The barrier to global health most often noted in Western discourse is the enduring disparity of access to medical technologies. This assessment of the circumstances in global health fits well within a bioethic centered on the equitable distribution of access to medical goods. Yet through an interrogative consideration of two episodes in the marketing of progress, namely the Century of Progress Exposition in Chicago (1933–1934) and one post-war spin on atomic development in the National Geographic, I suggest that the language (...) of medical advancement continues to trade on a division between civilized, rational, scientifically developed peoples and the atavism of peoples by whom Western science gauges its progress. I recommend unremittingly self-critical attention to the dynamics of language and legitimization used within the Western academy by those who seek ostensibly to be of use in regions (powerfully) labeled as “developing.”. (shrink)

In 2002, then Cambridge student Joanna Jepson initiated a legal, ecclesial, and media conversation on selective termination for disability. Making herself available in a way that is vulnerable, palpable, and effective, Jepson has used subtle rhetorical skill to question the ways certain lives are appraised as precious or expendable. The now Revd Jepson’s witness may adumbrate a boundary past which the task of truly public bioethics becomes precarious. While ethicists may persuasively argue in the public square against positive eugenics — (...) against selectively breeding or genetically enhancing conception — opposition to negative eugenics — against the elimination of ‘unfit’ lives — stretches the bounds of apologetics. The theological bioethicist may be called to gesture toward the Whence? and the Whither?, even if the purveyors of public bioethics find this an objectionable undertaking. (shrink)

Reading "Fear and Trembling" with "Works of Love" heightens Kierkegaard's summons to acknowledge the ambiguity of our aims and the treachery of our love. "Works of Love" underscores that there is a "neighbor" in "Fear and Trembling" whose justified or damnable banishment occasions Kierkegaard's attempt to "track down" the "illusions" of love. Through de Silentio, Kierkegaard prompts the reader to consider whether the promise has been broken due to radical obedience, lack of faith, dearth of imagination, or a gnarled combination (...) of motives. We are to recognize our kinship with the duplicitous merman and discover that we must, like Tobit's Sarah, receive an extravagant gift. "Fear and Trembling" is thus a text with soteriological import, but with ethical import as well. Convicted by and indebted to God, we are to find in Abraham's act a premonitory paradigm for every engagement. (shrink)

A major study of Kierkegaard and love exploring his description of love's treachery, difficulty, and hope.

When thinking about the intersection of care and Christian bioethics, it is helpful to follow closely the account of Ruth, who turned away from security and walked alongside her grieving mother-in-law to Bethlehem. Remembering Ruth may help one to heed Professor Kaveny?s summoning of Christians to remember ?the Order of Widows? and the church?s historic calling to bring ?the almanahinto its center rather than pushing her to its margins.? Disabled, elderly and terminally ill people often seem, at least implicitly, expendable. (...) By hearing the scriptural account of Jesus? steadfast great-grandmother, readers may recall another way. One may read Ruth?s care for Naomi as a performative, prophetic act of faith. Ruth?s faithful resolve, when set next to Orpah?s prudent way, challenges the notion that a bioethic of care is innately feminine, and may further call women and men corporately to participate in a kind of care that is strenuous work. My thanks to Cathleen Kaveny for allowing me to play off the title of her insightful essay. Thanks also to Willie James Jennings, whose 1998 baccalaureate sermon on Ruth inspired and much informed this essay. I wish also to thank Ellen Davis, who taught me to read Hebrew, and to read Ruth. (shrink)

Laughing at the Devil is an invitation to see the world with a medieval visionary now known as Julian of Norwich, believed to be the first woman to have written a book in English. (We do not know her given name, because she became known by the name of a church that became her home.) Julian “saw our Lord scorn [the Devil's] wickedness” and noted that “he wants us to do the same.” In this impassioned, analytic, and irreverent book, Amy (...) Laura Hall emphasizes Julian's call to scorn the Devil. Julian of Norwich envisioned courage during a time of fear. Laughing at the Devil describes how a courageous woman transformed a setting of dread into hope, solidarity, and resistance. (shrink)

