Parents who are facing decisions about life-sustaining treatment for their seriously ill or dying child are supported by their child's doctors and nurses. They also frequently seek other information sources to help them deal with the medical and ethical questions that arise. This might include written or web-based information. As part of a project involving the development of such a resource to support parents facing difficult decisions, some ethical questions emerged. Should this information be presented in a strictly neutral fashion? (...) Is it problematic if narratives, arguments or perspectives appear to favour stopping over continuing life-sustaining treatment? Similar questions might arise with written materials about decisions for adults, or for other ethically contentious decisions. This paper explores the meaning of ‘balance’ in information provision, focusing particularly on written information about life-sustaining treatment for children. We contrast the norm of non-directiveness in genetic counselling with the shared decision-making model often endorsed in end-of-life care. We review evidence that parents do not find neutrality from medical professionals helpful in discussions. We argue that balance in written information must be understood in the light of the aim of the document, the most common situation in which it will be used, and any existing biases. We conclude with four important strategies for ensuring that non-neutral information is nevertheless ethically appropriate. (shrink)

Infants are unable to make their own decisions or express their own wishes about medical procedures and treatments. They rely on surrogates to make decisions for them. Who should be the decision-maker when an infant’s biological parents are also minors? In this paper, we analyse a case in which the biological mother is a child. The central questions raised by the case are whether minor parents should make medical decisions on behalf of an infant, and if so, what are the (...) limits to this decision-making authority? In particular, can they refuse treatment that might be considered best for the infant? We examine different ethical arguments to underpin parental decision-making authority; we argue that provided that minor parents are capable of fulfilling their parental duties, they should have a right to make medical decisions for their infant. We then examine the ethical limits to minor parents’ decision-making authority for their children. We argue that the restricted authority that teenagers are granted to make medical decisions for themselves looks very similar to the restricted autonomy of all parents. That is, they are permitted to make choices, but not harmful choices. Like all parents, minor parents must not abuse or neglect their children and must also promote their welfare. They have a moral right to make medical decisions for their infants within the same ‘zone of parental discretion’ that applies to adult parents. We conclude that adult and minor parents should have comparable decision-making authority for their infants. (shrink)

The COVID-19 pandemic crisis has necessitated widespread adaptation of revised treatment regimens for both urgent and routine medical problems in patients with and without COVID-19. Some of these alternative treatments maybe second-best. Treatments that are known to be superior might not be appropriate to deliver during a pandemic when consideration must be given to distributive justice and protection of patients and their medical teams as well the importance given to individual benefit and autonomy. What is required of the doctor discussing (...) these alternative, potentially inferior treatments and seeking consent to proceed? Should doctors share information about unavailable but standard treatment alternatives when seeking consent? There are arguments in defence of non-disclosure; information about unavailable treatments may not aid a patient to weigh up options that are available to them. There might be justified concern about distress for patients who are informed that they are receiving second-best therapies. However, we argue that doctors should tailor information according to the needs of the individual patient. For most patients that will include a nuanced discussion about treatments that would be considered in other times but currently unavailable. That will sometimes be a difficult conversation, and require clinicians to be frank about limited resources and necessary rationing. However, transparency and honesty will usually be the best policy. (shrink)

Children dependent on life-prolonging medical technology are often subject to a constant background risk of sudden death or catastrophic complications. Such children can be cared for in hospital, in an intensive care environment with highly trained nurses and doctors able to deliver specialised, life-saving care immediately. However, remaining in hospital, when life expectancy is limited, can considered to be a harm in of itself. Discharge home offers the possibility for an improved quality of life for the child and their family (...) but comes with significant medical risks.When making decisions for children, two ethical models predominate, the promotion of the child’s best interests or the avoidance of harm. However, in some circumstances, particularly for children with life-limiting and/or life-threatening illness, all options may be associated with risk. There are no good options, only potentially harmful choices.In this paper, we explore decisions made by one family in such circumstances. We describe a model adopted from risk management programmes beyond medicine, which offers a potential framework for identifying risks to the child that are morally permissible. Some risks and harms to a child, not ordinarily permitted, may be acceptable when undertaken in the pursuit of a specified desired good, so long as they are as low as reasonably practicable. (shrink)

