This paper explores the impact that developments in the field of neuroprosthetics will have on the ethical viability of healthy limb amputation, specifically in cases of Body Integrity Identity Dis...

Interventions are medically necessary when they are vital in achieving the goal of medicine. However, with varying perspectives comes varying views on what interventions are (un)necessary and, thus, what potential treatment options are available for those suffering from the myriad of conditions, pathologies and disorders afflicting humanity. Medical necessity's teleological nature is perhaps best illustrated in cases where there is debate over using contentious medical interventions as a last resort. For example, whether it is appropriate for those suffering from body (...) integrity dysphoria to receive healthy limb amputations. This paper explores how one's perception of medicine's goal underpins whether interventions are necessary or unnecessary, using the controversial topic of therapeutic amputation as an example. By contrasting ‘classical’ amputations with their more contentious counterparts, it highlights how the idea of medical necessity influences and restrains clinical decision-making. The paper starts by giving an account of body integrity dysphoria, focusing on the debate concerning elective amputation's justifiability. It then introduces Georges Canguilhem's vitalist theory of health, paying particular attention to his emphasis on adaptability. Then, this paper uses his theory as a lens through which to evaluate the appropriateness of therapeutic amputation as a medically necessary procedure. Ultimately, the paper highlights how the label of medical necessity is withheld from potential therapeutic interventions because they fail to conform to pre-established ideas of medicine's purpose and that by doing so, potential harm befalls those who are left with no effective treatments and must look for solutions in the non-clinical world. (shrink)

Individuals with body integrity identity disorder seek to address a non-delusional incongruity between their body image and their physical embodiment, sometimes via the surgical amputation of healthy body parts. Opponents to the provision of therapeutic healthy-limb amputation in cases of BIID make appeals to the envisioned harms that such an intervention would cause, harms such as the creation of a lifelong physical disability where none existed before. However, this concept of harm is often based on a normative biomedical model of (...) health and disability, a model which conflates amputation with impairment, and impairment with a disability. This article challenges the prima facie harms assumed to be inherent in limb amputation and argues in favour of a potential treatment option for those with BIID. To do this, it employs the social model of disability as a means to separate the concept of impairment and disability and thereby separate the acute and chronic harms of the practice of therapeutic healthy-limb amputation. It will then argue that provided sufficient measures are put in place to ensure that those with atypical bodily constructions are not disadvantaged, the chronic harms of elective amputation would cease to be. (shrink)

Individuals with body integrity identity disorder seek to address a non-delusional incongruity between their body image and their physical embodiment, sometimes via the surgical amputation of healthy body parts. Opponents to the provision of therapeutic healthy-limb amputation in cases of BIID make appeals to the envisioned harms that such an intervention would cause, harms such as the creation of a lifelong physical disability where none existed before. However, this concept of harm is often based on a normative biomedical model of (...) health and disability, a model which conflates amputation with impairment, and impairment with a disability. This article challenges the prima facie harms assumed to be inherent in limb amputation and argues in favour of a potential treatment option for those with BIID. To do this, it employs the social model of disability as a means to separate the concept of impairment and disability and thereby separate the acute and chronic harms of the practice of therapeutic healthy-limb amputation. It will then argue that provided sufficient measures are put in place to ensure that those with atypical bodily constructions are not disadvantaged, the chronic harms of elective amputation would cease to be. (shrink)

Individuals with body integrity identity disorder seek to address a non-delusional incongruity between their body image and their physical embodiment, sometimes via the surgical amputation of healthy body parts. Opponents to the provision of therapeutic healthy-limb amputation in cases of BIID make appeals to the envisioned harms that such an intervention would cause, harms such as the creation of a lifelong physical disability where none existed before. However, this concept of harm is often based on a normative biomedical model of (...) health and disability, a model which conflates amputation with impairment, and impairment with a disability. This article challenges the prima facie harms assumed to be inherent in limb amputation and argues in favour of a potential treatment option for those with BIID. To do this, it employs the social model of disability as a means to separate the concept of impairment and disability and thereby separate the acute and chronic harms of the practice of therapeutic healthy-limb amputation. It will then argue that provided sufficient measures are put in place to ensure that those with atypical bodily constructions are not disadvantaged, the chronic harms of elective amputation would cease to be. (shrink)

Individuals with body integrity identity disorder seek to address a non-delusional incongruity between their body image and their physical embodiment, sometimes via the surgical amputation of healthy body parts. Opponents to the provision of therapeutic healthy-limb amputation in cases of BIID make appeals to the envisioned harms that such an intervention would cause, harms such as the creation of a lifelong physical disability where none existed before. However, this concept of harm is often based on a normative biomedical model of (...) health and disability, a model which conflates amputation with impairment, and impairment with a disability. This article challenges the prima facie harms assumed to be inherent in limb amputation and argues in favour of a potential treatment option for those with BIID. To do this, it employs the social model of disability as a means to separate the concept of impairment and disability and thereby separate the acute and chronic harms of the practice of therapeutic healthy-limb amputation. It will then argue that provided sufficient measures are put in place to ensure that those with atypical bodily constructions are not disadvantaged, the chronic harms of elective amputation would cease to be. (shrink)

