It is becoming more common that the decision-makers in private and public institutions are predictive algorithmic systems, not humans. This article argues that relying on algorithmic systems is procedurally unjust in contexts involving background conditions of structural injustice. Under such nonideal conditions, algorithmic systems, if left to their own devices, cannot meet a necessary condition of procedural justice, because they fail to provide a sufficiently nuanced model of which cases count as relevantly similar. Resolving this problem requires deliberative capacities uniquely (...) available to human agents. After exploring the limitations of existing formal algorithmic fairness strategies, the article argues that procedural justice requires that human agents relying wholly or in part on algorithmic systems proceed with caution: by avoiding doxastic negligence about algorithmic outputs, by exercising deliberative capacities when making similarity judgments, and by suspending belief and gathering additional information in light of higher-order uncertainty. (shrink)

English summary: Medicine is not only a technique or skill for obtaining or restoring health in the face of illness and death; it strives to be a component of life that has learned to deal with the inevitability of suffering and death. As meditatio vitae et mortis, it can become a field of reflection on being human par excellence. The increasing possibility of anti-aging, plastic surgery and enhancement procedures, however, again bring about questions of the limits of human medicine, even (...) moreso if, as in transhumanist utopia and cryonic practice, the possibility of postponement or even of overcoming human finitude becomes possible. Medicine, society and the presence of death and dying must respond to these challenges. Herein ies the focus of this volume: the authors reflect on finiteness and immortality in medicine from historical, philosophical, social science, and ethical perspectives. German text. German description: Die Medizin ist nicht nur Technik oder Kunst, das Leben und die Gesundheit angesichts von Krankheit und Tod zu erhalten bzw. wiederherzustellen, sondern strebt eine Praxis der Lebensfuehrung an, die mit der Unvermeidbarkeit von Leiden und Sterben umzugehen lernt. Als meditatio vitae et mortis kann sie zu einem Feld der Reflexion ueber das Menschsein par excellence werden. Die zunehmenden Moglichkeiten von Anti-Aging, Plastischer Chirurgie und Enhancement stellen dabei die Fragen nach Grenzen einer humanen Heilkunde wieder neu, noch dazu, wenn - wie in transhumanistischen Utopien und kryonischer Praxis - die Moglichkeit der Verschiebung oder gar Uberwindung menschlicher Endlichkeit in Aussicht gestellt wird. Medizin, Gesellschaft und Sterbekultur der Gegenwart muessen auf die Herausforderungen reagieren. In diesem Themenfeld liegt der Schwerpunkt des Bandes: Die Autoren reflektieren Endlichkeit und Unsterblichkeit in der Medizin aus historischer, philosophischer, sozialwissenschaftlicher wie auch ethischer Perspektive. (shrink)

Patients’ experience of symptoms does not follow the body–mind divide that characterizes the classification of disease in the health care system. Therefore, understanding patients in their entirety rather than in parts demands a different theoretical approach. Attempts have been made to formulate such approaches but many of these, such as the biopsychosocial model, are still basically dualistic or methodologically reductionist. In primary care, patients often present with diffuse symptoms, making primary care the ideal environment for understanding patients’ undifferentiated symptoms and (...) disease patterns which could readily fit both bodily and mental categories. In this article we discuss theoretical models that have attempted to overcome this challenge: The psychosomatic approach could be called holistic in the sense of taking an anti-dualistic stance. Primary care theorists have formulated integrative views but these have not gained a foothold in primary care medicine. McWhinney introduced a new metaphor, ‘the body–mind’, and Rudebeck advocated cultivating ‘bodily empathy’. These views have much in common with both phenomenological thinking and mentalization, a psychological concept for understanding others. In the process of understanding patients there is a need for the physician to enter an intersubjectivity that aims at understanding the patient’s experiences and sensations without initially jumping to diagnostic conclusions or into a division into mental and physical phenomena. Mentalization theory could form the basis of an approach to a more comprehensive understanding of patients. The success of such an approach is, however, dependent upon structural and organizational conditions that do not counteract it. (shrink)

