In this commentary, I consider how Giulia Cavaliere’s arguments about the limited reach of the current justifications offered for full ectogenesis in the bioethical literature apply in the context of partial ectogenesis. I suggest that considering the extent to which partial ectogenesis is freedom or equality promoting is more urgent because of the more realistic prospect of artificial womb technology being utilised to facilitate partial gestation extra uterum as opposed to facilitating complete gestation from conception to term. I highlight concerns (...) about potentially harmful social narratives surrounding pregnancy and about the current legal framework surrounding gestation limiting access to technology in the advent of partial ectogenesis. I do not advocate that these concerns mean that we ought not develop artificial wombs, but like Cavaliere I suggest that we must be mindful of these concerns, and I posit that legal reform must accompany technological developments. Ectogenesis as a political perspective, through which we consider the value in social reproduction and the experiences of pregnant people, is useful to prevent political capture of this technology for regressive policies. Using this perspective to examine the law is also a useful tool to expose just how restrictive the law is in relation to gestation and female reproductive health. (shrink)

For Humean atomists, cosmic contents supervene on a spatiotemporal mosaic of modally insulated, freely recombinable local qualities. One piecemeal subspecies of Humean atomism promises more than global supervenience—somehow or other—on a separable base; it constrains how exactly elemental inputs yield everything else. Roughly, the distribution of basic local qualities across elements in one part of our cosmos metaphysically suffices for the complete local physical state of that part: anything sharing this part’s basic elemental decoration should share its more complete contents, (...) regardless of what may be happening elsewhere. On a non-piecemeal alternative, derivative contents can be recognizably local to, or manifest within, one part of our cosmos while reflecting some more global elemental base. To develop this alternative, non-piecemeal Humeans can borrow inspiration from some critics of Humean supervenience, who already distinguish a broader notion of locality from strict Humean intrinsicality. (shrink)

I. Causal Thesis: Dispositions have a causal basis. II. Distinctness Thesis: Dispositions are distinct from their causal basis. III. Impotence Thesis: Dispositions are not causally active.

The number of cesarean sections performed globally has been consistently rising since the 1980s.1 The number of cesareans performed now greatly exceeds the number that experts predict are necessary.2 In Brazil, the world's "cesarean capital," over half of births are surgical. In the United States, approximately one third of babies are delivered by cesarean, and in the United Kingdom around 26 percent of births are by cesarean.3 Cesarean section can be a life-saving intervention when vaginal birth poses a risk to (...) woman or fetus.4 However, some doctors believe that cesareans performed in the absence of an emergency carry substantial risks for limited or no benefit (Wagner 2000... (shrink)

We argue for the addition of trauma informed awareness, training, and skill in clinical ethics consultation by proposing a novel framework for Trauma Informed Ethics Consultation (TIEC). This approach expands on the American Society for Bioethics and Humanities (ASBH) framework for, and key insights from feminist approaches to, ethics consultation, and the literature on trauma informed care (TIC). TIEC keeps ethics consultation in line with the provision of TIC in other clinical settings. Most crucially, TIEC (like TIC) is systematically sensitive (...) to culture, history, difference, power, social exclusion, oppression, and marginalization. By engaging a neonatal intensive care ethics consult example, we define our TIEC approach and illustrate its application. Through TIEC we argue it is the role of ethics consultants to not only hold open moral spaces, but to furnish them in morally habitable ways for all stakeholders involved in the ethics consultation process, including patients, surrogates, and practitioners. (shrink)

Theory of health care ethics -- Principles of health care ethics -- The moral status of gametes and embryos : storage and surrogacy -- The ethical challenges of the new reproductive technology -- Ethics and aging in America -- -- Healthcare ethics committees : roles, memberships, structure, and difficulties -- Ethics in the management of health information systems -- Technological advances in health care : blessing or ethics nightmare? -- Ethics and safe patient handling and mobility -- Spirituality and healthcare (...) organizations -- A new era of health care : the ethics of healthcare reform -- Health inequalities and health inequities -- The ethics of epidemics -- Ethics of disasters : planning and response -- Domestic violence : changing theory, changing practice -- Looking toward the future. (shrink)

