Health disparities education is an integral and required part of medical professional training, and yet existing curricula often fail to effectively denaturalize injustice or empower learners to advocate for change. We discuss a novel collaborative intervention that weds the health humanities to the field of health equity. We draw from the health humanities an intentional focus retraining provider imaginations by centering patient narratives; from the field of health equity, we draw the linkage between stigmatized social identities and health disparities. We (...) describe a longitudinal health equity curriculum for the Hospice and Palliative Medicine fellowship in Memphis, Tennessee, to give trainees exposure to the concept of structural violence and how it affects clinical care. The curriculum was developed in partnership with humanities and social sciences faculty who staff a Health Equity academic program at a small liberal arts college in Memphis. This curriculum has been implemented for the past four years in support of 22 hospice and palliative medicine fellows. Group debriefs and a mixed methods survey have revealed widespread and lasting impact towards understanding health equity concepts, enhanced communication and treatment of patients, and empowerment to address the broader needs and policies affecting patients and the communities in which they live. Ultimately, we model an educational initiative that integrates equity across the full scope of healthcare practice and equips learners with skills for sustaining compassionate practices, focusing on equity-oriented, person-centered care across the full scope of healthcare practice. (shrink)

Constitutivists hope to locate the foundations of ethics in the nature of action. They hope to find norms that are constitutive of agency. Recently David Enoch has argued that even if there are such norms, they cannot provide the last word when it comes to normativity, since they cannot tell us whether we have reason to be agents rather than shmagents. I argue that the force of the shmagency objection has been considerably overestimated, because philosophers on both sides of the (...) debate have failed to grasp the true source of the authority of agency’s constitutive norm. Some constitutivists believe that this authority is rooted in the inescapability of agency. Yet agency is not, in fact, inescapable. What actually grounds the authority of agency’s constitutive norm is the fact that there is no standpoint outside of agency from which we can intelligibly ask normative questions. (shrink)

Reasons are considerations that figure in sound reasoning. This is considered by many philosophers to be little more than a platitude. I argue that it actually has surprising and far-reaching metanormative implications. The view that reasons are linked to sound reasoning seems platitudinous only because we tend to assume that soundness is a normative property, in which case the view merely relates one normative phenomenon (reasons) to another (soundness). I argue that soundness is also a descriptive phenomenon, one we can (...) pick out with purely descriptive terms, and that the connection between normative reasons and sound reasoning therefore provides the basis for a reductive account of reasons. Like all proposed reductions, this one must confront some version of G. E. Moore’s open question argument. I argue that a reductive view rooted in the idea that reasons figure in sound reasoning is well-equipped to meet the open question challenge head on. (shrink)

When we make ethical claims, we invoke a kind of objective authority. A familiar worry about our ethical practices is that this invocation of authority involves a mistake. This worry was perhaps best captured by John Mackie, who argued that the fabric of the world contains nothing so queer as objective authority and thus that all our ethical claims are false. Kantians such as Christine Korsgaard and David Velleman offer accounts of the objectivity of ethics that do without the controversial (...) realist assumptions which gives rise to Mackie’s skepticism. They contend that our ethical claims correctly invoke objective authority not by corresponding to some normative pocket of the fabric of reality, but rather by expressing commitments that are inescapable. This Kantian strategy is often advertised as an alternative to traditional but “boring” metaethics. Its proponents promise to vindicate our ethical practices without entangling us in familiar metanormative disputes about the metaphysics, epistemology and semantics of ethics. In this paper, I argue that the Kantian strategy cannot make good on this promise. Considered as an attempt to sidestep traditional metaethics, it lacks the resources to produce the desired normative conclusions. The outlook for the Kantian strategy becomes more promising, though, if we pair it with one of two familiar metanormative theories: expressivism or reductionism. The resulting metaethically-loaded versions of the Kantian strategy can deliver the promised conclusions, but only by plunging straight into the quagmire of traditional metaethics. And there all of the familiar objections to expressivism and reductionism await. (shrink)

