The principle of informed consent obligates physicians to explain possible side effects when prescribing medications. This disclosure may itself induce adverse effects through expectancy mechanisms known as nocebo effects, contradicting the principle of nonmaleficence. Rigorous research suggests that providing patients with a detailed enumeration of every possible adverse event—especially subjective self-appraised symptoms—can actually increase side effects. Describing one version of what might happen (clinical “facts”) may actually create outcomes that are different from what would have happened without this information (another (...) version of “facts”). This essay argues that the perceived tension between balancing informed consent with nonmaleficence might be resolved by recognizing that adverse effects have no clear black or white “truth.” This essay suggests a pragmatic approach for providers to minimize nocebo responses while still maintaining patient autonomy through “contextualized informed consent,” which takes into account possible side effects, the patient being treated, and the particular diagnosis involved. (shrink)

Genomic research results and incidental findings with health implications for a research participant are of potential interest not only to the participant, but also to the participant's family. Yet investigators lack guidance on return of results to relatives, including after the participant's death. In this paper, a national working group offers consensus analysis and recommendations, including an ethical framework to guide investigators in managing this challenging issue, before and after the participant's death.

The concept of reproductive health promises to play a crucial role in improving health care provision and legal protection for women around the world. This is an authoritative and much-needed introduction to and defence of the concept of reproductive health, which though internationally endorsed, is still contested. The authors are leading authorities on reproductive medicine, women's health, human rights, medical law, and bioethics. They integrate their disciplines to provide an accessible but comprehensive picture. They analyse 15 cases from different countries (...) and cultures, and explore options for resolution. The aim is to equip readers to fashion solutions in their own health care circumstances, compatibly with ethical, legal and human rights principles. (shrink)

One of six commentaries on “Obesity: Chasing an Elusive Epidemic,” by Daniel Callahan, from the January‐February 2013 issue.

: The principle of equipoise traditionally is grounded in the special obligations of physician-investigators to provide research participants with optimal care. This grounding makes the principle hard to apply in contexts with limited health resources, to research that is not directed by physicians, or to non-therapeutic research. I propose a different version of the principle of equipoise that does not depend upon an appeal to the Hippocratic duties of physicians and that is designed to be applicable within a wider range (...) of research contexts and types—including health services research and research on social interventions. I consider three examples of ethically contentious research trials conducted in three different social settings. I argue that in each case my version of the principle of equipoise provides more plausible and helpful guidance than does the traditional version of the principle. (shrink)

Ongoing evaluation of a clinical ethics consultation service (ECS) allows for continuous quality improvement, a process-based, data-driven approach for improving the quality of a service. Evaluations by stakeholders involved in a consultation can provide realtime feedback about what is working well and what might need to be improved. Although numerous authors have previously presented data from research studies on the effectiveness of clinical ethics consultation, few ECSs routinely send evaluations as an ongoing component of their everyday clinical activities. The primary (...) purpose of this article is to equip and encourage others to engage in ongoing evaluation of their own ECS. Toward that end, the following resources are shared: (1) the survey tool used to gather the evaluation data, (2) the procedure used to elicit and collate responses, and (3) how the resulting data are used to support continuous quality improvement and justify the continued financial support of the ECS to hospital administration. (shrink)

Given the prevalence of emotional and psychological problems among professional psychologists, a primary concern to the field is impairment, or problems of professional competence. Graduate students, in particular, are an especially vulnerable subpopulation of mental health care professionals. Despite graduate students' heightened risk of impairment, relatively little attention has been paid in the literature to the handling of impairment in graduate students in academic training programs. Recommendations for a proactive approach to addressing impairment in trainees are discussed with respect to (...) students, supervisors, and training programs. As graduate school is the first major milestone in a therapist's development, psychologists as gatekeepers of the field of psychology must accept an ethical responsibility to appropriately monitor, acknowledge, and manage impairment among trainees. (shrink)

Most academics in philosophy departments accept that the discipline needs to change for the better. In this piece, Rebecca Buxton and Lisa Whiting offer several proposals for how to make philosophy a more inclusive place for everyone.

