In their target article, Childress et al provide a detailed analysis of dilemmas arising from disagreement between an ICU team and a competent patient (Mr J) about dis/continuation of extra-corpore...

BackgroundECMO is a particularly scarce resource during the COVID-19 pandemic. Its allocation involves ethical considerations that may be different to usual times. There is limited pre-pandemic literature on the ethical factors that ECMO physicians consider during ECMO allocation. During the pandemic, there has been relatively little professional guidance specifically relating to ethics and ECMO allocation; although there has been active ethical debate about allocation of other critical care resources. We report the results of a small international exploratory survey of ECMO (...) clinicians’ views on different patient factors in ECMO decision-making prior to and during the COVID-19 pandemic. We then outline current ethical decision procedures and recommendations for rationing life-sustaining treatment during the COVID-19 pandemic, and examine the extent to which current guidelines for ECMO allocation (and reported practice) adhere to these ethical guidelines and recommendations.MethodsAn online survey was performed with responses recorded between mid May and mid August 2020. Participants (n = 48) were sourced from the ECMOCard study group—an international group of experts (n = 120) taking part in a prospective international study of ECMO and intensive care for patients during the COVID-19 pandemic. The survey compared the extent to which certain ethical factors involved in ECMO resource allocation were considered prior to and during the pandemic.ResultsWhen initiating ECMO during the pandemic, compared to usual times, participants reported giving more ethical weight to the benefit of ECMO to other patients not yet admitted as opposed to those already receiving ECMO, (p < 0.001). If a full unit were referred a good candidate for ECMO, participants were more likely during the pandemic to consider discontinuing ECMO from a current patient with low chance of survival (53% during pandemic vs. 33% prior p = 0.002). If the clinical team recommends that ECMO should cease, but family do not agree, the majority of participants indicated that they would continue treatment, both in usual circumstances (67%) and during the pandemic (56%).ConclusionsWe found differences during the COVID-19 pandemic in prioritisation of several ethical factors in the context of ECMO allocation. The ethical principles prioritised by survey participants were largely consistent with ECMO allocation guidelines, current ethical decision procedures and recommendations for allocation of life-sustaining treatment during the COVID-19 pandemic. (shrink)

"Stop slacking off " Your parents may have said this to you when you were deep into a video-gaming marathon. Or maybe your roommate said it to you when you were lounging on the couch scrolling through Instagram. You may have even said it to yourself on days you did nothing. But what is so bad about slacking? Could it be that there's nothing bad about not making yourself useful? Against our hyper-productivity culture, Alison Suen critically interrogates our disapproval (...) of slackers--individuals who do the bare minimum just to get by. She offers a taxonomy of slackers, analyzes common objections to slacking, and argues that each of these objections either fails or carries problematic assumptions. But while this book defends slacking, it does not promote the slacker lifestyle as the key to something better, as some pro-leisure scholars have argued. In fact, Suen argues that slacking is unique precisely because it serves no noble cause. Slacking is neither a deliberate protest to social ills nor is it a path to autonomy. Slackers just slack. By examining the culture of hyper-productivity, Suen argues that it is in fact OK to be a slacker. Key Features Demonstrates the uniqueness of slacking, via a critical examination of six distinct "pro-leisure" philosophical accounts. Articulates a taxonomy of slackers, as well as in-depth examinations of Hollywood slackers and slackers in academia. Examines common objections to slacking, and offers a rebuttal to each of them. Offers an understanding of our productivity culture from an existential perspective. (shrink)

Mitochondrial replacement techniques are intended to avoid the transmission of mitochondrial diseases from mother to child. MRT represent a potentially powerful new biomedical technology with ethical, policy, economic and social implications. Among other ethical questions raised are concerns about the possible effects on the identity of children born from MRT, their families, and the providers or donors of mitochondria. It has been suggested that MRT can influence identity directly, through altering the genetic makeup and physical characteristics of the child, or (...) indirectly through changing the child's experience of disease, and by generating novel intrafamilial relationships that shape the sense of self. In this article I consider the plausibility and ethical implications of these proposed identity effects, but I focus instead on a third way in which identity may be affected, through the mediating influence of the wider social world on MRT effects on identity. By taking a narrative approach, and examining the nature and availability of identity narratives, I conclude that while neither direct genetic nor indirect experiential effects can be excluded, social responses to MRT are more likely to have a significant and potentially damaging influence on the generation of MRT children's narratives of identity. This conclusion carries some implications for the collective moral responsibility we hold to ensure that MRT, if implemented, are practised in ethically justifiable ways. (shrink)

Engaging with the work of Freud, Heidegger, Wittgenstein, and Derrida, this book reconceptualises the language divide between humans and animals within the context of animal ethics.

