Endosex, in contrast to intersex, refers to innate physical sex characteristics judged to fall within the broad range of what is considered normative or typical for ‘binary’ female or male bodies by the medical field, or to persons with such characteristics1 (p. 437). In this short contribution, we explain the origins and increasing use of this little-known term and discuss its practical and ethical relevance to medicine as well as to scholarship from a range of disciplines concerned with individuals’ sexed (...) embodiment. There is growing awareness in many quarters of the term intersex— used within some discourses to refer to clusters of bodily attributes (as in ‘intersex traits’, also termed differences of sex development or variations of sex characteristics)1 or more broadly to persons (as in ‘intersex persons’) whose bodily attributes differ from the dominant clinical, biological, or legal paradigms that categorise and differentiate female and male bodies. Intersex traits have historically been stigmatised as monstrous, morbid or tragic, justifying surgical and hormonal ‘fixing’.2 Persons born with the attributes named with these terms, even if physically healthy, therefore risk unnecessary pathologisation and medicalisation, prompting interventions, often non-voluntary, into their bodies to make them appear or function in ways that are deemed more typically female or male. In addition, some legal and social systems automatically associate persons with these traits with third categories of sex—neither female nor male—which may or may not align with their sex designation at birth, sex of rearing, personal experience or self-conception (see Coda). Being seen as intersex or being judged to have …. (shrink)

Proposed educational outcomes for the health humanities in medical education range from empathy to visual thinking skills to social accountability. This lack of widely agreed-upon high-level curricular goals limits humanities educators’ ability to design purposeful curricula toward clear, common ends and threatens justifications for scarce curricular time. We propose a novel approach to the hoped-for outcomes of health humanities training in medical schools, which has the potential to encompass traditional health humanities knowledge, skills, and behaviors while also being concrete and (...) measurable: humanistic practice. Humanistic practice, adapted from the concept of ethical sensitivity, is an intentional process of applying humanities knowledge and skills to a clinical scenario by 1) noticing that the scenario requires humanities knowledge or skills, 2) informing one’s clinical and interpersonal strategy and behavior with humanities knowledge or skills, 3) reflecting on the effectiveness of the strategy and behavior, and 4) reorienting to develop new approaches for future practice. The construct of humanistic practice may help address some of the foundational problems in health humanities outcomes research since it transcends the traditional diverse content domains in the health humanities, can link patient and provider experiences, and may bridge the divide among the additive, curative, and intrinsic epistemic positions of humanities to medical education. (shrink)

The Ebola epidemic that broke out inWest Africa West AfricaAfrica towards the end of 2013 had been brought under reasonable control by 2015. The epidemic had severely affected three countries. This case study is about a phase I/II clinical trial Phase I/II clinical trial of a candidate Ebola virus vaccine in 2015 in a sub-Saharan AfricanSub-Saharan Africa country which had not registered any cases of the Ebola virus disease. The study was designed as a randomized double-blinded trialRandomized double blinded trial. (...) It was sponsored and funded by one of the biggest Northern multinational pharmaceutical companiesPharmaceutical companies. The protocol received ethics clearance from the relevantNational Ethics Committee national ethics committeeEthics committee. The study was coordinated and managed at the local branch of a big Northern diagnostic laboratoryDiagnostic laboratory and a laboratory of a local regional hospital. The overall study was a multi-countryMulti-country, multi-siteMulti-site trial aimed at recruiting a total of 3,000 research participantsResearch participants across four or five sub-Saharan African countries. For this country, the recruitmentRecruitment sites were two big cities, each aiming to recruit 200 participants: adults at the first site and childrenChildren at the second. The target sampleSample size was almost achieved at the first site but, before the study commenced at the second site, some members of raised the alarm that the governmentGovernment was carelessly risking the health, safetySafety and lives of citizens in the cause of an unproven vaccine that could precipitate a public health disaster. The trial was immediately suspended. A commentary on this case, and on the importance of trustTrust, is provided by Katharine Browne and Doris Schroeder at the end of this chapter. It highlights differences between this case and a phase I Ebola vaccine trial in CanadaCanada in 2014. (shrink)

: In this essay, I contend that feminist theories of citizenship in the U.S. context must go beyond simply acknowledging the importance of race and grapple explicitly with the legacies of slavery. To sketch this case, I draw upon W.E.B. Du Bois's "The Damnation of Women," which explores the significance for all Americans of African American women's sexual, economic, and political lives under slavery and in its aftermath.