Reading Fear and Trembling with Works of Love heightens Kierkegaard's summons to acknowledge the ambiguity of our aims and the treachery of our love. Works of Love underscores that there is a“neighbor” in Fear and Trembling whose justified or damnable banishment occasions Kierkegaard's attempt to “track down” the “illusions” of love. Through de Silentio, Kierkegaard prompts the reader to consider whether the promise has been broken due to radical obedience, lack of faith, dearth of imagination, or a gnarled combination of (...) motives. We are to recognize our kinship with the duplicitous merman and discover that we must, like Tobit's Sarah, receive an extravagant gift. Fear and Trembling is thus a text with soteriological import, but with ethical import as well. Convicted by and indebted to God, we are to find in Abraham's act a premonitory paradigm for every engagement. (shrink)

Søren Kierkegaard and Dietrich Bonhoeffer provide provocatively individualistic, liturgical, Jesus-centered perspectives on anthropology that accentuate the neo-Hegelian, amoral, collectivist perspectives of geneticist Francis Collins, social psychologist Jonathan Haidt, and entomologist/political philosopher E. O. Wilson. In the mix of the vagaries of scientific developments, the offense of Jesus Christ does not change, and it seems vital for Christians to testify explicitly against any worldview (economic and/or scientific) that presents human lives (whether self-given sacrificially or taken involuntarily) as the dross of a (...) refined future. It is through the repetitive practice of Holy Communion that Christians consume the gift to see the world as gift, not for our own winning or saving. (shrink)

Fast delivery to customers required Amazon fulfillment center employees to meet high daily productivity quotas. In some of the centers, robots and people worked together. The efficiency of the robots and the company’s productivity standards, made it challenging for workers to avoid injury. Candace accepted a position in a center utilizing robots and was injured on the job, just like hundreds of others. Her injuries and lack of workplace accommodations prevented her from meeting productivity quotas and consequently jeopardized her job. (...) She wondered if customers understood the human cost incurred to achieve such fast delivery and if it was ethical to subject employees to such work environments. Students are asked to analyze the situation from various ethical perspectives and offer their opinions to Candace. During their analysis they will learn about ethics, ethical standards, stakeholders, and corporate social responsibility. (shrink)

Both realist and anti-realist accounts of natural kinds possess prima facie virtues: realists can straightforwardly make sense of the apparent objectivity of the natural kinds, and anti-realists, their knowability. This paper formulates a properly anti-realist account designed to capture both merits. In particular, it recommends understanding natural kinds as ‘categorical bottlenecks,’ those categories that not only best serve us, with our idiosyncratic aims and cognitive capacities, but also those of a wide range of alternative agents. By endorsing an ultimately subjective (...) categorical principle, this view sidesteps epistemological difficulties facing realist views. Yet, it nevertheless identifies natural kinds that are fairly, though not completely, stance-independent or objective. (shrink)

This paper sketches a causal account of scientific explanation designed to sustain the judgment that high-level, detail-sparse explanations—particularly those offered in biology—can be at least as explanatorily valuable as lower-level counterparts. The motivating idea is that complete explanations maximize causal economy: they cite those aspects of an event’s causal run-up that offer the biggest-bang-for-your-buck, by costing less (in virtue of being abstract) and delivering more (in virtue making the event stable or robust).

Though biologists identify individuals as ‘male’ or ‘female’ across a broad range of animal species, the particular traits exhibited by males and females can vary tremendously. This diversity has led some to conclude that cross-animal sexes (males, or females, of whatever animal species) have “little or no explanatory power” (Dupré 1986: 447) and, thus, are not natural kinds in any traditional sense. This essay will explore considerations for and against this conclusion, ultimately arguing that the animal sexes, properly understood, are (...) “historical explanatory kinds”: groupings that can be scientifically significant even while their members differ radically in their current properties and particular histories. Whether this makes them full-fledged natural kinds is a question I take up at the very end. (shrink)

Drawing on a landscape analysis of existing data-sharing initiatives, in-depth interviews with expert stakeholders, and public deliberations with community advisory panels across the U.S., we describe features of the evolving medical information commons. We identify participant-centricity and trustworthiness as the most important features of an MIC and discuss the implications for those seeking to create a sustainable, useful, and widely available collection of linked resources for research and other purposes.

