From reason to practice in bioethics brings together original contributions from some of the world's leading scholars in the field of bioethics. With a particular focus on, and critical engagement with, the influential work of Professor John Harris, the book provides a detailed exploration of some of the most interesting and challenging philosophical and practical questions raised in bioethics.

It now seems technically feasible to culture human embryos beyond the “fourteen‐day limit,” which has the potential to increase scientific understanding of human development and perhaps improve infertility treatments. The fourteen‐day limit was adopted as a compromise but subsequently has been considered an ethical line. Does it remain relevant in light of technological advances permitting embryo maturation beyond it? Should it be changed and, if so, how and why? What justifications would be necessary to expand the limit, particularly given that (...) doing so would violate some people's moral commitments regarding human embryos? Robust stakeholder engagement preceded adoption of the fourteen‐day limit and should arguably be part of efforts to reassess it. Such engagement could also consider the need for enhanced oversight of human embryo research. In the meantime, developing and implementing reliable oversight systems should help foster high‐quality research and public confidence in it. (shrink)

It now seems technically feasible to culture human embryos beyond the “fourteen‐day limit,” which has the potential to increase scientific understanding of human development and perhaps improve infertility treatments. The fourteen‐day limit was adopted as a compromise but subsequently has been considered an ethical line. Does it remain relevant in light of technological advances permitting embryo maturation beyond it? Should it be changed and, if so, how and why? What justifications would be necessary to expand the limit, particularly given that (...) doing so would violate some people's moral commitments regarding human embryos? Robust stakeholder engagement preceded adoption of the fourteen‐day limit and should arguably be part of efforts to reassess it. Such engagement could also consider the need for enhanced oversight of human embryo research. In the meantime, developing and implementing reliable oversight systems should help foster high‐quality research and public confidence in it. (shrink)

WQ.1 “Independent men and women, in independent homes, leading separate and independent lives, with full freedom to form and dissolve relations, and with perfectly equal opportunities to happiness, development, and love.” I leave out the word “rights,” doubtful I can use it without being misunderstood. Perhaps I can succeed in dispensing with its use altogether. This ideal, so stated, is attractive to me and completely in harmony with my idea of the course in life which will best further human happiness. (...) WQ.2 I am not sure that I quite understand Victor’s position in regard to the number of.. (shrink)

An emerging approach to complement randomised controlled trial (RCT) data in the development of radiotherapy treatments is to use routinely collected ‘real-world’ data (RWD). RWD is the data collected as standard-of-care about all patients during their usual cancer care pathway. Given the nature of this data, important questions remain about the permissibility and acceptability of using RWD in routine practice. We involved and engaged with patients, carers and the public in a two-day citizens’ jury to understand their views and obtain (...) decisions regarding two key issues: (1) preferred approaches to consent for the use of RWD within the context of patients receiving radiotherapy for lung cancer in RAPID-RT and (2) how RWD use should be best communicated to patients. Individual views were polled using questionnaires at various stages of the jury, whilst group discussion activities prompted further dialogue about the rationale behind choices of consent. Key decisions obtained from the jury include: (1) an opt-out approach to consent for the use of RWD; (2) the opt-out approach to consent should be informed. Furthermore, it was advised that information and communication regarding the consent process and use of RWD should be accessible, clear and available in a variety of formats. It is important that the consent process for patient data use is underpinned by principles of autonomy and transparency with clear channels of communication between those asking for and giving consent. Moreover, the process of seeking consent from patients should be proportionate to the risks presented from their participation. (shrink)

Throughout 2019, retired athletes Martina Navratilova, Sharron Davies, Kelly Holmes and Paula Radcliffe all spoke publically about what they perceive to b...

The view from inside : gendered embodiment and the medical representation of sex / Shelley Wall -- The politics of medico-legal recognition : the terms of gendered subjectivity in the UK Gender Recognition Act / Sarah Burgess -- Journeys of choice? : abortion, travel, and women's autonomy / Christabelle Sethna and Marion Doull -- The code of ethics in medicine : intertextuality and meaning in Plato's Sophist and Hippocrates' oath / Twyla Gibson -- Sleeping ethics : gene, episteme, and (...) the body politic / Deborah Lynn Steinberg -- The last temptation of Marion Woodman : the anorexic remainder in bone : dying into life / David L. Clark. (shrink)

