One of the most pervasive messages in modern advertising, both public and private, is that good health is something to strive for. Thus, the condition of our bodies and how the medical fraternity can impact on us is never far from our thoughts. Central to this interaction between doctor, patient, and society is a core group of terms that frame our discussions of sickness and health. Of particular interest to philosophers of medicine, the way we use and recognise the differences (...) between these terms has implications for how we decode the medical encounter. In this essay, three terms, disease, illness, and symptoms will be analysed to develop an argument for the continued separation and appreciation of them as distinct, although imbricated, concepts crucial to the performance of modern medicine. (shrink)

It is a truism that humans are social animals. Thus, it is no surprise that we understand the world, each other, and ourselves in terms of social kinds such as money and marriage, war and women, capitalists and cartels, races, recessions, and refugees. Social kinds condition our expectations, inform our preferences, and guide our behavior. Despite the prevalence and importance of social kinds, philosophy has historically devoted relatively little attention to them. With few exceptions, philosophers have given pride of place (...) to the kinds studied by the natural sciences, especially physics. However, philosophical interest in social kinds is growing in recent years. I critically examine answers to a cluster of related questions concerning the metaphysics of social kinds. Are social kinds natural kinds? Do social kinds have essences? Are social kinds mind dependent? Are social kinds real? (shrink)

This paper is an exploration of the Thomistic vice of despair, one of two vices opposed to the theological virtue of hope. Aquinas's conception of despair as a vice, and a theological vice in particular, distances him from contemporary use of the term "despair" to describe an emotional state. His account nonetheless yields a compelling psychological portrait of moral degeneration, which I explain via despair's link to its "root," the capital vice of sloth. Cases in which sloth and its offspring (...) vices progress into full-fledged despair raise intersecting issues about whether and how despair might be remediable. I conclude by considering puzzles regarding despair's disordered effects on the intellect and will and weighing three possible means of remedying it. (shrink)

Stanley Klein and Shaun Nichols describe the case of patient R.B., whose memories lacked the sense of “mineness” usually conveyed by memory. Klein and Nichols take R.B.’s case to show that the sense of mineness is merely a contingent feature of memory, which they see as raising two problems for memory-based accounts of personal identity. First, they see it as potentially undermining the appeal of memory-based accounts. Second, they take it to show that the conception of quasi-memory that underpins many (...) memory-based accounts is inadequate. I argue that Klein and Nichols’ characterization of R.B.’s experience is implausible; as a result, the problems that they describe for memory-based accounts of personal identity do not arise. (shrink)

Many countries are experiencing increasing levels of demand for access to assisted reproductive technologies. Policies regarding who can access ART and with what support from a collective purse are highly contested, raising questions about what state responses are justified. Whilst much of this debate has focused on the status of infertility as a disease, we argue that this is something of a distraction, since disease framing does not provide the far-reaching, robust justification for state support that proponents of ART seem (...) to suppose. Instead, we propose that debates about appropriate state responses should consider the various implications for health and broader well-being that may be associated with difficulties starting a family. We argue that the harms and disruption to valued life projects of subfertility-related suffering may provide a stronger basis for justifying state support in this context. Further, we suggest that, whilst ART may alleviate some of the harm resulting from subfertility, population-level considerations can indicate a broader range of interventions aimed at tackling different sources of subfertility-related harm, consistent with broader public health aims. (shrink)

How do teenage girls articulate sexism in an era where gender injustice has been constructed as a thing of the past? Our article addresses this question by qualitatively exploring Canadian girls’ experiences of being caught between the postfeminist belief that gender equality has been achieved and the realities of their lives in school, which include incidents of sexism in their classrooms, their social worlds, and their projected futures. This analysis takes place in relation to two celebratory postfeminist narratives: Girl Power, (...) where girls are told they can do, be, and have anything they want, and Successful Girls, where girls are told they are surpassing boys in schools and workplaces. We argue that these postfeminist narratives have made naming sexism in schools difficult for girls because they are now seen to “have it all.” Utilizing Foucault’s law of the tactical polyvalence of discourse, this article analyzes girls’ contradictory engagement with postfeminism in order to both show its importance in girls’ lives, and its instability as a narrative that can adequately explain gender injustice. (shrink)

When Sandra Harding called for an epistemology of science whose systematic attention to the gendered Status of epistemic agents renders it ‘less partial and distorted’ than ‘traditional’ epistemologies, some commentators recoiled in horror. Propelled by ‘a mad form of the genetic fallacy’ they said, she descends ‘the slide to an arational account of science.’ On a less melodramatic reading, feminist epistemologies such as Harding's advocate not irrationalism, but senses of rationality more expanded than those which they associate with ‘traditional’ epistemology.

