I argue that there is an affective injustice in gendered and racialized oppression. To account for this, we must deny the opposition of affect and intentionality often assumed in the philosophy of emotion and the affective turn: while affect and intentionality are not opposed in principle, affective intentionality may be refused uptake in oppressive practices. In section 1, I read Merleau‐Ponty’s theory of the body schema as a theory of affect that accommodates my account of affective injustice and aligns with (...) accounts of affect transmission and circulation in feminist philosophies of the affective turn. This is crucial for understanding Fanon’s contribution to the theory of the body schema, in which it is susceptible to historical‐racial “affective disorders.” In sections 2–4, I distinguish three types of affective injustice: affective marginalization, exploitation, and violence. In section 2 I develop an intersectional feminist account of this distinction drawing on Lorde and Lugones and raise questions about the limits of framing the issue of affective injustice in terms of intentionality as opposed to a more psychoanalytic conceptual vocabulary that accommodates the displacement of affective force. In sections 3 and 4, I explore these affective injustices through an analysis of Fanonian concepts, showing how the theory of the body schema can accommodate not only affective intentionality but also the oppressive disjunction of affect and intentionality, as well as forms of affective injustice that exceed the oppressive disabling of sense‐making and involve the exploitative and violent displacement of affective force. (shrink)

My aim in this paper is to introduce a theory of affective labor as byproductive, a concept I develop through analysis of the phenomenology of various affective labor practices in dialog with feminist scholarship, both on gendered and racialized labor, and on affect and emotion. I motivate my theory in the context of literature on affective and emotional labor in philosophy and the social sciences, engaging the post-Marxist literature on affective and immaterial labor and emphasizing feminist critiques. I argue that (...) affective labor is not only the work of producing affects for others to consume or the reproductive work that rejuvenates and sustains labor power and social life, but also the work of metabolizing waste affects and affective byproducts. Thus, byproductive labor is a neologism I develop to bring into view an affective economy and indeed a political economy of affects to the side of the distinction between productive and reproductive labor in its paid and unpaid variants. I make three central c... (shrink)

Anger gaslighting is behavior that tends to make someone doubt herself about her anger. In this paper, I analyze the case of anger gaslighting, using it as a paradigm case to argue that gaslighting can be an affective injustice (not only an epistemic one). Drawing on Marilyn Frye, I introduce the concept of “uptake” as a tool for identifying anger gaslighting behavior (persistent, pervasive uptake refusal for apt anger). But I also demonstrate the larger significance of uptake in the study (...) of affective injustice: just as the concept of credibility names the epistemic behavior whereby we take someone seriously as an epistemic being, the concept of uptake names the uniquely affective cooperative behavior whereby we take someone seriously as an affective being. I answer Miranda Fricker’s epistemic notion of a prejudicial credibility economy with the affective notion of prejudicial uptake economies: uptake, like credibility, can be produced in a deficit for one social group relative to a surplus for another. Deviating from the parallels with Fricker, for whom the injustice of epistemic injustice is due to prejudice in the motives or character of individuals, as well as from accounts that ground it in aptness or affective goods, I suggest that the injustice of anger gaslighting behavior can be located at the structural scale of power relationships between social groups, in the tradition of Iris Marion Young. Anger gaslighting behavior counts as unjust wherever it (re)produces prejudicial uptake economies. Adapting sociological concepts of feeling rules and the emotion work they demand, I introduce the concepts of “uptake rules” and “uptake work” to further enable analysis of uptake economies as affective social structures, and to suggest a site for resistant or reparative affective agency. (shrink)

One of the narratives of anger as a pandemic emotion is not diagnostic, but celebratory: anger at racial injustice made a social and political breakthrough during the pandemic. What this breakthrough narrative celebrates is that people who had previously been moved only to alarmed scrutiny of the anger itself and the project of quelling it began instead, not merely to approve of this anger, but to to be oriented and instructed by it, permitting the anti-racist anger of others to sensitize (...) them to the insults and injuries that provoked it. The breakthrough narrative implies that anger is a moral sentiment that can be instructive, not only for the angry person herself, but also for others. This suggests a phenomenonological puzzle: under what description of affective intentionality and its interpersonal and social triangulation would the breakthrough be possible? I draw on Marilyn Frye’s account of anger uptake and Merleau-Ponty’s phenomenology of the body schema to give an account of the conditions of possibility for the breakthrough narrative. Along the way, I offer an account of uniquely affective hermeneutical injustices, the uniquely affective variety of power at stake in them, and the reparative gesture required to remedy them. (shrink)