How is practical reasoning related to ethical reasoning? The most common view is that they are identical: practical reasoning just is ethical reasoning. I criticize this view and then propose an alternative account of the relation between ethical thought and practical thought: ethical reasoning is reasoning about sound practical reasoning. I argue that this account of the relation between ethics and practical reasoning explains various phenomena that more familiar views leave unexplained. It also entails that the philosophy of action bears (...) heavily on ethical inquiry. (shrink)

Constitutivists seek to locate the metaphysical foundations of ethics in nonnormative facts about what is constitutive of agency. For most constitutivists, this involves grounding authoritative norms in the teleological structure of agency. Despite a recent surge in interest, the philosophical move at the heart of this sort of constitutivism remains underdeveloped. Some constitutivists—Foot, Thomson, and Korsgaard (at least in her recent *Self-Constitution*)—adopt a broadly Aristotelian approach. They claim that the functional nature of agency grounds normative judgments about agents in much (...) the same way that the functional natures of artifacts and bodily organs ground normative judgments about those kinds of things. I argue that the neo-Aristotelian conclusions about goodness which follow so straightforwardly from teleological premises are not genuinely normative. Functions are not by their very nature normatively significant. Other constitutivists—notably J. David Velleman and Paul Katsafanas—eschew Aristotelian talk of functions in favor of an approach based on the idea that agency has a constitutive aim. Velleman and Katsafanas both claim that aims are normatively significant. I argue that the fact that agency has a constitutive aim is merely a fact about the motives that produce and regulate actions. And so we are still left with a gap between the teleological and the normative. I conclude by suggesting that constitutivists have failed to find a way to bridge this gap not because none exists, but rather because they have been looking in the wrong place. The constitutivist project can be salvaged, but only if it is supplemented with a reductive metanormative account of reasons for action, an account that links reasons to sound or successful practical reasoning. (shrink)

Contemporary feminist theory is at an impasse: the project of reformulating concepts of self and social identity is thwarted by an association between identity and oppression and victimhood. In Sacrificial Logics, Allison Weir proposes a way out of this impasse through a concept of identity which depends on accepting difference. Weir argues that the equation of identity with repression and domination links "relational" feminists like Nancy Chodorow, who equate self-identity with the repression of connection to others, and poststructuralist feminists (...) like Judith Butler, who view any identity as a repression of nonidentity and difference. Through readings of Chodorow, Butler, Jessica Benjamin, Luce Irigaray, Jacqueline Rose and Julia Kristeva, Weir analyzes the relation of theories of self-identity to theories of women's identity, social identity, the identity of meaning in language and feminist solidarity. Drawing particularly on the work of Julia Kristeva, she argues for a reformulation of self-identity as a capacity to participate in a social world, and sketches a model of a self-identity which depends on a capacity to accept nonidentity, difference and connections to others. (shrink)

Recently, bioethicists and the UNCRPD have advocated for supported medical decision-making on behalf of patients with intellectual disabilities. But what does supported decision-making really entail? One compelling framework is Anita Silvers and Leslie Francis’ mental prosthesis account, which envisions supported decision-making as a process in which trustees act as mere appendages for the patient’s will; the trustee provides the cognitive tools the patient requires to realize her conception of her own good. We argue that supported decision-making would be better understood (...) as a collaborative process, giving patients with intellectual disabilities the opportunity to make decisions in a respectful relationship with trusted others. We offer an alternative account of supported decision-making where the primary constraint is to protect the patient from domination by the trustee. This is advantageous in its preservation of the prospects for genuine collaboration, for the mental prosthesis approach ultimately reinforces a problematic ideal of isolated patient self-determination. (shrink)

Is conceptual engineering feasible? Answering that question requires a theory of semantic change, which is sometimes thought elusive. Fortunately, much is known about semantic change as it occurs in the wild. While usage is chaotic and complex, changes in a word’s use can produce changes in its meaning. There are several under-appreciated empirical constraints on how meanings change that stem from the following observation: word use finely reflects equilibrium between various communicative pressures. Much of the relevant work in linguistics has (...) employed the methods of empirical pragmatics and diachronic semantics. In this way, the study of meaning change can be brought to bear on the conceptual engineer’s normative project. The picture that emerges tells against the sorts of engineering projects most likely to appeal to philosophers. Some may stand to succeed, but they have significantly different contours than the typical ones. (shrink)

