One day soon it may be possible to replace a failing heart, liver, or kidney with a long-lasting mechanical replacement or perhaps even with a 3-D printed version based on the patient's own tissue. Such artificial organs could make transplant waiting lists and immunosuppression a thing of the past. Supposing that this happens, what will the ongoing care of people with these implants involve? In particular, how will the need to maintain the functioning of artificial organs over an extended period (...) affect patients and their doctors and the responsibilities of those who manufacture such devices? Drawing on lessons from the history of the cardiac pacemaker, this article offers an initial survey of the ethical issues posed by the need to maintain and service artificial organs. We briefly outline the nature and history of cardiac pacemakers, with a particular focus on the need for technical support, maintenance, and replacement of these devices. Drawing on the existing medical literature and on our conversations and correspondence with cardiologists, regulators, and manufacturers, we describe five sources of ethical issues associated with pacemaker maintenance: the location of the devices inside the human body, such that maintenance generates surgical risks; the complexity of the devices, which increases the risk of harms to patients as well as introducing potential injustices in access to treatment; the role of software—particularly software that can be remotely accessed—in the functioning of the devices, which generates privacy and security issues; the impact of continual development and improvement of the device; and the influence of commercial interests in the context of a medical device market in which there are several competing products. Finally, we offer some initial suggestions as to how these questions should be answered. (shrink)

Dystonia is a movement disorder that can have a debilitating impact on motor functions and quality of life. There are 250,000 cases in the United States, most with childhood onset. Due to the limited effectiveness and side effects of available treatments, pediatric deep brain stimulation has emerged as an intervention for refractory dystonia. However, there is limited clinical and neuroethics research in this area of clinical practice. This paper examines whether it is ethically justified to offer pDBS to children with (...) refractory dystonia. Given the favorable risk-benefit profile, it is concluded that offering pDBS is ethically justified for certain etiologies of dystonia, but it is less clear for others. In addition, various ethical and policy concerns are discussed, which need to be addressed to optimize the practice of offering pDBS for dystonia. Strategies are proposed to help address these concerns as pDBS continues to expand. (shrink)

Professional sport in the United States has widely adopted biometric technologies, dramatically expanding the monitoring of players’ biodata. These technologies have the potential to prevent injuries, improve performance, and extend athletes’ careers; they also risk compromising players’ privacy and autonomy, the confidentiality of their data, and their careers. The use of these technologies in professional sport and the consumer sector remains largely unregulated and unexamined. We seek to provide guidance for their adoption by examining five areas of concern: validity and (...) interpretation of data; increased surveillance and threats to privacy; risks to confidentiality and concerns regarding data security; conflicts of interest; and coercion. Our analysis uses professional sport as a case study; however, these concerns extend to other domains where their use is expanding, including the consumer sector, collegiate and high school sport, the military, and commercial sectors where monitori... (shrink)

Th is paper explores the perception of urban landscapes through sound, using two case studies of cities where bells played a significant role in the city, where a particular dramatic event silenced these bells, and where the act of remaking broken or tuneless bells re-creates an engagement with the lived places of the past. At Notre Dame Cathedral in Paris, newly cast bells recreate the melodious peal last heard before the French Revolution, and ChristChurch Cathedral in Christchurch, New Zealand, bells (...) damaged by destructive earthquakes of 2011 will eventually ring out their familiar tones in an urban landscape that is physically almost unrecognisable. Both case studies demonstrate the ways that the inadvertent and the deliberate transformation of soundscapes continually interacts with ideas of place and meaning within the constantly changing city. (shrink)

