There exists in academic medicine a core ethical issue that is seldom pursued: trainees are frequently not the best person in the operating room at a given intervention being performed, and yet as a profession we understand a fundamental need to afford them opportunities to perform. Academic centres are traditionally associated with a higher quality of care than non-academic centres, suggesting that practical measures exist within teaching hospitals that effectively mask the clinical discrepancies between trainees and their preceptors. Nonetheless, we (...) are bound by our ethical commitments as physicians to balance the obligations of care with the duty to teach. In order to ethically validate the model of ‘surgeon as teacher’, we propose that there must be a reconciliation of the tensions between traditional professional values in medicine with the constraints inherent in a time-bound utilitarian medical system. Ultimately, we must consciously accept that ensuring the longitudinal availability of skilled surgeons in society aligns more closely with our core ethical obligations as outlined in the social contract that medical professionals maintain with the general public than does the ethical demand to provide unreservedly individual-focused patient care. It is the duty of individual practitioners, as a necessity of lineage to maintain and fulfil our greater duties to society, to foster deontological relationships where possible within this utilitarian system while accepting short-term imperfection in our practice. There are no data in this manuscript. (shrink)

Emerging technologies such as artificial intelligence are actively revolutionizing the healthcare industry. While there is widespread concern that these advances will displace human practitioners within the healthcare sector, there are several tasks – including original and nuanced ethical decision making – that they cannot replace. Further, the implementation of artificial intelligence in clinical practice can be anticipated to drive the production of novel ethical tensions surrounding its use, even while eliminating some of the technical tasks which currently compete with ethical (...) deliberation for clinicians’ limited time. A new argument therefore arises to suggest that although these disruptive technologies will change the face of medicine, they may also foster a revival of several fundamental components inherent to the role of healthcare professionals, chiefly, the principal activities of moral philosophy. Accordingly, “machine medicine” presents a vital opportunity to reinvigorate the field of bioethics, rather than withdraw from it. (shrink)

Volume 20, Issue 8, August 2020, Page 51-53.

As Alfandre and colleagues describe in “Between Usual and Crisis Phases of a Public Health Emergency: The Mediating Role of Contingency Measures”, efforts to maintain standards of care durin...

In many jurisdictions, legal frameworks afford patients the opportunity to make prospective medical decisions or to create directives that contain a special provision forfeiting their own ability to object to those decisions at a future time point, should they lose decision‐making capacity. These agreements have been described with widely varying nomenclatures, including Ulysses Contracts, Odysseus Transfers, Psychiatric Advance Directives with Ulysses Clauses, and Powers of Attorney with Special Provisions. As a consequence of this terminological heterogeneity, it is challenging for healthcare (...) providers to understand the terms and uses of these agreements and for ethicists to engage with the nuances of clinical decision‐making with such unique provisions surrounding patient autonomy. In theory, prospective self‐binding agreements may safeguard patient's “authentic” wishes from future “inauthentic” changes of mind. In practice, it is unclear what may be comprised within these agreements or how—and to what effect—they are used. The primary focus of this integrative review is to curate the existing literature describing Ulysses Contracts (and analogous decisions) used in the clinical arena, in order to empirically synthesize their shared essence and provide insights into the traditional components of these agreements when used in practice, the requirements of their consent processes, and the outcomes of their utilization. (shrink)

Objective: To examine the role of explainability in machine learning for healthcare (MLHC), and its necessity and significance with respect to effective and ethical MLHC application. Study Design and Setting: This commentary engages with the growing and dynamic corpus of literature on the use of MLHC and artificial intelligence (AI) in medicine, which provide the context for a focused narrative review of arguments presented in favour of and opposition to explainability in MLHC. Results: We find that concerns regarding explainability are (...) not limited to MLHC, but rather extend to numerous well-validated treatment interventions as well as to human clinical judgment itself. We examine the role of evidence-based medicine in evaluating unexplainable treatments and technologies, and highlight the analogy between the concept of explainability in MLHC and the related concept of mechanistic reasoning in evidence-based medicine. Conclusion: Ultimately, we conclude that the value of explainability in MLHC is not intrinsic, but is instead instrumental to achieving greater imperatives such as performance and trust. We caution against the uncompromising pursuit of explainability, and advocate instead for the development of robust empirical methods to successfully evaluate increasingly inexplicable algorithmic systems. (shrink)

