Enhancement of autonomous choice may be considered as an important reason for facilitating the use of genetic tests such as preimplantation genetic diagnosis. The principle of respect for autonomy is a crucial component not only of Western liberal traditions but also of Western bioethics. This is especially so in bioethical discussions and analyses of clinical encounters within medicine. On the basis of an analysis of qualitative research interviews performed with British, Italian and Swedish geneticists and gynaecologists on ethical aspects of (...) preimplantation genetic diagnosis, the plausibility of the notion of autonomy within reproductive medicine is discussed. The analysis of interviews indicates not only that there is a gap between theoretical discussions and concrete practice, but also that an increase in choice — paradoxically — can hamper couples' choice. (shrink)

_Phenomenological insights into health issues relating to bodily self-experience, normality and deviance, self-alienation, and objectification._.

Death concept, death definition, death criterion and death test pluralism has been described by some as a problematic approach. Others have claimed it to be a promising way forward within modern pluralistic societies. This article describes the New Jersey Death Definition Law and the Japanese Transplantation Law. Both of these laws allow for more than one death concept within a single legal system. The article discusses a philosophical basis for these laws starting from John Rawls' understanding of comprehensive doctrines, reasonable (...) pluralism and overlapping consensus. It argues for the view that a certain legal pluralism in areas of disputed metaphysical, philosophical and/or religious questions should be allowed, as long as the disputed questions concern the individual and the resulting policy, law or acts based on the policy/law, do not harm the lives of other individuals to an intolerable extent. However, while this death concept, death definition, death criterion and death test pluralism solves some problems, it creates others. (shrink)

The influence of pervasive cultural norms on people’s actions constitutes a longstanding problem for autonomy theory. On the one hand, such norms often seem to elude the kind of reflection that autonomous agency requires. On the other hand, they are hardly entirely beyond the pale of autonomy: people do sometimes reflect critically on them and resist them. This paper draws on phenomenological accounts of embodiment in order to reconcile these observations. We suggest that pervasive cultural norms exert a strong and (...) elusive, but occasionally resistible, influence because they are incorporated – they operate on the largely pre-reflective bodily level of human existence. As an illustration we discuss parental decisions about surgery for children born with unclear sex, decisions permeated by deeply entrenched norms about sexual difference and genital appearance. (shrink)

The article examines how some culturally shared and corporeally enacted beliefs and norms about sexed and racialized embodiment can form embodied agency, and this with the aid of the concepts of incorporation and excorporation. It discusses how the phenomenological concept of excorporation can help us examine painful experiences of how one's lived body breaks in the encounter with others. The article also examines how a continuous excorporation can result in bodily alienation, and what embodied resistance can mean when one has (...) undergone or undergoes excorporation. Elaborating on the work of, among others, Maurice Merleau-Ponty, Martin Heidegger, Drew Leder, and Sarah Ahmed, I discuss incorporation and excorporation of beliefs and norms regarding sexual difference, such as beliefs and norms regarding female and male embodiment, through a reading of Jeffrey Eugenides' novel Middlesex. I also suggest that it is useful to understand the postcolonial scholar Frantz Fanon's narrative of how he could not but attend to his own skin color while living in France in the 1940s and 1950s, in terms of excorporation. Whereas these are different narratives in many ways, I regard them as helpful for clarifying what excorporation implies and what analytic work this concept can enable. (shrink)

By drawing on Jean-Luc Nancy’s philosophy of ontological relationality, this article explores what it means to be a ‘we’ in breast cancer. What are the characteristics—the extent and diversity—of couples’ relationally lived experiences of bodily changes in breast cancer? Through analyzing duo interviews with diagnosed women and their partners, four ways of sharing an embodied life are identified. While ‘being different together’, partners have different, albeit connected kinds of experiences of breast cancer. While ‘being there for you’, partners take care (...) of each other in mutually dependent ways. While ‘being reconnected to you’, partners relate to each other through intimacy and sexuality. While ‘being like you’, partners synchronize their embodied daily lives to one another, sometimes up to the point that the self cannot be distinguished from the other anymore. These ways reveal that being a ‘we’ involves complex affective, bodily encounters in which the many fault lines that both separate partners into individual selves and join them together as a unity are continuously reshaped and negotiated. Being a ‘we’ may be understood as something we have to do. Therefore, in being true to the legacy of Nancy, we argue at the end of this article for a sensible praxis of sharing a life and body, particularly in breast cancer. (shrink)

In vitro fertilization with reception of oocytes from partners allows lesbian mothers to share biological motherhood. The gestational mother receives an egg from her partner who becomes the genetic mother. This article examines the ethics of IVF with ROPA with a focus on the welfare of the woman and the resulting child, on whether ROPA qualifies as a “legitimate” medical therapy that falls within the goals of medicine, and on the meaning and value attributed to a biologically shared bond between (...) parents and child. We also contrast IVF with ROPA with egg donor IVF for heterosexual couples and intrafamilial live uterus transplantation with IVF, and show how Swedish legislation makes certain ways of sharing biological bonds out of place. In Sweden, IVF with ROPA is illegal, egg donor IVF for heterosexual couples is allowed and practiced as is sperm donor IVF for lesbians, and live uterus transplantation is performed within a research project. But is ROPA really ethically more problematic than these other cases? The article argues that IVF with ROPA gives rise to fewer ethical questions than does live uterus transplantation with IVF and, in some cases, egg donor IVF. (shrink)

