Background Despite decades of anti-racism and equity, diversity, and inclusion (EDI) interventions in academic medicine, medical racism continues to harm patients and healthcare providers. We sought to deeply explore experiences and beliefs about medical racism among academic clinicians to understand the drivers of persistent medical racism and to inform intervention design. Methods We interviewed academically-affiliated clinicians with any racial identity from the Departments of Family Medicine, Cardiac Sciences, Emergency Medicine, and Medicine to understand their experiences and perceptions of medical racism. (...) We performed thematic content analysis of semi-structured interview data to understand the barriers and facilitators of ongoing medical racism. Based on participant narratives, we developed a logic framework that demonstrates the necessary steps in the process of addressing racism using if/then logic. This framework was then applied to all narratives and the barriers to addressing medical racism were aligned with each step in the logic framework. Proposed interventions, as suggested by participants or study team members and/or identified in the literature, were matched to these identified barriers to addressing racism. Results Participant narratives of their experiences of medical racism demonstrated multiple barriers to addressing racism, such as a perceived lack of empathy from white colleagues. Few potential facilitators to addressing racism were also identified, including shared language to understand racism. The logic framework suggested that addressing racism requires individuals to understand, recognize, name, and confront medical racism. Conclusions Organizations can use this logic framework to understand their local context and select targeted anti-racism or EDI interventions. Theory-informed approaches to medical racism may be more effective than interventions that do not address local barriers or facilitators for persistent medical racism. (shrink)

Routine action sequences critically rely on neural mechanisms maintaining contextual and temporal information to disambiguate similar tasks (e.g. making coffee or tea). In this study we show the involvement of areas in temporal and lateral prefrontal cortices in maintaining temporal and contextual information for the execution of hierarchically‐organized action sequences.

The philosophical orientation of Gadamerian hermeneutic phenomenology is explored in this paper. Gadamer offers a hermeneutics of the humanities that differs significantly from models of the human sciences historically rooted in scientific methodologies. In particular, Gadamer proposes that understanding is first a mode of being before it is a mode of knowing; what this effectively offers is an alternative to the traditional way of understanding in the human sciences. This paper details why the work of hermeneutics is not to develop (...) a procedure for understanding, but to clarify the conditions of understanding. In this explication, the author examines the hermeneutic experience and, in the process, relates it to both the practical and the historical horizons of the lifeworld of health professionals, particularly nurses. Indo-Pacific Journal of Phenomenology<, Volume 7, Edition 2 September 2007. (shrink)

Open peer commentary on the article “Developing a Dialogical Platform for Disseminating Research through Design” by Abigail C. Durrant, John Vines, Jayne Wallace & Joyce Yee. Upshot: The experimental conference format described by Durrant et al. is intended to create an open platform for dissemination and knowledge creation. The field of open design, in which designers create structures to support creative action by others, offers relevant insights and alternative approaches. For example: while it is logical to see openness as open (...) choice, it can be productive to instead think of openness as constructed through a balance of structure and choice. (shrink)

This collection addresses a post-WWII shift in the hierarchy of scientific explanations, where the highest goal moves from reductionism towards some ...

Research programs in empirical psychology from the past two decades have revealed implicit biases. Although implicit processes are pervasive, unavoidable, and often useful aspects of our cognitions, they may also lead us into error. The most problematic forms of implicit cognition are those which target social groups, encoding stereotypes or reflecting prejudicial evaluative hierarchies. Despite intentions to the contrary, implicit biases can influence our behaviours and judgements, contributing to patterns of discriminatory behaviour. These patterns of discrimination are obviously wrong and (...) unjust. But in remedying such wrongs, one question to be addressed concerns responsibility for implicit bias. Unlike some paradigmatic forms of wrongdoing, such discrimination is often unintentional, unendorsed, and perpetrated without awareness; and the harms are particularly damaging because they are cumulative and collectively perpetrated. So, what are we to make of questions of responsibility? In this article, we outline some of the main lines of recent philosophical thought, which address questions of responsibility for implicit bias. We focus on (a) the kind of responsibility at issue; (b) revisionist versus nonrevisionist conceptions of responsibility as applied to implicit bias; and (c) individual, institutional, and collective responsibility for implicit bias. (shrink)

Philosophers who have written about implicit bias have claimed or implied that individuals are not responsible, and therefore not blameworthy, for their implicit biases, and that this is a function of the nature of implicit bias as implicit: below the radar of conscious reflection, out of the control of the deliberating agent, and not rationally revisable in the way many of our reflective beliefs are. I argue that close attention to the findings of empirical psychology, and to the conditions for (...) blameworthiness, does not support these claims. I suggest that the arguments for the claim that individuals are not liable for blame are invalid, and that there is some reason to suppose that individuals are, at least sometimes, liable to blame for the extent to which they are influenced in behaviour and judgment by implicit biases. I also argue against the claim that it is counter-productive to see bias as something for which individuals are blameworthy; rather, understanding implicit bias as something for which we are liable to blame could be constructive. (shrink)

