Our aim in this article is to bring some clarity to the clinical ethics expertise debate by critiquing and replacing the taxonomy offered by the Core Competencies report. The orienting question for our taxonomy is: Can clinical ethicists offer justified, normative recommendations for active patient cases? Views that answer “no” are characterized as a “negative” view of clinical ethics expertise and are further differentiated based on (a) why they think ethicists cannot give justified normative recommendations and (b) what they think (...) ethicists can offer, if they cannot offer recommendations. Views that answer “yes” to the orienting question are characterized as a “positive” view of clinical ethics expertise. Positive views are distinguished according to four additional questions. First (P1), how are those recommendations generated? Second (P2), what is the nature of the recommendations? Third (P3), we ask, how are the recommendations justified? And finally (P4), how are the recommendations communicated? (shrink)

Even though music and visual art have often been performed or installed together in the same places, sound-as-art entered the gallery space only after composers explored the idea of visualizing music, encouraging artists to use scores, sounds, and noises as plastic material. While it’s true that sound poetry was practiced by Futurist and Dadaist artists in the late nineteenth century1 and that Marcel Duchamp was working with the musical score from as early as 1913,2 it took almost another forty years, (...) and the work of avant-garde composers such as John Cage, to open up the definition of music and push sound towards visual art.The story is familiar: In 1952, with the first... (shrink)

In this paper we suggest a revisionist perspective on two significant figures in early modern life science and philosophy: William Harvey and John Locke. Harvey, the discoverer of the circulation of the blood, is often named as one of the rare representatives of the ‘life sciences’ who was a major figure in the Scientific Revolution. While this status itself is problematic, we would like to call attention to a different kind of problem: Harvey dislikes abstraction and controlled experiments (aside from (...) the ligature experiment in De Motu Cordis), tends to dismiss the value of instruments such as the microscope, and emphasizes instead the privileged status of ‘observed experience’. To use a contemporary term, Harvey appears to rely on, and chiefly value, ‘tacit knowledge’. Secondly, Locke’s project is often explained with reference to the image he uses in the Epistle to the Reader of his Essay, that he was an “underlabourer” of the sciences. In fact, despite the significant medical phase of his career, Locke’s ‘empiricism’ turns out to be above all a practical (i.e. ‘moral’) project, which focuses on the delimitation of our powers in order to achieve happiness, and rejects the possibility of naturalizing knowledge. When combined, these two cases suggest a different view of some canonical moments in early modern natural philosophy. (shrink)

Attuned to sonic, aesthetic, and sensory modes of experience, and directed particularly to explore the implications of sound as it informs political thought and actions, in 2021, I began investigating Jerusalem’s soundscape. Following Jean-Luc Nancy’s argument that our perception is impacted by the subjectivity of listening, I invited a group of Palestinian and Israeli artists to work with me on this project, hoping to capture the multiple soundscapes this city offers to its residents, visitors, and passers-by. In this essay, I (...) examine two of the group's projects: “Listening Walks in Jerusalem,” an online sonic archive open for anyone to listen to and download; and “Scores for Social Acoustics in Jerusalem,” an anthology of suggested listening paths in the city. I suggest that these artistic acts succeeded in capturing a range of sonic experiences of Jerusalem and may even have gone beyond Nancy’s words to provide tangible methods for listening to a sound event and hearing it (almost) the same. (shrink)

ABSTRACT Nationalism developed in Iraq before the creation of the modern state. As elsewhere, the basic European idea of modern nationalism took root quickly and widely, but it took the form of Arab/iraqi nationalism and Kurdish proto‐nationalism in the first decade of state formation. Shi‘i, Sunni, and leftist/liberal variants of nationalism evolved in the decades that followed—but all were forms of Iraqi nationalism, in which the legitimacy of the Iraqi state was taken for granted. Those who assumed that religious differences (...) would be fatal to the viability of the Iraqi state have overlooked the evolution of Iraqis’ senses of identity, and the power of nationalist identification. (shrink)

This article argues that while the presence and influence of “futility” as a concept in medical decision-making has declined over the past decade, medicine is seeing the rise of a new concept with similar features: suffering. Like futility, suffering may appear to have a consistent meaning, but in actuality, the concept is colloquially invoked to refer to very different experiences. Like “futility,” claims of patient “suffering” have been used (perhaps sometimes consciously, but most often unconsciously) to smuggle value judgments about (...) quality of life into decision-making. And like “futility,” it would behoove us to recognize the need for new, clearer terminology. This article will focus specifically on secondhand claims of patient suffering in pediatrics, but the conclusions could be similarly applied to medical decisions for adults being made by surrogate decision-makers. While I will argue that suffering, like futility, is not sufficient wholesale justification for making unilateral treatment decisions, I will also argue that claims of patient suffering cannot be ignored, and that they almost always deserve some kind of response. In the final section, I offer practical suggestions for how to respond to claims of patient suffering. (shrink)

