BackgroundAlthough the Life-Sustaining Treatment (LST) Decision Act was enforced in 2018 in Korea, data on whether it is well established in actual clinical settings are limited. Hospital-acquired pneumonia (HAP) is a common nosocomial infection with high mortality. However, there are limited data on the end-of-life (EOL) decision of patients with HAP. Therefore, we aimed to examine clinical characteristics and outcomes according to the EOL decision for patients with HAP.MethodsThis multicenter study enrolled patients with HAP at 16 referral hospitals retrospectively from (...) January to December 2019. EOL decisions included do-not-resuscitate (DNR), withholding of LST, and withdrawal of LST. Descriptive and Kaplan–Meier curve analyses for survival were performed.ResultsOf 1,131 patients with HAP, 283 deceased patients with EOL decisions (105 cases of DNR, 108 cases of withholding of LST, and 70 cases of withdrawal of LST) were analyzed. The median age was 74 (IQR 63–81) years. The prevalence of solid malignant tumors was high (32.4% vs. 46.3% vs. 54.3%, P = 0.011), and the ICU admission rate was lower (42.9% vs. 35.2% vs. 24.3%, P = 0.042) in the withdrawal group. The prevalence of multidrug-resistant pathogens, impaired consciousness, and cough was significantly lower in the withdrawal group. Kaplan–Meier curve analysis revealed that 30-day and 60-day survival rates were higher in the withdrawal group than in the DNR and withholding groups (log-rank P = 0.021 and 0.018). The survival of the withdrawal group was markedly decreased after 40 days; thus, the withdrawal decision was made around this time. Among patients aged below 80 years, the rates of EOL decisions were not different (P = 0.430); however, mong patients aged over 80 years, the rate of withdrawal was significantly lower than that of DNR and withholding (P = 0.001).ConclusionsAfter the LST Decision Act was enforced in Korea, a DNR order was still common in EOL decisions. Baseline characteristics and outcomes were similar between the DNR and withholding groups; however, differences were observed in the withdrawal group. Withdrawal decisions seemed to be made at the late stage of dying. Therefore, advance care planning for patients with HAP is needed. (shrink)

This paper develops an account of intersectional feminist theory by critically examining the notion of identity implicitly assumed in major critiques of intersectionality. Critics take intersectionality to fragment women along the lines of identity categories such as race, class, and sexuality. Underlying this interpretation, I argue, is the metaphysical assumption that identity is a fixed entity. This is a misunderstanding of identity that neglects how identity is actually lived. By exploring how Asian American women experience their “Asian” identity in their (...) everyday lives (e.g., the “Asian-as-patriarchal vs. White-as-gender-progressive” stereotype, growing anti-Asian racism amid COVID-19, and Asian-Black feminist solidarities), I demonstrate that Asian identity is not fixed but changing according to how it is related to power. I identify and discuss three characteristic types of the identity-power relationship: manifestation of power-as-oppression through the construction of identity, reproduction of power-as- oppression, and creation of new forms of power, namely resistance and solidarity, through the reconstruction of identity. The lives of multiply-oppressed women (e.g., Asian women) can be understood as the locus at which the identity-power relationship is worked out, that is, the power dynamics of oppression are manifested, reproduced, and resisted through the (re)construction of identity. Building on this analysis and engaging discussions on non-ideal theory in social/political philosophy, I argue that intersectional feminist theory can be best explained as a non-ideal theory in a strong sense: a theory that, by focusing on the lives of the multiply oppressed, presents the intersecting dynamics of oppression as central and theory-guiding. (shrink)

Does intersectionality divide marginalized groups (e.g., women) along identity lines (e.g., race, class, and sexuality)? In response to the criticism that intersectional approaches to feminist and critical race theories lead to fragmentation and division, this paper notes that it relies on an ontological (mis)understanding of identity as a fixed entity. I argue against this notion of identity by engaging in a detailed case study of how Asian American women experience their Asian identity. The case study demonstrates that identity is lived (...) not as a pre-given static object but rather as a fluid and flexible process: what Asian identity means varies according to how this identity is related to the dynamics of power. I propose a tripartite taxonomy of identity-power relationships exhibited in Asian American women’s lives, in which identities are 1) constructed by and 2) used to reproduce power as oppression, as well as 3) used to build power as resistance. In particular, I explore Black and Asian feminist solidarities to show that those at the margins recreate their identities and, in doing so, build positive forms of power such as resistance and solidarity. The criticism that intersectionality leads to fragmentation does not hold, as it is grounded in a flawed notion of identity that fails to consider how identities are actually lived in their changing relationships to power—especially how marginalized groups, such as women of color, build solidarity to resist oppression by recreating their identities, rather than being fragmented into smaller and mutually exclusive subgroups. (shrink)

