Most healthcare providers work from ethical principles based on a Western model of practice that may not adhere to the cultural values intrinsic to Indigenous peoples. Breaking bad news is an important topic of ethical concern in health research. While much has been documented on BBN globally, the ethical implications of receiving bad news, from an Indigenous patient perspective in particular, is an area that requires further inquiry. This article discusses the experiences of Māori lung cancer patients and their families, (...) in order to investigate the ethical implications of receiving bad news. Data collection occurred through 23 semistructured interviews and nine focus groups with Māori lung cancer patients and their families in four districts in the Midland Region of New Zealand: Waikato, Bay of Plenty, Lakes and Tairāwhiti. The findings of this study were categorised into two key themes: communication and context. Avenues for best practice include understanding the centrality of the HCP–patient relationship and family ties in the healthcare journey, and providing patients with the full range of viable treatment options including hope, clear advice and guidance when the situation calls for it. Overall, the findings of this study hold implications for providing culturally safe and humanistic cancer care when BBN to Māori and Indigenous patients. (shrink)

This essay brings psychoanalytic theory on trauma together with film and television criticism on rape narrative in an analysis of Michael Coel’s 2020 series I May Destroy You. Beyond the limited carceral framework of the police procedural, which dislocates the act of violence from the survivor’s history and context, Coel’s polyvalent, looping narrative metabolizes rape television’s forms and genres in order to stage and restage both trauma and genre again and anew. Contesting common conceptions of vulnerability and susceptibility that prefigure (...) a violent breach of autonomy, Coel’s series and her interviews about it invite an ethics of looking that embraces a curiosity in the unknowable and untreatable kernel of subjective experience and defies and resists a policing of the survivor’s thoughts and emotions. By emphasizing and exploring what psychoanalysis calls the “afterwardness” of trauma, Coel foregrounds her main character’s subjectivity prior to her victimization, widens the sphere of consequence beyond the victim and criminal justice system to the survivor’s larger community, and entreats that community to preserve a space for her to look and look again at everything, without judgment. (shrink)

On a version of consent theory that tempts many, predatory sexual relations involving significant power imbalances (e.g. between professors and students, adults and teenagers, or employers and employees) are wrong because they violate consent-centric norms. In particular, the wronged party is said to have been incapable of consenting to the predation, and the sexual wrong is located in the encounter’s nonconsensuality. Although we agree that these are sexual wrongs, we resist the idea that they are always nonconsensual. We argue instead (...) that it is possible for students, teenagers, employees, etc. to fully consent to sexually predatory encounters; denying as much renders survivors of predation vulnerable to compounding harms. Survivors face a dilemma: give up either their understanding of their experience as wrong, or their self-conception as an agent capable of consenting. We call the latter phenomenon agential demotion. (shrink)

The application of artificial intelligence and machine learning technologies in healthcare have immense potential to improve the care of patients. While there are some emerging practices surro...

Programs, policies, and technologies — particularly those concerned with health equity — are often designed with justice envisioned as the end goal. These policies or interventions, however, frequently fail to recognize how the beneficiaries have historically embodied the cumulative effects of marginalization, which undermines the effectiveness of the intended justice. These well-meaning attempts at justice are bounded by greater socio-historical constraints. Bounded justice suggests that it is impossible to attend to fairness, entitlement, and equity when the basic social and physical (...) infrastructures underlying them have been eroded by racism and other historically entrenched isms. Using the case of Brazil’s National Health Policy for the Black Population, this paper proposes that bounded justice can contribute to justice discourses by serving as a concept, a proffering to a multi-disciplinary conceptual framework, and a potential analytic for those interested in the design of policy, technology, and programmatic interventions towards health equity. (shrink)

Journal of Philosophy of Education, EarlyView.

There can be no doubt that Kant thought we should be reflective: we ought to care to make up our own minds about how things are and what is worth doing. Philosophical objections to the Kantian reflective ideal have centred on concerns about the excessive control that the reflective person is supposed to exert over her own mental life, and Kantians who feel the force of these objections have recently drawn attention to Kant’s conception of moral virtue as it is (...) developed in his later work, chiefly the Metaphysics of Morals. Melissa Merritt’s book is a distinctive contribution to this recent turn to virtue in Kant scholarship. Merritt argues that we need a clearer, and textually more comprehensive, account of what reflection is, in order not only to understand Kant’s account of virtue, but also to appreciate how it effectively rebuts long-standing objections to the Kantian reflective ideal. (shrink)

