Currently, much of the western world is experiencing a shift in the places where care is provided, namely from institutional settings like hospitals to diverse community settings such as the home. However, little is known about how language and the physical and social aspects of place interact to influence how health‐care is delivered and experienced in the home environment. Drawing on ethnographic participant observations of homecare nursing visits and semi‐structured interviews with Canadian family caregivers, care recipients and nurses, the intersection (...) of language, place and health‐care was explored in this secondary analysis. Our findings reveal four themes: homecare nurses view themselves as ‘guests’; home environments facilitate the development of nurse–client relationships; nurses adapt healthcare language to each home environment; and storytelling and illness narratives largely prevail during medical interactions in the home. These findings demonstrate the spatiality of language and how the home environment informs decisions regarding language use. Furthermore, these findings exemplify how language and place mutually influence the experiences and delivery of home health‐care. We conclude by discussing the importance of considering the language–place–healthcare intersection in order to gain a better understanding of medical exchanges in places and the associated implications for optimizing best nursing practice. (shrink)

Interpretations of family carer empowerment in much nursing research, and in home‐care practice and policy, rarely attend explicitly to families’ choice or control about the nature, extent or length of their involvement, or control over the impact on their own health. In this article, structural empowerment is used as an analytic lens to examine home‐care nurses’ interactions with families in one Western Canadian region. Data were collected from 75 hrs of fieldwork in 59 interactions (18 nurses visiting 16 families) and (...) interviews with 12 nurses and 11 family carers. Generally, nurses prioritized client empowerment, and their practice with families appeared oriented to supporting their role and needs as carers (i.e. rather than as unique individuals beyond the caring role), and reinforcing the caring role through validation and recognition. Although families generally expressed appreciation for these interactions, a structural empowerment lens illustrates how the broad context of home care shapes the interpretation and practice of empowerment in ways that can, paradoxically, be disempowering for families. Opportunities to effectively support family choice and control when a client is being cared for at home are discussed. (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)

Lightweight rowing – the most commonly used term for the weight category in rowing’s often bifurcated categorisation system – is under credible threat of being eliminated at virtually all levels of rowing in Canada and the U.S. The health concerns associated with weight loss reflect the most problematic aspects of lightweight rowing, where the acceptable limits of harm that one must tolerated in sport is brought into question. Also, such category protection seems arguably unnecessary, especially for lightweights who are nearly (...) as competitive as their openweight counterparts. This prompts reflection on the purpose and policies behind these categories. The justification for weight categories is scant or has simply been assumed as legitimate within the status quo. In the absence of any constructive debate on the topic, I will attempt to articulate the neglected rationale for why lightweight rowing ought to exist despite its apparent problems. In doing so, suggestions for further rules and policy improvements to lightweight rowing will be identified. (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)

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)

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)

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)

Despite reservations over the status of esports as sports, the International Olympic Committee (IOC) has, for policy reasons, encouraged International Federations to pursue links with providers of ‘virtual and simulated’ sports, in part by the introduction of an event, the Olympic Virtual Series, first held in 2021. In providing an account of ‘virtuality’ and ‘simulation’, we query the theoretical basis of the Olympic Virtual Series. In particular, we query the IOC’s use of the term ‘virtual’ in the description of two (...) very different activities: what it calls ‘physical virtual sports’ (which we argue are simply Olympic-type sports – real sports! – and should just be called ‘sports’) and ‘non-physical virtual sports’ (which we argue are not sports at all, and should be recognized for what they are – computer games). (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)

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)

Ethics researchers advise managers of organizations to link rewards and punishments to ethical and unethical behavior, respectively. We build on prior research maintaining that organizations operate at Kohlbergs stages of moral reasoning, and explain how the over-reliance on rewards and punishments encourages employees to operate at Kohlbergs lowest stages of moral reasoning. We advocate designing organizations as ethical communities and relying on different assumptions about employees in order to foster ethical reasoning at higher levels. Characteristics associated with ethical communities are (...) identified and AES Corporation and Semco S/A serve as examples of corporations exhibiting the design characteristics and assumptions of ethical organizations. (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...

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)

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)

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?

Journal of Philosophy of Education, EarlyView.

Network Democracy uses the contemporary tools of ecology and network thinking to unearth the ancient, intellectual ruins of traditional conservative thought. Questioning the West’s veneration of freedom, equality, contractual citizenship, economic progress, cosmopolitanism, secular institutionalism, and reason, Jared Giesbrecht illuminates how these ideals fuel violence and insecurity in our high-speed lives. While the modern age witnesses the rise of a violent conservatism in the form of revolutionary movements enacting terror and vengeance for the interventions of the liberal West, this (...) study reveals a different kind of conservatism - one that has emerged in direct conversation with liberal thought. Giesbrecht highlights the need for intermediate institutions and civil enterprises that form relations and traditions independent of the state in order to develop resistance to the insecurity of the liberal age. This book offers not only a poignant critique, but a constructive and peaceable alternative to the violence of both liberalism and reactionary anti-liberalism. Attuned to the new realities of globalization, advanced technology, and social acceleration, Network Democracy is a masterful hybrid of ancient and cutting-edge political philosophy that casts a new light on the values underlying western civilization. (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)