Richard Rorty, a neo-pragmatist well known for his anti-universalist philosophy, applies his anti-universalist approach to feminism in the paper titled “Feminism and Pragmatism” (1991). In this paper, Rorty claims that universalism is not helpful for feminists in making changes to a masculinist society. In contrast, the main point of my paper is to defend universalism as appropriate to feminism. It is not, however, argued in the form of advocacy for all versions of universalism. I will classify universalism into two distinguished (...) types, ahistoricist-essentialist universalism and historicist, anti-essentialist universalism, and I will defend the latter as consonant with feminism and with Rorty’s own pragmatist approach. (shrink)

Feminist critics of evolutionary psychology are often accused of committing the naturalistic fallacy, that is, of inferring certain normative conclusions from evolutionary psychology’s purely descriptive accounts. This article refutes the accusation of the naturalistic fallacy, by showing that evolutionary psychology’s accounts of human behavior are not purely descriptive, but rather grounded on biased value judgments. A paradigmatic example is Randy Thornhill and Craig Palmer’s well-known book A Natural History of Rape. I argue that at least three biased judgments are at (...) work in Thornhill and Palmer’s evolutionary psychology account of rape: (1) adaptationist approaches to evolution, (2) willful ignorance of cultural and social context, and (3) binary understanding of gender and sex. In that Thornhill and Palmer’s account cannot hold without the three biased value judgments, it is not a purely factual description of rape. Therefore, feminist concerns over its normative implications do not commit the naturalistic fallacy, as it is not the case that they infer a normative conclusion from a pure description. (shrink)

A growing number of studies on fairness in artificial intelligence (AI) use the notion of intersectionality to measure AI fairness. Most of these studies take intersectional fairness to be a matter of statistical parity among intersectional subgroups: an AI algorithm is “intersectionally fair” if the probability of the outcome is roughly the same across all subgroups defined by different combinations of the protected attributes. This paper identifies and examines three fundamental problems with this dominant interpretation of intersectional fairness in AI. (...) First, the dominant approach is so preoccupied with the intersection of attributes/categories (e.g., race, gender) that it fails to address the intersection of oppression (e.g., racism, sexism), which is more central to intersectionality as a critical framework. Second, the dominant approach faces a dilemma between infinite regress and fairness gerrymandering: it either keeps splitting groups into smaller subgroups or arbitrarily selects protected groups. Lastly, the dominant view fails to capture what it really means for AI algorithms to be fair, in terms of both distributive and non-distributive fairness. I distinguish a strong sense of AI fairness from a weak sense that is prevalent in the literature, and conclude by envisioning paths towards strong intersectional fairness in AI. (shrink)

Racial, Gender, and Intersectional Biases in AI / -/- Dominant View of Intersectional Fairness in the AI Literature / -/- Three Fundamental Problems with the Dominant View / 1. Overemphasis on Intersections of Attributes / 2. Dilemma between Infinite Regress and Fairness Gerrymandering / 3. Narrow Understanding of Fairness as Parity / -/- Rethinking AI Fairness: from Weak to Strong Fairness.

Recently, social and political philosophers have shown increased interest in the ideological nature of ideal theory and the importance of non-ideal theory. Charles Mills, who sparked recent critiques of ideal theory, invokes the notion of “non-idealizing abstractions” and argues that these are helpful when applying non-ideal theory. In contrast, I argue that the notion of non-idealizing abstractions is not a helpful tool for non-ideal theory. I suspect that it pays insufficient attention to the actual power dynamics of oppression, which significantly (...) influence judgments about whose experiences and interests are worth being reflected by an abstraction. Failing to take account of the power differences among the oppressed, what Mills considers non-idealizing abstractions falls into ideology, which cannot reflect the experiences or interests of less-privileged minorities, and only concerns those of more-privileged minorities. I examine cases in which the concept of “patriarchy,” which Mills alleges to be a non-idealizing abstraction, functions as what I refer to as the “Colonialist Concept of Patriarchy” that marginalizes Third World women’s experiences of intersectional oppression. I suggest that a more suitable and less ideological way to apply non-ideal theory should avoid asserting that an abstraction is “non-idealizing” and should, instead, protect “resignifiability” of the abstraction. (shrink)

