The COVID-19 pandemic laid bare systemic inequities shaped by social determinants of health (SDoH). Public health agencies, legislators, health systems, and community organizations took notice, and there is currently unprecedented interest in identifying and implementing programs to address SDoH. This special issue focuses on the role of medical-legal partnerships (MLPs) in addressing SDoH and racial and social inequities, as well as the need to support these efforts with evidence-based research, data, and meaningful partnerships and funding.

The coronavirus disease-2019 (COVID-19) has caused shortages of life-sustaining medical resources, and future waves of the virus may cause further scarcity. The Yale New Haven Health System developed a triage protocol to allocate scarce medical resources during the COVID-19 pandemic, with the primary goal of saving the most lives possible, and a secondary goal of making triage assessments and decisions consistent, transparent, and fair. We outline the process of developing the protocol, summarize the protocol, and discuss the major ethical challenges (...) encountered, along with our answers to the challenges. These challenges include (1) the role of age and chronic comorbidities; (2) evaluating children and pregnant patients; (3) racial, ethnic, and socioeconomic disparities in health; (4) prioritization of healthcare workers; and (5) balancing clinical judgment versus protocolized assessments.We conclude with a review of the limitations of our protocol and the lessons learned. We hope that a robust public discussion of such protocols and the ethical challenges they raise will result in the fairest possible processes, less need for triage, and more lives saved during future waves of the pandemic and similar public health emergencies. (shrink)

Shortages of life-saving medical resources caused by COVID-19 have prompted hospitals, healthcare systems, and governmentsto develop crisis standards of care, including 'triage protocols' to potentially ration medical supplies during the public health emergency. At the same time, the pandemic has highlighted and exacerbated racial, ethnic, and socioeconomic health disparities that together constitute a form of structural racism. These disparities pose a critical ethical challenge in developing fair triage systems that will maximize lives saved without perpetuating systemic inequities. Here we review (...) alternatives to 'utilitarian' triage, including first-come first-served, egalitarian, and prioritarian systems of allocating scarce medical resources. We assess the comparative advantages and disadvantages of these allocation schemes. Ultimately, we argue that while triage protocols should not exacerbate disparities, they are not an adequate mechanism for redressing systemic health inequities. Entrenched health disparities must be addressed through broader social change. (shrink)

This article examines five different Medical-Legal Partnerships associated with Yale Law School in New Haven, Connecticut to illustrate how MLP addresses the social determinants of poor health. These MLPs address varied and distinct health and legal needs of unique patient populations, including: 1) children; 2) immigrants; 3) formerly incarcerated individuals; 4) patients with cancer in palliative care; and 5) veterans. The article charts a research agenda to create the evidence base for quality and evaluation metrics, capacity building, sustainability, and best (...) practices; it also focuses specifically on a research agenda that identifies the value of the lawyers in MLP. Such a focus on the “L” has been lacking and is overdue. (shrink)

Firearm injury in the United States is a public health crisis in which physicians are uniquely situated to intervene. However, their ability to mitigate harm is limited by a complex array of laws and regulations that shape their role in firearm injury prevention. This piece uses four clinical scenarios to illustrate how these laws and regulations impact physician practice, including patient counseling, injury reporting, and the use of court orders and involuntary holds. Unintended consequences on clinical practice of laws intended (...) to reduce firearm injury are also discussed. Lessons drawn from these cases suggest that physicians require more nuanced education on this topic, and that policymakers should consult front-line healthcare providers when designing firearm policies. (shrink)

In our article, we share the lessons we have learned after creating and running a successful legal laboratory over the past seven years at Yale Law School. Our legal laboratory, which focuses on the intersection of law and severe brain injury, represents a unique pedagogical model for legal academia, and is closely influenced by the biomedical laboratory.

