Infants are unable to make their own decisions or express their own wishes about medical procedures and treatments. They rely on surrogates to make decisions for them. Who should be the decision-maker when an infant’s biological parents are also minors? In this paper, we analyse a case in which the biological mother is a child. The central questions raised by the case are whether minor parents should make medical decisions on behalf of an infant, and if so, what are the (...) limits to this decision-making authority? In particular, can they refuse treatment that might be considered best for the infant? We examine different ethical arguments to underpin parental decision-making authority; we argue that provided that minor parents are capable of fulfilling their parental duties, they should have a right to make medical decisions for their infant. We then examine the ethical limits to minor parents’ decision-making authority for their children. We argue that the restricted authority that teenagers are granted to make medical decisions for themselves looks very similar to the restricted autonomy of all parents. That is, they are permitted to make choices, but not harmful choices. Like all parents, minor parents must not abuse or neglect their children and must also promote their welfare. They have a moral right to make medical decisions for their infants within the same ‘zone of parental discretion’ that applies to adult parents. We conclude that adult and minor parents should have comparable decision-making authority for their infants. (shrink)

The COVID-19 pandemic crisis has necessitated widespread adaptation of revised treatment regimens for both urgent and routine medical problems in patients with and without COVID-19. Some of these alternative treatments maybe second-best. Treatments that are known to be superior might not be appropriate to deliver during a pandemic when consideration must be given to distributive justice and protection of patients and their medical teams as well the importance given to individual benefit and autonomy. What is required of the doctor discussing (...) these alternative, potentially inferior treatments and seeking consent to proceed? Should doctors share information about unavailable but standard treatment alternatives when seeking consent? There are arguments in defence of non-disclosure; information about unavailable treatments may not aid a patient to weigh up options that are available to them. There might be justified concern about distress for patients who are informed that they are receiving second-best therapies. However, we argue that doctors should tailor information according to the needs of the individual patient. For most patients that will include a nuanced discussion about treatments that would be considered in other times but currently unavailable. That will sometimes be a difficult conversation, and require clinicians to be frank about limited resources and necessary rationing. However, transparency and honesty will usually be the best policy. (shrink)

Children dependent on life-prolonging medical technology are often subject to a constant background risk of sudden death or catastrophic complications. Such children can be cared for in hospital, in an intensive care environment with highly trained nurses and doctors able to deliver specialised, life-saving care immediately. However, remaining in hospital, when life expectancy is limited, can considered to be a harm in of itself. Discharge home offers the possibility for an improved quality of life for the child and their family (...) but comes with significant medical risks.When making decisions for children, two ethical models predominate, the promotion of the child’s best interests or the avoidance of harm. However, in some circumstances, particularly for children with life-limiting and/or life-threatening illness, all options may be associated with risk. There are no good options, only potentially harmful choices.In this paper, we explore decisions made by one family in such circumstances. We describe a model adopted from risk management programmes beyond medicine, which offers a potential framework for identifying risks to the child that are morally permissible. Some risks and harms to a child, not ordinarily permitted, may be acceptable when undertaken in the pursuit of a specified desired good, so long as they are as low as reasonably practicable. (shrink)

As the COVID-19 pandemic impacts on health service delivery, health providers are modifying care pathways and staffing models in ways that require health professionals to be reallocated to work in critical care settings. Many of the roles that staff are being allocated to in the intensive care unit and emergency department pose additional risks to themselves, and new policies for staff reallocation are causing distress and uncertainty to the professionals concerned. In this paper, we analyse a range of ethical issues (...) associated with changes to staff allocation processes in the face of COVID-19. In line with a dominant view in the medical ethics literature, we claim, first, that no individual health professional has a specific, positive obligation to treat a patient when doing so places that professional at risk of harm, and so there is a clear ethical tension in any reallocation process in this context. Next, we argue that the changing asymmetries of health needs in hospitals means that careful consideration needs to be given to a stepwise process for deallocating staff from their usual duties. We conclude by considering how a justifiable process of reallocating professionals to high-risk clinical roles should be configured once those who are ‘fit for reallocation’ have been identified. We claim that this process needs to attend to three questions that we consider in detail: (1) how the choice to make reallocation decisions is made, (2) what justifiable models for reallocation might look like and (3) what is owed to those who are reallocated. (shrink)