I begin by reviewing recent research by Merleau-Ponty scholars opposing aspects of the critique of Merleau-Ponty made by Meltzoff and colleagues based on their studies of neonate imitation. I conclude the need for reopening the case for infant self-other indistinction, starting with a re-examination of Merleau-Ponty’s notion of indistinction in the Sorbonne lectures, and attending especially to the role of affect and to the non-exclusivity of self-other distinction and indistinction. In undertaking that study, I discover the importance of understanding self-other (...) distinction and indistinction in terms of their affective significance. For Merleau-Ponty, self-other indistinction is a virtual or imaginary participation in others’ orientations that he defines as an affective phenomenon. Further, Merleau-Ponty’s account of the advent of the body proper—the aspect of the body image that circumscribes the body as a distinct and private space—theorizes it as an affective innovation. Rather than being a fact of which we at first are ignorant and gradually grow to recognize, distinction from others in the sense that is important to Merleau-Ponty is a situation that must be cultivated and maintained through the negotiation of affective intimacy. Understanding indistinction and distinction in terms of the affective forces that sustain them explains how it is possible for them to coexist. (shrink)

In Brazil, the epicenter of the Zika crisis, brown, black, and indigenous poor women living in municipalities with scarce resources were disproportionally affected. The gendered consequences of the epidemic exposed how intersectional lenses are central to understand the impact of public health emergencies in the lives of women and girls. The demand for Zika-affected children and women to be research participants is relevant for an ethical analysis of participant protection procedures during a crisis. We investigated how women experienced research participation (...) by analyzing their narratives. Two-year-long longitudinal qualitative study in Brazilian sites located in the epidemic's epicenter was performed using mixed methods: ethnography with women from two distinct states and individual semi-structured interviews with five women in different Zika-affected states, four of which were community leaders. All women in the study were mothers or grandmothers of Zika-affected children. Thematic analysis was used for data evaluation. Women perceived being pressured to participate in research and a lack of benefit sharing. Structural determinants of gender inequality, such as its effect on power distribution, were found to impact research participant protection. Formal procedures for research protocols approvals were insufficient in protecting participants because these instruments were unable to account for structural aspects. Communitarian mobilization, through WhatsApp groups, was found to be an important mechanism to create conditions to challenge oppressive structures. Strengthening public health, effective community-based participation in research planning and implantation of ethical strategies that promotes gender equality can have transformative effect on unequal power structures and promote participant protection. (shrink)

Theories of the liberal tradition have relied on independence as a norm of personhood. Feminist theorists such as Eva Kittay in Love's Labor have been instrumental in critiquing normative independence. I explore the role of corporeal vulnerability in Kittay's account of personhood, developing a comparison to the role it plays in Thomas Hobbes's Leviathan. Kittay's crucial contribution in Love's Labor is that once we acknowledge the facts of corporeal vulnerability, we must not only acknowledge but also affirm dependency in a (...) genuinely inclusive affirmation of personhood. While endorsing Kittay's “dependency critique,” I discover difficulties that beleaguer Kittay's development of new norms of personhood. I trace these to a dependency of Kittay's account on a crucial premise of the liberal model it resists. I argue that in order to affirm dependency in a manner that departs more thoroughly from the criticized aspects of liberal personhood, we must cease to position it in a dichotomy of power and vulnerability. I suggest that attending to the corporeality of vulnerability can aid us in developing the terms of a discourse affirming relational personhood while undermining that dichotomy. (shrink)

Berichte zur Wissenschaftsgeschichte, Volume 45, Issue 3, Page 487-498, September 2022.

