Recent survey data gathered from British medical students reveal widespread acceptance of conscientious objection in medicine, despite the existence of strict policies in the UK that discourage conscientious refusals by students to aspects of their medical training. This disconnect demonstrates a pressing need to thoughtfully examine policies that allow conscience objections by medical students; as it so happens, the USA is one country that has examples of such policies. After presenting some background on promulgated US conscience protections and reflecting on (...) their significance for conscience objections by medical students, this paper observes that the dominant approach (following the American Medical Association's conscience clause) is to allow exempted students to instead be evaluated on the basis of alternative curricular activities to learn the associated underlying content. This paper then introduces and discusses an example in which male Muslim students who believe it is wrong to touch members of the opposite sex object to performing physical examinations on female subjects in their medical training. This sort of case, it is argued, causes difficulty for a conscience clause that resolves the dilemma by granting reasonable exemptions in the form of participation in alternative curricular activities: there are cases where one must perform the ‘objectionable’ activity itself in order to learn the necessary content and underlying principles. (shrink)

Friendships have important influences on children's well-being and future adjustment, and interpersonal forgiveness has been suggested as a crucial means for children to maintain friendships. However, existing measures of preadolescent children's forgiveness are restricted by developmental limitations to reporting emotional responses via questionnaire and inconsistent interpretations of the term “forgive.” This paper describes development and testing of concurrent and discriminant validity of a pictorial measure of children's emotional forgiveness, the Children's Forgiveness Card Set. In Study 1, 148 Australian children aged (...) 8–13 years responded to a hypothetical transgression in which apology was manipulated and completed the CFCS and extant measures of forgiveness and socially desirable responding. Following an exploratory factor analysis to clarify the structure of the CFCS, the CFCS correlated moderately with other forgiveness measures and did not correlate with socially desirable responding. Apology predicted CFCS responding among older children. In Study 2 an exploratory factor analysis broadly replicated the structure of the CFCS among a sample of N = 198 North American children aged 5–14 years. We also fitted an exploratory bi-factor model to the Study 2 data which clarified which cards best measured general forgiveness, or positive or hostile aspects of responding to transgressions. Apology once again predicted the CFCS, this time regardless of age. The CFCS appears a potentially valid measure of children's emotional forgiveness. Potential applications and differences between explicit and latent forgiveness in children are discussed. (shrink)

This study aims to examine the neural correlates of cognitive shifting during the Dimensional Change Card Sort Task task with functional near-infrared spectroscopy. Altogether 49 children completed the DCCS tasks, and 25 children passing all items were classified into the Switch group. Twenty children committing more than one perseverative errors were grouped into the Perseverate group. The Switch group had Brodmann Area 9 and 10 activated in the pre-switch period and BA 6, 9, 10, 40, and 44 in the post-switch (...) period. In contrast, the Perseverate group had BA 9 and 10 activated in the pre-switch period and BA 8, 9, 10 in the post-switch period. The general linear model results afford strong support to the “V-shape curve” hypothesis by identifying a significant decrease–increase cycle in BA 9 and 44, the neural correlations of cognitive shifting. (shrink)

Various philosophers have argued that in order to be morally responsible, we need to be the "ultimate sources'' of our choices and behavior. Although there are different versions of this sort of argument, I identify a "picture'' that lies behind them, and I contend that this picture is misleading. Joel Feinberg helpfully suggested that we scale down what might initially be thought to be legitimate demands on "self-creation,'' rather than jettison the idea that we are truly and robustly responsible. I (...) follow Feinberg in rejecting various "inflated'' demands on "origination,'' "initiation,'' or ultimate sourcehood. (shrink)

Various philosophers have argued that in order to be morally responsible, we need to be the "ultimate sources'' of our choices and behavior. Although there are different versions of this sort of argument, I identify a "picture'' that lies behind them, and I contend that this picture is misleading. Joel Feinberg helpfully suggested that we scale down what might initially be thought to be legitimate demands on "self-creation,'' rather than jettison the idea that we are truly and robustly responsible. I (...) follow Feinberg in rejecting various "inflated'' demands on "origination,'' "initiation,'' or ultimate sourcehood. (shrink)

Professor Card is not disposed to object to the main argument of my paper, which was intended to reply to Professor Lyons’ suggestion that a utilitarian cannot explain how legal rights have moral force, and at the same time to urge that the particular form of utilitarianism espoused by Professor Hare in his recent work does seem to be open to the difficulty Professor Lyons alleges. Professor Card says she is ‘not dissatisfied’ with this reasoning. I suspect that Card views (...) my criticism of Professors Lyons and Hare as part of an in-house squabble among philosophers all of whom have utilitarian leanings of one sort or another; and she is not disposed to intervene in this. She does, however, have serious reservations about utilitarian views of rights in general, and about mine in particular; her paper consists almost entirely of her statement of these reservations. I find her remarks very welcome, since they express some objections which may be widely felt, and a response to which may therefore contribute to philosophers’ thinking about these issues. (shrink)