Thomas Reid’s epistemological ambitions are decisively at the center of his work. However, if we take such ambitions to be the whole story, we are apt to overlook the theory of mind that Reid develops and deploys against the theory of ideas. Reid’s philosophy of mind is sophisticated and strikingly contemporary, and has, until recently, been lost in the shadow of his other philosophical accomplishments. Here I survey some aspects of Reid’s theory of mind that I find most interesting. I (...) examine whether Reid is a mysterian about the mind, whether Reid has a direct realist theory of perception, and whether Reid has a higher-order, or “inner-sense,” view of consciousness. Along the way I will mention portions of the secondary literature that examine these aspects and point out whether and to what degree I part ways with the interpretations present in the literature. (shrink)

This paper explores Cézanne’s art through the lens of disability gain. Disability gain defies the ability-disability binary, which defines disability as a lack of ability, by emphasizing what is gained through different disabilities. Central to my discussion are (1) Tobin Siebers’s description of modern art as vitally and thematically disabled and (2) Rosemarie Garland-Thomson’s concept of misfitting, which allows for a phenomenological account of disability that emphasizes the depth of awareness and creative world-making possibilities that are gained through disability. By (...) bringing Siebers’s approach to disability aesthetics and Garland-Thomson’s concept of misfitting into conversation with Merleau-Ponty’s “Cézanne’s Doubt” and “Eye and Mind,” I will explain how Cézanne’s unique way of perceiving the world and capturing it in paint helps Merleau-Ponty to dismantle abstract, disembodied concepts of visual perception and trace the nuanced contours of lived perspective. In other words, what is gained through Cézanne’s disabilities is a revolutionary optics that overcomes the limitations of Cartesian optics. (shrink)

This paper suggests that the stories that thoroughbred breeders tell about racehorse reproduction can contribute to an understanding of their ideas about relatedness between humans. It examines the thoroughbred pedigree as it is presented in the English sales catalogue as a locus of complex ideas about heredity, fertility, and procreation. It argues that resistance within the industry to new reproductive technologies, including artificial insemination, can be understood in terms of ideas about relatedness between horses and, by implication, between people.This paper (...) is based upon extensive participant observation conducted within the horseracing industry based in the town of Newmarket, England. (shrink)

Background: Nonhuman animals are regularly enhanced genomically with CRISPR and other gene editing tools as scientists aim at better models for biomedical research, more tractable agricultural animals, or animals that are otherwise well suited to a defined purpose. This study investigated how genome editors and policymakers perceived ethical or policy benefits and drawbacks for animal enhancement and how perceived benefits and drawbacks are alike, or differ from, those for human genome editing. Methods: We identified scientists through relevant literature searches as (...) well as conference presentations. Policymakers were identified through rosters of genome editing oversight groups (e.g., International Commission on the Clinical Use of Human Germline Genome Editing, World Health Organization) or efforts aimed at influencing policy (e.g., deliberative democracy groups). Interviews covered participants’ views on ethical differences between interventions affecting somatic or germline cells and distinctions between using gene editing for disease treatment, prevention, and enhancement purposes. Results: Of the 92 participants interviewed, 81 were genome editing scientists, and 33 were policymakers, with 22 interviewees being both scientists and policymakers. Multiple areas were identified in which the ethical implications of genomic enhancements for nonhuman animals differ from those for human animals including with respect to experiential welfare; germline edits; environmental sustainability; and justice. Conclusions: Overall, respondents viewed that animal enhancement is unburdened by the ethical complexities of human enhancement. These views may be related to participant perceptions of animals’ lesser moral status and because germline editing in animals is common practice. (shrink)

Craig Hanks and Aili Bresnahan are contributing editors only -- not main editors.

Why has Thomas Reid’s philosophy been neglected? One answer to this question might cite Reid’s treatment by critics of his day. But Reid may also have been neglected because his terminology suggests a kind of quaint, naive dogmatism: a “philosophy of common sense” might belong to a philosopher who resists skepticism by just saying “no” to all that fancy philosophizing. Indeed, Reid tells us in the Inquiry: “I despise Philosophy, and renounce its guidance, let my soul dwell with Common Sense.” (...) But Reid’s announcement holds only if skepticism can’t be refuted, and what Reid takes himself to have done is precisely that: refute skepticism. Philip de Bary’s Thomas Reid and Scepticism: His Reliabilist Response is an admirable account of Reid’s strongly philosophical response to skepticism. (shrink)

The American Journal of Bioethics, Volume 11, Issue 9, Page 37-39, September 2011.