This paper considers how Cato's status as a "new man" in the competitive social and political arena he entered at Rome shaped his self-representation in the sphere of his historical writing. At the heart of the argument is the question of how Cato's insertion of his own speeches into the fabric of the Origines modulated the tenor of his self-commemoration in that work. After briefly considering how previous historiography may have helped determine Cato's choices, the argument looks to Roman discursive (...) practices that appear to have taken shape around the 4th- and early 3rd-century rise of the nobilitas. Especially in focus are the functions of the ancestor mask and the use of voice in honorific epigraphy. (shrink)

This research provides a look at men doing gender in the highly feminized context of temporary clerical employment. Male clerical temporaries, as with other men who cross over into “women's work,” face institutionalized challenges to their sense of masculinity. In particular, male clerical temporary workers face gender assessment—highlighting their failure to live up to the ideals of hegemonic masculinity. The resulting gender strategies these men adopt reveal how male clerical temporary workers “do masculinity”—often in a collaborative performance shaped by the (...) gendered expectations of their agencies, their clients, and even themselves—to reassert the feminine identification of the job while at the same time rejecting its application to them. Paradoxically, rather than disrupting the gender order, the gender strategies used by these male clerical temporaries help to reproduce and naturalize the gendered organization of work and reinvigorate hegemonic masculinity and its domination over women and subaltern men. (shrink)

This article explores what might constitute the good-enough reader of Maggie Nelson's The Argonauts. Prompted by Nelson's use of D.W. Winnicott's theory of the good-enough mother whose insufficiencies generate the infant's capacity to tolerate ordinary frustration and move beyond both idealizations and denigrations, I argue that the good-enough reader here would be the one who resists the temptation to idealize both the book and its author. This argument is presented as an attempt to open up some spaces for the discussion (...) of ambivalent responses to this book, beyond the rather deferential fandom that has characterized the psychic life of its reception. (shrink)

In this paper, I offer justifications and strategies for teaching taboo, unpopular, or rarely contested views in undergraduate ethics courses. Teaching taboo topics, while challenging, forcefully demonstrates the commitment that few topics in ethics have obvious answers, and that the study of ethics is more than just debating right and wrong. Drawing from my experience teaching on the topic of bestiality, I articulate the importance of motivating topics that may appear remote and irrelevant to students. Inspired by Kathy Rudy’s queer (...) theory approach to the question of bestiality, I propose that we broaden and reframe taboo issues when teaching undergraduates. Instead of introducing these issues with the typical “Is it right or wrong to do X,” I recommend that we examine the essential political, metaphysical, and epistemological presumptions that inform and shape our moral judgments. (shrink)

Argument schemes are abstractions substantiating the inferential connection between premise(s) and conclusion in argumentative communication. Identifying such conventional patterns of reasoning is essential to the interpretation and evaluation of argumentation. Whether studying argumentation from a theory-driven or data-driven perspective, insight into the actual use of argumentation in communicative practice is essential. Large and reliably annotated corpora of argumentative discourse to quantitatively provide such insight are few and far between. This is all the more true for argument scheme corpora, which tend (...) to suffer from a combination of limited size, poor validation, and the use of ad hoc restricted typologies. In the current paper, we describe the annotation of schemes on the basis of two distinct classifications: Walton’s taxonomy of argument schemes, and Wagemans’ Periodic Table of Arguments. We describe the annotation procedure for each, and the quantitative characteristics of the resulting annotated text corpora. In doing so, we extend the annotation of the preexisting US2016 corpus of televised election debates, resulting in, to the best of our knowledge, the two largest consistently annotated corpora of schemes in argumentative dialogue publicly available. Based on evaluation in terms of inter-annotator agreement, we propose further improvements to the guidelines for annotating schemes: the argument scheme key, and the Argument Type Identification Procedure. (shrink)

This article draws on data from a qualitative research study undertaken in an old UK university with the main aim of investigating the issue of the gender dimension of academic careers. It examines the idea of an individualistic academic career that demands self-promotion, which is still used as a measure of achievement by those in senior positions. However, there is a basic contradiction. While this idea is upheld, men simultaneously gain by an in-built patriarchal support system. They do not have (...) to make a conscious effort to be helped by it, thereby perpetuating the cultural hegemony of individualism. Women are not admitted to this support system, and if they are seen as needing or wanting to set up their own system, this is viewed as a weakness. The answer appears to be for women to strategically harness feminist ways of working in a collaborative and supportive way. (shrink)

Kim Q. Hall, Feminist disability studies, Bloomington: Indiana University Press, 2011, reviewed by Jackie Leach Scully.