Whether adolescents should be allowed to make their own medical decisions has been a topic of discussion in bioethics for at least two decades now. Are adolescents sufficiently capacitated to make their own medical decisions? Is the mature-minor doctrine, an uncommon legal exception to the rule of parental decision-making authority, something we should expand or eliminate? Bioethicists have dealt with the curious liminality of adolescents—their being neither children nor adults—in a variety of ways. However, recently there has been a trend (...) to rely heavily, and often exclusively, on emerging neuroscientific and psychological data to answer these questions. Using data from magnetic resonance imaging and functional MRI studies on the adolescent brain, authors have argued both that the adolescent brain isn't sufficiently mature to broadly confer capacity on this population and that the adolescent brain is sufficiently mature to assume adolescent capacity. Scholars then accept these data as sufficient for concluding that adolescents should or should not have decision-making authority. Two critical mistakes are being made here. The first is the expectation that neuroscience or psychology is or will be able to answer all our questions about capacity. The second, and more concerning, mistake is the conflation of decision-making capacity with decision-making authority. (shrink)

Introduction : up against Carl Schmitt -- An afterlife for Carl Schmitt? -- On politics, law and ideology -- Mobilising direct political action: Sorel, myths and counter-myths -- Myths of parliamentarism -- Leviathan : a political myth misfired? -- Hamlet as an instructive prototype of a political myth? -- Political myths underpinning democracy.

I will argue in what follows that the reading of Smith which attributes to him a theory of the transition from feudalism to capitalism, and the implications which follow from it, are unfounded. There are three key aspects of the interpretation which I will challenge. First, that Smith's account of the destruction of feudal power by the progress of commerce is related to an explanation of the transition to the commercial stage; second, that the decline in baronial power incorporates Smith's (...) account of the ending of serfdom and a change in relations of production in the Marxian sense; and third, that the rise of international commerce -- the �prime-mover� in the whole process, is a force which is external to European feudalism. (shrink)

Cases like Mr. Walker’s are distressing, and for good reason. The Supreme Court has given clear moral and legal reasons to distinguish life-saving treatment refusal from suicide, and physicians are...

In lieu of an abstract, here is a brief excerpt of the content:Introduction to the Special Issue on Pediatric Decision-MakingErica K. SalterUnlike in the traditional decisional dyad in adult-based care, pediatric decision-making typically involves a triadic relationship among the patient, their parents, and the health-care providers. This complex relationship raises questions and concerns regarding each party’s expectations, obligations, and authority. For example, should a parent be allowed to withhold a poor diagnosis from an adolescent patient? Should an HLA-matched six-year-old sister (...) be permitted to serve as a bone marrow donor for her older sibling with lysosomal storage disease? Or, should parents be given decisional authority to consent to gender-affirming care for an adolescent with gender dysphoria? Cases like these are among the most ethically challenging decisions faced by parents and health-care providers because they present competing interests and values, and it’s not always clear what is in the best interests of the child.In the context of American medicine, the best interest standard has been identified as the primary ethical and legal guide for decision-making. In its most prominent form, the best interest standard requires parents and pediatric practitioners to choose the medical treatment that maximizes benefits and minimizes harms to the particular child in question. However, over the past few decades, the standard has come under significant scrutiny, with discussions and debate in the academic bioethics literature asking whether the standard is able to serve the [End Page 181] purposes it is thought to serve and whether alternative standards might be better suited to the task(s). Despite vigorous interest in these issues, the academic literature did not seem to generate any sense of identifiable consensus about how others ought to make health-care decisions on behalf of children.Thus, in June 2022, 17 scholar-experts on pediatric decision-making standards gathered in St. Louis, MO, for a three-day symposium of discussion and consensus-building. The participating authors represented different disciplinary perspectives and different viewpoints in the debate about guidance principles that underlie pediatrics. Despite apparent disagreement about such standards in the literature, the group was able to generate a set of six consensus-based recommendations (see Table 1) for pediatric decision-making. These recommendations, as well as their application, justification, and limitations, were published as a special article in Pediatrics in August 2023 (Salter et al. 2023), which was composed with the primary goals of accessibility, teachability, and implementability for practicing pediatric clinicians. Click for larger view View full resolutionTable 1.Six consensus recommendations for pediatric decision-makingWhile the group was able to find agreement about these six central principles of pediatric decision-making, there remained several related issues that were outside of the scope of the symposium aims. For example, should these recommendations apply to neonates, children in state custody, or adolescents, and if so, how would their application be operationalized? What specific conditions should justify state intervention on parental authority? How should parents and health-care providers think about obligations to siblings in health-care decisions? This [End Page 182] special issue of Perspectives in Biology and Medicine provides a forum for our authors and collaborators to further explore these, and other, important questions.The issue opens with a piece by the symposium organizers and editors of this special issue, Erica Salter, Lainie Friedman Ross, and D. Micah Hester, describing the symposium’s inspiration and design, its execution, and the implications it might have for pediatric ethics. This contribution compares the six symposium recommendations with existing statements about pediatric decision-making, in particular the statements developed by the American Academy of Pediatrics (AAP). In “How We Found Consensus on Pediatric Decision-Making and Why It Matters,” readers will find a detailed account of the process engaged to develop the six consensus-based recommendations, as well as a discussion of the value and limitations of such a process, which may serve as a model of consensus-building useful for other unsettled topics of interest in the bioethics community.The issue’s second article, “Childhood Interests: What They Are, and Why It Matters,” by Johan Bester and Jeffrey Blustein, dives into the conceptual foundation of the symposium’s first two recommendations. This... (shrink)