Women are under-represented in surgery, especially in leadership and academic roles, and face a gender pay gap. There has been little work on the role of implicit biases in women’s under-representation in surgery. Nor has the impact of epistemic injustice, whereby stereotyping influences knowledge or credibility judgements, been explored. This article reports findings of a qualitative in-depth interview study with women surgeons that investigates gender biases in surgery, including subtle types of bias. The study was conducted with 46 women surgeons (...) and trainees of the Royal Australasian College of Surgeons. Maximum variance sampling strategies ensured a comprehensive set of perspectives. Data were analysed using iterative thematic analysis to document and classify forms of gender bias experienced by the participants, including implicit bias and epistemic injustice. It found four types of bias affecting women surgeons: (1) workplace factors such as access to parental leave and role models; (2) epistemic injustices—unfair assessments of women surgeons’ credibility by patients and colleagues; (3) stereotyped expectations that they will carry out more of surgery’s carework, such as meeting the emotional needs of patients and (4) objectification. Implicit biases arose in each category. Given that many of the biases identified in this study are small, are harmless on their own and are not necessarily under anyone’s conscious control, important questions arise regarding how they cause harm and how to address them. I draw on theoretical work on cumulative harm to answer these questions. (shrink)

In this first-ever history of contemporary liberal theory, Forrester shows how liberal egalitarianism--a set of ideas about justice, equality, obligation, and the state--became dominant, and traces its emergence from the political and ideological context of the postwar United States and Britain.d Britain.

In lieu of an abstract, here is a brief excerpt of the content:Mild Cognitive Impairment Is RelevantRonald C. Petersen (bio)Keywordsaging, Alzheimer’s disease, dementia, mild cognitive impairment, pharmaceutical industryGraham and Ritchie (2006) have contributed a scholarly document that implores us to reexamine nosological categories and certain diagnostic outcomes. They have chosen mild cognitive impairment (MCI) as the target of their scrutiny and have raised several interesting issues. I would like to comment on their approach and suggest that MCI is a (...) useful clinical entity that does serve a practical function and hopefully will lead to a better quality of life for aging persons.There are several clarifications concerning the construct of MCI that need to be emphasized. Graham and Ritchie have asserted that all persons with MCI eventually evolve to Alzheimer's disease (AD) and have claimed that this is the inevitable outcome of the disorder. Although it is true that many of the early studies on MCI focused on the amnestic subtype as a precursor to AD (Bennett et al. 2002; Ganguli, Dodge, Shen, and DeKosky 2004; Lopez et al. 2003; Petersen et al. 1999), subsequent work has expanded the construct to include prodromal forms of other disorders (Petersen 2004; Winblad et al. 2004). As such, the construct of MCI has become flexible in recent years to account for alternative types of intermediate cognitive impairment.The authors state that MCI addresses those individuals speculated to have an inevitable dementia. Certainly, we do not presume that dementia is inevitable in the aging process; rather, we posit that if certain criteria are fulfilled in persons who are aging, the likelihood of a person progressing to a certain type of dementia is quite high. As such, this is an important precondition about which to learn, because interventional strategies may be available.Graham and Ritchie argue that some cognitive changes with aging are "normal" and trying to classify these individuals as "abnormal" is performing a disservice to much of the aging population. We draw an important distinction between the cognitive changes of normal aging, as they are recognized to exist, and what we feel constitutes the pathologic changes of MCI. We believe that the abnormal cognitive function found in MCI has a high probability of progressing to a greater degree of cognitive dysfunction in a relatively short period of time and these behavioral changes are accompanied by pathologic brain changes that are manifested on magnetic resonance imaging scans, positron emission tomography scans, cerebrospinal fluid biomarkers, and autopsy studies (Hampel et al. 2004; Jack et al. 1999; Markesbery et al. [End Page 45] 2006; Petersen et al. 2006). This type of progression is in contradistinction to other individuals who are experiencing cognitive changes of normal aging. These individuals do not progress rapidly to greater degrees of impairment and autopsy studies reveal that their brains do not harbor the pathologic changes found in the MCI population (Knopman et al. 2003).The cognitive and behavioral changes accompanying persons with MCI are devastating and cannot be ascribed to "senility" or "He is just getting old." It is a mistake to imply that by labeling people with a condition such as MCI we are doing them a disservice. Most of these individuals are seeking medical attention for their perceived difficulties. Consequently, addressing these concerns and educating the individuals on the implications of their symptoms are important services. Although we may not have adequate therapies at present, this does not imply that we should ignore the symptoms.We cannot treat many conditions at present, yet we do not avoid the opportunity to characterize the condition and make a diagnosis. Even if this were part of the aging process, this does not mean that we should ignore the disability and refuse to treat it. Most individuals develop an inflexibility of their optical lenses as they age, yet corrective lenses of one type or another are believed to be extremely beneficial at alleviating this disability associated with the aging phenomenon. No one would argue that it is inappropriate to treat this condition because it is "just a part of aging."It should be noted that I have stressed the situation in which individuals are seeking medical attention for their cognitive concerns. It is quite a different situation if an... (shrink)