This book reconceives disability as a set of social relations and practices, as experienced embodiment, and as an emancipatory movement, as well as a biomedical phenomenon. The author brings new attention to complex ethical questions surrounding disability, looking at not only the biomedical understanding of impairment, but also its cultural representations and social organization.

Pandemics such as COVID-19 place everyone at risk, but certain kinds of risk are differentially severe for groups already made vulnerable by pre-existing forms of social injustice and discrimination. For people with disability, persisting and ubiquitous disablism is played out in a variety of ways in clinical and public health contexts. This paper examines the impact of disablism on pandemic triage guidance for allocation of critical care. It identifies three underlying disablist assumptions about disability and health status, quality of life, (...) and social utility, that unjustly and potentially catastrophically disadvantage people with disability in COVID-19 and other global health emergencies. (shrink)

Long considered to be institutions outside of time, the temples of India are today the subject of ethno-historical studies that attempt to establish their continuous and recent transformations. Recent monographs, based especially on relationships between the central government and local authorities, reconstruct by periods their medieval, modern and present history, that is the long destiny of constant restructuring over time (Appadurai 1981; Fuller 1984; Reiniche 1989), showing that temples, whether large or small, never ceased being the center of important conflicts (...) between social groups seeking dominance. (shrink)

Anesthesia research has focused on showing learning in the absence of awareness for good practical reasons. Crucially, continued learning during otherwise clinically adequate anesthesia may affect patients’ well-being on recovery. Theoretically, preserved perceptual priming during anesthesia offers a useful starting point for consciousness research by determining the limits of memory function during minimal consciousness. The big question for consciousness research is not to demonstrate absolutely unconscious processing, but rather to map out the cognitive and neurobiological processes that enable conscious experience (...) itself. (shrink)

During the twelfth and thirteenth centuries, great new trends of Jewish thought emerged whose widely varied representatives--Kabbalists, philosophers, and astrologers--each claimed that their particular understanding revealed the actual secret of the Torah. They presented their own readings in a coded fashion that has come to be regarded by many as the very essence of esotericism. Concealment and Revelation takes us on a fascinating journey to the depths of the esoteric imagination. Carefully tracing the rise of esotericism and its function in (...) medieval Jewish thought, Moshe Halbertal's richly detailed historical and cultural analysis gradually builds conceptual-philosophical force to culminate in a masterful phenomenological taxonomy of esotericism and its paradoxes. Among the questions addressed: What are the internal justifications that esoteric traditions provide for their own existence, especially in the Jewish world, in which the spread of knowledge was of great importance? How do esoteric teachings coexist with the revealed tradition, and what is the relationship between the various esoteric teachings that compete with that revealed tradition? Halbertal concludes that, through the medium of the concealed, Jewish thinkers integrated into the heart of the Jewish tradition diverse cultural influences such as Aristotelianism, Neoplatonism, and Hermeticisims. And the creation of an added concealed layer, unregulated and open-ended, became the source of the most daring and radical interpretations of the tradition. (shrink)

The last half of the twentieth century saw an explosion in our understanding of genetics and molecular biology; the questions now are in what form that genetic understanding will be put to use; and how and by whom it will be controlled. It's about science and spirituality, and how the two are connected.

In this paper, I investigate Freud’s study of infantile zoophobias. According to Freud, in nearly all cases of infantile animal phobias, the feared animal functions as a father figure. The feared animal takes on the prohibitive role as the father substitute. The substitutability of the animal and the father is crucial for Freud, as it anchors his theory regarding the familial, social, and religious structure of a patriarchal society. In light of this standard animal-father substitution, Freud’s biography of Leonardo da (...) Vinci stands out as a provocative exception. In this psychoanalytic biography, Freud examines da Vinci’s relationship with a vulture—only here the vulture is an androgynous creature that serves as a mother substitute. More significantly, unlike other accounts of infantile zoophobia, the vulture has an empowering rather than crippling effect on the infant da Vinci. With the story of the androgynous vulture, I argue that Freud’s interpretation of da Vinci opens up a new way to understand our relationships with animals—a way that not even Freud himself anticipated. In short, I analyze the significance of this deviant case of animal obsession in Freud’s corpus and its ramifications for reconceiving the human-animal relationship. (shrink)

