New methods to analyse social media data provide a powerful way to know publics and capture what they say and do. At the same time, access to these methods is uneven, with corporations and governments tending to have best access to relevant data and analytics tools. Critics raise a number of concerns about the implications dominant uses of data mining and analytics may have for the public: they result in less privacy, more surveillance and social discrimination, and they provide new (...) ways of controlling how publics come to be represented and so understood. In this paper, we consider if a different relationship between the public and data mining might be established, one in which publics might be said to have greater agency and reflexivity vis-à-vis data power. Drawing on growing calls for alternative data regimes and practices, we argue that to enable this different relationship, data mining and analytics need to be democratised in three ways: they should be subject to greater public supervision and regulation, available and accessible to all, and used to create not simply known but reflexive, active and knowing publics. We therefore imagine conditions in which data mining is not just used as a way to know publics, but can become a means for publics to know themselves. (shrink)

Background Best interests is a ubiquitous principle in medical policy and practice, informing the treatment of both children and adults. Yet theory underlying the concept of best interests is unclear and rarely articulated. This paper examines bioethical literature for theoretical accounts of best interests to gain a better sense of the meanings and underlying philosophy that structure understandings. Methods A scoping review of was undertaken. Following a literature search, 57 sources were selected and analysed using the thematic method. Results Three (...) themes emerged. The first placed best interests within the structure of wider theory, noting relationships with consequentialism, deontology, prudential value theory, rights and political philosophy. The second mapped a typology of processes of decision-making, among which best interests was ambiguously positioned. It further indicated factors that informed best interests decision-making, primarily preferences, dignity and quality of life. The final theme considered best interests from a relational perspective. Conclusions Characterisation of best interests as strictly paternalist and consequentialist is questionable: while accounts often suggested a consequentialist basis for best interests, arguments appeared philosophically weak. Deontological accounts, found in law and Kantianism, and theories of political liberalism influenced accounts of best interests, with accounts often associating best interests with negative patient preferences (i.e. individual refusals). There was much more emphasis on negative interests than positive interests. Besides preference, factors like dignity and quality of life were held to inform best interests decisions, but generally were weakly defined. To the extent that preferences were unable to inform decision making, decisions were either made by proxy authority or by an intersubjective process of diffuse authority. Differing approaches reflect bifurcations in liberal philosophy between new liberalism and neo-liberalism. Although neither account of authority appears dominant, bias to negative interests suggests that bioethical debate tends to reflect the widespread ascendancy of neo-liberalism. This attitude was underscored by the way relational accounts converged on private familial authority. The visible connections to theory suggest that best interests is underpinned by socio-political trends that may set up frictions with practice. How practice negotiates these frictions remains a key question. (shrink)

Sexuality is a basic feature of human life. Gender, sexual and romantic attraction, sexual excitement, and sexual desire and fantasies all move in various degrees through our daily awareness. However, despite this pervasiveness, there is much disagreement surrounding the nature of such things and experiences. This book explores just these issues in an attempt to get clear about this enigmatic aspect of our existence. Through a series of interrelated essays, internationally acclaimed philosopher James Giles takes the reader on a (...) fascinating journey to the depths of experiential, social, biological, and evolutionary aspects of sexual life. Presenting his arguments and ideas in a clear and easy to follow language, Giles criticizes several popular views, clearing the way for his own unique vision of human sexuality. Often controversial, always engaging, these pages will prove to be absorbing reading for anyone who has ever pondered the nature of sexuality and why it fills our lives in the way it does. (shrink)

Whether ethics is too important to be left to the experts or so important that it must be is an age-old question. The emergence of clinical ethicists raises it again, as a question about professionalism. What role clinical ethicists should play in healthcare decision making – teacher, mediator, or consultant – is a question that has generated considerable debate but no consensus.

