Background The ethical governance of Artificial Intelligence (AI) in health care and public health continues to be an urgent issue for attention in policy, research, and practice. In this paper we report on central themes related to challenges and strategies for promoting ethics in research involving AI in global health, arising from the Global Forum on Bioethics in Research (GFBR), held in Cape Town, South Africa in November 2022. Methods The GFBR is an annual meeting organized by the World Health (...) Organization and supported by the Wellcome Trust, the US National Institutes of Health, the UK Medical Research Council (MRC) and the South African MRC. The forum aims to bring together ethicists, researchers, policymakers, research ethics committee members and other actors to engage with challenges and opportunities specifically related to research ethics. In 2022 the focus of the GFBR was “Ethics of AI in Global Health Research”. The forum consisted of 6 case study presentations, 16 governance presentations, and a series of small group and large group discussions. A total of 87 participants attended the forum from 31 countries around the world, representing disciplines of bioethics, AI, health policy, health professional practice, research funding, and bioinformatics. In this paper, we highlight central insights arising from GFBR 2022. Results We describe the significance of four thematic insights arising from the forum: (1) Appropriateness of building AI, (2) Transferability of AI systems, (3) Accountability for AI decision-making and outcomes, and (4) Individual consent. We then describe eight recommendations for governance leaders to enhance the ethical governance of AI in global health research, addressing issues such as AI impact assessments, environmental values, and fair partnerships. Conclusions The 2022 Global Forum on Bioethics in Research illustrated several innovations in ethical governance of AI for global health research, as well as several areas in need of urgent attention internationally. This summary is intended to inform international and domestic efforts to strengthen research ethics and support the evolution of governance leadership to meet the demands of AI in global health research. (shrink)

Drawing on the writings of the Jewish thinker, Abraham Joshua Heschel, I defend a partial response to the problem of divine hiddenness. A Jewish approach to divine love includes the thought that God desires meaningful relationship not only with individual persons, but also with communities of persons. In combination with John Schellenberg’s account of divine love, the admission of God’s desire for such relationships makes possible that a person may fail to believe that God exists not because of any individual (...) failing, but because the individual is a member of a larger community that itself is culpable. (shrink)

Modern technologies have enabled the development of dynamic game- and simulation-based assessments to measure psychological constructs. This has highlighted their potential for supplementing other assessment modalities, such as self-report. This study describes the development, design, and preliminary validation of a simulation-based assessment methodology to measure psychological resilience—an important construct for multiple life domains. The design was guided by theories of resilience, and principles of evidence-centered design and stealth assessment. The system analyzed log files from a simulated task to derive individual (...) trajectories in response to stressors. Using slope analyses, these trajectories were indicative of four types of responses to stressors: thriving, recovery, surviving, and succumbing. Using Machine Learning, the trajectories were predictive of self-reported resilience with high accuracy, supporting construct validity of the simulation-based assessment. These findings add to the growing evidence supporting the utility of gamified assessment of psychological constructs. Importantly, these findings address theoretical debates about the construct of resilience, adding to its theory, supporting the combination of the “trait” and “process” approaches to its operationalization. (shrink)

Recently, there has been a surge of interest in the lexicon. The demand for a fuller and more adequate understanding of lexical meaning required by developments in computational linguistics, artificial intelligence, and cognitive science has stimulated a refocused interest in linguistics, psychology, and philosophy. Different disciplines have studied lexical structure from their own vantage points, and because scholars have only intermittently communicated across disciplines, there has been little recognition that there is a common subject matter. The conference on which this (...) volume is based brought together interested thinkers across the disciplines of linguistics, philosophy, psychology, and computer science to exchange ideas, discuss a range of questions and approaches to the topic, consider alternative research strategies and methodologies, and formulate interdisciplinary hypotheses concerning lexical organization. The essay subjects discussed include: * alternative and complementary conceptions of the structure of the lexicon, * the nature of semantic relations and of polysemy, * the relation between meanings, concepts, and lexical organization, * critiques of truth-semantics and referential theories of meaning, * computational accounts of lexical information and structure, and * the advantages of thinking of the lexicon as ordered. (shrink)

The increasing use of opioid treatment agreements has prompted debate within the medical community about ethical challenges with respect to their implementation. The focus of debate is usually on the efficacy of OTAs at reducing opioid misuse, how OTAs may undermine trust between physicians and patients and the potential coercive nature of requiring patients to sign such agreements as a condition for receiving pain care. An important consideration missing from these conversations is the potential for racial bias in the current (...) way that OTAs are incorporated into clinical practice and in the amount of physician discretion that current opioid guidelines support. While the use of OTAs has become mandatory in some states for certain classes of patients, physicians are still afforded great leeway in how these OTAs are implemented in clinical practice and how their terms should be enforced. This paper uses the guidelines provided for OTA implementation by the states of Indiana and Pennsylvania as case studies in order to argue that giving physicians certain kinds of discretion may exacerbate racial health disparities. This problem cannot simply be addressed by minimising physician discretion in general, but rather by providing mechanisms to hold physicians accountable for how they treat patients on long-term opioid therapy to ensure that such treatment is equitable. There are no data in this work. (shrink)