Physicians play a critical role in preventing and treating firearm injury, although the scope of that role remains contentious and lacks systematic definition. This piece aims to utilize the fundamental principles of medical ethics to present a framework for physician involvement in firearm violence. Physicians' agency relationship with their patients creates ethical obligations grounded on three principles of medical ethics — patient autonomy, beneficence, and nonmaleficence. Taken together, they suggest that physicians ought to engage in clinical screening and treatment related (...) to firearm violence. The principle of beneficence also applies more generally, but more weakly, to relations between physicians and society, creating nonobligatory moral ideals. Balanced against physicians' primary obligations to patient agency relationships, general beneficence suggests that physicians may engage in public advocacy to address gun violence, although they are not ethically obligated to do so. A fourth foundational principle — justice — requires that clinicians attempt to ensure that the benefits and burdens of healthcare are distributed fairly. (shrink)

We articulate a view of natural kinds as complex universals. We do not attempt to argue for the existence of universals. Instead, we argue that, given the existence of universals, and of natural kinds, the latter can be understood in terms of the former, and that this provides a rich, flexible framework within which to discuss issues of indeterminacy, essentialism, induction, and reduction. Along the way, we develop a 'problem of the many' for universals.

Can human beings be free and responsible if there is an all-powerful God? Anselm of Canterbury offers viable answers to questions which have plagued religious people for at least two thousand years. Katherin Rogers examines Anselm's reconciliation of human free will and divine omnipotence in the context of current philosophical debates.

Introduction -- Anselm's classical theism -- The Augustinian legacy -- The purpose, definition, and structure of free choice -- Alternative possibilities and primary agency -- The causes of sin and the intelligibility problem -- Creaturely freedom and God as Creator Omnium -- Grace and free will -- Foreknowledge, freedom, and eternity : part I, the problem and historical background -- Foreknowledge, freedom, and eternity : part II, Anselm's solution -- The freedom of God.

Abstract In this paper I suggest a way that an already promising view on ethical art criticism can account for the value of mediocre artworks which endorse morally commendable perspectives. In order for the view I call prescriptive ethicism to deal with such cases of critical ambivalence, it must take account of the interaction between moral content and form in art. Such interaction is seen in the way the aesthetic features of an artwork partly determine its moral value, or success (...) in providing ethical insight. I argue that if a work lacks the kind of moral value which is determined by the interaction between form and content, then we have little reason to engage with that work. When a work expresses an otherwise commendable moral attitude in a clumsy or trite manner, while it is clearly compromised aesthetically, it is also compromised ethically. For such a work forfeits the ability to reveal new aspects of ethical life. (shrink)

Gatekeeping, or determining membership of your group, is crucial to science: the moniker ‘scientific’ is a stamp of epistemic quality or even authority. But gatekeeping in science is fraught with dangers. Gatekeepers must exclude bad science, science fraud and pseudoscience, while including the disagreeing viewpoints on which science thrives. This is a difficult tightrope, not least because gatekeeping is a human matter and can be influenced by biases such as groupthink. After spelling out these general tensions around gatekeeping in science, (...) we shed light on them with a case study from psychology. This concerns whether academic psychologists rightly or wrongly classify the applied-psychology framework of NLP (‘neuro-linguistic programming’) as unscientific and even pseudoscientific. This example of gatekeeping is particularly instructive because both the NLP community and the psychology community, we argue, make legitimate but also illegitimate moves. This case gives rise to several general insights about gatekeeping in science more generally. (shrink)

This is a very introductory introduction to some ways in which the special and general theories of relativity may bear upon metaphysical questions about the nature of time and space, and the persistence of objects.

Accessible and elegant teachings from a well-loved and revered woman Zen teacher. “The truth and joy of this life is that we cannot change things as they are.” The import of those words can be found beautifully expressed in the work of the woman who spoke them, Katherine Thanas (1927–2012)—in her art, in her writing, and especially in her Zen teaching. Fearlessly direct and endlessly curious, Katherine’s understanding of Zen was inseparable from her affinity for the arts. She (...) was an MFA student studying painting with Richard Diebenkorn, the preeminent Californian abstract painter, when she met Shunryu Suzuki, author of Zen Mind, Beginner’s Mind, in the sixties. Soon thereafter she decided to drop painting to dedicate herself to Zen, which she did for the last forty years of her life. In these essential teachings taken from her dharma talks—which make up her only book—her love of art and literature shine through in her elegant prose and her vast references, from poets William Stafford and Naomi Shihab Nye to the Zen teachings of Dogen and Robert Aitken. Ranging on subjects from the practice of zazen to the meaning of life, Katherine urges us to “develop an insatiable appetite for inner awareness, to become proficient with this mind.” This slim volume is an important contribution by a well-loved and revered teacher. (shrink)

Learn to be responsible with Grover and your Sesame Street friends! Young readers will discover how to be a good helper to both themselves and those around them. Now in Spanish!