For the theorists of crisis, the revolutionary state comes into existence through violence, and due to its inability to provide an authoritative katechon (restrainer) against internal and external violence, it perpetuates violence until it self-destructs. Writing during extreme economic depression and growing social and political violence, the crisis theorists––Joseph de Maistre, Juan Donoso Cortés, and Carl Schmitt––each sought to blame the chaos of their time upon the Janus-faced postrevolutionary ideals of liberalism and socialism by urging a return to pre-revolutionary moral (...) and religious values. They are united by three counterrevolutionary principles, all of which are purported to remedy revolutionary violence: traditional constitutional fidelity, the philosophy of the decision, and opposition to bourgeois liberalism. This essay is followed by the first complete English translation and publication of Donoso’s letter of October 24, 1851, which contains Donoso’s only reference to the “discussing class,” a political entity later popularized by Schmitt in his 1922 work Political Theology. (shrink)

The term 'implicit bias' has very swiftly been incorporated into philosophical discourse. Our aim in this paper is to scrutinise the phenomena that fall under the rubric of implicit bias. The term is often used in a rather broad sense, to capture a range of implicit social cognitions, and this is useful for some purposes. However, we here articulate some of the important differences between phenomena identified as instances of implicit bias. We caution against ignoring these differences: it is likely (...) they have considerable significance, not least for the sorts of normative recommendations being made concerning how to mitigate the bad effects of implicit bias. (shrink)

Dembroff and Wodak (2018, 2021) argue that we have a duty to use gender-neutral pronouns, but do not extend this argument to all other aspects of our language. We evaluate the extent to which gender neutral language is desirable in the context of parental leave schemes, taking as a case study the parental leave schemes found at a Higher Education Institution in the UK. We argue that the considerations Dembroff and Wodak (2018, 2021) take to speak against gender specific pronouns (...) and some other gender specific aspects of language also strongly speak against gender specific language in the context of parental leave policies. As a project in non-ideal theory, we argue against the framing of existing policies which refer to ‘maternity’ and ‘paternity’ leave, and for moving to the language of ‘parental’ or ‘family’ leave. The fact that the majority of those giving birth are women does not provide decisive reasons for framing policies in gender-specific terms. Moreover, we argue that given the welcome move to facilitate shared parental leave, any concerns for gender equity, and equity for carers, are better served by requesting demographic information for monitoring purposes, rather than by policies that refer to gender specific parenting roles. -/- . (shrink)

Our focus here is on whether, when influenced by implicit biases, those behavioural dispositions should be understood as being a part of that person’s character: whether they are part of the agent that can be morally evaluated.[4] We frame this issue in terms of control. If a state, process, or behaviour is not something that the agent can, in the relevant sense, control, then it is not something that counts as part of her character. A number of theorists have argued (...) that individuals do not have control, in the relevant sense, over the operation of implicit bias. We will argue that this claim is mistaken. We articulate and develop a notion of control that individuals have with respect to implicit bias, and argue that this kind of control can ground character-based evaluation of such behavioural dispositions. (shrink)

Research programs in empirical psychology over the past few decades have led scholars to posit implicit biases. This is due to the development of innovative behavioural measures that have revealed aspects of our cognitions which may not be identified on self-report measures requiring individuals to reflect on and report their attitudes and beliefs. But what does it mean to characterise such biases as implicit? Can we satisfactorily articulate the grounds for identifying them as bias? And crucially, what sorts of cognitions (...) are in fact being measured; what mental states or processes underpin such behavioural responses? In this paper, we outline some of the philosophical and empirical issues engaged when attempting to address these three questions. Our aim is to provide a constructive taxonomy of the issues, and how they interrelate. As we will see, any view about what implicit bias is may depend on a range of prior theoretical choices. (shrink)

Philosophers have had a lot to say about blame, much less about praise. In this paper, I follow some recent authors in arguing that this is a mistake. However, unlike these recent authors, the reasons I identify for scrutinising praise are to do with the ways in which praise is, systematically, unjustly apportioned. Specifically, drawing on testimony and findings from social psychology, I argue that praise is often apportioned in ways that reflect and entrench existing structures of oppression. Articulating what (...) is going wrong here helps us to see what to do about it. (shrink)