Over the course of the past 15 years, there has been a vast sea change in American psychoanalysis. It takes the form of a broad movement away from classical psychoanalytic theorizing grounded in Freud's drive theory toward models of mind and development grounded in object relations concepts. In clinical practice, there has been a corresponding movement away from the classical principles of neutrality, abstinence and anonymity toward an interactive vision of the analytic situation that places the analytic relationship, with its (...) powerful, reciprocal affective currents, in the foreground. These developments have been evident in virtually all schools of psychoanalysis in America, from the most traditional to the most radical. Collected together for the first time, this three volume set brings together this ongoing project for a new audience. _Relational Psychoanalysis: The Emergence of a Tradition_ - Each paper in Volume 1 is accompanied by an introduction, in which the editors place it in its historical context, and a new afterward, in which the author suggests subsequent developments in his or her thinking. This book is an invaluable resource for any clinical practitioner, teacher or student of psychoanalysis interested in exploring the exciting developments of recent years. _Relational Psychoanalysis: Innovation and Expansion_ - Volume 2 brings together key papers of the recent past that exemplify the continuing growth and refinement of the relational sensibility. In selecting these papers, editors Lewis Aron and Adrienne Harris have stressed the shared relational dimension of different psychoanalytic traditions, and they have used such commonalities to structure the best recent contributions to the literature. The topics covered in Volume 2 reflect both the evolution of psychoanalysis and the unique pathways that leading relational writers have been pursuing and in some cases establishing. _Relational Psychoanalysis: New Voices_ - Volume 3 is a forum for new relational voices and new idioms of relational discourse. Established writers, Muriel Dimen, Sue Grand, and Ruth Stein among them, utilize aspects of their own subjectivity to illuminate heretofore neglected dimensions of cultural experience, of trauma, and of clinical stalemate. A host of new voices applies relational thinking to aspects of race, class, and politics as they emerge in the clinical situation. (shrink)

Standard quantum theory is inadequate to explain the mechanisms by which potential becomes actual. It is inadequate and therefore unable to describe generation of events. Niels Bohr emphasized long ago that the classical part of the world is necessary. John Bell stressed the same point: that “measurement≓ cannot even be defined within the standard quantum theory, and he sought a solution within hidden variable theories and his concept of “beables.≓Today it is customary to try to explain emergence of the classical (...) world through a decoherence mechanism due to “environment.≓ But, we believe, as it was with the concept of measurement, “environment≓ itself cannot be defined within the standard quantum theory.We have proposed a semiphenomenological solution to this problem by introducing explicitly, from the very beginning, classical degrees of freedom, and by coupling these degrees of freedom, through a Lindblad type coupling, to the quantum world. The resulting theory, we call “event-enhanced quantum theory.≓ EEQT allows us to describe an event-generating mechanism for individual quantum systems under continuous observation. The objections of John Bell are met and precise definitions of an “experiment≓ and of a “measurement≓ have been given within EEQT. However EEQT is, essentially, a nonrelativistic theory.In the present paper we extend the ideas of L. P. Horwitz and C. Piron and we propose a relativistic version of EEQT, with an event-generating algorithm for spin one-half particle detectors. The algorithm is based on proper time formulation of the relalivistic quantum theory. Although we use indefinite metric, all the probabilities controlling the random process of the detector clicks are nonnegative. (shrink)

