In Setting Limits, Daniel Callahan advances the provocative thesis that age be a limiting factor in decisions to allocate certain kinds of health services to the elderly. However, when one looks at available data, one discovers that there are many more elderly women than there are elderly men, and these older women are poorer, more apt to live alone, and less likely to have informal social and personal supports than their male counterparts. Older women, therefore, will make the heaviest demand (...) on health care resources. If age were to become a limiting factor, as Dr. Callahan suggests it should, the limits that will be set are limits that will affect women more drastically than they affect men. This review essay examines the implications of Callahan's thesis for elderly women. (shrink)

Recent developments in AI programming allow for new applications: individualized chatbots which mimic the speaking and writing behaviour of one specific living or dead person. ‘Deathbots’, chatbots of the dead, have already been implemented and are currently under development by the first start-up companies. Thus, it is an urgent issue to consider the ethical implications of deathbots. While previous ethical theories of deathbots have always been based on considerations of the dignity of the deceased, I propose to shift the focus (...) on the dignity and autonomy of the bereaved users of deathbots. Drawing on theories of internet-scaffolded affectivity and on theories of grief, I argue that deathbots may have a negative impact on the grief process of bereaved users and therefore have the potential to limit the emotional and psychological wellbeing of their users. Deathbot users are likely to become dependent on their bots which may make them susceptible to surreptitious advertising by deathbot providing companies and may limit their autonomy. At the same time, deathbots may prove to be helpful for people who suffer from prolonged, severe grief processes. I caution against the unrestricted usage of deathbots and suggest that they should be classified as medical devices. This classification would not the least mean that their non-harm, as well as their helpfulness for people suffering from prolonged grief needs to be proven and that their potential for autonomy infringements is reduced. (shrink)

Traditionally, empiricism has relied on the specialness of human observation, yet science is rife with sophisticated instrumentation and techniques. The present article advances a conception of empirical evidence applicable to actual scientific practice. I argue that this conception elucidates how the results of scientific research can be repurposed across diverse epistemic contexts: it helps to make sense of how evidence accumulates across theory change, how different evidence can be amalgamated and used jointly, and how the same evidence can be used (...) to constrain competing theories in the service of breaking local underdetermination. (shrink)

Structural gaslighting arises when conceptual work functions to obscure the non-accidental connections between structures of oppression and the patterns of harm they produce and license. This paper examines the role that structural gaslighting plays in white feminist methodology and epistemology using Fricker’s (2007) discussion of hermeneutical injustice as an illustration. Fricker’s work produces structural gaslighting through several methods: i) the outright denial of the role that structural oppression plays in producing interpretive harm, ii) the use of single-axis conceptual resources to (...) understand intersectional oppression, and iii) the failure to recognize the legacy of women of color’s epistemic resistance work surrounding the issue of sexual harassment in the workplace. I argue that Fricker’s whitewashed discussion of epistemic resistance to sexual harassment in the United States is a form of structural gaslighting that fails to treat women of color as knowers and exemplifies the strategic forgetting that is a central methodological tactic of white feminism. (shrink)

Abstract:This essay historicizes the genre of women’s autobiography and the concept of genius in the context of Gertrude Stein’s popular work, The Autobiography of Alice B. Toklas. It argues that Stein draws on the form, content, and style of the domestic memoir, a type of self-writing that was popularized in the nineteenth century as a specifically feminine form of autobiography and remained central to women's self-writing into the twentieth century. Because of its relational and anecdotal nature, the domestic memoir provides (...) Stein a canvas on which to play with the gendered categories of "wife" and "genius." Ultimately, Stein's playful reimagining of gender roles and domesticity serves to redefine the modernist notion of the genius as autonomous and male in favor of a feminine, domestic, and collaborative conception of genius. (shrink)

Four detailed cases of delusions of misidentification (DM) are presented: two cases of misidentification of the reflected self, one of reverse intermetamorphosis, and one of reduplicative paramnesia. The cases are discussed in the context of three levels of interpretation: neurological, cognitive and phenomenological. The findings are compared to previous work with DM patients, particularly the work of Ellis and Young (1990; Young, 1998) who found that loss of the normal affective response to familiar faces was a contributing factor in the (...) Capgras delusion. The four cases presented suggest that this particular deficit is not a critical factor in the development of other forms of DM. (shrink)