In their forthcoming article, ‘What makes a medical intervention invasive?’ De Marco, Simons, and colleagues explore the meaning and usage of the term ‘invasive’ in medical contexts. They describe a ‘Standard Account’, drawn from dictionary definitions, which defines invasiveness as ‘incision of the skin or insertion of an object into the body’. They then highlight cases wherein invasiveness is employed in a manner that is inconsistent with this account (eg, in describing psychotherapy) to argue that the term invasiveness is often (...) used to explicitly or implicitly reference interventions that do not fall under the standard account. The authors offer an alternative ‘schematic’ definition of invasiveness, whereby medical interventions entail an underlying context-independent property of ‘basic invasiveness’ and may be understood both relative to each other and to a context-specific threshold of what is ‘invasive’.1 We propose that the meaning of terms such as ‘invasiveness’ is necessarily heterogeneous, and that what is implied by its usage will certainly depend on context, particularly in medical settings. Hence, the creation of a unifying definition is less critical than clarification of the implied and intended meanings of each instance of the term’s use. We further argue that interpreting the use of terms like ‘invasiveness’ in medical practice is complicated by the embedding of each use of this term in a different ‘language game’, whereby words and their meanings are understood by an in-group familiar with …. (shrink)

Analgesia and amnesia represent two complimentary pillars of anesthesia directed, respectively, at mitigating the experience of pain and the processes of encoding that experience into memory. These elements are typically combined in modern anesthetic techniques, but some circumstances exist – such as conscious sedation – in which the conditions of amnesia are satisfied while analgesia plays an auxiliary and often incomplete role. These activities reflect a widely held yet underrecognized belief in clinical practice that although pain experiences may be short-lived, (...) their representation in memory and its subsequent effects on thought and emotion can have enduring consequences for patients. In this exploratory article, we delineate phenomenal and abstract ontological categories of pain experience; advance a claim that they are treated by analgesic and amnestic agents, respectively; and describe how each class of experience is uniquely able to bring about individual harm. Beginning with the question of how it can be permissible to allow any preventable experiences or memories of pain, we identify that both phenomenal and abstract pain manifest on a spectrum of severity, each with an enigmatic threshold – unique to circumstance and individual – that determines whether or not pain will translate into harm, and what permissions therefore surround its treatment. Ultimately, we find that there are compelling physiological reasons for the concurrent use of analgesics and amnestics when pain experience exceeds these thresholds, while the treatment of “sub-threshold” experience in either class is a purely ethical imperative to be balanced with considerations of the potential harms posed by the treatments themselves. (shrink)

In their forthcoming article, Shavelson and colleagues (2023) identify a key ethical concern associated with medical aid-in-dying (MAiD) laws in the eleven US jurisdictions where the practice is le...

BackgroundThe expectation of pandemic-induced severe resource shortages has prompted authorities to draft and update frameworks to guide clinical decision-making and patient triage. While these documents differ in scope, they share a utilitarian focus on the maximization of benefit. This utilitarian view necessarily marginalizes certain groups, in particular individuals with increased medical needs.Main bodyHere, we posit that engagement with the disability critique demands that we broaden our understandings of justice and fairness in clinical decision-making and patient triage. We propose the capabilities (...) theory, which recognizes that justice requires a range of positive capabilities/freedoms conducive to the achievement of meaningful life goals, as a means to do so. Informed by a disability rights critique of the clinical response to the pandemic, we offer direction for the construction of future clinical triage protocols which will avoid ableist biases by incorporating a broader apprehension of what it means to be human.ConclusionThe clinical pandemic response, codified across triage protocols, should embrace a form of justice which incorporates a vision of pluralistic human capabilities and a valuing of positive freedoms. (shrink)

"Why should we care about having true beliefs? And why do demonstrably false beliefs persist and spread despite consequences for the people who hold them? Philosophers of science Cailin O’Connor and James Weatherall argue that social factors, rather than individual psychology, are what’s essential to understanding the spread and persistence of false belief. It might seem that there’s an obvious reason that true beliefs matter: false beliefs will hurt you. But if that’s right, then why is it irrelevant to (...) many people whether they believe true things or not? In an age riven by "fake news," "alternative facts," and disputes over the validity of everything from climate change to the size of inauguration crowds, the authors argue that social factors, not individual psychology, are what’s essential to understanding the persistence of false belief and that we must know how those social forces work in order to fight misinformation effectively."–Publisher’s description. (shrink)