As the COVID-19 pandemic impacts on health service delivery, health providers are modifying care pathways and staffing models in ways that require health professionals to be reallocated to work in critical care settings. Many of the roles that staff are being allocated to in the intensive care unit and emergency department pose additional risks to themselves, and new policies for staff reallocation are causing distress and uncertainty to the professionals concerned. In this paper, we analyse a range of ethical issues (...) associated with changes to staff allocation processes in the face of COVID-19. In line with a dominant view in the medical ethics literature, we claim, first, that no individual health professional has a specific, positive obligation to treat a patient when doing so places that professional at risk of harm, and so there is a clear ethical tension in any reallocation process in this context. Next, we argue that the changing asymmetries of health needs in hospitals means that careful consideration needs to be given to a stepwise process for deallocating staff from their usual duties. We conclude by considering how a justifiable process of reallocating professionals to high-risk clinical roles should be configured once those who are ‘fit for reallocation’ have been identified. We claim that this process needs to attend to three questions that we consider in detail: (1) how the choice to make reallocation decisions is made, (2) what justifiable models for reallocation might look like and (3) what is owed to those who are reallocated. (shrink)

Predictive processing accounts of neural function view the brain as a kind of prediction machine that forms models of its environment in order to anticipate the upcoming stream of sensory stimulation. These models are then continuously updated in light of incoming error signals. Predictive processing has offered a powerful new perspective on cognition, action, and perception. In this chapter we apply the insights from predictive processing to the study of emotions. The upshot is a picture of emotion as inseparable from (...) perception and cognition, and a key feature of the embodied mind. (shrink)

This chapter examines the role played by derogatory terms (e.g., ‘inyenzi’ or cockroach, ‘inzoka’ or snake) in laying the social groundwork for the genocide of the Tutsi in Rwanda in 1994. The genocide was preceded by an increase in the use of anti-Tutsi derogatory terms among the Hutu. As these linguistic practices evolved, the terms became more openly and directly aimed at Tutsi. Then, during the 100 days of the genocide, derogatory terms and coded euphemisms were used to direct killers (...) to their victims. Understanding these speech acts helps to illuminate the important ways that power is enacted through discourse, how speech acts can prepare the way for physical and material acts, and how speech generates permissions for actions hitherto uncountenanced. Studying the role of speech acts and linguistic practices in laying the groundwork of the genocide illuminates how patterns of speech acts become linguistic practices that constitute permissibility conditions for non-linguistic behaviors. Further, the analysis presented here helps to make sense of the view that a steady, deep, and widespread derogation of a group can be part and parcel of genocide, not only an antecedent to it. (shrink)

Various decision theories share a troubling implication. They imply that, for any finite amount of value, it would be better to wager it all for a vanishingly small probability of some greater value. Counterintuitive as it might be, this fanaticism has seemingly compelling independent arguments in its favour. In this paper, I consider perhaps the most prima facie compelling such argument: an Egyptology argument (an analogue of the Egyptology argument from population ethics). I show that, despite recent objections from Russell (...) (2023) and Goodsell (2021), the argument’s premises can be justified and defended, and the argument itself remains compelling. (shrink)

Identifying a range of key concerns related to representation and difference, Representing the Other offers a provocative agenda for the future development of feminist theory and practice. The book's contributors, including many key international researchers in women's studies, draw on personal experiences of speaking "for" and "about" others in their research, professional practice, academic writing, or political activism. They highlight problems of representing the Other with an ethnic or cultural background different from one's own and extend discussions of "Othering" to (...) representations of children, prostitutes, infertile women, fat women, gay men with HIV/AIDS, and people with disabilities. The reader, which includes articles and discussions from four issues of the journal Feminism & Psychology, also features new pieces and an extensive editorial introduction. Representing the Other will be integral reading for students and academics in women's studies, gender studies, and feminist theory across a range of social science disciplines, including social psychology, sociology, anthropology, sociolinguistics, social policy, and political science. (shrink)

INTRODUCTION Reopening a Discussion The empiricist-derived epistemology that has directed most social and natural scientific inquiry for the last three ...