Many philosophers believe that Robert Nozick's experience machine argument poses an insurmountable obstacle to hedonism as a theory of well-being. After an initial attempt to demonstrate that the persuasiveness of this argument rests on a key ambiguity, I argue that the intuitions to which the thought experiment appeals are not nearly as clear as many philosophers suppose they are. I believe that a careful consideration of the origin of those intuitions -- especially in light of the so-called "paradox of hedonism" (...) -- reveals that they can, in fact, fit quite comfortably into a hedonistic theory of well-being. (shrink)

Henry E. Allison presents an analytical and historical commentary on Kant`s transcendental deduction of the pure concepts of the understanding in the Critique of Pure Reason. He argues that, rather than providing a new solution to an old problem, it addresses a new problem, and he traces the line of thought that led Kant to the recognition of the significance of this problem in his 'pre-critical' period. In addition to the developmental nature of the account of Kant`s views presented (...) here, two distinctive features of Allison's reading of the deduction are a defense of Kant`s oft criticized claim that the conformity of appearances to the categories must be unconditionally rather than merely conditionally necessary and an insistence that the argument cannot be separated from Kant`s transcendental idealism. (shrink)

How can we think about identities in the wake of feminist critiques of identity and identity politics? Allison Weir rethinks conceptions of individual and collective identities in relation to freedom.

This book constitutes one of the most important contributions to recent Kant scholarship. In it, one of the pre-eminent interpreters of Kant, Henry Allison, offers a comprehensive, systematic, and philosophically astute account of all aspects of Kant's views on aesthetics. The first part of the book analyses Kant's conception of reflective judgment and its connections with both empirical knowledge and judgments of taste. The second and third parts treat two questions that Allison insists must be kept distinct: the (...) normativity of pure judgments of taste, and the moral and systematic significance of taste. The fourth part considers two important topics often neglected in the study of Kant's aesthetics: his conceptions of fine art, and the sublime. (shrink)

This landmark book is now reissued in a new edition that has been vastly rewritten and updated to respond to recent Kantian literature.

Henry Allison is one of the foremost interpreters of the philosophy of Kant. This new volume collects all his recent essays on Kant's theoretical and practical philosophy. All the essays postdate Allison's two major books on Kant, and together they constitute an attempt to respond to critics and to clarify, develop and apply some of the central theses of those books. Two are published here for the first time. Special features of the collection are: a detailed defence of (...) the author's interpretation of transcendental idealism; a consideration of the Transcendental Deduction and some other recent interpretations thereof; further elaborations of the tensions between various aspects of Kant's conception of freedom and of the complex role of this conception within Kant's moral philosophy. (shrink)

When I classify Fluffy as a cat, I appear to do so out of an appreciation of a prior metaphysical fact, namely, that she has a nature or essence common to creatures we classify as cats. Locke turns this picture on its head. Our actual practices of naming and sorting individuals into kinds proceed according to ideas in the mind. As Locke puts it, species (kinds) are ‘the Workmanship of the Understanding,’ not the workmanship of nature, because their essences consist (...) in abstract ideas, or ‘nominal essences,’ we make. Many take Locke to mean that the observable similarities and differences between things leave it undetermined how we are to group and distinguish them, so that classification is, and must be, a matter of convention. And while Locke never denies that individuals have real essences, it is argued that knowledge of them would not reveal natural boundaries, either. On this influential reading, nature does not draw boundaries between kinds, and she makes this fact apparent to us. I argue that Locke’s claim that nature does not determine the ‘Boundaries of the Species of Things’ should be understood as the claim that nature does not draw the variable boundaries set out in the nominal essences we make. Differences in our nominal essences reflect differences in speakers’ knowledge of external ‘standards,’ which we latch on to by way of their ‘leading’ qualities, which present the mind with a limited number of unique and highly salient bases for classification. On my reading, nature may very well draw boundaries of her own. (shrink)

Phillips & Singer's compelling presentation is weakest in its demonstration of commonalities between sensory plasticity and higher forms of learning and behavior. We propose that available data on schizophrenia can provide such evidence, because of the presence of impairments in a number of functions central to their model, and strong relationships between these dysfunctions and behavior.