The self-disorder model provides a phenomenological framework for understanding how the core symptoms of Schizophrenia Spectrum Disorders (SSDs) are rooted in an instability of minimal selfhood. This instability involves a range of “anomalous experiences”: transformations in an individual’s perceptual field and sense of being an agent of action. The explanatory value of this theoretical model can be summarized in two claims about the role of anomalous experiences in self-disorders: (1) anomalous experiences express a common trait-like disturbance that is characteristic of (...) SSDs, and (2) anomalous experiences contribute to explanations regarding how self-disorders progress into SSDs. While hypotheses consistent with the first claim have been substantiated in several studies, hypotheses consistent with the second claim remain underexamined. We argue that attending to this gap in the literature requires considering which methodological strategies are best suited for investigating if and how anomalous experiences contribute to the development of self-disorders into SSDs and psychotic states. Network modeling is discussed as one such strategy suitable for examining the role of anomalies of lived-world in the maintenance of paranoid delusions in SSDs. (shrink)

Repression is one of the most haunting concepts in psychology. Something shocking happens, and the mind pushes it into some inaccessible corner of the unconscious. Later, the memory may emerge into consciousness. Repression is one of the foundation stones on which the structure of psychoanalysis rests. Recently there has been a rise in reported memories of childhood sexual abuse that were allegedly repressed for many years. With recent changes in legislation, people with recently unearthed memories are suing alleged perpetrators for (...) events that happened 20, 30, even 40 or more years earlier. These new developments give rise to a number of questions: (a) How common is it for memories of child abuse to be repressed? (b) How are jurors and judges likely to react to these repressed memory claims? (c) When the memories surface, what are they like? and (d) How authentic are the memories? (shrink)

This paper raises three concerns regarding self-ownership rhetoric to describe autonomy within healthcare in general and reproductive justice in specific. First, private property and the notion of “ownership” embedded in “self-ownership,” rely on and replicate historical injustices related to the initial acquisition of property. Second, not all individuals are recognized as selves with equal access to self-ownership. Third, self-ownership only justifies negative liberties. To fully protect healthcare access and reproductive care in specific, we must also be able to make claims (...) on others to respect, protect, and fulfill our positive rights. As much as nondomination remains an urgent demand for reproductive rights, it does not go far enough to ensure reproductive justice. (shrink)

Mental simulation refers to the imagination of alternative, counterfactual realities. This chapter provides an overview of research on simulations of the past— retrospective simulation—and simulations of the future— prospective simulation. Two major themes run throughout. The first is that both retrospective and prospective thinking are inextricably linked, relying on a mixture of episodic and semantic memories that share common neural substrates. The second is that retrospective and prospective simulation present trade-offs for the individual. On the one hand, they are functional, (...) identifying causal inferences and potential obstacles that prepare us to try harder and perform better in the future. On the other hand, they sometimes produce bias—retrospective thinking can enhance hindsight bias, whereas prospective thinking can evoke biased predictions about the likelihood of certain events as well as how one is going to feel about those events in the future. Fortunately, however, these biases can be diminished with debiasing techniques. (shrink)

It has been argued that people in areas with high pathogen loads will be more likely to avoid outsiders, to be biased in favor of in-groups, and to hold collectivist and conformist values. Cross-national studies have supported these predictions. In this paper we provide new pathogen codes for the 186 cultures of the Standard Cross-Cultural Sample and use them, together with existing pathogen and ethnographic data, to try to replicate these cross-national findings. In support of the theory, we found that (...) cultures in high pathogen areas were more likely to socialize children toward collectivist values (obedience rather than self-reliance). There was some evidence that pathogens were associated with reduced adult dispersal. However, we found no evidence of an association between pathogens and our measures of group bias (in-group loyalty and xenophobia) or intergroup contact. (shrink)

When Cool finally realized that false memories had been planted, she sued the psychiatrist for malpractice. In March 1997, after five weeks of trial, her case was settled out of court for $2.4 million. Nadean Cool is not the only patient to develop false memories as a result of questionable therapy. In Missouri in 1992 a church counselor helped Beth Rutherford to remember during therapy that her father, a clergyman, had regularly raped her between the ages of seven and 14 (...) and that her mother sometimes helped him by holding her down. Under her therapist's guidance, Rutherford developed memories of her father twice impregnating her and forcing her to abort the fetus herself with a coat hanger.The father had to resign from his post as a clergyman when the allegations were made public. Later medical examination of the daughter revealed, however, that she was still a virgin at age 22 and had never been pregnant. The daughter sued the therapist and received a $1-million settlement in 1996. (shrink)