Michel Foucault was the first to embed the roots of human sexuality in discipline and biopolitics, therefore revolutionizing our conception of sex and its relationship to society, economics, and culture. Yet over the past two decades, scholars have limited themselves to the study of Foucault's _History of Sexuality_, volume 1 paying lesser attention to his equally explosive _History of Madness_. In this earlier volume, Foucault recasts Western rationalism as a project that both produces and represses sexual deviants, calling out the (...) complicity of modern science and the exclusionary nature of family morality. By reclaiming these deft moves, Lynne Huffer teases out exciting new strands of Foucauldian thought. She then revisits the theorist's ethical work in light of these discoveries, divining an ethics of eros that sees sexuality as a lived experience we are repeatedly called on to remember. Throughout her study, Huffer weaves her own experiences together with Foucault's, sampling from unpublished interviews and other archived materials in order to intimately rework the problem of sexuality as a product of reason. (shrink)

Various philosophers accept moral views that are impartial, additive, and risk-neutral with respect to moral betterness. But, if that risk neutrality is spelt out according to expected value theory alone, such views face a dire reductio ad absurdum. If the expected sum of value in humanity's future is undefined--if, e.g., the probability distribution over possible values of the future resembles the Pasadena game, or a Cauchy distribution--then those views say that no option is ever better than any other. And, as (...) I argue, this holds in practice: our evidence supports such a probability distribution. Indeed, it supports a probability distribution that cannot be evaluated even if we adopt one of the various extensions of expected value theory proposed in the literature. Must we therefore reject all impartial, additive, risk-neutral moral theories? It turns out that we need not. I develop an alternative solution: a new method of extending expected value theory, which allows us to deal with this distribution and to salvage those moral views. I also examine how this solution affects one of the most notable implications of those views--namely, longtermism. (shrink)

The expression ‘nonreductive materialism’ refers to a variety of positions whose roots lie in attempts to solve the mind-body problem. Proponents of nonreductive materialism hold that the mental is ontologically part of the material world; yet, mental properties are causally efficacious without being reducible to physical properties.s After setting out a minimal schema for nonreductive materialism (NRM) as an ontological position, I’ll canvass some classical arguments in favor of (NRM).1 Then, I’ll discuss the major challenge facing any construal of (NRM): (...) the problem of mental causation, pressed by Jaegwon Kim. Finally, I’ll offer a new solution to the problem of mental causation. (shrink)

Lynne Huffer's ambitious inquiry redresses the rift between feminist and queer theory, traversing the space of a new, post-moral sexual ethics that includes pleasure, desire, connection, and betrayal. She begins by balancing queer theorists' politics of sexual freedoms with a moralizing feminist politics that views sexuality as harm. Drawing on the best insights from both traditions, she builds an ethics centered on eros, following Michel Foucault's ethics as a practice of freedom and Luce Irigaray's lyrical articulation of an ethics of (...) sexual difference. Through this theoretical lens, Huffer examines everyday experiences of ethical connection and failure connected to sex, including queer sexual practices, sodomy laws, interracial love, pornography, and work-life balance. Her approach complicates sexual identities while challenging the epistemological foundations of subjectivity. She rethinks ethics "beyond good and evil" without underestimating, as some queer theorists have done, the persistence of what Foucault calls the "catastrophe" of morality. Elaborating a thinking-feeling ethics of the other, Huffer encourages contemporary intellectuals to reshape sexual morality from within, defining an ethical space that is both poetically suggestive and politically relevant, both conceptually daring and grounded in common sexual experience. (shrink)

A particular feature of this book is substantial "Stretch and Challenge" material throughout which allows students to develop further.

Doctors’ strikes are legally permissible in the UK, with the situation differing in other countries. But are they morally permissible? Doug McConnell and Darren Mann have systematically attempted to dismiss the arguments for the moral impermissibility of doctors’ strikes and creatively attempted to provide further moral justification for them. Unfortunately for striking doctors, they fail to achieve this. Meanwhile, junior doctors’ strikes have continued in the UK through 2023 and have now extended into 2024. In this response, which focuses on (...) the UK situation and specifically junior doctors’ strikes in the National Health Service (NHS) in England, I will demonstrate a central problem with their arguments—namely that they underplay the harms caused by prolonged doctors’ strikes by ignoring the harms to patients with cancer. This weakens their conclusion that strikes are morally permissible in terms of the conditions and thresholds they set. I then provide a psychological critique of their justification for strikes in terms of the interests of the public. It follows that invoking the controversial concept of supererogatory action is ungrounded but also absurd when you consider time-critical cancer care. If those representing striking doctors wish to maintain a modicum of moral respectability, they should mitigate for patients with cancer and negotiate reasonably and with urgency. (shrink)