Critical Notice on Organizations as Wrongdoers By Stephanie Collins Oxford University Press, 2023. -/- Extract: What, if any, role does metaphysics have to play in addressing moral questions? When answering questions about moral responsibility, many theories rely on answers to questions about the nature of agency and agents, the persistence of persons and the existence and nature of free will. In recent work in social ontology, philosophers have argued for views of social categories or identities that take ethical and social–political (...) desiderata into consideration in several ways. Some argue for views of gender identities that depend on epistemic and ethical considerations (Bettcher, 2009). Others develop views of gender categories in ways they take to be metaphysically realist, tracking robust explanatory patterns in the world. For instance, Barnes (2017) argues for this interpretation of Haslanger’s views of racial and gender categories. Others argue that injustice and oppression are reflected in the nature of social categories. For instance, while it ought not to be this way, some gender categories are, for instance, trans-exclusionary (Ásta 2018). Indeed, one might even argue that social categories can involve a distinctively metaphysical form of oppression (Jenkins 2020, 2023). It is clear that many philosophers argue in ways that draw close connections between metaphysical and moral theorizing. ... (shrink)

Altruism is a well-studied phenomenon in the social sciences, but online altruism has received relatively little attention. In this article, we examine several cases of online altruism, and analyse the key characteristics of the phenomenon, in particular comparing and contrasting it against models of traditional donor behaviour. We suggest a novel definition of online altruism, and provide an in-depth, mixed-method study of a significant case, represented by the r/Assistance subreddit. We argue that online altruism can be characterized by its differing (...) experiences compared to traditional giving, from a giver’s point of view, and unique mechanisms and actions made possible by the internet. These findings explain why people give to anonymous strangers online and provide a new perspective on altruism that is important in building a more altruistic internet and society. (shrink)

This is a short response to Aaron Cotnoir's 'Composition as General Identity', in which I suggest some further applications of his ideas, and try to press the question of why we should think of his 'general identity relation' as a genuine identity relation.

In this chapter I outline some metaphysical views about time, and about persistence, and discuss how they can help us clarify our thinking about life and death.

The main goal of publicly funded biomedical research is to generate social value through the creation and application of knowledge that can improve the well-being of current and future people. Prioritising research with the greatest potential social value is crucial for good stewardship of limited public resources and ensuring ethical involvement of research participants. At the National Institutes of Health (NIH), peer reviewers hold the expertise and responsibility for social value assessment and resulting prioritisation at the project level. However, previous (...) research has shown that peer reviewers place more emphasis on a study’s methods (‘Approach’) than on its potential social value (best approximated by the criterion of ‘Significance’). Lower weighting of Significance may be due to reviewers’ views on the relative importance of social value, their belief that social value is evaluated at other stages of the research priority-setting process or the lack of guidance on how to approach the challenging task of assessing expected social value. The NIH is currently revising its review criteria and how these criteria contribute to overall scores. To elevate the role of social value in priority setting, the agency should support empirical research on how peer reviewers approach the assessment of social value, provide more specific guidance for reviewing social value and experiment with alternative reviewer assignment strategies. These recommendations would help ensure that funding priorities align with the NIH’s mission and the obligation of taxpayer-funded research to contribute to the public good. (shrink)

Dialogue, as a philosophical form, enables the exploration of the conditions, limits, and consequences of understanding arguments. Two philosophers who undertook to write dialogues—Plato and Heidegger—feature moments in philosophical conversation in which understanding, on its own, fails to convince an interlocutor of an argument. In this article, I examine the philosophical stakes of the collisions which unfold in Plato’s Gorgias, between Socrates and Callicles, and in Heidegger’s “Triadic Conversation,” between the Guide and the Scientist. Plato’s Socrates is ostensibly unsuccessful in (...) persuading Callicles to adopt his position while Heidegger’s Guide is able to support the Scientist in learning a new way of thinking. I argue that it is Heidegger’s attention to feeling as a philosophically significant phenomenon which can overcome trans-rational resistance which may persist even after truth has been determined. (shrink)