This dissertation addresses the question of how to reconceptualize “women” in order to do a more intersectional feminism. Intersectionality—the idea that gender, race, class, sexuality, and so on operate not as separate entities but as mutually constructing phenomena—has become a gold standard in contemporary feminist scholarship. In particular, intersectionality has achieved success in showing that the old conception of women as a single, uniform concept marginalizes women and others who exist at the intersecting axes of multiple oppressions (e.g., women of (...) color, women in the global South, working-class women, and/or queer and trans people), and thus, demonstrating the need to develop a new way of conceptualizing women. However, the question of what such a new conception would be remains unanswered. Specifically, if feminist theory today is to destabilize the old notion of “women” that relegates multiply oppressed women to the margin of feminism, and yet still needs to use some notion of “women” to critically analyze how the social structure of sexist oppression operates to subordinate women and to dismantle this oppression, how should the concept “women” be reformulated? In this dissertation, I argue that we need to understand women as a concept that is open to constant redefinition, which is socio-historically situated in the actualities of oppression. This is what I refer to as the “situated redefinition” model of women, which is formulated in more detail as follows: -/- The Situated Redefinition Model of Women (SR) – The concept “women” should be always open to being redefined in a way that it could better serve political goals grounded in the actual, daily lives of the marginalized. That is, “women” should be always open to new meanings and provisional definitions that the marginalized would find more useful to achieve political goals, which grow out of their concrete experiences in the current intersecting structures of oppression. -/- My central argument is that we need to understand the concept “women” according to the situated redefinition model, in order to employ this concept for doing intersectional feminism. To support this thesis, the dissertation is divided into two main parts. By engaging with the intersectionality literature, critical race feminisms, Asian/American feminisms, and recent critiques of intersectionality, the first part of the dissertation elucidates what exactly it means for feminism to be more “intersectional.” The second part develops the situated redefinition model and articulates why this model is needed to do intersectional feminism, drawing on the social/political philosophy literature on non-ideal theory, postmodern discussions of universality, and feminist discussions of identity politics. Broadly, this dissertation seeks to shed new light on how we understand and use the concept women for feminist ends. My conceptual model offers a way for feminist scholar-activists to subvert the essentialist/exclusionary notion of “women” without abandoning altogether feminist-political deployments of the concept “women” for the purpose of ending sexist and intersecting oppressions. (shrink)

This paper is the introduction to the volume. It gives an argumentative view of the philosophical landscape concerning incommensurability and incomparability. It argues that incomparability, not incommensurability, is the important phenomenon on which philosophers should be focusing and that the arguments for the existence of incomparability are so far not compelling.

Can quite different values be rationally weighed against one another? Can the value of one thing always be ranked as greater than, equal to, or less than the value of something else? If the answer to these questions is no, then in what areas do we find commensurability and comparability unavailable? And what are the implications for moral and legal decision making? This book struggles with these questions, and arrives at distinctly different answers.".

The central aim of this book is to answer two questions: Are alternatives for choice ever incomparable? and, In what ways can items be compared? The arguments offered suggest that alternatives for choice no matter how different are never incomparable, and that the ways in which items can be compared are richer and more varied than commonly supposed. This work is the first book length treatment of the topics of incomparability, value, and practical reason.

What sorts of consideration can be normative reasons for action? If we systematize the wide variety of considerations that can be cited as normative reasons, do we find that there is a single kind of consideration that can always be a reason? Desire-based theorists think that the fact that you want something or would want it under certain evaluatively neutral conditions can always be your normative reason for action. Value-based theorists, by contrast, think that what plays that role are evaluative (...) facts (or the facts that subvene them) about what you want, such as the fact that having it would be good in some way. This paper argues that value-based theorists are wrong; if we try to find a single kind of consideration that can always be normative reason, we find that sometimes our reason is the fact that we want something and not any corresponding evaluative fact. (shrink)

What, normatively speaking, are the grounds of rational choice? This paper defends ‘comparativism’, the view that a comparative fact grounds rational choice. It examines three of the most serious challenges to comparativism: 1) that sometimes what grounds rational choice is an exclusionary-type relation among alternatives; 2) that an absolute fact such as that it’s your duty or conforms to the Categorial Imperative grounds rational choice; and 3) that rational choice between incomparables is possible, and in particular, all that is needed (...) for the possibility of rational choice is that one alternative is not worse than the others. Each challenge is questioned. If comparativism is correct, then no matter what normative theory you favor, your answer to the question, ‘What makes my choice rational?’ must be comparative in form. In this way, comparativism provides a framework for normative theorizing. (shrink)