Currently, there is no non-anthropocentric guide to the practice of nature conservation and the treatment of invasive species and domestic animals. In examining the so-called ‘ecocentric’ and ‘animal’ ethics, we highlight some differences between them, and argue that the basic aspiration for support of all nonhuman life needs to be retained. We maintain that hierarchies of value need to be flexible, establishing basic principles and then weighing up the options in the context of anthropocentrism, industrial development and human population growth. (...) Acknowledging the role of these conditions creates space for combining individual-based and collective-based ethics in practice. (shrink)

A balance needs to be struck between facilitating compassionate access to innovative treatments for those in desperate need, and the duty to protect such vulnerable individuals from the harms of untested/unlicensed treatments. We introduced a principle-based framework to evaluate such requests and describe its application in the context of recently evolved UK, US and European regulatory processes. 24 referrals were received by our quaternary children's hospital Clinical Ethics Committee over the 5-year period. The CEC-rapid response group evaluated individual cases within (...) 48-hours; the main referrers being haematology/oncology, immunology or transplant services. Most requests were for drug/vaccine/pre-trial access or biological/cellular therapies. The majority of individual requests were approved ; neutral or negative opinions were given in 5, including 3 group requests. Recently evolved regulatory processes share common criteria and conditions to our framework including: demonstration of clinical need; sound scientific basis with lack of viable alternative; risks-benefit/best interests evaluation; arrangements for fully informed consent; no compromise of arrangements to test treatment for licensing purposes; consideration of resource implications. There are differences between individual processes and with our framework, with respect to procedures, scope, application format, costs and obligation to make available all outcome data. Our experience has emphasized the need for an independent, principled, consistent, fair and transparent response to the increasing demand for innovative treatment on a compassionate basis. We believe that there is a need for harmonization of the recent proliferation of regulation and legislation in this area. (shrink)

In this paper the current legislative landscape and the challenges researchers face in obtaining informed consent in acute situations are explored. In such situations, some current guidelines can be difficult or impossible to apply. Capacity should be formally assessed before consent is sought to ensure that vulnerable persons are neither inappropriately recruited to a study nor denied the opportunity to participate. However, there is little guidance in current legislation as to how this should be achieved. When the patient is considered (...) to be unable to provide prospective informed consent, other forms are sometimes permissible, although all have specific drawbacks. First, it is argued that a brief instrument, suitable for the acute situation, is needed to determine whether patients have the capacity to consent to clinical trials. Secondly, it is argued that there are areas of the informed consent process that require review, and ways that improvements could be made are suggested. (shrink)

In emergency research, obtaining informed consent can be problematic. Research to develop and improve treatments for patients admitted to hospital with life-threatening and debilitating conditions is much needed yet the issue of research without consent (RWC) raises concerns about unethical practices and the loss of individual autonomy. Consistent with the policy and practice turn towards greater patient and public involvement in health care decisions, in the US, Canada and EU, guidelines and legislation implemented to protect patients and facilitate acute research (...) with adults who are unable to give consent have been developed with little involvement of the lay public. This paper reviews research examining public opinion regarding RWC for research in emergency situations, and whether the rules and regulations permitting research of this kind are in accordance with the views of those who ultimately may be the most affected. (shrink)

We consider Helen Longino's proposal that "ontological heterogeneity", "complexity of relationship", and "the non-disappearance of gender" are criteria for good science and cannot be separated into cognitive and social virtues. Using a research program in neuroendocrinology investigating a hormonal basis for sex-differentiated lateralization as a case study, the authors disagree concerning whether the first two criteria can be construed as criteria for good science. Concerning the non-disappearance of gender criterion, we argue that its appropriateness is context specific, and that (...) its cognitive and social formulations are separable and should be construed as such. (shrink)

This collection of essays reveals that across Jacques Derrida's work as a whole, as well as that of Hélène Cixous and Nicholas Royle, deconstruction has always addressed questions about animality.