Maurice Merleau-Ponty did not author an ethic, and yet it is possible to extend his ontological descriptions to an ethic similar to that espoused by post modern thinkers. It is even possible to distill an environmental ethic, or at least, one of consideration of the more-than-human, from his work. This paper attempts to do some preliminary work in light of this, and lays some groundwork for the future direction of an environmental ethic inspired by a Merleau-Pontian ontology. At the same (...) time, it challenges the popularised view of Merleau-Ponty espoused by David Abram – viz., of Merleau-Ponty as an animist – and properly situates Merleau Ponty. (shrink)

What makes someone the same person over time? There are (at least) two ways of understanding this question: A person can be the same in the sense of being very similar to how they used to be (similarity), or they can be the same in the sense of being the same individual (numerical identity). In recent years, several papers have claimed to explore the commonsense notion of numerical identity. However, we suggest here that these researchers have instead been studying similarity. (...) We develop a novel method that uses simple intuitions about objects to illustrate these two notions of “same person”, and then asks which concept applies to instances of personal change. Across 4 studies (N = 2446), we find that these previously documented intuitions are best understood as reflecting judgments about similarity, not identity (Experiments 1 and 2). We then use this method to explore the situations in which participants do perceive a change in numerical identity. We find that when a person's entire brain (Experiments 3 and 4) or soul (Experiment 4) has been replaced with that of another person, the majority of participants judge that numerical identity has changed. However, we also note that a substantial minority of participants denied that identity had changed, opening new questions about the role of the body in intuitive judgments of personal identity. (shrink)

Explores the challenges facing democracies in the twenty-first century In Democratic Failure, Melissa Schwartzberg and Daniel Viehoff bring together a distinguished group of interdisciplinary scholars in political science, law, and philosophy to explore the key questions and challenges facing democracies, both in the past and present, around the world. In ten timely essays, contributors examine the fascinating, centuries-old question of whether or not democracy can ever fulfill the promise of its ideals. Together, they explore lessons from the history of (...) democracy, various failures of democratic representation, and more. Ultimately, this latest installment of the NOMOS series provides thought-provoking insights into how we conceptualize, measure, and address democratic erosion in our present-day world. (shrink)

Competition among scientists for funding, positions and prestige, among other things, is often seen as a salutary driving force in U.S. science. Its effects on scientists, their work and their relationships are seldom considered. Focus-group discussions with 51 mid- and early-career scientists, on which this study is based, reveal a dark side of competition in science. According to these scientists, competition contributes to strategic game-playing in science, a decline in free and open sharing of information and methods, sabotage of others’ (...) ability to use one’s work, interference with peer-review processes, deformation of relationships, and careless or questionable research conduct. When competition is pervasive, such effects may jeopardize the progress, efficiency and integrity of science. (shrink)

This article explains the problems with Alan Shewmon’s critique of brain death as a valid sign of human death, beginning with a critical examination of his analogy between brain death and severe spinal cord injury. The article then goes on to assess his broader argument against the necessity of the brain for adult human organismal integration, arguing that he fails to translate correctly from biological to metaphysical claims. Finally, on the basis of a deeper metaphysical analysis, I offer a revised (...) rationale for the validity of the neurological criterion of human death. (shrink)

The moral philosophy of the first half of the twentieth century, at least in the English-speaking part of the world, has been largely devoted to problems of an ontological or epistemological nature. This concentration of effort by many acute analytical minds has not produced any general agreement with respect to the solution of these problems; it seems likely, on the contrary, that the wealth of proposed solutions, each making some claim to plausibility, has resulted in greater disagreement than ever before, (...) and in some cases disagreement about issues so fundamental that certain schools of thought now find it unrewarding, if not impossible, to communicate with one another. Moral philosophers of almost all schools seem to agree, however, that no major possibility has been neglected during this period, and that every proposed solution which can be adjudged at all plausible has been examined with considerable thoroughness. It is now common practice, for example, for the authors of books on moral philosophy to introduce their own theories by what purports to be a classification and review of all \emph{possible} solutions to the basic problems of analysis; and in many cases, indeed, the primary defense of the author's own position seems to consist in the negative argument that his own position cannot fail to be correct because none of the others which he has mentioned is satisfactory. (shrink)

This paper argues that a worthwhile life is one in which the meaningful relationships existing in nature are recognised and respected. A meaningful relationship occurs when the interactions between two entities have significance in their past history and its anticipated continuation. The form in which the history of both the human and the non-human is related is narrative. A life is enriched or impoverished by the subject's relationships to other people and nature, and as such is more or less worthwhile. (...) The argument presented here shows how Alan Holland's approach to conservation decision making can be extended to have relevance to individual lives, and that a strong ethical position can be developed from this insight. (shrink)