Employing Porter and Kramer’s corporate social responsibility framework, we explored the strategic CSR programs of two Korean and two Japanese electronics multinational enterprises in Indonesia. We observed that the sample MNEs engage in strategic CSR either through investment in competitive context or the transformation of value chain activities. In addition, these firms strongly favor strategic CSR over responsive CSR, not just because of the economic benefits offered by the former, but also its advantages in managing the programs and communicating with (...) stakeholders. Furthermore, they have developed varied organizational methods and tend to manage their key CSR programs centrally to effectively link them to the competitive strategy. Lastly, the results of our analysis suggest that Korean MNEs have customized their strategic CSR programs for emerging countries more actively than Japanese MNEs. In sum, our analysis elucidates several important features of strategic CSR employed by the MNEs in emerging countries. (shrink)

This book exhibits deep philosophical quandaries and intricacies of the historical development of science lying behind a simple and fundamental item of common sense in modern science, namely the composition of water as H2O. Three main phases of development are critically re-examined, covering the historical period from the 1760s to the 1860s: the Chemical Revolution, early electrochemistry, and early atomic chemistry. In each case, the author concludes that the empirical evidence available at the time was not decisive in settling the (...) central debates and therefore the consensus that was reached was unjustified or at least premature. This leads to a significant re-examination of the realism question in the philosophy of science and a unique new advocacy for pluralism in science. Each chapter contains three layers, allowing readers to follow various parts of the book at their chosen level of depth and detail. The second major study in "complementary science", this book offers a rare combination of philosophy, history and science in a bid to improve scientific knowledge through history and philosophy of science. (shrink)

This book presents the concept of “complementary science” which contributes to scientific knowledge through historical and philosophical investigations. It emphasizes the fact that many simple items of knowledge that we take for granted were actually spectacular achievements obtained only after a great deal of innovative thinking, painstaking experiments, bold conjectures, and serious controversies. Each chapter in the book consists of two parts: a narrative part that states the philosophical puzzle and gives a problem-centred narrative on the historical attempts to solve (...) the puzzle; and the analysis part which provides in-depth analyses of certain scientific, historical, and philosophical aspects of the story. (shrink)

In virtue of what is something a reason for action? That is, what makes a consideration a reason to act? This is a metaphysical or meta-normative question about the grounding of reasons for action. The answer to the grounding question has been traditionally given in ‘pure’, univocal terms. This paper argues that there is good reason to understand the ground of practical normativity as a hybrid of traditional ‘pure’ views. The paper 1) surveys the three leading ‘pure’ answers to the (...) question of a normative ground, 2) examines one or two of the most difficult problems for each, proposing along the way a new objection to one, and 3) argues that a particular hybrid view about normative grounds –‘hybrid voluntarism’ – avoids each of the main problems faced by the three leading ‘pure’ views. (shrink)

Why do some epistemic objects persist despite undergoing serious changes, while others go extinct in similar situations? Scientists have often been careless in deciding which epistemic objects to retain and which ones to eliminate; historians and philosophers of science have been on the whole much too unreflective in accepting the scientists’ decisions in this regard. Through a re-examination of the history of oxygen and phlogiston, I will illustrate the benefits to be gained from challenging and disturbing the commonly accepted continuities (...) and discontinuities in the lives of epistemic objects. I will also outline two key consequences of such re-thinking. First, a fresh view on the (dis)continuities in key epistemic objects is apt to lead to informative revisions in recognized periods and trends in the history of science. Second, recognizing sources of continuity leads to a sympathetic view on extinct objects, which in turn problematizes the common monistic tendency in science and philosophy; this epistemological reorientation allows room for more pluralism in scientific practice itself. (shrink)