Feminist technoscience and feminist phenomenology have seldom been brought into dialogue with each other, despite them sharing concerns with subjectivity and normativity, and despite both of them moving away from sharp subject-object distinctions. This is unfortunate. This article argues that, while differences between these strands need to be acknowledged, such differences should be put to productive use. The article discusses a case of school bullying, and suggests that bringing these analytic perspectives together enables and sharpens examinations of the role of (...) subjectification and subject positions for subjectivity in the phenomenological sense; affectivity within material-discursive entanglements and constellations of humans and things, and as connecting the body, things and the world in specific ways; and normativity as enacted, lived and embedded in perception. (shrink)

The global shortage of organs for transplantation and the development of new and better medical technologies for organ preservation have resulted in a renewed interest in non-heart-beating donation (NHBD). This article discusses ethical questions related to controlled and uncontrolled NHBD. It argues that certain preparative measures, such as giving anticoagulants, should be acceptable before patients are dead, but when they have passed a point where further curative treatment is futile, they are in the process of dying and they are unconscious. (...) Furthermore, the article discusses consequences of technological developments based on improvement of a chest compression apparatus used today to make mechanical heart resuscitation. Such technological development can be used to transform cases of non-controlled NHBD to controlled NHBD. In our view, this is a step forward since the ethical difficulties related to controlled NHBD are easier to solve than those related to non-controlled NHBD. However, such technological developments also evoke other ethical questions. (shrink)

Emotionally-related live organ donation is different from almost all other medical treatments in that a family member or, in some countries, a friend contributes with an organ or parts of an organ to the recipient. Furthermore, there is a long-acknowledged but not well-understood gender-imbalance in emotionally-related live kidney donation. This article argues for the benefit of the concept of just love as an analytic tool in the analysis of emotionally-related live organ donation where the potential donor(s) and the recipient are (...) engaged in a love relation. The concept of just love is helpful in the analysis of these live organ donations even if no statistical gender-imbalance prevails. It is particularly helpful, however, in the analysis of the gender-imbalance in live kidney donations if these donations are seen as a specific kind of care-work, if care-work is experienced as a labour one should perform out of love and if women still experience stronger pressures to engage in care-work than do men. The aim of the article is to present arguments for the need of just love as an analytic tool in the analysis of emotionally-related live organ donation where the potential donor(s) and the recipient are engaged in a love relation. The aim is also to elaborate two criteria that need to be met in order for love to qualify as just and to highlight certain clinical implications. (shrink)

With pre-implantation genetic diagnosis (PGD), genetic testing and selective transfer of embryos is possible. In the future, germ-line gene therapy (GLGT) applied to embryos before implantation, in order to introduce missing genes or replace mutant ones, may be possible. The objective of this dissertation is to analyse moral aspects of these technologies, as described by eighteen British, Italian and Swedish gynaecologists and geneticists. The objective is systematised into three parts: research interviews and qualitative analysis, philosophical analysis, and elaboration of a (...) framework that supports the combination of analytic methods. PGD was described as positive since it enabled some couples at risk for a genetic disease to have a child without the disease. PGD was described as in different senses ‘better’ than methods for prenatal diagnosis and selective termination of pregnancy. It was also described as positive since it provided couples at risk with one more option, even if it did not result in the birth of a healthy child. However, interviewees were concerned about the difficulty of defining and evaluating genetic disease. They were also concerned about patients’ choices, and about exaggerated use or misuse. Whereas PGD gave rise to ambivalence in terms of how to understand, describe and evaluate it, GLGT was often described as unrealistic or undesirable. The results of the qualitative analysis are used in a philosophical analysis of the concepts of choice, autonomous choice, ambivalence, trust and ambivalence in trust relations. A set of distinct characteristics of each concept are elaborated. The results of the philosophical analysis are used in the discussion of the results of the qualitative analysis. The study shows that the technologies imply both ‘new’ ways to perform ‘old’ medical practices and ‘new’ practices. Old moral questions are reformulated. New moral questions are added. Against the background of this, the concept of genetic identity is discussed. Key words: empirical ethics, pre-implantation genetic diagnosis, germ-line gene therapy, qualitative research, philosophical analysis, medical progress, genetic disease, choice, autonomous choice, ambivalence, trust, genetic identity. (shrink)

Recent years have seen a rise in the number of sociological, anthropological, and ethnological works on the gift metaphor in organ donation contexts, as well as in the number of philosophical and theological analyses of giving and generosity, which has been mirrored in the ethical debate on organ donation. In order to capture the breadth of this field, four frameworks for thinking about bodily exchanges in medicine have been distinguished: property rights, heroic gift-giving, sacrifice, and gift-giving as aporia. Unfortunately, they (...) all run into difficulties in terms of both making sense of the relational dimensions of postmortem and live organ donations and being normatively adequate in the sense of shedding light and providing guidance on ethical concerns when body parts are donated. For this reason, this article presents a phenomenological framework of giving-through-sharing, based on Maurice Merleau-Ponty’s philosophy. This framework makes sense of relational dimensions of postmortem and live organ donation. It also sheds light on three highly debated concerns in organ donation ethics: indebtedness on the part of recipients, the fact that some live donors do not experience donation as a matter of choice, and the potentially painful experience of donors’ relatives, who need to make decisions about postmortem organ donation at a time of bereavement. It can indirectly support what may be called a normalization of bodily exchanges in medicine. (shrink)