This is an important book precisely because there is none other quite like it.

This chapter examines the role played by derogatory terms (e.g., ‘inyenzi’ or cockroach, ‘inzoka’ or snake) in laying the social groundwork for the genocide of the Tutsi in Rwanda in 1994. The genocide was preceded by an increase in the use of anti-Tutsi derogatory terms among the Hutu. As these linguistic practices evolved, the terms became more openly and directly aimed at Tutsi. Then, during the 100 days of the genocide, derogatory terms and coded euphemisms were used to direct killers (...) to their victims. Understanding these speech acts helps to illuminate the important ways that power is enacted through discourse, how speech acts can prepare the way for physical and material acts, and how speech generates permissions for actions hitherto uncountenanced. Studying the role of speech acts and linguistic practices in laying the groundwork of the genocide illuminates how patterns of speech acts become linguistic practices that constitute permissibility conditions for non-linguistic behaviors. Further, the analysis presented here helps to make sense of the view that a steady, deep, and widespread derogation of a group can be part and parcel of genocide, not only an antecedent to it. (shrink)

INTRODUCTION Reopening a Discussion The empiricist-derived epistemology that has directed most social and natural scientific inquiry for the last three ...

This article aims to develop new conceptions of the psychosocial dynamics that drive the re-romanticization of domestic femininity in current financialized capitalism. Feminist scholars have described this heightened cultivation of mothering as a reparative move in response to irreconcilable tensions between cultural ideals of the ‘balancing mother’ and ‘lean-in femininity’. This article adds a materialist-psychosocial lens to these conceptions, to enhance understanding of what drives this craving for domestic femininity. Drawing on a free-association narrative interview study with couples in the (...) financial elite in the comparatively gender-egalitarian Norwegian context, I describe a specific emotional mechanism that resists democratization of gender in this specific group. The interviews reveal a felt need to cultivate ‘the human side of things’ at safe distance from the competitiveness of ‘hard-core finance’. The Nordic earner–carer model with its entwinement of care and professional pursuits, cultivated by the more self-fulfilment-oriented parts of the professional middle-class appears not only unwanted but threatening. In my analysis, I retrieve and develop a psychoanalytically inspired historical-materialist feminism, one that perceives of the gendered division of work as a split in modes of focusing human energy. I suggest that the resurgent cultivation of domestic femininity is nurtured by a self-energizing antagonism between competitive and relational practices. I further argue that the cultivation of domestic femininity in these financial couples points to a potential antagonism between the democratization of love and the specific anxiety-driven competitiveness to which this financial-elite group may be particularly susceptible. (shrink)

The term “value of life” can refer to life’s intrinsic dignity: something nonincremental and time-unaffected in contrast to the fluctuating, incremental “value” of our lives, as they are longer or shorter and more or less flourishing. Human beings are equal in their basic moral importance: the moral indignities we condemn in the treatment of e.g. those with dementia reflect the ongoing human dignity that is being violated. Indignities licensed by the person in advance remain indignities, as when people might volunteer (...) their living, unconscious bodies for surrogacy or training in amputation techniques. Respect for someone’s dignity is significantly impacted by a failure to value that person’s very existence, whatever genuine respect and good will is shown by wanting the person’s life to go well. Valuing and respecting life is not, however, vitalism: there can be good and compelling reasons for eschewing some means of prolonging life. (shrink)

This chapter considers the ways in which whiteness as a skin color and ideology becomes a dominant level that sets the background against which all things, people and relations appear. Drawing on Merleau-Ponty's phenomenology, it takes up a series of films by Bruce Nauman and Marlon Riggs to consider ways in which this level is phenomenally challenged providing insights into the embodiment of racialization.