What exactly is hope and how does it influence our decisions? In How We Hope, Adrienne Martin presents a novel account of hope, the motivational resources it presupposes, and its function in our practical lives. She contends that hoping for an outcome means treating certain feelings, plans, and imaginings as justified, and that hope thereby involves sophisticated reflective and conceptual capacities. Martin develops this original perspective on hope--what she calls the "incorporation analysis"--in contrast to the two dominant philosophical conceptions (...) of hope: the orthodox definition, where hoping for an outcome is simply desiring it while thinking it possible, and agent-centered views, where hoping for an outcome is setting oneself to pursue it. In exploring how hope influences our decisions, she establishes that it is not always a positive motivational force and can render us complacent. She also examines the relationship between hope and faith, both religious and secular, and identifies a previously unnoted form of hope: normative or interpersonal hope. When we place normative hope in people, we relate to them as responsible agents and aspire for them to overcome challenges arising from situation or character. Demonstrating that hope merits rigorous philosophical investigation, both in its own right and in virtue of what it reveals about the nature of human emotion and motivation, How We Hope offers an original, sustained look at a largely neglected topic in philosophy. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Journal of the History of Ideas 62.3 (2001) 401-423 [Access article in PDF] Petrarch and the Genealogy of Asceticism W. Scott Blanchard The morality of thought lies in a procedure that is neither entrenched nor detached. --Theodor Adorno Perhaps no author within or outside of the canon of Western literature wrote as extensively on the topic of solitude as did Francesco Petrarch. While many of our modern associations with (...) the term may find some of their origins traceable as far back as Petrarch's career, the term "solitude" carried with it much different associations in his century than it does for us today, influenced as we are by the Romantic tradition and especially by Wordsworth's absorption with the idea of solitude as an ideal state for self-conscious reflection on the individual's personal history and its meaning. No less than three of Petrarch's major prose works--the De otio religioso, the De vita solitaria, and the Secretum--confront the topic of solitude directly, and we can also point to many letters, poems, and portions of his treatises that either directly or indirectly reflect Petrarch's virtual obsession with solitude. In Petrarch we are confronted with an author who was at once the most politically connected intellectual of his century--we are even tempted to call him a "public intellectual"--and yet who constantly invoked his desire for solitude, for an escape from the many distractions and seductions that the cities and courts of his society offered. For Petrarch these were invariably places where desire lurked and power held sway, so that the life of solitude was often invoked as an alternative--a counter-cultural locus, perhaps--where freedom from temptation and subjection was imagined as an escape from the negotium of worldly life. There is much in Petrarch's writings on the solitary life that is wishful and that we might characterize as merely compensatory in a life that was otherwise quite active and engaged, but there is also a [End Page 401] strain of thought in these works that indicates a certain intransigence beneath Petrarch's overdetermined attachment to the idea, if not the practice, of withdrawal and detachment. An inquiry into Petrarch's idealization of the solitary life may even yield a somewhat reactionary aspect of his complex mind, a conservative strain in an author who was in almost every other way the literary herald of a humanism that was at the center of the cultural avant-garde of the Trecento. Is the Petrarch that in so many accounts of his character is construed as the "first modern man" actually something else, a reluctant ascetic holdover from the Middle Ages? How did Petrarch use his unique understanding of the life of solitude, of ascesis, as a pose from which to construct his sense of himself as an author and intellectual? Or are we simply confronted in the figure of a worldly and an ascetic Petrarch with yet another set of contradictions so appropriate to the "immensely complex" author whose poetic signature was the oxymoron? 1"Asceticism" and "solitude" are of course not synonymous terms, but any examination of a number of Petrarch's works as they fall within what might be called a genealogy of asceticism must recognize from the start that Petrarch's brand of asceticism was somewhat unique, especially insofar as it was deeply influenced by ancient Stoicism as well as by his reading in authors from the early Christian era. The most useful expression for our purposes may be the medieval concept of the "contemplative life," since much of the analysis in what follows will focus on how Petrarch often used his self-proclaimed pose of detachment and withdrawal as a technique for carrying on what were otherwise quite engaged dialogues with those worldly formations of power and authority that are normally conceived of as belonging to the "active" sphere of human existence. 2 For despite Petrarch's participation in or association with a number of political and civic ventures during his long and productive career, he likely never would have freely chosen... (shrink)

In cases of identity crowding, a subject consciously sees items in a figure, even though they are presented too closely together for her to shift attention to each item. Block uses such cases to challenge the view that attention is necessary for consciousness. I argue that in identity crowding cases, subjects really do attend to the items. Specifically, they attend to the figure as a global object that contains the individual items as parts. To support this view, I provide evidence (...) that attention can be directed to a global object or a local object. My response helps to defend the view that attention is necessary for conscious perception. (shrink)

Ethics in business is the most urgent problem facing America today. Now two of the best-selling authors of our time, Kenneth Blanchard and Norman Vincent Peale, join forces to meet this crisis head-on in this vitally important new book. The Power of Ethical Management proves you don't have to cheat to win. It shows today's managers how to bring integrity back to the workplace. It gives hard-hitting, practical, ethical strategies that build profits, productivity, and long-term success. From a straightforward three-step (...) Ethics Check that helps you evaluate any action or decision, to the "Five P's" of ethical behavior that will clarify your purpose and your goals, The Power of Ethical Management gives you an immensely useful set of tools. These can be put to work right away to enhance the performance of your business and to enrich the quality of your life. The Power of Ethical Management is no theoretical treatise Peale and Blanchard speak from their own enormous and unique experience, They reveal the nuts and bolts, practical strategies for ethical decisions that will show you why integrity pays. "So Vince Lombardi was wrong. Winning is not the only thing as headlines and hearings from Wall Street to Washington confirm. Now comes a better game plan from the powerful one-two punch of Ken Blanchard and Norman Vincent Peale in a quickreading new book, The Power of Ethical Management. Peale and Blanchard may be the best thing that has happened to business ethics since Mike Wallace invented 60 Minutes. -- JOHN MACK CARTIER Editor-in-Chief Good Housekeeping. (shrink)