In this paper, I identify a theoretical and political role for ‘white ignorance’, present three alternative accounts of white ignorance, and assess how well each fulfils this role. On the Willful Ignorance View, white ignorance refers to white individuals’ willful ignorance about racial injustice. On the Cognitivist View, white ignorance refers to ignorance resulting from social practices that distribute faulty cognitive resources. On the Structuralist View, white ignorance refers to ignorance that results as part of a social process that systematically (...) gives rise to racial injustice, and is an active player in the process. I argue that, because of its greater power and flexibility, the Structuralist View better explains the patterns of ignorance that we observe, better illuminates the connection to white racial domination, and is overall better suited to the project of ameliorating racial injustice. As such, the Structuralist View should be preferred. (shrink)

Die Spannungen zwischen deutscher Philosophie und jüdischer Politik waren für Hannah Arendt von existentieller Bedeutung.

In this paper, I identify a theoretical and political role for ‘white ignorance’, present three alternative accounts of white ignorance, and assess how well each fulfils this role. On the Willful Ignorance View, white ignorance refers to white individuals’ willful ignorance about racial injustice. On the Cognitivist View, white ignorance refers to ignorance resulting from social practices that distribute faulty cognitive resources. On the Structuralist View, white ignorance refers to ignorance that (1) results as part of a social process that (...) systematically gives rise to racial injustice, and (2) is an active player in the process. I argue that, because of its greater power and flexibility, the Structuralist View better explains the patterns of ignorance that we observe, better illuminates the connection to white racial domination, and is overall better suited to the project of ameliorating racial injustice. As such, the Structuralist View should be preferred. (shrink)

Disagreement persists about when, if at all, disenfranchisement is a fitting response to criminal wrongdoing of type X. Positive retributivists endorse a permissive view of fittingness: on this view, disenfranchising a remarkably wide range of morally serious criminal wrongdoers is justified. But defining fittingness in the context of criminal disenfranchisement in such broad terms is implausible, since many crimes sanctioned via disenfranchisement have little to do with democratic participation in the first place: the link between the nature of a criminal (...) act X (the ‘desert basis’) and a fitting sanction Y is insufficiently direct in such cases. I define a new, much narrower account of the kind of criminal wrongdoing which is a more plausible desert basis for disenfranchisement: ‘political wrongdoing’, such as electioneering, corruption, or conspiracy with foreign powers. I conclude that widespread blanket and post-incarceration disenfranchisement policies are overinclusive, because they disenfranchise persons guilty of serious, but non-political, criminal wrongdoing. While such overinclusiveness is objectionable in any context, it is particularly objectionable in circumstances in which it has additional large-scale collateral consequences, for instance by perpetuating existing structures of racial injustice. At the same time, current policies are underinclusive, thus hindering the aim of holding political wrongdoers accountable. (shrink)

The influence of liberal political ideology on nursing sciencePrevious notions of science as impartial and value-neutral have been refuted by contemporary views of science as influenced by social, political and ideological values. By locating nursing science in the dominant political ideology of liberalism, the author examines how nursing knowledge is influenced by liberal philosophical assumptions. The central tenets of liberal political philosophy — individualism, egalitarianism, freedom, tolerance, neutrality, and a free-market economy — are primarily manifested in relation to: (i) the (...) individualistic focus of our science; (ii) our view of society as essentially egalitarian and equitable; (iii) our preference for politically neutral knowledge development, and (iv) an economy of knowledge development that supports rather than challenges the status quo. I argue that exposing, rather than ignoring, the liberal ideological values inherent in nursing science will render these assumptions open to debate, stimulate ongoing development of critically oriented knowledge, and increase our capacity to influence the social, political and economic determinants of health. (shrink)

We show that a popular class of connectionist models (which we label 'first order connectionism') looks unlikely to provide the kind of resources required by the hypothesis. We examine some alternative hybrid models that seem more promising. Finally, we raise a more purely philosophical issue concerning the conditions under which a being can count as a genuine believer or cognizer.".