Unlike most fiction writers, Proust was trained in philosophy. In fact, he even considered writing a philosophical treatise instead of the novel we know so well. This hesitation about what form his writing should take still haunts his final choice of a novel, which is both philosophical, and yet, not philosophy. Take your pick of philosophers, from Plato to Nietzsche, and you can easily find an essay or even a book arguing that this particular philosopher most applies to Proust. But (...) as one plunges into the narrative that he finally wrote, one is struck by the fact that In Search of Lost Time feels nothing like what we often call a philosophical novel, or even, a novel of ideas. Instead, philosophical reflection lies in the shadows of his fictional world, a sort of parallel life that can be found in the underweave. (shrink)

The lifeworld of the classroom -- Getting deep : the integrative biology of teaching and learning -- Preparation for teaching : "what can they experience in class?" -- Teaching as improvisational jazz : "to go somewhere to answer a big question" -- Free to learn : a radical aspect of our approach -- Student experiences of other students : "all together in this space" -- Transcending the classroom : student reports of personal and professional change -- Messing up and messing (...) about : student needs and teachers' adaptation of our phenomenological approach -- The contribution of our existential phenomenological approach to higher education pedagogy : implications for theory, research, and practice. (shrink)

Over the past two decades, stories of world-ending catastrophe have featured prominently in film and television. Zombie apocalypses, climate disasters, alien invasions, global pandemics and dystopian world orders fill our screens-typically with a singular figure or tenacious group tasked with saving or salvaging the world. Why are stories of End Times crisis so popular with audiences? And why is the hero so often a white man who overcomes personal struggles and incredible obstacles to lead humanity toward a restored future? This (...) book examines the familiar trope of the hero and the recasting of contemporary anxieties in narratives like The Walking Dead, Snowpiercer and Mad Max: Fury Road. Some have familiar roots in Western cultural traditions yet many question popular assumptions about heroes and heroism to tell new and fascinating stories about race, gender and society and the power of individuals to change the world. (shrink)

How do things persist? Are material objects spread out through time just as they are spread out through space? Or is temporal persistence quite different from spatial extension? This key question lies at the heart of any metaphysical exploration of the material world, and it plays a crucial part in debates about personal identity and survival. This book explores and compares three theories of persistence — endurance, perdurance, and stage theories — investigating the ways in which they attempt to account (...) for the world around us. Having provided valuable clarification of its two main rivals, the book concludes by advocating stage theory. Such a basic issue about the nature of the physical world naturally has close ties with other central philosophical problems. This book includes discussions of change and parthood, of how we refer to material objects at different times, of the doctrine of Humean supervenience, and of the modal features of material things. In particular, it contains new accounts of the nature of worldly vagueness, and of what binds material things together over time, distinguishing the career of a natural object from an arbitrary sequence of events. Each chapter concludes with a reflection about the impact of these metaphysical debates upon questions about our personal identity and survival. (shrink)

Stereotypes sometimes lead us to make poor judgements of other people, but they also have the potential to facilitate quick, efficient, and accurate judgements. How can we discern whether any individual act of stereotyping will have the positive or negative effect? How Stereotypes Deceive Us addresses this question. It identifies various factors that determine whether or not the application of a stereotype to an individual in a specific context will facilitate or impede correct judgements and perceptions of the individual. It (...) challenges the thought that stereotyping only and always impedes correct judgement when the stereotypes that are applied are inaccurate, failing to reflect social realities. It argues instead that stereotypes that reflect social realities can lead to misperceptions and misjudgements, and that inaccurate but egalitarian social attitudes can therefore facilitate correct judgements and accurate perceptions. The arguments presented in this book have important implications for those who might engage in stereotyping and those who are at risk of being stereotyped. They have implications for those who work in healthcare and those who have mental health conditions. How Stereotypes Deceive Us provides a new conceptual framework-evaluative dispositionalism-that captures the epistemic faults of stereotypes and stereotyping, providing conceptual resources that can be used to improve our own thinking by avoiding the pitfalls of stereotyping, and to challenge other people's stereotyping where it is likely to lead to misperception and misjudgement. (shrink)

