There is a growing interest in the ethics of Health Policy and Systems Research, and especially in areas that have particular ethical salience across HPSR. Hyder et al provide an initial framework to consider this, and call for more conceptual and empirical work. In this paper, we respond by examining the ethical issues that arose for researchers over the course of conducting three HPSR studies in Kenya in which health managers and providers were key participants. All three studies involved qualitative (...) work including observations and individual and group interviews. Many of the ethical dilemmas researchers faced only emerged over the course of the fieldwork, or on completion, and were related to interactions and relationships between individuals operating at different levels or positions in health/research systems. The dilemmas reveal significant ethical challenges for these forms of HPSR, and show that potential ‘solutions’ to dilemmas often lead to new issues and complications. Our experiences support the value of research ethics frameworks, and suggest that these can be enriched by incorporating careful consideration of context embedded social relations into research planning and conduct. Many of these essential relational elements of ethical practice, and of producing quality data, are given stronger emphasis in social science research ethics than in epidemiological, clinical or biomedical research ethics, and are particularly relevant where health systems are understood as social and political constructs. We conclude with practical and research implications. (shrink)

We introduce two concepts—social certainty and social doubt—that help to articulate a variety of experiences of the social world, such as shyness, self-consciousness, culture shock, and anxiety. Following Carel's (2013) analysis of bodily doubt, which explores how a person's tacit confidence in the workings of their body can be disrupted and undermined in illness, we consider how an individual's faith in themselves as a social agent, too, can be compromised or lost, thus altering their experience of what is afforded by (...) the social environment. We highlight how a loss of bodily or social certainty can be shaped and sustained by the environments in which one finds oneself. As such, we show how certain individuals might be more vulnerable to experiences of bodily and social doubt than others. (shrink)

Philosophical work exploring the relation between cognition and the Internet is now an active area of research. Some adopt an externalist framework, arguing that the Internet should be seen as environmental scaffolding that drives and shapes cognition. However, despite growing interest in this topic, little attention has been paid to how the Internet influences our affective life — our moods, emotions, and our ability to regulate these and other feeling states. We argue that the Internet scaffolds not only cognition but (...) also affect. Using various case studies, we consider some ways that we are increasingly dependent on our Internet-enabled “techno-social niches” to regulate the contours of our own affective life and participate in the affective lives of others. We argue further that, unlike many of the other environmental resources we use to regulate affect, the Internet has distinct properties that introduce new dimensions of complexity to these regulative processes. First, it is radically social in a way many of these other resources are not. Second, it is a radically distributed and decentralized resource; no one individual or agent is responsible for the Internet’s content or its affective impact on users. Accordingly, while the Internet can profoundly augment and enrich our affective life and deepen our connection with others, there is also a distinctive kind of affective precarity built into our online endeavors as well. (shrink)

Grief is, and has always been, technologically supported. From memorials and shrines to photos and saved voicemail messages, we engage with the dead through the technologies available to us. As our technologies evolve, so does how we grieve. In this paper, we consider the role chatbots might play in our grieving practices. Influenced by recent phenomenological work, we begin by thinking about the character of grief. Next, we consider work on developing “continuing bonds” with the dead. We argue that for (...) some, chatbots may play an important role in establishing these continuing bonds by helping us develop what we term “habits of intimacy”. We then turn to the “ick factor” some may feel about this prospect, focusing especially on ethical concerns raised by Patrick Stokes and Adam Buben about the risk of replacing our dead with chatbots. We argue that replacement worries are not as pressing as Stokes and Buben suggest. We resist these replacement worries by appealing to the “thin reciprocity”, as we refer to it, that such bots offer, as well as the fictionalist stance that we think users of the bots adopt when engaging with them. We conclude by briefly raising some additional concerns and highlighting future research questions. (shrink)

