Regulations implemented by World Athletics (WA) require female athletes with differences of sexual development to suppress their blood testosterone levels in order to participate in certain women’s sporting competitions. These regulations have been justified by reference to fairness. In this paper, we reconstruct WA’s understanding of fairness, which requires a “level playing field” where no athlete should have a significant performance advantage based on factors other than talent, dedication, and hard work over an average athlete in their category. We demonstrate (...) that by placing regulations only on testosterone levels, while ignoring physical as well as socioeconomic advantages, WA consistently fails to meet its own definition of fairness. We then discuss several ways in which this definition could be met. Our analysis shows that a categorical system, in which athletes are divided into categories based on properties leading to significant performance advantages, is best suited for meeting WA’s definition of fairness. (shrink)

In mental health ethics, it is generally assumed that coercive measures are sometimes justified when persons with mental illness endanger themselves or others. Coercive measures are regarded as ethically justified only when certain criteria are fulfilled: for example, the intervention must be proportional in relation to the potential harm. In this paper, we demonstrate shortcomings of this established ethical framework in cases where people with mental illness experience structural racism. By drawing on a case example from mental healthcare, we first (...) demonstrate that biases in assessing whether the coercive intervention is proportional are likely, for example, due to an overestimation of dangerousness. We then show that even if proportionality is assessed correctly, and the specific coercive intervention would thus be regarded as ethically justified according to the standard framework, coercion may still be ethically problematic. This is because the standard framework does not consider how situations in which coercive measures are applied arise. If structural racism causally contributes to such situations, the use of coercion can compound the prior injustice of racist discrimination. We conclude that the ethical analysis of coercion in mental healthcare should consider the possibility of discriminatory biases and practices and systematically take the influence of structural discrimination into account. (shrink)

In a recent article, Wilkinson puts forward the notion of identity-relative paternalism. According to Wilkinson’s final formulation of this principle, ‘[i]ndividuals should be prevented from doing to future selves (where there are weakened prudential unity relations between the current and future self) what it would be justified to prevent them from doing to others’.1 In medical ethics, it is usually assumed that hard paternalism, that is, acting against a competent person’s wishes for their own benefit, is not justified. According to (...) Mill’s harm principle, we may only limit people’s freedom if they cause harm to others.2 Harm to self is not a sufficient reason for overriding competent persons’ decisions. Wilkinson, however, draws on Parfit’s reductionist view of personal identity to argue that sometimes, patients’ future selves are sufficiently disconnected from their present selves to treat future selves like different persons. If a competent person’s medical decision negatively affects a future self, this should be treated like a case of harm to others. Thus, overriding competent persons’ decisions in such cases—and treating them against their will—could be justified. In this commentary, I point out two problems with this approach. First, I demonstrate that the cases Wilkinson’s argument is based on are not examples of harm to others but rather cases of surrogate decision making gone wrong, …. (shrink)

In several jurisdictions, irremediable suffering from a medical condition is a legal requirement for access to assisted dying. According to the expressivist objection, allowing assisted dying for a specific group of persons, such as those with irremediable medical conditions, expresses the judgment that their lives are not worth living. While the expressivist objection has often been used to argue that assisted dying should not be legalised, I show that there is an alternative solution available to its proponents. An autonomy-based approach (...) to assisted suicide regards the provision of assisted suicide (but not euthanasia) as justified when it is autonomously requested by a person, irrespective of whether this is in her best interests. Such an approach has been put forward by a recent judgment of the German Federal Constitutional Court, which understands assisted suicide as an expression of the person’s right to a self-determined death. It does not allow for beneficence-based restrictions regarding the person’s suffering or medical diagnosis and therefore avoids the expressivist objection. I argue that on an autonomy-based approach, assisted suicide should not be understood as a medical procedure but rather as the person’s autonomous action. (shrink)

Crutchfield and Redinger (2024) propose that the use of a chemical restraint that affects only a particular conscious state is ethically permissible if, and only if, (1) it is the least restrictive...