This article defends a theory of diffuse attention and distinguishes it from focal attention. My view is motivated by evidence from psychology and neuroscience, which suggests that we can deploy visual selective attention in at least two ways: by focusing on a small number of items, or by diffusing attention over a group of items taken as a whole. I argue that diffuse attention is selective and can be object‐based. It enables a subject to select an object to guide behavior, (...) albeit in a different way than focusing does. (shrink)

Fact-finding hearings may be held to determine disputed allegations of domestic violence in child contact cases in England and Wales, and can play a vital role for mothers seeking protection and autonomy from violent fathers. Drawing on the author’s empirical study, this article examines the implications for the holding of fact-finding hearings of judges’ and professionals’ understandings of domestic violence and the extent to which they perceive it to be relevant to contact. While more judges and professionals are developing their (...) understanding of domestic violence, the ambit of when and how it is considered relevant to contact has grown increasingly narrow, which suggests that many disputed allegations of domestic violence are disregarded and women and children continue to be put at risk from violent fathers. This bifurcated approach is likely to have significant implications for recent developments in this area of family law which are considered in this article. (shrink)

Attention seems to raise a problem for pure representationalism, the view that phenomenal content supervenes on representational content. The problem is that shifts of attention sometimes seem to bring about a change in phenomenal content without a change in representational content. I argue that the representationalist can meet this challenge, but that doing so requires a new view of the representational content of perception. On this new view, the representational content of perception is always relative to a way of attending. (...) I call this the attention-indexed view of perceptual content. (shrink)

It is gratifying that thoughtful philosophers and bioethicists like Mahowald and Nelson are continuing to address the objections to prenatal testing that have been made by disability scholars and advocates. But it is frustrating to see those objections presented in ways that reflect the doubts of those who reject them more than the intentions of those who make them, in ways that make those objections appear censorious toward pregnant women and prospective parents or naïve about nonverbal expression. We recognize that (...) disability critics share the responsibility for these misunderstandings, that their objections to prenatal disability testing have not always been made as clearly or consistently as they might have been. We therefore welcome this opportunity for clarification and rebuttal. Briefly, we will argue against Mahowald that it is not apparent how prospective parents could have a duty to potential offspring requiring them to prevent the birth of any child expected to have a life worth living. And we will remind Nelson that our primary concern is with the perpetuation of stigma; that even if any reason for abortion can be framed in terms of a trait of the fetus to be aborted, only certain reasons for abortion are based on the rejection of future children because of stigmatized traits. (shrink)

This article addresses an issue overlooked in most of the literature on judicial review: the legitimacy of judicial review of a constitution's federal and structural provisions. Debates about the legitimacy of judicial review—at least as conducted throughout the Commonwealth—are usually focussed on rights. These debates appear to assume that the power of courts like the Australian High Court and the Canadian Supreme Court to interpret and enforce federal and structural provisions is unproblematic. This article tests that assumption and concludes that (...) those who hold democracy-based objections to constitutional rights should seriously reconsider, and perhaps oppose, federal and structural judicial review as well. (shrink)

An ageing population and increased life expectancy are a characteristic of the Western world. Nevertheless, as Roger Fontaine writes, “although we should be glad about this fact, it should also be stressed that old age reveals profound discrepancies between individuals. In fact, we should not speak of ‘old age’ but ‘old ages’. Specialists make a distinction between normal old age, successful old age, and pathological old age.”Catherine Guchet points out that, at the end of the twentieth century, two images of (...) old age coexist, utilitarian in conception: that of ‘flamboyant’ old age and that of ‘dependent’ old age. The latter is associated with a loss of autonomy and dignity, especially for subjects affected by senile dementia, described as ‘unconscious’. We shall focus on these more problematic forms of old age. (shrink)

In this report we focus on the definition of autonomous weapons systems (AWS). We provide a comparative analysis of existing official definitions of AWS as provided by States and international organisations, like ICRC and NATO. The analysis highlights that the definitions draw focus on different aspects of AWS and hence lead to different approaches to address the ethical and legal problems of these weapons systems. This approach is detrimental both in terms of fostering an understanding of AWS and in facilitating (...) agreement around conditions of deployment and regulations of their use and, indeed, whether AWS are to be used at all. We draw from the comparative analysis to identify essential aspects of AWS and then offer a definition that provides a value-neutral ground to address the relevant ethical and legal problems. In particular, we identify four key aspects—autonomy; adapting capabilities of AWS; human control; and purpose of use—as the essential factors to define AWS and which are key when considering the related ethical and legal implications. (shrink)