The term body integrity identity disorder (BIID) describes the extremely rare phenomenon of persons who desire the amputation of one or more healthy limbs or who desire a paralysis. Some of these persons mutilate themselves; others ask surgeons for an amputation or for the transection of their spinal cord. Psychologists and physicians explain this phenomenon in quite different ways; but a successful psychotherapeutic or pharmaceutical therapy is not known. Lobbies of persons suffering from BIID explain the desire for amputation in (...) analogy to the desire of transsexuals for surgical sex reassignment. Medical ethicists discuss the controversy about elective amputations of healthy limbs: on the one hand the principle of autonomy is used to deduce the right for body modifications; on the other hand the autonomy of BIID patients is doubted. Neurological results suggest that BIID is a brain disorder producing a disruption of the body image, for which parallels for stroke patients are known. If BIID were a neuropsychological disturbance, which includes missing insight into the illness and a specific lack of autonomy, then amputations would be contraindicated and must be evaluated as bodily injuries of mentally disordered patients. Instead of only curing the symptom, a causal therapy should be developed to integrate the alien limb into the body image. (shrink)

The term body integrity identity disorder (BIID) describes the extremely rare phenomenon of persons who desire the amputation of one or more healthy limbs or who desire a paralysis. Some of these persons mutilate themselves; others ask surgeons for an amputation or for the transection of their spinal cord. Psychologists and physicians explain this phenomenon in quite different ways; but a successful psychotherapeutic or pharmaceutical therapy is not known. Lobbies of persons suffering from BIID explain the desire for amputation in (...) analogy to the desire of transsexuals for surgical sex reassignment. Medical ethicists discuss the controversy about elective amputations of healthy limbs: on the one hand the principle of autonomy is used to deduce the right for body modifications; on the other hand the autonomy of BIID patients is doubted. Neurological results suggest that BIID is a brain disorder producing a disruption of the body image, for which parallels for stroke patients are known. If BIID were a neuropsychological disturbance, which includes missing insight into the illness and a specific lack of autonomy, then amputations would be contraindicated and must be evaluated as bodily injuries of mentally disordered patients. Instead of only curing the symptom, a causal therapy should be developed to integrate the alien limb into the body image. (shrink)

Sufferers of body integrity identity disorder (BIID) experience a severe, non-delusional mismatch between their physical body and their internalised bodily image. For some, healthy limb amputation is the only alleviation for their significant suffering. Those who achieved an amputation, either self-inflicted or via surgery, often describe the procedure as resulting in relief. However, in England, surgeons who provide ‘elective amputations’ could face prosecution for causing grievous bodily harm (GBH) under section 18 of the Offences Against the Persons Act (...) 1861. Whether such a therapeutic intervention should be classified as GBH depends on the presence of harm, as, without harm, it is hard to argue that GBH has occurred. However, there is no agreed-upon definition of what constitutes harm. Such a definitional absence then begs the question, what is harm? It is this question which this article addresses, using the provision of healthy limb amputation in cases of BIID as an example. Drawing on metaphysics, this article will seek to clarify three separate contemporary models of harm: the counter-temporal, the counterfactual, and the non-comparative. Each model will be applied to the scenario of a surgeon carrying out a BIID-induced, therapeutic, healthy limb amputation, and in each, how harm may, or may not, be understood to have been caused will be explored. It concludes that an unexamined conception of harm is ill-equipped for employment in suspected cases of GBH when it is unclear whether harm has been caused and that a better-informed understanding of harm is required in cases where there is potential disagreement, be that in instances of BIID or a myriad of other borderline scenarios. (shrink)

The Problem of Overlappers is a puzzle about what makes it the case, and how we can know, that we have the parts we intuitively think we have. In this paper, I develop and motivate an overlooked solution to this puzzle. According to what I call the self-making view it is within our power to decide what we refer to with the personal pronoun ‘I’, so the truth of most of our beliefs about our parts is ensured by the very (...) mechanism of self-reference. Other than providing an elegant solution to the Problem of Overlappers, the view can be motivated on independent grounds. It also has wide-ranging consequences for how we should be thinking about persons. Among other things, it can help undermine an influential line of argument against the permissibility of elective amputation. After a detailed discussion and defence of the self-making view, I consider some objections to it. I conclude that none of these objections is persuasive and we should at the very least take seriously the idea that we are to some extent self-made. (shrink)