Building trust between academic medical centers and certain communities they depend on in the research process is hard, particularly when those communities consist of minoritized or historically marginalized populations. Some believe that engagement activities like the creation of advisory boards, town halls, or a research workforce that looks more like community members will establish or reestablish trust between academic medical centers and racialized communities. However, without systematic approaches to dismantle racism, those well‐intended actions become public performativity, and trust building will (...) fail. In this essay, we draw upon foundational ethical principles of trust, distrust, and trust building; apply the concept of bounded justice to performative trust acts; and center the works of Black and Indigenous feminist bioethicists to revisit some of the wisdom and valuable lessons they have contributed. Rebuilding trust is hard to do because people and institutions are often not honest about how hard it is and there is no simple box‐checking task that can disentangle our society's injustices, but there are steps to take in this direction. Individuals and institutions can recognize valuable relevant work that has already been written, partake in critical reflection, and then apply insights gained to take both small and sustainable steps toward transformational change and deeper trust. (shrink)

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 is the second of the four essays in Part II of the book on liberalism and traditionalist education; all four are by authors who would like to find ways for the liberal state to honour the self-definitions of traditional cultures and to find ways of avoiding a confrontation with differences. Melissa Williams examines citizenship as identity in relation to the project of nation-building, the shifting boundaries of citizenship in relation to globalization, citizenship as shared fate, and the role (...) of multicultural education within the view of citizenship-as-shared-fate. She argues the other side of the same coin to that presented by Shelley Burtt in the previous chapter: according to Williams, the liberal state often demands too much in the way of loyalty from traditional groups, and when it does, it runs a strong risk of becoming oppressive and illiberal. Moreover, she holds that there is no need for a single shared identity among citizens of the liberal state. Her conception of people tied together by a shared fate is to this extent compatible with Burtt’s attempt to make liberalism’s commitment to autonomy more hospitable to groups of individuals encumbered by unchosen attachments, but her notion of citizenship as shared fate also goes further than that, and possibly stands in some tension with, Burtt’s view, since it allows and even encourages people to develop primary affiliation to all kind of groups – traditional as well as global. (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)

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)

Observers have difficulty detecting visual changes. However, they are unaware of this inability, suggesting that people do not have an accurate understanding of visual processes. We explored whether this error is related to participants’ beliefs about the roles of intention and scene complexity in detecting changes. In Experiment 1 participants had a higher failure rate for detecting changes in an incidental change detection task than an intentional change detection task. This effect of intention was greatest for complex scenes. However, participants (...) predicted equal levels of change detection for both types of changes across scene complexity. In Experiment 2, emphasizing the differences between intentional and incidental tasks allowed participants to make predictions that were less inaccurate. In Experiment 3, using more sensitive measures and accounting for individual differences did not further improve predictions. These findings suggest that adults do not fully understand the role of intention and scene complexity in change detection. (shrink)

Scholars exploring the logic of Rousseau's voting rules have typically turned to the connection between Rousseau and the Marquis de Condorcet. Though Condorcet could not have had a direct influence on Rousseau's arguments about the choice of decision rules in "Social Contract," the possibility of a connection has encouraged the view that Rousseau's selection of voting rules was based on epistemic reasons. By turning to alternative sources of influence on Rousseau--the work of Hugo Grotius and particularly that of Samuel Pufendorf--a (...) moral, and not purely epistemic, logic of rules governing collective decision making emerges. For Rousseau, as for Pufendorf, the proper choice of voting rule can elicit the appropriate attitude of an individual with respect to the decision of the whole, and can support the morally significant activity of acknowledging error upon discovering that one has voted against the general will. (shrink)

Disclosure in clinical practice is aimed at promoting patient autonomy, usually culminating in patient choice (e.g., to consent to an operation or not, or between different medications). In medical ethics, there is an implicit background assumption that knowing more about (X) automatically translates to greater, or more genuine, autonomy with respect to one's choices involving (X). I challenge this assumption by arguing that in rare cases, withholding information can promote a patient's autonomy (understood as the capacity for rational choice in (...) alignment with one's values and goals). (shrink)

Globalization generates new structures of human interdependence and vulnerability while also posing challenges for models of democracy rooted in territorially bounded states. The diverse phenomena of globalization have stimulated two relatively new branches of political theory: theoretical accounts of the possibilities of democracy beyond the state; and comparative political theory, which aims at bringing non-Western political thought into conversation with the Western traditions that remain dominant in the political theory academy. This article links these two theoretical responses to globalization by (...) showing how comparative political theory can contribute to the emergence of new global “publics” around the common fates that globalization forges across borders. Building on the pragmatist foundations of deliberative democratic theory, it makes a democratic case for comparative political theory as an architecture of translation that helps deliberative publics grow across boundaries of culture. (shrink)

Noah Rosenberg et al.'s 2002 article “Genetic Structure of Human Populations” reported that multivariate genomic analysis of a large cell line panel yielded reproducible groupings (clusters) suggestive of individuals' geographical origins. The paper has been repeatedly cited as evidence that traditional notions of race have a biological basis, a claim its authors do not make. Critics of this misinterpretation have often suggested that it follows from interpreters' personal biases skewing the reception of an objective piece of scientific writing. I contend, (...) however, that the article itself to some degree facilitates this misrepresentation. I analyze in detail several verbal and visual features of the original article that may predispose aspects of its racial interpretation; and, tracing the arguments of one philosopher and one popular science writer, I show how these features are absorbed, transformed into arguments for a biological basis of race, and re-attributed to the original. The essay demonstrates how even slight ambiguities can enable the misappropriation of scientific writing, unintentionally undermining the authors' stated circumspection on the relationship between cluster and race. (shrink)

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)

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)

Political scientist Melissa Orlie asks what it means to live freely and responsibly when advantages are distributed disproportionately according to race, gender ...