The objective of this study was to review the design and delivery of medical ethics education within medical programs across Australia and New Zealand, how current teaching has been informed by the proposed core curriculum published in 2001 by the ATEAM and how it could look moving forward. We conducted a mixed methods study using an online questionnaire consisting of 51 items. This included both binary and open-ended questions to categorise and explore similarities and differences in medical ethics curricula in (...) medical programs accredited by the Australian Medical Council across ANZ. Participants were asked about curriculum design format, duration, goals, assessments, content areas of their own ME curriculum. Convenors from 18 universities responded. The main commonality was that ME curricula were integrated both longitudinally and laterally with other content. There was also commonality in content areas addressed. The goals, format, educators, and assessments of the ME curricula were highly variable. Most respondents described a curriculum which prioritised knowledge and skill development related to ME. Although the core goals of including knowledge, skills, and attitudinal development in ME curricula are still present, there is no uniformity in terms of format, delivery, or assessment across medical programs in ANZ. This is an area for collaborative development. (shrink)

I argue for adopting a conception of obligation that is broader than the conception commonly adopted by moral philosophers. According to this broader conception, the crucial marks of an obligatory action are, first, that the reasons for the obliged party to perform the action include an exclusionary reason and, second, that the obliged party is the appropriate target of blaming reactive attitudes, if they inexcusably fail to perform the obligatory action. An obligation is directed if the exclusionary reason depends on (...) the relationship between the obliged person and the person to whom they owe the obligatory action, and the latter person is positioned to personally blame the obligated person for inexcusably failing to perform the obligatory action. Some direc- ted obligations are not owed as a matter of right, and the person to whom the obligatory action is owed is the only person positioned to blame nonperformance. Other directed obligations are owed as a matter of right, and people who are not part of the relationship grounding the obligation nevertheless are also positioned to (impersonally) blame non-performance. Only the rights-based form of directed obligation has received signifi- cant attention from moral philosophers, yet the former—which is at the heart of what I call “personal bonds”—is a pervasive and significant theme of our ordinary interpersonal lives. (shrink)

Purpose– This paper aims to consider selected results from the Arts and Humanities Research Council -funded “Managing Access to the internet in Public Libraries” project, from 2012-2014. MAIPLE has explored the ways in which public library services manage use of the internet connections that they provide for the public. This included the how public library services balance their legal obligations and the needs of their communities in a public space and the ethical dilemmas that arise.Design/methodology/approach– The researchers used a mixed-method (...) approach involving a review of the literature, legal analysis, a questionnaire survey and case studies in five public library authorities.Findings– UK public library services use a range of methods to regulate internet access. The research also confirms previous findings that filtering software is an ubiquitous tool for controlling access to and protecting library users from “inappropriate”, illegal and harmful internet content. There is a general, if sometimes reluctant, acceptance of filtering software as a practical tool by library staff, which seems to contrast with professional codes of ethics and attitudes in other countries. The research indicates that public library internet access will be a valued service for some time to come, but that some aspects of how public library services regulate internet access is currently managed can have socially undesirable consequences, including blocking legitimate sites and preventing users from accessing government services. Education could play a greater part in helping the general population to exercise judgement in selection of materials to view and use. This does not preclude implementing stricter controls to protect children, whilst allowing public libraries to continue providing a social good to those who are unable to otherwise participate in the digital age.Research limitations/implications– The response to the survey was 39 per cent meaning that findings may not apply across the whole of the UK. The findings of this study are compared with and supplemented by other quantitative sources, but a strength of this study is the depth of understanding afforded by the use of case studies.Originality/value– This paper provides both a quantitative and qualitative analysis of how internet access is managed in UK public libraries, including how library services fulfil their legal obligations and the ethical implications of how they balance their role in facilitating access to information with their perceived role as a safe and trusted environment for all members of their communities. The findings add to the international discussion on this issue and stimulate debate and policy making in the UK. (shrink)