Lynne Huffer's ambitious inquiry redresses the rift between feminist and queer theory, traversing the space of a new, post-moral sexual ethics that includes pleasure, desire, connection, and betrayal. She begins by balancing queer theorists' politics of sexual freedoms with a moralizing feminist politics that views sexuality as harm. Drawing on the best insights from both traditions, she builds an ethics centered on eros, following Michel Foucault's ethics as a practice of freedom and Luce Irigaray's lyrical articulation of an ethics (...) of sexual difference. Through this theoretical lens, Huffer examines everyday experiences of ethical connection and failure connected to sex, including queer sexual practices, sodomy laws, interracial love, pornography, and work-life balance. Her approach complicates sexual identities while challenging the epistemological foundations of subjectivity. She rethinks ethics "beyond good and evil" without underestimating, as some queer theorists have done, the persistence of what Foucault calls the "catastrophe" of morality. Elaborating a thinking-feeling ethics of the other, Huffer encourages contemporary intellectuals to reshape sexual morality from within, defining an ethical space that is both poetically suggestive and politically relevant, both conceptually daring and grounded in common sexual experience. (shrink)

Michel Foucault was the first to embed the roots of human sexuality in discipline and biopolitics, therefore revolutionizing our conception of sex and its relationship to society, economics, and culture. Yet over the past two decades, scholars have limited themselves to the study of Foucault's _History of Sexuality_, volume 1 paying lesser attention to his equally explosive _History of Madness_. In this earlier volume, Foucault recasts Western rationalism as a project that both produces and represses sexual deviants, calling out the (...) complicity of modern science and the exclusionary nature of family morality. By reclaiming these deft moves, Lynne Huffer teases out exciting new strands of Foucauldian thought. She then revisits the theorist's ethical work in light of these discoveries, divining an ethics of eros that sees sexuality as a lived experience we are repeatedly called on to remember. Throughout her study, Huffer weaves her own experiences together with Foucault's, sampling from unpublished interviews and other archived materials in order to intimately rework the problem of sexuality as a product of reason. (shrink)

The expression ‘nonreductive materialism’ refers to a variety of positions whose roots lie in attempts to solve the mind-body problem. Proponents of nonreductive materialism hold that the mental is ontologically part of the material world; yet, mental properties are causally efficacious without being reducible to physical properties.s After setting out a minimal schema for nonreductive materialism (NRM) as an ontological position, I’ll canvass some classical arguments in favor of (NRM).1 Then, I’ll discuss the major challenge facing any construal of (NRM): (...) the problem of mental causation, pressed by Jaegwon Kim. Finally, I’ll offer a new solution to the problem of mental causation. (shrink)

A curious feature of Aztec philosophy is that the basic metaphysical question of the “Western” tradition cannot be formulated in their language, in Nahuatl. This did not, however, prevent the Aztecs from developing an account of 'reality', or whatever it is that might exist. The article is the first of its kind to compare the work of Aristotle on ousia (being) and the Aztecs on teotl and ometeotl. Through this analysis, it suggests that both of the Nahuatl terms are fundamental (...) for expressing the basic character of reality as process for the Aztecs. It also defends their notion as prima facia reasonable, despite its wide divergence from Aristotle's view. (shrink)

In recent years, calls have been made to address the relative dearth of qualitative sociological investigation into the sensory dimensions of embodiment, including within physical cultures. This article contributes to a small, innovative and developing literature utilizing sociological phenomenology to examine sensuous embodiment. Drawing upon data from three research projects, here we explore some of the ‘sensuousities’ of ‘intense embodiment’ experiences as a distance-running-woman and a boxing-woman, respectively. Our analysis addresses the relatively unexplored haptic senses, particularly the ‘touch’ of heat. (...) Heat has been argued to constitute a specific sensory mode, a trans-boundary sense. Our findings suggest that ‘lived’ heat, in our own physical-cultural experiences, has highly proprioceptive elements and is experienced as both a form of touch and as a distinct perceptual mode, dependent upon context. Our analysis coheres around two key themes that emerged as salient: (1) warming up, and (2) thermoregulation, which in lived experience were encountered as strongly interwoven. (shrink)