This article is the second one in a series dealing with mental health ethics in Cuba. It reports on ethical dilemmas, resources and limitations to their resolution, and recommendations for action. The data, obtained through individual interviews and focus groups with 28 professionals, indicate that Cubans experience dilemmas related to the interests of clients, their personal interests, and the interest of the state. These conflicts are related to power differentials among clients and professionals, professionals from various disciplines, and professionals and (...) organizational authorities. Resources to solve ethical dilemmas include government support, ethics committees, and collegial dialogue. Limitations include minimal training in ethics, lack of safe space to discuss professional disagreements, and little tolerance for criticism. Recommendations to address ethical dilemmas include better training, implementation of a code of ethics, and provision of safe space to discuss ethical dilemmas. The findings are discussed in light of the role of power in applied ethics. (shrink)

In this article we review the emerging literature on the self-transcendent emotions. We discuss how the self-transcendent emotions differ from other positive emotions and outline the defining features of this category. We then provide an analysis of three specific self-transcendent emotions—compassion, gratitude, and awe—detailing what has been learned about their expressive behavior, physiology, and likely evolutionary origins. We propose that these emotions emerged to help humans solve unique problems related to caretaking, cooperation, and group coordination in social interactions. In our (...) final section we offer predictions about the self-transcendent emotions that can guide future research. (shrink)

As part of a project on professionals' lived experience of ethics, this article explores the guiding concepts and values concerning ethics of mental health professionals in Cuba. The data, obtained through individual interviews and focus groups with 28 professionals, indicate that Cubans conceptualize applied ethics in terms of its central role in professional practice and its connection to the social context and subjective processes. Findings also show that Cuban professionals are guided not only by a set of professional values but (...) by a specific set of civic values as well. The former are subdivided into other-oriented values and self-oriented values. The study of ethics in another culture such as Cuba offers a unique point of view from which to critique the social construction of our own conceptions of applied ethics in North America. (shrink)

Plato‘s often-quoted statement in the Phaedrus that we should 'cut up each kind according to its species along its natural joints' (265e) has been an influential metaphor in discussions of natural kinds. In this essay, I investigate the source domain of the metaphor, the joints of the animal body, to determine whether, as users of the metaphor often assume, there is just one scientifically legitimate division of the body into component skeletal parts. Through an examination of animal joints from the (...) perspective of both the butcher and then the biologist, I argue that there are multiple, legitimate divisions. Yet I suggest that, properly interpreted, the deeper message of the metaphor may still be defensible: the suggestion that some 'carvings' are more natural or real than others. I conclude by considering the implications this result should have for our approach to natural kinds and for the metaphors we use to describe them. (shrink)

Plato’s often-quoted statement in the Phaedrus that we should “cut up each kind according to its species along its natural joints” (265e) has become an influential metaphor in discussions of natural kinds and natural properties. In this essay, I investigate the source domain of the metaphor, the joints of the animal body, to determine if these joints are indeed “natural”—meaning that there exists a single, non-disjunctive account of joint-hood applicable to the osteological world. By examining animal joints from the perspective (...) of both the butcher and the biologist, I argue that there is no single natural division of the body into component skeletal parts. I conclude by considering what impact this result should have on our understanding of natural kinds and on the metaphors we use to describe them. (shrink)