Collaboration requires agents to coordinate their behavior on the fly, sometimes cooperating to solve a single task together and other times dividing it up into sub‐tasks to work on in parallel. Underlying the human ability to collaborate is theory‐of‐mind (ToM), the ability to infer the hidden mental states that drive others to act. Here, we develop Bayesian Delegation, a decentralized multi‐agent learning mechanism with these abilities. Bayesian Delegation enables agents to rapidly infer the hidden intentions of others by inverse planning. (...) We test Bayesian Delegation in a suite of multi‐agent Markov decision processes inspired by cooking problems. On these tasks, agents with Bayesian Delegation coordinate both their high‐level plans (e.g., what sub‐task they should work on) and their low‐level actions (e.g., avoiding getting in each other's way). When matched with partners that act using the same algorithm, Bayesian Delegation outperforms alternatives. Bayesian Delegation is also a capable ad hoc collaborator and successfully coordinates with other agent types even in the absence of prior experience. Finally, in a behavioral experiment, we show that Bayesian Delegation makes inferences similar to human observers about the intent of others. Together, these results argue for the centrality of ToM for successful decentralized multi‐agent collaboration. (shrink)

In his recent book, Frame It Again: New Tools for Rational Decision-Making, J. L. Bermúdez argues that it can be rational to evaluate the same thing differently when it is described using alternati...

Discussion of the role which religious experience can play in warranting theistic belief has received a great deal of attention within contemporary philosophy of religion. By contrast, the relationship between experience and atheistic belief has received relatively little focus. Our aim in this paper is to begin to remedy that neglect. In particular, we focus on the hitherto under-discussed question of whether experiences of God’s absence can provide positive epistemic status for a belief in God’s nonexistence. We argue that there (...) is good reason to accept an epistemic parity between experiences of God’s presence and experiences of God’s absence. (shrink)

Since its introduction in the 1980s, futility as a concept has held contested meaning and applications throughout medicine. There has been little discussion within the psychiatric literature about the use of futility in the care of individuals experiencing severe and persistent mental illness (SPMI), despite some tacit acceptance that futility may apply in certain cases of psychiatric illness. In this paper, we explore the literature surrounding futility and argue that its connotation within medicine is to describe situations where patients (or (...) their substitute decision-makers) believe that interventions will almost certainly provide no meaningful benefit. We then provide two arguments in support of the use of futility within the care of individuals experiencing SPMI: that some SPMI can be considered a terminal illness, and that the risk-benefit ratio is a dynamic entity such that futility can help describe what Gillett calls the ‘risk of unacceptable badness’ when it comes to considering how an intervention might impact a patient’s quality of life. We posit that capacity should not pose an obstacle to declaring futility when caring for individuals experiencing SPMI and explain how futility is not antithetical to recovery in mental health. Finally, we describe how using futility within psychiatric practice can allow for a reorientation of care by signalling the need to shift to a palliative approach. (shrink)

This article examines verbal humour in routine interactions within professional workplaces, using material recorded in four New Zealand government departments. The problem of defining humour is discussed, followed by a brief outline of the theoretical models which underpin the analysis of the various functions which humour serves in professional organizations. Humour can express positive affect in interaction. It can also facilitate or `licence' more negative interpersonal communicative intent. While politeness theory can account for the former, as a means of expressing (...) collegiality at work, or de-emphasizing power imbalances, in its standard form politeness theory does not explain barbed, competitive or confrontational humour. For this it is necessary to look to `the dark side of politeness'. An alternative perspective thus examines the extent to which humour functions, especially in unequal encounters, as an acceptable strategy to help superiors maintain a position of power but also as a strategy used by subordinates to licence challenges to the power structures within which they operate, and as a legitimizing strategy in attempts at subverting the repressive or coercive discourse of superiors. (shrink)

ABSTRACT The political works of Adam Blackwood offer a powerful defence of absolute monarchy, and one which explicitly sets political power within a religious framework. Critiquing the resistance theories of his contemporaries, Blackwood was sceptical about the political value of natural law and of any appeal to popular sovereignty, at least in contemporary Europe. Blackwood was deeply troubled by the way Christianity was being used to justify resistance, often in Protestant texts that aligned Christianity and natural law, and he insisted (...) that true Christianity taught obedience. Though he has often been likened to his contemporary Jean Bodin, a closer examination of Blackwood’s writing reveals significant differences, especially on the linked issues of natural law, the value of historical argument, and religion. For Blackwood, sovereign power in general had to be underpinned by religion, the one constant in a world of diverse and mutable social practices, and its particular, local manifestation had to be understood historically, as the product of conquest and force. Aware of the potential tensions between Catholic Christianity and monarchical authority, Blackwood also developed a distinctive piety in an attempt to bolster the alliance he advocated between religious and political authority. (shrink)