From the editor: On behalf of the editors of FPQ, I thank our colleagues for providing us their public addresses at the Celebration of Life of Professor Claudia Falconer Card of the University of Wisconsin-Madison, who died on Saturday, September 12, 2015. Claudia Card was the author of over one hundred articles and books, key works of moral and feminist philosophy including Confronting Evils: Terrorism, Torture, Genocide, The Atrocity Paradigm: A Theory of Evil, and The Unnatural Lottery: Character and Moral (...) Luck. She was the president of the Central division of the APA 2010-2011, which she often described as her favorite division of the APA. She earned her BA from UW-Madison, and her PhD in 1969 from Harvard University, as the advisee of John Rawls, whom she spoke of with affection as one of the most sensitive and generous of philosophers. I remain grateful to Claudia for being the sort of philosopher who helped her students, colleagues, and readers to confront our responsibilities, and the responsibilities of others, as she lived her own philosophy of taking responsibility for one’s own identity. K.J. Norlock. (shrink)

What distinguishes evils from ordinary wrongs? Are some evils unforgivable? How should we respond to evils? Card offers a secular theory of evil--representing a compromise between classic utilitarian and stoic approaches--that responds to these and other questions.

Social death, central to the evil of genocide, distinguishes genocide from other mass murders. Loss of social vitality is loss of identity and thereby of meaning for one's existence. Seeing social death at the center of genocide takes our focus off body counts and loss of individual talents, directing us instead to mourn losses of relationships that create community and give meaning to the development of talents.

The opportunities to become a good person are not the same for everyone. Modern European ethical theory, especially Kantian ethics, assumes the same virtues are accessible to all who are capable of rational choice. Character development, however, is affected by circumstances, such as those of wealth and socially constructed categories of gender, race, and sexual orientation, which introduce factors beyond the control of individuals. Implications of these influences for morality have, since the work of Williams and Nagel in the seventies, (...) raised questions in philosophy about the concept of moral luck. In The Unnatural Lottery, Claudia Card examines how luck enters into moral character and considers how some of those who are oppressed can develop responsibility. Luck is often best appreciated by those who have known relatively bad luck and have been unable to escape steady comparison of their lot with those of others. The author takes as her paradigms the luck of middle and lower classes of women who face violence and exploitation, of lesbians who face continuing pressure to hide or self-destruct, of culturally Christian whites who have ethnic privilege, and of adult survivors of child abuse. How have such people been affected by luck in who they are and can become, the good lives available to them, the evils they may be liable to embody? Other philosophers have explored the luck of those who begin from privileged positions and then suffer reversals of fortune. Claudia Card focuses on the more common cases of those who begin from socially disadvantaged positions, and she considers some who find their good luck troubling when its source is the unnatural lottery of social injustice. (shrink)

This essay reflects on issues raised by commentators regarding my book, The Atrocity Paradigm: A Theory of Evil (Oxford 2002). They are (1) Robin Schott's observation of the tension between my discussion of forgiveness and of castration fantasies; (2) Bat-Ami Bar On's questions regarding whether evil is ethical, political, or both; (3) Adam Morton's queries regarding the relative seriousness of evils and injustices; and (4) María Pía Lara's concerns regarding what is valuable in Kant's ethics.

Margaret Walker's Moral Understandings offers an “expressive-collaborative,” culturally situated, practice—based picture of morality, critical of a “theoretical-juridical” picture in most prefeminist moral philosophy since Henry Sidgwick. This essay compares her approach to ethics with that of John Rawls, another exemplar of the “theoretical-juridical” model, and asks how Walker's approach would apply to several ethical issues, including interaction with animals, social reform and revolution, and basic human rights.

: Margaret Walker's Moral Understandings offers an "expressive-collaborative," culturally situated, practice-based picture of morality, critical of a "theoretical-juridical" picture in most prefeminist moral philosophy since Henry Sidgwick. This essay compares her approach to ethics with that of John Rawls, another exemplar of the "theoretical-juridical" model, and asks how Walker's approach would apply to several ethical issues, including interaction with (other) animals, social reform and revolution, and basic human rights.

Although the exclusion of LGBTs from the rites and rights of marriage is arbitrary and unjust, the legal institution of marriage is itself so riddled with injustice that it would be better to create alternative forms of durable intimate partnership that do not invoke the power of the state. Card's essay develops a case for this position, taking up an injustice sufficiently serious to constitute an evil: the sheltering of domestic violence.