In this introduction, we acquaint readers with a selection of work coming out of the "Bias in Context" conference series, which ran from 2016 to 2017. Featured authors in the symposium include Gabriella Beckles-Raymond (writing about bad faith and implicit bias explanations), Daniel Kelly and Lacey Davidson (writing about gender norms and the internalization of social structures), and Alex Madva (writing about solutions to racial integration and an empirical mindset). We sketch the larger themes of the conference, as well as (...) how these three pieces of work fit into them. (shrink)

Some theories of goodness are descriptively rich: they have much to say about what makes things good. Neo-Aristotelian accounts, for instance, detail the various features that make a human being, a dog, a bee good relative to facts about those forms of life. Famously, such theories of relative goodness tend to be comparatively poor: they have little or nothing to say about what makes one kind of being better than another kind. Other theories of goodness—those that take there to be (...) absolute goodness—are comparatively rich: they offer grounds for judging some types of things better than others because they have more absolute goodness. Moorean accounts, for example, can tell us that humans and human experiences are superior to bees and blades of grass. But such theories tend to be descriptively poor: they struggle to tell us in virtue of what this is so. In this essay we motivate and flesh out a view that splits the difference between accounts of goodness as relative and accounts of goodness as absolute. Such a view holds promise only if the mechanics of this kind of metaphysics of goodness can be worked out. Here we present a view on which the paradigm for absolute goodness is God and the paradigm for each kind of relative goodness is a divine idea. (shrink)

In this paper, I set out some desiderata for a model of implicit cognition. I present test cases and suggest that, when considered in light of them, some recent models of implicit cognition fail to satisfy these desiderata. The test cases also bring to light an important class of cases that have been almost completely ignored in philosophical discussions of implicit cognition and implicit bias. These cases have important work to do in helping us understand both the role of implicit (...) cognition in action and our attempts to combat implicit biases. (shrink)

Recent empirical research has substantiated the finding that very many of us harbour implicit biases: fast, automatic, and difficult to control processes that encode stereotypes and evaluative content, and influence how we think and behave. Since it is difficult to be aware of these processes - they have sometimes been referred to as operating 'unconsciously' - we may not know that we harbour them, nor be alert to their influence on our cognition and action. And since they are difficult to (...) control, considerable work is required to prevent their influence. We here focus on the implications of these findings for epistemology. We first look at ways in which implicit biases thwart our knowledge seeking practices (sections 1 & 2). Then we set out putative epistemic benefits of implicit bias, before considering ways in which epistemic practices might be improved (section 3). Finally, we consider the distinctive challenges that the findings about implicit bias pose to us as philosophers, in the context of feminist philosophy in particular (section 4). (shrink)

Should the state punish its disadvantaged citizens who have committed crimes? Duff has recently argued that where disadvantage persists the state loses its authority to hold individuals to account and to punish for criminal wrongdoings. I here scrutinize Duff’s argument for the claim that social justice is a precondition for the legitimacy of state punishment. I sharpen an objection to Duff’s argument: with his framework, we seem unable to block the implausible conclusion that where disadvantage persists the state lacks the (...) authority to punish any citizen for any crime. I then set out an alternative line of argument in support of the claim that social deprivation can threaten the states legitimate punitive authority. I argue that a penal system must incorporate certain proportionality principles, and that these principles cannot both be met where citizens suffer from deprivation. (shrink)

Relational conceptions of autonomy attempt to take into account the social aspects of autonomous agency. Those views that incorporate not merely causally, but constitutively necessary relational conditions, incorporate a condition that has the form: A necessary condition for autonomous agency is that the agent stands in social relations S. I argue that any account that incorporates such a condition cannot play one of autonomy’s key normative roles: identifying those agents who ought to be protected from paternalistic intervention. I argue, against (...) objections from Oshana, that there are good reasons for maintaining the notion of autonomy in this role, and thus that such relational conceptions should not be accepted. This rejection goes beyond that from John Christman, which holds only for those relational conditions which are value-laden. (shrink)

Motivating reforms to address discrimination and exclusion is important. But what epistemic practices characterize better or worse ways of doing this? Recently, the phenomena of implicit biases have played a large role in motivating reforms. We argue that this strategy risks perpetuating two kinds of epistemic oppression: the vindication dynamic and contributory injustice. We offer positive proposals for avoiding these forms of epistemic oppression when confronting racism.