Stakeholder participation is an increasingly popular ingredient within environmental management and decision-making. While much has been written about its purported benefits, a question that has been largely neglected is whether decision-making informed through stakeholder participation is actually likely to yield decisions that are morally justified in their own right. Using moral methodology as a starting point, we argue that stakeholder participation in environmental decision-making may indeed be an appropriate means to produce morally justified decisions, the reason being that such participation (...) may constitute an efficient way to satisfy the standard requirements on moral reasoning and moral justification. This finding also emphasizes the importance of identifying those settings most conducive to allowing different stakeholders to both challenge each other’s arguments and to adopt each other’s perspectives in order to make effective use of participation in environmenta... (shrink)

We invite systematic consideration of the metaphors of cycles and circulation as a long-term theme in the history of the life and environmental sciences and medicine. Ubiquitous in ancient religious and philosophical traditions, especially in representing the seasons and the motions of celestial bodies, circles once symbolized perfection. Over the centuries cyclic images in western medicine, natural philosophy, natural history and eventually biology gained independence from cosmology and theology and came to depend less on strictly circular forms. As potent ‘canonical (...) icons’, cycles also interacted with representations of linear and irreversible change, including arrows, arcs, scales, series and trees, as in theories of the Earth and of evolution. In modern times life cycles and reproductive cycles have often been held to characterize life, in some cases especially female life, while human efforts selectively to foster and disrupt these cycles have harnessed their productivity in medicine and agriculture. But strong cyclic metaphors have continued to link physiology and climatology, medicine and economics, and biology and manufacturing, notably through the relations between land, food and population. From the grand nineteenth-century transformations of matter to systems ecology, the circulation of molecules through organic and inorganic compartments has posed the problem of maintaining identity in the face of flux and highlights the seductive ability of cyclic schemes to imply closure where no original state was in fact restored. More concerted attention to cycles and circulation will enrich analyses of the power of metaphors to naturalize understandings of life and their shaping by practical interests and political imaginations. (shrink)

Loneliness is a near-universal experience. It is particularly common for individuals with (so-called) psychopathological conditions or disorders. In this paper, we explore the experiential character of loneliness, with a specific emphasis on how social goods are experienced as absent in ways that involve a diminished sense of agency and recognition. We explore the role and experience of loneliness in three case studies: depression, anorexia nervosa, and autism. We demonstrate that even though experiences of loneliness might be common to many psychopathologies, (...) these experiences nevertheless have distinctive profiles. Specifically, we suggest that: (i) loneliness is often a core characteristic of depressive experience; (ii) loneliness can drive, and even cement, disordered eating practices and anorectic identity in anorexia nervosa; iii) loneliness is neither a core characteristic of autism nor a driver but is rather commonly experienced as stemming from social worlds, environments, and norms that fail to accommodate autistic bodies and their distinctive forms of life. We aim to do justice to the pervasiveness of loneliness in many — if not all — psychopathologies, while also highlighting the need to attend to psychopathology-specific experiences of loneliness, agency, and (non-)recognition. (shrink)

Book description: * Seventeen brand-new essays by leading philosophers and psychologists * Genuinely interdisciplinary work, at the forefront of both fields * Includes a valuable introduction, uniting common threads Leading philosophers and psychologists join forces to investigate a set of problems to do with agency and self-awareness, in seventeen specially written essays. In recent years there has been much psychological and neurological work purporting to show that consciousness and self-awareness play no role in causing actions, and indeed to demonstrate that (...) free will is an illusion. The essays in this volume subject the assumptions that motivate such claims to sustained interdisciplinary scrutiny. Patients with Anarchic Hand syndrome sometimes find their hands perform apparently goal-directed actions which the patients disown, yet seem to be unable to suppress (for example, reaching out for someone else's food in a restaurant). On the face of it, these patients lack the kind of control and self-awareness we ordinarily take ourselves to have when acting intentionally. Questions raised by this phenomenon include: What is involved in being aware of an action as one's own? What is the nature of the control these patients are lacking and which characterizes normal intentional actions? What is the relation between a priori explanations of consciousness and self-consciousness, on the one hand, and empirical work on the information-processing mechanisms involved in action control, on the other? Questions of action control and self-awareness tend to be treated separately in both philosophy and psychology. The central idea behind this volume is that outstanding unresolved issues on both topics, and in both disciplines, can only be resolved by an interdisciplinary examination of the relations between them. The editors' useful introductory essay offers a guide to cross-disciplinary reading of the contributions, and makes connections between them explicit. The book will be compulsory reading for psychologists and philosophers working on action explanation, and for anyone interested in the relation between the brain sciences and consciousness. (shrink)