Although vast and complex, the universe is orderly in many ways, and conditions at its beginning were right for the eventual evolution of life on this planet. But with life there is death, and with sentient life there is great pain and suffering, often with no apparent justification or purpose. Taking these things together, is it reasonable to conclude that the universe was brought about by God? Moreover, does the magnitude of seemingly pointless suffering square with the idea that God (...) exists, or is it good reason to think there is no God? These questions come up for many people, not just religious believers, and are examined in this engaging and thought-provoking book. Starting out with no pre-disposition to theism, atheism, or agnosticism, God, Evil, and Design takes up these questions in order to see where an impartial investigation leads. To achieve impartiality, the reader is invited to simulate ignorance insofar as his or her own religious preference is concerned. With this approach, God, Evil, and Design provides both a fresh look at important and controversial issues in philosophy and an excellent introduction to the contemporary debates surrounding them. Lively and non-technical, this book will be accessible to anyone with an interest in these topics. (shrink)

Mild signs of postpartum depression or anxiety are present in up to half of all new mothers. However, the impact of having the “baby blues” on infant development remains largely unknown. The current study explores a potential relation between mother’s self-reported depression or anxiety symptoms and infant’s motor development in a longitudinal sample of 50 mother-infant dyads. Further, we examine whether engaging in fetal kick counting during pregnancy may reduce maternal psychopathology symptoms and thereby positively influence infant motor development and (...) parent-child engagement during the first months of life. We hypothesized that subclinical maternal psychopathology would negatively impact infant motor development, and that completing a fetal kick count activity during the third trimester would reduce overall signs of maternal psychopathology. Results only partially support these hypotheses. Postpartum maternal anxiety seems to negatively affect the emergence of infants’ fine motor skills. However, engaging in fetal kick counting during pregnancy did not reduce maternal depression or anxiety symptoms. Nevertheless, preliminary evidence suggests that engaging in fetal kick counting may impact early child development by altering the mother’s attitudes toward the child. Future research is needed to examine the value of this low-cost intervention strategy more closely. (shrink)

The shortages of baby formula in the US resulting from the voluntary recall of contaminated products and shutdown of manufacturing facility in February led to increases in the national out-of-stock rate of the baby formula from 18 to 70% over the summer of 2022. This study utilizes social media listening and data analysis to examine how online media reactions to the physical shortage changed over time and how the reaction to the shortage differed from to the initial recall announcements. Improved (...) understanding of reactions to emergent issues in foods through this lens may improve communication efficiency to mitigate potential consequences. (shrink)