A growing number of bioethics papers endorse the harm threshold when judging whether to override parental decisions. Among other claims, these papers argue that the harm threshold is easily understood by lay and professional audiences and correctly conforms to societal expectations of parents in regard to their children. English law contains a harm threshold which mediates the use of the best interests test in cases where a child may be removed from her parents. Using Diekema9s seminal paper as an example, (...) this paper explores the proposed workings of the harm threshold. I use examples from the practical use of the harm threshold in English law to argue that the harm threshold is an inadequate answer to the indeterminacy of the best interests test. I detail two criticisms: First, the harm standard has evaluative overtones and judges are loath to employ it where parental behaviour is misguided but they wish to treat parents sympathetically. Thus, by focusing only on ‘substandard’ parenting, harm is problematic where the parental attempts to benefit their child are misguided or wrong, such as in disputes about withdrawal of medical treatment. Second, when harm is used in genuine dilemmas, court judgments offer different answers to similar cases. This level of indeterminacy suggests that, in practice, the operation of the harm threshold would be indistinguishable from best interests. Since indeterminacy appears to be the greatest problem in elucidating what is best, bioethicists should concentrate on discovering the values that inform best interests. (shrink)

Assent to medical research or treatment may be an intuitively attractive way to address the area between incapacity and capacity that might otherwise be subject to a best interests assessment. Assent has become a widely disseminated concept in law, research, and clinical ethics, but little conceptual work on assent has so far occurred. An exploration of use of assent in treatment and research in children and people with dementia suggests that at least five claims are made on behalf of assent. (...) Since at least some of these may lead to tensions with others, assent requires firmer conceptual underpinning. Whether assent remains primarily a local approach to research in children in the United States, where it appears to fit with legal background conditions, or develops its promise to overturn the dominant, binary, approach to (in)capacity will depend on the strength of future philosophical work to improve the theoretical foundations to assent. (shrink)

Best known for having declared the death of God, Nietzsche was a thinker thoroughly absorbed in the Christian tradition in which he was born and raised. Yet while the atheist Nietzsche is well known, the pious Nietzsche is seldom recognised and rarely understood. Redeeming Nietzsche examines the residual theologian in the most vociferous of atheists. Fraser demonstrates that although Nietzsche rejected God, he remained obsessed with the question of human salvation. Examining his accounts of art, truth, morality and eternity, Nietzsche's (...) thought is revealed to be a series of experiments in redemption. (shrink)

_Beyond Solidarity_ is an impassioned argument for a sharable morality in a world increasingly fractured along lines of difference. Giles Gunn asks how human solidarity can be reconceived when its expressions have become increasingly exceptionalist and outmoded, and when the pressures of globalization divide as much as they unify. He finds the terms for answering these questions in a more inclusive, cosmopolitan pragmatism—one willing to explore fundamental values without recourse to absolutist arguments. Drawing on the work of William and (...) Henry James, John Dewey, Primo Levi, Richard Rorty, and many others, as well as postcolonial writing, Jewish literature of the Holocaust, and the cultural and religious experience of African Americans in slavery, Gunn points pragmatism in a transnational direction and shows how it can better account for the consequences of diversity. _Beyond Solidarity_, then, is a study of the difference that difference makes in a globalized world. (shrink)

We develop and test a trickle-down model of how authentic leadership at the department level flows down the organizational hierarchy to encourage team leader authentic leadership and consequently, promotes team and individual-level supervisor-directed helping behavior. Analyses of multi-level and multi-source data collected from a total of 487 employees comprising 122 teams, 47 departments, and 4 different working areas of a major public sector organization in Taiwan show that team leaders’ authentic leadership mediates the relationship between departmental authentic leadership and individual-level (...) leader–member exchange. We also found that intra-team trust completely mediates the influence of team authentic leadership on both team helping behavior and individual-level supervisor-directed helping behavior. Finally, the results reveal that self-concordance mediates the influence of team authentic leadership on individual-level supervisor helping behavior as well as the influence of individual-level LMX on individual-level supervisor-directed helping behavior. Theoretical and practical implications of these findings are discussed. (shrink)