Treatment pressures are communicative strategies that mental health professionals use to influence the decision-making of mental health service users and improve their adherence to recommended treatment. Szmukler and Appelbaum describe a spectrum of treatment pressures, which encompasses persuasion, interpersonal leverage, offers and threats, arguing that only a particular type of threat amounts to informal coercion. We contend that this account of informal coercion is insufficiently sensitive to context and fails to recognize the fundamental power imbalance in mental healthcare. Based on (...) a set of counterexamples, we argue that what makes a proposal coercive is not whether service users will actually be made worse off if they reject the proposal, but rather whether they have the justified belief that this is the case. Whether this belief is justified depends on the presence of certain contextual factors, such as strong dependency on professionals and the salient possibility of formal coercion. (shrink)

According to the “discrimination argument,” it would be discriminatory and hence impermissible to categorically exclude people with mental illness (PMI) from access to assisted suicide (AS) if AS is accessible to people with somatic illnesses. In objection to this, it could be argued that excluding PMI is not discriminatory, but rather based on their inability to meet certain eligibility criteria for AS. Which criteria are deemed necessary depends on the approach taken to justifying AS. In this article, we describe two (...) distinct ethical approaches to justifying AS and the eligibility criteria they entail and examine whether PMI can fulfill these criteria. A widespread “joint” approach based on beneficence and autonomy assumes that AS is justified when it alleviates the severe and irremediable suffering of a person who autonomously requests AS. An alternative, exclusively autonomy‐based approach assumes that providing AS is justified when a person's request is autonomous, regardless of whether AS is in her best interests. The latter approach underlies an important judgment of the German Federal Constitutional Court from 2020. We argue that PMI can in principle fulfill both beneficence‐ and autonomy‐based eligibility criteria for AS, and that a blanket exclusion of all PMI from AS is thus discriminatory on either approach. However, depending on which approach is taken, there are differences regarding the subgroups of PMI that would be eligible for AS. Whether the exclusion of specific PMI is discriminatory therefore depends on how we understand and justify AS. (shrink)

Mitochondrial replacement techniques (MRTs) usually aim to prevent the genetic transmission of maternally inherited mitochondrial diseases. Until now, only the UK and Australia have implemented specific legal regulations of MRTs. In both countries, clinical trials on these techniques are only permissible for cases with a high risk of severe mitochondrial disease in the offspring. However, these techniques can also be applied to treat infertility, especially for older women with impaired oocyte quality. In some countries without legal regulation of these techniques, (...) MRTs are already offered for this purpose. Yet, this application of MRTs has received insufficient attention in the bioethical literature so far.In this paper, I examine whether there are ethical reasons to prohibit trials on MRTs in the context of infertility when they are permitted for preventing mitochondrial disease. Allowing MRTs in one context but not the other might be justified either because their application in the context of mitochondrial disease (1) is supported by a more convincing evidence base, (2) has a higher potential benefit or (3) has a lower risk. I compare both applications of MRTs with respect to these three factors. I conclude that there is no convincing reason to prohibit clinical trials on MRTs for infertility when they are permitted in the context of mitochondrial disease. (shrink)

In a compelling article, Peterson, Karlawish and Largent argue that supported decision-making is preferable to substitute decision-making for people with dynamic impairments. We fully...

Definition of the problem The reform of German guardianship law coming into force in 2023 will remove the term “well-being” from the law. This is intended to emphasise that the legal guardian should be guided by the subjective wishes of the person rather than by an objective understanding of well-being. This article analyses the understanding of well-being underlying the reformed guardianship law in comparison to common conceptions of well-being in philosophy and medical ethics, aiming to promote interdisciplinary understanding between ethics (...) and law. Arguments The justification for the reform emphasises that the law is based on a subjective understanding of well-being. However, this understanding does not correspond to philosophical subjective theories of well-being, according to which only things that a person desires can contribute to her well-being. In contrast, the guardianship law assumes that the fulfilment of certain wishes can lead to objective harm to the person and thus impair her well-being. Negative consequences for the objective well-being of a person are only relevant insofar as they indicate a limit to following current wishes that are based on a natural will and are not an expression of self-determination. Conclusion While the term “well-being” is removed from reformed guardianship law, the law implicitly contains an understanding of well-being comparable to a hybrid conception of well-being from a medical ethics perspective. According to this conception, fulfilment of a person’s wishes generally contributes to her well-being, although certain objective criteria are also taken into consideration. (shrink)

Definition of the problem The reform of German guardianship law coming into force in 2023 will remove the term “well-being” from the law. This is intended to emphasise that the legal guardian should be guided by the subjective wishes of the person rather than by an objective understanding of well-being. This article analyses the understanding of well-being underlying the reformed guardianship law in comparison to common conceptions of well-being in philosophy and medical ethics, aiming to promote interdisciplinary understanding between ethics (...) and law. Arguments The justification for the reform emphasises that the law is based on a subjective understanding of well-being. However, this understanding does not correspond to philosophical subjective theories of well-being, according to which only things that a person desires can contribute to her well-being. In contrast, the guardianship law assumes that the fulfilment of certain wishes can lead to objective harm to the person and thus impair her well-being. Negative consequences for the objective well-being of a person are only relevant insofar as they indicate a limit to following current wishes that are based on a natural will and are not an expression of self-determination. Conclusion While the term “well-being” is removed from reformed guardianship law, the law implicitly contains an understanding of well-being comparable to a hybrid conception of well-being from a medical ethics perspective. According to this conception, fulfilment of a person’s wishes generally contributes to her well-being, although certain objective criteria are also taken into consideration. (shrink)

Florijn’s analysis of the Dutch Supreme Court ruling on the Albert Heringa case demonstrates that the Dutch approach to justifying physician-assisted death is based primarily on the physician...