What goods are produced by affective labor? And at what cost—are there uniquely affective costs to this sort of production? If we assume that, like any variety of labor, affective labor has the potential for exploitation, we should ask what risks of exploitation are unique to it. Are these dangers of paid, commodified affective labor only? How should we understand the political economy organized around the production and circulation of affects and the racialization and gendering of affective labor?In this article, (...) I suggest that in order to understand the risks of exploitation indigenous to affective labor, we must consider the way in which the production of affects functions according to a logic of transmission... (shrink)

While Merleau-Ponty’sPhenomenology of Perceptionrelies on the descriptive register of the body proper, his Sorbonne lectures on child psychology investigate the genesis of the experience of a body as one’s own. I demonstrate the uniqueness of Merleau-Ponty’s account of the narcissistic affect and sociality involved in this developmental process, distinguishing his account vis-à-vis Wallon’s and Lacan’s studies of the mirror stage. I conclude that in Merleau-Ponty’s account, (1) the experience of the body proper is not singular, but encompasses a range of (...) phenomenological variation; and (2) the genesis of the body proper is not confined to the mirror stage. The production of bodily boundaries is an ongoing process identified not only with its advent in childhood, but also with adult emotional life. The boundaries between inner and outer domains of perception are not merely discovered, but must be negotiated and cultivated in the intercorporeal affective dramas of adult life. (shrink)

This is an ironic moment for Edouard Glissant’s growing community of readers. So many are discovering Glissant’s work for the first time, myself included, in part because a fervent commitment to a politics of recognition now dominates in many corners of the humanities. This is ironic largely because while the choice to engage with Glissant might be motivated by an all too generalized logic of recognition, to read Glissant is to learn about how the basic premises underpinning this logic are (...) deeply misguided. The politics of recognition, as a term of art, after all, is built on the conceptual planks made available by the standardizing impulses of the nation-state form and capitalism combined. Glissant, on the other hand, is nothing if not a theorist calling fervently for a path forward that does not depend on the complicities found in the conceptual imperialism inherent to the bureaucratic standardizing practices that bolster both the nation-state and contemporary capitalism. Glissant calls instead for an approach that offers the philosophical building blocks for a politics of coordination, which is described in Patchell Markell’s book, Bound by Recognition (2003) as a politics of acknowledgement. This politics entails forgingan alternative approach to the self and other, to identity and place, and to social orders in general than what the politics of recognition espouses. (shrink)

As mídias facilitam as aprendizagens e oportunizam a expressão das Habilidades Sociais dos estudantes. Este estudo objetiva caracterizar o uso das Tecnologias da Informação e Comunicação e as Habilidades Sociais de 456 estudantes de escolas privadas do Sul do Brasil. Trata-se de um estudo quantitativo, descritivo e transversal. Utilizou-se um questionário de dados sociodemográficos, Questionário de Utilização das Tecnologias de Informação e Comunicação e Inventário de Habilidades Sociais para Adolescentes Del-Prette. O celular/ smartphone e as redes sociais foram as principais (...) tecnologias utilizadas. Destaca-se maior frequência nas Habilidades Sociais de Civilidade e Desenvoltura social e menores frequências em Empatia, Autocontrole, Assertividade e Abordagem Afetiva. Além de alta dificuldade na emissão de Empatia, Autocontrole e Assertividade. Sugere-se estudos clínicos para desenvolvimento de maior repertório de habilidades sociais nesta população para fins de prevenção de comportamentos problemáticos relacionados a baixos níveis de habilidades sociais e alto uso de mídias. (shrink)

This paper explores the Shanghai 2010 World Expo to show how spectacle serves a governing function of the Chinese developmental state. I introduce soil exegesis as a method to excavate sedimented power relations of spectacle, undergirding the expo’s presentation. This approach investigates how spectacle is a state-territorializing project and pedagogical venture that relies on and denies the state socialist-era’s waste, to produce a ‘new nature’ and perform socio-technical management of crisis and crowds. Dynamic rearrangement of soil quality and composition facilitated (...) the urban redevelopment zone of sustainable futures, while interactive-technocratic environments inserted visitor bodies into expo surveillance systems and infrastructure without reference to the embedded political ecology of the mass event within Shanghai and beyond. The article concludes by considering ethical legacies of the event and the ways ‘sustainable spectacle’ operates through waste administration and environmental performance that ‘greenwash’ the socialist past and obstruct other governing arrangements. (shrink)