According to the US National Institute on Aging and the Alzheimer’s Association (NIA-AA), Alzheimer’s disease (AD) should be understood as a biological construct. It can be diagnosed based on AD-characteristic biomarkers only, even if AD biomarkers can be present many years before a person experiences any symptoms of AD. The NIA-AA’s conceptualisation of AD radically challenges past AD conceptualisations. This article offers ananalytic framework for the clarification and analysis of meanings and effects of conceptualisations of diseases such as that of (...) AD. This framework consists of nine questions that allows us to determine how the conceptualisations of diseases, such as that of AD, link or decouple the following terms to/from each other: screening, diagnosis, pathology, disease (along the lines of what have been labelled as “biological-physiological” or “normative” conceptions of disease in philosophy of medicine), symptoms, and illness. It also includes questions regarding how specific decouplings open up for new categories through which people can understand themselves in new ways, and what spaces of possibilities specific conceptualisations (and their decouplings and linkages) open to. The article shows how specific decouplings/linkages can open up not only for the phenomena of pathologisation but also for a distinct, but related phenomenon here termed as diseasisation. (shrink)

Some bioethicists engage with empirical work on stakeholders’ values, attitudes, and experiences as a basis for theorizing ethics in the context of healthcare. Related to this empirical turn, a deb...

Few parents-to-be consider that their child may be born with ambiguous sex. Still, parents of a newborn child with ambiguous sex are expected to make a far-reaching decision for the child: should the child be operated upon so that it has either female or male genitals? The aim of this article is to examine, phenomenologically, why parents decide to have their children undergo genital surgery when it is not necessary for the child’s physiological functions. Drawing on phenomenological work by Maurice (...) Merleau-Ponty, Simone de Beauvoir and Sara Ahmed, we examine parents’ frustration when their child’s sex is ambiguous and their experiences of the practice of medical sex assignment. We also examine parental identity work when the child has been assigned a sex and the interaction between parents and medical professionals when parents make decisions regarding surgery on their child. Furthermore, we provide a critical perspective on the surgical practice. (shrink)

Medical therapy, research and technology enable us to make our bodies, or parts of them, available to others in an increasing number of ways. This is the case in organ, tissue, egg and sperm donation as well as in surrogate motherhood and clinical research. Bringing together leading scholars working on the ethical, social and cultural aspects of such bodily exchanges, this cutting-edge book develops new ways of understanding them. Bodily Exchanges, Bioethics and Border Crossing both probes the established giving and (...) selling frameworks for conceptualising bodily exchanges in medicine, and seeks to develop and examine another, less familiar framework: that of sharing. A framework of sharing can capture practices that involve giving up and giving away part of one's body, such as organ and tissue donation, and practices that do not, such as surrogacy and research participation. Sharing also recognizes the multiple relationalities that these exchanges can involve and invites inquiry into the context in which they occur. In addition, the book explores the multiple forms of border crossing that bodily exchanges in medicine involve, from the physical boundaries of the body to relational borders - as can happen in surrogacy - to national borders and the range of ethical issues that these various border-crossings can give rise to. Engaging with anthropology, sociology, philosophy, and feminist and postcolonical perspectives, this is an original and timely contribution to contemporary bioethics in a time of increasing globalization. It will be of use to students and researchers from a range of humanities and social science backgrounds as well as medical and other healthcare professionals with an interest in bioethics. (shrink)

Studies on surrogate motherhood have mostly explored paid arrangements through the lens of a contract model, as clinical work or as a maternal identity-building project. Turning to the under-examined case of unpaid, so-called altruistic surrogate motherhood and based on an analysis of interviews with women who had been unpaid surrogate mothers in a full gestational surrogacy with a friend or relative in Canada, the United States or Australia, this article explores altruistic surrogate motherhood as relational work. It argues that this (...) form of surrogate motherhood within close interpersonal relations can be conceptualised through the relational work involved in hosting a child for the intended parents. The article explores how relational work in this context implies an embodied, asymmetrical and far-reaching sense of responsibility that surrogate mothers describe as characteristic of their surrogacy experience. In this way, the article sheds light on feminist concerns about surrogacy as an embodied and objectifying work of women while at the same time illuminating how surrogate mothers respond to the intended parents in light of their pre-surrogacy relationship, how meanings are negotiated by them and how relationships are managed during the pregnancy. (shrink)