In the UK, it has been proposed that alongside the current advice to abstain from alcohol completely in pregnancy, there should be increased screening of pregnant women for alcohol consumption in order to prevent instances of fetal alcohol spectrum disorder. The Scottish Intercollegiate Guidelines Network published guidelines in 2019 recommending that standardised screening questionnaires and associated use of biomarkers should be considered to identify alcohol exposure in pregnancy. This was followed in 2020 by the National Institute for Health and Care (...) Excellence Draft Quality Standard, which recommended that pregnant women should have information on their alcohol consumption recorded throughout their pregnancy and this information transferred to the child’s health records. Most recently, Public Health England has stated that the alcohol intake of all women should be recorded throughout pregnancy, not just at the initial booking appointment and that tools such as blood biomarkers and meconium testing should be researched in order to determine true prevalence rates of alcohol in pregnancy. We argue that this proposed enhanced screening undermines women’s autonomy and their legal right to be sufficiently informed to consent to screening. We argue that there is no evidence that this kind of screening will result in a reduction of fetal harm and there is a danger that undermining the autonomy of women and the trust relationship between women and healthcare professionals may even increase harm to future children. (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)

My particular focus in this article is on getting clearer about what Nietzsche’s experimentalism entails. Some immediate resistance may form in response to this proposal, based on my use of the term experimentalism. As Walter Kaufmann has pointed out in a discussion of experimentalism, Nietzsche himself does not discuss his work using this concept; in the original German, Nietzsche uses the terms “Experiment” and “Versuch.”1 In light of this, two main concerns may be raised about my proposal that experimentalism is (...) worth some of our time and attention: whether it is necessary or helpful to focus discussion on yet another “ism” within Nietzsche scholarship and given that experimentalism is not Nietzsche’s.. (shrink)

Moral perception, as the term is used in moral theory, is the perception of normatively contoured objects and states of affairs, where that perception enables us to engage in practical reason and judgment concerning these particulars. The idea that our capacity for moral perception is a crucial component of our capacity for moral reasoning and agency finds its most explicit origin in Aristotle, for whom virtue begins with the quality of perception. The focus on moral perception within moral theory has (...) made a comeback in the last few decades, especially in the hands of self-proclaimed neo-Aristotelians such as John McDowell, Martha Nussbaum, and Nancy Sherman. For these writers, our perceptual capacities are not static, and the laborious honing of our perceptual skills is a crucial moral task. On this picture, as Nancy Sherman puts it, “How to see becomes as much a matter of inquiry as what to do.”Moral particularists—including but not restricted to the neo-Aristotelians—have emphasized the centrality of moral perception to moral agency and judgment, as a corrective to moral theories that treat deliberation in terms of universal principles as the privileged keystone of moral agency. (shrink)

Several personality dispositions with common features capturing sensitivities to negative social cues have recently been introduced into psychological research. To date, however, little is known about their interrelations, their conjoint effects on behavior, or their interplay with other risk factors. We asked N = 349 adults from Germany to rate their justice, rejection, moral disgust, and provocation sensitivity, hostile attribution bias, trait anger, and forms and functions of aggression. The sensitivity measures were mostly positively correlated; particularly those with an egoistic (...) focus, such as victim justice, rejection, and provocation sensitivity, hostile attributions and trait anger as well as those with an altruistic focus, such as observer justice, perpetrator justice, and moral disgust sensitivity. The sensitivity measures had independent and differential effects on forms and functions of aggression when considered simultaneously and when controlling for hostile attributions and anger. They could not be integrated into a single factor of interpersonal sensitivity or reduced to other well-known risk factors for aggression. The sensitivity measures, therefore, require consideration in predicting and preventing aggression. (shrink)