This paper considers the analogies and disanalogies between a certain sort of argument designed to oppose scepticism about free will and a certain sort of argument designed to oppose scepticism about the external world. In the case of free will, I offer the ancient Lazy Argument and an argument of my own, which I call the Agency Argument, as examples of the relevant genre; and in the case of the external world, I consider Moore’s alleged proof of an external world. (...) I draw attention to analogies and disanalogies between the arguments offered in each case in order to suggest that although the Agency Argument shares with its Moorean relative the unfortunate property of being dialectically ineffective against some of those it is mainly hoping to convince, it will not be dialectically ineffective against all of them. It is also argued that the Agency Argument is less vulnerable than Moore’s proof to worries about its justificatory structure. (shrink)

Although Nietzsche's writings clearly deliver an unhealthy dose of misogyny, it must be noticed that they also contain the seeds of a deconstruction of that misogyny. This paper exposes one set of deconstructing elements of Nietzsche's works with respect to his views on women. The wider philosophical context of Nietzsche's thought provides grounds for taking seriously several passages of The Gay Science that reveal a more sympathetic understanding of women, since these passages take seriously Nietzsche's anti-dualism, his perspectivism, and his (...) early existentialist notion of the self. The destabilizing force of these passages, combined with Nietzsche's remarks about women within this philosophical context, reveals that Nietzsche's works promise more insight than many feminists have previously noted. A feminist analysis of Nietzsche's anti-dualism, perspectivism and discussion of the power of naming promises to inform contemporary feminist concerns about the importance of women's articulating our lives. (shrink)

_Three Steps on the Ladder of Writing_ is a poetic, insightful, and ultimately moving exploration of 'the strange science of writing.' In a magnetic, irresistible narrative, Cixous reflects on the writing process and explores three distinct areas essential for 'great' writing: _The School of the Dead_--the notion that something or someone must die in order for good writing to be born; _The School of Dreams_--the crucial role dreams play in literary inspiration and output; and _The School of Roots_--the importance of (...) depth in the 'nether realms' in all aspects of writing. Cixous's love of language and passion for the written word is evident on every page. Her emotive style draws heavily on the writers she most admires: the Brazilian novelist Clarice Lispector, the Russian poet Marina Tsvetaeva, the Austrian novelists Ingeborg Bachmann and Thomas Bernhard, Dostoyevsky and, most of all, Kafka. (shrink)

This article argues that the real promise of feminist philosophy of language is in its account of articulated normativity. Feminist philosophy of language began within a descriptivist framework, seeking to identify and root out sexist discursive practices, like naming practices that subsume women’s identity under men’s, descriptive practices that erase or undermine women’s accomplishments and presence as subjects, and so on. This approach had its limits, and led to increased attention to the discursive practices through which we articulate our experiences (...) and construct our lives. Examining the core frameworks through which feminists have analyzed the power of language to shape social reality and construct social selves, this article shows how language is normative in its production and reproduction of social norms by way of its content, forms, and constitutive discursive practices. The article urges feminists to use knowledge of the processes of articulation and legitimation to effect and explain feminist reconstitution of women as whole. (shrink)

What is a human person, and what is the relation between a person and his or her body? In her third book on the philosophy of mind, Lynne Rudder Baker investigates what she terms the person/body problem and offers a detailed account of the relation between human persons and their bodies. Baker's argument is based on the 'Constitution View' of persons and bodies, which aims to show what distinguishes persons from all other beings and to show how we can (...) be fully material beings without being identical to our bodies. The Constitution View yields answers to the questions 'What am I most fundamentally?', 'What is a person?', and 'What is the relation between human persons and their bodies'? Baker argues that the complex mental property of first-person perspective enables one to conceive of one's body and mental states as one's own. (shrink)