How we experience space by listening: the concepts of aural architecture, with examples ranging from Gothic cathedrals to surround sound home theater. We experience spaces not only by seeing but also by listening. We can navigate a room in the dark, and "hear" the emptiness of a house without furniture. Our experience of music in a concert hall depends on whether we sit in the front row or under the balcony. The unique acoustics of religious spaces acquire symbolic meaning. Social (...) relationships are strongly influenced by the way that space changes sound. In Spaces Speak, Are You Listening?, Barry Blesser and Linda-Ruth Salter examine auditory spatial awareness: experiencing space by attentive listening. Every environment has an aural architecture.The audible attributes of physical space have always contributed to the fabric of human culture, as demonstrated by prehistoric multimedia cave paintings, classical Greek open-air theaters, Gothic cathedrals, acoustic geography of French villages, modern music reproduction, and virtual spaces in home theaters. Auditory spatial awareness is a prism that reveals a culture's attitudes toward hearing and space. Some listeners can learn to "see" objects with their ears, but even without training, we can all hear spatial geometry such as an open door or low ceiling. Integrating contributions from a wide range of disciplines—including architecture, music, acoustics, evolution, anthropology, cognitive psychology, audio engineering, and many others—Spaces Speak, Are You Listening? establishes the concepts and language of aural architecture. These concepts provide an interdisciplinary guide for anyone interested in gaining a better understanding of how space enhances our well-being. Aural architecture is not the exclusive domain of specialists. Accidentally or intentionally, we all function as aural architects. (shrink)

The global development of human embryonic stem cell science and its therapeutic applications are dependent on the nature of its engagement at national and international levels with key cultural values and beliefs concerning the moral status of the early human embryo. This article argues that the political need to reconcile the promise of new health technologies with the cultural costs of scientific advance, dependent in this case on the use of the human embryo, has been met by the evolution of (...) bioethics as a political community, transnational network, and bureaucratic device. Bioethics has become the political means for the creation of a global moral economy where the trading and exchange of values is normalized and legitimated. As a result of such trading, value compromises are produced capable of legitimizing the regulatory policies necessary for maintaining public trust in the new science. (shrink)

The siren call of individualism is compelling. And although we have recognized its dangerous allure in the realm of adult decision-making, it has had profound and yet unnoticed dangerous effects in pediatric decision-making as well. Liberal individualism as instantiated in the best interest standard conceptualizes the child as independent and unencumbered and the goal of child rearing as rational autonomous adulthood, a characterization that is both ontologically false and normatively dangerous. Although a notion of the individuated child might have a (...) place in establishing a threshold of care obligated and enforced by the state, beyond this context we should turn our attention more explicitly to the relational interests of children. (shrink)

An investigation into what happens in creative practice when the materials of art and research behave and perform in ways beyond the creators' intentions. In Alien Agency, Chris Salter tells three stories of art in the making. Salter examines three works in which the materials of art—the “stuff of the world”—behave and perform in ways beyond the creator's intent, becoming unknown, surprising, alien. Studying these works—all three deeply embroiled in and enabled by science and technology—allows him to focus (...) on practice through the experiential and affective elements of creation. Drawing on extensive ethnographic observation and on his own experience as an artist, Salter investigates how researcher-creators organize the conditions for these experimental, performative assemblages—assemblages that sidestep dichotomies between subjects and objects, human and nonhuman, mind and body, knowing and experiencing. Salter reports on the sound artists Bruce Odland and Sam Auinger (O+A) and their efforts to capture and then project unnoticed urban sounds; tracks the multi-year project TEMA (Tissue Engineered Muscle Actuators) at the art research lab SymbioticA and its construction of a hybrid “semi-living” machine from specially grown mouse muscle cells; and describes a research-creation project (which he himself initiated) that uses light, vibration, sound, smell, and other sensory stimuli to enable audiences to experience other cultures' “ways of sensing.” Combining theory, diary, history, and ethnography, Salter also explores a broader question: How do new things emerge into the world and what do they do? (shrink)