Mr. C is a twenty‐two‐year‐old who was flown to a level‐1 trauma center after diving headfirst into shallow water. Prior to this accident, he was in excellent health. At the scene, he had been conscious but was paralyzed and had no sensation below his neck. The emergency medical services team immobilized Mr. C's neck with a cervical collar and intubated him for airway protection before transport. As Mr. C's medical care proceeds, he expresses a desire for extubation, although it was (...) not clear that he had the capacity to make this (or any other) decision. It also was unclear whether this desire reflected his authentic wishes to be allowed to die or stemmed from feelings of discomfort and agitation. Over a period of several days, Mr. C's sedation was lightened, and the psychiatry service conducted a formal decision‐making capacity assessment. Mr. C continues to express a desire to withdraw life‐sustaining medical treatment. However, the psychiatry service is concerned that Mr. C seems to lack adequate insight into what it would mean to die.What does it mean to respect Mr. C's autonomy? (shrink)

All forms of beauty create appeal or enticement with moral significance. Sublime beauty draws one into a deep relationship that properly promotes the good and true. Parents tend to experience such beauty in their children, as eloquently described in works such as the 14th-century poem ‘The Pearl’, and they see this even when their children are desperately ill or dying. The experience of beauty in one’s child creates or reinforces the morality of caring. Unfortunately, at the end of modernity, the (...) framing of beauty as only instrumental and subjective generally works against any recognition of dignity or respect for the very small pediatric patient. Practitioners who believe in the intrinsic value and dignity of persons as general concepts should recognize parental drawing toward their children as a particularization of a transcendental value. (shrink)

There is a large literature on technology adoption and environmental management in agriculture. Included in this literature are debates about the role world view or attitudinal variables play in adoption decisions, and whether smaller farms or larger farms exhibit superior environmental performance or differ in commitment to environmental values. In this paper we attempt to extend the literature in this area by proposing and measuring discrete environmental management approaches among sixty-six farmers in Northern New York. Using key informants interviews, purposeful (...) sampling of farmers and a mail survey we find two environmental management types: (1) the larger-scale conservation farmer; and (2) the alternative/ecological farmer. (shrink)

Feminism is an antiauthoritarian movement that has sought to unmask many traditional “authorities” as ungrounded. Given this, it might seem as if feminists are required to abandon the concept of authority altogether. But, we argue, the exercise of authority enables us to coordinate our efforts to achieve larger social goods and, hence, should be preserved. Instead, what is needed and what we provide for here is a way to distinguish legitimate authority from objectionable authoritarianism.

In this issue, Paul Menzel and M. Colette Chandler‐Cramer propose a novel advance directive. Besides giving competent people the opportunity to refuse future life‐prolonging medical interventions, they say, advance directives should give people the opportunity to refuse ordinary food and water if they later experience severe dementia.This proposal is both appealing and unsettling. It is appealing because it offers some relief to people seeking to avoid the prolonged decline and extreme incapacity they have witnessed in relatives and friends with advanced (...) dementia. But does it sufficiently protect patients? Menzel and Chandler‐Cramer want to empower competent persons to impose potential discomfort and distress on a later self who cannot understand the reasons for that choice. In this situation, the price of respecting autonomy is paid by a frail incapacitated patient who has no idea why food and water are no longer offered to her. (shrink)

Should monkeys be used in painful and often deadly infectious disease research that may save many human lives? This is the challenging question that Anne Barnhill, Steven Joffe, and Franklin G. Miller take on in their carefully argued and compelling article “The Ethics of Infection Challenges in Primates.” The authors offer a nuanced and even-handed position that takes philosophical worries about nonhuman primate moral status seriously and still appreciates the very real value of such research for human welfare. Overall, they (...) argue for an extension and revision of the recommendations regarding chimpanzee research offered by the Institute of Medicine in 2011; the practical upshot of their argument would allow for infection challenge research for promising interventions for Ebola and Marburg virus diseases but not for smallpox or the common cold. The IOM recommendations regarding chimpanzee research put in motion an exceptionalist policy for this great ape population. Barnhill and colleagues’ proposal would enlarge the scope of that exceptionalism to embrace NHPs other than great apes. But is such exceptionalism warranted? It is not obvious to me either that the more sophisticated capacities of a species as a whole give it greater ethical protections or that less intellectually or socially sophisticated animals ought to therefore receive less protection when it comes to painful experimental interventions. (shrink)

In Western societies, height is positively correlated with reproductive success (RS) for men but negatively correlated with RS for women. These relationships have been attributed to sexual selection: women prefer tall men, and men prefer short women. It is this success in the marriage market which leads to higher RS for tall men and short women. We have already shown that the relationship between height and RS for women is quite different in a non-Western context. In a subsistence farming community (...) in rural Gambia, height is positively correlated with reproductive success for women, largely owing to the higher survival of the children of tall women. Here, the relationship between height and reproductive success is analyzed for men in the same community. For these Gambian men, there is no significant relationship between height and the number of children they produce, although tall men do contract more marriages than shorter men. We conclude that environmental context needs to be taken into account when analyzing human reproductive behavior. (shrink)

A concise and lively overview of the intriguing and provocative life and ideas of twentieth century French philosopher, mystic, and social activist Simone Weil. The breadth, poignancy, and prescience of Weil's philosophy has much to offer us in our times of personal, communal, political, and environmental crises.