In the Doctrine of Virtue Kant stipulates that ‘Love is a matter of feeling, not of willing . . . so a duty to love is an absurdity.’ Nonetheless, in the same work Kant claims that we have duties of love to other human beings. According to Kant, the kind of love which is commanded by duty is practical love. This paper defends the view that the duty of practical love articulated in the Doctrine of Virtue is distinct from the (...) duty of beneficence and best understood as a duty of self-transformation, which agents observe by cultivating a benevolent disposition and practical beneficent desires. (shrink)

Researchers are studying how artificial intelligence (AI) can be used to better detect, prognosticate and subgroup diseases. The idea that AI might advance medicine’s understanding of biological categories of psychiatric disorders, as well as provide better treatments, is appealing given the historical challenges with prediction, diagnosis and treatment in psychiatry. Given the power of AI to analyse vast amounts of information, some clinicians may feel obligated to align their clinical judgements with the outputs of the AI system. However, a potential (...) epistemic privileging of AI in clinical judgements may lead to unintended consequences that could negatively affect patient treatment, well-being and rights. The implications are also relevant to precision medicine, digital twin technologies and predictive analytics generally. We propose that a commitment to epistemic humility can help promote judicious clinical decision-making at the interface of big data and AI in psychiatry. (shrink)

In the Doctrine of Virtue Kant divides duties of love into three categories: beneficent activity , gratitude and Teilnehmung – commonly referred to as the duty of sympathy . In this paper I will argue that the content and scope of the third duty of love has been underestimated by both critics and defenders of Kant's ethical theory. The account which pervades the secondary literature maintains that the third duty of love includes only two components: an obligation to make use (...) of our natural receptivity to sympathetic feelings as a means to fulfilling other duties of love, and an indirect duty to cultivate these feelings. As a result, Kant's duty of sympathy has been widely regarded as a duty whose value is derived from the way in which it serves other duties, in particular, the duty of beneficent activity, which obliges agents ‘to promote according to one's means the happiness of others in need’ . Teilnehmung has thus assumed something of a second-class status among the duties to others. My aim in this paper is to demonstrate that the prevailing account of Kant's third duty of love is incomplete. (shrink)

Since ancient Athens, democrats have taken pride in their power and inclination to change their laws, yet they have also sought to counter this capacity by creating immutable laws. In Democracy and Legal Change, Melissa Schwartzberg argues that modifying law is a fundamental and attractive democratic activity. Against those who would defend the use of 'entrenchment clauses' to protect key constitutional provisions from revision, Schwartzberg seeks to demonstrate historically the strategic and even unjust purposes unamendable laws have typically served, (...) and to highlight the regrettable consequences that entrenchment may have for democracies today. Drawing on historical evidence, classical political theory, and contemporary constitutional and democratic theory, Democracy and Legal Change reexamines the relationship between democracy and the rule of law from a new, and often surprising, set of vantage points. (shrink)

I propose a unified solution to two puzzles: Ross's puzzle and free choice permission. I begin with a pair of cases from the decision theory literature illustrating the phenomenon of act dependence, where what an agent ought to do depends on what she does. The notion of permissibility distilled from these cases forms the basis for my analysis of 'may' and 'ought'. This framework is then combined with a generalization of the classical semantics for disjunction — equivalent to Boolean disjunction (...) on the diagonal, but with a different two-dimensional character — that explains the puzzling facts in terms of semantic consequence. (shrink)

In this paper, I argue that brain death is death because, despite the appearance of genuine integration, the brain-dead body does not in fact possess the unity that is proper to a human organism. A brain-dead body is not a single entity, but a multitude of organs and tissues functioning in a coordinated manner with the help of artificial life support. In order to support this claim, I first lay out Hoffmann and Rosenkrantz’s ontological account of the requirements for organismal (...) unity and summarize an earlier paper in which I apply this account to the brain death debate. I then further support this ontological argument by developing an analogy between the requirements for the unity of an organism and the requirements for the unity of an orchestra. To do so, I begin by examining the role that a conductor plays in unifying a traditional orchestra, and then go on to show that the human organism functions like a traditional orchestra that relies upon a conductor for its unity. Next, I consider the conditions required to achieve orchestral unity in conductorless orchestras and show that, in contrast to simpler organisms like plants, the postnatal human organism lacks those conditions. I argue, in other words, that although conductorless orchestras do exist, the human organism is not one of them. Like a traditional orchestra without a conductor, the brain-dead body is not a unified whole. (shrink)

Astrophysics faces methodological challenges as a result of being a predominantly observation-based science without access to traditional experiments. In light of these challenges, astrophysicists frequently rely on computer simulations. Using collisional ring galaxies as a case study, I argue that computer simulations play three roles in reasoning in astrophysics: (1) hypothesis testing, (2) exploring possibility space, and (3) amplifying observations.