This is a review of a collection of six essays. These essays, with the exception of one, are written by the followers of Shin Buddhism. The last essay in this collection is written from the perspective of Theravada Buddhism rather than Mahayana Buddhism. This collection is a result of the initiative by Rev. Yoshiharu Tomatsu who, as a Buddhist priest, has acquired hands-on experience in dealing with grieving Temple members and became acutely aware of the discrepancy between a medical system (...) and a ritualistic Buddhist system. While a medical system overlooks the spiritual needs of the dying, a Buddhist temple system neglects the spiritual needs of the living. This book ensued from a project that was initiated in 2006 and focused on the above-mentioned missing links, aiming to bring into conversation medical and religious practitioners. (shrink)

Orientation affective, différence et « écrasante proximité » dans l’analyse merleau-pontyenne de la profondeur pureJe montre ici que la théorie de Merleau-Ponty sur l’expérience particulière d’une « profondeur pure » peut être comprise comme une orientation affective précédant l’orientation perceptive, et explique son rôle dans la proposition d’une « nouvelle conception de l’intentionnalité ». Le corps-monde comme relation de différenciation est repensé comme la différenciation intime et pré-objective de cette dimension affective. Je pense, contrairement à Toadvine (2009), que la position (...) de Merleau-Ponty dans la Phénoménologie de la perception, peut être distinguée de la conception sartrienne de l’intentionnalité comme annihilation. La dimension provocatrice de ma lecture sur la profondeur pure vis-à-vis des discours érudits sur Merleau-Ponty est discutée en conclusion, et je pose en particulier la question de savoir s’il peut être utile de lire Merleau-Ponty comme un penseur de la différence.Orientamento affettivo, differenza e “schiacciante prossimità” nell’analisi merleau-pontyana della pura profonditàNel mio saggio, illustro la descrizione che Merleau-Ponty propone della particolare esperienza della “pura profondità” come un’orientazione affettiva che precede l’orientamento percettivo e ipotizzo il suo ruolo nel quadro del progetto merleau-pontiano di costruire una “nuova concezione dell’intenzionalità”. La relazione differenziante tra corpo e mondo è riformulata come quella differenziazione intima e pre-oggettiva che caratterizza tale dimensione affettiva; ciò supporta la mia ipotesi, in opposizione a Toadevine (2009), che la posizione sostenuta da Merleau-Ponty in Fenomenologia della Percezione può essere distinta dalla proposta sartriana d’intendere l’intenzionalità in termini di annichilamento. Concludo il saggio con una discussione delle possibili provocazioni che la mia lettura della teoria della pura profondità potrebbe sollevare nella comunità scientifica merlau-pontiana, soffermandomi in particolare sull’interrogativoriguardo alla possibilità di leggere produttivamente Merleau-Ponty come un pensatore della differenza. (shrink)

Prior research on engineering students’ understandings of ethics and social responsibility has produced mixed and sometimes conflicting results. Seeking greater clarity in this area of investigation, we conducted an exploratory, longitudinal study at four universities in the United States to better understand how engineering undergraduate students perceive ethics and social responsibility and how those perceptions change over time. Undergraduate engineering students at four U.S. universities were surveyed three times: during their 1st (Fall 2015), 5th (Fall 2017), and 8th semesters (Spring (...) 2019). The students who completed all three surveys (_n_ = 226) comprise the sample that was analyzed in this paper for changes in their scores on five instruments: Fundamentals of Engineering/Situational Judgment, Moral Disengagement, ABET Engineering Work and Practice Considerations, Macroethics, and Political and Social Involvement Scale. We found that students modestly increased their knowledge of ethics and ability to apply that knowledge in situations calling for them to exercise judgment. In addition, they consistently indicated that health and safety considerations in engineering were of highest importance. They also showed steady levels of social consciousness over time, in contrast to other studies which detected a culture of increasing disengagement in engineering students throughout the four years of their undergraduate studies. (shrink)

