Relational autonomy theorists attempt to accommodate social embeddedness within a conception of autonomy. These attempts are conceptually messy, at best, and category errors, at worst. Rejecting the liberal conception of autonomy due to feminist concerns is more helpfully answered by the neorepublican notion of freedom as nondomination. The conception of freedom as nondomination captures the values that motivate the relational turn in moral and political theory and does so in a conceptually neater way than attempting to accommodate those concerns in (...) our accounts of autonomy. (shrink)

The author replies to a letter to the editor from Felicitas Sofia Holzer concerning Wenner’s article “The Social Value Requirement in Research: From the Transactional to the Basic Structure Model of Stakeholder Obligations,” in the Hastings Center Report’s January‐February 2019 issue.

Within bioethics as well as in broader clinical practice, support for transgender and gender‐questioning adolescent access to pubertal suppression has often relied heavily on the desire to prevent risky, self‐destructive, and suicidal behavior. We argue that framing justifications for access to puberty suppression in this way can actually be harmful to both individual patients as well as to the broader trans population. This justification for access to care makes such access precarious, limits its scope, and introduces perverse incentives to the (...) patient population that is being served. We go on to offer an alternative, positive defense of access to puberty‐blocking treatment for transgender youth grounded in the child's right to an open future. We argue that decisions related to pubertal suppression are both importantly weighty and potentially irreversible, and show why this justification is preferable to so‐called “informed consent” approaches. (shrink)

Ethical oversight of clinical research is one of the primary means of ensuring that human subjects are protected from the natural bias of researchers and research institutions in favor of experimentation. At a minimum, effective oversight should ensure that risks are minimized and reasonable in relation to anticipated benefits, protect vulnerable subjects from potential coercion or undue influence, ensure full and informed consent, and promote the equitable distribution of the risks and benefits of research. Because these assessments often involve value (...) judgments for which there are no agreed-upon objective standards, we rely on deliberative procedures thought to have the greatest likelihood of producing the right or best outcomes. Concerns about the potential for improperly functioning IRBs to waste scarce human and institutional resources and impede biomedical progress have motivated a surge in empirical research assessing their procedures and outcomes. Yet within this literature, there has been minimal attention paid to the social scientific evidence regarding how individuals and deliberating groups make decisions, nor how those data might inform IRB practice. This essay seeks to fill that gap, locating recent empirical data on IRB composition and process within the context of data regarding what I call “deliberative pathologies,” or instances when deliberation fails to live up to one or more aspect of the deliberative ideal because of systematic biases in the ways participants interact. The paper goes on to make evidence-based recommendations to reduce the vulnerability of IRB deliberations to the kinds of pathologies discussed and indicate directions for future research. (shrink)

This paper examines the moral force of exploitation in developing world research agreements. Taking for granted that some clinical research which is conducted in the developing world but funded by developed world sponsors is exploitative, it asks whether a third party would be morally justified in enforcing limits on research agreements in order to ensure more fair and less exploitative outcomes. This question is particularly relevant when such exploitative transactions are entered into voluntarily by all relevant parties, and both research (...) sponsors and host communities benefit from the resulting agreements. I show that defenders of the claim that exploitation ought to be permitted rely on a mischaracterization of certain forms of interference as unjustly paternalistic and two dubious empirical assumptions about the results of regulation. The view I put forward is that by evaluating a system of constraints on international research agreements, rather than individual transaction-level interference, we can better assess the alternatives to permitting exploitative research agreements. (shrink)

It has long been taken for granted that clinical research involving human subjects is ethical only if it holds out the prospect of producing socially valuable knowledge. Recently, this social value requirement has come under scrutiny, with prominent ethicists arguing that the social value requirement cannot be substantiated as an ethical limit on clinical research, and others attempting to offer new support. In this paper, I argue that both criticisms and existing defenses of the social value requirement are predicated on (...) what I call the “transactional model of stakeholder obligations”. I go on to problematize this framework, and to introduce an alternative framework for conceptualizing ethical obligations within clinical research. In defending this framework, which I call the “basic structure model of stakeholder obligations”, I also demonstrate how it provides a stronger grounding for the social value requirement that is not vulnerable to critiques grounded in the transactional model. (shrink)

Patient-funded trials are gaining traction as a means of accelerating clinical translation. However, such trials sidestep mechanisms that promote rigor, relevance, efficiency, and fairness. We recommend that funding bodies or research institutions establish mechanisms for merit review of patient-funded trials, and we offer some basic criteria for evaluating PFT protocols.