Accumulating evidence suggests that different magnitudes (e.g., number, size, and duration) are spatialized in the mind according to a common left–right metric, consistent with a generalized system for representing magnitude. A previous study conducted by two of us (Holmes & Lourenco, ) provided evidence that this metric extends to the processing of emotional magnitude, or the intensity of emotion expressed in faces. Recently, however, Pitt and Casasanto () showed that the earlier effects may have been driven by a left–right (...) mapping of mouth size rather than emotional magnitude, and they found no evidence for an emotional magnitude mapping when using words as stimuli. Here, we report two new experiments that further examine these conclusions. In Experiment 1, using face stimuli with mouths occluded, we replicate the original finding: Less emotional faces were associated with the left and more emotional faces with the right. However, we also find that people can reliably infer the sizes of the occluded mouths, and that these inferred mouth sizes can explain the observed left–right mapping. In Experiment 2, we show that comparative judgments of emotional words yield a left–right mapping of emotional magnitude not attributable to stimulus confounds. Based on these findings, we concur with Pitt and Casasanto that faces pose challenges for isolating the forces driving spatialization, but we suggest that emotional magnitude, when assessed using unconfounded stimuli in a sufficiently sensitive task, may indeed be spatialized as originally proposed. Suggestions for further research on the spatialization of emotional magnitude are discussed. (shrink)

Over the past decade land has again moved to the centre of resource conflicts, agrarian struggles, and competing visions over the future of food and farming. This renewed interest in land necessitates asking the seemingly simple, but pertinent, question ‘whatisland?’ To reach a more profound understanding of the uniqueness of land, and what distinguishes land from other resources, this symposium suggests the notion of ‘land imaginaries’ as a crucial lens in the study of current land transformations. Political-economy, and the particular (...) economic, financial, or political interests of various actors involved in land projects do not directly result in, or translate into, outcomes, such as dispossession and enclosure, increased commodification, financialization, and assetization, or mobilization and resistance. All these processes are informed by different imaginaries of land—the underlying understandings, views, and visions of what land is, can, and should be—and associated visions, hopes, and dreams regarding land. Drawing on a variety of case studies from across the world, crossing Global North/South and East/West, and including contemporary and historical instances of land transformation, this symposium addresses the multifaceted ways in which implicit, explicit, and emergent understandings of land shape current land transformations. (shrink)

This paper opens with first‐hand accounts of critical care medical interventions in which detainees, in the custody of U.S. Immigration and Customs Enforcement (ICE), are brought to the emergency department for treatment. This case dramatizes the extent to which the provision of ethical and acceptable nursing care is jeopardized by federal law enforcement paradigms. Drawing on the scholarship of Michel Foucault and Giorgio Agamben, this paper offers a theoretical account of the power dynamics that inform the health care of patients (...) who find themselves caught in the custodial scaffolding of a vast immigration and detention apparatus. It offers an analysis of the display of sovereign and biopolitical power over the lives (and deaths) of detainees (Foucault), as well as the ways these individuals are reduced to “bare life” under the political pretext of an emergency or “state of exception” (Agamben). Our purpose here is both theoretical and practical: to better understand the often hidden agency or impersonal “will” exercised by the immigrant detention system, but also to equip clinicians in these and cognate facilities (e.g., prisons) with the critical tools by which they might better navigate incommensurable paradigms (i.e., care vs. custody) in order to deliver the best care while upholding their ethical duties as a care provider. This is all the more pressing because hospitals are not sanctuaries and given the incursion of federal law enforcement agents, nurses may find themselves conscripted as de facto agents of the state. (shrink)

Working within the tradition of continental philosophy, this article argues in favour of a phenomenological understanding of language as a crucial component of bioethical inquiry. The authors challenge the ‘commonsense’ view of language, in which thinking appears as prior to speaking, and speech the straightforward vehicle of pre-existing thoughts. Drawing on Maurice Merleau-Ponty's (1908–1961) phenomenology of language, the authors claim that thinking takes place in and through the spoken word, in and through embodied language. This view resituates bioethics as a (...) matter of bodies that speak. It also refigures the meaning of ethical self-reflexion, and in so doing offers an alternative view on reflexivity and critique. Referring to the Kantian critical tradition and its reception by Hannah Arendt and Michel Foucault, we advance a position we call ‘critical ethical reflexivity’. We contend that Merleau-Ponty's phenomenology of language offers valuable insight into ethical reflexivity and subject formation. Moreover, his understanding of language may foster new qualitative empirical research in bioethics, lead to more nuanced methods for interpreting personal narratives, and promote critical self-reflexion as necessary for bioethical inquiry. (shrink)