The goal of this paper is to examine the impact of leadership and promotion regulatory focus on employees’ willingness to engage in unethical pro-organizational behavior . Building from a person–situation interactionist perspective, we investigate the interaction of leadership style and how leaders frame messages, as well as test a three-way interaction with promotion focus. Using an experimental design, we found that inspirational and charismatic transformational leaders elicited higher levels of UPB than transactional leaders when the leaders used loss framing, but (...) not gain framing. Furthermore, followers’ promotion regulatory focus moderated this relationship such that the effect held for followers with low promotion focus, but not for individuals with high promotion focus. Our findings extend the understanding of UPB, offer theoretical mechanisms to explain when this behavior occurs, and contribute to leadership theory and research on ethical decision making. (shrink)

In April 2018, the International Association of Athletics Federations released new regulations placing a ceiling on women athletes’ natural testosterone levels to “ensure fair and meaningful competition.” The regulations revise previous ones with the same intent. They require women with higher natural levels of testosterone and androgen sensitivity who compete in a set of “restricted” events to lower their testosterone levels to below a designated threshold. If they do not lower their testosterone, women may compete in the male category, in (...) an intersex category, at the national level, or in unrestricted events. Women may also challenge the regulation, whether or not they have lowered their testosterone, or quit sport. Irrespective of IAAF’s stated aims, the options forced by the new regulations are impossible choices. They violate dignity, threaten privacy, and mete out both suspicion and judgement on the sex and gender identity of the athletes regulated. (shrink)

Standard epistemology takes it for granted that there is a special kind of value: epistemic value. This claim does not seem to sit well with act utilitarianism, however, since it holds that only welfare is of real value. I first develop a particularly utilitarian sense of “epistemic value”, according to which it is closely analogous to the nature of financial value. I then demonstrate the promise this approach has for two current puzzles in the intersection of epistemology and value theory: (...) first, the problem of why knowledge is better than mere true belief, and second, the relation between epistemic justification and responsibility. (shrink)

Anatomy texts are seen as authoritative sources for knowledge about natural sex differences. The concepts of a natural, biological sex and of a natural difference are, however, increasingly difficult to sustain. A growing number of scholars have pointed to the fact that `sex' as much as `gender' is a historical and social construction. This article examines how the multiple-edition anatomy textbook, Gray's Anatomy, has portrayed the sexed body and male/female differences during the course of its publication, 1858 to the present, (...) focusing on specific parts of the anatomy, namely the sex organs or `organs of generation', the pelvis, the skull and the brain. An analysis of textual descriptions and graphic illustrations reveals that the male body has been the stable norm or standard against which the female body has been compared and implicitly judged as underdeveloped, weak or faulty. Only rarely has the male body been compared with the female body. Reflecting long-standing views about sexual complementarity and natural differences between men and women, some comparisons emphasize the reproductive functioning of females or imply that females are intellectually inferior. It would appear that the discipline of anatomy has remained largely immune from broader public debates about sexual inequality and gender representations. (shrink)

In this paper, we wish to propose a notion Kunstangst [Danish for art anxiety] as a designation for the destabilising and transformative state that art can impose on its spectator. To this day, art discourse and curation continue to be shaped by Enlightenment ideals. This legacy urges us to dispose of our individuality, either by putting ourselves in someone else’s place or by striving towards objectivity and repeatability. We regard this as highly problematic, and to question the scientific, rational, and (...) disinterested approaches, we have chosen to investigate a more personal, intimate relation between artwork and spectator. The notion Kunstangst derives from the existentialist concept of anxiety, which originates in the philosophy of Søren Kierkegaard. We hope that the transfer of this existentialist concept will provide us with a new aesthetic tool that can enable us to undo the chains of Enlightenment thought and help us approximate the intensity at the heart of aesthetic experience. Aiding us in the appropriation of such an abstract philosophical concept and its application to aesthetics, we incorporate the research of psychologist Kazimierz Dabrowski. He claims that external conflicts can evoke anxiety, which can – if properly engaged with – become transformative experiences. Following this line of reasoning in an aesthetic context, we believe that this is how the art experience can have transformative potential. (shrink)