This current study is a pilot project designed to clarify changes in the lived world among people with diagnoses within the schizophrenia spectrum. The Examination of Anomalous World Experience was used to interview ten participants with schizophrenia spectrum disorders and a comparison group of three participants with major depressive disorder. Interviews were analyzed using the descriptive phenomenological method. This analysis revealed two complementary forms of experience unique toszparticipants: Destabilization, the experience that reality and the intersubjective world are less comprehensible, less (...) stable, and generally less real; and Subjectivization, the dominance of one’s internal, subjective experiences in the perception or interpretation of the lived world. Persons with depressive disorders, by contrast, did not experience disruptions of the reality or independence of the world or any significant disruptions of appearance or meaning. These results are consistent with contemporary and classic phenomenological views on anomalous world experience in schizophrenia. (shrink)

This essay is a critical engagement with recent assessments of comparative religious ethics by John Kelsay and Jung Lee. Contra Kelsay's proposal to return to a neo-Weberian sociology of religious norm elaboration and justification, the authors argue that comparative religious ethics is and should be practiced as a field of study in active conversation with other fields that consider human flourishing, employing a variety of methods that have their roots in multiple disciplines. Cross-pollination from a variety of disciplines is a (...) strength of comparative ethics, which has enlivened recent and ongoing research on ethics, not a problem to be resolved by convergence on a single, distinctively comparative project. The authors also argue in response to Lee and Kelsay that while individual comparative studies of virtue and personal formation can be flawed in various ways, this line of research has been productive and at times very compelling. Moreover, attention to comparative virtue ethics shows how scholarship on some ethical topics necessitates drawing on a variety of perspectives and disciplinary backgrounds, a conclusion relevant to all work in religious ethics today. (shrink)

In ‘Ethics of sharing medical knowledge with the community: is the physician responsible for medical outreach during a pandemic?’ Strous and Karni note that the revised physician’s pledge in the World Medical Association Declaration of Geneva obligates individual physicians to share medical knowledge, which they interpret to mean a requirement to share knowledge publicly and through outreach. In the context of the COVID-19 pandemic, Strous and Karni defend a form of medical paternalism insofar as the individual physician must reach out (...) to communities who may not want, or know to seek out, medical advice, for reasons of public health and health equity. Strous and Karni offer a novel defence of why physicians ought to intervene even in insular communities, and they offer suggestions for how this could be done in culturally sensitive ways. Yet their view rests on an unfounded interpretation of the Geneva Declaration language. More problematically, their paper confuses shared and collective responsibility, misattributing the scope of individual physician obligations in potentially harmful ways. In response, this reply delineates between shared and collective responsibility, and suggests that to defend the obligation of medical outreach Strous and Karni propose, it is better conceptualised as a collective responsibility of the medical profession, rather than a shared responsibility of individual physicians. This interpretation rejects paternalism on the part of individual providers in favour of a more sensitive and collaborative practice of knowledge sharing between physicians and communities, and in the service of collective responsibility. (shrink)

In this article, we blend the Piagetian informed understanding of critical thinking with the scholarship of critical theory to analyze service-Iearning as a pedagogical strategy to promote critically conscious thinking among Students in higher education. We draw from our teaching experiences and student reflections in three different courses at two universities. In these courses, service-leaming was designed to: promote understandings of course content related to societal systems of advantage and disadvantage, develop self-awareness, promote understanding of sociocultural identity differences, and to (...) instill a sense of responsibility for social change. Recommendations are provided. (shrink)

This literature review focused on effective teaching strategies for children with Attention Deficit Hyperactivity Disorder (ADHD) in classrooms where English as a Foreign Language (EFL) is taught, which is undoubtedly a novel and crucial issue that demands immediate attention. This review not only concentrates on identifying the teaching strategies used for students with ADHD but also delves into and considers different teaching approaches and inclusive education adaptations for students with ADHD. The impact of this review might be significant for educators, (...) parents, and stakeholders alike since it could provide valuable recommendations and knowledge based on the evidence gathered. This would lead to developing more effective, efficient, and inclusive teaching strategies or mechanisms for students with ADHD. Programs aimed at teacher training could also benefit from the findings of this review, contributing to the general support and improving the academic experience of students with ADHD in foreign language learning environments. (shrink)

In ‘The ethics of consent during labour and birth: episiotomies,’ van der Pijl et al 1 respond to the prevalence of unconsented procedures during labour, proposing a set of necessary features for adequate consent to episiotomy. Their model emphasises information sharing, value exploration and trust between a pregnant person and their healthcare provider(s). While focused on consent to episiotomy, van der Pijl et al contend their approach may be applicable to consent for other procedures during labour and beyond pregnancy-related care. (...) One feature of their model for adequate informed consent is trust in the systems in which prenatal and labour and delivery care are provided. Yet, for some pregnant persons, mistrust in health systems is a reasonable sequela of experiences like racism and epistemic injustice. For a programme in which trust is central to adequate consent, it is important to identify—and counter—forms of mistrust toward pregnant persons within healthcare and acknowledge and rectify reasonable mistrust of pregnant persons toward healthcare. Like other kinds of healthcare disparities, van der Pijl et al note that ‘the burden of unconsented procedures is not evenly distributed over groups’ and tracks with ‘racial, socioeconomic and other disparities in maternity care’. They are drawing on data from a less diverse context than the one …. (shrink)

Arising and emptiness are the two essential Buddhist concepts, which when understood, lead to the highest school of Buddhist philosophy.