The term body integrity identity disorder (BIID) describes the extremely rare phenomenon of persons who desire the amputation of one or more healthy limbs or who desire a paralysis. Some of these persons mutilate themselves; others ask surgeons for an amputation or for the transection of their spinal cord. Psychologists and physicians explain this phenomenon in quite different ways; but a successful psychotherapeutic or pharmaceutical therapy is not known. Lobbies of persons suffering from BIID explain the desire for amputation in (...) analogy to the desire of transsexuals for surgical sex reassignment. Medical ethicists discuss the controversy about elective amputations of healthy limbs: on the one hand the principle of autonomy is used to deduce the right for body modifications; on the other hand the autonomy of BIID patients is doubted. Neurological results suggest that BIID is a brain disorder producing a disruption of the body image, for which parallels for stroke patients are known. If BIID were a neuropsychological disturbance, which includes missing insight into the illness and a specific lack of autonomy, then amputations would be contraindicated and must be evaluated as bodily injuries of mentally disordered patients. Instead of only curing the symptom, a causal therapy should be developed to integrate the alien limb into the body image. (shrink)

Easy to understand philosophy papers in all areas. Table of contents: Three Short Philosophy Papers on Human Freedom The Paradox of Religions Institutions Different Perspectives on Religious Belief: O’Reilly v. Dawkins. v. James v. Clifford Schopenhauer on Suicide Schopenhauer’s Fractal Conception of Reality Theodore Roszak’s Views on Bicameral Consciousness Philosophy Exam Questions and Answers Locke, Aristotle and Kant on Virtue Logic Lecture for Erika Kant’s Ethics Van Cleve on Epistemic Circularity Plato’s Theory of Forms Can we trust our senses? Yes (...) we can Descartes on What He Believes Himself to Be The Role of Values in Science Modern Science Kant’s Moral Philosophy Plato’s Republic as Pol Potist Bureaucracy Schopenhauer on Human Suffering Bertrand Russell on the Value of Philosophy The Philosophical Value of Uncertainty Logic Homework: Theorems and Models Searle vs. Turing on the Imitation Game Hume, Frankfurt, and Holbach on Personal Freedom Manifesto of the University of Wisconsin, Madison Secular Society Michael’s Analysis of the Limits of Civil Protections Bentham and Mill on Different Types of Pleasure Set Theory Homework Aristotle on Virtue Nagel On the Hard Problem Wittgenstein on Language and Thought Camus and Schopenhauer on the Meaning of Life Camus’ Hero as Rebel without a Cause My Little Finger: Camus’ Absurdism Illustrated Are Late-term Abortions Ethical? Does Mathematics Assume the Truth of Platonism? The Self-defeating Nature of Utilitarianism and Consequentialism Generally What is The Good Life? Bentham and Mill regarding types of pleasures Kant’s Moral Philosophy Five Short Papers on Mind-body Dualism Tracy Latimer’s Father had the Right to Kill Her: Towards a doctrine of generalized self-defense Arguments Concerning God and Morality Goldman, Rousseau and von Hayek on the Ideal State J.S Mill on Liberty and Personal Freedom A Kantian Analysis of a Borderline Date-rape Situation Living Well as Flourishing: Aristotle’s Conception of the Good Life Three Essays on Medical Ethics: Answers to Exam Questions on Elective Amputation, Vaccination, and Informed Consent Hobbes, Marx, Rousseau, Nietzsche: Their Central Themes De Tocqueville on Egoism Mill vs. Hobbes on Liberty Exam-Essays on the Moral Systems of Mill, Bentham, and Kant Kant’s Moral System Aristotle on Virtue Plato’s Cave Allegory An Ethical Quandary Superorganisms The Tuskegee Experiment A Rawlsian Analysis Why Moore’s Proof of an External World Fails A Defense of Nagel’s Argument Against Materialism A Utilitarian Analysis of a Case of Theft The Paradox of the Self-aware Wretch: An Analysis of Pascal’s Moral Philosophy Jean-Paul Sartre: Decline and Fall of a Marxist Sell-out A One Page Proof of Plato’s Theory of Forms Plato’s Republic as Pol Potist Bureaucracy The problem of the one and the many Four Short Essays on Truth and Knowledge What is ‘the Good Life?’ The Ontological Argument Different Political Philosophies: Plato, Locke, Madison, Rousseau, Hayek, and Mill on the State What do I know with certainty? Skepticism about skepticism Neuroscience and Freewill Operant Conditioning What makes us special? Are Late-term Abortions Ethical? No Two Papers on Epistemology: Gettier and Bostrom Examination Nietzsche on Punishment God’s Foreknowledge and Moral Responsibility . (shrink)