_In _Challenging the One Best System_, a team of leading education scholars offers a rich comparative analysis of the set of urban education governance reforms collectively known as the “portfolio management model.”_ They investigate the degree to which this model—a system of schools operating under different types of governance and with different degrees of autonomy—challenges the standard structure of district governance famously characterized by David Tyack as “the one best system.” The authors examine the design and enactment of the portfolio (...) management model in three major cities: New Orleans, Los Angeles, and Denver. They identify the five interlocking mechanisms at the core of the model—planning and oversight, choice, autonomy, human capital, and school supports—and show how these are implemented differently in each city. Using rich qualitative data from extensive interviews, the authors trace the internal tensions and tradeoffs that characterize these systems and highlight the influence of historical and contextual factors as well. Most importantly, they question whether the portfolio management model represents a fundamental restructuring of education governance or more incremental change, and whether it points in the direction of meaningful improvement in school practices. Drawing on a rigorous, multimethod study, _Challenging the One Best System_ represents a significant contribution to our understanding of system-level change in education. (shrink)

In this article, we examine disability and eugenics discourses and the ways they function in spaces where vulnerable persons have been historically excluded by the state and blamed for their own “immiseration.” We ask how queer theories of repudiation, abjection, and vulnerability lend insight into the ways that people with intellectual disabilities are discursively located outside normative discourses of home, care, and quality of life, and whether these discourses shifted to serve this vulnerable population when historically the very places in (...) question repudiated them, infringed on their human rights, and questioned their sexuality. To address these questions, we focus on the recent and impending closures of Virginia’s Training Centers, residential institutions for persons with intellectual disabilities now scheduled for staggered closures before 2020. (shrink)

_The Essential Framework: Classic Film and TV Essays_ Edited by Paul Willemen and Jim Pines London: Epigraph Publications, 1998 ISBN 1902458001 258 + vi pp.

There is considerable concern that climate change will displace many people in developing countries from their homes. This article examines whether developed countries are morally obligated to assist people displaced by climate change in developing countries. The article argues that there may not be a moral duty to assist climate change migrants as a category. Nonetheless, developed countries may have duties to assist vulnerable people elsewhere and may be obligated to assist climate change migrants along with other vulnerable people. In (...) addition, there likely is a duty to assist a particular subset of climate change migrants, specifically the citizens of small island countries existentially threatened by climate change. The article concludes by assessing the implications of its moral analysis for the focus of law and policy. Instead of developing new treaties to assist climate change migrants as a number of academics and practitioners have recently proposed, law and policy should be concerned with assisting migrants at risk generally, and/or the citizens of small island countries existentially threatened by climate change. (shrink)

In a recent article, I criticized Kathrin Glüer and Åsa Wikforss's so‐called “no guidance argument” against the truth norm for belief, for conflating the conditions under which that norm recommends belief with the psychological state one must be in to apply the norm. In response, Glüer and Wikforss have offered a new formulation of the no guidance argument, which makes it apparent that no such conflation is made. However, their new formulation of the argument presupposes a much too narrow understanding (...) of what it takes for a norm to influence behaviour, and betrays a fundamental misunderstanding of the point of the truth norm. Once this is taken into account, it becomes clear that the no guidance argument fails. (shrink)