Henri Bergson's philosophy has attracted increasing feminist attention in recent years as a fruitful locus for re-theorizing temporality. Drawing on Luce Irigaray's well-known critical description of metaphysics as phallocentrism, Hill argues that Bergson's deduction of duration is predicated upon the disavowal of a sexed hierarchy. She concludes the article by proposing a way to move beyond Bergson's phallocentrism to articulate duration as a sensible and transcendental difference that articulates a nonhierarchical qualitative relation between the sexes.

This chapter examines the consequences of Nietzsche's campaign against morality for the pursuit of knowledge in philosophy, and specifically, on values and methods of the German Enlightenment. In Dawn, Nietzsche explores how an experimental approach to knowing and to knowledge involves us in adopting different ways of being toward things in the world, as well as toward ourselves and our experiences, and in using associated diverse methods of inquiry. Nietzsche's free‐spirit writings, including Dawn, are works of a particular kind of (...) enlightenment project that works against all expressions of fanaticism, especially religious and moral, and in an effort to temper emotional and mental excess. Nietzsche's primary commitment in Dawn is to experimentation in which the love of, or passion for, knowledge gives humanity back its right to engage in self‐experimentation. (shrink)

Abstract:I raise several concerns with Earp and colleagues' analysis of enhancement through neurochemical modulation of love as a key issue in contemporary neuroethics. These include: (i) strengthening their deflation of medicalization concerns by showing how the objection that love should be left outside of the scope of medicine would directly undermine the goal of medicine; (ii) developing stronger analysis of the social and political concerns relevant to neurochemical modulation of love, by exploring and suggesting possible counters to ways in which (...) 'wellbeing' may be used as a tool of oppression; (iii) providing reasons to support a broad need for ecological investigation of, and indeed ecological education concerning, neurotechnology; (iv) suggesting ways in which philosophy, and the humanities more broadly, remain directly relevant to responding effectively to issues in contemporary neuroethics. (shrink)

Aanerud's project is to develop an account of white antiracist mothering, using a model of maternal duty to raise antiracist white children. The author sets this project in the context of historic constructions of white mothering in the twentieth century and then contrasts the need for an exploration of white mothers raising white children against the literature of white mothers’ raising children of color and mothers of color raising their own children, Once this distinction is made, Aanerud uses Collins's account (...) of racial ethnic mothering as a springboard into her discussion of antiracist white mothering of white children. (shrink)

Here I argue that aspects of Nietzsche's thought may be productively compared with the role played by the concept of ubuntu in talk of cultural renaissance in South Africa. I show that Nietzsche respects and writes for humanity conceived of in a vital sense, thereby imagining a sense of authenticity that may prove significant to talk of cultural renaissance in South Africa. I question the view that Nietzsche is an individualist, drawing on debate between Conway (1990) and Gooding-Williams (2001), concerning (...) the interpretation of ‘The Dance-Song' in Thus Spoke Zarathustra, as well as on the notion of reciprocity intrinsic to the concept of ubuntu (Shutte, 1993). South African Journal of Philosophy Vol. 26 (1) 2007: pp. 85-97. (shrink)

Examining the Danish poultry industry in a time of rising outbreaks of infectious disease (the so-called ‘pandemic era’) including avian influenza, this study documents the often-unseen harms resulting from current dominant forms of response. Inspired by multispecies studies and ethnography, we pay attention to entangled human and more-than-human worlds. Specifically, we document the multifarious ways in which responses to worsening avian influenza alter the everyday lives of birds in production, their farmers, and public veterinarians. We also show how such changes (...) are distributed in ways that further slant the playing field against smaller scale and organic poultry production, under the hegemony of globalized capitalist agriculture. Throughout, we shed light on the analytical purchase of two key concepts in feminist scholarship and science and technology studies respectively: care and repair. While understood as integral to human and more-than-human wellbeing, care’s tendency to summon pleasant associations is challenged by the reality of embodied care practices in complex and compromised socio-ecological contexts. Repair has been wielded conceptually to interrogate activities that stabilize systems at risk, while largely ignoring or even exacerbating the drivers of instability. Mobilized together, we can better understand how hegemonic logics delimit possibilities for care, but also the limits and limitations of dominant response repertoires. Finally, we illuminate farming practices of care beyond repair, which may help chart alternatives for Danish agriculture within, and perhaps beyond, the pandemic era. (shrink)