Though explicit references to music are infrequent in Barthes's Collège de France lectures, Barthes's use of music in other work from the 1970s makes it clear that music can act as a fruitful analogy in consideration of the text. This article uses the serialist or atonal analogy, as set up by Barthes in ‘From Work to Text’ and elsewhere, to examine the structuring of Comment vivre ensemble and The Neutral. In viewing these courses as serial or open works we can, (...) it is hoped, arrive at a fuller understanding of their methodology and the role they ascribe to the listener or reader. The atonal analogy, however, is left behind in 1978, as Barthes's major projects employ more conventional, developmental structuring. It is here, then, that the analogy with tonality, again suggested by Barthes, can be usefully employed. (shrink)

Lucy F. O'Brien; XII*—The Problem of Self-Identification, Proceedings of the Aristotelian Society, Volume 95, Issue 1, 1 June 1995, Pages 235–252, https://doi.o.

Freedom of conscience is a core element of human rights respected by most European countries. It allows abortion through the inclusion of a conscience clause, which permits opting out of providing such services. However, the grounds for invoking conscientious objection lack clarity. Our aim in this paper is to take a step in this direction by carrying out a systematic review of reasons by midwives and nurses for declining, on conscience grounds, to participate in abortion. We conducted a systematic review (...) of ethical arguments asking, “What reasons have been reported in the argument based literature for or against conscientious objection to abortion provision by nurses or midwives?” We particularly wanted to identify any discussion of the responsibilities of midwives and nurses in this area. Search terms were conscientious objection and abortion or termination and nurse or midwife or midwives or physicians or doctors or medics within the dates 2000–2016 on: HEIN legal, Medline, CINAHL, Psychinfo, Academic Search Complete, Web of Science including publications in English, German and Dutch. Final articles were subjected to a rigorous analysis, coding and classifying each line into reason mentions, narrow and broad reasons for or against conscientious objection. Of an initial 1085 articles, 10 were included. We identified 23 broad reasons, containing 116narrow reasons and 269 reason mentions. Eighty one narrow reasons argued in favour of and 35 against conscientious objection. Using predetermined categories of moral, practical, religious or legal reasons, “moral reasons” contained the largest number of narrow reasons. The reasons and their associated mentions in this category outnumber those in the sum of the other three categories. We identified no absolute argument either for or against conscientious objection by midwives or nurses. An invisibility of midwives and nurses exists in the whole debate concerning conscientious objection reflecting a gap between literature and practice, as it is they whom WHO recommend as providers of this service. While the arguments in the literature emphasize the need for provision of conscientious objection, a balanced debate is necessary in this field, which includes all relevant health professionals. (shrink)

DNA repetitions may provoke heterochromatinization. We explore here a model in which multiple cis‐acting sequences that display no silencing activity on their own (protosilencers) may cooperate to establish and maintain a heterochromatin domain efficiently. Protosilencers, first defined in budding yeast, have now been found in a wide range of genomes where they appear to stabilize and to extend the propagation of heterochromatin domains. Strikingly, isolated or moderately repeated protosilencers can also be found in promoters where they participate in transcriptional activation (...) and have insulation functions. This suggests that the proper juxtaposition of a threshold number of protosilencers converts them from neutral or transactivating elements into ones that nucleate heterochromatin. Interactions might be transient or permanent, and are likely to occur over distances by looping. This model provides a conceptual framework for as varied phenomena as telomere‐driven silencing in Drosophila, X inactivation in mammals, and rDNA silencing in S. cerevisiae. It may also account for the silencing that occurs when multiple copies of a transgene are inserted in tandem. BioEssays 24:828–835, 2002. © 2002 Wiley Periodicals, Inc. (shrink)