The democratic boundary problem raises the question of who has democratic participation rights in a given polity and why. One possible solution to this problem is the all-affected principle, according to which a polity ought to enfranchise all persons whose interests are affected by the polity’s decisions in a morally significant way. While AAP offers a plausible principle of democratic enfranchisement, its supporters have so far not paid sufficient attention to economic participation rights. I argue that if one commits oneself (...) to AAP, one must also commit oneself to the view that political participation rights are not necessarily the only, and not necessarily the best, way to protect morally weighty interests. I also argue that economic participation rights raise important worries about democratic accountability, which is why their exercise must be constrained by a number of moral duties. (shrink)

ZusammenfassungDie aktuellen Entwicklungen und Anforderungen in der pflegeberuflichen Bildung, das Ausbildungsziel im Pflegeberufegesetz vom 17. Juli 2017 und die Explikationen in der dazugehörigen Ausbildungs- und Prüfungsverordnung für die Pflegeberufe fordern eine stärkere Ausrichtung auf die Entwicklung ethischer Kompetenzen explizit ein. Bislang liegen tendenziell übergreifende Definitionen und Darlegungen zu ethischen Kompetenzen in der Pflege vor, deren Verdienst es ist, das Spezifische der Pflegeethik zu konturieren und erstmals ethische Kompetenzen für das Feld zu konkretisieren. In methodischer und didaktischer Hinsicht ist indes eine (...) spezifische Differenzierung gemäß unterschiedlicher Bildungsniveaus relevant. Lehrende werden ihre Lehre nicht mehr nur im Sinne einer allgemeinen Förderung ethischer Kompetenz entwickeln können, sondern müssen dabei den jeweiligen Verantwortungsbereich und das angezielte Qualifikationsniveau der Lernenden berücksichtigen. Ziel der Darlegungen ist es, konkrete Kompetenzniveaus für die Anbahnung professionsethischer Kompetenzen zu operationalisieren, die einerseits die Anforderungen aus dem zukünftigen Pflegeberufegesetz aufgreifen und andererseits anstehende curriculare Entwicklungsprozesse unterstützen. (shrink)

Cultural safety is a relatively new concept that has emerged in the New Zealand nursing context and is being taken up in various ways in Canadian health care discourses. Our research team has been exploring the relevance of cultural safety in the Canadian context, most recently in relation to a knowledge-translation study conducted with nurses practising in a large tertiary hospital. We were drawn to using cultural safety because we conceptualized it as being compatible with critical theoretical perspectives that foster (...) a focus on power imbalances and inequitable social relationships in health care; the interrelated problems of culturalism and racialization; and a commitment to social justice as central to the social mandate of nursing. Engaging in this knowledge-translation study has provided new perspectives on the complexities, ambiguities and tensions that need to be considered when using the concept of cultural safety to draw attention to racialization, culturalism, and health and health care inequities. The philosophic analysis discussed in this paper represents an epistemological grounding for the concept of cultural safety that links directly to particular moral ends with social justice implications. Although cultural safety is a concept that we have firmly positioned within the paradigm of critical inquiry, ambiguities associated with the notions of 'culture', 'safety', and 'cultural safety' need to be anticipated and addressed if they are to be effectively used to draw attention to critical social justice issues in practice settings. Using cultural safety in practice settings to draw attention to and prompt critical reflection on politicized knowledge, therefore, brings an added layer of complexity. To address these complexities, we propose that what may be required to effectively use cultural safety in the knowledge-translation process is a 'social justice curriculum for practice' that would foster a philosophical stance of critical inquiry at both the individual and institutional levels. (shrink)