IntroductionThe Managing Cancer and Living Meaningfully therapy for patients with advanced cancer was tested against a supportive psycho-oncological counseling intervention in a randomized controlled trial. We investigated whether CALM was delivered as intended ; whether CALM therapists with less experience in psycho-oncological care show higher adherence scores; and whether potential overlapping treatment elements between CALM and SPI can be identified.MethodsTwo trained and blinded raters assessed on 19 items four subscales of the Treatment Integrity Scale covering treatment domains of CALM. A (...) random sample of 150 audio recordings were rated on a three-point Likert scale with 1 = “adherent to some extent,” 2 = “adherent to a sufficient extent,” 3 = “very adherent.”ResultsAll 19 treatment elements were applied, but in various frequencies. CALM therapists most frequently explored symptoms and/or relationship to health care providers and allowed expression of sadness and anxiety about the progression of disease. The exploration of CALM treatment element SC_1 was most frequently implemented in a satisfactory or excellent manner, whereas the treatment element SMP_4: Therapist promotes acknowledgment that some life goals may no longer be achievable was not implemented in a satisfactory manner. In terms of treatment differentiation, no treatment elements could be identified which were applied significantly more often by CALM therapists than by SPI therapists.ConclusionResults verify the application of CALM treatment domains. However, CALM therapists’ adherence scores indicated manual deviations. Furthermore, raters were not able to significantly distinguish CALM from SPI, implying that overlapping treatment elements were delivered to patients. (shrink)

This essay considers Simone Weil's experiences in factories and her social–political reflections on work, time and energy, in conjunction with arguments from theorists Melissa Gregg, Theodor Adorno and Sara Ahmed, to raise questions about supposedly humane interventions, including the cultivation of resilience, in the contemporary workplace. The transition from time‐sense in factory work at the turn of the century is examined, along with the growth of corporate time management ideologies and practices in the mid–late 20th century, and finally, the associated (...) forms of disciplining resilience/elasticity in the worker that bring together certain notions of time, space and psychological investments. (shrink)

The target article is focused on locating the popularity of imaginary worlds in our adaptations for exploration. This commentary touches on developmental influences, vicarious enjoyment, the challenging of societal mores, plot, and whether men and women are drawn to the same features in the same ways.

Volume 24, Issue 8, August 2024, Page 37-40.

The terminology of “lives not worth living,” “worthwhile lives,” and “unworthwhile lives,” used by John Harris and many others, has become an accepted linguistic convention in bioethical discussions. These terms are used to distinguish lives of overwhelming negative experience from lives that are or are expected to be of overall positive value. As such, this terminology seems helpful in discussions around resource allocation, end-of-life decision making and questions of when it might be acceptable (and unacceptable) to reproduce. This paper argues (...) that there is, however, a problematic ambiguity inherent in these general terms that is particularly evident when it comes to discussing reproductive choices. It is suggested that in this context, this ambiguity can conceal authoritarian eugenic motivations that are difficult to justify and that many using these terms would not adhere to. As a result, it is argued that we should replace these terms with the terms “intrinsically valuable” and “intrinsically harmful.” This would make it more explicit what exactly is meant and would allow these matters to be debated with greater clarity. (shrink)

Who should define what constitutes ethical and lawful medical practice? Judges? Doctors? Scientists? Or someone else entirely? This volume analyses how effectively criminal law operates as a forum for resolving ethical conflict in the delivery of health care. It addresses key questions such as: how does criminal law regulate controversial bioethical areas? What effect, positive or negative, does the use of criminal law have when regulating bioethical conflict? And can the law accommodate moral controversy? By exploring criminal law in theory (...) and in practice and examining the broad field of bioethics as opposed to the narrower terrain of medical ethics, it offers balanced arguments that will help readers form reasoned views on the ethical legitimacy of the invocation and use of criminal law to regulate medical and scientific practice and bioethical issues. (shrink)