Attempts to conduct systematic reviews of ethical arguments in bioethics are fundamentally misguided. All areas of enquiry need thorough and informative literature reviews, and efforts to bring transparency and systematic methods to bioethics are to be welcomed. Nevertheless, the raw materials of bioethical articles are not suited to methods of systematic review. The eclecticism of philosophy may lead to suspicion of philosophical methods in bioethics. Because bioethics aims to influence medical and scientific practice it is tempting to adopt scientific language (...) and methods. One manifestation is the increasing innovation in, and use of, systematic reviews of ethical arguments in bioethics. Yet bioethics, as a broadly philosophical area of enquiry, is unsuited to systematic review. Bioethical arguments are evaluative, so notions of quality and bias are inapplicable. Bioethical argument is conceptual rather than numerical, and the classification of concepts is itself a process of argument that cannot aspire to neutrality. Any ‘systematic review’ of ethical arguments in bioethics thus falls short of that name. Furthermore, labels matter. Although the bioethics research community may find that adopting the language and the outward methods of clinical science offers apparent prospects of credibility, policy influence and funding, we argue that such misdirection carries risks and is unlikely to pay dividends in the long term. Bioethical sources are amenable to the review methods of the social sciences, and it is on these methods that specific methods of bioethics literature review should be built. (shrink)

Whatever else these articles demonstrate, they reveal that two efforts closely associated with professionalizing healthcare ethics consultants —surveying the practice and certificating its pra...

The problem of personal identity is often said to be one of accounting for what it is that gives persons their identity over time. However, once the problem has been construed in these terms, it is plain that too much has already been assumed. For what has been assumed is just that persons do have an identity. A new interpretation of Hume's no-self theory is put forward by arguing for an eliminative rather than a reductive view of personal identity, and (...) by approaching the problem in terms of phenomenology, Buddhist psychology, and the idea of a constructed self-image. (shrink)

This paper examines the political and ethical problems which arise in the course of undertaking participatory research in developing countries. It argues that, rather than supplanting relationships of power within the knowledge creating process, most participatory research actually strengthens them. Instead a more complete form of dialogic research is required, which will involve struggles within our academies as well as in those other organisations in which our research is situated.

Given how long bioethics has been around, how long bioethicists have devoted themselves to tackling ethical issues, how much work has gone into professionalizing the practice of clinical ethics consultation, how often bioethicists have either testified as experts in court proceedings or attached their names to amicus curiae briefs, and how ubiquitously they are present throughout the clinical, research, administrative, and other dimensions of health care, one would have thought that a convergence of opinion would exist on what it is (...) that the clinical ethics consultant's expertise consists of—if only for reasons of professional solidarity and reputation management. And yet, as a recent series of articles written by... (shrink)

As everybody knows, advances in medicine and medical technology have brought enormous benefits to, and created vexing choices for, us all – choices that can, and occasionally do, test the very limits of thinking itself. As everyone also knows, we live in the age of consultants, i.e., of professional experts who are ready, willing, and able to give us advice on any and every conceivable question. One such consultant is the medical ethics consultant, or the medical ethicist who consults.Medical ethics (...) consultants involve themselves in just about every aspect of health care decision making. They help legislators and judges determine law, hospitals formulate policies, medical schools develop curricula, etc. In addition to educating physicians, nurses, and lawyers, amongst others, including medical, nursing, and law students, they participate in clinical decision making at the bedside. (shrink)