Epistemologies have power. They have the power not only to transform worlds, but to create them. And the worlds that they create can be better or worse. For many people, the worlds they create are predictably and reliably deadly. Epistemologies can turn sacred land into ‘resources’ to be bought, sold, exploited, and exhausted. They can turn people into ‘labor’ in much the same way. They can not only disappear acts of violence but render them unnamable and unrecognizable within their conceptual (...) architectures. Settler systems of epistemic and conceptual resources and the relations among them are constructed to preclude certain forms of knowledge. This is not an accident; it is a central goal of colonial violence. Colonization and land dispossession would not be possible without the violent disruption of Indigenous knowledge systems and ongoing organized attempts to disrupt their survival. Violently disrupting the relationships of people to land is as much an epistemic project as it is a material one, and these two projects are inherently linked. The task of theorizing epistemic oppression is not only about epistemic oppression. Epistemic oppression is a story that gives language to a phenomenon in order to get past it, to carry on with the maintaining and reviving the forms of Indigenous and diasporic knowledge that colonialism has worked tirelessly to corrupt and silence. (shrink)

The so-called “conciliatory” norm in epistemology and meta-ethics requires that an agent, upon encountering peer disagreement with her judgment, lower her confidence about that judgment. But whether agents actually abide by this norm is unclear. Although confidence is excessively researched in the empirical sciences, possible effects of disagreement on confidence have been understudied. Here, we target this lacuna, reporting a study that measured confidence about moral beliefs before and after exposure to moral discourse about a controversial issue. Our findings indicate (...) that participants do not abide by the conciliatory norm. Neither do they conform to a rival “steadfast” norm that demands their confidence to remain the same. Instead, moral discourse seems to boost confidence. Interestingly, we also find a confidence boost for factual beliefs, and a correlation between the extremity of moral views and confidence. One possible explanation of our findings is that when engaging in moral discourse participants become more extreme in their opinions, which leads them to become more confident about them, or vice versa: they become more confident and in turn more extreme. Although our work provides initial evidence for the former mechanism, further research is needed for a better understanding of confidence and moral discourse. (shrink)

Virtual reality is all too often considered as antithetical to reality, the former being an entity fully separated from the latter. Since there has been historically no consensus among philosophers as to what constitutes reality, this article seeks to contribute to the debate on i crucial issue. It argues that reality should be considered as including non-tangible properties and that, from the first-person point of view, virtual reality is part of the reality of each and every one of us. Furthermore, (...) grey zones between reality and virtual reality, that is to say environments in which reality blends with fantasy and highly personal perception of our surroundings are much more common than often assumed. The article claims that architecture is the most powerful foundation for virtual reality and therefore creator of grey zones. Real spaces (such as cafés or streets, and moreover cities) offer experiences more intense than any typical virtual environment and cause the blurring of awareness in which world we are. Virtual reality is an impoverished reality, and attempts to realize it have led to disastrous outcomes. On the contrary, grey zones, partially anchored on the materiality, actually enrich reality with non-tangible qualities, without threatening its authority in our souls and minds. (shrink)

Based on brain imaging findings, we present a model according to which addiction emerges as an imbalance in the information processing and integration among various brain circuits and functions. The dysfunctions reflect (a) decreased sensitivity of reward circuits, (b) enhanced sensitivity of memory circuits to conditioned expectations to drugs and drug cues, stress reactivity, and (c) negative mood, and a weakened control circuit. Although initial experimentation with a drug of abuse is largely a voluntary behavior, continued drug use can eventually (...) impair neuronal circuits in the brain that are involved in free will, turning drug use into an automatic compulsive behavior. The ability of addictive drugs to co‐opt neurotransmitter signals between neurons (including dopamine, glutamate, and GABA) modifies the function of different neuronal circuits, which begin to falter at different stages of an addiction trajectory. Upon exposure to the drug, drug cues or stress this results in unrestrained hyperactivation of the motivation/drive circuit that results in the compulsive drug intake that characterizes addiction. (shrink)