This chapter evaluates two competing views of morally responsible agency. The first view at issue is Vargas’s circumstantialism—on which responsible agency is a function of the agent and her circumstances, and so is highly context sensitive. The second view is McGeer’s scaffolded-responsiveness view, on which responsible agency is constituted by the capacity for responsiveness to reasons directly, and indirectly via sensitivity to the expectations of one’s audience (whose sensitivity may be more developed than one’s own). This chapter defends a version (...) of the scaffolded-responsiveness view, and develops two further claims. Firstly, moral responsibility should not be tied too closely to liability to praise or blame. Secondly, rather than revising our existing concept of responsibility, we would do better to ask what we want the concept of responsibility for. (shrink)

Since 1900, debates about the justification of punishment have also been debates about the cause of crime. In the early twentieth century, the rehabilitative ideal of punishment viewed mental illness and dysfunction in individuals as the cause of crime. Starting in the 1970s, retributivism identified the immorality of human agents as the source of crime, which dovetailed well with the “tough-on-crime” political milieu of the 1980s and 1990s that produced mass incarceration. After surveying these historical trends, Wirts argues for a (...) social critical view that crime is best understood as a product of an unjust society, not faulty human beings. This view should take the lessons learned by the critiques of rehabilitation, however, and resist the tendency to reduce human beings to recipients of social services. (shrink)

Donald Davidson has made enormous contributions to the philosophy of action, epistemology, semantics and philosophy of mind and today is recognized as one of the most important analytical philosophers of the late twentieth century. _Donald Davidson: Truth, Meaning and Knowledge_ addresses * Davidson's writings on epistemology and theory of language with their implications of ontology and philosophy of mind * the central issue of whether truth is the ultimate goal of enquiry, challenged by contributions from Richard Rorty and Paul Horwich (...) * Davidson's approach to semantics and applied linguistics as addressed by Kirk Ludwig, Gabriel Segal, Peter Pagin, Stephen Neale, Herman Cappelen and Ernie Lepore and Reinaldo Elugardo * Davidson's advances in the philosophy of mind in relation to the views of Williard V. Quine, John McDowell and Peter F. Strawson, in essays by Roger Gibson and Anita Avramides. (shrink)

The topic of professionalism has dominated the content of major academic medicine publications during the past decade and continues to do so. The message of this current wave of professionalism is that medical educators need to be more attentive to the moral sensibilities of trainees, to their interpersonal and affective dimensions, and to their social conscience, all to the end of skilled, humanistic physicians. Urgent calls to address professionalism from such groups as the Association of American Medical Colleges, the American (...) Board of Internal Medicine, and the Accreditation Council for Graduate Medical Education, among others. In fact, at the 2004 annual meeting of the AAMC six separate presentations addressed professionalism with such titles as "Evaluating Humanism and Professionalism," Professionalism: Expectation, Education, Evaluation," or "Toward Assessing Professional Behaviors of Medical Students through Peer Observations". Professionalism, then, has become part of the current academic medicine parlance, used by administrators, clinical faculty, residency programs, and professional organizations with an expectation of shared meanings and goals. All of these stakeholders focus on what has become a consistent list of attributes deemed to be the essence of professionalism, which usually include variations on altruism, duty, excellence, honor and integrity, accountability, and respect. In fact, most of the scholarly work to date has been listing, describing, decrying, and measuring/evaluating it. In this collection of essays, we don’t argue with these attributes. Instead, we ask questions of the discourse from which they arise, how the specialized language of academic medicine disciplines has defined, organized, contained, and made seemingly immutable a group of attitudes, values, and behaviors subsumed under the label "professional" or "professionalism." This collection aims to be a critical text, one that questions the profession’s beliefs about the nature of its work and how such beliefs are enacted in medical education, particularly as they fuel the professionalism discourse. In addition, we will scrutinize how the discourse is enacted in both the formal and hidden curriculum, and in the larger medical environment. (shrink)

This paper takes as its focus efforts to address particular aspects of sexist oppression and its intersections, in a particular field: it discusses reform efforts in philosophy. In recent years, there has been a growing international movement to change the way that our profession functions and is structured, in order to make it more welcoming for members of marginalized groups. One especially prominent and successful form of justification for these reform efforts has drawn on empirical data regarding implicit biases and (...) their effects. Here, we address two concerns about these empirical data. First, critics have for some time argued that the studies drawn upon cannot give us an accurate picture of the workings of prejudice, because they ignore the intersectional nature of these phenomena. More recently, concerns have been raised about the empirical data supporting the nature and existence of implicit bias. Each of these concerns, but perhaps more commonly the latter, are thought by some to undermine reform efforts in philosophy. In this paper, we take a three- pronged approach to these claims. First, we show that the reforms can be motivated quite independently of the implicit bias data, and that many of these reforms are in fact very well suited to dealing with intersectional worries. Next, we show that in fact the empirical concerns about the implicit bias data are not nearly as problematic as some have thought. Finally, we argue that while the intersectional concerns are an immensely valuable criticism of early work on implicit bias, more recent work is starting to address these worries. (shrink)