Smart-home technologies, comprising environmental sensors, wearables and video are attracting interest in home healthcare delivery. Development of such technology is usually justified on the basis of the technology’s potential to increase the autonomy of people living with long-term conditions. Studies of the ethics of smart-homes raise concerns about privacy, consent, social isolation and equity of access. Few studies have investigated the ethical perspectives of smart-home engineers themselves. By exploring the views of engineering researchers in a large smart-home project, we sought (...) to contribute to dialogue between ethics and the engineering community. Either face-to-face or using Skype, we conducted in-depth qualitative interviews with 20 early- and mid-career smart-home researchers from a multi-centre smart-home project, who were asked to describe their own experience and to reflect more broadly about ethical considerations that relate to smart-home design. With participants’ consent, interviews were audio-recorded, transcribed and analysed using a thematic approach. Two overarching themes emerged: in ‘Privacy’, researchers indicated that they paid close attention to negative consequences of potential unauthorised information sharing in their current work. However, when discussing broader issues in smart-home design beyond the confines of their immediate project, researchers considered physical privacy to a lesser extent, even though physical privacy may manifest in emotive concerns about being watched or monitored. In ‘Choice’, researchers indicated they often saw provision of choice to end-users as a solution to ethical dilemmas. While researchers indicated that choices of end-users may need to be restricted for technological reasons, ethical standpoints that restrict choice were usually assumed and embedded in design. The tractability of informational privacy may explain the greater attention that is paid to it. However, concerns about physical privacy may reduce acceptability of smart-home technologies to future end-users. While attention to choice suggests links with privacy, this may misidentify the sources of privacy and risk unjustly burdening end-users with problems that they cannot resolve. Separating considerations of choice and privacy may result in more satisfactory treatment of both. Finally, through our engagement with researchers as participants this study demonstrates the relevance of ethics as a critical partner to smart-home engineering. (shrink)

The case of Charlie Gard, an infant with a genetic illness whose parents sought experimental treatment in the USA, brought important debates about the moral status of parents and children to the public eye. After setting out the facts of the case, this article considers some of these debates through the lens of parental rights. Parental rights are most commonly based on the promotion of a child’s welfare; however, in Charlie’s case, promotion of Charlie’s welfare cannot explain every fact of (...) the case. Indeed, some seem most logically to extend from intrinsic parental rights, that is, parental rights that exist independent of welfare promotion. I observe that a strong claim for intrinsic parental rights can be built on arguments for genetic propriety and children’s limited personhood. Critique of these arguments suggests the scope of parental rights remains limited: property rights entail proper use; non-personhood includes only a small cohort of very young or seriously intellectually disabled children and the uniqueness of parental genetic connection is limited. Moreover, there are cogent arguments about parents’ competence to make judgements, and public interest arguments against allowing access to experimental treatment. Nevertheless, while arguments based on propriety may raise concerns about the attitude involved in envisioning children as property, I conclude that these arguments do appear to offer a prima facie case for a parental right to seek experimental treatment in certain limited circumstances. (shrink)

Abstract‘Dogwhistles’ and microtargeted political advertisements are objects of widespread moral and political concern. With a few notable exceptions in the case of dogwhistles (and none in the case of microtargeting) moral criticism of these speech act types generally focuses on problematiccontent—that a dogwhistle is, for instance, racist, or a microtargeted advertisement misleading. I argue that these practices areadditionallymorally wrongful on content-neutral grounds—regardless of their content. My argument proceeds from a deliberative conception of democracy according to which only a vote which (...) follows from anadequate deliberative processconfers democratic legitimacy on its results. I claim that both dogwhistles and microtargeting threaten to prevent adequate democratic deliberation from taking place, and therefore that these practices are anti-democratic and, additionally, morally impermissible. I then discuss potential objections and how my argument relates to existing work. (shrink)

Where a decision has been made to stop futile treatment of critically ill patients on an intensive care unit – what is termed withdrawal of treatment in the UK – yet no doctor is available to perform the actions of withdrawal, nurses may be called upon to perform key tasks. In this paper I present two moral justifications for this activity by offering answers to two major questions. One is to ask if it can be in patients' best interests for (...) nurses to be the key actors in withdrawal of life‐sustaining treatment. The other is to ask if there is any reason that the nursing profession should not undertake such tasks if this is so. Both these questions require the resolution of weighty moral and philosophical issues. Thus, while offering a serious attempt to provide moral justifications for nurses undertaking withdrawal, this paper also invites debate over both the aim of task division between nurses and doctors, and how we might decide what is in the best interests of patients. (shrink)