We argue that social deliberation may increase an agent’s confidence and credence under certain circumstances. An agent considers a proposition H and assigns a probability to it. However, she is not fully confident that she herself is reliable in this assignment. She then endorses H during deliberation with another person, expecting him to raise serious objections. To her surprise, however, the other person does not raise any objections to H. How should her attitudes toward H change? It seems plausible that (...) she should increase the credence she assigns to H and, at the same time, increase the reliability she assigns to herself concerning H. A Bayesian model helps us to investigate under what conditions, if any, this is rational. (shrink)

Epistemic exploitation occurs when privileged persons compel marginalized persons to educate them about the nature of their oppression. I argue that epistemic exploitation is marked by unrecognized, uncompensated, emotionally taxing, coerced epistemic labor. The coercive and exploitative aspects of the phenomenon are exemplified by the unpaid nature of the educational labor and its associated opportunity costs, the double bind that marginalized persons must navigate when faced with the demand to educate, and the need for additional labor created by the default (...) skepticism of the privileged. I explore the connections between epistemic exploitation and the two varieties of epistemic injustice that Fricker (2007) identifies, testimonial and hermeneutical injustice. I situate epistemic exploitation within Dotson’s (2012; 2014) framework of epistemic oppression, and I address the role that epistemic exploitation plays in maintaining active ignorance and upholding dominant epistemic frameworks. (shrink)

This Element introduces major issues in the epistemology of experimental physics through discussion of canonical physics experiments and some that have not yet received much philosophical attention. The primary challenge is to make sense of how physicists justify crucial decisions made in the course of empirical research. Judging a result as epistemically significant or as calling for further technical scrutiny of the equipment is one important context of such decisions. Judging whether the instrument has been calibrated, and which data should (...) be included in the analysis are others. To what extent is it possible to offer philosophical analysis, systematization, and prescriptions regarding such decisions? To what extent can there be explicit epistemic justification for them? The primary aim of this Element is to show how a nuanced understanding of science in practice informs an epistemology of experimental physics that avoids strong social constructivism. (shrink)

While the pursuitworthiness of philosophical ideas has changed over time, philosophical practice and methodology have not kept pace. The worthiness of a philosophical pursuit includes not only the ideas and objectives one pursues but also the methods with which one pursues them. In this paper, we articulate how empirical approaches benefit philosophy of science, particularly advocating for the use of qualitative methods for understanding the social and normative aspects of scientific inquiry. After situating qualitative methods within empirical philosophy of science, (...) we discuss how to adapt these traditionally sociological methods to empirically inform philosophical questions. Our aim is to normalize and legitimize qualitative methods for philosophical purposes and discuss how they can elucidate descriptive and normative components of scientific practice in a more generalizable non-idealized manner. We contend that qualitative methods are particularly well suited to philosophical interest in the social norms of science, their achievability, and their mutability. Furthermore, unlike more historical case studies in philosophy, qualitative methods enable more confidence in generalizability, albeit limited, from a concrete sample to a larger class. We conclude by addressing anxieties about the distinctness of empirical philosophy of science from social epistemology and from sociology of science. (shrink)

Empirical research into moral decision-making is often taken to have normative implications. For instance, in his recent book, Greene (2013) relies on empirical findings to establish utilitarianism as a superior normative ethical theory. Kantian ethics, and deontological ethics more generally, is a rival view that Greene attacks. At the heart of Greene’s argument against deontology is the claim that deontological moral judgments are the product of certain emotions and not of reason. Deontological ethics is a mere rationalization of these emotions. (...) Accordingly Greene maintains that deontology should be abandoned. This paper is a defense of deontological ethical theory. It argues that Greene’s argument against deontology needs further support. Greene’s empirical evidence is open to alternative interpretations. In particular, it is not clear that Greene’s characterization of alarm-like emotions that are relative to culture and personal experience is empirically tenable. Moreover, it is implausible that such emotions produce specifically deontological judgments. A rival sentimentalist view, according to which all moral judgments are determined by emotion, is at least as plausible given the empirical evidence and independently supported by philosophical theory. I therefore call for an improvement of Greene’s argument. (shrink)