Katharine Tait, daughter of Bertrand and Dora Russell, here vividly portrays the extraordinary and stimulating environment she grew up in. In refreshing contrast to the interpretation of Russell as philosopher and public figure, Tait's is a close personal account of her deep love and admiration for her father and its gradual tempering by the imperfections she came to see in him. Touchingly written and beautifully described, the book shows Russell to be a man of great warmth, charm and humour, (...) but is also a testament to the traumas created when he applied his views on marriage and education to his own home. My Father Bertrand Russell is essential reading for those seeking to understand the private background to Russell's ideas, the personal effects of his lifestyle prescriptions, and what it was like to live with a man of such genious. (shrink)

Artificial intelligence and robotics have increasingly been adopted in agri-food systems—from milking robots to self-driving tractors. New projects extend these technologies in an effort to automate skilled work that has previously been considered dependent on human expertise due to its complexity. In this paper, we draw on qualitative research carried out with farm managers on apple orchards and winegrape vineyards in Aotearoa New Zealand. We investigate how agricultural managers’ perceptions of future agricultural automation relates to their approach to expertise, or (...) the degree to which they think specialised skills and knowledge are required to perform agricultural work on their orchards and vineyards. Our research generates two insights: the perceived potential for work to be automated is related to the degree to which it is seen to require technical or embodied expertise, with technical expertise being more automatable; and, while embodied expertise is perceived to be more difficult to automate, it is sometimes attributed more exclusively to those in positions of power, such that embodied expertise can be highly valued while the majority of embodied work is viewed as non-expert and thus automatable. Our analysis illustrates that a robot can be an expert when expertise is technical. It also shows variability in the conceptualization of skilled or unskilled work, and that those conceptualizations can set the stage for the future effects of new technologies. This generates new insights into the conditions under which automation might reproduce existing inequalities in agriculture, and also raises new questions about responsibility in the context of automation. (shrink)

In this article, I identify a distinctive form of injustice—ontic injustice—in which an individual is wronged by the very fact of being socially constructed as a member of a certain social kind. To be a member of a certain social kind is, at least in part, to be subject to certain social constraints and enablements, and these constraints and enablements can be wrongful to the individual who is subjected to them, in the sense that they inflict a moral injury. The (...) concept of ontic injustice is valuable in three main ways: it draws our attention to the role played by social kinds in enacting wrongful constraints and enablements; it clarifies our options for developing accounts of the ontology of particular social kinds, such as gender kinds; and, along with the related concept of ‘ontic oppression’, it helps us to understand and respond to oppression. (shrink)

The way society is organised means that we all get made into members of various types of people, such as judges, wives, or women. These ‘human social kinds’ may be brought into being by oppressive social arrangements, and people may suffer oppression in virtue of being made into a member of a certain human social kind. This book argues that we should pay attention to the ways in which the very fact of being made into a member of a certain (...) human social kind can be oppressive in and of itself. For example, someone who becomes a wife under circumstances where husbands have unjust powers over their wives has suffered a wrong, even if her husband never in fact exercises these powers. The book argues that social movements against racial and gendered oppression, including efforts to advance trans liberation, must get to grips with this phenomenon, and it supplies the conceptual tools needed to do so. The first tool is an analysis of this general form of wrong, termed ‘ontic injustice’. The second tool is an account of ‘ontic oppression’, a particular kind of ontic injustice in which the wrong amounts to a form of oppression, in the sense of being structural and pervasive. The third tool is a pluralist account of race and gender kinds, according to which there is no single social kind that corresponds to a gender category such as ‘woman’, but, rather, there are various different social kinds, each of which is explanatory for different purposes. (shrink)