Norman Daniels’ theory of justice and health faces a serious practical problem: his theory can ground the special moral importance of health and allows distinguishing just from unjust health inequalities, but it provides little practical guidance for allocating resources when they are especially scarce. Daniels’ solution to this problem is a fair process that he specifies as "accountability for reasonableness". Daniels claims that accountability for reasonableness makes limit-setting decisions in healthcare not only legitimate, but also fair. This paper assesses the (...) latter claim. Does accountability for reasonableness result in fair limit-setting decisions? It is argued that the answer to this question is not a clear yes. Daniels is remarkably unclear about the criterion of fairness that accountability for reasonableness satisfies. The paper discusses different options for resolving this lack of clarity and examines how they apply to Daniels’ accountability for reasonableness framework. It is concluded, first, that accountability for reasonableness is not a paradigm case of any of the classic notions of procedural justice; second, that what might be called "constrained pure procedural justice" best reflects how accountability for reasonableness results in fair limit-setting decisions; and third, that the procedural conditions of accountability for reasonableness must be further specified and amended to better achieve a fair process, and hence fair limit-setting decisions. (shrink)

Nurse practitioners (NPs) are increasingly called on to provide high‐quality health‐care particularly for people who face significant barriers to accessing services. Although discourses of social justice have become relatively common in nursing and health services literature, critical analyses of how NP roles articulate with social justice issues have received less attention. In this study, we examine the role of NPs from a critical social justice perspective. A critical social justice lens raises morally significant questions, for example, why certain individuals and (...) groups bear a disproportionate burden of illness and suffering; what social conditions contribute to disparities in health and social status; and what social mandate NPs ought to develop in response to these realities. In our analysis, we draw on lessons learned from the initial Canadian experience with the introduction of NPs in the 1970s to consider the renewed and burgeoning interest in NPs in Canada, Australia and elsewhere. As we argue, a critical social justice perspective (in addition to the biomedical foci of NP practice) will be essential to sustaining long‐term, socially responsive NP roles and achieving greater equity in health and health‐care. (shrink)

It has recently been proposed to incorporate the use of a “Patient Preference Predictor” (PPP) into the process of making treatment decisions for incapacitated patients. A PPP would predict which treatment option a given incapacitated patient would most likely prefer, based on the individual’s characteristics and information on what treatment preferences are correlated with these characteristics. Including a PPP in the shared decision-making process between clinicians and surrogates has the potential to better realize important ethical goals for making treatment decisions (...) for incapacitated patients. However, developing and implementing a PPP poses significant practical challenges. The present paper discusses these practical challenges and considers ways to address them. (shrink)

We discuss the variety of sorts of sympathy Hume recognizes, the extent to which he thinks our sympathy with others’ feelings depends on inferences from the other’s expression, and from her perceived situation, and consider also whether he later changed his views about the nature and role of sympathy, in particular its role in morals.

One of the key ethical requirements for biomedical research is that it have an acceptable risk-benefit profile (Emanuel, Wendler, and Grady 2000). The International Conference of Harmonization guidelines mandate that clinical trials should be initiated and continued only if “the anticipated benefits justify the risks” (1996). Guidelines from the Council for International Organizations of Medical Sciences state that biomedical research is acceptable only if the “potential benefits and risks are reasonably balanced” (2002). U.S. federal regulations require that the “risks to (...) subjects” be “reasonable in relation to anticipated benefits, if any, to subjects and the importance of the knowledge” to be gained from the .. (shrink)

This essay examines the possible systematic bias against the disabled in the structure and practice of genetic counseling. Finding that the profession's “nondirective” imperative remains problematic, the authors recommend that methodology developed by feminist standpoint epistemology be used to incorporate the perspective of disabled individuals in genetic counselors' education and practice, thereby reforming society's view of the disabled and preventing possible negative effects of genetic counseling on the self-concept and material circumstance of disabled individuals.

"Huizenga examines the Greco-Roman moral-philosophical 'curriculum' for women by comparing these two epistolary collections. The analysis is organized around four elements: textual resources, teachers and learners, instructional strategies, and subject matter. Huizenga shows that the author of the Pastorals has adopted nearly all of the 'pagan' aspects of this curriculum, but has supplemented these with theological justifications drawn from Pauline literature and traditions"--Publisher description.