Social studies of science and technology are dominated by action and macro approaches. This has led to a neglect of institutions and institutional arrangements at the meso level, which are important, in particular to the student of technology. The transfer of concepts and methods from social studies of science to technology studies has conserved this lack of concern with the meso level. This article suggests a more critical evaluation of this transfer, along with a review of the now popular assumption (...) of a high degree of similarity between science and technology. Two case studies show how meso-level considerations are important to an understanding of the nature of technological innovation and illustrate the lack of similarity between scientific and technological development. (shrink)

In a recent editorial published in Nature, the journal's editors comment on a new automated software that has been used to check findings in psychology publications. The editors express concern with the way in which the anonymous fact-checkers have proceeded, but at the same time, they underscore the crucial role of peer criticism for scientific progress and insist: "self-correction is at the heart of science." Brief as it is, the editorial showcases that peer criticism and the application of norms of (...) good research practice are very thorny issues indeed.It is essential for the functioning of science that empirical findings, arguments, as well as methodological approaches are scrutinized... (shrink)

There is good reason to believe that scientific realism requires a commitment to the objective modal structure of the physical world. Causality, equilibrium, laws of nature, and probability all feature prominently in scientific theory and explanation, and each one is a modal notion. If we are committed to the content of our best scientific theories, we must accept the modal nature of the physical world. But what does the scientific realist’s commitment to physical modality require? We consider whether scientific realism (...) is compatible with Humeanism about the laws of nature, and we conclude that it is not. We specifically identify three major problems for the best-systems account of lawhood: its central concept of strength cannot be formulated non-circularly, it cannot offer a satisfactory account of the laws of the special sciences, and it can offer no explanation of the success of inductive inference. In addition, Humeanism fails to be naturalistically motivated. For these reasons, we conclude that the scientific realist must embrace natural necessity. (shrink)

To integrate social robots in real-life contexts, it is crucial that they are accepted by the users. Acceptance is not only related to the functionality of the robot but also strongly depends on how the user experiences the interaction. Established design principles from usability and user experience research can be applied to the realm of human–robot interaction, to design robot behavior for the comfort and well-being of the user. Focusing the design on these aspects alone, however, comes with certain ethical (...) challenges, especially regarding the user’s privacy and autonomy. Based on an example scenario of human–robot interaction in elder care, this paper discusses how established design principles can be used in social robotic design. It then juxtaposes these with ethical considerations such as privacy and user autonomy. Combining user experience and ethical perspectives, we propose adjustments to the original design principles and canvass our own design recommendations for a positive and ethically acceptable social human–robot interaction design. In doing so, we show that positive user experience and ethical design may be sometimes at odds, but can be reconciled in many cases, if designers are willing to adjust and amend time-tested design principles. (shrink)

Progress in neurotechnology and Artificial Intelligence (AI) provides unprecedented insights into the human brain. There are increasing possibilities to influence and measure brain activity. These developments raise multifaceted ethical and legal questions. The proponents of neurorights argue in favour of introducing new human rights to protect mental processes and brain data. This article discusses the necessity and advantages of introducing new human rights focusing on the proposed new human right to mental self-determination and the right to freedom of thought as (...) enshrined in Art.18 International Covenant on Civil and Political Rights (ICCPR) and Art. 9 European Convention on Human Rights (ECHR). I argue that the right to freedom of thought can be coherently interpreted as providing comprehensive protection of mental processes and brain data, thus offering a normative basis regarding the use of neurotechnologies. Besides, I claim that an evolving interpretation of the right to freedom of thought is more convincing than introducing a new human right to mental self-determination. (shrink)

This article addresses the question: how do Norwegian Jewish parents reflect on _brit milah_ (circumcision) in a context where this practice is frequently criticised? The data are derived from twenty-five in-depth interviews. Drawing on the perspectives of Catherine Bell and Joseph Bulbulia, the text explores circumcision as part of social life. The parental narratives uncover ongoing negotiations occurring between parents and the minority/majority population. The article argues that circumcision serves as a rite of passage as much for parents as for (...) the infant. For most parents, circumcision is utilised to strengthen a Jewish identity and as a cultural strategy to recreate a Jewish cosmos, even if it entails a costly signal, owing to ambivalence and/or majority opposition. Some individuals find the costs too high and discontinue the practice. However, they all desire to manifest Jewish identity, whether through bodily adaptation or the lack thereof. In this manner, bodies speak louder than words. (shrink)