. Undoubtedly, multinational corporations must play a significant role in the advancement of global ecological ethics. Our research offers a glimpse into the process of how goals of ecological sustainability in one multinational corporation can trickle down through the organization via the sustainability support behaviors of supervisors. We asked the question “How do supervisors in a multinational corporation internalize their corporation’s commitment to ecological sustainability and, in turn, behave in ways that convey this commitment to their subordinates?” In response, we (...) created a theoretical framework for supervisor sustainability support behavior based on Stern et al., Human Ecology Review 6(2), 81-97 (1999) value-belief-norm (VBN) theory. We then tested our framework by performing a survey-based field study of supervisors in a multinational pharmaceutical company that has publicly professed a goal of ecological sustainability. (shrink)

This paper examines, on the basis of a longitudinal corpus of 50 early modern authors, how change at the aggregate level of the community interacts with variation and change at the micro-level of the individual language user. In doing so, this study aims to address the methodological gap between collective change and entrenchment, that is, the gap between language as a social phenomenon and the cognitive processes responsible for the continuous reorganization of linguistic knowledge in individual speakers. Taking up the (...) case of the prepositional passive, this study documents a strong community-wide increase in use that is accompanied by increasing schematicity. A comparison of the 50 authors reveals that regularities arising at the macro-level conceal highly complex and variable individual behavior, aspects of which may be explained by studying the larger (social) context in which these individuals operate (e. g., age cohorts, community of practice, biographical insights). Further analysis, focusing on how authors use the prepositional passive in unique and similar ways, elucidates the role of small individual biases in long-term change. Overall, it is demonstrated that language change is an emergent phenomenon that results from the complex interaction between individual speakers, who themselves may change their linguistic behavior to varying degrees. (shrink)

For a long time, linguists more or less denied the existence of individual differences in grammatical knowledge. While recent years have seen an explosion of research on individual differences, most usage-based research has failed to address this issue and has remained reluctant to study the synergy between individual and community grammars. This paper focuses on individual differences in linguistic knowledge and processing, and examines how these differences can be integrated into a more comprehensive constructionist theory of grammar. The examination is (...) guided by the various challenges and opportunities that may be extracted from scattered research that exists across disciplines touching on these matters, while also presenting some new data that illustrate how differentiation between individuals can improve models of long-term language change. The paper also serves as the introduction to this special issue of Cognitive Linguistics, which collects seven contributions from various linguistic disciplines focusing on key aspects of individuals’ grammars. (shrink)

Holobionts are multicellular eukaryotes with multiple species of persistent symbionts. They are not individuals in the genetic sense— composed of and regulated by the same genome—but they are anatomical, physiological, developmental, immunological, and evolutionary units, evolved from a shared relationship between different species. We argue that many of the interactions between human and microbiota symbionts and the reproductive process of a new holobiont are best understood as instances of reciprocal scaffolding of developmental processes and mutual construction of developmental, ecological, and (...) evolutionary niches. Our examples show that mother, fetus, and different symbiotic microbial communities induce or constitute conditions for the development and reproduction of one another. These include the direct induction of maternal or fetus physiological changes, the restructuring of ecological relations between communities, and evolutionary selection against undesirable competitors. The mutual scaffolding and niche constructing processes start early—prior to amniotic rupture. We are evolutionarily, physiologically, and developmentally integrated holobiont systems, strung together through mutual reliance and mutual construction. Bringing the processes of niche construction and developmental scaffolding together to interpret holobiont birth conceptually scaffolds two new directions for research: in niche construction, identifying the evolutionary implications of organisms actively constructing multiple overlapping niches and scaffolds, and in Evolutionary Developmental Biology, characterizing evolutionary and ecological processes as developmental causes. (shrink)