-/- Background: Nurses who provide aggressive care often experience the ethical challenge of needing to preserve the hope of seriously ill patients and their families without providing false hope. -/- Research objectives: The purpose of this inquiry was to explore nurses’ moral competence related to fostering hope in patients and their families within the context of aggressive technological care. A secondary purpose was to understand how this competence is shaped by the social–moral space of nurses’ work in order to capture (...) how competencies may reflect an adaptation to a less than ideal work environment. -/- Research design: A critical qualitative approach was used. -/- Participants: Fifteen graduate nursing students from various practice areas participated. -/- Ethical considerations: After receiving ethics approval from the university, signed informed consent was obtained from participants before they were interviewed. -/- Findings: One overarching theme ‘Mediating the tension between providing false hope and destroying hope within biomedicine’ along with three subthemes, including ‘Reimagining hopeful possibilities’, ‘Exercising caution within the social–moral space of nursing’ and ‘Maintaining nurses’ own hope’, was identified, which represents specific aspects of this moral competency. -/- Discussion: This competency represents a complex, nuanced and multi-layered set of skills in which nurses must be well attuned to the needs and emotions of their patients and families, have the foresight to imagine possible future hopes, be able to acknowledge death, have advanced interpersonal skills, maintain their own hope and ideally have the capacity to challenge those around them when the provision of aggressive care is a form of providing false hope. -/- Conclusion: The articulation of moral competencies may support the development of nursing ethics curricula to prepare future nurses in a way that is sensitive to the characteristics of actual practice settings. (shrink)

Counterfactual imaginings are known to have far reaching implications. In the present experiment, we ask if imagining events from one's past can affect memory for childhood events. We draw on the social psychology literature showing that imagining a future event increases the subjective likelihood that the event will occur. The concepts of cognitive availability and the source monitoring framework provide reasons to expect that imagination may inflate confidence that a childhood event occurred. However, people routinely produce myriad counterfactual imaginings (i.e., (...) daydreams and fantasies) but usually do not confuse them with past experiences. To determine the effects of imagining a childhood event, we pretested subjects on how confident they were that a number of childhood events had happened, asked them to imagine some of those events, and then gathered new confidence measures. For each of the target items, imagination inflated confidence that the event had occurred in childhood. We discuss implications for situations in which imagination is used as an aid in searching for presumably lost memories. (shrink)

This commentary responds to the article “What Is the Aim of Pediatric ‘Gender‐Affirming’ Care?,” by Moti Gorin, in the same issue of the journal. Gender‐affirming care is often treated as exceptional and subject to heightened scrutiny. This exceptionalization results in its being held to stricter evidentiary standards than other forms of medical interventions are. But values and value judgments are inextricable from the practice of evidence‐based medicine. For gender‐affirming care, values shape what counts as “strong” evidence, whether the legitimacy of (...) transgender identity is assumed versus treated as something to be investigated, how to characterize the testimonial accounts of trans and gender‐nonconforming patients, and more. We argue that these kinds of questions are part of the practice of medicine, not exceptional to transgender people and gender‐affirming care. However, litigation of evidence for gender‐affirming care in state and national policy underscores the moral urgency of thinking carefully about what values ought to guide evidence. (shrink)

Not only is deception commonplace in medical encounters, according to Christopher Meyers (2021), but the clinical ethicist might have moral obligations to support and even enact deception. Descriptively Meyers is right that there are “opportunistic, self-interested and benevolent reasons” for deception through omission and commission in clinical medicine. But it is possible to retain this premise while rejecting the normative conclusion that the clinical ethicist “should sometimes be an active participant in the deception of patients and families.” One reason to (...) reject the normative conclusion is its incompatibility with providing trauma informed ethics consultation (TIEC). In the TIEC framework I developed with Uchenna Anani, we defend the integration of trauma informed care (TIC) into ethics consultation (Lanphier and Anani 2021). While ethicists narrowly attend to the question and scope of the ethics consults made to them, doing so in alignment with trauma informed principles is tantamount to providing good ethics consultation. According to Meyers, the clinical ethicist is an “advocate for the best ethical choices.” The best ethical choices are also trauma informed ones. (shrink)