The “scarred villain” trope, where facial differences like scars signify moral corruption, is ubiquitous in film (e.g., Batman’s The Joker). Strides by advocacy groups to undermine the trope, however, suggest cinematic representations of facial differences could be improving with time. This preregistered study characterized facial differences in film across cultures (US vs. India) and time (US: 1980-2019, India: 2000-2019). Top-grossing films by country and decade were screened for characters with facial differences. We found that the scarred villain trope has actually (...) worsened with time, although in tandem with progress in also representing non-villainous characters with facial anomalies. Country of origin did not predict the presence of facial differences in villains or heroes. “Action” and “fantasy” movies were the most likely genres to depict villains with facial differences. Finally, villains’ facial differences crossed more facial subunits and were more likely to involve lips, chin, and mandible than when present in heroes. Our findings underscore the need for critical reflection on the role of cultural practices—even when seemingly innocuous—in shaping and maintaining negative biases against already stigmatized groups. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:AsphyxiationsSteven Connor (bio)Recent events and sociorhetorical expatiations upon them have reaffirmed breathing as the ideal form of free and unimpeded life, that struggles against the throttlings of oppression. The root meaning of oppression, from the past participle of Latin opprimere, is to press, crush or bear down upon, and the word oppression has commonly been used to signify the feeling of the difficulty of breathing, through some constriction (...) or pressure, as in the nocturnal attentions of the nightmare, the spirit imagined as settling suffocatingly on the chest of the sleeper. As a mare that rides rather than being ridden, the spirit is often imagined as a female succubus, though in Fuseli's 1781 painting the mare is accompanied by a simian incubus who squats on the chest of a female sleeper, prompting these lines from Erasmus Darwin:So on his Nightmare through the evening fogFlits the squab Fiend o'er fen, and lake, and bog;Seeks some love-wilder'd maid with sleep oppress'd,Alights, and grinning sits upon her breast.(Darwin 2.16)'Pressing' meant the forcing of somebody into some condition or service, typically the army or navy. In oppressive weather, the clouds may seem to 'lower', or the humid air to cramp and confine the body.We think of breathing as opening or release, of a piece with open windows and unbounded spaces. Human beings have brewed up fantasies for centuries of more complete modes of breathing that would overcome the constriction represented by the respiratory apparatus, exhorting themselves and each other to breathe more deeply, suffusing, not just the lungs, but the diaphragm, the head, and other items of phantasmal physiology. Indeed, the factitiously hollow spaces of the body–the head that we seek to keep 'clear'–are the proof of the belief in the strange principle of vital vacuity, the idea that we exist most fully in empty spaces of innerness, bodily enclosures evacuated of body. Without this sense of the animating function of the breath, the body suffers the inanition of a "want of living [End Page 74] breath in its lungs, which are full of gases but empty of spirit" (Wilkinson 78). In being taken in and given out, breath seems to commute between what Wittgenstein calls "two kinds of worlds, worlds built of different materials." The fact that "the mental world in fact is liable to be imagined as gaseous, or rather, aethereal," seems to Wittgenstein to be related to "the queer role which the gaseous and the aethereal play in philosophy,–when we perceive that a substantive is not used as what in general we should call the name of an object, and when therefore we can't help saying to ourselves that it is the name of an aethereal object" (Wittgenstein 47). The conception of the soul as an afflatus, or a special kind of magic gas, which has been common among so many different peoples, suggests just this kind of aethereal object-that-is-not-one. It embodies the conviction that we are most essentially present as ourselves where we are closest to being nothing, in an out-of-body kind of body.We breathe out–phew, originally in the seventeenth century a violent expression of disgust or emancipatory emptying, as we might nowadays plosively and purifyingly say poo–when we 'ex-press', as we say, our sense of being, as we also say, 'relieved,' from re + levare, to lift up, implying a lightening, or levitation, that approaches in imagination the condition of air itself. To ventilate is to levitate. To be relieved is to dream of remission from the clinging pressure of your own embodiment, as though you could simply emit or expel your own weight. To inhale is to prepare for stress and struggle: to exhale is to relax, to sigh into satisfaction, converting becoming momentarily to being. Exhalation is therefore the decorporizing of the body, or the corporealization of the incorporeal. But though human beings exalt imaginary emptying, as the purifying expulsion of what is evil, infective, invasive, persecutory, expiration is also death. Speech is the expressive sound formed from the impressing of exhaled breath, the dissolving openness of air given imaginary... (shrink)

Most non-human animals live in the wild and it is probable that suffering predominates in their lives due to natural events. Humans may at some point be able to engage in paradise engineering, or the modification of nature and animal organisms themselves, to improve the well-being of wild animals. We may, in other words, make nature 'red in tooth and claw' no more. We argue that this creates a tension between environmental ethics and animal ethics which is likely insurmountable. First, (...) we argue that concern for the environment can be compatible with helping individual wild animals but should see redesigning nature as morally impermissible. Second, we argue that if we are concerned with animal well-being, we may reject that we have a duty to help wild animals even to the point of redesigning nature, but we must nevertheless concede that it is permissible to do so under certain circumstances. We show how this permissibility can be derived from three animal rights views: Tom Regan's, a novel account inspired by Thomas Pogge and a libertarian approach to animal rights. (shrink)

The last decade has seen an explosion of research on the gut microbiota—the trillions of microorganisms that colonize the human gut. It is now clear that interindividual diversity in microbiota composition plays an important role in determining susceptibility to a wide variety of diseases. However, identifying the precise changes in microbiota composition that play causal roles has remained a largely unrealized goal. Here, we propose that functional classifications of microbes based on their interactions with and effects on the host—particularly the (...) host immune system—will illuminate the role of the microbiota in shaping human physiology. We outline the benefits of “functional” classification compared to phylogenetic classifications, and review current efforts at functional classification of the microbiota. Finally, we outline a theoretical framework for classifying host-microbiota interactions. Future advances enabling broader functional classifications of the microbiota promise to revolutionize our understanding of the role of gut microbes in health and disease. Functional classifications of the human microbiota reveal previously hidden patterns and will be key to cracking the microbiota composition code. This figure shows a theoretical comparison between phylogenetic classification and functional classification of a host-associated microbial community. (shrink)