This article explores the psychological literature on rationalization and connects it with contemporary questions about the role of in-house lawyers in ethical dilemmas. Using the case study of AWB Ltd, the exclusive marketer of Australian wheat exports overseas, it suggests that rationalizations were influential in the perpetuation by in-house lawyers of AWB's payment of kickbacks to the Iraqi regime. The article explores how lawyers' professional rationalizations can work together with commercial imperatives to prevent in-house lawyers from seeing ethical issues as (...) those outside the organisation would see them. In particular, where lawyers over-identify with their client's commercial point of view and convince themselves that their role is primarily about providing 'technical' advice on commercial matters, wilful or unintended 'ethical blindness' can result. Lawyers can end up involved in or perpetuating serious misconduct by their client organizations. (shrink)

The present article explores the views of al-Jāḥiẓ, Abū Bakr al-Rāzī, and Fakhr al-Dīn al-Rāzī - three pre-modern thinkers of the Islamic world outside the Peripatetic tradition - on the question o...

In Memory: A Self-Referential Account, Fernández offers a functionalist account of the metaphysics of memory, which is portrayed as presenting significant advantages over causal and narrative theories of memory. In this paper, I present a series of challenges for Fernández’s functionalism. There are issues with both the particulars of the account and the use of functionalism more generally. First, in characterizing the mnemonic role of episodic remembering, Fernández fails to make clear how the mental image type that plays this role (...) should be identified. Second, I argue that a functionalist approach, which appeals to the overall structure of the memory system and tendencies of mental state types, is ill-suited to the metaphysical question about episodic remembering that is of interest to the causal and narrative theorists with which Fernandez engages. Fernández’s self-referential account of memory has many other virtues, but functionalism is a poor fit for episodic remembering. (shrink)

Based on our respective research programs (psychiatry, forensic psychiatry, public health, HIV/AIDS, harm reduction) this article aims to use purposely non‐conventional means to present the substantial contribution of poststructuralist perspectives to knowledge development in nursing science in general and in our current research in particular. More specifically, we call on the work of Michel Foucault and Deleuze & Guattari to politicize nursing science using examples from our empirical research programs with marginal and often highly marginalized populations. We discuss the concepts (...) of power, discourse, and resistance to illustrate the essential contribution of poststructuralism to marginal, even “nomadic”, nursing research. (shrink)

“Ambivalence” is the key word in much of this book; “comic” [is the book’s] most obscure and I think absolutely without use value. I don’t know what B[urke] means by “comic,” as a matter of fact. I wonder if he does, and could define it briefly. Readers of Kenneth Burke are well aware of the importance of comedy and its associated cluster of concepts in his work: comic, comic frame, comic attitude, comic corrective. This cluster of terms figures prominently in (...) his 1937 book Attitudes Toward History, most notably in two key passages that scholars turn to time and again. In the first, from the “Poetic Categories” section of the book, Burke explains how different genres serve as guides for how to act in the... (shrink)

After offering an opening consideration of the hazards of neoliberalism, I address the general shape of the crisis of care that has evolved under its auspices. Two aspects of this crisis require greater attention: the moral precarity of caregivers and the relational harms of neoliberal capitalism. Thus, I first consider the moral precarity that caregivers experience by drawing on a concept that originates in scholarly work on the experiences of healthcare workers and combat veterans, namely, moral injury. Through this concept, (...) we can see how caregivers in late-stage capitalism face a seemingly unavoidable violation of their own significant moral beliefs. Second, I examine how the crisis of care results not only in individual harms of moral injury but also in harms to relationships themselves, as I continue to track the impact of moral injury on our intrapersonal and interpersonal lives. Ultimately, I argue that an important facet of the crisis of care is how it operates as a crisis of relationality in which our intrapersonal and interpersonal connections are placed under practical and moral strain. In taking a broader view, we can see how the fraying of particular intrapersonal and interpersonal connections can accumulate, resulting in the unraveling of wider webs of interdependency, just when we need them most. Throughout the paper, I zero in on the moral implications of the crisis of care driven by neoliberalism, featuring the damages that caregivers and their relationships sustain when situated in morally precarious ways. In doing so, I drive home the point that the crisis of care under neoliberalism is as much a moral and relational crisis as it is a political and economic one. (shrink)