The aim of this article is to explore nuances within the field of bodily self-awareness. My starting-point is phenomenological. I focus on how the subject experiences her or his body, i.e. how the body stands forth to the subject. I build on the phenomenologist Drew Leder’s distinction between bodily dis-appearance and dys-appearance. In bodily dis-appearance, I am only prereflectively aware of my body. My body is not a thematic object of my experience. Bodily dys-appearance takes place when the body appears (...) to me as “ill” or “bad.” This is often the case when I experience pain or illness. Here, I will examine three versions of bodily dys-appearance. Whereas many phenomenological studies have explored cases of bodily dys-appearance, few studies have focused on the opposite of bodily dys-appearance, i.e. on bodily modes of being where the body appears to the subject as something good, easy or well. This is done in this article. When the body stands forth as good, easy or well to the subject, I suggest that the body eu-appears to this person. The analysis of eu-appearance shows that the subject can attend to her or his body as something positive and that this attention need not result in discomfort or alienation. Eu-appearance can take place in physical exercise, in sexual pleasure and in some cases of wanted pregnancies. I also discuss, briefly, the case of masochism. (shrink)

What is the impact of genetics and genomics on issues of identity and what do we mean when we speak of identity? This paper explores how certain concepts of identity used in philosophy can be brought together in a multi-layered concept of identity. It discusses the concepts of numerical, qualitative, personal and genetic identity-over-time as well as rival concepts of genomic identity-over-time. These are all understood as layers in the multi-layered concept of identity. Furthermore, the paper makes it clear that (...) our understanding of genomic identity and the importance attached to genomic sameness-over-time matters for the ethical questions raised by certain new gene technologies. (shrink)

Much discussion of decision-making processes in medicine has been patient-centred. It has been assumed that there is, most often, one patient. Less attention has been given to shared decision-making processes where two or more patients are involved. This article aims to contribute to this special area. What conditions need to be met if decision-making can be said to be shared? What is a shared decision-making process and what is a shared autonomous decision-making process? Why make the distinction? Examples are drawn (...) from the area of new reproductive medicine and clinical genetics. Possible gender-differences in shared decision-making are discussed. (shrink)

In 2014, the first child in the world was born after live uterus transplantation and IVF (UTx-IVF). Before and after this event, ethical aspects of UTx-IVF have been discussed in the medical and bioethical debate as well as, with varying intensity, in Swedish media and political fora. This article examines what comes to be identified as important ethical problems and solutions in the media debate of UTx-IVF in Sweden, showing specifically how problems, target groups, goals, benefits, risks and stakes are (...) delineated and positioned. It also demonstrates how specific assumptions, norms and values are expressed and used to underpin specific positions within this debate, and how certain subjects, desires and risks become shrouded or simply omitted from it. This approach—which we label the Ethics of the Societal Entrenchment-approach, inspired by Koch and Stemerding (1994)—allows us to discuss how the identification of something as the problem helps to shape what gets to be described as a solution, and how specific solutions provide frameworks within which problems can be stated and emphasised. We also offer a critical discussion of whether some of these articulations and formations should be seen as ethically troubling, and if so, why. (shrink)

The article’s aim is to explore human hand allograft recipients’ postoperative experience of disownership and their gradual experience of their new hand as theirs, with the aid of the work of the French phenomenologist Maurice Merleau-Ponty. Many have used a Merleau-Pontinian perspective in the analysis of embodiment. Far fewer have used it in medico-ethical analysis. Drew Leder’s phenomenologically based ethics of organ donation and organ sale is an exception to this tendency. The article’s second aim is to examine Leder’s phenomenologically (...) based ethics of organ donation and organ sale. Though I find parts of Leder’s approach promising, I also elaborate a line of reasoning that draws on Merleau-Ponty, that does allow us to argue for certain kinds of organ donation and against organ sale—and that avoids some of the problems with Leder’s approach. This alternative route builds on the concept of the integrity of the body-subject. (shrink)

While the value of early detection of dementia is largely agreed upon, population-based screening as a means of early detection is controversial. This controversial status means that such screening is not recommended in most national dementia plans. Some current practices, however, resemble screening but are labelled “case-finding” or “detection of cognitive impairment”. Labelled as such, they may avoid the ethical scrutiny that population-based screening may be subject to. This article examines conceptualizations of screening and case-finding. It shows how the definitions (...) and delimitations of the concepts (the _what_ of screening) are drawn into the ethical, political, and practical dimensions that screening assessment criteria or principles are intended to clarify and control (the _how_ of screening, how it is and how it should be performed). As a result, different conceptualizations of screening provide the opportunity to rethink what ethical assessments should take place: the conceptualizations have different ethico-political implications. The article argues that population-based systematic screening, population-based opportunistic screening, and case-finding should be clearly distinguished. (shrink)

Since John Locke, regnant conceptions of personhood in Western philosophy have focused on individual capabilities for complex forms of consciousness that involve cognition such as the capability to remember past events and one’s own past actions, to think about and identify oneself as oneself, and/or to reason. Conceptions of personhood such as Locke's qualify as cognition-oriented, and they often fail to acknowledge the role of embodiment for personhood. This article offers an alternative conception of personhood from within the tradition of (...) phenomenology of the body. The article presents a phenomenological analysis of joint musical activity in dementia care and outlines an intercorporeal conception of personhood based on this analysis. It also provides a philosophical basis for the idea that others can hold us in personhood, and it questions a strict one-body-one-person logic that has pertained in much personhood debate. (shrink)