In her Pharmaceutical Freedom, Jessica Flanigan argues that antibiotics can be regulated consistent with her otherwise largely deregulatory view with respect to pharmaceuticals and recreational drugs. I contend in this essay that the reasons for justifying antibiotic regulation are reasons that can be offered to justify the regulation of many other drugs, both pharmaceutical and recreational. After laying out the specifics of Flanigan’s view, I suggest that it is amenable to the regulation of drugs like varenicline. Though such drugs can (...) legitimately improve the quality of a patient’s life by helping them quit smoking, they could be permissibly regulated if they expose others to impermissible risks. I then argue that recreational drugs like alcohol could be regulated using the same reasoning. In the penultimate section of this essay, I anticipate objections that one might have to my extension of arguments favoring antibiotic regulation to drugs correlated with aggression. Flanigan might find my extrapolation of her view as entirely plausible and accept that her view is relatively friendly to these regulations, or she might reconsider her antibiotic caveat if these regulations are overly paternalistic on her understanding. I conclude by briefly considering the benefits and drawbacks of adopting each view. (shrink)

In this article the author examines Fitzpatrick’s foundational critique of liberal legality and racism, a theme which remained central to his decades-long excavation of modern law’s self-identity. After considering Fitzpatrick’s ‘separation thesis’, the author then turns to consider the ways in which neoliberal legality is parasitic upon liberal legal racial formations while at the same time, obscuring the foundational place of race in contemporary capitalism by subsuming material life within its modes of value extraction.

ArgumentBy the mid-eighteenth century, governors of the major European states promoted the study of nature as part of natural-resource based schemes for improvement and economic self-sufficiency. Procuring beneficial knowledge about nature, however, required observers, collectors, and compilers who could produce usable and useful descriptions of nature. The ways governments promoted scientific explorations varied according to the form of government, the makeup of the civil society, the state's economic ideologies and practices, and the geographical situation. This article argues that the roots (...) of a major natural history initiative in Denmark-Norway were firmly planted in the state-church organization. Through the clergymen and their activities, a bishop, supported by the government in Copenhagen, could gather an impressive collection of natural objects, receive observations and descriptions of natural phenomena, and produce natural historical publications that described for the first time many of the species of the north. Devout naturalists were a common species in the eighteenth century, when clergymen and missionaries involved themselves in the investigation of nature in Europe and far beyond. The specific interest here is in how natural history was supported and enforced as part of clerical practice, how specimen exchange was grafted on to pre-existing institutions of gift exchange, and how this influenced the character of the knowledge produced. (shrink)

The defection thesis holds that members of marginalized social groups are obligated not to express views important to others in the group that are regarded by the others as substantively wrong. In this essay, I evaluate arguments that seek to vindicate the defection thesis and conclude they all fail. Then, I argue that we have reason to believe sanctioning defectors in certain ways is wrongful and that the expression of their contentious ideas is good for members of marginalized groups. We (...) are left to conclude both that members of marginalized groups have no obligation to suppress certain heterodox views and that it is likely wrong to sanction them for expressing these views even if it were wrong for them to do so. (shrink)

Catherine Malabou's concept of plasticity has influenced and inspired scholars from across disciplines. The contributors to _Plastic Materialities_—whose fields include political philosophy, critical legal studies, social theory, literature, and philosophy—use Malabou's innovative combination of post-structuralism and neuroscience to evaluate the political implications of her work. They address, among other things, subjectivity, science, war, the malleability of sexuality, neoliberalism and economic theory, indigenous and racial politics, and the relationship between the human and non-human. _Plastic Materialities_ also includes three essays by Malabou (...) and an interview with her, all of which bring her work into conversation with issues of sovereignty, justice, and social order for the first time. Contributors. Brenna Bhandar, Silvana Carotenuto, Jonathan Goldberg-Hiller, Jairus Victor Grove, Catherine Kellogg, Catherine Malabou, Renisa Mawani, Fred Moten, Alain Pottage, Michael J. Shapiro, Alberto Toscano. (shrink)

This essay examines some stereotypes of bisexuals held by some lesbians. I argue that the decision that a lesbian makes not to become involved with a bisexual woman because she is bisexual can recenter men in lesbian desire, a consequence many lesbians would find deeply problematic. The acceptance of these stereotypes also results in sex becoming the defining characteristic of one's sexual orientation, thus privileging sex over any emotional, affectional, and political commitments to women.