Plato’s Socrates says in the Phaedrus that we should “cut up each kind according to its species along its natural joints, and to try not to splinter any part, as a bad butcher might” (265e). In the Statesman Plato’s interlocutors make the similar suggestion that kinds should be divided from one another “limb by limb, like a sacrificial animal” (287c). This jointing metaphor is often used to illustrate the divisibility of the natural world into objective kinds or natural categories—such as (...) into particles like electrons, species, such as Homo sapiens, or even into sociological kinds like care-giver or psychological ones like fear. It has been thought that by dividing the world at its joints, we can lay bare the natural kinds; when we fail to so divide we splinter the world’s kinds like an incompetent butcher. In accordance with the metaphor, each bone in the animal body is likened to a category of things in the natural world. The claim that there is one natural set of joints at which we can physically separate the parts of the animal parallels the claim that there is a unique set of natural categories into which we should partition objects into species. Some, such as David Hull, say that this metaphor is “apt” (Hull 1989, 153) and others, like Ian Hacking, that it is “unsavory rubbish” (Hacking 1991, 111). Philip Kitcher is equally critical, writing that: “Plato gave us a vivid metaphor, suggesting that our classificatory task is like that of carving a beast at its joints. But that is just metaphor. I find it hard to give substance to the notion that nature is a beast with joints or that it comes with neat fenceposts that our scientific language must respect.”. (shrink)

The authors of this book show that the failure of public health arises, not from a failure of contemporary medicine, but from a failure of the philosophical assumptions upon which it rests. They suggest an alternative approach to health care that derives from a ecological and holistic philosophy of nature.

In lieu of an abstract, here is a brief excerpt of the content:Narrative Symposium:Living Organ DonationLaura Altobelli, Sherri Bauman, Janice Flynn, Andy Heath, Joseph Jacobs, Tim Joos, Amy K. Lewensten, Donna L. Luebke, Sarah A. McDaniel, Donald Olenick, Laurie E Post, Vicky Young, Blake Adams, Anonymous One, Michael Sauls, Christine Wright, Shannon D. Wyatt, and Cara Yesawich• An Altruistic Living Donor’s Story• Surgery for the Soul• Kidney Donation Story• The Essence of Giving—A Transplant Story• Love—the Risk Worth Taking• My Donation (...) Journey• A Life For A Life: My Gift To My Dad• Lessons Learned: The Realities of Living Organ Donation• Sarah’s List Exchange Experience• Accelerated Living Donation• Liver Donor Nightmare• Adrift After Donation• Getting Our Child Off Dialysis• A Living Donor’s Journey• The Spare Kidney• Living Donors are People Too• The Gift of Life—Walking by Faith• Journey of an Altruistic, Non–designated Living DonorCopyright © 2012 The Johns Hopkins University Press... (shrink)