Philosophers have predominantly regarded morality and aesthetics judgments as fundamentally different. However, whether this claim is empirically founded has remained unclear. In a novel task, we measured brain activity of participants judging the aesthetic beauty of artwork or the moral goodness of actions depicted. To control for the content of judgments, participants assessed the age of the artworks and the speed of depicted actions. Univariate analyses revealed whole-brain corrected, content-controlled common activation for aesthetics and morality judgments in frontopolar, dorsomedial and (...) ventrolateral prefrontal cortex. Temporoparietal cortex showed activation specific for morality judgments, occipital cortex for aesthetics judgments. Multivariate analyses revealed both common and distinct whole-brain corrected representations for morality and aesthetics judgments in temporoparietal and prefrontal regions. Overall, neural commonalities are more pronounced than predominant philosophical views would predict. They are compatible with minority accounts that stress commonalities between aesthetics and morality judgments, such as sentimentalism and a valuation framework. (shrink)

The paper assesses current rising reparations claims for the Maafa/ Maangamizi from two angles. First, it explores the connectivity of reparations and global justice, peace and security. Second, it discusses how the claim is justified in international law. The concept of reparations in international law is also explored, revealing that reparations cannot be limited to financial compensation due to the nature of the damage and international law prescriptions. Comprehensive reparations based in international law require the removal of structures built on (...) centuries of illegal acts and aggression, in the forms of transatlantic slavery, colonialism and neo-colonialism. Reparations must also lead to the restitution of sovereignty to African and indigenous peoples globally. They are indispensable to halt the destruction of the earth as human habitat, caused by the violent European cultural, political, socio-economic system known as capitalism that is rooted in transatlantic slavery. (shrink)

Artikkelen undersøker hvordan NIPT ble vedtatt implementert i det norske fosterdiagnostiske systemet gjennom en fagligpolitisk prosess mellom 2012 og 2017. Prosessen innebar at Nasjonalt kunnskapssenter for helsetjenesten, Helsedirektoratet, Bioteknologirådet og Helse- og Omsorgsdepartementet ga sine vurderinger av testen og sine råd omkring en eventuell innføring. Artikkelen viser at det i denne prosessen foregikk en forsiktig tilnærming eller sammensmelting mellom de tradisjonelt helt ulike måtene å forstå og å ramme inn fosterdiagnostikk på i Norge, dvs. i en ‘autonomi/ behandlingsramme’ og en (...) ‘sorteringsramme’. Artikkelen argumenterer videre for at denne tilnærmingen eller konvergensen var mulig fordi prosessen ble holdt innenfor de fagligpolitiske byråkratiene, og de ulike etatene var innstilt på å ‘samarbeide’ om å inkludere både kunnskap og verdier fra begge rammene i sine tilrådninger. Politikk for fosterdiagnostikk er imidlertid et svært politisk betent område i Norge, og denne konvergensen var et skjørt byggverk. Den sprakk da også opp i løpet av tre uker i mai 2020, da Fremskrittspartiet plutselig inngikk et ‘bioteknologiforlik’ med Arbeiderpartiet og SV etter at de hadde gått ut av Solbergregjeringen. Dermed endte spørsmålet om implementeringen av NIPT i Stortinget, hvor konvergensen i den fagpolitiske prosessen ble erstattet av de tradisjonelle frontene, og de gamle innrammingene igjen ble ‘satt i arbeid’. Artikkelen diskuterer avslutningsvis kort de bortimot uløselige dilemmaene disse innrammingene både representerer og produserer. Nøkkelord: NIPT, fosterdiagnostikk, humanmedisinsk bioteknologi, regulering English Title: Fetal diagnostics between medicine and ethics: Implementation of Prenatal Invasive Testing in a turbulent policy area: The article examines how the decision to implement Prenatal Invasive Testing in the Norwegian Fetal Diagnostic System was reached through a professional policy process between 2012 and 2017. The process involved the Norwegian Research Centre for Health Services, the Norwegian Directorate of Health, the Norwegian Biotechnology Advisory Board and the Ministry of Health and Care Services, which provided their individual assessments and advice regarding the potential implementation of the test. The article finds that a careful convergence took place between traditionally opposing ways to understand and frame fetal diagnostics in Norway – either as a ‘treatment frame’ or a ‘sorting frame’. The article further argues that this convergence was possible because the process was kept within these bureaucracies, and that the different agencies were willing to collaborate to include knowledge and values from both frames in their recommendations. However, policy for fetal diagnostics is a very turbulent political area in Norway, and this convergence was a fragile construction. During three weeks in May 2020, the convergence collapsed when the Norwegian Progress Party suddenly entered a “biotechnology settlement” with the Labour Party and the Socialist Left Party after exiting the conservative Government coalition. Hence, the question of implementing NIPT ended up in the Norwegian Parliament, where the convergence from the professional policy process was replaced by the traditional fronts, and the old framings were again set in motion. Lastly, the article briefly discusses the almost unsolvable dilemmas these framings both produce and represent. Keywords: NIPT, non-invasive prenatal testing, fetal diagnostics, medical biotechnology, regulation. (shrink)