Social network analysis has become an increasingly important tool among political scientists for understanding legislative cooperation in modern, democratic nation-states. Recent research has demonstrated the influence that group affinity (homophily) and mutual exchanges (reciprocity) have in structuring political relationships. However, this literature has typically focused on political cooperation where costs are low, relationships are not exclusive, and/or partisan competition is high. Patterns of legislative behavior in alternative contexts are less clear and remain largely unexamined. Here, we compare theoretical expectations of (...) cooperation in these contexts from the political and biosocial sciences and implement the first assessment of political alliance formation in a novel legislative environment where costs to cooperation are high and party salience low. We implement a stochastic actor-oriented model (SAOM) to examine bill floor sponsorship, a process in which a “floor sponsor” becomes the exclusive advocate for a colleague’s piece of legislation, in the Utah state legislature from 2005 to 2008—a context in which gender (male) and political party (Republican) supermajorities exist. We find that (1) party and gender homophily predict who legislators recruit as floor sponsors, whereas seniority does not, and (2) legislators frequently engage in reciprocal exchanges of floor sponsorship. In addition, whereas gender homophily increases the likelihood of reciprocity, party homophily decreases it. Our findings suggest that when the cost of cooperation is high, political actors use in-group characteristics for initiating alliances, but once a cooperative relationship is established with an out-group political member, it is reinforced through repeated exchanges. These findings may be useful for understanding the rise of political polarization and gridlock in democracies internationally. (shrink)

In this classic, exciting, and thoughtful text, Metaphysics , Peter van Inwagen examines three profound questions: What are the most general features of the world? Why is there a world? and What is the place of human beings in the world? Metaphysics introduces to readers the curious notion that is metaphysics, how it is conceived both historically and currently. The author's work can serve either as a textbook in a university course on metaphysics or as an introduction to metaphysical thinking (...) for the interested reader. This second edition, revised though not fundamentally changed, includes the basis of the first edition with a new chapter on the nature of time. (shrink)

Faces provide information about a person's identity, as well as their sex, age, and ethnicity. People also infer social and personality traits from the face — judgments that can have important societal and personal consequences. In recent years, deep convolutional neural networks (DCNNs) have proven adept at representing the identity of a face from images that vary widely in viewpoint, illumination, expression, and appearance. These algorithms are modeled on the primate visual cortex and consist of multiple processing layers of simulated (...) neurons. Here, we examined whether a DCNN trained for face identification also retains a representation of the information in faces that supports social‐trait inferences. Participants rated male and female faces on a diverse set of 18 personality traits. Linear classifiers were trained with cross validation to predict human‐assigned trait ratings from the 512 dimensional representations of faces that emerged at the top‐layer of a DCNN trained for face identification. The network was trained with 494,414 images of 10,575 identities and consisted of seven layers and 19.8 million parameters. The top‐level DCNN features produced by the network predicted the human‐assigned social trait profiles with good accuracy. Human‐assigned ratings for the individual traits were also predicted accurately. We conclude that the face representations that emerge from DCNNs retain facial information that goes beyond the strict limits of their training. (shrink)

In this new book, Alessandra Tanesini demonstrates that feminist thought has a lot to offer to the study of Wittgenstein's philosophical work, and that -at the same time-that work can inspire feminist reflection in new directions. In Wittgenstein, Tanesini offers a highly original interpretation of several themes in Wittgenstein's philosophy. She argues that when we look at his work through feminist eyes we discover that he is not primarily concerned with providing solutions to technical problems in the philosophy of mind, (...) mathematics, and language. Instead, his remarks on these topics are intended to offer insights about human finitude, the loneliness of the modern autonomous self, and our relations to other human beings. Thus, the modern conception of the individual emerges as the critical target of Wittgenstein's philosophical work, both early and late. This conception has also been one of the dominant concerns of contemporary feminist philosophy. In this book, Wittgenstein's insights are deployed to further feminist debates on issues such as identity, difference, the masculine character of the modern self. (shrink)

This article argues that Habermas’s formal-pragmatics are better understood as a set of weak-universal dispositions susceptible to erosion over the course of a lifetime, if exposed to continual “disappointing” communicative experiences. Habermas’s rational-reconstructive project to explicate the intuitive rule-consciousness held by competent speakers retains immense theoretical value for analyzing both partisan and mass political discourse, if his emphasis on isolated speech situations is supplemented with a logic of communicative memory better accounting for how disagreement antecedes discourse on the formal-pragmatic register. (...) I argue that Habermas’s concept of the “lifeworld” contains untapped theoretical resources for thinking about the formal-pragmatic consequences of accumulated partisan experiences; namely, how such experiences lead inter-partisan actors to jettison mutual imputations of communicative accountability. I conclude by offering revisions to Habermas’s discourse ethics. Rapport-building intended to alleviate the negative effects of prior accumulated partisan experiences is first necessary if a norm is to enjoy real justification. (shrink)