Although the principle of fair subject selection is a widely recognized requirement of ethical clinical research, it often yields conflicting imperatives, thus raising major ethical dilemmas regarding participant selection. In this paper, we diagnose the source of this problem, arguing that the principle of fair subject selection is best understood as a bundle of four distinct sub-principles, each with normative force and each yielding distinct imperatives: (1) fair inclusion; (2) fair burden sharing; (3) fair opportunity; and (4) fair distribution of (...) third-party risks. We first map out these distinct sub-principles, and then identify the ways in which they yield conflicting imperatives for the design of inclusion and exclusion criteria, and the recruitment of participants. We then offer guidance for how decision makers should navigate these conflicting imperatives to ensure that participants are selected fairly. (shrink)

This chapter contains section titled: The ‘Essence’ of a Philosophical Prejudice One Philosophical Task or Two? Techniques for Ridding People of Philosophical Prejudices.

A who's who of Sartre scholars contribute to a collection of multidisciplinary perspectives from sociology, religion, and bioethics, on a hitherto neglected area of Sartre's philosophy.

Social groups—like teams, committees, gender groups, and racial groups—play a central role in our lives and in philosophical inquiry. Here I develop and motivate a structuralist ontology of social groups centered on social structures (i.e., networks of relations that are constitutively dependent on social factors). The view delivers a picture that encompasses a diverse range of social groups, while maintaining important metaphysical and normative distinctions between groups of different kinds. It also meets the constraint that not every arbitrary collection of (...) people is a social group. In addition, the framework provides resources for developing a broader structuralist view in social ontology. (shrink)

Introduction to Kristeva -- Horror/basic concepts: the abject and its varieties -- Horror/specifying the circumstances -- Strangers/basic concepts: strangers without and within -- Strangers/expansions: the stranger's story -- Love/basic concepts -- Love/basic concepts the text of society and history -- Love/ Expansions: Old and new discourses -- The text of society and history -- Women and social change.

Social groups, including racial and gender groups and teams and committees, seem to play an important role in our world. This article examines key metaphysical questions regarding groups. I examine answers to the question ‘Do groups exist?’ I argue that worries about puzzles of composition, motivations to accept methodological individualism, and a rejection of Racialism support a negative answer to the question. An affirmative answer is supported by arguments that groups are efficacious, indispensible to our best theories, and accepted given (...) common sense. Then, I turn to an examination of the features of social groups. I argue that social groups can be divided into two sorts. Groups of Type 1 are organized social groups like courts and clubs. Groups of Type 2 are groups like Blacks, women, and lesbians. While groups of both sorts have some features in common, they also have marked differences in features. Finally, I turn to views of the nature of social groups. I argue that the difference in features provides evidence that social groups do not have a uniform nature. Teams and committees are structured wholes, while race and gender groups are social kinds. (shrink)

It has been argued that humans can face an ethical/epistemic dilemma over the automatic stereotyping involved in implicit bias: ethical demands require that we consistently treat people equally, as equally likely to possess certain traits, but if our aim is knowledge or understanding our responses should reflect social inequalities meaning that members of certain social groups are statistically more likely than others to possess particular features. I use psychological research to argue that often the best choice from the epistemic perspective (...) is the same as the best choice from the ethical perspective: to avoid automatic stereotyping even when this involves failing to reflect social realities in our judgements. This argument has an important implication: it shows that it is not possible to successfully defend an act of automatic stereotyping simply on the basis that the stereotype reflects an aspect of social reality. An act of automatic stereotyping can be poor from an epistemic perspective even if the stereotype that is activated reflects reality. (shrink)

In this paper I argue for a view of groups, things like teams, committees, clubs and courts. I begin by examining features all groups seem to share. I formulate a list of six features of groups that serve as criteria any adequate theory of groups must capture. Next, I examine four of the most prominent views of groups currently on offer—that groups are non-singular pluralities, fusions, aggregates and sets. I argue that each fails to capture one or more of the (...) criteria. Last, I develop a view of groups as realizations of structures. The view has two components. First, groups are entities with structure. Second, since groups are concreta, they exist only when a group structure is realized. A structure is realized when each of its functionally defined nodes or places are occupied. I show how such a view captures the six criteria for groups, which no other view of groups adequately does, while offering a substantive answer to the question, “What are groups?”. (shrink)