In this article, we focus on the attribution of moral responsibility for the actions of autonomous weapons systems (AWS). To do so, we suggest that the responsibility gap can be closed if human agents can take meaningful moral responsibility for the actions of AWS. This is a moral responsibility attributed to individuals in a justified and fair way and which is accepted by individuals as an assessment of their own moral character. We argue that, given the unpredictability of AWS, meaningful (...) moral responsibly can only be discharged by human agents who are willing to take a moral gambit: they decide to design/develop/deploy AWS despite the uncertainty about the effects an AWS may produce, hoping that unintended and unwanted or unforeseen outcomes may never occurs, but also accepting to be held responsible if such outcomes will occur. We argue that, while a moral gambit is permissible for the use of non-lethal AWS, this is not the case for the actions of lethal autonomous weapon systems. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:I Had Never Heard Someone Use That Word BeforeAdrienne Feller NovickThe patient was dying. As the social worker, I had arranged the meeting and sat shoulder to shoulder with the family and the attending physician in the small nondescript room. The family was grief-stricken and asked intelligent questions as they made difficult decisions about end-of-life care for their loved one. The doctor spoke with gentle kindness, acknowledging their difficult (...) decision as he completed the neon pink Medical Orders for Life Sustaining Treatment (MOLST) form and left the room. I was tangled up with emotions; I felt relieved that the meeting had gone smoothly, sad for the patient and family, and in awe of the doctor for his ability to lead the difficult conversation. I stayed behind to ask the family if there was anything I could do to help them. [End Page E4]Before I could speak, the patient's wife turned to me and said, "I am so glad that k--- left the room." (Using a derogatory word for a person of the Jewish faith). My brain began processing the statement. I am a Jewish woman. Did I hear that right? Did she say what I think she said? Should I say something? I froze, and time seemed to stop. She was looking at me expectantly, waiting for a response. Her face reminded me of someone waiting for the other person to return a "high five." I was flooded with emotion. A succession of thoughts ran through my head, everything from being rude in response or getting physical. I did neither. I said nothing. I smiled and left the room feeling like I had been gut-punched.I was in denial. I made excuses for the wife; she was stressed. I kept thinking I must not have heard her correctly and that I was overreacting. I continued to work with the family as though nothing had happened until the patient died five days later. I felt ashamed and never told anyone about what happened. I regretted not saying anything. I replayed the conversation in my mind and felt depressed and angry. Inside I felt complicit for not speaking up, but I had no words. I assumed bias in healthcare was rare. I did nothing.Years later, after I completed a patient visit in the Intensive Care Unit (ICU), I observed a group of surgical residents doing rounds. The attending welcomed me to join this valuable clinical learning experience. As the group approached the next bed, the patient pointed to one resident and loudly said, "I don't want a doctor who looks like that to come near me." I gasped aloud and froze, waiting to see what would happen next. The attending looked directly at the patient and said calmly, "We are all here to help you. That is not an appropriate thing for you to say." Then, he turned to the resident and nodded, directing them to resume their bedside assessment. The patient mumbled something inaudibly and said nothing.To my astonishment, the doctor acknowledged the microaggression (a microaggression is a statement, action, or incident regarded as discrimination), addressed the issue, respectfully supported the resident, created a safe space for everyone on the healthcare team and resumed quality patient care without missing a beat. He modeled a strategy to address patient bias and taught a valuable skill. This was a learning moment for me. It helped me refocus my past experience and provided me with a useful strategy to address bias in the future.As a member of the medical ethics consultation service, I listen, provide support, and aid in challenging communications. I had the opportunity to model the communication strategy I acquired in the ICU. The medical ethics team was consulted for a patient refusing treatment. The patient was disrespectful to healthcare team members, cursing at nurses and residents, using ethnic slurs, and saying he "would rather die than let one of them touch him. I entered the patient's room with the healthcare team, introduced myself, and explained the reason for my visit. The patient defiantly agreed he had used slurs, saying he wanted to go home. I continued, everyone here... (shrink)

Pacific Philosophical Quarterly, March 2006. Significant effort has been devoted to locating a good argument for Kant ’s Formula of Humanity. In this paper, I contrast two arguments, based on Kant ’s text, for the Formula of Humanity. The first, which I call the “Valued Ends” argument, is an influential and appealing argument developed most notably by Christine Korsgaard and Allen Wood. Notwithstanding the appeal and influence of this argument, it ultimately fails on several counts. I therefore present as an (...) alternative the “Autonomy” argument, which is largely inspired by the failings of the Valued Ends argument. (shrink)

_Demons in the Consulting Room: Echoes of Genocide, Slavery and Extreme Trauma in Psychoanalytic Practice_ isthe second of two volumes addressing the overwhelming, often unmetabolizable feelings related to mourning, both on an individual and mass scale. Authors in this volume explore the potency of ghosts, ghostliness and the darker, often grotesque aspects of these phenomena. While ghosts can be spectral presences that we feel protective of, demons haunt in a particularly virulent way, distorting experience, our sense of reality and our (...) character. Bringing together a collection of clinical and theoretical papers, _emons in the Consulting Room_, reveals how the most extreme types of trauma can continue to have effects across generations, and how these effects manifest in the consulting room. Essays in this volume consider traumas that have affected multiple generations of people, such as the Holocaust, experiences in the gulags, and the experience of slavery. Authors here consider the clinical challenges of working with the demonic force in severe childhood abuse and the effects of serious and prolonged physical injury and illness. Inevitably, there is in such difficult clinical work, the combined effects of hauntings in the analysts and in patients and often in the surrounding culture. In this book, distinguished psychoanalysts explore the myriad forms of ghosts and the demonic, which interfere and disrupt the endlessly difficult psychic work of mourning. It will be of interest to psychotherapists and psychoanalysts, as well as social workers, family therapists, psychologists, and psychiatrists. _emons in the Consulting Room _ill appeal to those specializing in bereavement and trauma and, on a broader level, to sociologists and historians interested in understanding means of coping with loss and grief on both an individual and larger scale basis. (shrink)