I argue that Locke’s various descriptions of real essence pick out one and the same thing, namely a nature that can be ascribed to many things, and in terms of which we can get matters of classification right or wrong. On my reading, Locke does not attack real essences of the sort that are the essences of real species, but rather the presumption that a sorting according to our species concepts and their names is a sorting of things according to (...) their real essences. And the lesson of Locke’s empirical argument against that presumption, I argue, is that our species concepts often function more like higher taxa, grouping together things that knowledge of their real essences would distinguish into distinct lowest species. (shrink)

We are agents: we can deliberate about what to do, and then act on the basis of that deliberation. We are also capable of normative self-governance: we can identify and respond to reasons as reasons. Many theorists believe that these two capacities are intimately connected. On the basis of this connection they conclude that practical reasoning must be carried out under the guise of a justification. This paper explores two strategies for avoiding that conclusion. The first, which just denies the (...) connection between agency and normative self-governance, is rejected as too costly, since it leaves the normative significance of agency unexplained. The second, which suggests that we can respond to a consideration as a reason without representing it as a reason, seems more promising, but it requires a reductive account of reasons for action. The upshot is that metaethics and action theory are entwined in ways that few have recognized. (shrink)

In his new book the eminent Kant scholar Henry Allison provides an innovative and comprehensive interpretation of Kant's concept of freedom. The author analyzes the concept and discusses the role it plays in Kant's moral philosophy and psychology. He also considers in full detail the critical literature on the subject from Kant's own time to the present day. In the first part Professor Allison argues that at the centre of the Critique of Pure Reason there is the foundation (...) for a coherent general theory of rational agency. The second part employs this account of rational agency as a key to understanding Kant's concept of moral agency and associated moral psychology. The third part focuses on Kant's attempt to ground both moral law and freedom in the Groundwork and the Critique of Practical Reason. This is a major contribution to the interpretation of Kant which will be of special interest to scholars and graduate students of Kant's moral theory. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Feminist Studies 44, no. 2. © 2018 by Feminist Studies, Inc. 281 Allison Kimmich National Women’s Studies Association: Women’s, Gender, and Sexuality Studies Placement Data 2018 In response to a request from the National Women’s Studies Association, the institutions listed in Table 1 provided data about their PhD students’ placement in the categories listed in Table 2. The institutions provided data about all WGSS PhD graduates since the (...) programs began. Longstanding programs have graduated nearly 100 PhDs; more recent programs have graduated fewer than 10. 282 Allison Kimmich Institution Name Year First Class Matriculated Arizona State University 2007 Emory University 1990 Indiana University 2006 Ohio State University 2002 Pennsylvania State University 2001 Rutgers, the State University of New Jersey 2001 Texas Woman’s University 2010 University of California, Los Angeles 2000 University of California, Santa Barbara 2009 University of Kansas 2011 University of Kentucky 2013 University of Maryland 2000 University of Michigan 1994 University of Minnesota 1998 University of Washington 1998 Table 1  Year of Inception for WGSS Departments That Provided Data to NWSA Allison Kimmich 283 Type of Position Number of Students Percentage Tenure-track/Tenured 207 45.5% Post-doctoral fellowship/Visiting professorship 38 8.4% Lecturer/Adjunct 50 10.9% Administrative (higher education) 32 7% Researcher 14 3.1% Nonprofit 14 3.1% High school teacher 3 0.7% Currently searching/Unknown 63 13.8% Other (i.e., writer, attorney, consultant) 34 7.5% TOTAL: 455 100% Table 2 Placement of WGSS PhD Students from Departments Listed in Table 1... (shrink)

A number of philosophers have accepted the thesis that reasons for action are 'universalizable' in the sense that every such reason commits one to a universal prescription or practical judgment. The purpose of the present paper is to refute this thesis. The author presents and defends counterexamples to both strong and weak versions of the thesis, And shows that the thesis can be given up without denying the general contention that 'reason'-Statements imply universals.