The ‘new normality’ of food crises requires nuanced understandings of emergent responses. Through an exploratory analysis of public-facing reports from major food governance actors, this study empirically outlines mainstream solution frames for addressing the contemporary food crisis and the ways in which these differ from the 2008 food crisis. Using food regime theory as the theoretical underpinning, four con­sistently used solution frames are identified that provide insight into the organizing principles of the third food regime: promoting trade liberalization, emphasizing agricultural (...) productivism, mobilizing private finance, and leveraging data. The latter two involve recent shifts in governance responses that shape global food governance and impact global food insecurity in novel ways. (shrink)

My aim in this paper is to articulate further what may be called an agency theory of self-knowledge. Many theorists have stressed how important agency is to self- knowledge, and much work has been done drawing connections between the two notions.² However, it has not always been clear what _epistemic_ advantage agency gives us in this area and why it does so. I take it as a constraint on an adequate account of how a subject knows her own mental states (...) and acts, that it construe the known mental states and acts realistically and as independent of their self-ascription, and that it deliver genuine epistemic standing to the knower. The main task of the paper will, then, be to explore how our having rational agency with respect to our mental states may be able to secure genuine epistemic warrant for our self-ascriptions of states or acts independent of the ascriptions. This task will be carried out by focussing on the question of what account we should give of our knowledge of what I call our acts of judging. In the remainder of this section, I will do a little to clarify what is meant by that question. Section 2 will attempt to introduce us to elements of the best way to approach the question by considering some alternative strategies. Section 3 is devoted to forming some idea of what _kind_ of warrant we are looking for when considering how agency might give us self-knowledge. Section 4 aims to present a suggestion as to how agency gives us the kind of warrant identified over our acts of judging. Section 5 deals with some objections. (shrink)

Research in the philosophy of addiction commonly explores how agency is impacted in addiction by focusing on moments of apparent loss of control over addictive behavior and seeking to explain how such moments result from the effects of psychoactive substance use on cognition and volition. Recently, Glackin et al. (2021) have suggested that agency in addiction can be helpfully analyzed using the concept of affordances. They argue that addicted agents experience addiction-related affordances, such as action possibilities relating to drugs, drug (...) paraphernalia, and drug-related activities, as aberrantly salient motivations for action. Building on this approach, we present a novel two-tiered affordance model of addiction. In doing so, we suggest that what is significant about the addicted person’s world is not simply what affordances are experienced as salient, but also the way in which the addicted person’s world is shaped by a dominant concern. It is not only that addiction-related affordances become more prominent as addiction progresses but that one’s plurality of concerns become monopolized by and funneled through addiction. Our model endorses Glackin et al.’s idea that addiction-related affordances become aberrantly salient, while proposing why they become and remain so. This way of viewing agency in addiction also brings to light important implications for recovery and treatment. For, if an addicted person adopts a new, even “socially approved”, dominant concern, there is a risk that the shape of addiction is preserved, even though the content changes, leaving an individual at the risk of addiction substitution or relapse. (shrink)

In this paper I am going to argue that we should take actions to be prime. This will involve clarifying what it means to claim that actions are prime. I will consider Williamson's construal of actions as prime in a way that parallels his treatment of knowledge. I will argue that we need to be careful about treating our actions in the way suggested because of an internal relation between the success condition of an action and the action itself; a (...) parallel relation does not hold for most cases of knowledge. (shrink)