George Lakoff discusses how emotion metaphors reflect the discrete bodily states associated with each emotion. The analysis raises questions about the context for and frequency of use of emotion metaphors and, indeed, emotion labels, per se. An assumption implicit to most theories of emotion is that emotion language is just another channel through which people express ongoing emotion states. Drawing from recent evidence that labeling ongoing emotions reduces their intensity, we propose that a primary function of emotion language is regulatory (...) rather than expressive. (shrink)

ABSTRACTRecognising a facial expression is more difficult when the expresser's body conveys incongruent affect. Existing research has documented such interference for universally recognisable bodil...

Over the last two decades, legal scholarship has been catching up with the more than century old calls by black Americans for reparations.1 Tax scholar Boris Bittker (in)famously launched the viability of black reparations into legal scholarship with his now classic monograph, The Case for Black Reparations.2 However, it would take more than twenty years for mainstream legal scholarship to take up the robust and wide-ranging set of questions raised by the possibility of reparations for American slavery.3 In the late (...) 1990s private law scholars leapt into the debate, discussing unjust enrichment and torts-based models of black reparations.4 While these scholars made a variety of distinct arguments, collectively, their model rested on the contention that America had wrongfully expropriated the labor of generations of enslaved African Americans and the result had been systemic unjust enrichment, or a species of mass torts. Grounded in various conceptions of corrective justice, these models conceive black reparations as a set of claims that would be litigated through the courts. Over the ensuing two decades, the private law model has become somewhat of an outlier in reparations discussions, largely set aside in favor of broader, more explicitly political approaches. (shrink)

Dans cette réflexion surgie des premières expériences de la pandémie du Covid-19, l’autrice met en écho nos peurs et nos réactions face aux dangers de la maladie et face aux actes de violence. Les condamnations sommaires et instantanées auxquelles les militant·es se livrent sur les réseaux sociaux reproduisent partiellement des dynamiques de lynchage dont il faut apprendre à davantage se méfier. Avec la distance de l’abstentiel, il est parfois plus facile de dénoncer ( call-out ) les mauvais comportements, que d’interpeler (...) et d’inclure ( call-in ) celleux qui ont fait du mal. Comment croire les survivant·es tout en restant abolitionnistes? Comment croire les survivant·es tout en pratiquant une justice transformatrice? (shrink)

At the outset of World War I - the "Great War" - Freud supported the Austro-Hungarian Empire for which his sons fought. But the cruel truths of that bloody conflict, wrought on the psyches as much as the bodies of the soldiers returning from the battlefield, caused him to rethink his stance and subsequently affected his theory: Psychoanalysis, a healing science, could tell us much about both the drive for war and the ways to undo the trauma that war inherently (...) breeds, but its principles could just as easily serve the enemy's desires to inculcate its own brand of "truth." Even a century later, psychoanalysis can still be used as much for the justifications of warfare and propaganda as it is for the defiance of and resistance to those same things. But it is in the investigation of the motives and methods behind these uses that psychoanalysis proves its greatest strength. To wit, this edited collection presents published and unpublished material by analysts, writers, and activists who have worked at the front lines of psychic life and war from various stances. Set at a point of tension and contradiction, they illustrate the paradoxical relation of psychoanalysis as both a site of resistance and healing and a necessary aspect of warmaking, propaganda, and militarism. In doing so, we venture from the home front - from the trauma of returning veterans to the APA's own complicity in CIA "black sites" - across international borders - from the treatment of women in Latin American dictatorships to the resistance to occupation in Palestine, from mind control to an ethics of responsibility. Throughout, a psychoanalytic sensibility deconstructs the very opposition that it inhabits, and seeks to reestablish psychoanalysis as the healing discipline it was conceived to be. (shrink)

_Ghosts in the Consulting Room: Echoes of Trauma in Psychoanalysis_ is the first of two volumes that delves into the overwhelming, often unmetabolizable feelings related to mourning. The book uses clinical examples of people living in a state of liminality or ongoing melancholia. The authors reflect on the challenges of learning to move forward and embrace life over time, while acknowledging, witnessing and working through the emotional scars of the past. Bringing together a collection of clinical and theoretical papers, _Ghosts (...) in the Consulting Room _features accounts of the unpredictable effects of trauma that emerge within clinical work, often unexpectedly, in ways that surprise both patient and therapist. In the book, distinguished psychoanalysts examine how to work with a variety of ‘ghosts’, as they manifest in transference and countertransference, in work with children and adults, in institutional settings and even in the very founders and foundations of the field of psychoanalysis itself. They explore the dilemma of how to process loss when it is unspeakable and unknowable, often manifesting in silence or gaps in knowledge, and living in strange relations to time and space. This book will be of interest to psychotherapists and psychoanalysts, as well as social workers, family therapists, psychologists, and psychiatrists. It will appeal to those specializing in bereavement and trauma and, on a broader level, to sociologists and historians interested in understanding means of coping with loss and grief on both an individual and larger scale basis. (shrink)