A synchronic probability is the probability at a time that an outcome occurs at that very time. Common sense invokes synchronic probabilities with values between 0 and 1, as do scientific theories such as classical statistical mechanics. Recently, philosophers have argued about whether any synchronic probabilities are best interpreted as objective chances. I add to this debate an underappreciated reason we might have to believe in synchronic chance; it might turn out that the best interpretation of our common sense and (...) scientific theories is one in which the macrophysical properties of physical systems are partly determined by synchronic chance distributions over microphysical properties of those systems. Additionally, I argue against the common charge that synchronic probability fails to satisfy various platitudes about chance—most notably Lewis’s Principal Principle. (shrink)

The psychological literature now differentiates between two types of psychopath:successful (with little or no criminal record) and unsuccessful (with a criminal record). Recent research indicates that earlier findings of reduced autonomic activity, reduced prefrontal grey matter, and compromised executive activity may only be true of unsuccessful psychopaths. In contrast, successful psychopaths actually show autonomic and executive function that exceeds that of normals, while having no difference in prefrontal volume from normals. We argue that many successful psychopaths are legally responsible for (...) their actions, as they have the executive capacity to choose not to harm (and thus are legally rational). However, many unsuccessful psychopaths have a lack of executive function that should at least partially excuse them from criminal culpability. Although a successful psychopath's increased executive function may occur in conflict with, rather than in consonance with their increased autonomic activity - producing a cognitive style characterized by self deception and articulate-sounding, but unsound reasoning - they may be capable of recognizing and correcting their lack of autonomic data, and thus can be held responsible. (shrink)

Despite its place in the humanities, the career prospects and numbers of women in philosophy much more closely resemble those found in the sciences and engineering. This book collects a series of critical essays by female philosophers pursuing the question of why philosophy continues to be inhospitable to women and what can be done to change it. By examining the social and institutional conditions of contemporary academic philosophy in the Anglophone world as well as its methods, culture, and characteristic commitments, (...) the volume provides a case study in interpretation of one academic discipline in which women's progress seems to have stalled since initial gains made in the 1980s. Some contributors make use of concepts developed in other contexts to explain women's under-representation, including the effects of unconscious biases, stereotype threat, and micro-inequities. Other chapters draw on the resources of feminist philosophy to challenge everyday understandings of time, communication, authority and merit, as these shape effective but often unrecognized forms of discrimination and exclusion. Often it is assumed that women need to change to fit existing institutions. This book instead offers concrete reflections on the way in which philosophy needs to change, in order to accommodate and benefit from the important contribution women's full participation makes to the discipline. (shrink)

Scepticism is central to Nietzsche’s philosophical project, both as a tool of criticism and, through its role in self-transformation, as a tool for responding to criticism. While its importance in his thought and its complexity have been acknowledged, exactly what kind of scepticism Nietzsche calls for still stands in need of analysis. Jessica Berry’s [Nietzsche and the Ancient Skeptical Tradition. New York: Oxford University Press, 2011] comparison between Nietzsche and Pyrrhonian scepticism recognized the importance of the practical dimension of Nietzschean (...) scepticism but distorted Nietzsche’s philosophy in attempting to paint it as Pyrrhonian in character. Earlier discussions recognize Nietzsche’s opposition to Pyrrhonian suspension of judgement and tranquillity. They have not, however, explored in sufficient detail Nietzsche’s sceptical practice and how it affects the individual. In this article, I combine Berry’s emphasis on scepticism as a practice with attention to the important differences between Nietzsche and Pyrrhonism. I outline Nietzsche’s scepticism as a transformative practice, arguing that its differences from Pyrrhonian scepticism are as illuminating as any similarities. The scepticism that Nietzsche advocates involves not just destruction of our beliefs but destruction of who we are, and at the same time as cultivating the capacity to do without certainty, requires an experimental engagement with our drives – allowing the creation of new values. (shrink)

This study is an analysis of surrogate-focused ethics consultations in the Intensive Care Unit (ICU) and the general wards (Ward) of a large community hospital in Northern California. We identified the major themes of surrogate-focused ethics consultations to better understand the root cause of surrogate conflicts, and identified the similarities and differences between surrogate-based conflicts in the two settings. Consults requested because the surrogate had desires that conflicted with the physicians medical opinion of ‘best interest’, or cases involving surrogates not (...) upholding a patient’s known values reflected the root cause of the majority of surrogate conflicts (72.7% ICU, 83.3% Ward). (shrink)