Despite the growing literature on childhood obesity and lifestyle intervention programmes focusing on weight loss, few studies have examined young persons’ experiences of being identified as candidates for such programmes and of participating in them. This paper does so. Juxtaposing insights from phenomenology with an approach inspired by Foucault, the paper shows how teenage girls’ bodily self-perception and bodily self-awareness are shaped in intercorporeal assemblages comprising other people and specific features or elements of the lifestyle programme. Inspired by van Manen’s (...) hermeneutic-phenomenological approach, with its point of departure in lived experience, this paper draws on interviews with Norwegian teenage girls participating in the same lifestyle programme and identifies three core thematic aspects of the girls’ experiences: being identified as a candidate for a lifestyle programme and not wanting this; negotiating the lack of weight loss and the scales; and bodily situated agency – feeling good and being able. Permeating all three themes are two central, interrelated phenomena: agency and resistance. Furthermore, the paper shows how a combination of Foucauldian insights and a phenomenological understanding of intercorporeality can help to shed light on the power, affective, material and temporal dimensions of dys-appearance, as well as those of eu-appearance, and thus contribute to the understanding of the girls’ narrated lived experiences. On the basis of these findings, we argue that weight-related treatment goals are not necessarily compatible with the strengthening of adolescents’ body images and self-esteem. However, whilst being obliged to attend to their bodies while in the programme, the girls also encountered unexpected, positive bodily feelings and experiences. Such events, we suggest, offer a means of resisting the more troubling dys-appearing bodily situations our participants described so powerfully. (shrink)

Two ethical frameworks have dominated the discussion of organ donation for long: that of property rights and that of gift-giving. However, recent years have seen a drastic rise in the number of philosophical analyses of the meaning of giving and generosity, which has been mirrored in ethical debates on organ donation and in critical sociological, anthropological and ethnological work on the gift metaphor in this context. In order to capture the flourishing of this field, this article distinguishes between four frameworks (...) for thinking about bodily exchanges in medicine: those of property rights, heroic gift-giving, sacrifice, and gift-giving as aporia. These frameworks represent four different ways of making sense of donation of organs as well as tissue, gametes and blood, draw on different conceptions of the relations between the self and the other, and bring out different ethical issues as core ones. The article presents these frameworks, argues that all of them run into difficulties when trying to make sense of reciprocity and relational interdependence in donation, and shows how the three gift-giving frameworks (of heroism, sacrifice and aporia) hang together in a critical discussion about what is at stake in organ donation. It also presents and argues in favour of an alternative intercorporeal framework of giving-through-sharing that more thoroughly explicates the gift metaphor in the context of donation, and offers tools for making sense of relational dimensions of live and post mortem donations. (shrink)

Free and informed choice is an oft-acknowledged ethical basis for living kidney donation, including parental living kidney donation. The extent to which choice is present in parental living kidney donation has, however, been questioned. Since parents can be expected to have strong emotional bonds to their children, it has been asked whether these bonds make parents unable to say no to this donation. This article combines a narrative analysis of parents’ stories of living kidney donation with a philosophical discussion of (...) conditions for parental decision-making. Previous research has shown that parents often conclude that it is “natural” to donate. Our study shows that this naturalness needs to be understood as part of a story where parental living kidney donation is regarded as natural and as a matter of non-choice. Our study also highlights the presence of a parenthood moral imperative of always putting one’s child’s needs before one’s own. On the basis of these results, we discuss conditions for decision-making in the context of parental LKD. We argue that the presence of a parenthood moral imperative can matter with regard to the decision-making process when parents consider whether to volunteer as living kidney donors, but that it need not hamper choice. We emphasise the need for exploring relational and situational factors in order to understand parental decision-making in the context of parental LKD. (shrink)

This article examines a population-based opportunistic screening practice for cognitive impairment that takes place at a hospital in Sweden. At the hospital, there is a routine in place that stipulates that all patients over the age of 65 who are admitted to the ward will be offered testing for cognitive impairment, unless they have been tested within the last six months or have been diagnosed with any form of cognitive impairment. However, our analysis shows that this routine is not universally (...) and mechanically applied. Rather, the health care professionals have developed and use an ethico-political judgment, concerning, for example,whomto test,whento offer the tests, andhowto explain and perform them. This article explores the role and practice of this form of judgment, emphasising its political and ethical nature. The analysis is based on qualitative interviews with professionals and patients, and draws on the theories of Aristotle and Hannah Arendt. (shrink)

The article’s aim is to explore human hand allograft recipients’ postoperative experience of disownership and their gradual experience of their new hand as theirs, with the aid of the work of the French phenomenologist Maurice Merleau-Ponty. Many have used a Merleau-Pontinian perspective in the analysis of embodiment. Far fewer have used it in medico-ethical analysis. Drew Leder’s phenomenologically based ethics of organ donation and organ sale is an exception to this tendency. The article’s second aim is to examine Leder’s phenomenologically (...) based ethics of organ donation and organ sale. Though I find parts of Leder’s approach promising, I also elaborate a line of reasoning that draws on Merleau-Ponty, that does allow us to argue for certain kinds of organ donation and against organ sale—and that avoids some of the problems with Leder’s approach. This alternative route builds on the concept of the integrity of the body-subject. (shrink)