In philosophy of religion, there are few more frequently visited topics than the problem of evil, which has attracted considerable interest since the time of Epicurus. It is well known that the problem of evil involves responding to the apparent tension between 1) belief in the existence of a good, all powerful, all knowing God and 2) the existence of evil—such as personal suffering embodied in the experience of cancer. While a great deal has been written concerning abstract philosophical theories (...) that academics use to explain the existence of evil, much less has been written about how religious lay people make sense of evil and suffering. What explanations, meanings, and perceptions do they hold concerning the religious significance of evil? What can theologians and philosophers learn from these lay experiences? Our interdisciplinary team designed an experiment to identify the religious significance that personal suffering held for a group of religious cancer sufferers. We interviewed twenty-nine self-identified evangelical Christians who had received a cancer diagnosis at some point in their lives for our experiment. Since all interviewees identified as Christians, it was expected that they would assent to belief in a theistic God. It was also expected that each interviewee would assent the existence of evil and see their cancer experience as a dramatic and personal instance of an evil event. The explicit existential threat of cancer guarantees that the individual has much at stake in the experience. Furthermore, the pain and suffering that typically accompanies either the cancer itself or cancer treatments make it a compelling example of evil experienced in a very personal way. Finally, even when successfully treated, the ongoing threat of potentially fatal recurrence looms over the sufferer for years to come. We asked 17 questions related to the religious significance of their cancer experience in each interview and coded these interviews looking for five distinct types of explanations for/meaning of evil: trusting God in mystery, free will, moral development, spiritual growth, and growth in human relationships/community. These categories were meant to correspond loosely to five philosophical responses to the existence of evil.Our interviews included several important results. First, 79% of interviewees had at least one answer that fit into the ‘trust God in mystery’ category of responses with 48% using this category of responses as their most frequently cited theme. This result could be interpreted as a kind of generic theodical response: God has a good, but unknown reason for allowing evil/suffering. Alternatively, another possible interpretation is that at least some of these interviewees intuited something similar to skeptical theism, since it claims that if one understands the type of God proposed by theism and possesses an accurate view of human cognitive capacities, it is apparent that there is no real tension to be resolved between theism and the existence of evil. Some of our interviewees seemed to believe not only that the answer to why evil exists is mysterious, but that they simply could not have the necessary perspective to judge what kinds of purposes God might have for allowing this painful episode in their lives.While it was unsurprising that religious sufferers would find it important to trust God in ambiguous difficult circumstances, more surprisingly, we found that 52% of our respondents did not judge that their cancer experience was at all in tension with their religious beliefs. Whereas a broad range of philosophers and theologians acknowledge that there is at least an apparent conflict between the existence of a good, all-powerful God and the existence of evil, most of our interviewees did not even perceive an apparent tension between theistic beliefs and their painful cancer experiences that would be in need of additional reconciliation.There are at least two ways this result might be interpreted. First, our interviewees might hold additional beliefs that make the existence of evil easier for them to accept. After all, these interviewees were not ‘bare theists’ who held only to the existence of God, but presumably held a broad range of religious beliefs which may already serve to reconcile the existence of evil: that growing closer to God is more important than earthly life itself, that in evil in this life allows us a greater appreciation of a blessed eternity, or simply that ‘God works for our good in mysterious ways.’ Thus, a fully developed Christian worldview may already accommodate the existence of evil in a way not fully appreciated by philosophers.Another possible interpretation is that at least some of our interviewees were not adequately reflective to perceive the tension between their religious beliefs and their experience of suffering. There is at least some reason to doubt this explanation as an overarching interpretation of this result since our interviewees were generally well educated with the median participant holding at least a Bachelor’s degree, and most were ongoing participants in a cancer support group ensuring long-term ongoing engagement with their cancer experience.A final significant finding is that a high portion of our interviewees, 83% reported specific examples of beneficial personal growth—moral, spiritual, or relational— that resulted from their cancer experience. When asked about their cancer experience’s broad effect upon their lives in these areas they volunteered at least one example of a benefit they received in these areas. Depending on one’s accompanying value theory and whether such benefits might have been otherwise achieved, they might provide a morally sufficient reason for the existence of suffering. Our interviewees frequently described experiencing the kind of benefits at the heart of John Hick’s soul making theodicy and Eleonore Stump’s ‘spiritual growth’ theodicy, providing at least some corroborating evidence for such views. Experiences common to our interviewees were similar to what such theodicies would predict. (shrink)

The early literature on base of the pyramid strategies argued that multinational enterprises can contribute significantly to poverty alleviation of the poorest population in the world. An emergent perspective suggests that the solution to poverty lies within the BOP itself. Here, entrepreneurship within the BOP population is seen as the more credible solution to poverty. In this Special Issue introduction, we briefly present how the literature has further shifted the discussion of BOP strategies toward issues such as innovation, networks, business (...) models, and sustainability at the BOP. This analysis signals a gap in our knowledge related to the success factors in business models of BOP entrepreneurs, with attention to economic, social, and environmental impacts. We present the five articles accepted for publication in this Special Issue, of which three contribute to our knowledge of BOP business models and two to our knowledge of sustainability at the BOP. In conclusion, we propose several avenues for future research. (shrink)

The literature on deep brain stimulation (DBS) and adaptive DBS (aDBS) raises concerns that these technologies may affect personality, mood, and behavior. We conducted semi-structured interviews with researchers (n = 23) involved in developing next-generation DBS systems, exploring their perspectives on ethics and policy topics including whether DBS/aDBS can cause such changes. The majority of researchers reported being aware of personality, mood, or behavioral (PMB) changes in recipients of DBS/aDBS. Researchers offered varying estimates of the frequency of PMB changes. A (...) smaller majority reported changes in personality specifically. Some expressed reservations about the scientific status of the term ‘personality,’ while others used it freely. Most researchers discussed negative PMB changes, but a majority said that DBS/aDBS can also result in positive changes. Several researchers viewed positive PMB changes as part of the therapeutic goal in psychiatric applications of DBS/aDBS. Finally, several discussed potential causes of PMB changes other than the device itself. (shrink)