I provide a critical interpretation of Morgenröthe: Gedanken über die moralischen Vorurteile that identifies the key philosophical work done by Nietzsche in this text, as well as presenting the text as a type of medical narrative. I show how Nietzsche engages with three main questions, drawing thematic connections between themes of physical and psychological health and of ethics, in order to develop a foundation for his critical transvaluation project: First, what is the nature of, and relationship between psycho-physiological and cultural (...) health? Second, by which method of critical engagement may our health be diagnosed and promoted? And third, what virtues are required for such work? (shrink)

An international team of eighteen doctors, philosophers, and lawyers present a fresh and thorough discussion of the ethical, legal, and social issues raised by testing and screening for HIV and AIDS. They aim to point the way to practical advances but also to give an accessible guide for those new to the debate.

The mirror analogy in Republic X (596c-e) helps Socrates formulate the conception of mimesis used to make the argument that the painter is an imitator and his works are inferior, being thrice-removed from reality (596a-598d). The painter is classified as an impostor by an unfair assimilation with the sophistic mirror-holder. The mirror analogy and its imaging-devices give Socrates a dialectical advantage that he would not otherwise have. If Socrates succeeds with Glaucon in showing that painters are imitators, his success is (...) due primarily to the mirror analogy and its metaphorical imagery. (shrink)

Deception is an all-too-common human activity, one that succeeds because we cannot always detect it in others. It complicates all sorts of human decision-making, including attributing guilt for criminal offenses. The law relies on human fact-finders to determine whether criminal defendants claiming innocence, as well as witnesses testifying about a case, are telling the truth. But the fallibility of human lie detection has fueled the search for a more accurate replacement. Scientists have developed new approaches to lie detection that use (...) a brain scanning technique called functional magnetic resonance imaging (fMRI) to evaluate whether someone is lying. In experimental settings, researchers have found .. (shrink)

Journal of Mass Media Ethics, Volume 26, Issue 3, Page 246-249, July-September.

Book review: James Souter, Asylum as Reparation: Refuge and Responsibility for the Harms of Displacement. London: Palgrave Macmillan.

In 1997, when Oregon became the first U.S. jurisdiction authorizing medical aid in dying (MAID), its law included a requirement that patients be legal residents of the state. Other U.S. jurisdictions legalizing MAID followed Oregon in adopting residency requirements. Recent litigation challenges the legality, as well as the justification, for such requirements. Facing such challenges, Oregon and Vermont eliminated their MAID residency requirements. More states could follow this move, for, in certain circumstances, the U.S. Constitution's privileges and immunities clause protects (...) citizens’ right to travel to secure medical care. Policy considerations could also motivate states to reexamine whether such requirements are justified in light of existing evidence of how MAID laws have been applied. (shrink)

Smajdor and Rasanen (2024) argue that pregnant women are routinely denied appropriate treatment because pregnancy is seen as normal, and so they are denied ‘patient status’. They claim that formally classifying pregnancy as a disease may lead to better treatment for pregnant women. In this response, we argue that pathologising pregnancy and classifying all pregnant women as ‘diseased patients’ won’t reconfigure care in ways that benefit all women. Rather, it will likely only embolden the view that clinicians are entitled to (...) exercise jurisdiction over pregnant women and beget the increased use of medical intervention where it is not necessarily needed. (shrink)

Activists have challenged the reach of the carceral state into higher education. Whether calling out the exclusion of currently and formerly incarcerated people from higher education or the ways campus police perpetuate the racial and economic biases that plague the US criminal legal system, these voices offer insights that higher education leaders should take seriously. Yet, these challenges are often met with appeals to safety, which purport to override concerns about the harms produced by extension of the criminal legal system (...) into educational contexts. Campus safety debates offer an opportunity to examine the role of wilful ignorance in the perpetuation of systemic injustices on college and university campuses, highlighting tensions between the testimony of those challenging these systems and practices and prevailing narratives around safety. In analysing the operation of wilful ignorance in this context, we will focus on campus policing as a manifestation of carcerality in higher education. We argue that the perpetuation of policing in higher education in the USA reflects wilful White ignorance that represents both an epistemic and moral failing on the part of higher education leaders. (shrink)

This paper uses examples of conversational understandings, misunderstandings and non-understandings to explore the role of prototypes and schemata in conversational understanding. An investigation of the procedures by which we make sense of lexical items in utterances by fitting prototypes into schemata is followed by an examination of how schemata are instantiated across conversational sequences by means of topics. In interaction, conflicts over meaning illuminate the decisive role of social and cultural factors in understanding. Overall, understanding is seen to be critically (...) dependent on principles of categorisation and contrast, which form the basis of both cognitive and sociocultural means of organisation. (shrink)