Improving surgical interventions is key to improving outcomes. Ensuring the safe and transparent translation of such improvements is essential. Evaluation and governance initiatives, including the IDEAL framework and the Macquarie Surgical Innovation Identification Tool have begun to address this. Yet without a definition of innovation that allows non-surgeons to identify when it is occurring, these initiatives are of limited value. A definition seems elusive, so we undertook a conceptual study of surgical innovation. This indicated common conceptual areas in discussions of (...) innovation, that we categorised alliteratively under the themes of “purpose”, “place”, “process”, “product” and “person”. These conceptual areas are used in varying—sometimes contradictory—ways in different discussions. Highlighting these conceptual areas of surgical innovation may be useful in clarifying what should be reported in registries of innovation. However our wider conclusion was that the term “innovation” carries too much conceptual baggage to inform normative inquiry about surgical practice. Instead, we propose elimination of the term “innovation” from serious discourse aimed at evaluation and regulation of surgery. In our view researchers, philosophers and policy-makers should consider what it is about surgical activity that needs attention and develop robust definitions to identify these areas: for our own focus on transparency and safety, this means finding criteria that can objectively identify certain risk profiles during the development of surgery. (shrink)

Those with a keen sense of the history of ideas will have noticed that just a few years before Kierkegaard’s 200th birthday was Darwin’s 200th birthday. Those with an even keener perception will have also seen the significance of the relation between these two bi-centenaries For Kierkegaard’s writings were a reaction to Darwin or, more broadly put, to the spirit of the times of which Darwin was the pinnacle. Both Darwin and Kierkegaard lived when it was becoming obvious that the (...) claims of the Bible could not literally be true. The findings of science rendered the Christian account of creation untenable. It was during the rush to discover the mechanisms of evolution, a discovery that would ring the death knell for any objective truth in the Christian story of creation, that Kierkegaard came up with the idea that objective truth had nothing to do with Christianity. Kierkegaard thus can easily be seen as fighting a rear-guard action to salvage what was left of Christianity. For if the objective findings of science were raising questions about the objective truth of Christian beliefs, then one way to avoid answering these questions would be to argue that Christianity has nothing to do with objectivity. There is, however, a major problem with Kierkegaard’s attempt to save Christianity in this “retreat to subjectivity” fashion. For in addition to pulling the carpet out from under the evolutionists, he also pulled the carpet out from under himself. The reason for this is because, despite his claims about Christian truths existing only in subjectivity and Christianity having no existence in objectivity, it is quite clear that Kierkegaard wants various Christian claims to be objectively true and therefore for Christianity also to have an objective existence. (shrink)

The ideas of mindfulness and no-self are intimately connected in Buddhist philosophy. This is because, in Buddhist Philosophy, the practice of mindfulness leads to the realization that there is no self. In contemporary mindfulness in psychology, the no-self theory has not played such a basic role. An outline of Buddhist philosophy is given showing how the ‘root delusion’ of having a self lies at the base of human suffering and how mindfulness, when appropriately deployed, enables one to free oneself from (...) this delusion and thus achieve psychological well-being. This is not to say that mindfulness based interventions do not help to alleviate suffering. Nor is it to say that people working in these areas should not use mindfulness in their own way. It is only to say that by ignoring the no-self experience, teachers and practioners are falling short of achieving what mindfulness was originally employed to achieve. (shrink)

This paper asks and examines the question “who are you?” In doing so it embarks across the conceptual terrain of subjectivity, passing through five different regions. First is the subject and otherness, in which are considered Arendtian notions of the “who” of the individual in the appearing world. Next is the relation between the “I” and the “you” in systems of recognition, and how those systems are creations and expressions of social normativity. This is followed by the idea of the (...) sovereignty of the self as a reaction to its dislocation within systems of recognition. Sovereignty as such is viewed through the thought of Jacques Derrida and Hannah Arendt. With Foucault, the authors approach the question of social normativity as a frame rather than a constraint by which the self is stylized. The fourth section of the paper then explores self-questioning as a means of explicit or intentional self-stylization. Contrasting the “mere liberation” of thinking in Arendt’s thought with broader understandings of freedom, the fifth section relates Arendt’s conception of the miraculous with Derrida’s of the event. The paper’s trajectory returns in conclusion to the implications of its course for the initial question of who one is, particularly with respect to the teaching subject. (shrink)