It is often claimed both that forgiveness is elective and that forgiveness is something that we do for reasons. However, there is a tension between these two central claims about the nature of forgiveness. If forgiving is something one does for reasons, then, at least sometimes, those reasons may generate a requirement to forgive or withhold forgiveness. While not strictly inconsistent with electivity, the idea of required forgiveness strikes some as antithetical to the spirit of the concept. They argue (...) that forgiveness is essentially elective. In this paper, I dispute these arguments. I argue that the intuitive plausibility of the position diminishes upon reflection and that the best arguments fail to explain why reasons to forgive, unlike most other reasons for action, cannot generate requirements. (shrink)

It is widely accepted that electoral representative democracy is better—along a number of different normative dimensions—than any other alternative lawmaking political arrangement. It is not typically seen as much of a competition: it is also widely accepted that the only legitimate alternative to electoral representative democracy is some form of direct democracy, but direct democracy—we are told—would lead to bad policy. This article makes the case that there is a legitimate alternative system—one that uses lotteries, not elections, to select political (...) officials— that would be better than electoral representative democracy. (shrink)

Jeremy sustained bilateral complete brachial plexus injuries in an auto collision on an icy road a month before his third birthday. The accident rendered both upper extremities completely flail and insensate: he has no motor or sensory function of his shoulders, elbows, wrists, or digits. Jeremy does, however, have normal function of the lower extremities. Physical therapists have worked with the child for over a year with no noted improvement in arm function. Jeremy falls frequently, causing injury to his face (...) and head, and occasionally, his arms get twisted or caught in his crib and his fingers turn blue. Jeremy's mother, who carries the main responsibility for his daily care, believes that his insensate arms are too heavy and “get in his way,” causing the falls. She and Jeremy's father present to the orthopedic clinic at the children's hospital with the request of having both arms amputated. The primary orthopedic surgeon and the orthopedic team disagree with the parents that bilateral upper-extremity amputation offers any medical benefit, but Jeremy's mother tells the surgeon that, if he will not perform the surgery, her family will find a doctor who will. The surgeon, who feels ethically distressed by the parental insistence on this amputation in such a young child, requests an ethics consultation. (shrink)

Twelve years ago the British media got wind of a London gynecologist who performed an elective reduction on a twin pregnancy reducing it to a singleton. Perhaps not surprisingly, opinion on the moral status of twin reductions was divided. But in the last few years new evidence regarding the medical risks of twin pregnancies has emerged, suggesting that twin reductions are relevantly similar to the reductions performed on high‐end multi‐fetal pregnancies. This evidence has appeared to resolve the moral debate.In (...) this paper I look at the role of clinical evidence in medical ethics. In particular I examine the role of clinical evidence in determining what counts as a significant harm or risk. First, I challenge the extent to which these empirical claims are descriptive, suggesting instead that the evidence is to some degree normative in character. Second, I question whether such empirical claims should count as evidence for what are essentially difficult ethical decisions – a role they appear to play in the case of elective reductions. I will argue that they should not, primarily because the value‐laden nature of this evidence conceals much of what is ethically at stake. It is important to recognize that empirical evidence cannot be a substitute for ethical deliberation. (shrink)

Few recent developments in information technology have been as hyped as blockchain, the first implementation of which was the cryptocurrency Bitcoin. Such hype furnishes ample reason to be skeptical about the promise of blockchain implementations, but I contend that there’s something to the hype. In particular, I think that certain blockchain implementations, in the right material, social, and political conditions, constitute excellent bases for common knowledge. As a case study, I focus on trust in election outcomes, where the ledger records (...) not financial transactions but vote tallies. I argue that blockchain implementations could foster warranted trust in vote tallies and thereby trust in the democratic process. Finally, I argue that if the promise of blockchain implementations as democratic infrastructure is to be realized, then democracies first need to ensure that these material, social, and political conditions obtain. (shrink)

Without drastic adjustment, this system cannot last much longer," writes Van Reybrouck. "If you look at the decline in voter turnout and party membership, and at the way politicians are held in contempt, if you look at how difficult it is to form governments, how little they can do and how harshly they are punished for it, if you look at how quickly populism, technocracy and anti-parliamentarianism are rising, if you look at how more and more citizens are longing for (...) participation and how quickly that desire can tip over into frustration, then you realize we are up to our necks." Not so very long ago, the great battles of democracy were fought for the right to vote. Now, Van Reybrouck writes, "it's all about the right to speak, but in essence it's the same battle, the battle for political emancipation and for democratic participation. We must decolonize democracy. We must democratize democracy." As history, Van Reybrouck makes the compelling argument that modern democracy was designed as much to preserve the rights of the powerful and keep the masses in line, as to give the populace a voice. As change-agent, Against Elections makes the argument that there are forms of government, what he terms sortitive or deliberative democracy, that are beginning to be practiced around the world, and can be the remedy we seek. In Iceland, for example, deliberative democracy was used to write the new constitution. A group of people were chosen by lot, educated in the subject at hand, and then were able to decide what was best, arguably, far better than politicians would have. A fascinating, and workable idea has led to a timely book to remind us that our system of government is a flexible instrument, one that the people have the power to change. (shrink)