This paper introduces The Certainty Trap, a pervasive cognitive distortion that leads individuals to treat their knowledge and beliefs as definitive and final rather than provisional, particularly regarding contentious social and political issues. It explores three key fallacies underlying this trap, discusses its consequences, and proposes strategies for moving from certainty to confidence in thinking and discourse. By revealing the mechanisms of The Certainty Trap and its overall impact on various domains of society, this essay aims to contribute to the (...) clearer thinking that can lead to more nuanced and productive approaches to addressing complex societal challenges. (shrink)

What resources does Merleau-Ponty’s account of the body schema offer to the Fanonian one? First I show that Merleau-Ponty’s theory of the body schema is already a theory of affect: one that does not oppose affects to intentionality, positioning them not only as sense but as force, cultivating affective agencies rather than constituting static sense content. Then I argue that by foregrounding the role of affect in both thinkers, we can understand the way in which the historical-racial schema innovates, anticipating (...) and influencing feminist theories of the affective turn – especially Sara Ahmed’s theory of affective economies. The historical-racial schema posits the constitution of affective agencies on a sociogenic scale, and these affective economies in turn account for the possibility of the collapse of the body schema into a racial epidermal schema, a disjunction of affective intentionality Fanon calls “affective tetanization.” Quelles ressources l’analyse du schéma corporel faite par Merleau-Ponty fournit-elle au schéma historico-racial proposé par Fanon? En premier lieu, je vise à montrer que la théorie du schéma corporel de Merleau-Ponty est déjà une théorie de l’affect : une théorie qui n’oppose pas les affects à l’intentionnalité, qui ne les considère pas seulement comme un sens, mais comme une force, en cultivant des agentivités affectives plutôt qu’en constituant des contenus de sens statiques. Ensuite, j’affirmerai qu’en mettant en premier plan le rôle de l’affect chez ces deux penseurs, nous pouvons comprendre les innovations qu’apporte le schéma historico-racial, en anticipant et en influençant les théories féministes du tournant affectif – surtout la théorie de Sara Ahmed au sujet des économies affectives. Le schéma historico-racial établit la constitution d’agentivités affectives sur une échelle sociogénique, et ces économies affectives expliquent à leur tour la possibilité d’une dégradation du schéma corporel en schéma épidermique racial, une disjonction de l’intentionnalité affective que Fanon appelle « tétanisation affective ».Quali risorse può offrire la nozione merleau-pontiana di schema corporeo a quella di Fanon? In primo luogo, mi propongo di mostrare che la teoria dello schema corporeo elaborata da Merleau-Ponty è allo stesso tempo una teoria dell’affetto: una teoria che non oppone la dimensione degli affetti all’intenzionalità, poiché li considera non solo come senso ma come forze, in quanto implicano delle agentività affettive piuttosto che costituire meri contenuti statici di senso. Intendo quindi sostenere che mettendo in evidenza il ruolo dell’affetto in questi due autori sia possibile comprendere il portato innovativo dello schema storico-razziale, che anticipa e influenza le teorie femministe legate all’affective turn – e in particolare la teoria delle economie affettive elaborata da Sara Ahmed. Lo schema storico-razziale afferma la costituzione di agentività affettive a un livello sociogenetico, mentre le economie affettive rendono conto della possibilità del collasso dello schema corporeo in uno schema razziale epidermico, una disgiunzione dell’intenzionalità affettiva che Fanon definisce “tetanizzazione affettiva”. (shrink)

Name der Zeitschrift: Naharaim Jahrgang: 10 Heft: 2 Seiten: 247-272.

In this piece, I respond to the responses provided by reviewers to my original forum article titled “Democracy and the Problem of Certainty.” I remain grateful for the editor’s and for the reviewers’ engagement.