Metacognitive mental states are mental states about mental states. For example, I may be uncertain whether my belief is correct. In social discourse, an interlocutor’s metacognitive certainty may constitute evidence about the reliability of their testimony. For example, if a speaker is certain that their belief is correct, then we may take this as evidence in favour of their belief, or its content. This paper argues that, if metacognitive certainty is genuine evidence, then it is disproportionate evidence for extreme beliefs. (...) In support of the argument, we report findings from five studies with different participant samples, designs, and measures. These studies show that, the more extreme an agent’s belief (positive or negative), the more certain they are about it, and vice versa. This relationship might contribute to moralism, virtue signalling, and polarisation, which in turn may be epistemically and morally problematic. Therefore, we caution against taking metacognitive certainty as genuine evidence. (shrink)

Although affective facial pictures are widely used in emotion research, standardised affective stimuli sets are rather scarce, and the existing sets have several limitations. We therefore conducted a validation study of 490 pictures of human facial expressions from the Karolinska Directed Emotional Faces database (KDEF). Pictures were evaluated on emotional content and were rated on an intensity and arousal scale. Results indicate that the database contains a valid set of affective facial pictures. Hit rates, intensity, and arousal of the 20 (...) best KDEF pictures for each basic emotion are provided in an appendix. (shrink)

This paper shows that our popular account of weakness of will is inconsistent with dilemmas. In dilemmas, agents judge that they ought to do one thing, that they ought to do something else, and that they cannot do both. They must act against either of their two judgments. But such action is commonly understood as weakness of will. An agent is weak-willed in doing something if she judges that she ought to and could do something else instead. Thus, it seems (...) that, in a dilemma, the agent is weak-willed by definition. But this is puzzling: clearly, the two are different phenomena. The puzzle may support scepticism about weakness of will or dilemmas. Here, I argue that the two are consistent on a revised understanding of weakness of will. To do so, I further distinguish the mental states of an agent in a dilemma from those of a weak-willed person. (shrink)

In 2023, online search engine provider Microsoft integrated a language model that provides direct answers to search queries into its search engine Bing. Shortly afterwards, Google also introduced a similar feature to its search engine with the launch of Google Gemini. This introduction of direct answers to search queries signals an important and significant change in online search. This article explores the implications of this new search paradigm. Drawing on Donna Haraway’s theory of _Situated Knowledges_ and Rainer Mühlhoff’s concept of (...) _Sealed Surfaces_, I introduce the term _Sealed Knowledges_ to draw attention to the increasingly difficult access to the plurality of potential answers to search queries through the output of a singular, authoritative, and plausible text paragraph. I argue that the integration of language models for the provision of direct answers into search engines is based on a de-situated and disembodied understanding of knowledge and affects the subjectivities of its users. At the same time, the _sealing of knowledges_ can lead to an increasing spread of misinformation and may make marginalized knowledge increasingly difficult to find. The paper concludes with an outlook on how to resist the increasing _sealing of knowledges_ in online search. (shrink)