Festschrift with papers by Stephan Otto, Michel Malherbe, Jean-Marie Pousseur, Wolfgang Bartuschat, Rita Widmaier, Franco Volpi, Guiseppe Micheli, Han-ding Hong, Esther Seidel, Gregorio Piaia, Mario Longo, Larry Steindler, Ulrich Charpa, Anne Mylott, Rudolf A. Makkreel, Frederick Gregory, Lucien Braun and Hardy Boullion. - The three parts of the book are related to the categories Metaphysics and History of Ideas, Cultural Identities in History of Philosophy, and Hermeneutics and Philosophy of Science.

Indexicals are linguistic expressions whose reference shifts from context to context: some paradigm examples are ‘I’, ‘here’, ‘now’, ‘today’,‘he’, ‘she’, and ‘that’. Two speakers who utter a single sentence that contains an indexical may say different things. For instance, Fred and Wilma say different things when they utter the sentence ‘I am female’. Many philosophers (following David Kaplan 1989a) hold that indexicals have two sorts of meaning. The first sort of meaning is often called ‘character’ or ‘linguistic meaning’; the second (...) sort is often called ‘content’. Using this terminology, we can say that the word ‘I’ has a single character (or linguistic meaning), but has different contents in different contexts. (shrink)

This chapter surveys essentialist and anti-essentialist theories of sex and gender. It does so by engaging three approaches to sex and gender: externalism, internalism, and contextualism. The chapter also draws attention to two key debates about sex and gender in the feminist literature: the debate about the sex/gender distinction (the distinction debate) and the debate about whether sex and gender have essences (the essentialism/anti-essentialism debate). In addition, it describes three problems that theories of sex and gender tend to face: the (...) Inclusion Problem, the Definition Problem, and the Exclusion Problem. Lastly, the chapter highlights why the division between essentialist and anti-essentialist accounts of sex and gender is not clear. (shrink)

Many competent speakers initially judge that (i) is true and (ii) isfalse, though they know that (iii) is true. (i) Superman leaps more tallbuildings than Clark Kent. (ii) Superman leaps more tall buildings thanSuperman. (iii) Superman is identical with Clark Kent. Semanticexplanations of these intuitions say that (i) and (ii) really can differin truth-value. Pragmatic explanations deny this, and say that theintuitions are due to misleading implicatures. This paper argues thatboth explanations are incorrect. (i) and (ii) cannot differ intruth-value, yet (...) the intuitions are not due to implicatures, but ratherto mistakes in evaluating (i) and (ii). (shrink)

Successful trust-relations exist if the trustee reciprocates in accordance with his/her promises to the trustor’s unilateral cooperation. Using a parametric rational choice approach, Coleman shows that an egoist without a moral conscience may place trust in another unmoral egoist. Consequently, successful trust-relations between those actors are possible if strategic considerations play no role for individual decision-making. This paper focusses on such considerations for the emergence of those relations, given complete information (in the sense of common knowledge) of the players. Generally, (...) trust-relations are hard to establish if unmoral egoists take into account their strategic interdependence. It is shown that two different motivations of the trustee, viz., altruism and morality, may suffice to overcome the characteristic conflict between individual rationality and social efficiency in situations with strategically deciding actors. (shrink)

I modify Grice's theory of conversational implicature so as to accommodate acts of implicating propositions by asking questions, acts of implicating questions by asserting propositions, and acts of implicating questions by asking questions. I describe the relations between a declarative sentence's semantic content (the proposition it semantically expresses), on the one hand, and the propositions that a speaker locutes, asserts, and implicates by uttering that sentence, on the other. I discuss analogous relations between an interrogative sentence's semantic content (the question (...) it semantically expresses), and the questions that a speaker locutes, asks, and implicates by uttering that sentence. (shrink)

This essay investigates the change in the Catholic attitude toward nuclear weapons as articulated by Pope Francis. Francis has generally followed the position of his immediate predecessors with regard to the Catholic teaching on just war. While the resort to armed force remains a morally justifiable option if the principles of just war have been met, the pope forcefully emphasises the tools of nonviolent peacebuilding. Recently, however, Francis made an original just war argument when he broke with the Church’s established (...) position on nuclear weapons. The pope declared both the use and possession of nuclear weapons “immoral” and, thus, abandoned the Church’s reluctant acceptance of nuclear deterrence that had survived the end of the Cold War. In this essay, I analyse the rationale behind Francis’s decision to break with nuclear deterrence, which is mainly grounded in the disillusionment about the failed promise of nuclear disarmament. Furthermore, I assess the impact of the new position with regard to Catholic soldiers serving in nuclear armed militaries. (shrink)