Feminist analyses of gender concepts must avoid the inclusion problem, the fault of marginalizing or excluding some prima facie women. Sally Haslanger’s ‘ameliorative’ analysis of gender concepts seeks to do so by defining woman by reference to subordination. I argue that Haslanger’s analysis problematically marginalizes trans women, thereby failing to avoid the inclusion problem. I propose an improved ameliorative analysis that ensures the inclusion of trans women. This analysis yields ‘twin’ target concepts of woman, one concerning gender as class and (...) the other concerning gender as identity, both of which I hold to be equally necessary for feminist aims. (shrink)

To investigate the metaphysics of gender categories—categories like “woman,” “genderqueer,” and “man”—is to ask questions about what gender categories are and how they exist. This chapter offers a pluralist account of the metaphysics of gender categories, according to which there are several different varieties of gender categories. I begin by giving a brief overview of some feminist accounts of the metaphysics of gender categories and illustrating how certain moral and political considerations have been in play in these discussions as constraints (...) on acceptable accounts of gender categories. I then present my pluralist account of gender categories and highlight some of its virtues. Finally, I assess how my pluralist account fares relative to the moral and political considerations identified earlier in the chapter. I argue that although the account does not fare well, we should in fact revise our understanding of what those considerations are and how they should constrain our accounts of gender categories. I then show that, on this revised understanding, my pluralist account emerges as a viable position. (shrink)

This paper is a cross-cultural examination of the development of hunting skills and the implications for the debate on the role of learning in the evolution of human life history patterns. While life history theory has proven to be a powerful tool for understanding the evolution of the human life course, other schools, such as cultural transmission and social learning theory, also provide theoretical insights. These disparate theories are reviewed, and alternative and exclusive predictions are identified. This study of cross-cultural (...) regularities in how children learn hunting skills, based on the ethnographic literature on traditional hunters, complements existing empirical work and highlights future areas for investigation. (shrink)

Scholars have revealed how moral evaluation is woven into formal administrative processes. While research examining these dynamics tends to assume that a person’s naturalized identity (such as race and gender) precedes administrative processing, we argue that social categorization by administrators is the tacit precondition upon which further processing takes place. We make this argument by looking at a set of unusual cases: parole hearings where prisoners fall outside of, conflict with, or move between categories of gender, sexuality, race, and ability. (...) We find that categorization acts as a prerequisite to moral evaluation. When administrators cannot easily categorize a prisoner, they resolve this uncertainty by denying parole. Yet, social categorization can also serve as a pathway to moral approval and administrative allocation. In certain situations, administrators encourage prisoners’ identification with a new social category as proof that they are deserving of parole. In both cases, successful administrative categorization occurs through a combination of what we call narrativization, or crafting a narrative around one’s identity that aligns with administrators’ presumptions, and authorization, or marshalling official evidence from prior classification moments to support identity claims. These insights extend our understanding of classification, moral evaluation, and the administrative reproduction of inequality. (shrink)

Stories evoke emotions in their hearers. Do they evoke emotions in their tellers as well? Tellers can tell stories from the inside as if they were characters in the world of the tale or they can tell stories from the outside as if they were perceiving the taleworld from elsewhere. From the outside, the teller can represent the emotion a character feels; from the inside, the teller can express the emotion the character feels. In either instance, tellers can be moved (...) by the story they tell. When they are, they can experience their emotions as a suffusion of sensation that springs forth in their bodies. The body’s experience of its sensation can appear in the gestures that accompany the telling. On the occasion presented here, the teller represents her emotion in metaphorical gestures that figure her body as the container of a fluid substance that threatens to overflow its boundaries. Her gestures disclose and elaborate this metaphoricity while at the same time disclosing and elaborating the sensations that motivate the metaphor. (shrink)