In this paper, I submit that it is the controlled part of skilled action, that is, that part of an action that accounts for the exact, nuanced ways in which a skilled performer modifies, adjusts and guides her performance for which an adequate, philosophical theory of skill must account. I will argue that neither Jason Stanley nor Hubert Dreyfus have an adequate account of control. Further, and perhaps surprisingly, I will argue that both Stanley and Dreyfus relinquish an account of (...) control for precisely the same reason: each reduce control to a passive, mechanistic, automatic process, which then prevents them from producing a substantive account of how controlled processes can be characterized by seemingly intelligent features and integrated with personal-level states. I will end by introducing three different kinds of control, which are constitutive of skilled action: strategic control, selective, top–down, automatic attention, and motor control. It will become clear that Dreyfus cannot account for any of these three kinds of control while Stanley has difficulty tackling the two latter kinds. (shrink)

A 1999–2000 national study of U.S. hospitals raised concerns about ethics consultation (EC) practices and catalyzed improvement efforts. To assess how practices have changed since 2000, we administered a 105-item survey to “best informants” in a stratified random sample of 600 U.S. general hospitals. This primary article details the methods for the entire study, then focuses on the 16 items from the prior study. Compared with 2000, the estimated number of case consultations performed annually rose by 94% to 68,000. The (...) median number of consults per hospital was unchanged at 3, but more than doubled for hospitals with 400+ beds. The level of education of EC practitioners was unchanged, while the percentage of hospitals formally evaluating their ECS decreased from 28.0% to 19.1%. The gap between large, teaching hospitals and small, nonteaching hospitals widened since the prior study. We suggest targeting future improvement efforts to hospitals where needs are not being met by current approaches to EC. (shrink)

ABSTRACTThis essay argues that there was a sense in which Shelley actively approved of “jingling verse.” His poetic energy was sustained by a substratum of popular and tuneful versifying, such as impromptus, bouts-rimés, anagrams, enigmas, ballads, Mother Goose rhymes, proverbs, hymns, and drinking songs. He hybridizes the registers and meters of these humble forms with elevated, sublime, and erudite ones. This hybridization is, arguably, connected to the characteristic coexistence of the direct and clear with the knotty and puzzling in his (...) poetry. After a brief account of Shelley’s submerged youthful reading, noting in passing that Shelley’s lyrics proved amenable during the early twentieth century to recycling as Shelleyesque jingles, the essay illustrates its thesis from unfamiliar fragments in Shelley’s notebooks, such as the late lyric fragment “Time is flying,” and from more familiar matter such as “Dirge for the Year,” “Mont Blanc,” “The Cloud,” “On the Medusa of Leonardo da Vinci,” “The Sensitive... (shrink)

Claims for improving migrants’ access to care often draw on universalistic ethical notions, such as the principle of equity as it is specified in human rights law and public health ethics. These claims contrast with political realities across most welfare states. In the underlying public discourses, the frontline arguments against greater inclusion have often focused on practical concerns, such as the costs of healthcare provision. Yet it has also been suggested that ultimately context‐specific moral frameworks play a key role in (...) demarcating legitimate right‐holders from undeserving others. Hence, is this a conflict between ethical principles and practical concerns? Or between different ethical perspectives? And why would that question matter? We propose that awareness of the nature of the arguments involved and respect for different ethical views are critical for coherent and constructive debates. This paper looks at the ways in which ethical concepts are used to justify exclusionary policy decisions. In particular, it examines the rationales that inform health policies towards documented and undocumented labor migrants in two welfare states, Germany and Israel, through the qualitative analysis of policy documents and 71 in‐depth interviews. The study points to the central role of particular concepts of health‐related deservingness. These results lead to the proposition that the fundamental clash in the discussion on migrants’ access to care is one, albeit not solely, between contrasting ethical perspectives. Drawing on process‐oriented approaches to ethical decision‐making, the paper concludes with three suggestions for moving forward with the migrant health rights debate. (shrink)