Informed by ABET accreditation criteria and broader societal needs, ethics has been emphasized as important for engineering professionals. Engineering students are thus exposed to professional ethics and related concerns throughout their college experiences both within and beyond the formal engineering curriculum, but little is known about what learning experiences and lessons engineering students view as most memorable and salient as they approach graduation. Therefore, this paper answers the following research questions: RQ1) What types of experiences do senior engineering students report (...) as salient learning experiences for their ethical and moral formation as they approach graduation? and RQ2) What do students learn from the most commonly discussed types of experiences? To address these questions, we conducted semi-structured interviews with senior engineering students and performed inductive thematic analysis on the resulting transcripts. Among various types of experiences that students reported as influencing their ethical and moral perspectives, this paper highlights work experiences, formal education, and family environment as the most frequently mentioned. Our results suggest that work experiences were especially significant for students’ learning of engineering ethics in a professional context, followed by academic experiences as a source of both professional/ethical and more general moral lessons. Many students also described family and friends as influential, especially as related to their general perceptions of morality. Based on these findings, a variety of educational implications are discussed. (shrink)

Following Levinas’ articulation that “truth is accessible only to the mind capable of experiencing an exile away from its preconceptions and prejudices,” Exile and Otherness posits that Shinran, the founder True Pure Land Buddhism, and Maimonides, a Jewish philosopher and Torah scholar, exhibit sensitivity to the neglected and suffering others.

Preferences for options that do not secure optimal outcomes, like the ones catalogued by Sunstein, derive from two sources: cognitive heuristics and deontological rules. Although rules may stem from automatic affective reactions, they are deliberately maintained. Because strongly held convictions have important behavioral implications, it may be useful to regard cognitive heuristics and deontological rules as separate sources of nonconsequential judgment in the moral domain.

S.N. Eisenstadt’s theory of culture has remained little examined as such. This article starts by assessing the place given to theorizing culture in the vast corpus of his writings, and the part played by successive theoretical influences, as well as shifting research priorities in that regard. The following section delineates the core arguments or ‘key ideas’ that arise from his most explicit theoretical writings with respect to culture. The article ends by positioning Eisenstadt’s approach relative to some major trends and (...) issues in contemporary cultural sociology at large and drawing some implications for the further elaboration of a ‘strong’, modular and multi-level approach to culture. (shrink)

Due to an oversight, Ilana Raburn's article “Intrinsic Kinds in Internal Medicine,” Philosophy of Medicine 5, no. 1 (2024), https://doi.org/10.5195/pom.2024.189, failed to acknowledge the influence of Harriet Fagerberg’s characterisation of diseases as Millikanian natural kinds in “Reactive Natural Kinds and Varieties of Dependence,” European Journal for Philosophy of Science 12, article 72 (2022), https://doi.org/10.1007/s13194-022-00500-x.

Doctors Pratt and de Vries propose a well-structured and courageous approach to analyse and repair an insufficiently recognised discussion about epistemologies and knowledge production in bioethics.1 The authors invite researchers, scholars, public health experts and bioethicists from the global North to reflect about their lack of imagination regarding different sources of narratives produced by the global South. There is a critical analysis of injustices and an urgent call for global bioethicists to reorient their field and focus on the analysis and (...) development of ethical interventions to achieve a comprehensive epistemic justice for global health ethics. Feminist bioethicists from the global South already argued about the importance of the voices and biographies of the people and groups in the communities to reframe the bioethical reasoning regarding the meaning of individual’s needs during public health and humanitarian emergencies.2 Over a decade ago, Diniz and Guilhem described the role and goal of feminist bioethics in Latin America, shaped in an oppressive context promoted and created by …. (shrink)

Fifteen years into a successful career as a college professor, Ilana Blumberg encounters a crisis in the classroom that sends her back to the most basic questions about education and prompts a life-changing journey that ultimately takes her from East Lansing to Tel Aviv. As she explores how civic and religious commitments shape the culture of her humanities classrooms, Blumberg argues that there is no education without ethics. When we know what sort of society we seek to build, our (...) teaching practices follow. In vivid classroom scenes from kindergarten through middle school to the university level, Blumberg conveys the drama of intellectual discovery as she offers novice and experienced teachers a pedagogy of writing, speaking, reading, and thinking that she links clearly to the moral and personal development of her students. Writing as an observant Jew and as an American, Blumberg does not shy away from the difficult challenge of balancing identities in the twenty-first century: how to remain true to a community of origin while being a national and global citizen. As she negotiates questions of faith and citizenship in the wide range of classrooms she traverses, Blumberg reminds us that teaching - and learning - are nothing short of a moral art, and that the future of our society depends on it. (shrink)

"In a complex world where competing groups claim to be speaking on behalf of incommensurate versions of 'humanity, ' the authors represented in "In the Name of ...