In light of the growth in the conduct of international clinical research in developing populations, this paper seeks to explore what is owed to developing world communities who host international clinical research. Although existing paradigms for assigning and assessing benefits to host communities offer valuable insight, I criticize their failure to distinguish between those benefits which can justify the conduct of research in a developing world setting and those which cannot. I argue that the justification for human subjects research is (...) fundamentally grounded in the social value of knowledge, and that this value is context-dependent in a manner which should inform our ethical evaluation of the conduct of research in specific settings. I propose a new framework for the assessment of research benefits assigned to developing world host communities, a natural implication of which is to limit the types of research projects which may permissibly be conducted in developing world settings. (shrink)

Ethicists have long recognized that two necessary features of ethical research are scientific validity and social value. Yet despite a significant literature surrounding the validity component of this dictate, until recently there has been little attention paid to unpacking what the social value component might require. This article introduces a framework for assessing the social value of research, and in particular, for determining whether a given research program is likely to have significant social value of the kind necessary to fulfill (...) the social value requirement. The article goes on to illustrate how this framework can provide a clearer account of the responsiveness requirement, an ethical dictum that is oft-repeated but whose content and value as a guideline in international research remains contested. Although I introduce this conception of social value in the context of the responsiveness requirement, the account offered can, and is intended to, stand alone as a tool for the assessment of the social value of research. As such it can be usefully applied to discussions about the value of comparative effectiveness trials, the assessment of the continued proliferation of me-too drugs and the research done to develop them, the demand for public access to study-generated data, and persistent deficits in the publication of negative results. (shrink)

Pratt, Zion, and Loff (2012) correctly point out that most international clinical research (ICR) is not intended to address the vast inequities in access to health care between developed and develo...

Volume 19, Issue 9, September 2019, Page 60-62.

A growing proportion of clinical research funded by pharmaceutical companies, high-income country research agencies, and not-for-profit funders is conducted in low- and middle-income settings. Disparities in wealth and access to healthcare between the populations where new interventions are often tested and those where many of them are ultimately marketed raise concerns about exploitation. This chapter examines several ethical requirements frequently advanced as mechanisms for protecting research subjects in underserved communities from exploitation and evaluates the effectiveness of those mechanisms as responses (...) to exploitation worries. It goes on to highlight where the conceptual frameworks relied upon by research ethicists must be improved if we are to fully understand the nature of the moral claims and obligations that arise in research conducted in underserved communities. (shrink)

The global impact of Dobbs v. Jackson Women’s Health Organization and the backlash towards reproductive justice that it represents warrant a global feminist response informed by broad theoretical and geopolitical lenses. We consider how a solidaristic, transnational feminist movement might learn from Latin American feminist movements that have been successful in uniting broad coalitions in the fight for reproductive justice as situated within far-reaching political goals. The success of such a global movement must be decolonial and must contend with the (...) fact that overlapping realities of global inequality, severe poverty, extractivism, and western-backed violence are fundamentally implicated in reproductive justice. (shrink)

California has focused on health equity in the state’s COVID-19 reopening plan. The Blueprint for a Safer Economy assigns each of California’s 58 counties into 1 of 4 tiers based on 2 metrics: test positivity rate and adjusted case rate. To advance to the next less-restrictive tier, counties must meet that tier’s test positivity and adjusted case rate thresholds. In addition, counties must have a plan for targeted investments within disadvantaged communities, and counties with more than 106 000 residents must (...) meet an equity metric. California's explicit incorporation of health equity into its reopening plan underscores the interrelated fate of its residents during the COVID-19 pandemic and creates incentives for action. This article evaluates the benefits and challenges of this novel health equity focus, and outlines recommendations for other US states to address disparities in their reopening plans. (shrink)