Notion complexe et problématique objet de crainte et de crispation, la stásis renvoie tout autant à la discorde, à la sédition, à la guerre civile, qu'à la division. Loin de lire dans cette équivocité le signe de son indétermination, cette enquête se propose de mettre en lumière l'unité et la cohérence de ce concept dans la philosophie pratique d'Aristote. Sans être banalisée, comment la stásis devient-elle le corrélat direct et explicite de la cité? En quel sens la théorie aristotélicienne rompt-elle (...) avec la tradition grecque, pour laquelle la stásis, figure du mal absolu, constituait pourtant un impensé de la cité grecque? (shrink)

Governments, companies, and citizens all think trust is important. Especially today, in the networked era, where we make use of all sorts of e-services and increasingly interact and buy online, trust has become a necessary condition for society to thrive. But what do we mean when we talk about trust and how does the rise of the Internet transform the functioning of trust? This books starts off with a thorough conceptual analysis of trust, drawing on insights from - amongst others (...) philosophy and sociology - to sharpen our understanding of the topic. The book explains how the arrival of large systems - such as the internet - has changed the character of trust which today is no longer based on interpersonal interactions but has become completely mediated by technologies. Based on the layered building plan of the Internet itself, a new conceptual lens called 4 Cs is developed to analyse and understand trust in the networked era. The 4Cs refer to the 4 layers which all have to be taken into account to assess trust online, namely: context, code, codification, and curation. The 4Cs bring together the firsthand experiences of the user (context), the sort of technology that is being used (code), the legal implication (codification) and business interests (curation) in order to get a clear picture of the trust issues that may arise. In the final part of the book some real-life cases are discussed (digital hotel keys, Airbnb, online personalization) to illustrate how trust -analysed through the 4 Cs lens- might flourish or be challenged in our current networked era. (shrink)

The overall goal of this target article is to demonstrate a mechanism for an embodied cognition. The particular vehicle is a much-studied, but still widely debated phenomenon seen in 7–12 month-old-infants. In Piaget's classic “A-not-B error,” infants who have successfully uncovered a toy at location “A” continue to reach to that location even after they watch the toy hidden in a nearby location “B.” Here, we question the traditional explanations of the error as an indicator of infants' concepts of objects (...) or other static mental structures. Instead, we demonstrate that the A-not-B error and its previously puzzling contextual variations can be understood by the coupled dynamics of the ordinary processes of goal-directed actions: looking, planning, reaching, and remembering. We offer a formal dynamic theory and model based on cognitive embodiment that both simulates the known A-not-B effects and offers novel predictions that match new experimental results. The demonstration supports an embodied view by casting the mental events involved in perception, planning, deciding, and remembering in the same analogic dynamic language as that used to describe bodily movement, so that they may be continuously meshed. We maintain that this mesh is a pre-eminently cognitive act of “knowing” not only in infancy but also in everyday activities throughout the life span. Key Words: cognitive development; dynamical systems theory; embodied cognition; infant development; motor control; motor planning; perception and action. (shrink)

The life, works, and philosophy of rabbi Hasdai Crescas.

A orientação filosófica de João Mendes Júnior, por E. de Figueiredo Ferraz.--Pressupostos filosófico-jurídicos da revisão constitucional, por T. Cavalcanti Filho.--A justiça como história, por R. Cirell Czerna.--As regras de trato social em confronto com o direito, por D. de Santis Garcia.--Estado e direito, por C. Ashcar.--Doutrinas interpretativas do fenômeno jurídico, por J. Cretella Júnior.

"In 'Mag ik Orpheus zijn?' legt Esther Jansma messcherp uit wat het lezen en schrijven van poëzie en proza voor haar inhoudt. Wat betekent het om 'ik' te zeggen in een gedicht, mag een tekst worden herleid tot de persoon van de maker, in hoeverre wordt wat wij 'het leven' noemen bepaald door wat we hebben gelezen, zijn er grenzen aan de verbeelding en waar zouden die dan moeten liggen, wie bepaalt wat wel en niet mag of kan in (...) een tekst? Voor deze essays bewerkte zij vier lezingen die zij in Berkeley en als gastschrijver aan de Rijksuniversiteit Groningen heeft gegeven."--Back cover. (shrink)