Smajdor addresses the problem of inferior clinical outcomes among adults with impairments of capacity to give informed consent (AWIC). She notes that AWIC are generally excluded from clinical trials to protect them against harms and avoid exploitation and claims there is a causal link between involvement in clinical trials and favourable outcomes. She argues, given this link, that we should increase AWIC representation in clinical trials and can justifiably do so by recognising the capacity of AWIC to assent. AWIC form (...) a diverse group, with multiple aetiologies, including, for example, Down syndrome, traumatic brain injury and dementia. In some cases, the inability to consent may fluctuate so that the same person could be AWIC only at certain times. Yet despite these differences, the group has a shared unmet need. We agree with Smajdor that AWIC outcomes should be improved, but question whether simply increasing representation in clinical trials is sufficient to achieve this. We identify the following points: 1. AWIC are under-represented in clinical trials. There is evidence of widespread exclusion of AWIC in clinical trials within the UK and abroad and it is often a specific exclusion criterion.1 2. AWIC have worse clinical outcomes and a lower life expectancy. The life expectancy …. (shrink)

This paper focuses on the role of regulation in the shaping new scientific facts. Fleck chose to study the origins of a diagnostic test for a disease seen as a major public health problem, that is, a ‘scientific fact’ that had a direct and immediate influence outside the closed universe of fundamental scientific research. In 1935, when Fleck wrote his book, Genesis and development of a scientific fact, he believed that the tumultuous early history of the Wassermann reaction had come (...) to an end, and that this reaction was successfully stabilized through the standardization of laboratory practices and thanks to the rise of a specific professional segment—the serologists. He could not have predicted that in the 15 years that followed the publication of his book, regulatory measures—barely metioned in his historical narrative—would play a key role in the destabilization of the original meaning of this reaction. The introduction of mass screening for syphilis—mainly via legislation that introduced obligatory premarital tests and promoted the testing of pregnant women—weakened in fine the link between Wassermann serology and infection by the etiological agent of syphilis, the bacterium Treponema pallidum. Fleck elected to study the Wassermann reaction because of its novelty, its complexity, and because it became the focus of a controversy regarding its origins. However, the Wassermann reaction was also one the first examples of a medical technology regulated by the state and incorporated into legal dispositions. It may therefore be seen as an exemplary case of the close intertwining of scientific investigations, their practical applications and regulatory practices. (shrink)

In 1910, Charles Richet suggested that studying individual variations in anaphylactic responses might both open a way to experimental investigation of the biological basis of individuality and help unify the immunological and physiological approaches to biological phenomena. The very opposite would happen however. In the next two decades, physiologists and immunologists interested in anaphylaxis and allergy experienced more and more difficulties in communicating. This divergence between the physiopathological and immunological approaches derived from discrepancies between the experimental systems used by each (...) of these scientific communities. Trying to develop a point of view that took into account all bodily reactions to stimuli, physiologists thought that individual variations between the laboratory animals they used (mainly dogs and cats) constituted important experimental data. Seeking to develop reproducible studies of infection, immunity and 'sensitisation', bacteriologists and immunologists considered that individual variations between the laboratory animals they used (mainly small rodents) constituted 'noise' and not a 'signal'. Each group's loyalty to the experimental models used in their discipline widened the gap between immunological and physiological explanations of allergies and led to the abandonment of studies on the biological basis of individuality. (shrink)