This book argues that a conscientiously objecting medical professional should receive an exemption only if the grounds of an objector's refusal are reasonable. It defends a detailed, contextual account of public reasonability suited for healthcare, which builds from the overarching concept of Rawlsian public reason. The author analyzes the main competing positions and maintains that these other views fail precisely due to their systematic inattention to the grounding reasons behind a conscientious objection; he argues that any such view is plausible (...) to the extent that it mimics the 'reason-giving requirement' for conscience objections defended in this work. Only reasonable objections can defeat the prior professional obligation to assign primacy to patient well-being, therefore one who refuses a patient's request for a legally available, medically indicated, and safe service must be able to explain the grounds of their objection in terms understandable to other citizens within the public institutional structure of medicine. The book further offers a novel policy proposal to deploy the Reasonability View: establishing conscientious objector status in medicine. It concludes that the Reasonability View is a viable and attractive position in this debate. A New Theory of Conscientious Objection in Medicine: Justification and Reasonability will be of interest to researchers and advanced students working in bioethics, medical ethics, and philosophy of medicine, as well as thinkers interested in the intersections between law, medical humanities, and philosophy. (shrink)

What distinguishes evils from ordinary wrongs? Is hatred a necessarily evil? Are some evils unforgivable? Are there evils we should tolerate? What can make evils hard to recognize? Are evils inevitable? How can we best respond to and live with evils? Claudia Card offers a secular theory of evil that responds to these questions and more. Evils, according to her theory, have two fundamental components. One component is reasonably foreseeable intolerable harm -- harm that makes a life indecent and impossible (...) or that makes a death indecent. The other component is culpable wrongdoing. Atrocities, such as genocides, slavery, war rape, torture, and severe child abuse, are Card's paradigms because in them these key elements are writ large. Atrocities deserve more attention than secular philosophers have so far paid them. They are distinguished from ordinary wrongs not by the psychological states of evildoers but by the seriousness of the harm that is done. Evildoers need not be sadistic:they may simply be negligent or unscrupulous in pursuing their goals. Card's theory represents a compromise between classic utilitarian and stoic alternatives (including Kant's theory of radical evil). Utilitarians tend to reduce evils to their harms; Stoics tend to reduce evils to the wickedness of perpetrators: Card accepts neither reduction. She also responds to Nietzsche's challenges about the worth of the concept of evil, and she uses her theory to argue that evils are more important than merely unjust inequalities. She applies the theory in explorations of war rape and violence against intimates. She also takes up what Primo Levi called "the gray zone", where victims become complicit in perpetrating on others evils that threaten to engulf themselves. While most past accounts of evil have focused on perpetrators, Card begins instead from the position of the victims, but then considers more generally how to respond to -- and live with -- evils, as victims, as perpetrators, and as those who have become both. (shrink)

In this contribution to philosophical ethics, Claudia Card revisits the theory of evil developed in her earlier book The Atrocity Paradigm, and expands it to consider collectively perpetrated and collectively suffered atrocities. Redefining evil as a secular concept and focusing on the inexcusability - rather than the culpability - of atrocities, Card examines the tension between responding to evils and preserving humanitarian values. This stimulating and often provocative book contends that understanding the evils in terrorism, torture and genocide enables us (...) to recognise similar evils in everyday life: daily life under oppressive regimes and in racist environments; violence against women, including in the home; violence and executions in prisons; hate crimes; and violence against animals. Card analyses torture, terrorism and genocide in the light of recent atrocities, considering whether there can be moral justifications for terrorism and torture, and providing conceptual tools to distinguish genocide from non-genocidal mass slaughter. (shrink)

Torture is like slavery (and unlike murder and genocide) in that it is not inconceivable that torture might be justifiable. But the circumstances that would make it tolerable are unrealistic in philosophically interesting ways. It is unrealistic to think we can predict when torture will be effective and containable; unwarranted to suppose that humane alternatives are impossible; disastrous to remove motivations to create alternatives; unacceptable to be satisfied with available evidence regarding suspects’ identity, knowledge of critical detail, ability to recall (...) it, or reasons for not providing it. Most importantly, the costs of even successful interrogational torture would negate the gains sought. Or so this essay argues. (shrink)

This article argues that practitioners have a professional ethical obligation to dispense emergency contraception, even given conscientious objection to this treatment. This recent controversy affects all medical professionals, including physicians as well as pharmacists. This article begins by analyzing the option of referring the patient to another willing provider. Objecting professionals may conscientiously refuse because they consider emergency contraception to be equivalent to abortion or because they believe contraception itself is immoral. This article critically evaluates these reasons and concludes that (...) they do not successfully support conscientious objection in this context. Contrary to the views of other thinkers, it is not possible to easily strike a respectful balance between the interests of objecting providers and patients in this case. As medical professionals, providers have an ethical duty to inform women of this option and provide emergency contraception when this treatment is requested. (shrink)

Current mainstream approaches to conscientious objection either uphold the standards of public health care by preventing objections or protect the consciences of health‐care professionals by accommodating objections. Public justification approaches are a compromise position that accommodate conscientious objections only when objectors can publicly justify the grounds of their objections. Public justification approaches require objectors and assessors to speak a common normative language and to this end it has been suggested that objectors should be required to cast their objection in terms (...) of public reason. We provide critical support for such a public reason condition and argue that it would be neither too demanding nor too permissive. We also respond to objections that it unfairly favours secular over religious objectors and that public reasons cannot be held with the kind of sincerity thought to characterize conscientious objections. (shrink)