Within biology and in society, living creatures have long been described using metaphors of machinery and computation: ‘bioengineering’, ‘genes as code’ or ‘biological chassis’. This paper builds on Lakoff and Johnson’s argument that such language mechanisms shape how we understand the world. I argue that the living machines metaphor builds upon a certain perception of life entailing an idea of radical human control of the living world, looking back at the historical preconditions for this metaphor. I discuss how design is (...) perceived to enable us to shape natural beings to our will, and consider ethical, epistemological and ontological implications of the prevalence of this metaphor, focusing on its use within synthetic biology. I argue that we urgently need counter-images to the dominant metaphor of living machines and its implied control and propose that artworks can provide such counter-images through upsetting the perception of life as controllable. This is argued through discussion of artworks by Oron Catts and Ionat Zurr, by Tarsh Bates and by Ai Hasegawa, which in different ways challenge mechanistic assumptions through open-ended engagement with the strangeness and messiness of life. (shrink)

This paper argues that scientific realism commits us to a metaphysical determination relation between the mathematical entities that are indispensible to scientific explanation and the modal structure of the empirical phenomena those entities explain. The argument presupposes that scientific realism commits us to the indispensability argument. The viewpresented here is that the indispensability of mathematics commits us not only to the existence of mathematical structures and entities but to a metaphysical determination relation between those entities and the modal structure of (...) the physical world. The no-miracles argument is the primary motivation for scientific realism. It is a presupposition of this argument that unobservable entities are explanatory only when they determine the empirical phenomena they explain. I argue that mathematical entities should also be seen as explanatory only when they determine the empirical facts they explain, namely, the modal structure of the physical world. Thus, scientific realism commits us to a metaphysical determination relation between mathematics and physical modality that has not been previously recognized. The requirement to account for the metaphysical dependence of modal physical structure on mathematics limits the class of acceptable solutions to the applicability problem that are available to the scientific realist. (shrink)

The business case constitutes an important instrumental motive for corporate social responsibility (CSR), but its relationship with other moral and relational motives remains controversial. In this article, we examine the articulation of motives for CSR among different stakeholders in Germany historically. On the basis of reports of German business associations, state agencies, unions, and nongovernmental organizations from 1970 to 2014, we show how the business case came to be a dominant motive for CSR by acting as a coalition magnet: the (...) vocabulary was used strategically by key policy entrepreneurs, while being ambiguous for flexible interpretations by different stakeholders, and thereby growing in attractiveness. As a resulting discourse coalition emerged among business, state, and civil society actors, the moral and relational motives for CSR became increasingly marginalized. The article offers a new approach to studying motives and contributes to understanding the complementary or competing nature of different motives for CSR. (shrink)

Starting from methodological aspects of a study performed about features that characterized social representation of infantile malnutrition, qualitative and quantitative treatment of the data are presented. Traditional quantitative studies are characterized for the emphasis in the definition of the..

When reflecting on the nature of skilled action, it is easy to fall into familiar dichotomies such that one construes the flexibility and intelligence of skill at the level of intentional states while characterizing the automatic motor processes that constitute motor skill execution as learned but fixed, invariant, bottom-up, brute-causal responses. In this essay, I will argue that this picture of skilled, automatic, motor processes is overly simplistic. Specifically, I will argue that an adequate account of the learned motor routines (...) that constitute embodied skills cannot be given in a purely bottom-up, brute-causal fashion. Rather, motor control is intelligent all the way down. To establish this, I will first review two recent accounts of skill, Stanley and Krakauer and Papineau, which characterize the automatic motor control responsible for the fine-grained movements constitutive of motor skill as brute, low-level phenomena. I will then isolate five key features that should apply to skilled motor control, if these accounts are correct. Together, the accounts posit that motor control is: ballistic, invariant, independent of general action trajectories, Insensitive to semantic content, and independent of personal-level intentions. In the final section of this paper, I will appeal to optimal control theory for empirical evidence to challenge the commitment to skilled action as qualified by the above features. (shrink)