The U.S. healthcare system has a long history of displaying racist contempt toward Black people. From medical schools’ use of enslaved bodies as cadavers to the widespread hospital practice of reporting suspected drug users who seek medical help to the police, the institutional practices and policies that have shaped U.S. healthcare systems as we know them cannot be minimized as coincidence. Rather, the very foundations of medical discovery, diagnosis, and treatment are built on racist contempt for Black people and have (...) become self-perpetuating. Yet, I argue that bioethics and bioethicists have a role in combatting racism. However, in order to do so, bioethicists have to understand the workings of contemptuous racism and how that particular form of racism manifests in U.S. healthcare institutions. Insofar as justice is part of the core mission of bioethics, then antiracism must also be part of the mission of bioethics. (shrink)

The problems of racism and racially motivated violence in predominantly African American communities in the United States are complex, multifactorial, and historically rooted. While these problems are also deeply morally troubling, bioethicists have not contributed substantially to addressing them. Concern for justice has been one of the core commitments of bioethics. For this and other reasons, bioethicists should contribute to addressing these problems. We consider how bioethicists can offer meaningful contributions to the public discourse, research, teaching, training, policy development, and (...) academic scholarship in response to the alarming and persistent patterns of racism and implicit biases associated with it. To make any useful contribution, bioethicists will require preparation and should expect to play a significant role through collaborative action with others. (shrink)

Taking Hobbesian logic as my starting point, I argue that Hobbesian diffidence, one of the causes of quarrel in the state of nature, does not disappear once the citizens enter civil society. Rather, diffidence is merely contained by the sovereign. Following Alice Ristroph, I argue that diffidence comes to shape what citizens demand of the state/sovereign in the criminal law. However, I show that Ristroph does not fully appreciate that the concept of diffidence is a racialized one, and as such, (...) race underlies how the citizens understand their own diffidence, what citizens demand of the sovereign, and how they demand it. Further, because diffidence itself is racialized, criminal law need not make explicit appeals to race. Once racialized diffidence becomes embedded in the criminal law, it remains there regardless of any conscious racial animus. I show that racial profiling is a prime example of how this racialized diffidence manifests. Thus, I present Hobbesian diffidence as a framework from which to understand racial oppression. This paper is primarily an application of Hobbes to contemporary issues rather than an exegesis and analysis of Hobbes’s views. (shrink)

Intersectionality has become a significant intellectual approach for those thinking about the ways that race, gender, and other social identities converge in order to create unique forms of oppression. Although the initial work on intersectionality addressed the unique position of black women relative to both black men and white women, the concept has since been expanded to address a range of social identities. Here we consider how to apply some of the theoretical tools provided by intersectionality to the clinical context. (...) We begin with a brief discussion of intersectionality and how it might be useful in a clinical context. We then discuss two clinical scenarios that highlight how we think considering intersectionality could lead to more successful patient–clinician interactions. Finally, we extrapolate general strategies for applying intersectionality to the clinical context before considering objections and replies. (shrink)

Hastings Center Report, Volume 52, Issue S1, Page S12-S17, March‐April 2022.

“Ignorance,” Jim Hudson, the art dealer, declares shortly before the climactic scene in the 2017 film, Get Out. “They mean well, but they have no idea what real people will go through”...

Professional philosophy in the US remains relatively homogenous. I use four anecdotes to amplify some of the practices that may contribute to the dearth of underrepresented philosophers. Each anecdote highlights a different problem—lack of proper mentoring, stereotype threat, difficulties navigating sexism, and a sense of exclusion. Although I discuss each of these issues separately, it is certainly the case that these can and often do occur concurrently. I offer preliminary thoughts on how these problems could be addressed while keeping in (...) mind that philosophy in the US is a microcosm of the larger US society. (shrink)

This chapter shows that feminist bioethics begins with critical engagement. Feminist bioethics as perspective centers the experiences of women – women's health, challenges that women primarily face within health care contexts, gaps in research that are only understood as gaps when one takes women seriously as women. The chapter highlights a few significant breakthroughs in feminist theory broadly that have informed feminist bioethics as perspective and as methodology – standpoint theory, relational autonomy, and intersectionality – in order to show how (...) an intentionally feminist lens can improve bioethics for everyone. Feminists understood that healthcare generally, and bioethics, in particular, were important sites for feminist thought. The traditional view of autonomy in bioethics is centered on the individual. The chapter also highlights an example of public practice, The Black Mamas Matter Alliance, that shows the important work of Black women's community advocacy as a blueprint for a public feminist bioethics. (shrink)

Camisha Russell argues that this contemporary moment of societal reckoning with the value of Black lives is also a moment for considering racism as a bioethical issue. She continues that bioethicis...