This paper examines what, if anything, is morally problematic about the desire for healthy limb amputation. The paper begins with a brief survey of the empirical data concerning the desire to amputate a healthy limb, focusing on questions of characterisation and treatment. Subsequent to this, the paper focuses on two normative questions: is the amputation of a healthy limb in and of itself morally questionable if those persons requesting it are autonomous? And, are patients who desire the amputation of a (...) healthy limb autonomous? With respect to the first question, I reject two possible objections to healthy limb amputation, namely the claim that it is repugnant, and that it might cause harm to others, thus showing there is nothing inherently objectionable to healthy limb amputation. With respect to the second question, I critique two opposing views of patient autonomy from the healthy limb amputation literature, in order to show that the nature of the desire itself may inhibit a person‟s autonomy. (shrink)

In the United Kingdom, a number of National Health Service Clinical Commissioning Groups have proposed controversial measures to restrict elective surgery for patients who either smoke or are obese. Whilst the nature of these measures varies between NHS authorities, typically, patients above a certain Body Mass Index and smokers are required to lose weight and quit smoking prior to being considered eligible for elective surgery. Patients will be supported and monitored throughout this mandatory period to ensure their clinical (...) needs are appropriately met. Controversy regarding such measures has primarily centred on the perceived unfairness of targeting certain health states and lifestyle choices to save public money. Concerns have also been raised in response to rhetoric from certain NHS authorities, which may be taken to imply that such measures punitively hold people responsible for behaviours affecting their health states, or simply for being in a particular health state. In this paper, we examine the various elective surgery rationing measures presented by NHS authorities. We argue that, where obesity and smoking have significant implications for elective surgical outcomes, bearing on effectiveness, the rationing of this surgery can be justified on prognostic grounds. It is permissible to aim to maximise the benefit provided by limited resources, especially for interventions that are not urgently required. However, we identify gaps in the empirical evidence needed to conclusively demonstrate these prognostic grounds, particularly for obese patients. Furthermore, we argue that appeals to personal responsibility, both in the prospective and retrospective sense, are insufficient in justifying this particular policy. Given the strength of an alternative justification grounded in clinical effectiveness, rhetoric from NHS authorities should avoid explicit statements, which suggest that personal responsibility is the key justificatory basis of proposed rationing measures. (shrink)

In Section 1, we begin by asking what, exactly, it might mean for God to “elect” people and how this relates to their agency and freedom. After getting clearer on what God is supposed to elect people to or for, we argue against the view that a person’s will is not involved in the process by which God elects her, which we identify in part as the person’s coming to have faith. But, in Section 2, we consider several reasons for (...) thinking that a person’s free will is not involved in her coming to have faith, as well as a potential problem facing this view. Then, in the next three sections (3, 4, and 5) we examine three views on which one’s free will is involved in one’s coming to faith, corresponding roughly to three systematic views of divine providence. We discuss certain objections to each of these “models of election,” as well as how each speaks to the possibility of the non-elect. In the sixth and final section, we conclude by addressing the concern that any such philosophizing about God is too anthropomorphic. (shrink)

National Baha’i elections, conducted world-wide without nominations, competitive campaigns, or parties, challenge the emerging consensus that the only truly democratic elections are multiparty elections in which each party’s candidates compete freely for votes. National Baha’i electoral institutions are based on three core values: respect for the inherent dignity of each person, the unity and solidarity of persons collectively, and the justice and fairness of institutions. While liberal political philosophy interprets respect for dignity exclusively in terms of equality and freedom, the (...) Baha’i model interprets dignity to require respect for the equality, freedom, and nobility of each person. The perfectionist focus on nobility helps explain the distinct features of national Baha’i elections and, in particular, the ban on campaigning. In light of ongoing concerns about the character of the electoral process in actually existing democracies, further research into Baha’i elections and their philosophical foundations provides a promising basis for rethinking widely held liberal assumptions about how democratic elections must be conducted. (shrink)

The ethics of medically-authorized limb amputation in individuals with Body integrity identity disorder (BIID) remains extremely controversial. One factor to consider is the putative locus of a disease process, and whether the proposed treatment--in this case, limb amputation—reasonably addresses the issue of what organ is mediating the patient’s complaint.