There has been a growing concern over establishing norms that ensure the ethically acceptable and scientifically sound conduct of clinical trials. Among the leading norms internationally are the World Medical Association's Declaration of Helsinki, guidelines by the Council for International Organizations of Medical Sciences, the International Conference on Harmonization's standards for industry, and the CONSORT group's reporting norms, in addition to the influential U.S. Federal Common Rule, Food and Drug Administration's body of regulations, and information sheets by the Department of (...) Health and Human Services. There are also many norms published at more local levels by official agencies and professional groups.Any account of international standards should cover both scientific and ethical norms at once – the two are conceptually intertwined. Recent sources recognize that “[s]cientifically unsound research on human subjects is unethical in that it exposes research subjects to risks without possible benefit.”. (shrink)

Danielle Wenner has crafted novel arguments in defense of republican accounts of freedom. I learned a lot from her discussion of how Philip Pettit's neorepublican account of freedom as nondomination does a better job than standard accounts of freedom as noninterference of explaining how power over an agent can restrict their freedom to act autonomously. The real crux of Wenner's argument, however, is that freedom as nondomination can do this work in a way that those who defend an account (...) of relational autonomy cannot. I will start with Wenner's defense of freedom as nondomination and of what it can do as the background for assessing her critique of relational autonomy. The upshot of my comments will be that Wenner... (shrink)

In "Nondomination and the Limits of Relational Autonomy," Danielle Wenner aims to achieve the political goals of relational theorists through a more effective means. This is a worthy aspiration. She believes the neorepublican conception of freedom as nondomination "can best promote the aims embodied in the political project of feminist theorists", including reducing conditions of oppression, and do it in a way that avoids the conceptual problems inherent in relational autonomy. While I appreciate the pragmatism and clarity of her (...) argument, in this commentary I raise a challenge to the freedom as nondomination approach, specifically Wenner's claim that it can avoid making substantive value judgments. I... (shrink)

There is much to learn from and admire in Danielle Wenner's "Nondomination and the Limits of Relational Autonomy." The core claim Wenner advances is that the very concerns that have motivated feminist relational autonomy theorists would be better pursued by foregoing their concern with autonomy and pursuing instead the political aim of promoting a neorepublican conception of freedom as nondomination. While leaving open the possibility that "autonomy speak may remain valuable in some contexts", Wenner nevertheless claims that "for the (...) purposes of understanding and combating relations of oppression and subjection, freedom as nondomination provides a more useful conceptual apparatus than the ideal of... (shrink)

There are two distinct approaches to Bayesian modelling in cognitive science. Black-box approaches use Bayesian theory to model the relationship between the inputs and outputs of a cognitive system without reference to the mediating causal processes; while mechanistic approaches make claims about the neural mechanisms which generate the outputs from the inputs. This paper concerns the relationship between these two approaches. We argue that the dominant trend in the philosophical literature, which characterizes the relationship between black-box and mechanistic approaches to (...) Bayesian cognitive science in terms of the dichotomy between instrumentalism and realism, is misguided. We propose that the two distinctions are orthogonal: black-box and mechanistic approaches to Bayesian modelling can each be given either an instrumentalist or a realist interpretation. We argue that the current tendency to conflate black-box approaches with instrumentalism and mechanistic approaches with realism stems from unwarranted assumptions about the nature of scientific explanation, the ontological commitments of scientific theories, and the role of abstraction and idealization in scientific models. We challenge each of these assumptions to reframe the debates over Bayesian modelling in cognitive science. (shrink)