Although the concept of gender identity plays a prominent role in campaigns for trans rights, it is not well understood, and common definitions suffer from a problematic circularity. This paper undertakes an ameliorative inquiry into the concept of gender identity, taking as a starting point the ways in which trans rights movements seek to use the concept. First, I set out six desiderata that a target concept of gender identity should meet. I then consider three analytic accounts of gender identity: (...) the dispositional account, the self-identification account, and the norm-relevancy account. I argue that only the norm-relevancy account can meet all six desiderata. Finally, I defend the norm-relevancy account from three objections: that it is cis-normative, that it has problematic implications regarding trans women, and that it entails that some people do not have the gender identity they take themselves to have. (shrink)

This article argues that rape myths and domestic abuse myths constitute hermeneutical injustices. Drawing on empirical research, I show that the prevalence of these myths makes victims of rape and of domestic abuse less likely to apply those terms to their experiences. Using Sally Haslanger's distinction between manifest and operative concepts, I argue that in these cases, myths mean that victims hold a problematic operative concept, or working understanding, which prevents them from identifying their experience as one of rape or (...) of domestic abuse. Since victims in this situation lack the conceptual resources needed to render their experience sufficiently intelligible, they are suffering a form of hermeneutical injustice. Attending to this distinctive case sheds new light not only on the functioning of social myths of this kind but on the nature of hermeneutical injustice itself, since the case of the victim who accepts myths is importantly different from other cases of hermeneutical injustice discussed in the literature to date. In practical terms, this analysis supports calls for juries in rape trials to be warned about rape myths at the start of the trial, and may have implications for calls for statutory Sex and Relationships Education in schools. (shrink)

The term sustainability can be used so liberally within production industries that it becomes meaningless. There is also recognition that for sustainability to be a useful concept, it must be crafted for the context in which it is deployed. A paradox of sustainability, it seems, lies in the conflict between the practical adoptability and context specificity of programs paired with the need for significant change. One response for those grappling with this sustainability challenge has been to adopt flexible approaches to (...) sustainability through the development of technologies and governance processes that focus on benchmarking, monitoring and ongoing change, rather than hard limits and targets. In this paper we elaborate on this point by evaluating how sustainability programs in a transition context can be seen as deliberative platforms and thus actors in governance processes. Through an analysis of the development of a sustainability program deployed in the wine industry in New Zealand, we argue that a widely adopted and clearly defined program can be an asset to democratic environmental governance, if viewed as a shared project. Drawing on interviews with key personnel in the wine industry and reviews of industry literature and media, we suggest that substantiating sustainability can have benefits for environmental governance through the precipitation of distinction and dialogue. We conclude with some suggestions about how to encourage visionary forms of practice and engagement with sustainability programs in ways that can aid their democratic development and expand the reach of their goals. (shrink)

We argue that autism and psychosis spectrum disorders cannot be conceptualized as polar extremes of mentalizing ability. We raise two main objections: (1) the autistic-psychotic continuum, as conceptualized by the authors, excludes defining features of schizophrenia spectrum: negative symptoms, which correlate more strongly with mentalizing impairments; and (2) little evidence exists for a relationship between mentalizing ability and positive symptoms.

Here I consider the possible role of the temporal updating system in the development of the temporal reasoning system. Using evidence from children's acquisition of time words, I argue that abstract temporal concepts are not built from primitive representations of time. Instead, I propose that language and cultural learning provide the primary sources of the temporal reasoning system.