Kristiansen's "Feeling like a perpetual outsider: relationality in Social Anxiety Disorder" offers a valuable analysis of loneliness within social anxiety disorder (SAD). Although phenomenological psychopathology has given extensive attention to conditions like schizophrenia, depression, and disordered eating, a more nuanced phenomenological examination of SAD is needed (Bortolan, 2023; Tanaka, 2020; Trigg, 2016). Kristiansen's work addresses this deficit and contributes to broader philosophical and phenomenological discussions of loneliness, including recent work on loneliness within psychopathology (e.g., Krueger et al., 2023; Motta, 2021; (...) Roberts & Krueger, 2021; Seemann, 2022). We propose that first-person narratives illuminate two additional, phenomenologically and clinically relevant aspects: bodily doubt and experiences of absence. Understanding these aspects enriches our descriptive understanding of SAD and potentially informs more effective treatment strategies. (shrink)

This paper argues that Gareth Evans' treatment of first person reference based on the myriad ways we have of receiving information about our bodies and location, cannot secure the guaranteed reference exhibited by first person reference. It faces a problem both when a subject fails to receive such information about herself, and when she receives misinformation.

BackgroundDespite its ubiquity in academic research, the phrase ‘ethical challenge(s)’ appears to lack an agreed definition. A lack of a definition risks introducing confusion or avoidable bias. Conceptual clarity is a key component of research, both theoretical and empirical. Using a rapid review methodology, we sought to review definitions of ‘ethical challenge(s)’ and closely related terms as used in current healthcare research literature.MethodsRapid review to identify peer-reviewed reports examining ‘ethical challenge(s)’ in any context, extracting data on definitions of ‘ethical challenge(s)’ (...) in use, and synonymous use of closely related terms in the general manuscript text. Data were analysed using content analysis. Four databases (MEDLINE, Philosopher’s Index, EMBASE, CINAHL) were searched from April 2016 to April 2021.Results393 records were screened, with 72 studies eligible and included: 53 empirical studies, 17 structured reviews and 2 review protocols. 12/72 (17%) contained an explicit definition of ‘ethical challenge(s), two of which were shared, resulting in 11 unique definitions. Within these 11 definitions, four approaches were identified: definition through concepts; reference to moral conflict, moral uncertainty or difficult choices; definition by participants; and challenges linked to emotional or moral distress. Each definition contained one or more of these approaches, but none contained all four. 68/72 (94%) included studies used terms closely related to synonymously refer to ‘ethical challenge(s)’ within their manuscript text, with 32 different terms identified and between one and eight different terms mentioned per study.ConclusionsOnly 12/72 studies contained an explicit definition of ‘ethical challenge(s)’, with significant variety in scope and complexity. This variation risks confusion and biasing data analysis and results, reducing confidence in research findings. Further work on establishing acceptable definitional content is needed to inform future bioethics research. (shrink)

Forty years have passed since video-games were first made widely available to the public and subsequently playing games has become a favorite past-time for many. Players continuously engage with dynamic visual displays with success contingent on the time-pressured deployment, and flexible allocation, of attention as well as precise bimanual movements. Evidence to date suggests that both brief and extensive exposure to video-game play can result in a broad range of enhancements to various cognitive faculties that generalize beyond the original context. (...) Despite promise, video-game research is host to a number of methodological issues that require addressing before progress can be made in this area. Here an effort is made to consolidate the past 30 years of literature examining the effects of video-game play on cognitive faculties and, more recently, neural systems. Future work is required to identify the mechanism that allows the act of video-game play to generate such a broad range of generalized enhancements. (shrink)

The twelve specially written essays in this volume investigate the neglected topic of mental action, and show its importance for the metaphysics, epistemology, and phenomenology of mind. The essays investigate what mental actions are, how we are aware of them, and what is the relationship between mental and physical action.

This volume is devoted entirely to exploring the role of animals in the thought of Immanuel Kant. Leading scholars address questions regarding the possibility of objective representation and intentionality in animals, the role of animals in Kant's scientific picture of nature, the status of our moral responsibilities to animals' welfare, and more.

In 2008 UK legislation was amended to enable the use of deferred consent for paediatric emergency care (EC) trials in recognition of the practical and ethical difficulties of obtaining prospective consent in an emergency situation. However, ambiguity about how to make deferred consent acceptable to parents, children and practitioners remains. In particular, little is known about practitioners’ views and experiences of seeking deferred consent in this setting.