This book discusses the relevance of philosophy courses within the undergraduate curriculum as integral to the self-formation that is at the heart of a liberal education. The objective is to provide a historically layered view of what it can still mean to study for its own sake. The elective university classroom is important because the course of study is chosen out of personal interest and enthusiasm, as opposed to being primarily governed by predetermined disciplinary objectives. It engages the student's (...) mind directly and freely, and counters the overly specialized minds favoured by the contemporary university as well as the commodification of its degrees. The discussion builds on the distinction put forward by Raymond Williams between a dominant culture (in this case, university study as contributing to research and/or marketable degrees) and alternative and/or oppositional cultures that have both residual and emergent dimensions. The elective stream of university study is treated as alternative and oppositional to the dominant culture. The elective university classroom is examined as a combination of a classroom, students, texts, and professors. Each element is explored in terms of its alternative/residual significance as illustrated through the history of philosophy: the classroom and students through the life and death of Socrates; texts through the origins of the university in medieval scholasticism; the professor in the Humboldtian reform of the university at the beginning of the nineteenth century in Berlin. (shrink)

In this essay I consider whether the political perspective of third wave science studies – ‘elective modernism’ – offers a suitable framework for understanding the policy-making contributions that (bio)ethical experts might make. The question arises as a consequence of the fact that I have taken inspiration from the third wave in order to develop an account of (bio)ethical expertise. I offer a précis of this work and a brief summary of elective modernism before considering their relation. The view (...) I set out suggests that elective modernism is a political philosophy and that although its use in relation to the use of scientific expertise in political and policy-making process has implications for the role of (bio)ethical expertise it does not, in the final analysis, provide an account that is appropriate for this latter form of specialist expertise. Nevertheless, it is an informative perspective, and one that can help us make sense of the political uses of (bio)ethical expertise. (shrink)

This paper examines the idea that forgiveness requires, either for its existence or for its justification, the meeting of moral and epistemic conditions which show that resentment is no longer warranted. I argue that this idea results in over-intellectualizing and over-moralizing forgiveness, and in failing to accommodate its elective nature. I sketch an alternative account, which appeals to the differences between emotions and beliefs, and the idea that we have more rational optionality with respect to emotions.

Proponents of the duty to vote (DTV) argue that in normal circumstances, citizens have the moral duty to vote in political elections. Discussions about DTV analyze _what_ the duty is, _who_ has this duty, _when_ they have it, and _why_ they have it. Missing are answers to the Specification Question: to _which_ elections does DTV apply? A dilemma arises for some supporters of DTV—in this paper, I focus on Julia Maskivker’s work—because either answer is problematic. First, I argue that it (...) is implausible that DTV applies to _all_ elections because this makes the duty too costly for the voter. Second, I argue that there are no good reasons why under normal circumstances DTV applies only to _some_ elections. I consider objections but conclude that the dilemma is successful and therefore the case for DTV is incomplete. (shrink)

This paper explains why elections are popular in India and why voter turnouts have remained stable. The evidence presented here shows that voters consider the electoral process itself as important, as this allows for the performative expression of the core ideals of democracy—citizenship, duty and rights, equality, cooperation, imagination of a common good-values that are otherwise wholly missing from polity the rest of the time. It is precisely because of its absence in daily life that people feel the urge to (...) embrace and celebrate these values when they are available during elections. Elections therefore emerge as aesthetic and ritual moments that allow for the inversion of the rules of normal social life. The resulting communitas creates a heightened awareness of what is missing in everyday hierarchical life, while simultaneously providing a glimpse of democracy's ideals of egalitarianism and cooperation. (shrink)

Egg freezing can allow women to preserve their eggs to avoid age-related infertility. The UK's recent extension of elective egg freezing storage has been welcomed as a way of enhancing the reproductive choices of young women who wish to delay having children. In this paper, I explore the issue of enhancing women’s reproductive choices, questioning whether there is a more significant aspect overlooked in egg freezing. While increasing storage limits expands reproductive choices for some women, focus on this extension (...) alone, I argue, misses a fundamental issue with egg preservation that often remains ignored; the importance of effective information on egg freezing and the effect this has on women’s reproductive choices. Ultimately, I highlight the crucial role of balanced information in enhancing women’s choices regarding egg freezing and argue that focusing on extending and increasing provision may obscure this real opportunity to empower women and their authentic reproductive choices. (shrink)

As illustrated in Goethe's famous novel of the same name, elective affinities are powerful relationships that crystallize under changing conditions. In this new book, Lydia Goehr focuses on the history of elective affinities between philosophy and music from German classicism, romanticism, and idealism to the modernist aesthetic theory of Theodor W. Adorno and Arthur C. Danto. Aesthetic theory, she argues, depends on a dynamic philosophy of history centered on tendencies, yearnings, needs, and potentialities. With this in mind, she (...) recasts the theses of Adorno and Danto regarding the death or end of philosophy, art, music, and human experience as arguments for continuation and survival. _Elective Affinities_ tracks the migration of aesthetic and critical theory from Germany to the United States following the catastrophic period of the twentieth century marked by the Second World War. (shrink)

The elections for the provincial councils, held on the 10th of March 1974, has shown results that are quite similar to those shown by the parliamentary elections. Traditional parties keep or reinforce their positions, whereas the linguistic parties suffer a setback-clear-cut in the case of the Rassemblement Wallon and the Front Démocratique des Bruxellois, but only limited for the Volksunie, which has a long-standing Flemish-nationalist tradition.