ABSTRACT:U.S. Organizational Sentencing Guidelines provide firms with incentives to develop formal ethics programs to promote ethical organizational cultures and thereby decrease corporate offenses. Yet critics argue such programs are cosmetic. Here we studied bank employees before and after the introduction of formal ethics training—an important component of formal ethics programs—to examine the effects of training on ethical organizational culture. Two years after a single training session, we find sustained, positive effects on indicators of an ethical organizational culture (observed unethical behavior, (...) intentions to behave ethically, perceptions of organizational efficacy in managing ethics, and the firm’s normative structure). While espoused organizational values also rose in importance post-training, the boost dissipated after the second year which suggests perceptions of values are not driving sustained behavioral improvements. This finding conflicts with past theory which asserts that enduring behavioral improvements arise from the inculcation of organizational values. Implications for future research are discussed. (shrink)

How Do We Reimagine?We reimagine by combining activism with philosophy.... We have to see every crisis as both a danger and an opportunity. It's a danger because it does so much damage to our lives, to our institutions, to all that we have expected. But it's also an opportunity for us to become creative; to become the new kind of people that are needed at such a huge period of transition.—Boggs, "How Do We Reimagine?"this essay seeks to add to the (...) emerging dialogue about the incredibly rich and complex nature of Grace Lee Boggs's philosophic activism by exploring the connections and tensions between her philosophic activism and pragmatist feminism. As an Asian American immigrant with a PhD in philosophy, her... (shrink)

Throughout its long history, mathematics has involved the use ofsystems of written signs, most notably, diagrams in Euclidean geometry and formulae in the symbolic language of arithmetic and algebra in the mathematics of Descartes, Euler, and others. Such systems of signs, I argue, enable one to embody chains of mathematical reasoning. I then show that, properly understood, Frege’s Begriffsschrift or concept-script similarly enables one to write mathematical reasoning. Much as a demonstration in Euclid or in early modern algebra does, a (...) proof in Frege’s concept-script shows how it goes. (shrink)

Images of vulnerability have populated the philosophical landscape from Hobbes to Hegel, Levinas to Foucault, often designating a sense of corporeal susceptibility to injury, or of being threatened or wounded and therefore have been predominantly associated with violence, finitude, or mortality. More recently, feminist theorists such as Judith Butler and Adriana Cavarero have begun to rethink corporeal vulnerability as a critical or ethical category, one based on our primary interdependence and intercorporeality. However, many contemporary theorists continue to associate vulnerability with (...) violence and finitude rather than providing an account of the normative theory that might underpin vulnerability as a critical category. In this article, I explore an alternative notion of vulnerability in relation to both a theory of power and a normative account that draws on recognition theory. My aim in this article is twofold: first, to examine the complexity of vulnerability and how it relates to forms of recognition; second, to outline how the notion of vulnerability can operate as the basis for critiquing objectionable forms of vulnerability. This is to consider vulnerability not only as an ethical or ontological question but as a political one, and shifts arguments about its abuse and entanglement with power and violence to the public political sphere. (shrink)

I apply stigma-management strategies to corporate scandals and expand on past research by (a) describing a particular type ofstigma management strategy that involves accepting responsibility while denying it, (b) delineating types of stigma that occur in scandals (demographic versus character), and (c) considering the moral implications of shifting stigmas that arise from scandals. By emphasizing the distinction between character and demographic stigma, I make progress in evaluating the moral implications of shifting different types of stigma.

ABSTRACT:U.S. Organizational Sentencing Guidelines provide firms with incentives to develop formal ethics programs to promote ethical organizational cultures and thereby decrease corporate offenses. Yet critics argue such programs are cosmetic. Here we studied bank employees before and after the introduction of formal ethics training—an important component of formal ethics programs—to examine the effects of training on ethical organizational culture. Two years after a single training session, we find sustained, positive effects on indicators of an ethical organizational culture (observed unethical behavior, (...) intentions to behave ethically, perceptions of organizational efficacy in managing ethics, and the firm’s normative structure). While espoused organizational values also rose in importance post-training, the boost dissipated after the second year which suggests perceptions of values are not driving sustained behavioral improvements. This finding conflicts with past theory which asserts that enduring behavioral improvements arise from the inculcation of organizational values. Implications for future research are discussed. (shrink)

Rarely have these separate approaches been brought into the same conversation. Education, Justice, and Democracy does just that, offering an intensive discussion by highly respected scholars across empirical and philosophical disciplines.