Our approach to global bioethics will depend, among other things, on how we answer the questions whether global bioethics is possible and whether it, if it is possible, is desirable. Our approach to global bioethics will also vary depending on whether we believe that the required bioethical deliberation should take as its principal point of departure that which we have in common or that which we have in common and that on which we differ. The aim of this article is (...) to elaborate a theoretical underpinning for a bioethics that acknowledges the diversity of traditions and experiences without leading to relativism. The theoretical underpinning will be elaborated through an exploration of the concepts of sameness, otherness, self and other, and through a discussion of the conditions for understanding and critical reflection. Furthermore, the article discusses whether the principle of respect for the other as both the same and different can function as the normative core of this global bioethics. The article also discusses the New Jersey Death Definition Law and the Japanese Transplantation Law. These laws are helpful in order to highlight possible implications of the principle of respect for the other as both the same and different. Both of these laws open the door to more than one concept of death within one and the same legal system. Both of them relate preference for a particular concept of death to religious and/or cultural beliefs. (shrink)

Background In Scandinavia 13–28% of gynecology patients have experienced abuse in health care in their life time, which contradicts the ethical obligations not to harm the patient and to protect the patient's dignity. Concerning learning to act ethically, scholars have emphasized the importance of combining theoretical and practical dimensions. This article explores Forum Play as a way of learning to act ethically in abusive situations in health care. Method Ten health-care workers participating in a Forum Play course took part in (...) this study. To explore participants' experiences of Forum Play, semi-structured interviews were conducted and processed by using the grounded theory analysis techniques of coding and constant comparison. Results The analysis resulted in the core category “developing response–ability.” It encompasses the processes bringing about the ability to respond adequately to situations where abuse occurs and the conditions for these processes, as well as the participants' achieved understanding of the third person's potential to act in a situation with a power imbalance. Forum Play allows participants to reflect on both verbal and body language, and gives them time to enact and think through issues of moral agency. Conclusion The simulated reality of Forum Play offers a platform where learning to act ethically in abusive situations in health care is facilitated by providing a safe space, suspending constricting structural conditions such as hierarchies and lack of time, fostering moral imagination, allowing creativity in developing and trying out a variety of acting alternatives, and reflecting upon the observed and experienced situation. (shrink)

In Feminist Phenomenology and Medicine, the editors have assembled a collection of papers on important topics that should be addressed in the modern phenomenology of medicine - topics which do not exclusively focus on illness, disability, bodily deterioration or pathologies, as seen for instance in prior work of the philosophers S Kay Toombs, Frederik Svenaeus, and Havi Carel. The contributors met at a congress on feminist phenomenology and medicine in Sweden in 2011, and come from a variety of relevant disciplines (...) including bioethics, philosophy of medicine, feminism and gender studies. All contributors are well-known, major players within their particular fields.Although it seems obvious that new developments in medicine, such as organ transplantation and plastic surgery, will push the boundaries of normality within the medical discourse, this volume is the first of its kind to offer a collection of essays exploring a variety of medical conditions that are situated within the gray zo .. (shrink)

Sometimes, we operate as though we live in the center of our brains at the top of the tower that is our bodies. We are aware of our bodies as instrumental to accomplishing various pragmatic tasks, but we are unaware or forgetful about how the body constitutes our conscious experience of self and world. The deeper nature and significance of our lived bodily experience is hidden, and it is challenging to discover and describe adequately. Nonetheless, during periods of sickness and (...) injury, we are forced into dramatic confrontations with our bodies and must address our lived bodily experience in often vivid and visceral detail. Fortunately, we are not without resources in the effort to... (shrink)

This much-anticipated work is a rich and insightful collection of essays that restores women and minorities to the arena of political theory and debate.

Ereignet sich anstelle von Klang oder Sprache, Musik oder Lärm lediglich Stille oder vielmehr das, was wir für Stille halten, kommt ein unerwartetes Aufmerken in Gang. Die Stille kann auffordern, genauer hinzuhören, aber auch genauer hinzusehen. Ein plötzliches Aufmerken geschieht jedoch nur, wenn die Stille den Wahrnehmenden unerwartet trifft. Einer im Alltäglichen zumeist durch die Priorität des Bewussten, Bekannten oder Vertrauten untergeordneten Stille, können Arbeiten, wie jene von Aernout Mik, eine konkrete Erfahrbarkeit geben. Was er erfahrbar werden lässt, ist aber (...) nicht die Stille, sondern das, was in der Regel überhört wird. In der Verkehrung des vermeintlich Unhörbaren in ein Hörbares zeigt sich mit der Stille ein Möglichkeitsraum, dessen Besonderheit die Autorin mit der Frage, was sich in der Erfahrung von Stille zeigt, nachgeht. Ist also von einer Stille als ästhetischem Phänomen die Rede, ist nicht eine Stille innerhalb der Rezeption genuin stiller Kunstwerke gemeint, sondern der bewusste Entzug des Auditiven. Damit widerspricht die Autorin zugleich einer Vorstellung von Stille als mess- oder bestimmbarer Grösse und stellt die Stille aus der ästhetischen Erfahrung heraus ins Zentrum ihrer Betrachtungen. (shrink)