Within the growing developmental literature on children's testimonial learning, the emphasis placed on children's evaluations of testimonial evidence has shielded from view some of the more collaborative dimensions of testimonial learning. Drawing on recent philosophical work on testimony and interpersonal trust, we argue for an alternative way of conceptualizing the social nature of testimonial learning. On this alternative, some testimonial learning is the result of a jointly collaborative epistemic activity, an activity that aims at the epistemic goal of true belief, (...) but that does so by means of an irreducibly social process. (shrink)

This article discusses the concept of publicity in Kant’s moral philosophy. Insofar as the concepts of ‘public’ and ‘private’ can describe our relations with others, they can be considered to be moral concepts. I argue that we can find in Kant a moral duty not to keep our maxims of action private, or secret. Whereas Korsgaard argues that sometimes in the face of evil it is permissible to sidestep the moral law, I argue that it is rather through publicity that (...) we can deal with evil in the non-ideal world. Moreover, by being open with our maxims, moral progress is possible. View HTML Send article to KindleTo send this article to your Kindle, first ensure [email protected] is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle. Find out more about sending to your Kindle. Note you can select to send to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply. Find out more about the Kindle Personal Document Service.Making the Ideal Real: Publicity and Morality in KantVolume 21, Issue 2Melissa Zinkin DOI: https://doi.org/10.1017/S1369415416000042Your Kindle email address Please provide your Kindle [email protected]@kindle.com Available formats PDF Please select a format to send. By using this service, you agree that you will only keep articles for personal use, and will not openly distribute them via Dropbox, Google Drive or other file sharing services. Please confirm that you accept the terms of use. Cancel Send ×Send article to Dropbox To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about sending content to Dropbox. Making the Ideal Real: Publicity and Morality in KantVolume 21, Issue 2Melissa Zinkin DOI: https://doi.org/10.1017/S1369415416000042Available formats PDF Please select a format to send. By using this service, you agree that you will only keep articles for personal use, and will not openly distribute them via Dropbox, Google Drive or other file sharing services. Please confirm that you accept the terms of use. Cancel Send ×Send article to Google Drive To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about sending content to Google Drive. Making the Ideal Real: Publicity and Morality in KantVolume 21, Issue 2Melissa Zinkin DOI: https://doi.org/10.1017/S1369415416000042Available formats PDF Please select a format to send. By using this service, you agree that you will only keep articles for personal use, and will not openly distribute them via Dropbox, Google Drive or other file sharing services. Please confirm that you accept the terms of use. Cancel Send ×Export citation. (shrink)

Many extant theories of placebo focus on their causal structure wherein placebo effects are those that originate from select features of the therapy (e.g., client expectations or “incidental” features like size and shape). Although such accounts can distinguish placebos from standard medical treatments, they cannot distinguish placebos from everyday occurrences, for example, when positive feedback improves our performance on a task. Providing a social-epistemological account of a treatment context can rule out such occurrences, and furthermore reveal a new way to (...) distinguish clinical placebos from standard medical treatments. (shrink)

Is the debate over the existence of numbers unsolvable? Mario Gómez-Torrente presents a novel proposal to unclog the old discussion between the realist and the anti-realist about numbers. In this paper, the strategy is outlined, highlighting its results and showing how they determine the desiderata for a satisfactory theory of the reference of Arabic numerals, which should lead to a satisfactory explanation about numbers. It is argued here that the theory almost achieves its goals, yet it does not capture the (...) relevant association between how a number can be split up and the morphological property of Arabic numerals to be positional. This property seems to play a substantial role in providing a complete theory of Arabic numerals and numbers. (shrink)

Kant's discussion of the feeling of respect presents a puzzle regarding both the precise nature of this feeling and its role in his moral theory as an incentive that motivates us to follow the moral law. If it is a feeling that motivates us to follow the law, this would contradict Kant's view that moral obligation is based on reason alone. I argue that Kant has an account of respect as feeling that is nevertheless not separate from the use of (...) reason, but is intrinsic to willing. I demonstrate this by taking literally Kant's references to force in the second Critique. By referring to Kant's pre-critical essay on Negative Magnitudes (1763), I show that Kant's account of how the moral law effects in us a feeling of respect is underpinned by his view that the will is a kind of negative magnitude, or force. I conclude by noting some of the implications of my discussion for Kant's account of virtue. (shrink)

Should animals have similar rights as humans? -- Is it moral to eat animals? -- Should animals be used for entertainment? -- Is it ethical to experiment on animals?

