move freely between them, but leave the cages themselves in place?. Should we add more cages?. Should we make the cages bigger, so that people have a lot more room to move around inside them? Or should we dismantle the cages, so there are no more genders at all?. Some of these options are ‘gender revisionist’, others are gender abolitionist. I’ll argue in favour of a gender abolitionist pathway. (shrink)

This paper examines the practice implications of various state policies that provide publicly funded prenatal care to undocumented immigrants for health care workers who see undocumented patients. Data were collected through in-depth interviews with purposively sampled health care workers at safety net clinics in California, Maryland, Nebraska, and New York. Health care workers were asked about the process through which undocumented patients receive prenatal care in their health center and the ethical tensions and frustrations they encounter when providing or facilitating (...) this care under policy restrictions. Respondents discussed several professional practice norms as well as the ethical tensions they encountered when policy or institutional constraints prevented them from living up to professional norms. Using Nancy Berlinger's “workarounds” framework, this paper examines health care workers' responses to the misalignment of their professional norms and the policy restrictions in their state. These findings suggest that the prenatal policies in each state raise ethical and professional challenges for the health care workers who implement them. (shrink)