In order to conduct medical examinations, physicians transform patients from social subjects into medical objects. The routines associated with conducting medical examinations constitute rituals for effecting this transformation: moving from public space to private space; changing into ritual costumes; taking up ritual positions in an examination room; conducting ritual verbal and physical examinations. The transformations endow participants with a different ontological status from the one they hold in everyday life. They address the phenomenological problem of how a self is inserted (...) into a body. (shrink)

This article presents two studies that examine cause-related marketing promotions that require consumers’ active participation. Requiring a follow-up behavior has very valuable implications for maximizing marketing expenditures and customer relationship management. Theories related to ethical behavior, like motivated reasoning and defensive denial, are used to explain when and why consumers respond negatively to these effort demands. The first study finds that consumers rationalize not participating in CRM by devaluing the sponsored cause. The second study identifies a tactic marketers can utilize (...) to neutralize consumers’ use of defensive denial. Allowing the consumer to choose the sponsored cause seems to effectively refocus their attention and increases consumers’ threshold for campaign requirements. Implications for nonprofits and marketing managers include a tendency for consumers to be more likely to perceive a firm as ethical and socially responsible when they are allowed to choose the specific cause that is supported. (shrink)

Domination as opposed to what? Michel Foucault’s works on power and subject formation uncover the subtle ways in which disciplinary power structures create opportunities for domination. Yet Foucaul...

Bridging the gap between the world of science and the realm of the spiritual, B. Alan Wallace introduces a natural theory of human consciousness that has its roots in contemporary physics and Buddhism. Wallace's "special theory of ontological relativity" suggests that mental phenomena are _conditioned_ by the brain, but do not _emerge_ from it. Rather, the entire natural world of mind and matter, subjects and objects, arises from a unitary dimension of reality that is more fundamental than these dualities, as (...) proposed by Wolfgang Pauli and Carl Jung. To test his hypothesis, Wallace employs the Buddhist meditative practice of _samatha_, refining one's attention and metacognition, to create a kind of telescope to examine the space of the mind. Drawing on the work of the physicist John Wheeler, he then proposes a more general theory in which the participatory nature of reality is envisioned as a self-excited circuit. In comparing these ideas to the Buddhist theory known as the Middle Way philosophy, Wallace explores further aspects of his "general theory of ontological relativity," which can be investigated by means of _vipasyana_, or insight, meditation. Wallace then focuses on the theme of symmetry in reference to quantum cosmology and the "problem of frozen time," relating these issues to the theory and practices of the Great Perfection school of Tibetan Buddhism. He concludes with a discussion of the general theme of complementarity as it relates to science and religion. The theories of relativity and quantum mechanics were major achievements in the physical sciences, and the theory of evolution has had an equally deep impact on the life sciences. However, rigorous scientific methods do not yet exist to observe mental phenomena, and naturalism has its limits for shedding light on the workings of the mind. A pioneer of modern consciousness research, Wallace offers a practical and revolutionary method for exploring the mind that combines the keenest insights of contemporary physicists and philosophers with the time-honored meditative traditions of Buddhism. (shrink)

Many kinds of health compromising norms, habits, and beliefs are highly resistant to change thereby preventing new knowledge about health maintenance from advancing widespread better health. Persons would be more responsive if they used a health ethic to harmonize personal behavior with health-maintaining practices. We argue that common sense morality includes a portion of a health ethic in the guise of responsibilities to maintain health as well as avoid self destruction. We discuss an example in which its application can retard (...) decline in older age that results from a sedentary lifestyle. (shrink)

Despite an abundance of theoretical literature on virtue ethics in nursing and health care, very little research has been carried out to support or refute the claims made. One such claim is that ethical nursing is what happens when a good nurse does the right thing. The purpose of this descriptive, qualitative study was therefore to examine nurses’ perceptions of what it means to be a good nurse and to do the right thing. Fifty-three nurses responded to two open-ended questions: (...) (1) a good nurse is one who...; and (2) how does a nurse go about doing the right thing? Three hundred and thirty-one data units were analysed using qualitative content analysis. Seven categories emerged: personal characteristics, professional characteristics, patient centredness, advocacy, competence, critical thinking and patient care. Participants viewed ethical nursing as a complex endeavour in which a variety of decision-making frameworks are used. Consistent with virtue ethics, high value was placed on both intuitive and analytical personal attributes that nurses bring into nursing by virtue of the persons they are. Further investigation is needed to determine just who the ‘good nurse’ is, and the nursing practice and education implications associated with this concept. (shrink)