One of the most contentious ethical issues in the neonatal intensive care unit is the withdrawal of life-sustaining treatment from infants who may otherwise survive. In practice, one of the most important factors influencing this decision is the prediction that the infant will be severely intellectually disabled. Most professional guidelines suggest that decisions should be made on the basis of the best interests of the infant. It is, however, not clear how intellectual disability affects those interests. Why should intellectual disability (...) be more important than physical disability to the future interests of an infant? Is it discriminatory to base decisions on this? This paper will try to unravel the above questions. It seems that if intellectual disability does affect the best interests of the child it must do so in one of three ways. These possibilities will be discussed as well as the major challenges to the notion that intellectual disability should have a role in such decisions. The best interests of the child can be affected by severe or profound intellectual disability. It is, though, not as clear-cut as some might expect. (shrink)

A curious feature of Aztec philosophy is that the basic metaphysical question of the “Western” tradition cannot be formulated in their language, in Nahuatl. This did not, however, prevent the Aztecs from developing an account of 'reality', or whatever it is that might exist. The article is the first of its kind to compare the work of Aristotle on ousia (being) and the Aztecs on teotl and ometeotl. Through this analysis, it suggests that both of the Nahuatl terms are fundamental (...) for expressing the basic character of reality as process for the Aztecs. It also defends their notion as prima facia reasonable, despite its wide divergence from Aristotle's view. (shrink)

Scholars in the early seventeenth century who studied ancient Greek scientific theories often drew upon philology and history to reconstruct a more general picture of the Greek past. Gassendi's training as a humanist historiographer enabled him to formulate a conception of the history of philosophy in which the rationality of scientific and philosophical inquiry depended on the historical justifications which he developed for his beliefs. Professor Joy examines this conception and analyzes the nature of Gassendi's historical training, especially its relationship (...) to his career as a physicist and astronomer. She shows how he rehabilitated Epicurean atomism by bringing together the arguments of the Greek atomists and those of his contemporaries. In doing so, he produced an account of the natural world which made it an object of empirical study and mechanical explanation. (shrink)

Monotheistic conceptions of an afterlife raise a philosophical question: In virtue of what is a postmortem person the same person who lived and died? Four standard answers are surveyed and criticized: sameness of soul, sameness of body or brain, sameness of soul-body composite, sameness of memories. The discussion of these answers to the question of personal identity is followed by a development of my own view, the Constitution View. According to the Constitution View, you are a person in virtue of (...) having a first-person perspective, and a postmortem person is you if and only if that person has the same first-person perspective. The Christian doctrine of resurrection has three features: a postmortem person is embodied; a postmortem person is identical to some premortem person; and the postmortem person owes existence to a miracle. I show how the Constitution View accommodates these three features. (shrink)

The current position on the deceased’s consent and the family’s consent to organ and tissue donation from the dead is a double veto—each has the power to withhold and override the other’s desire to donate. This paper raises, and to some extent answers, questions about the coherence of the double veto. It can be coherently defended in two ways: if it has the best effects and if the deceased has only negative rights of veto. Whether the double veto has better (...) effects than other policies requires empirical investigation, which is not undertaken here. As for rights, the paper shows that it is entirely possible that individuals have a negative right of veto but no positive right to compel acceptance of their offers. Thus if intensivists and transplant teams turn down the deceased’s offer, they do not thereby violate the deceased’s right. This leaves it open whether non-rights based reasons—such as avoiding bad publicity or distress —require intensivists and transplant teams to turn down or accept the deceased’s offer. This, however, is beyond the scope of this paper. The current position may or may not be wrong, but it is at least coherent. (shrink)