Bioethics, Volume 36, Issue 3, Page 283-289, March 2022.

Fabi and Goldberg have made an important contribution to the understanding of how bioethicists do bioethics, or more precisely, how bioethics research funding mechanisms reflect the values o...

Abstract:James Groves opens his 1978 foundational article, "Taking Care of the Hateful Patient," thusly, "Admitted or not, the fact remains that a few patients kindle aversion, fear, despair, or even downright malice in their doctors." Groves understood his article as pulling back the curtain on an experience that physicians had but that few dared discuss without shame. His taxonomy of four types of "hateful" patients: clingers, entitled demanders, manipulative help rejectors, and self-destructive deniers may still be instructive. However, the intervening (...) years have revealed that this taxonomy does not adequately capture the nuances present when patients are described as "difficult." This issue of Narrative Inquiry in Bioethics situates this complexity. Different kinds of providers in a variety of healthcare delivering institutions have offered accounts of their own interactions with so-called difficult patients. In each of these stories, the providers tell the reader how the providers were transformed through these interactions: what they learned about their patients, what they learned about patient care, what they could have done differently or better, and what lessons they have taken with them into subsequent encounters. (shrink)

Hastings Center Report, Volume 52, Issue 3, Page 49-51, May–June 2022.

The “happiness agenda” is a worldwide movement that claims that happiness is the highest good, happiness can be measured, and public policy should promote happiness. Against Happiness is a thorough and powerful critique of this program, revealing the flaws of its concept of happiness and advocating a renewed focus on equality and justice. Written by an interdisciplinary team of authors, this book provides both theoretical and empirical analysis of the limitations of the happiness agenda. The authors emphasize that this movement (...) draws on a parochial, Western-centric philosophical basis and demographic sample. They show that happiness defined as subjective satisfaction or a surplus of positive emotions bears little resemblance to the richer and more nuanced concepts of the good life found in many world traditions. Cross-cultural philosophy, comparative theology, and social and cultural psychology all teach that cultures and subcultures vary in how much value they place on life satisfaction or feeling happy. Furthermore, the ideas promoted by the happiness agenda can compete with rights, justice, sustainability, and equality—and even conceal racial and gender injustice. Against Happiness argues that a better way forward requires integration of cross-cultural philosophical, ethical, and political thought with critical social science. Ultimately, the authors contend, happiness should be a secondary goal—worth pursuing only if it is contingent on the demands of justice. (shrink)

Written in response to what he recognizes as the problematic philosophical underpinnings of “orthodox research ethics,” Alex John London’s For the Common Good reimagines what is called for in any effort to create a better system of oversight and regulation in biomedical research. London weaves a common thread — justice — through this historical and critical account of the practice of research ethics and its organization of stakeholders, institutions and regulations. By introducing the idea of “a common good” London reframes (...) the narrative and responsibilities of the research ethics field to demonstrate that scientific research and regard for the rights and welfare of individuals are not mutually exclusive. This impressive monograph encourages its readers to push past the limitations of traditional research ethics to consider the context in which the discipline is embedded. That is, rather than settling for analysis at the level of researchers and research participants alone, London encourages us to expand our inquiry to encompass a wider array of stakeholders who co-labor in the social undertaking of biomedical knowledge production. London accomplishes the difficult task of upstream analysis — turning his attention to the conditions and assumptions which create ethical dilemmas rather than applying a retrospective ethical salve to injuries near-guaranteed by a broken system. As opposed to the limited domain of orthodox research ethics (researchers, participants, and the institutional bodies which regulate interaction between the two) London also considers the role and contributions of affected communities, pharmaceutical firms, philanthropic organizations, and journal editors among others. (shrink)

Developing countries are faced with the mutually perpetuating obstacles of poverty and inadequate development. Their needs are often so vast that their scarce resources prove too meager even to begin to address the problems.It is estimated that close to 2.2 billion people live in a state of severe poverty. The precarious housing and health of these people, 60 percent of the population of developing countries, are compounded by hunger and dangerous environmental conditions. Generally, they have large families and their incomes (...) are extremely low. Malnutrition is widespread despite the fact that 80 percent of their earnings are spent on food. (shrink)