This article explores the main similarities and differences between Derek Parfit’s notion of imprecise comparability and a related notion I have proposed of parity. I argue that the main difference between imprecise comparability and parity can be understood by reference to ‘the standard view’. The standard view claims that 1) differences between cardinally ranked items can always be measured by a scale of units of the relevant value, and 2) all rankings proceed in terms of the trichotomy of ‘better than’, (...) ‘worse than’, and ‘equally good’. Imprecise comparability, which can be understood in terms of the more familiar notions of cardinality and incommensurability, rejects only the first claim while parity rejects both claims of the standard view. -/- I then argue that insofar as those attracted to imprecise comparability assume that all rankings are trichotomous, as Parfit appears to, the view should be rejected. This is because imprecise equality is not a form of equality but is a sui generis ‘fourth’ basic way in which items can be ranked. We should, I argue, understand imprecise equality as parity, and imprecise comparability as entailing ‘tetrachotomy’ – that if two items are comparable, one must better than, worse than, equal to, or on a par with the other. Thus those attracted to the idea that cardinality can be imprecise should abandon trichotomy and accept parity and tetrachotomy instead. -/- Finally, I illustrate the difference between Parfit’s trichotomous notion of imprecise comparability and parity by examining how each notion might be employed in different solutions to the problem posed by the Repugnant Conclusion in population ethics. I suggest that parity provides the arguably more ecumenical solution to the problem. (shrink)

Part 1. Human capability in light of God's power -- Divine power and the creation -- God's will and human destiny -- Part 2. Human capability to understand God -- Human knowledge -- Human knowledge of God -- Part 3. Human capability in relation to doctrinal ordination -- Criteria of Christian authorities -- Philosophical freedom and doctrinal minimalism : two test cases -- Conclusion.

This chapter argues that there is a particular kind of ‘internal’ commitment typically made in the context of romantic love relationships that has striking meta-normative implications for how we understand the role of the will in practical normativity. Internal commitments cannot plausibly explain the reasons we have in committed relationships on the usual model—as triggering reasons that are already there, in the way that making a promise triggers a reason via a pre-existing norm of the form ‘If you make a (...) promise to x, then you have a reason to x’. Instead, internal commitments are that in virtue of which one has the special reasons of committed relationships; they are the grounds of such reasons. In this way, the will is a source of practical normativity. (shrink)

One of the most common judgments of normative life takes the following form: With respect to some things that matter, one item is better than the other, with respect to other things that matter, the other item is better, but all things considered – that is, taking into account all the things that matter – the one item is better than the other. In this paper, I explore how all-things-considered judgments are possible, assuming that they are. In particular, I examine (...) the question of how the different considerations relevant to an all-things-considered judgment come together in a way that gives each relevant consideration its proper due. I propose an answer which provides a unified account of all-things-considered judgments and highlights a deep connection between value and reason. My suggestion is that ‘all things considered’ is, in effect, a placeholder for a more comprehensive, sometimes nameless, value that includes the things considered as parts, and that this more comprehensive value determines how the things considered normatively relate. (shrink)

This paper investigates two puzzles in practical reason and proposes a solution to them. First, sometimes, when we are practically certain that neither of two alternatives is better than or as good as the other with respect to what matters in the choice between them, it nevertheless seems perfectly rational to continue to deliberate, and sometimes the result of that deliberation is a conclusion that one alternative is better, where there is no error in one’s previous judgment. Second, there are (...) striking differences between rational agents – some rational agents have most reason to pursue careers on Wall Street while others have most reason to take up a career in teaching, or scuba diving, or working for political causes. These differences aren’t plausibly explained by ‘passive’ facts about our psychology or their causal interaction with our environment; instead, these facts seem in some sense to ‘express who we are’. But what is this sense? These puzzles disappear if we adopt a novel view about the source of the normativity of reasons – some reasons are given to us and others are reasons in virtue of an act of will. We make certain considerations reasons through an act of will and thus sometimes make it true through an act of agency that we have most reason to do one thing rather than another. (shrink)

‘Value pluralism’ as traditionally understood is the metaphysical thesis that there are many values that cannot be ‘reduced’ to a single supervalue. While it is widely assumed that value pluralism is true, the case for value pluralism depends on resolution of a neglected question in value theory: how are values properly individuated? Value pluralism has been thought to be important in two main ways. If values are plural, any theory that relies on value monism, for example, hedonistic utilitarianism, is mistaken. (...) The plurality of values is also thought to raise problems for rational choice. If two irreducibly distinct values conflict, it seems that there is no common ground that justifies choosing one over the other. The metaphysical plurality of values does not, however, have the implications for rational choice that many have supposed. A charitable interpretation of value pluralist writings suggests a ‘nonreductive’ form of value pluralism. Nonreductive value pluralism maintains that in the context of practical choice, there are differences between values—whether or not those values reduce to a single supervalue—that have important implications for rational choice. This article examines the main arguments for metaphysical value pluralism, argues that metaphysical value pluralism does not have certain implications that it is widely thought to have, and outlines three forms of nonreductive value pluralism. (shrink)