One of the pressures placed upon researchers is the process of ethics review. This frequently provides considerable conflict. The process of review of student projects of little inherent risk is identical to that of their more senior colleagues. In this article I propose that we should be more tolerant of design problems within student research if the overall risk is minimal in order that the student can learn about the process of carrying out research.The frequency and content of papers discussing (...) research ethics review in specialist,1 professional2 3 and lay4 press suggests that many senior researchers find the process challenging. The opinion most frequently expressed is that research ethics committees work to an imprecise set of rules and represent a barrier to significant pieces of clinical research. In particular, specific criticism has been aimed at the review of student research5–8 and the difficulties that students and their supervisors face.In ethics committees we usually police research very carefully, monitoring the detail of projects, including how participants will be selected, what data will be collected, how it will be handled and how the research is funded in addition to the adequacy of the consent process and information that underlies it. My experience as a member of NHS REC and governance committees and, more particularly, coordinator of student research, is that National Research Ethics Service REC usually apply the same standards to student research with little inherent risk as to complex phase 1 studies with significant risk. Guidance in the standard operating procedures for NHS REC is at best unhelpful and at worst supportive of this view. …. (shrink)

Preimplantation genetic diagnosis and some prenatal screening programmes have been criticized for being 'eugenic'. This paper aims to analyse this criticism and to evaluate one of the main ethical arguments lying behind it. It starts with a discussion of the meaning of the term 'eugenics' and of some relevant distinctions: for example, that between objections to eugenic ends and objections to certain means of achieving them. Next, a particular argument against using preimplantation genetic diagnosis to 'screen out' disability is considered, (...) one based on the Equal Value Principle, which says that we should value disability and non-disability equally. It is argued that present practice and policy probably do violate the Equal Value Principle, but that this principle is itself unsound. (shrink)

This article argues that the real promise of feminist philosophy of language is in its account of articulated normativity. Feminist philosophy of language began within a descriptivist framework, seeking to identify and root out sexist discursive practices, like naming practices that subsume women’s identity under men’s, descriptive practices that erase or undermine women’s accomplishments and presence as subjects, and so on. This approach had its limits, and led to increased attention to the discursive practices through which we articulate our experiences (...) and construct our lives. Examining the core frameworks through which feminists have analyzed the power of language to shape social reality and construct social selves, this article shows how language is normative in its production and reproduction of social norms by way of its content, forms, and constitutive discursive practices. The article urges feminists to use knowledge of the processes of articulation and legitimation to effect and explain feminist reconstitution of women as whole. (shrink)

Although Nietzsche's writings clearly deliver an unhealthy dose of misogyny, it must be noticed that they also contain the seeds of a deconstruction of that misogyny. This paper exposes one set of deconstructing elements of Nietzsche's works with respect to his views on women. The wider philosophical context of Nietzsche's thought provides grounds for taking seriously several passages of The Gay Science that reveal a more sympathetic understanding of women, since these passages take seriously Nietzsche's anti-dualism, his perspectivism, and his (...) early existentialist notion of the self. The destabilizing force of these passages, combined with Nietzsche's remarks about women within this philosophical context, reveals that Nietzsche's works promise more insight than many feminists have previously noted. A feminist analysis of Nietzsche's anti-dualism, perspectivism and discussion of the power of naming promises to inform contemporary feminist concerns about the importance of women's articulating our lives. (shrink)

This paper examines, on the basis of a longitudinal corpus of 50 early modern authors, how change at the aggregate level of the community interacts with variation and change at the micro-level of the individual language user. In doing so, this study aims to address the methodological gap between collective change and entrenchment, that is, the gap between language as a social phenomenon and the cognitive processes responsible for the continuous reorganization of linguistic knowledge in individual speakers. Taking up the (...) case of the prepositional passive, this study documents a strong community-wide increase in use that is accompanied by increasing schematicity. A comparison of the 50 authors reveals that regularities arising at the macro-level conceal highly complex and variable individual behavior, aspects of which may be explained by studying the larger (social) context in which these individuals operate (e. g., age cohorts, community of practice, biographical insights). Further analysis, focusing on how authors use the prepositional passive in unique and similar ways, elucidates the role of small individual biases in long-term change. Overall, it is demonstrated that language change is an emergent phenomenon that results from the complex interaction between individual speakers, who themselves may change their linguistic behavior to varying degrees. (shrink)