The expansion of research on deep brain stimulation (DBS) and adaptive DBS (aDBS) raises important neuroethics and policy questions related to data sharing. However, there has been little empirical research on the perspectives of experts developing these technologies. We conducted semi-structured, open-ended interviews with aDBS researchers regarding their data sharing practices and their perspectives on ethical and policy issues related to sharing. Researchers expressed support for and a commitment to sharing, with most saying that they were either sharing their data (...) or would share in the future and that doing so was important for advancing the field. However, those who are sharing reported a variety of sharing partners, suggesting heterogeneity in sharing practices and lack of the broad sharing that would reflect principles of open science. Researchers described several concerns and barriers related to sharing, including privacy and confidentiality, the usability of shared data by others, ownership and control of data (including potential commercialization), and limited resources for sharing. They also suggested potential solutions to these challenges, including additional safeguards to address privacy issues, standardization and transparency in analysis to address issues of data usability, professional norms and heightened cooperation to address issues of ownership and control, and streamlining of data transmission to address resource limitations. Researchers also offered a range of views on the sensitivity of neural activity data (NAD) and data related to mental health in the context of sharing. These findings are an important input to deliberations by researchers, policymakers, neuroethicists, and other stakeholders as they navigate ethics and policy questions related to aDBS research. (shrink)

The Monographs produced by the International Agency for Research on Cancer (IARC) apply rigorous procedures for the scientific review and evaluation of carcinogenic hazards by independent experts. The Preamble to the IARC Monographs, which outlines these procedures, was updated in 2019, following recommendations of a 2018 expert Advisory Group. This article presents the key features of the updated Preamble, a major milestone that will enable IARC to take advantage of recent scientific and procedural advances made during the 12 years since (...) the last Preamble amendments. The updated Preamble formalizes important developments already being pioneered in the Monographs Programme. These developments were taken forward in a clarified and strengthened process for identifying, reviewing, evaluating and integrating evidence to identify causes of human cancer. The advancements adopted include strengthening of systematic review methodologies; greater emphasis on mechanistic evidence, based on key characteristics of carcinogens; greater consideration of quality and informativeness in the critical evaluation of epidemiological studies, including their exposure assessment methods; improved harmonization of evaluation criteria for the different evidence streams; and a single-step process of integrating evidence on cancer in humans, cancer in experimental animals and mechanisms for reaching overall evaluations. In all, the updated Preamble underpins a stronger and more transparent method for the identification of carcinogenic hazards, the essential first step in cancer prevention. (shrink)

The capacity of next-generation closed-loop or adaptive deep brain stimulation devices to read and write shows great potential to effectively manage movement, seizure, and psychiatric disorders, and also raises the possibility of using aDBS to electively modulate mood, cognition, and prosociality. What separates aDBS from most neurotechnologies currently used for enhancement is that aDBS remains an invasive, surgically-implanted technology with a risk-benefit ratio significantly different when applied to diseased versus non-diseased individuals. Despite a large discourse about the ethics of enhancement, (...) no empirical studies yet examine perspectives on enhancement from within the aDBS research community. We interviewed 23 aDBS researchers about their attitudes toward expanding aDBS use for enhancement. A thematic content analysis revealed that researchers share ethical concerns related to safety and security; enhancement as unnecessary, unnatural or aberrant; and fairness, equality, and distributive justice. Most researchers felt that enhancement applications for DBS will eventually be technically feasible and that attempts to develop such applications for DBS are already happening. However, researchers unanimously felt that DBS ideally should not be considered for enhancement until researchers better understand brain target localization and functioning. While many researchers acknowledged controversies highlighted by scholars and ethicists, such as potential impacts on personhood, authenticity, autonomy and privacy, their ethical concerns reflect considerations of both gravity and perceived near-term likelihood. (shrink)