Patient safety is a central aspect of healthcare quality, focusing on preventable, iatrogenic harm. Harm, in this context, is typically assumed to mean physical injury to patients, often caused by technical error. However, some contributions to the patient safety literature have argued that disrespectful behavior towards patients can cause harm, even when it does not lead to physical injury. This paper investigates the nature of such dignitary harms and explores whether they should be included within the scope of patient safety (...) as a field of practice. We argue that dignitary harms in health care are—at least sometimes—preventable, iatrogenic harms. While we caution against including dignitary harms within the scope of patient safety just because they are relevantly similar to other iatrogenic harms, we suggest that thinking about dignitary harms can help to elucidate the value of patient safety, and to illuminate the evolving relationship between safety and quality. (shrink)

This paper begins with the idea that there are sometimes gaps in our shared linguistic/ conceptual resources that make it difficult for us to understand our own social experiences, and to make them intelligible to others. In this paper, I focus on three cases of this sort, some of which are drawn from the literature on hermeneutical injustice. I offer a diagnosis of what the gaps in these cases consist in, and what it takes to fill them. I argue that (...) these gaps are filled in, at least initially, by labels of a particular kind. Specifically, these are labels that allow us to see the experiences in question as novel instances of phenomena with which we are already normatively familiar. Further, I also show that these labels bring with them important downsides: they introduce distortions into our understandings of these experiences. Using a pair of case studies (‘statutory rape,’ ‘sexual harassment’), I illustrate these distortions. (shrink)

ABSTRACT This paper examines Mary Kate McGowan’s account of oppressive speech. McGowan argues that ordinary hateful speech can oppress by enacting discriminatory norms, and further, that this enactment sometimes renders the speech regulable under current United States law. In response, the paper raises two sets of questions. First, it asks about the contents of the norms enacted by a given hateful utterance, and specifically, about what determines those contents. Second, the paper also questions McGowan’s emphasis on the distinction between causing (...) harm and enacting (or constituting) harm. It argues that, contra that emphasis, this distinction doesn’t matter for the regulability of speech in McGowan’s central cases. (shrink)

Discrimination is typically understood to be a comparative phenomenon: S is discriminated against on the basis of trait T if she would not have been treated in the same way if she did not possess T. But the comparative test for discrimination may hide from view some important cases: associational discrimination and stereotype policing. These cases show more clearly what is true of discrimination in general: that it involves a vicarious wrong, that is, an action which wrongs someone other than (...) the primary object of disregard. This suggests why philosophers disagree whether discrimination is wrong because it causes harm or because it expresses disrespect. Paradigmatic cases of discrimination involve both harm and disrespect, but direct the harm and the disrespect towards different targets by treating the harmed individual as a mere representative of the targeted group. Discrimination is dehumanizing, and morally distinctive, precisely because of this fact. (shrink)

According to Miranda Fricker, being hindered from rendering something significant about oneself intelligible to someone constitutes a hermeneutical injustice only if it results from the hermeneutical marginalization of some group to which one belongs. A major problem for Fricker’s picture is that it cannot properly account for the paradigm case of hermeneutical injustice Fricker herself takes from Ian McEwan’s novel Enduring Love. In order to account properly for this case, I argue that being hindered from rendering something significant about oneself (...) intelligible to someone can constitute a hermeneutical injustice so long as it results from the hermeneutical marginalization of some group - whether or not one belongs to that group. One upshot is that Fricker’s distinction between systematic and incidental cases of hermeneutical injustice needs redrawing, and I show how this can be done. Another is that hermeneutical injustice is more widespread than Fricker recognizes. (shrink)

Journal of Political Philosophy, EarlyView.

Although feminists resist accounts that define women as having certain features that are essential to their being women, feminists are also guilty of giving essentialist definitions. Because women are extremely diverse in their experiences, the essentialist critics question whether a universal account of women can be given. I argue that it is possible to formulate a valuable category of woman, despite potential essentialist challenges. Even with diversity among women, women are oppressed as women by patriarchal structures such as rape, pornography, (...) and sexual harassment that regulate women’s sexuality and construct women as beings whose main role is to service men’s sexual needs. (shrink)

In a critique of sex-based theories of rape, Aletta Brenner suggests that feminists such as Catharine MacKinnon rely on a harmful set of assumptions when theorizing about the law of rape leading to harms to victims and perpetrators. I defend MacKinnon’s position in order to demonstrate how MacKinnon’s theory does not employ the assumptions Brenner suggests and therefore does not lead harms. However, I highlight one concern of Brenner’s that MacKinnon’s theory does not adequately address: that MacKinnon insists that all (...) rape is sex based. I posit that in Same Sex Mutual Intimate Partner Violence, rape appears to be sexual-orientation based rather that sex based and suggest that MacKinnon’s theory ought to make distinctions that allow the law to be sensitive to those most vulnerable to rape. (shrink)

This dissertation develops and defends a conception of sexualized violence that is rooted in philosophical theories of violence, and at the same time helps us understand the way that violence is connected to various kinds of oppression, namely, the oppression of women. It argues that sexualized violence, which is typically theorized through related notions of physical violation and psychological trauma, is best understood in terms of its moral quality. Sexualized violence against women is fundamentally a moral problem insofar as it (...) disrupts victims' ability to grow and develop in relationships with others, to conceive and meet responsibilities to and emerging from those relationships, and well as the ability to challenge unjust social norms, practices and institutions that in part constitute who we are. This moral quality of violence is investigated through an engagement with the concept of moral integrity, arguing that integrity is grounded in authenticity, understood through the existential-phenomenological tradition. Integrity-as-authenticity paves the way for understanding sexualized violence as a form of moral disintegration, where the dynamism and flexibility required of authentic selfhood is frustrated. Understanding violence and victimization in this way, I argue for a robust notion of advocacy as part of our response to victims. Advocacy--giving voice--will require the development of new concepts and language adequate to the experiences of victims, it will also require the cultivation of spaces and relationships where victims can speak, and it may require that we lend our voices to and for victims. (shrink)