What is a human person, and what is the relation between a person and his or her body? In her third book on the philosophy of mind, Lynne Rudder Baker investigates what she terms the person/body problem and offers a detailed account of the relation between human persons and their bodies. Baker's argument is based on the 'Constitution View' of persons and bodies, which aims to show what distinguishes persons from all other beings and to show how we can be (...) fully material beings without being identical to our bodies. The Constitution View yields answers to the questions 'What am I most fundamentally?', 'What is a person?', and 'What is the relation between human persons and their bodies'? Baker argues that the complex mental property of first-person perspective enables one to conceive of one's body and mental states as one's own. (shrink)

. Undoubtedly, multinational corporations must play a significant role in the advancement of global ecological ethics. Our research offers a glimpse into the process of how goals of ecological sustainability in one multinational corporation can trickle down through the organization via the sustainability support behaviors of supervisors. We asked the question “How do supervisors in a multinational corporation internalize their corporation’s commitment to ecological sustainability and, in turn, behave in ways that convey this commitment to their subordinates?” In response, we (...) created a theoretical framework for supervisor sustainability support behavior based on Stern et al., Human Ecology Review 6(2), 81-97 (1999) value-belief-norm (VBN) theory. We then tested our framework by performing a survey-based field study of supervisors in a multinational pharmaceutical company that has publicly professed a goal of ecological sustainability. (shrink)

For a long time, linguists more or less denied the existence of individual differences in grammatical knowledge. While recent years have seen an explosion of research on individual differences, most usage-based research has failed to address this issue and has remained reluctant to study the synergy between individual and community grammars. This paper focuses on individual differences in linguistic knowledge and processing, and examines how these differences can be integrated into a more comprehensive constructionist theory of grammar. The examination is (...) guided by the various challenges and opportunities that may be extracted from scattered research that exists across disciplines touching on these matters, while also presenting some new data that illustrate how differentiation between individuals can improve models of long-term language change. The paper also serves as the introduction to this special issue of Cognitive Linguistics, which collects seven contributions from various linguistic disciplines focusing on key aspects of individuals’ grammars. (shrink)

Holobionts are multicellular eukaryotes with multiple species of persistent symbionts. They are not individuals in the genetic sense— composed of and regulated by the same genome—but they are anatomical, physiological, developmental, immunological, and evolutionary units, evolved from a shared relationship between different species. We argue that many of the interactions between human and microbiota symbionts and the reproductive process of a new holobiont are best understood as instances of reciprocal scaffolding of developmental processes and mutual construction of developmental, ecological, and (...) evolutionary niches. Our examples show that mother, fetus, and different symbiotic microbial communities induce or constitute conditions for the development and reproduction of one another. These include the direct induction of maternal or fetus physiological changes, the restructuring of ecological relations between communities, and evolutionary selection against undesirable competitors. The mutual scaffolding and niche constructing processes start early—prior to amniotic rupture. We are evolutionarily, physiologically, and developmentally integrated holobiont systems, strung together through mutual reliance and mutual construction. Bringing the processes of niche construction and developmental scaffolding together to interpret holobiont birth conceptually scaffolds two new directions for research: in niche construction, identifying the evolutionary implications of organisms actively constructing multiple overlapping niches and scaffolds, and in Evolutionary Developmental Biology, characterizing evolutionary and ecological processes as developmental causes. (shrink)

This volume reaches beyond the controversy surrounding the teaching and learning of evolution in the United States, specifically in regard to the culture, politics, and beliefs found in the Southeast. The editors argue that despite a deep history of conflict in the region surrounding evolution, there is a wealth of evolution research taking place—from biodiversity in species to cultural evolution and human development. In fact, scientists, educators, and researchers from around the United States have found their niche in the South, (...) where biodiversity is high, culture runs deep, and the pace is just a little bit slower. (shrink)

Persons and Bodies develops and defends an account of persons and of the relation between human persons and their bodies. Human persons are constituted by bodies, without being identical to the bodies that constitute them—just as, I argue, statues are constituted by pieces of bronze, say, without being identical to the pieces of bronze that constitute them. The relation of constitution, therefore, is not peculiar to persons and their bodies, but is pervasive in the natural world.