Two of the most influential arguments in favour of the permissibility of abortion were put forward in the latter half of the twentieth century by Judith Jarvis Thomson and Mary Anne Warren. The implications of these arguments for unwilling putative fathers have largely not been considered. Some have argued that Thomson's defence of abortion might allow a man under certain circumstances to terminate his parental responsibilities and rights. To my knowledge, nobody has considered the implications of Warren's argument for men. (...) I will consider the implications of both arguments for men. I will argue that if they are successful defences of abortion then they are also successful in justifying a male counterpart to abortion which I label ‘elective abandonment’. I will not be defending or attacking these arguments as defences of abortion, but will defend the claim that they apply as well to elective abandonment as they do to abortion. (shrink)

L'élection du sacerdoce, aux origines de la Compagnie de Jésus, paraît relever d'une évidence que n'explicitent guère les documents fondateurs. À la lumière de l'histoire, des Exercices, de la Storta, des premiers ministères et de la genèse de la Formula, ce choix d'un sacerdoce apostolique, pauvre et lettré, semble s'inscrire dans le désir d'imiter le Christ et les apôtres dans la totalité sacramentelle de leurs paroles et de leurs gestes. Centré sur la Parole, la Réconciliation et «l'office de consolation», enraciné (...) dans l'Eucharistie, le sacerdoce jésuite dessine une manière originale d'exercer le triple munus docendi, sanctificandi et gubernandi, dont Presbyterorum ordinis se fera l'écho. (shrink)

Lower limb major amputations are both life-saving procedures and life-changing events. Individual responses to limb loss are varied and complex, some individuals experience functional, psychological and social dysfunction, many others adjust and function well. Some patients refuse amputation for religious and/or cultural reasons. One of the greatest difficulties for a person undergoing amputation surgery is overcoming the psychological stigma that society associates with the loss of a limb. Persons who have undergone amputations are often viewed as incomplete individuals. (...) The medical and physical consequences of amputation serve as the centerpiece in acute care and are commonly at the forefront of prosthetic rehabilitation. Prosthetic prescription aims to compensate for functional and/or cosmetic losses where possible. The aims of rehabilitation following amputation are to restore acceptable levels of functioning that allow individuals to achieve their goals, to facilitate personal health, and to improve participation in society and quality of life either with or without prosthesis. Our article aims at underscoring some medical, social and religious aspects that can contribute to the wellbeing of patients who suffer a life changing event such as lower limb amputation. (shrink)

Elective Affinities: Musical Essays on the History of Aesthetic Theory collects a selection of Lydia Goehr's recent essays. In them she traces “a history of attraction and reaction … of music to philosophy, drama, birdsong, crime, film, and nationhood” . Goehr examines the ways that philosophers, the ideas that they present, and works of art display “elective affinities”. Her procedure is like that of an art historian who presents parallel slides to reveal visual affinities, even between artists who (...) themselves were unaware of each other. Her analyses are erudite, lucid, and always suggestive, but what I found most admirable in Elective Affinities is Goehr's extraordinarily brave experimentation with a novel form of philosophy-writing, the adumbration of which is the focus of this review. Her book is strange enough to be genuinely magnificent and lastingly influential. (shrink)

In deciding whether to forgive, we often focus on the wrongdoer, looking for an apology or a change of ways. However, to fully consider whether to forgive, we need to expand our focus from the wrongdoer and their wrongdoing, and we need to consider who we are, what we care about, and what we want to care about. The difference between blame and forgiveness is, at bottom, a difference in priorities. When we blame, we prioritize the wrong, and when we (...) forgive, we shift our priorities away from the wrong. Recognizing this essential role for priorities in forgiveness allows us to address a thorny puzzle in thinking about forgiveness: how is it that forgiveness can be both principled and elective? If there is sufficient reason to forgive, as will sometimes be the case because forgiveness is principled, how can it be reasonable to withhold forgiveness? Recognizing that forgiveness is a shift in our priorities dissolves this apparent tension between forgiveness being principled and forgiveness being elective. (shrink)