We report three experiments investigating whether people’s judgments about causal relationships are sensitive to the robustness or stability of such relationships across a range of background circumstances. In Experiment 1, we demonstrate that people are more willing to endorse causal and explanatory claims based on stable (as opposed to unstable) relationships, even when the overall causal strength of the relationship is held constant. In Experiment 2, we show that this effect is not driven by a causal generalization’s actual scope of (...) application. In Experiment 3, we offer evidence that stable causal relationships may be seen as better guides to action. Collectively, these experiments document a previously underappreciated factor that shapes people’s causal reasoning: the stability of the causal relationship. (shrink)

It is gratifying that thoughtful philosophers and bioethicists like Mahowald and Nelson are continuing to address the objections to prenatal testing that have been made by disability scholars and advocates. But it is frustrating to see those objections presented in ways that reflect the doubts of those who reject them more than the intentions of those who make them, in ways that make those objections appear censorious toward pregnant women and prospective parents or naïve about nonverbal expression. We recognize that (...) disability critics share the responsibility for these misunderstandings, that their objections to prenatal disability testing have not always been made as clearly or consistently as they might have been. We therefore welcome this opportunity for clarification and rebuttal. Briefly, we will argue against Mahowald that it is not apparent how prospective parents could have a duty to potential offspring requiring them to prevent the birth of any child expected to have a life worth living. And we will remind Nelson that our primary concern is with the perpetuation of stigma; that even if any reason for abortion can be framed in terms of a trait of the fetus to be aborted, only certain reasons for abortion are based on the rejection of future children because of stigmatized traits. (shrink)

Apologies are strange. They are, in a certain sense, very small. An apology is just a gesture—a set of words, a physical posture, perhaps a gift. But an apology can also be very powerful—this power is implicit in the facts that it can be difficult to offer an apology and that, when we are wronged, we may want an apology very much. More, even we have been severely wronged, we are sometimes willing to forgive or pardon the wrongdoer, if we (...) receive a sincere apology. In this paper, I want to begin to figure out how a mere gesture can be so powerful. The philosophers who discuss apology generally do not go into much detail, and they discuss it almost exclusively in connection with forgiveness. 2 I, too, will discuss apology’s power to provide reason to forgive, but in order to provide the resources to examine another power. Some apologies, I will argue, fail to provide reason to forgive, but nevertheless do provide the recipient a reason to maintain a relationship with the wrongdoer, or to allow the wrongdoer to remain in her community. To be clear: the “powers” I am interested in are reason-giving powers, or powers to make certain beliefs, attitudes, or actions rational. Apologies also, no doubt, have a sort of bare causal power. The sight of a vicious, racist, cruel war criminal on his knees and in tears, sincerely begging forgiveness, may inspire in us pity or even compassion, in spite of what we believe we have reason to feel. “I can’t help but feel sorry for the bastard,” we may say, even while believing that.. (shrink)

A theory of word meaning developed jointly by Adrienne and Keith Lehrer is summarized, which accommodates the empirical facts of natural languages, especially the diversity of types of words. Reference characterizes the application of words to things, events, properties, etc. and sense the relationship among words and linguistic expressions. Although reference and sense are closely connected, neither can be reduced to the other. We use the metaphor of vectors to show how different, sometimes competing forces interact to provide an (...) understanding of what a word in context means. Topics discussed include vagueness, indeterminacy, the role of experts, possible worlds, pragmatic influences, semantic change, semantic networks, fields, and entailments. A formal theory for understanding the relationship of idiolects, dialects, and communal languages is proposed to account for the dynamic interaction of individuals and communities which occurs continuously. (shrink)

It is a commonplace in both the popular imagination and the philosophical literature that hope has a special kind of motivational force. This commonplace underwrites the conviction that hope alone is capable of bolstering us in despairinducing circumstances, as well as the strategy of appealing to hope in the political realm. In section 1, I argue that, to the contrary, hope’s motivational essence is not special or unique—it is simply that of an endorsed desire. The commonplace is not entirely mistaken, (...) however, because standard ways of expressing hope do have motivational influence that is different in kind from that of desire. In sections 2 through 4, I examine one of these ways of expressing hope, fantasizing, and argue that fantasies can present us with reasons to modify our goals and projects in multiple ways. (shrink)