Derk Pereboom's Four-Case Argument is among the most famous and resilient manipulation arguments against compatibilism. I contend that its resilience is not a function of the argument's soundness but, rather, the ill-gotten gain from an ambiguity in the description of the causal relations found in the argument's foundational case. I expose this crucial ambiguity and suggest that a dilemma faces anyone hoping to resolve it. After a thorough search for an interpretation which avoids both horns of this dilemma, I conclude (...) that none is available. Rather, every metaphysically coherent interpretation invites either a hard- or soft-line reply to Pereboom's argument. I then consider a recharacterization of the dilemma which seems to clear the way for the defence of a revised Four-Case Argument. I address this rejoinder by identifying a still more fundamental problem shared by all viable interpretations of the manipulation cases, showing that each involves a type of manipulation which undermines the victim's agency. Because this diagnosis supports a soft-line reply to every viable interpretation of the argument and can be endorsed by any compatibilist, I consider it the final piece of the Soft-line Solution to the Four-Case Argument. Finally, I suggest a new taxonomy of manipulation arguments, arguing that none that employs the suppressive variety of manipulation found in Pereboom's argument offers a threat to compatibilism. -/- (For direct download option, search Kristin M. Mickelson, Soft-line Solution). (shrink)

The terms ‘compatibilism’ and ‘incompatibilism’ were introduced in the mid-20th century to name conflicting views about the logical relationship between the thesis of determinism and the thesis that someone has free will. These technical terms were originally introduced within a specific research paradigm, the classical analytic paradigm. This paradigm is now in its final stages of degeneration and few free-will theorists still work within it (i.e. using its methods, granting its substantive background assumptions, etc.). This chapter discusses how the ambiguity (...) of the terms ‘incompatibilism’ and ‘compatibilism’ took root and why it matters to the contempory debate. I explain why the ambiguity of these anachronistic terms, though relatively innocuous when they were first introduced, is now encouraging theorists to tolerate and perpetuate serious philosophical errors (e.g. to conflate relations as different in kind and importance as correlation and causation, to knowingly promote invalid arguments, and to equivoate on jargon in ways that keep the free-will debate mired in psuedo-stalemates). I also suggest a new paradigm for anyone looking for relief from the confusion and deadlock created by the use of inadequate classical narratives and jargon. -/- A selection from the publication is available to download here. For full version, please gmail me, username: kristin.mickelson.42 -/- . (shrink)

Conceptions of autonomy in western philosophy and ethics have often centred on self-governance and self-determination. However, a growing bulk of literature also questions such conceptions, including the understanding of the autonomous self as a self-governing independent individual that chooses, acts, and lives in accordance with her or his own values, norms, or sense of self. This article contributes to the critical interrogation of selfhood, autonomy, and autonomous decision making by combining a feminist focus on relational dimensions of selfhood and autonomy (...) with phenomenological philosophy of the embodied self as being-in-the-world. It offers a philosophical investigation of different dimensions of bodily relational autonomy by turning to phenomenological accounts of the lived body as self-reflexive. When so doing, we hope to contribute to bridging the gap that sometimes exists between discussions of autonomy in analytic moral philosophy and of freedom and facticity in phenomenological philosophy. We see this gap as unfortunate, and hold that a nuanced understanding of autonomy and autonomous decision making can be reached if these strands of philosophy are brought into dialogue. (shrink)

*As mentioned in Peter Coy's NYT essay "When Being Good Is Just a Matter of Being Lucky" (2023) -/- ----- -/- How is the problem of free will related to the problem of moral luck? In this essay, I answer that question and outline a new solution to the paradox of moral luck, the source-paradox solution. This solution both explains why the paradox arises and why moral luck does not exist. To make my case, I highlight a few key connections (...) between the paradox of moral luck and two related problems, namely the problem of free will and determinism and the paradox of self-creation. Piecing together intuitions, arguments, and insights from recent work on each of these three problems, I argue that the type of control necessary for moral responsibility can only be had by someone who is a genuine source of his own actions, but the relevant notion of sourcehood admits no coherent characterization. If our commonsense view of moral responsibility is incoherent, it is unsurprising that our commitment to the existence of morally responsible agents commits us to some paradoxical things—e.g. to both the existence and impossibility of moral luck. For more information about this article, please write to gmail account: kristin.mickelson.42. (shrink)