IN THE JEWISH—CHRISTIAN SCHISM REVISITED, JOHN HOWARD YODER gives an account of the Jewishness of the politics of Jesus and Pauline Christianity. He rightly claims that irresponsible historiography has presented early Christianity as a departure from the Jewish ways of its time, reading the later schism into the New Testament and belying the Jewishness of Christian ethics. He contends that living in the faithfully Jewish ways of Jeremiah, Jesus, and Paul, as many Jewish communities did up to the time of (...) Jesus and many non-Christian Jewish communities and free churches have done since, is what it means to be the people of God. After an appreciative exposition of Yoder's account and a brief articulation of its theological and ethical stakes, I argue that the biblical witness to the election of Israel troubles his understanding of the people of God as presupposed and conveyed by his revisionist historiography of the Jewish—Christian schism. (shrink)

The parliamentary elections in Albania took place on 25th March 2021 and they were won by the Socialist Party. Even though elections took place during the pandemic, the pandemics itself had a minor impact on the process. With the exception of making compulsory a two-week quarantine for those entering the country and thus making it impossible for the Albanian emigrants to cast their vote, the election campaign was organized similarly with the preceding campaigns without concerns for social distancing. The real (...) change which eventually influenced the campaign was the change in the electoral law from closed to open list. For the first time, the party and the party candidates pursued different strategies. In addition to the official campaign, there was an underground campaign with vote buying and exercise of influence which aimed and achieved to transfer vote from the top of the top of the list to candidates in the middle or even lower part of the list. This made it possible to observe and understand the internal conflicts within the parties. (shrink)

This paper presents the foundation upon which the contemporary knowledge of body integrity dysphoria (BID) is built. According to the World Health Organisation’s International Classification of Diseases, 11th edition (ICD-11), the main feature of BID is an intense and persistent desire to become physically disabled in a significant way. Three putative aetiologies that are considered to explain the insurgence of the condition are discussed: neurological, psychological and postmodern theories. The concept of bodily representation within the medical context is highlighted, with (...) the concept of dysphoria, which was brought to the fore with the introduction of the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5), and the ICD-11. Contemporary issues of “justice” are addressed to identify ethically relevant distinctions between BID and sex reassignment surgery. It is argued that there is no ethically relevant difference between the BID actor’s desire for invasive surgical intervention and the wish of gender dysphoric individuals to undergo sex reassignment surgery procedures. Some BID actors self-mutilate, and this presents medical professionals with difficult choices regarding whether or not to intervene in order to satisfy the BID patient’s desire. Both abstention and intervention may lead to severe ethical complications for doctors and patients despite the positive outcomes in terms of quality of life for BID individuals who manage to undergo such procedures. (shrink)

Under what conditions would we expect 100 million votes to divide 50-50, with variations that fall well within expected margins of error of 1-2 percent? There is a very simple model that would yield such expectations: people were voting at random. If tens of millions of votes were cast for X vs. Y as president of Mars, such results would be expected. To the extent that the simplest model is valid, the elections did not take place.

The word that immediately rolled off of every tongue after the presidential election was "historic." And rightly so. A Black family in the White House is truly a momentous event.

Since 2012-2013 academic years, elective courses have been added to the weekly course schedules. Within the religion, morality/ ethic and values group in the elective courses, Hz. Muhammad's Life, Koran and Basic Religious Knowledge (I-II) coursesare also included. This research was conducted on 413 students in five different schools affiliated to Kırıkkale Provincial Directorate of National Education in the academic year of 2017-2018 that is aiming to determine students' evaluations on subjects in the context of the course contents, (...) textbooks and teacher competences of elective religious courses. In this study, survey model and questionnaire technique were used in the study. According to the results of the research; Students who choose elective religion courses learn accurate information about religion. The sub subjects/ contents in elective religion course are given daily necessities of the students. There isn’t the effect of the friends on students’ choice of these classes. Also, there isn’t the effect of the headmaster and guidance teachers on students’ choice of these classes. But, there is also the effect of the parents on students’ choice of these classes. Elective religious lesson books are not prepared well. The textbook in elective courses doesn’t include enough activities / exercises. But the textbooks in elective religion courses have got enough pictures, photographs and tables. Training materials are not used in the courses. The teachers of these courses are adequate that is thought by the students. But on the other hand, it has been determined that the classes are crowded in the Qur'an courses so that there is not enough time left for the students. (shrink)

In response to foreign interference in elections, warlike language is understandable. As a hostile violation of sovereignty, election meddling fits one technical description of an invasion. However, just war theory, the most influential source of objective guidance for the ethical prosecution of wars, and the philosophical heart of international law concerning war, offers a sobering rejoinder. The theory suggests that, while election meddling is in fact a belligerent act, no actual use of military force could ever be ethically justified as (...) a response. (shrink)