La maladie de l'ame... la belle expression platonicienne n'a de cesse d'etre d'actualite. Non seulement elle est prompte a revenir d'epoque en epoque, mais elle semble particulierement friande de la notre. Que cette maladie designe une vague tristesse, un taedium vitae, ou, plus grave, une depression, elle implique tout a la fois la souffrance morale et la souffrance physique. L'ame et le corps sont divises mais se retrouvent dans la douleur si bien que la maladie de l'ame vient de ce (...) que nous avons un corps. De ce constat paradoxal Jackie Pigeaud tire une histoire, celle du triomphe du dualisme, du fardeau de l'ame et du corps contraints a etre separes et ensemble a perpetuite. Cette histoire trouve son origine dans le monde grec, et plus exactement dans sa philosophie. La division entre maladies de l'ame et autres maladies, c'est-a-dire maladies du corps, appartient a la philosophie. La medecine aurait ete bien soulagee de cette partition. Est-ce a dire qu'elle n'entendait pas etre philosophique? Sans doute: Hippocrate en offre un bon exemple. L'accord, tacite, est le suivant: l'ame appartient au philosophe et le corps au medecin. Ciceron s'occupe des passions et Galien suspend son jugement des qu'il approche la psyche. Chacun y trouve son compte mais les consequences sont importantes: la partition du champ des maladies, la place du malade dans la societe, les traitements a apporter, notamment a la folie, dependent de ce dualisme initial. Si le legs de la medecine greco-romaine est riche, il est aussi fort lourd et trouve des developpements tout au long de l'histoire de la medecine, jusqu'a la constitution au XVIIIe siecle de la psychiatrie. D'une ecriture et d'une pensee personnelles et profondes, ce livre est un essai sur l'histoire de la pensee medicale, depuis l'Antiquite jusqu'a nos jours. La Maladie de l'ame a ete un succes des sa parution, et ce succes n'a pas ete dementi depuis. L'ouvrage n'etait malheureusement plus disponible: les livres ont leur destin commentait l'auteur. Avec cette edition revue et augmentee, accompagnee d'une preface nouvelle, le livre connait enfin le sort qu'il merite.Jackie Pigeaud est professeur emerite de litterature latine a l'Universite de Nantes et membre de l'Institut universitaire de France. On lui doit egalement, aux Belles Lettres, Folie et cures de la folie chez les medecins de l'Antiquite greco-romaine. La manie. (shrink)

This chapter examines the ways in which disabled people are subject to epistemic injustice. It starts by introducing how social epistemology models the creation of shared knowledge and then uses feminist epistemology to highlight the role of social and political power in producing epistemic privilege, exclusion, and oppression. The well-known concepts of testimonial and hermeneutic epistemic injustice are discussed in relation to disability, showing how these forms of injustice are frequently experienced within the lives of disabled people. In particular, disabled (...) experience has features that distinguish it from the experiences of sexism and racism most commonly used as illustrations of epistemic injustice. The chapter ends by arguing that the potential for epistemic injustice poses unprecedented risks for disabled people in the current context, which could be minimized by recognizing that ignorance about disabled lives is not inevitable, but something that can and should be challenged. (shrink)

In this paper a dialogue game for critical discussion is developed. The dialogue game is a formalisation of the ideal discussion model that is central to the pragma-dialectical theory of argumentation. The formalisation is intended as a preparatory step to facilitate the development of computational tools to support the pragma-dialectical study of argumentation. An important dimension of the pragma-dialectical discussion model is the role played by speech acts. The central issue addressed in this paper is how the speech act perspective (...) can be accommodated in the formalisation as a dialogue game. The starting point is an existing ‘basic’ dialogue game for critical discussion, in which speech acts are not addressed. The speech act perspective is introduced into the dialogue game by changing the rules that govern the moves that can be made and the commitments that these result in, while the rules for the beginning, for the end, and for the structure of the dialogue game remain unchanged. The revision of the move rules is based on the distribution of speech acts in the pragma-dialectical discussion model. The revision of the commitment rules is based on the felicity conditions that are associated with those speech acts. (shrink)

Susan has been profoundly deaf since childhood. She is a hearing aid wearer, and likes to use the induction loops built into some public spaces, such as theaters and cinemas, to help cut down the background noise that can make hearing speech very difficult. But this depends on the building having an induction loop fitted and properly maintained. Like many other induction loop users, Susan frequently finds that the advertised loop system is either working poorly or not working at all. (...) Almost as often, she then has the experience of making a complaint about it only to have the problem denied. If she persists, she is often then met... (shrink)

Research has shown that gossip plays an important role in establishing and supporting group values and behaviors. However, gossip also plays a role in the development and social construction of identity. In particular, gossip is a discursive resource that enables participants to create what Kyratzis refers to as practice communities: discursive contexts where speakers can explore the acceptability of social behaviors and values with their peers. This study analyzed excerpts of gossip taken from conversations involving 16-year-old high school girls to (...) examine the role gossip plays in negotiating adulthood. (shrink)