Experience and expression are orthogonal emotion dimensions: we do not always show what we feel, nor do we always feel what we show. However, the experience and expression dimensions of emotion are rarely considered simultaneously. We propose a model outlining the intersection of goals for emotion experience and expression. We suggest that these goals may be aligned or misaligned. Our model posits these states can be separated into goals to experience and express, experience but not express, express but not experience, (...) or neither experience nor express positive and negative emotion. We contend that considering intersections between experience and expression goals will advance understanding of emotion regulation choice and success. (shrink)

The Jamesian notion of fringe consciousness as elaborated by Mangan provides a theoretical motivation for drawing together a diverse class of experiences which are called "feelings" in everyday language. Thus, feelings of knowing and emotional feelings are seen not to differ in kind from each other. Further, both kinds of feelings are seen to reflect the consonance or dissonance of current conscious experience with unconscious contexts and may be used as "handles" to draw unconscious material into consciousness.

Quayshawn Spencer argues for radical racial pluralism, the position that there is a plurality of natures and realities for race in the United States. In this paper, I raise two difficulties for Spencer’s argument. The first is targeted narrowly at his response to a potential objection to his argument, and the second is a more general difficulty to do with how the argument handles the social consequences of the authoritative categorization of people. Although the second difficulty is more serious than (...) the first, neither is insurmountable. I then sketch an alternative argument for radical racial pluralism, one that would be likely to succeed in the event that Spencer’s argument turned out to fail. Considering these two contrasting routes to radical racial pluralism highlights the fact that radical racial pluralism is a rather more modest metametaphysical position than it may have initially appeared to be. In virtue of this, I suggest that we should develop and assess a more radically pluralist metametaphysical account of race, which I term ‘ultra-radical racial pluralism’. (shrink)

One challenge in providing an adequate definition of physical disability is unifying the heterogeneous bodily conditions that count as disabilities. We examine recent proposals by Elizabeth Barnes (2016), and Dana Howard and Sean Aas (2018), and show how this debate has reached an impasse. Barnes’ account struggles to deliver principled unification of the category of disability, whilst Howard and Aas’ account risks inappropriately sidelining the body. We argue that this impasse can be broken using a novel concept: marginalised functioning. Marginalised (...) functioning concerns the relationship between a person’s bodily capacities and their social world: specifically, their ability to function in line with the default norms about how people can typically physically function that influence the structuring of social space. We argue that attending to marginalised functioning allows us to develop, not one, but three different models of disability, all of which—whilst having different strengths and weaknesses—unify the category of disability without sidelining the body. (shrink)

Professor Vickers extracts two or three sentences out of a long article I wrote on a completely different topic and misreads them, attributing to me statements I never made and positions I have explicitly argued against. When Francis Bacon used the metaphor of rape to refer to the Baconian natural philosopher's relationship to nature, which he did relatively infrequently, he invoked the classical, "heroic" sense of rape as the act whereby gods and heroes found dynasties and empires, as in the (...) rape of the Sabine women, the rape of Europa, and the rape of the daughters of Leucippus. (shrink)

In this paper I develop a systemic discrimination approach to defining a narrowly construed category of ‘hate speech’, as speech that harms to a sufficient degree to warrant government regulation. This is important due to the lack of definitional clarity, and the extraordinarily wide usage, of the term. This article extends current literature on how hate speech can harm by identifying under what circumstances speakers have the capacity to harm, and under what circumstances targets are vulnerable to harm. It also (...) shows how the capacity to harm can be mobile and involve the construction of new targets. Finally, it bridges the gap between conceptual understandings of hate speech and policy designed to regulate it. (shrink)