Danielle Macbeth offers a new account of mathematical practice as a mode of inquiry into objective truth, and argues that understanding the nature of mathematical practice provides us with the resources to develop a radically new conception of ourselves and our capacity for knowledge of objective truth.

This paper aims to provide autonomy-based reasons in favour of limitarianism. Limitarianism affirms it is of primary moral importance that no one gets too much. The paper challenges the standard assumption that having more material resources always increases autonomy. It expounds five mechanisms through which having too much material wealth might undermine autonomy. If these hypotheses are true, a theory of justice guided by a concern for autonomy will support a limitarian distribution of wealth. Finally, the paper discusses two issues (...) autonomy-based limitarianism would raise. First, insofar as coercion invades autonomy, do autonomy-based reasons legitimate coercive measures to secure a limitarian distribution of wealth? Second, is a limitarian ethos consistent with the incentive to produce enough wealth to secure distributive justice? (shrink)

Rankings of countries by perceived corruption have emerged over the past decade as leading indicators of governance and development. Designed to highlight countries that are known to be corrupt, their objective is to encourage transparency and good governance. High rankings on corruption, it is argued, will serve as a strong incentive for reform. The practice of ranking and labeling countries "corrupt," however, may have a perverse effect. Consistent with Social Labeling Theory, we argue that perceptual indices can encourage the loss (...) of needed investment and, thus, contribute to higher rates of corruption within unfavorably ranked countries. In effect, corruption indices may inhibit foreign direct investment, the effect of which is to encourage the status quo in terms of corruption ranking. Using an experimental study design, we test the effects of country corruption rankings on the assessment of country investment desirability and find ranking exposure causes shifts in country investment desirability for 10 of 12 countries studied. These findings suggest that corruption rankings, which are based on perceptions of corruption, may cause country isolation and a reduction in legitimate means of investment. (shrink)

I apply stigma-management strategies to corporate scandals and expand on past research by (a) describing a particular type ofstigma management strategy that involves accepting responsibility while denying it, (b) delineating types of stigma that occur in scandals (demographic versus character), and (c) considering the moral implications of shifting stigmas that arise from scandals. By emphasizing the distinction between character and demographic stigma, I make progress in evaluating the moral implications of shifting different types of stigma.

Over the past two decades, researchers have made great advances in the area of computational methods for extracting meaning from text. This research has to a large extent been spurred by the development of latent semantic analysis (LSA), a method for extracting and representing the meaning of words using statistical computations applied to large corpora of text. Since the advent of LSA, researchers have developed and tested alternative statistical methods designed to detect and analyze meaning in text corpora. This research (...) exemplifies how statistical models of semantics play an important role in our understanding of cognition and contribute to the field of cognitive science. Importantly, these models afford large-scale representations of human knowledge and allow researchers to explore various questions regarding knowledge, discourse processing, text comprehension, and language. This topic includes the latest progress by the leading researchers in the endeavor to go beyond LSA. (shrink)

We present two studies that examine the effects of guanxi on multiple social groups from the perspective of Chinese business people. Study 1 (N = 203) tests the difference in perceived effects of six guanxi contextualizations. Study 2 (N = 195) examines the duality of guanxi as either helpful or harmful to social groups, depending on the contextualization. Findings suggest guanxi may result in positive as well as negative outcomes for focal actors and the aggregate.