United States statistics continue to indicate that the human donor heart pool does not and will not meet the great demand for hearts. For those patients unresponsive to maximal medical therapy (approximately 60,000 patients per year), cardiac transplantation is currently their best hope for increased survival. To address the need for additional end-stage congestive heart failure (CHF) therapy options, three medical device manufacturers have developed implantable left ventricular assist devices (LVAD) which act as a pump for hemodynamic support of the (...) patient’s diseased heart. Although LVADs have been shown to improve patient disease state prior to organ transplantation. LVADs do nothing to increase the pool of human donor hearts, and they negatively impact the United Network for Organ Sharing (UNOS) waiting list by increasing the size of the waiting pool. This paper identifies and explores the ethical challenges presented by the use of LVADs as a bridging technology for heart transplant candidates. Although LVADs raise some ethical concerns, these concerns are outweighed by the proven medical efficacy of these devices. Thus, this technology should continue to be used and further developed. (shrink)

I present and develop a novel account of the schematism by reading it through the distinction between constitution and regulation. I thus show that Kant’s stipulation of only eight schemata for the twelve pure concepts of the understanding is not haphazard but answers, instead, to two distinct processes of synthesis, mathematical and dynamical, that either constitute objects in intuition or regulate objects of experience. Based on this, I offer a detailed reconstruction of each of the schemata specified by Kant, and (...) I provide an explanation of the systematic role each plays in the Analytic. (shrink)

ABSTRACTIn this article, I demonstrate how Louise Bourgeois used her artworks not only to better understand herself but also to cultivate a self capable of taking control of and reshaping the material of her past. Exploring her artworks in the context of Michel Foucault's understanding of technologies of the self, I both contribute to the appreciation of Bourgeois’ work and show how visual artworks can be used to understand, cultivate, and transform aspects of the self. Foucault's understanding of our subjectivity, (...) as formed and deployed by power tactics, suggests the need for the formation of new subjectivities as a tactic of resistance. While his view of subjectivity as contingently created allows for the possibility that it could be different, his understanding of the conditions of its creation in terms of power tactics seems to constrain the possibilities for alternative subjectivities. I argue that artworks can help us understand the contingency of our subjectivity and illustrate how something new can be created out of existing conditions, in ways that may disrupt those very conditions. Further, in addition to bringing us to an awareness of the possibility of creating new subjectivities, artworks can directly contribute to this process for both artists and audience members. Turning to Foucault's own understanding of Stoic writing practices as a means of knowing and controlling the self, I use Bourgeois’ work to illustrate how artworks can operate as technologies of the self, which work directly on the self, extending Foucault's understanding of the role of writing to consider the particular contribution that visual artworks can make. I explore how the visual form, sculptural medium, and materials of Louise Bourgeois’ works contribute to their operation as technologies of the self which can allow one to relate to oneself differently. (shrink)

ABSTRACT Both Nietzsche and Freud believe that our conscious experiences and actions are shaped by the activity of unconscious drives. Despite the significant differences in their understanding of drives and the obstacles faced uncovering them, there is sufficient common ground in their view of drives as multiple, contingent, and historically formed, to compare their methods of investigating them. For Nietzsche, solitude is essential to any project of self-knowledge, while Freud transplants the process of uncovering the activity of the drives from (...) the loneliness of a metaphorical desert to the therapeutic relationship in the consulting room, relying on the effects of transference between analyst and analysand. If drives are relational, then understanding their activity seems to require exploring them in the context of relationships. These relationships, however, may constrain the process of investigation. By contrasting the methods of Freud and Nietzsche, I highlight dangers present in both approaches. Such awareness allows us to find ways to mitigate the inevitable bias that their methods introduce. I conclude that the limitations of a purely solitary or dialogical approach to self-knowledge point to the need to employ both solitude and dialogue to explore our drives, combining a capacity for solitude with a capacity to engage. (shrink)