Medico-philosophical reflections were developed in the 19th and the 20th centuries by three consecutive generations of Polish physicians, active in what was later named the Polish School of Philosophy of Medicine. The second generation of this school published its own journal, Medical Critique [Krytika Lekarska], from 1897 to 1907. Medical Critique included numerous articles on the nature of medical knowledge, the reductionism versus holism debate in biology and medicine, the importance of teleologically-oriented approaches in medicine, the influence of theories and (...) of a priori ideas on clinical observations and on ‘clinical facts’, the problem of classification of diseases, the normative and ethical dimension of medicine, and the ion relationships between philosophy, history and medicine. The existence of a journal dealing specifically with theoretical reflections on medicine undoubtedly contributed to the propagation of original work in the philosophy of medicine in Poland. (shrink)

What do we mean when we diagnose a patient with a disease? What does it mean to say that two people have the same disease? In this paper, I argue that diseases are natural kinds, using a conception of kinds derived from John Stuart Mill and Ruth Millikan. I demonstrate that each disease is a natural kind and that the shared properties occur as a result of the pathogenesis of the disease. I illustrate this with diverse examples from internal medicine (...) and compare my account to alternative ontologies. (shrink)

Next SectionBackground There is an established link between depression and interest in hastened death in patients who are seriously ill. Concern exists over the extent of depression in patients who actively request euthanasia/physician-assisted suicide (PAS) and those who have their requests granted. Objectives To estimate the prevalence of depression in refused and granted requests for euthanasia/PAS and discuss these findings. Methods A systematic review was performed in MEDLINE and PsycINFO in July 2010, identifying studies reporting rates of depression in requests (...) for and cases of euthanasia/PAS. One author critically appraised the strength of the data using published criteria. Results 21 studies were included covering four countries. There was considerable heterogeneity in methods of assessing depression and selecting patients. In the highest quality studies, in the Netherlands and Oregon, 8–47% of patients requesting euthanasia/PAS had depressive symptoms and 2–17% of completed euthanasia/PAS cases had depressive symptoms. In the Netherlands, depression was significantly higher in refused than granted requests, and there was no significant difference in the rate of depression between euthanasia cases and similar patients who had not made a request for euthanasia. Conclusion It is unclear whether depression increases the probability of making a request for euthanasia/PAS, but in the Netherlands most requests in depressed patients are rejected, leaving a depression rate in cases that is similar to the surrounding population. Less evidence is available elsewhere, but some level of depression has been identified in patients undergoing euthanasia/PAS in all the countries studied. Whether the presence of depression is ever compatible with an ethical decision on euthanasia/PAS is discussed. (shrink)

Pragmatic sociology is often read as a reaction to and an alternative to Bourdieu’s ‘critical sociology’. This article, in contrast, offers an assessment of pragmatic sociology in terms of its contribution to the theory of culture in general and its affinities with repertoire theory in particular. Whereas the tendency has been to conceive of repertoires as largely unstructured entities, pragmatic sociology has demonstrated a systematic interest in their internal contents and structure, which it has even expanded through its more recent (...) turn to historical and macro comparative analysis. In the process, however, pragmatic sociology has also been leaning towards a form of cultural sociology that actually challenges some major aspects of repertoire theory–thus also bringing into relief the dilemmas facing any attempt at further elaboration of what is now a growing strand of cultural theory. (shrink)

Le cancer est perçu aujourd’hui comme une maladie qui affecte à peu près autant d’hommes que de femmes. C’est cependant une conception relativement récente. Jusqu’au milieu du xxe siècle, le cancer était considéré comme une pathologie principalement féminine, les tumeurs malignes produisant des symptômes typiques faciles à détecter. Au xxe siècle, les cancers féminins – du sein et de l’utérus – sont les principales cibles des campagnes publiques pour la détection précoce des tumeurs malignes. Depuis les années 1950, le développement (...) de méthodes efficaces de diagnostic et l’augmentation des cancers du poumon, plus fréquents chez les hommes, met fin à l’image du cancer comme une pathologie féminine. Dans les discours publics et les medias, les cancers des organes reproducteurs féminins continuent cependant d’être plus visibles que ceux des organes reproducteurs masculins, et les femmes à risques sont plus souvent sujettes à une chirurgie de prévention mutilante. (shrink)