I build on Christoyannopoulous’s compendium of Christian anarchist thought to shed light on the divergence between Christian anarcho-communitarians and Christian anarcho-capitalists. The anarcho-communitarians believe the institution of private property is contrary to the Word of Christ, while the anarcho-capitalists hold it is justifiable. I show that the anarcho-communitarians misunderstand the nature of property, rendering them unable to reconcile an apparent contradiction between Christ’s command to renounce violence and His violent cleansing of the temple. The Christian anarcho-capitalists, drawing upon the philosophy (...) of natural law, face no such difficulty. Although their position is far from unassailable, the Christian anarcho-capitalist paradigm is currently the only theoretically consistent interpretation, and will remain so unless the Christian anarcho-communitarians can discover and advance a new theoretical framework. (shrink)

Carl Schmitt, an increasingly influential German law professor, developed a provocative and historically oriented model of “political theology” with specific relevance to legal scholarship and the authorship of constitutional texts. His “political theology” is best understood neither as an expressly theological discourse within constitutional law, nor as a uniquely legal discourse shaped by a hidden theological agenda. Instead, it addresses the possibility of the continual resurfacing of theological ideas and beliefs within legal discourses of, for instance, sovereignty, the force of (...) law and states of emergency (or “exception”) that present themselves as relentlessly secular, even—in the case of Kelsenian jurisprudence—”scientific”. This article illustrates and then critically evaluates Schmitt’s theory in terms of the authorship of constitutional texts in particular. It includes two case studies—genocidal colonial land appropriation and Kelsenian positivism in order to illustrate aspects of his political theology. Whilst Schmitt is defended against reductionist interpretations, I show that there remains considerable unfinished business before a Schmittian approach to legal theory merits full acceptance. (shrink)

Grotius argued that it was sometimes permissible to excuse from punishment those who commit crimes out of extreme poverty. The grounds for doing so were separate from the grounds of the right of necessity. Leniency was possible because the seriousness of the crime and the degree of guilt of the offender were separate considerations. Punishment should be related to guilt, which, according to Grotius, was partly a matter of the circumstances and motives of the offender. He thought there were some (...) circumstances, such as extreme poverty, which people cannot be reasonably expected to endure. Smith's retributivist theory ruled out the possibility of moderating punishment for crimes committed out of extreme poverty. Justice requires the self-command to endure our personal hardships rather than harm the innocent. Smith was optimistic about the capacity of people to endure harsh conditions and also about the possibility of improving them. (shrink)

Originally published in 1933, this book presents the content of the Alfred Marshall Lectures for that year, which were delivered by Sir Arthur Salter at Cambridge University. The text sets out Salter's vision regarding the fundamental components of an ordered society. This book will be of value to anyone with an interest in political philosophy and the nature of statehood.

With a selection of essays chosen from a wide range of possible candidates this collection strikes an optimal balance between direct relevance to controversies and rigorous contributions from Hegelian scholarship with regard to Hegel and the law.

This paper suggests looking at cuisines of poverty as practical and political systems practiced by urban and rural Palestinian citizens of Israel. It is an important and interesting case study within which political and economical considerations govern and enhance the development, change, and acceptance of culinary knowledge. Cuisines of poverty operate in two simultaneous arenas. As systems of practical knowledge, they repeatedly center on the ability to maintain the traditional kitchen, turning it into a tool-kit out of which information is (...) recruited upon need. Simultaneously, cuisines of poverty reveal the inter-connection between the culinary discourse and the political one. It is where issues such as access to land, national and ethnic identity, and means to participation in the dominant culture are of major concern. The analysis of cuisines as operating on two complementary discourses contributes to the understanding of the relationship between food and the arena of power. (shrink)

Empathy is commonly regarded as an essential attribute for doctors and there is a conviction that empathy must be taught to medical students. Yet it is not clear exactly what empathy is, from a philosophical or sociological point of view, or whether it can be taught. The meaning, role and relevance of empathy in medical education have tended to be unquestioningly assumed; there is a need to examine and contextualise these assumptions. This paper opens up that debate, arguing that ‘empathy’, (...) as it is commonly understood, is neither necessary nor sufficient to guarantee good medical or ethical practice. (shrink)