Patient or public involvement in health research is increasingly expected as a matter of policy. In theory, PPI can contribute both to the epistemic aims intrinsic to research, and to extrinsically valued features of research such as social inclusion and transparency. In practice, the aims of PPI have not always been clear, although there has been a tendency to encourage the involvement of so-called ordinary people who are regarded as representative of an assumed patient perspective. In this paper we focus (...) on the epistemic potential of PPI, using theoretical work in epistemology to develop a nuanced account of patients’ experiential knowledge and how this might contribute directly to conceptual development, hypothesis generation and data interpretation. We also consider how some features of health research pose barriers to this kind of epistemic contribution. Drawing on Miranda Fricker’s idea of testimonial injustice, we explore how disciplinary indicators of credibility in clinical and academic health research contexts might be wrongly applied to those involved in PPI, undermining their potential to contribute. Finally we argue for a range of strategies to maximize opportunities for patients to engage with research teams and make epistemologically significant contributions to research. (shrink)

In light of recent interest among political theorists in the idea of political realism, Judith Shklar’s liberalism of fear has come to be associated with anti-Rawlsian thought. This paper seeks to show that, on the contrary, Shklar’s specific formulation of political realism, unlike more recent variations, was not motivated by a critique of Rawls. This paper will address three concerns: first, it will show what exactly Shklar’s initial realism was responding to; second, it will consider the implications of this realism (...) for thinking about liberal democracies; third, it will attempt, briefly, in light of this, to make sense of her relationship with Rawls and, in turn, through a comparison with Bernard Williams’s thought, her relationship to anti-Rawlsian political realism. (shrink)

Does neo-Rawlsian political philosophy offer an adequate account of the social conditions of capitalism? In this paper, I present two arguments for thinking that it does not. First, I develop a historicist critique of liberal egalitarianism, arguing that it provides a vision of social reality that is intimately connected to the historical and ideological constellation that I call postwar liberalism, and as such cannot account for social reality since the neoliberal revolutions of the late twentieth century. Second, I explore arguments (...) in Marxist and critical social theory that cast liberal egalitarianism as partial, on account of its inadequate portrait of capitalist society. In surveying responses to these critiques, I argue that merely extending liberal egalitarianism into new domains to account for how contemporary circumstances have changed since the mid-twentieth century cannot address the problem of its partial view of the social world. Taking seriously the insights of critical social theory and the study of capitalism should lead to a challenge to liberal egalitarianism, not an extension of it. (shrink)

Worldwide there are currently over 1200 research studies being performed on the topic of COVID-19. Many of these involve children and adults over age 65 years. There are also numerous studies testing investigational vaccines on healthy volunteers. No research team is exempt from the pressures and speed at which COVID-19 research is occurring. And this can increase the risk of honest error as well as misconduct. To date, 33 papers have been identified as unsuitable for public use and either retracted, (...) withdrawn, or noted with concern. Asia is the source of most of these manuscripts (n=19; 57.6%) with China the largest Asian subgroup (n=11; 57.9%). This paper explores these findings and offers guidance for responsible research practice during pandemics. (shrink)

In a recent paper in this journal, Carter and Peterson raise two distinctly epistemological puzzles that arise for anyone aspiring to defend the precautionary principle. The first puzzle trades on an application of epistemic contextualism to the precautionary principle; the second puzzle concerns the compatibility of the precautionary principle with the de minimis rule. In this note, I argue that neither puzzle should worry defenders of the precautionary principle. The first puzzle can be shown to be an instance of the (...) familiar but conceptually harmless challenge of adjudicating between relevant interests to reach assessments of threats when applying the precautionary principle. The second puzzle can be shown to rely on a subtle but crucial misrepresentation of the relevant probabilities at play when applying the precautionary principle. (shrink)