Cosmopolitanism and Its Discontents seeks to address the kinds of challenges that cosmopolitan perspectives and practices face in a world organized increasingly in relation to a proliferating series of global absolutisms--religious, political, social, and economic. While these challenges are often used to support the claim that cosmopolitanism is impotent to resist such totalizing ideologies because it is either a Western conceit or a globalist fiction, Gunn argues that cosmopolitanism is neither. Situating his discussion in an emphatically global context, Gunn shows (...) how cosmopolitanism has been effective in resisting such essentialisms and authoritarianisms precisely because it is more pragmatic than prescriptive, more self-critical than self-interested and finds several of its foremost recent expressions in the work of an Indian philosopher, a Palestinian writer, and South African story-tellers. This kind of cosmopolitanism offers a genuine ethical alternative to the politics of dogmatism and extremism because it is grounded on a new delineation of the human and opens toward a new, indeed, an "other," humanism. (shrink)

In this paper, I consider Aristotle’s views in relation to the Humean theory of motivation. I distinguish three principles which HTM is committed to: the ‘No Besires’ principle, the ‘Motivation Out—Desire In’ principle, and the ‘Desire Out—Desire In’ principle. To reject HTM, one only needs to reject one of these principles. I argue that while it is plausible to think that Aristotle accepts the first two principles, there are some grounds for thinking that he might reject the third.

The Nature of Sexual Desire takes the reader on a fascinating journey through the psychology, philosophy, and anthropology of this most urgent of human desires. Examining both ancient writings and modern research, both Eastern and Western thought, the author argues that sexual desire is a continuous element in awareness and can only be understood in terms of our experience. The experience of sexual desire is explored and its relation to sexual interaction, erotic pleasure, the experience of gender, and romantic love, (...) is skilfully unravelled. Sexual desire is presented in a new light: an existential need that is continually sweeping through us, pulling us on to one of life’s highest fulfilments. (shrink)

This letter responds to the essay “If Not Now, Then When? Taking Disability Seriously in Bioethics,” by Debjani Mukherjee, Preya S. Tarsney, and Kristi L. Kirschner, in the May‐June 2022 issue of the Hastings Center Report.

In an earlier paper entitled _Harm is all you need?_, I used an analysis of English law to claim that the harm threshold was an unsuitable mediator of the best interests test when deciding if parental decisions should be overruled. In this paper I respond to a number of commentaries of that paper, and extend my discussion to consider the claim that the harm threshold gives appropriate normative weight to the interests of parents. While I accept that parents have some (...) rights over their children, I argue these are dependent on parents’ duties to benefit their children. While many such benefits are understood pluralistically, and are thus within parents’ ambit to decide, I claim that health benefits are ordinally different, because they play a foundational role in the flourishing of an individual. In the light of this, clinicians have the moral authority to override parental refusals, although in some cases abstaining from exercising this authority may be a pragmatic way to maintain parental engagement and ensure our ability to benefit the child in future. (shrink)

Phenomenalism is a philosophical theory of perception involving the idea that statements about material objects can be explained in terms of statements about actual and possible sense experiences. In this study James Giles explores the development of phenomenalism through the works of Locke, Berkeley, Hume, and others. He shows how problems occur for phenomenalists precisely at the point where they abandon their empiricism. Holding to empiricism, Giles then presents his own version of phenomenalism as a metaphysical thesis in (...) which the material objects are constructed out of sense experience. He then argues that the major critiques of phenomenalism, including Wittgenstein’s private language argument and Sellars’ famous attack on the ‘myth of the given’, all fail to dislodge the basic phenomenalist insights. (shrink)

This book is a critical appraisal of the distinctive modern school of thought known as French existentialism. It philosophically engages the ideas of the major French existentialists, namely, Beauvoir, Merleau-Ponty, Marcel, Camus, and, because of his central role in the movement, especially Sartre, in a fresh attempt to elucidate their contributions to contemporary philosophy.