As is clear in the 2008 report of the President's Council on Bioethics, the brain death debate is plagued by ambiguity in the use of such key terms as ‘integration’ and ‘wholeness’. Addressing this problem, I offer a plausible ontological account of organismal unity drawing on the work of Hoffman and Rosenkrantz, and then apply that account to the case of brain death, concluding that a brain dead body lacks the unity proper to a human organism, and has therefore undergone (...) a substantial change. I also show how my view can explain hard cases better than one in which biological integration is taken to imply ontological wholeness or unity. (shrink)

In this essay, I outline fundamental anthropological and moral principles related to human sexuality and gender identity and then apply these principles to analyze and evaluate the views of several authors who attempt to carve out a “middle way” between liberal and traditionalist approaches to these issues. In doing so, I engage especially with the claim that gender dysphoria, rather than being a psychological issue, is a type of biological intersex condition in which one’s “brain sex” is out of line (...) with one’s genital and chromosomal sex. I argue that understanding the human person as a unity of body and soul and recognizing human sexuality as ordered toward the human good of marriage understood as inseparably unitive and procreative reveals the flaws in this position and helps to show why hormonal or surgical gender reassignment therapy is not a medically or ethically appropriate response to gender dysphoria. I also offer an alternative characterization of gender dysphoria and suggestions for responding with true compassion to those who suffer from it. (shrink)

In a world no longer centered on the West, what should political theory become? Although Western intellectual traditions continue to dominate academic journals and course syllabi in political theory, up-and-coming contributions of 'comparative political theory' are rapidly transforming the field. Deparochializing Political Theory creates a space for conversation amongst leading scholars who differ widely in their approaches to political theory. These scholars converge on the belief that we bear a collective responsibility to engage and support the transformation of political theory. (...) In these exchanges, 'deparochializing' political theory emerges as an intellectual, educational and political practice that cuts across methodological approaches. Because it is also an intergenerational project, this book presses us to re-imagine our teaching and curriculum design. Bearing the marks of its beginnings in East Asia, Deparochializing Political Theory seeks to de-center Western thought and explore the evolving tasks of political theory in an age of global modernity. (shrink)

In this article, I explore difficult and sensitive questions regarding the nature of transgender identity claims and the appropriate medical treatment for those suffering from gender dysphoria. I first analyze conceptions of transgender identity, highlighting the prominence of the wrong-body narrative and its dualist presuppositions. I then briefly argue that dualism is false because our bodily identity is essential and intrinsic to our overall personal identity and explain why a sound, nondualist anthropology implies that gender identity cannot be entirely divorced (...) from sexual identity. Finally, I make the case that arguments in favor of hormonal and surgical treatments for gender dysphoria rest on this mistaken dualist anthropology, and that these treatments therefore give false hope to those suffering from gender dysphoria, while causing irreversible bodily harm and diverting attention from underlying psychological problems that often need to be addressed. I also briefly discuss how these philosophical claims relate to empirical studies on the outcomes of hormonal and surgical treatments for gender dysphoria and to testimonies of transgender individuals who regret having undergone these treatments. (shrink)

Eco-minimalism is an emerging approach to building design, construction, and retrofitting. The approach is exemplified by the work of architect Howard Liddell and sustainable water management consultant Nick Grant. The fundamental tenet of this approach is an opposition to the use of inappropriate, unnecessary, and ostentatious eco-technology—or “eco-bling”—where the main emphasis is on being seen to be green. The adoption of the principles of the eco-minimalist approach offers, they argue, a significant opportunity to improve sustainability in construction. However, a critical (...) examination of eco-minimalism as a design philosophy shows that eco-minimalism needs to be further developed within the framework of virtue ethics. The focus should be on two main themes: (1) incommensurabilities arising in relation to eco-minimalism’s goals of minimizing environmental impact and maximizing human benefit, which cannot be resolved from the principles Liddell and Grant have articulated, and (2) the practical importance of cultivating settled dispositions to act eco-minimally on the part of those who design, construct, and use buildings. A strong emphasis needs to be placed on the role of practical wisdom when navigating challenging decisions of the kind facing eco-minimalists in practice. (shrink)

Royal Statuary of Early Dynastic Mesopotamia. By Gianni Marchesi and Nicolò Marchetti. Mesopotamian Civilizations, vol. 14. Winona Lake, Ind.: Eisenbrauns, 2011. Pp. ix + 374, plates. $89.50.