OBJECTIVES: This article presents an original definition of surgical innovation and a practical tool for identifying planned innovations. These will support the responsible introduction of surgical innovations. BACKGROUND: Frameworks developed for the safer introduction of surgical innovations rely upon identifying cases of innovation; oversight cannot occur unless innovations are identified. However, there is no consensus among surgeons about which interventions they consider innovative; existing definitions are vague and impractical. METHODS: Using conceptual analysis, this article synthesizes findings from relevant literature, and (...) from qualitative research with surgeons, to develop an original definition of surgical innovation and a tool for prospectively identifying planned surgical innovations. The tool has been developed in light of feedback from health care professionals, surgeons, and policy makers. RESULTS: This definition of innovation distinguishes between variations, introduction of established interventions, and innovations in surgical techniques or use of devices. It can be applied easily and consistently, is sensitive to the key features of innovation, is prospective, and focuses on features relevant to safety and evaluation. The accompanying tool is deliberately broad so that appropriate supports may, if necessary, be provided each time that a surgeon does something "new". CONCLUSIONS: The definition presented in this article overcomes a number of practical challenges. The definition and tool will be of value in supporting responsible surgical innovation, in particular, through the prospective identification of planned innovations. (shrink)

Background: The current study was designed to examine whether ethnic-racial identity moderated the relationship between disordered eating and primary ethnic identification.Methods: Three hundred and ninety-eight undergraduate women were recruited from a large university in Hawai‘i. Participants completed the Eating Disorder Examination Questionnaire, the ERI measure, and reported their primary ethnicity as an index of ethnicity.Results: There was a significant correlation between eating concerns and centrality, r = 0.127, p < 0.05. Moderation analyses indicated that only ERI centrality moderated the predictive (...) effect of ethnicity on the importance of eating concerns, b = 0.05, t = 2.37, p = 0.018.Conclusions: The results suggest that the relationship between self-reported primary ethnicity and EDEQ scores is greater when ethnicity is more central to the individual's identity or when the in-group affect is important to an individual. Findings underscore the need for further research on the underlying mechanisms that account for the differing ways that ERI may affect eating concerns. (shrink)

Frames, i.e., recursive attribute-value structures, are a general format for the decomposition of lexical concepts. Attributes assign unique values to objects and thus describe functional relations. Concepts can be classified into four groups: sortal, individual, relational and functional concepts. The classification is reflected by different grammatical roles of the corresponding nouns. The paper aims at a cognitively adequate decomposition, particularly, of sortal concepts by means of frames. Using typed feature structures, an explicit formalism for the characterization of cognitive frames is (...) developed. The frame model can be extended to account for typicality effects. Applying the paradigm of object-related neural synchronization, furthermore, a biologically motivated model for the cortical implementation of frames is developed. Cortically distributed synchronization patterns may be regarded as the fingerprints of concepts. (shrink)

Background Medical boards and fitness-to-practice committees aim to ensure that medical students and physicians have “good moral character” and are not impaired in their practice of medicine. Method Presented here is an ethical analysis of stalking behavior by physicians and medical students, with focus on the case of Teleka Patrick, MD (a psychiatry resident practicing medicine while under a restraining order due to her alleged stalking behavior). Conclusions While a restraining order is not generally considered a criminal conviction, stalking behavior (...) is clearly unprofessional and a marker of inappropriate character and fitness, yet the reporting obligations for such matters are complex. Medical schools and training programs that fail to assess, record, and report matters of moral conduct such as this potentially allow impaired students to graduate and enter the work force (unless a robust licensing process identifies them). Patrick’s case should be a wake-up call for medical schools and medical boards to better integrate the professionalism domain into their operations. Further, the professionalism of students and doctors need to be integrated into the legal domain, so that those who are unfit to practice are, in fact, prevented from doing so. Guidance for integration is provided. (shrink)

The first ethicists of the 1970s paved the way for the three most familiar models of clinical ethics consultation: (1) a single consultant, (2) a member of a hospital ethics committee, and (3) a member of a subcommittee of a hospital ethics committee. Within the single consultant model there are (A) the lone ethicist (a member of hospital staff, working alone when consulting) and (B) the independent ethicist (a freelance, external consultant, working alone). This article discusses the structure and opportunities (...) offered by the freelance, independent ethicist model, and provides guidance for those who employ freelance, independent ethicists, as well as guidance for ethicists who are considering adopting this practice model. (shrink)

The resurgence of psychedelic research has brought with it unique ethical considerations, including the role of personal psychedelic experience among facilitators. Some have argued that personal ps...