It is proposed here that there is a sensitive period in the first two to three years of life during which humans acquire a basic knowledge of what foods are safe to eat. In support of this, it is shown that willingness to eat a wide variety of foods is greatest between the ages of one and two years, and then declines to low levels by age four. These data also show that children who are introduced to solids unusually late (...) have a narrower diet breadth throughout childhood, perhaps because the duration of the sensitive period has been shortened. By reducing the costs associated with learning, a sensitive period for food learning should be adaptive for any omnivore (including early humans) that remains in the same environment throughout its life. (shrink)

the issue of liberal neutrality, a topic suggested by the work of Catharine MacKinnon. I discuss two kinds of neutrality: neutrality at the level of justifying liberalism itself, and state neutrality in political decision-making. Both kinds are contentious within liberal theory. Rawls’s argument for justice as fairness has been criticized for non-neutrality at the justificatory level, a problem noted by Rawls himself in Political Liberalism . I will defend a qualified account of neutrality at the justificatory level, taking an epistemic (...) approach to argue for the exclusion of certain doctrines from the justificatory process. I then argue that the justification process I describe offers a justificatory stance supportive of the feminist rejection of state-sponsored gender hierarchy. Further, I argue that liberal neutrality at the level of political decision-making will have surprising implications for gender equality. Once the extent of the state’s involvement in the apparently private spheres of family and civil society is recognized, and the disproportionate influence of a sexist conception of the good on those structures—and concomitant promotion of that ideal—is seen, state neutrality implies substantive change. While—as Susan Moller Okin avowed—Rawls himself may have remained ambiguous on how to address gender inequality, his theory implies that the state must seek to create substantive, not merely formal, equality. I suggest that those substantive changes will not conflict with liberal neutrality but instead be required by it. (shrink)

In writing 'How to Disagree', Ferner and Chetty aim to bring to light those assumptions we make about the world, its structure and the lived reality of what we assume to be real, in order to see how these assumptions affect the ways we engage with each other. It is a fascinating endeavour and very well done through this thoughtful text. 'How to Disagree' is part of the 'Build and Become' series, a community of texts adopting a particular shared approach (...) to enacting their commitment to ‘building knowledge that helps you navigate your world’. The emphasis, as reiterated by the authors, is on finding enjoyment in thinking and talking about difference. (shrink)

The Internet has been used as a place for and site of an array of research activities. From online ethnographies to public data sets and online surveys, researchers and research regulators have struggled with an array of ethical issues around the conduct of online research. This paper presents a discussion and findings from Buchanan and Ess's study on US-based institutional review boards and the state of internet research ethics.

We are grateful for the excellent and incisive commentaries on our paper “Trauma Informed Ethics Consultation” (Lanphier and Anani 2022). It is heartening to see most commentators agree with why cl...

Volume 20, Issue 8, August 2020, Page 76-78.

The Metaphysics of Experience styles itself as "a Sherpa guide to Process and Reality, whose function is to assist the serious reader in grasping the meaning of the text and to prevent falls into misinterpretation." Although originally published in 1925, Process and Reality has perhaps even more relevance to the contemporary scene in physics, biology, psychology, and the social sciences than it had in the mid-twenties. Hence its internal difficulty, its quasi-inaccessibility, is all the more tragic, since, unlike most metaphysical (...) endeavors, it is capable of interpretating and unifying theories in the above sciences in terms of an organic world view, instead of selecting one theory as the paradigm and reducing all others to it. Because Alfred North Whitehead is so crucial to modern philosophy, The Metaphysics of Experience plays an important role in making Process and Reality accessible to a wider readership. (shrink)

I argue for a conception of moral community as “ethical home,” in which home is a hybrid public and private concept, cohered through members’ complicit participation in the formation and endorsement of the community’s values and practices. In this essay I present and defend three premises that comprise my argument for this conception of moral community as an ethical home. First, I make a case for why “home” is an apt conception of moral community, defining the features of home relevant (...) to my claim, and clarifying which connotations of home I am abandoning by modifying home to be an “ethical” home. Second, I illustrate how when the concept of moral community is conceptualized as an ethical home, it is formed and defined by a community’s practices of moral self-definition, that occur within the ethical home-making process. Third, I claim that the process of ethical home-making, through moral self-definition around cohering values and practices, renders members of an ethical home as both rights holders within the ethical home, and as having shared responsibility for their fellow ethical home members. (shrink)