This paper is based on the comments I gave to Alfred Mele regarding his original Zygote Argument during my presentation at a small workshop on manipulation arguments in Budapest back in 2012. After those comments, Mele changed the conclusion of his original Zygote Argument (OZA) from a positive, explanatory conclusion to a negative, non-explanatory conclusion--and, correspondingly, redefined 'incompatibilism' so that it would no longer refer in his work to the view that determinism precludes (undermines, eliminates, destroys, etc.) free will, but (...) refers narrowly to the perhaps spurious association claim that appears in the conclusion of the revised Zygote Argument (Mele 2013+). Yet, over the last decade, Mele has made no comment in print about the changes he made, the invalidity objection that led to them, nor to the fact that his revised Zygote Argument was originally presented by me as a (non-optimal) reaction to my invalidity objection to his original Zygote Argument. To my knowledge, Mele has only mentioned this 2015 paper once, at it was not in the context of understanding manipulation arguments; it was, rather, in the context of defending his revised, non-explanatory definition of 'incompatibilism' at the opening of Aspects of Agency (p. 6, n. 4). There, Mele singles out *just this 2015 paper* as a place where they'll find what Mele degrades as a type of nonstandard/nontraditional definition of 'incompatibilism' that he rejects. This is notable because Mele provides no empirical evidence that his preferred definition is standard, and most (including Lehrer, who coined the term) reject the negative, non-explanatory, association-based definition that Mele came to endorse in the aftermath of my invalidity objection to OZA. So, if Mele had a genuine concern about philosophers who use the term 'incompatibilism', then Mele could have--and should have--named almost any leading figure in free will for this purpose (since most--including Pereboom, Vihvelin, Haji, etc.) reject the non-explanatory definition that Mele-2013+ now endorses. Yet, for untold reasons, Mele isolated the working definition of 'incompatibilism' used in one paper by one unemployed junior researcher to use as his example--even though Neil Levy had used this same definition in previously published work (eg. Levy 2011). Moreover, if Mele were genuinely interested in helping his readers understand the ambiguity of terms like 'compatibilism' and 'incompatibilism' it is a mystery that he referenced a paper in which nothing of substance hung on the definitions given to these terms -- especially considering that he might have instead pointed them to my OTHER 2015 paper, "A Critique of Vihvelin's Three-Fold Classification" in which the MAIN AIM of the paper is to expose the difficulties facing anyone who wants to define the terms 'compatibilism' and 'incompatibilism' in a way that everyone will accept (including a critique of the negative, non-explanatory "incompossibilist" definition that Mele adopted after my objection to OZA). By all appearances, Mele's main aim in citing specifically THIS paper and none of my other work was to give readers the false impression that my working definition of 'incompatibilism' played some role in my charge that his argument is invalid (which it doesn't, given that the term doesn't appear in either the premises or conclusion of that argument). Mele adds to this unseemly rhetorical campaign in his book *Manipulation Agents* where he mentions an invalidity objection in the intro (p. 84) and then discusses that objection in the final lines of Chapter 5 of the book (p. 120-121). The invalidity objection discussed here is completely pedantic, has never been seriously raised in the primary literature (and was previously addressed in multiple places my multiple philosophers, including me), and has nothing whatever to do with my invalidity objection. In other words, Mele was content to discuss an invalidity objection that no one has ever had to an argument that is clearly valid while completely ignoring the ONLY substantive invalidity objection to his argument in print. This is unfortunate, because it has led to serious confusion --including the patently false description of my invalidity objection to OZA as an objection to the revised version of the Zygote Argument that Mele adopted in *response* my objection (e.g., Capes mistakenly claims "Mickelson (2015) contends that arguments like this [i.e. like the revised Zygote Argument] are invalid. But that’s because she defines “incompatibilism” differently than I’ve defined it here" in his "Manipulation Arguments and Direct Arguments" chapter in the 2023 Wiley-Blackwell Companion to Free Will; I did not say this, and the definition of 'incompatibilism' is irrelevant to my objection). In "The Zygote Argument Is Invalid--Now What?", I simply use the invalidity of the simple 2-premise Zygote Argument as a foil to make a series of more philosophically significant points (e.g. regarding the dialectical structure of the free-will debate, the role of best-explanation reasoning, and to develop the first-ever "master manipulation argument"). Mele has yet to address my reasons for calling attention to the non-trivial invalidity of his OZA or to any of my answers to the "Now What?" question in this paper, even though this question and my proposed answers to this question are the paper's main point. For those interested in a more recent discussion of how the logical and metaphilosophical observations made in this "Now What?" paper have helped to move the free-will debate forward, I suggest looking at the discussions of the "paradigm shift" in the free-will debate that helps to explain why the free-will debate has become mired in stalemates and empty verbal disputes that are found, for example, in my contributions to the Wiley-Blackwell Companion to Free Will (Intro and Chapter 4, 2023) and my paper "Free Will, Self-Creation, and the Paradox of Moral Luck" (2019). (shrink)

I suggest a pluralistic account of folk psychology according to which not all predictions or explanations rely on the attribution of mental states, and not all intentional actions are explained by mental states. This view of folk psychology is supported by research in developmental and social psychology. It is well known that people use personality traits to predict behavior. I argue that trait attribution is not shorthand for mental state attributions, since traits are not identical to beliefs or desires, and (...) an understanding of belief or desire is not necessary for using trait attributions. In addition, we sometimes predict and explain behavior through appeal to personality traits that the target wouldn't endorse, and so could not serve as the target's reasons. I conclude by suggesting that our folk psychology includes the notion that some behavior is explained by personality traits—who the person is—rather than by beliefs and desires—what the person thinks. Consequences of this view for the debate between simulation theory and theory theory, as well as the debate on chimpanzee theory of mind are discussed. (shrink)