When patients cannot make their own treatment decisions, surrogates typically step in to do it for them. Surrogate decision‐making is far from ideal, of course, as the surrogate may not know what the patient prefers or what best promotes her interests. One way to improve it would be to arm surrogates with information about what patients in similar circumstances tend to prefer, allowing them to make empirically grounded predictions about what their patient would want.

: This essay examines the possible systematic bias against the disabled in the structure and practice of genetic counseling. Finding that the profession's "nondirective" imperative remains problematic, the authors recommend that methodology developed by feminist standpoint epistemology be used to incorporate the perspective of disabled individuals in genetic counselors' education and practice, thereby reforming society's view of the disabled and preventing possible negative effects of genetic counseling on the self-concept and material circumstance of disabled individuals.

The au pair program in general is still known as a form of cultural exchange program and a good possibility for young women to spend a year abroad, although it has undergone great changes during the last 10 years. This article argues that due to different socio-economic and cultural processes in Western postindustrial societies as well as in the eastern and southern parts of the world the au pair program is becoming a form of domestic work with quite similar working (...) and living conditions to that of live-in migrant domestic workers. This article which is based on two empirical studies on the globalizing au pair business in Eastern and Western Europe as well in the United States looks into the motivations and expectations, the living conditions and interactions between the au pairs and the employer families and contrasts these findings with the discourse of the au pair agencies still advertising au pair as a form of cultural exchange. In doing so the paper can show that it is the still dominant image of au-pair as a cultural exchange program (disarticulating the work aspect) that leaves the young au pair women even more vulnerable to exploitation: ‘big sisters’ are the best domestic servants. This article draws attention to the racialized economization of the private sphere and care work, the inherent traps and exploitative features of this very specific work place. (shrink)

This excerpt from our collective biography emerges from a dialogue that commenced when Noel interjected the concept of ‘becoming-cyborg’ into our conversations about Annette’s experiences of breast cancer, which initially prompted her to interpret her experiences as a ‘chaos narrative’ of cyborgian and environmental embodiment in education contexts. The materialisation of Donna Haraway’s figuration of the cyborg in Annette’s changing body enabled new appreciations of its interpretive power, and functioned in some ways as a successor project to Noel’s (...) earlier deployment of cyborgs in what he now recognises as a ‘posthumanising’ of curriculum inquiry. Noel’s subsequent experiences with throat cancer drew us towards exploring the possibilities that concepts such as Deleuze and Guattari’s machinic assemblage and Karen Barad’s ontoepistemology offer as a mean of thinking the meetings of bodies and technologies in educational inquiry beyond Haraway’s hybrid cyborg. Through both collective biography and playfully scripted conversations with other theorists we explore what it means to perform diffractive interpretations and analyses in posthumanist educational inquiry. Our essay also contributes to contemporary conversations about the uses of collaborative biographical writing as a method of inquiry in educational research. (shrink)

This is a collection of four papers about the All-Affected Principle (AAP): the view that every person whose morally weighty interests are affected by a democratic decision has the right to participate in that decision. -/- The first paper (“Narrow Possibilism about Democratic Enfranchisement”) examines how we should distribute democratic participation rights: a plausible version of AAP must avoid treating unlike cases alike, which would be procedurally unfair. The solution is to distribute participation rights proportionately to the risk that a (...) person’s interests will be affected. AAP thus implies an account of political equality that requires adherence to the ‘one person—one vote’ model only if interests are indeed equally affected. -/- The second paper (“Economic Participation Rights and the AAP”) argues that AAP supporters have paid insufficient attention to economic participation rights. The exercise of such rights raises unique worries about democratic accountability, which is why their exercise is constrained by a number of duties. -/- The third paper (“What AAP Is, and How (Not) to Fight It”) explores how AAP fares in light of possible objections from desirability and feasibility. Unlike crude versions of AAP, a plausibly restricted version of AAP cannot be dismissed as easily as many AAP sceptics may have thought. My reflections here are useful for AAP supporters and sceptics alike: this paper helps clarify what kind of objection can cast serious doubt on AAP. -/- The fourth paper (“Criminal Disenfranchisement, Political Wrongdoing, and Affected Interests”) asks: is AAP compatible with criminal disenfranchisement? AAP, when endorsed in combination with a plausible theory of punishment, is compatible with disenfranchising a narrow set of criminal wrongdoers only: those guilty of ‘political wrongdoing’, which is wrong primarily because it undermines democratic procedures and institutions for private gain. The upshot is that current blanket policies of criminal disenfranchisement are incompatible with AAP. (shrink)