Developing countries are faced with the mutually perpetuating obstacles of poverty and inadequate development. Their needs are often so vast that their scarce resources prove too meager even to begin to address the problems.It is estimated that close to 2.2 billion people live in a state of severe poverty. The precarious housing and health of these people, 60 percent of the population of developing countries, are compounded by hunger and dangerous environmental conditions. Generally, they have large families and their incomes (...) are extremely low. Malnutrition is widespread despite the fact that 80 percent of their earnings are spent on food. (shrink)

How are non-declarative sentences understood? How do they differ semantically from their declarative counterparts? Answers to these questions once made direct appeal to the notion of illocutionary force. When they proved unsatisfactory, the fault was diagnosed as a failure to distinguish properly between mood and force. For some years now, efforts have been under way to develop a satisfactory account of the semantics of mood. In this paper, we consider the current achievements and future prospects of the mood-based semantic programme.

Recent events at Enron, K-Mart, Adelphia, and Tyson would seem to suggest that managers are still experiencing ethical lapses. These lapses are somewhat surprising and disappointing given the heightened focus on ethical considerations within business contexts during the past decade. This study is designed, therefore, to increase our understanding of the forces that shape ethical perceptions by considering the effects of business school education as well as a number of other individual-level factors (such as intra-national culture, area of specialization within (...) business, and gender) that may exert an influence on ethical perceptions. We found significant effects for business education, self-reported intra-national culture, area of specialization within business, and gender for some and/or all areas of ethics examined (i.e., deceit, fraud, self-interest, influence dealing, and coercion). One of our most encouraging findings is that tolerance for unethical behavior appears to decrease with formal business education. Despite the prevalent stereotype that business students are only interested in the bottom line or that business schools transform idealistic freshman into self-serving business graduates, our results suggest otherwise. Given the heightened criticism of the ethicality of contemporary managerial behavior, it is heartening to note that, even as adults, individuals can be positively affected by integration of ethics training. (shrink)

This study examined the potential for a new area of corporate social responsibility washing: gender equality. Companies are increasingly recognized for advertisements promoting gender equality, termed “femvertisements.” However, it is unclear whether companies that win femvertising awards actually support women with an institutionalized approach to gender equality. A quantitative content analysis was performed assessing company leadership team listings, annual reports, CSR reports, and CSR websites of 61 US-based companies to compare the prevalence of internal and external gender-equality CSR activities of (...) companies that have won femvertising awards. When controlling for number of employees and annual revenue, award-winning companies committed to more internal efforts that support women than non-award-winning companies. However, no significant differences were found in the number of external efforts or representation in female leadership between companies with and without award-winning femvertisements. Overall, a majority of award-winning companies engaged in less than ten of the possible 23 gender-equality CSR activities, suggesting these companies’ female empowerment commercials were often not in line with their broader CSR activities. While more research is needed in this area, we propose the term “fempower-washing” to describe CSR-washing in the context of gender equality. (shrink)

Competition plays a substantial and structural role in philosophy today. It is therefore remarkable that it has received little systematic ethical scrutiny in the literature until now. This paper aims to contribute to establishing a discussion about competition in the discipline of philosophy by arguing (i) that philosophy is not inherently competitive and (ii) that competition tends to corrupt the practice of philosophy. Regarding (i), I argue that philosophy can best be understood as a cooperative endeavour. The idea that philosophy (...) is a matter of competitive adversarial argumentation impedes philosophers from achieving what philosophy is all about, that is, realising what Alasdair MacIntyre calls ‘internal goods’: acquiring greater wisdom and knowledge and getting closer to the truth. I then show that a lot of the competition that characterises today’s practice of philosophy revolves around obtaining external goods, such as money, status, prizes and academic positions. While external goods are needed to sustain and regulate the practice of philosophy, competition for such goods also tends to corrupt the practice (ii), by which I mean that internal goods are seriously compromised. This, in turn, excludes prospective philosophers who are not ‘competitive’ enough, which is also a loss for philosophy generally. (shrink)