In this paper we investigate the connection between forms of sustainability and masculinity through a study of everyday life in a Danish alternative slaughterhouse. In contrast to the predominant form of slaughterhouses today in Western contexts, the ‘alternative’ slaughterhouse is characterized as non-industrial in scale and articulating some form of a sustainability orientation. Acknowledging the variability of the term, we firstly explore how ‘sustainability’ is understood and practiced in this place. We then illuminate the situated manifestations of masculinities, which appear (...) predominantly- though not exclusively- hegemonic in nature. We next reflect on how the situated and particular sustainability of this site come to bear on a workplace long characterized as a masculinized site of, e.g., violence and repression, showing how the sustainability of the alternative slaughterhouse has potential to nourish alternative masculinities. We finally call for more attention at this nexus of sustainability and masculinities studies, to examine how the broad sustainability turn in food systems needs to be further examined in relation to what masculinities it perpetuates, as well as how a focus on masculinities may enhance our understanding of varying forms of sustainability, especially their potential for ecologically and socially just food systems. (shrink)

There is a strong disconnect between humans and other species in our societies. Zoos particularly expose this disconnect by displaying the asymmetry between visitors in search of entertainment, and animals often suffering from a lack of meaningful interactions and natural behaviors. In zoos, many species are unable to mate, raise young, or exhibit engagement behaviors. Enrichment is a way to enhance their quality of life, enabling them to express natural behaviors and reducing stereotypies. Prior work on sound-based enrichment and interactivity (...) suggest that a better understanding of animals’ sensory needs and giving them options to shape their surroundings can yield substantial benefits. However, current zoo management and conservation practices lack tools and frameworks to leverage innovative technology to improve animal well-being and zookeepers’ ability to care for them. Ethical considerations are called for in developing such interventions as human understanding of animals’ worlds is still limited, and assumptions can have detrimental consequences. Based on several interventions, four principles are proposed to guide a more systematic implementation of sonic enrichment in zoos. The goal is to lay the groundwork for the design of the zoos of the future, with a focus on sounds, for the benefit of the animals. (shrink)

In the literature on refugeehood in political theory, there has been a recent turn towards what have been called “state system legitimacy” views. These views derive an account of states’ obligations to refugees from a broader picture of the conditions for international legitimacy. This paper seeks to develop the state system legitimacy view of refugeehood by subjecting the most developed version of it—the account developed by David Owen—to critical scrutiny. We diagnose an ambiguity in Owen’s theory of refugeehood, in the (...) concept of political membership, and unpack the implications of this ambiguity for state system legitimacy views. First, we reconstruct the key aspects of Owen’s account of refugeehood and show how it represents an advance over competing theories. Then we discuss the methodological underpinnings of Owen’s account, showing the constraints and opportunities faced by state system legitimacy views. Next, we raise some problems for the conceptual distinctions that Owen develops between different types of refugee protection: asylum, sanctuary, and refuge. The underlying feature that leads to these problems is an ambiguity in the concept of political membership, which is at the core of Owen’s view of refugeehood. Finally, we distinguish two interpretations of political membership in the institution of refugeehood and chart out some possible ways forward for state system legitimacy views. The critique developed here is a sympathetic one, aimed at the further development of state system legitimacy views. (shrink)

Philosopher, theologian, philologist, urban sociologist, literary critic, collector, archivist, essayist, memoirist, children's author, allegorist, media theorist, hashish connoisseur, closet surrealist, theorist of fascism, professional melancholic – it is by now habitual to begin any account of Walter Benjamin's work with an inventory of the grafts and incongruities traversing his tangled maze of writings. First known through his rather fraught association with Gershom Scholem and Theodor Adorno (who were effectively responsible for the posthumous dissemination of his corpus); sometime ally and interlocutor (...) of Brecht, Kracauer, Bloch, and Buber; refugee in the Paris of Bataille and company during the 1930s: Benjamin exerts today a fascination all the more striking for its untimeliness. Adopted as spiritual soulmate and precursor of almost every major trend in contemporary Continental thought – from cultural studies to deconstruction, from psychoanalysis to new historicism, from critical theory à la Frankfurt school to poststructural linguistics, from molecular politics to death‐of‐God theology, from radical geography to phantomology, from film theory to Heideggerean hermeneutics, from Foucaultian micrology to cyberpunk aesthetics – he epitomizes that unclassifiable swirl of intellectual impulses we have come to associate with the peregrinations of Weimar culture. (shrink)