The democratic boundary problem raises the question of who has democratic participation rights in a given polity and why. One possible solution to this problem is the all-affected principle, according to which a polity ought to enfranchise all persons whose interests are affected by the polity’s decisions in a morally significant way. While AAP offers a plausible principle of democratic enfranchisement, its supporters have so far not paid sufficient attention to economic participation rights. I argue that if one commits oneself (...) to AAP, one must also commit oneself to the view that political participation rights are not necessarily the only, and not necessarily the best, way to protect morally weighty interests. I also argue that economic participation rights raise important worries about democratic accountability, which is why their exercise must be constrained by a number of moral duties. (shrink)

Can aesthetic concepts reflect and provide answers for ethical aspects and issues? Is "more ethics, less aesthetics" applicable, according to the motto of the Venice Biennial for architecture in the year 2000? Or isn't "more aesthetics" in fact just what is required to encourage reflection about ethical responsibilities and dimensions in architecture, art, and design? This publication is a collection of reflections about the ethical and political dimensions of creations, presented from the point of view of art, architecture, design, and (...) curatorial practice. The contributions range from historical reviews to future-oriented outlooks, illustrating interdisciplinary connections. (shrink)

Motion is both elementary and fleeting; it is a fundamental precondition to our survival and our civilisation. Motion is the functional basis to the discovery, measurement and exploration of the world that we live in. Elucidating and calculating motion are central issues within our culture, which is not only based on motion but designs it, being built upon a history of dynamics and acceleration. Representatives of different disciplines - ranging from architecture to car design, from art-, cultural- and media-studies to (...) sociology- discuss the depiction and design of motion in art, architecture, design, dance and technology. This overview of historic developments and current trends discloses some surprising, border-crossign correlations. (shrink)

Several influential ethical guidelines and frameworks endorse the view that research with human participants is ethically acceptable only when it has “social value,” meaning that it generates knowledge which can be used to benefit society. For example, the Nuremberg Code requires that medical experiments on human beings “yield fruitful results for the good of society, unprocurable by other methods or means of study”. The Council for International Organizations of Medical Sciences guidelines hold that “health-related research with humans... must have social (...) value” or the “prospect of generating the knowledge and the means necessary to protect and promote people’s health” (CIOMS... (shrink)

In controlled human infection (CHI) studies, investigators deliberately infect healthy individuals with pathogens in order to study mechanisms of disease or obtain preliminary efficacy data on investigational vaccines and medicines. CHI studies offer a fast and cost‐effective way of generating new scientific insights, prioritizing investigational products for clinical testing, and reducing the risk that large numbers of people are exposed to ineffective or harmful substances in research or in practice. Yet depending on the pathogen, CHI studies can involve significant risks (...) or burdens for participants, pose risks to individuals or communities not involved in the research, and lead to public controversy. It is therefore essential to ensure that the risks of CHI studies are justified by their social value—that is, their potential to generate benefits for society—and that public trust can be maintained. In this paper, we aim to clarify how research sponsors, research ethics committees and other reviewers should judge the social value of CHI studies. We develop a list of relevant considerations for making social value judgments based on the standard view of social value. We then use this list to discuss the example of potentially conducting dengue virus CHI studies in endemic settings. We argue that dengue virus CHI studies in endemic settings would fall on the higher end of the spectrum of social value, mostly because of their potential to redirect all fields of future dengue research. Drawing on this discussion, we derive several general recommendations for how reviewers should judge the social value of CHI studies. (shrink)