The story of change and growth, i.e., evolution, in the traditional manner, involves an epistemology of indigenous knowledge systems that admits both evolution and the divine—and therefore the human capacity for free choice—that tells us that fossil fuels are a bad choice. Steven Biko’s message of “Black Consciousness” responds to the dilemma of how we belong to the species that is damaging the planetary ecosystem, amd yet how we can deny complicity by saying that reclaiming our culture enables us to (...) see what we have done, so we can refuse complicity with the system that has divided us and take responsibility for giving birth to new life. The uncertainties of climate change can be thought through using race, class, gender, sexual orientation, indigeneity, and disability as categories of analysis. The result is an understanding that through both climate science and lived experience, we can know enough to know we ought to act on climate change. We do not need more research; we need instead an acceptance of our ignorance amid a sense of ethical responsibility. This story speaks of liberation from oppression and of climate action as deeply entangled in. (shrink)

PurposeThe relation between fear of childbirth and gestational age is inconclusive, and self-reported need for help regarding this fear has never been investigated. This study aimed to determine the prevalence and course of FoC according to gestational age, to identify risk factors for the development of FoC, the influence of this fear on preferred mode of delivery, and self-reported need for help.MethodsNulliparous pregnant women of all gestational ages completed an online survey. The study consisted of a cross-sectional and a longitudinal (...) analysis. Women who completed the survey in the first or second trimester were approached again in their third trimester. The Wijma Delivery Expectancy Questionnaire Version A was used with a cut-off score ≥ 85 to define presence of fear of childbirth. Questionnaires indexing social support, anxiety, symptoms of depression, preferred mode of delivery, and self-reported need for help were included.ResultsIn total, 364 women were enrolled at T0, and 118 out of 184 eligible women were included in the longitudinal analysis. Point prevalence of FoC at T0 was 18.4% with no significant difference between trimesters. In the longitudinal sample, the prevalence of FoC decreased from 18.6% to 11.0%, p = 0.004. Although mean scores for FoC decreased significantly, p < 0.001, scores increased in 41 women. The presence of FoC was associated with elevated anxiety, less family support, prenatal care of the obstetrician by choice, preference for a cesarean section, and for pain relief. Women with FoC were more likely to actively seek for help compared to women without FoC.ConclusionWhile FoC is common in each trimester, prevalence decreases over the course of pregnancy. Women with FoC are often actively seeking for help, suggesting that this fear should be addressed better, and help should be offered accordingly. (shrink)

At the beginning of the 1890s, Schwarz and Peano (independently of each other) showed that Serret’s definition of the area of a surface was flawed. This paper first aims at describing the various methods that the mathematicians have used for correcting Serret’s reasoning; its second goal is to compare and to present more in detail two solutions: Lebesgue’s notorious construction and Peano’s definition.

This paper takes issue with the widespread claim that positional competitions are zero-sum games. It shows how the notions of ‘positional good’ and ‘positional competition’ have changed in meaning and how this has resulted in conceptual confusion in discussions amongst economists and philosophers. I argue that the Zero-Sum Claim is hardly ever true when it comes to the novel understanding of positionality that currently dominates the philosophical literature. I propose dropping the Zero-Sum Claim and construing positional competitions as win-lose. This (...) is conceptually clearer and deepens our understanding and ethical evaluation of these important competitions in contemporary societies. (shrink)

When people speak, their words never fully encode what they mean, and the context is always compatible with a variety of interpretations. How can comprehension ever be achieved? Wilson and Sperber argue that comprehension is an inference process guided by precise expectations of relevance. What are the relations between the linguistically encoded meanings studied in semantics and the thoughts that humans are capable of entertaining and conveying? How should we analyse literal meaning, approximations, metaphors and ironies? Is the ability (...) to understand speakers' meanings rooted in a more general human ability to understand other minds? How do these abilities interact in evolution and in cognitive development? MEANING AND RELEVANCE sets out to answer these and other questions, enriching and updating relevance theory and exploring its implications for linguistics, philosophy, cognitive science and literary studies. (shrink)

When Australian economist Ross Garnaut proposed to increase the commercial kangaroo industry in 2008, it started a national debate on the supposed edibility of kangaroos. Campaigns against the commercial kangaroo industry and hesitance amongst many consumers to eat kangaroo reflect concerns about viewing kangaroos as food. This article explores the reactions and challenges that originate from the kangaroo’s changing role in society by using Judith Butler’s concept of grievable lives. Using this framework shows that what animals we eat goes beyond (...) nutritional value; it symbolizes deeper values regarding human–animal relations and illustrates why and how not all animals are seen and treated as the same. (shrink)

This paper explores the relationship between eugenics, disability, and dehumanization, with a focus on forms of eugenics beyond Nazi eugenics.