Drawing on data from 100 qualitative interviews with the recently unemployed, this study examines how participants made decisions about attempting to return to work and identifies how class and gender shape these decisions. Middle-class men were most likely to take time to attempt to return to work, middle-class women were most likely to begin a deliberate job search, working-class men were most likely to report an urgent search, and working-class women were most likely to have diverted searches. Financial resources, gendered (...) labor force attachments, and family responsibilities shaped decision making. Ultimately, those in the middle-class appear doubly advantaged—both in their financial capabilities and in their ability to respond to the crisis with greater gender flexibility. (shrink)

During the latter-half of the nineteenth century, the utility of the house sparrow to humankind was a contentious topic. In Britain, numerous actors from various backgrounds including natural history, acclimatisation, agriculture and economic ornithology converged on the bird, as contemporaries sought to calculate its economic cost and benefit to growers. Periodicals and newspapers provided an accessible and anonymous means of expression, through which the debate raged for over 50 years. By the end of the century, sparrows had been cast as (...) detrimental to agriculture. Yet consensus was not achieved through new scientific methods, instruments, or changes in practice. This study instead argues that the rise and fall of scientific disciplines and movements paved the way for consensus on “the sparrow question.” The decline of natural history and acclimatisation stifled a raging debate, while the rising science of economic ornithology sought to align itself with agricultural interests: the latter overwhelmingly hostile to sparrows. (shrink)

This work addresses the case of the Ballet National de Marseille (BNM) and the 2017 recreation of the piece Passione, created by the artistic directors Emio Greco and Pieter C. Scholten. This study, informed by a phenomenological approach, adopts ethnographic methods, including participant observation, in-depth interviews, and one researcher’s direct involvement with the practices of enculturation and enskillment in this dance form. It investigates how the dancers of the BNM articulate their diverse forms of agency in relation to the choreographer’s (...) artistic vision and demands. By looking at the specific case of the BNM staging of Passione, we can isolate some significant features of contemporary ballet’s trajectory as an emergent dance genre on the edge between innovation and tradition. (shrink)

This article argues that the mid-1960s saw a dramatic shift in how ‘brainwashing’ was popularly imagined, reflecting Anglo-American developments in the sciences of mind as well as shifts in mass media culture. The 1965 British film The Ipcress File provides a rich case for exploring these interconnections between mind control, mind science and media, as it exemplifies the era’s innovations for depicting ‘brainwashing’ on screen: the film’s protagonist is subjected to flashing lights and electronic music, pulsating to the ‘rhythm of (...) brainwaves’. This article describes the making of The Ipcress File’s brainwashing sequence and shows how its quest for cinematic spectacle drew on developments in cybernetic science, multimedia design and modernist architecture. I argue that often interposed between the disparate endeavours of 1960s mind control, psychological science and media was a vision of the human mind as a ‘cybernetic spectator’: a subject who scrutinizes how media and other demands on her sensory perception can affect consciousness, and seeks to consciously participate in this mental conditioning and guide its effects. (shrink)

The past few years have brought significant breakthroughs in understanding human genetics. This knowledge has been used to develop ‘polygenic scores’ (or ‘polygenic risk scores’) which provide probabilistic information about the development of polygenic conditions such as diabetes or schizophrenia. They are already being used in reproduction to select for embryos at lower risk of developing disease. Currently, the use of polygenic scores for embryo selection is subject to existing regulations concerning embryo testing and selection. Existing regulatory approaches include ‘disease-based' (...) models which limit embryo selection to avoiding disease characteristics (employed in various formats in Australia, the UK, Italy, Switzerland and France, among others), and 'laissez-faire' or 'libertarian' models, under which embryo testing and selection remain unregulated (as in the USA). We introduce a novel 'Welfarist Model' which limits embryo selection according to the impact of the predicted trait on well-being. We compare the strengths and weaknesses of each model as a way of regulating polygenic scores. Polygenic scores create the potential for existing embryo selection technologies to be used to select for a wider range of predicted genetically influenced characteristics including continuous traits. Indeed, polygenic scores exist to predict future intelligence, and there have been suggestions that they will be used to make predictions within the normal range in the USA in embryo selection. We examine how these three models would apply to the prediction of non-disease traits such as intelligence. The genetics of intelligence remains controversial both scientifically and ethically. This paper does not attempt to resolve these issues. However, as with many biomedical advances, an effective regulatory regime must be in place as soon as the technology is available. If there is no regulation in place, then the market effectively decides ethical issues. (shrink)