The new field of neuroethics has recently emerged following unprecedented developments in the neurosciences. Neuroimaging and cognitive enhancement in particular are demanding ethical debate. For example, neuroscientists are able to measure, with increasing accuracy, intimate personal biases and thoughts as they occur in the brain. Smart drugs are now available that can effectively and safely enhance mental functioning in both healthy and clinical populations. This article describes the scientific principles behind these technologies, and urges the development of ethical principles based (...) on a clear understanding of them. Europe should take the United States’ lead in devoting resources specifically intended to examine neuroethical concerns within European healthcare and legal frameworks. (shrink)

Advances in medicine in the latter half of the twentieth century have dramatically altered human bodies, expanding choices around what we do with them and how they connect to other bodies. Nowhere is this more so than in the area of reproductive technologies. Reproductive medicine and the laws surrounding it in the UK have reconfigured traditional boundaries surrounding parenthood and the family. Yet culture and regulation surrounding RTs have combined to try to ensure that while traditional boundaries may be pushed, (...) they are reconstructed in similar ways. This paper looks at the most recent RT to be permitted in the UK, mitochondria replacement therapy. Despite controversial media headlines surrounding the technique, MRT is in fact an example of how science and regulation seek to expand models of traditional relatedness in a way that doesn’t challenge the existing order. Yet, like other RTs, while attempts are made to ensure it doesn’t push traditional boundaries too far, fissures and inconsistencies appear in law and culture, which give interesting insights into how genetics, parentage and identity are being mediated in new but familiar ways. (shrink)

Most regulations and guidelines require that potential research participants be told a great deal of information during the consent process. Many of these documents, and most of the scholars who consider the consent process, assume that all this information must be disclosed because it must all be understood. However, a wide range of studies surveying apparently competent participants in clinical trials around the world show that many do not understand key aspects of what they have been told. The standard view (...) of the conditions for valid consent therefore implies that these people have failed to give valid consent to research participation. In this paper we argue that the standard view is false. The primary function of the requirement that researchers disclose information about a study is the avoidance of illegitimate control over someone’s consent decision, which is a form of fraud.We derive the content and manner of appropriate disclosure by analysing the ways in which the manipulation of information can invalidate consent. Our analysis shows that the informational requirements for valid consent are conceptually distinct and thus unlikely to have identical contents. This implies that consent can be valid when not everything that ought to be disclosed by the person asking for consent is understood by the person who proffers it. (shrink)

_Axel Honneth: Critical Essays_ brings together critical interpretations of the work of Axel Honneth, from his earliest to his most recent writings, together with a comprehensive reply by Honneth that provides significant insights and clarifications into his project overall.

Most regulations and guidelines require that potential research participants be told a great deal of information during the consent process. Many of these documents, and most of the scholars who consider the consent process, assume that all this information must be disclosed because it must all be understood. However, a wide range of studies surveying apparently competent participants in clinical trials around the world show that many do not understand key aspects of what they have been told. The standard view (...) of the conditions for valid consent therefore implies that these people have failed to give valid consent to research participation. In this paper we argue that the standard view is false. The primary function of the requirement that researchers disclose information about a study is the avoidance of illegitimate control over someone’s consent decision, which is a form of fraud.We derive the content and manner of appropriate disclosure by analysing the ways in which the manipulation of information can invalidate consent. Our analysis shows that the informational requirements for valid consent are conceptually distinct and thus unlikely to have identical contents. This implies that consent can be valid when not everything that ought to be disclosed by the person asking for consent is understood by the person who proffers it. (shrink)

To attain individual morality in an age demanding social morality, to pride oneself on the results of personal effort when the time demands social adjustment, is utterly to fail to apprehend the situation.melioration of most social problems today—problems like health care and environmental justice—requires a feminist pragmatist methodology1 because many of these problems are not only dynamically complex, but inherently wicked. That is, many of our social problems today are characterized by intense disagreement between fragmented stakeholders, multiple and often conflicting (...) objectives, as well as high levels of uncertainty, variability, and risk. While the burgeoning field of wicked problems implicitly relies on a .. (shrink)