In section 24 of The Antichrist, Nietzsche notes a problem namely “the origin of Christianity.” He offers two propositions toward its solution: the first is that “Christianity can only be understood on the soil where it grew:” and the second is that “the psychological type of the Galilean is still recognizable, but it had to assume a completely degenerate form (simultaneously mutilated and full of alien features) before it came to be used as a redeemer of humanity” (A 24). Significantly (...) this passage suggests that the origins of Christianity rest on a reinterpretation of the type of the redeemer. This paper seeks to clarify the nature of such a modification and to identify some of its key ramifications. After clarifying the type, the paper argues that the type, thus understood, serves as a link between the texts On the Genealogy of Morality and The Antichrist and, as such, reveals the connection between Nietzsche's genealogical methods and the wider project of reevaluation. Though this reading is not the standard interpretive strategy, the paper argues that it is the strategy that Nietzsche himself recommends. (shrink)

Mood disorders, including major depressive disorder and bipolar disorder, are highly prevalent, frequently disabling, and sometimes deadly. Additional research and more effective medications are desperately needed, but clinical trials research in mood disorders is fraught with ethical issues. Although many authors have discussed these issues, most do so from a theoretical viewpoint. This manuscript uses available empirical data to inform a discussion of the primary ethical issues raised in mood disorders research. These include issues of consent and decision-making capacity, including (...) patients’ motivations for participating in research. We also address drug withdrawals, placebo controls, and the overall safety of research. Finally, we examine the extant literature for studies discussing potential indirect benefits of clinical trials research to participants. Taken together, the evidence suggests that clinical trials research incorporating drug withdrawals and placebo controls can be conducted safely and ethically, even in patients with severe or treatment-resistant mood disorders. In fact, given the dearth of effective treatment options for this population, it is our opinion that a moral imperative exists to extend the offer of research participation to severely ill or treatment-resistant groups. (shrink)

Henry E. Allison presents a comprehensive commentary on Kant's Groundwork for the Metaphysics of Morals. Allison pays special attention to the structure of the work and its historical and intellectual context. He argues that, despite its relative brevity, the Groundwork is the single most important work in modern moral philosophy.

The Internet and electronic communication technologies have taken the psychological field by storm. From the innovations of new web interventions for easier access to care to the increased ease of client scheduling and communication, these developments have greatly advanced mental health care. However, these advantages are also laced with ethical implications that warrant attention. Without judicious consideration, social media use by psychotherapists can lead to inadvertent self-disclosures to clients that risk damaging the therapeutic alliance, interfering with therapeutic processes, and placing (...) both the client and clinician at risk. A better understanding of the ethical implications of social media use is warranted so that guidelines for appropriate use can be developed and implemented. This article highlights the potential risks associated with social media use by psychotherapists and, in absence of formalized guidelines, offers recommendations for best practices. (shrink)

ABSTRACTThe attentional blink is the impaired ability to detect a second target when it follows shortly after the first among distractors in a rapid serial visual presentation...

In 2018, at least 12 adults and 3 children died in U.S. detention facilities. In 2017, 12 people died in U.S. detention facilities and at least 10 women filed complaints against ICE for mistreatment that led them to miscarry. At the time of this writing, 26 people have died in US Custody during the Trump Administration and 74 people have died in U.S. detention facilities between 2010 and 2018, including Raul Ernesto Morales-Ramos, Augustina Ramirez-Arreola, Moises Tino-Lopez, Jose Azurdia, and Roxana (...) Hernandez. I am not going to argue that these deaths are wrong – I take that as obvious. Instead, I will suggest that nonideal theory shows why bioethicists have special obligations for condemning these deaths and getting involved to make them stop. When we heed nonideal theory’s demand to consider empirical realities, we will see that the role of the bioethicist extends wherever health care does. Moreover, when bioethicists expressly embrace nonideal rather than ideal theories to ground our work, we will see that there are plenty such theories available to us. Shelly Wilcox’s nonideal theory of immigration justice is especially well suited for bioethicists to use in relation to detainee health care and enter the conversation where they are so desperately needed. (shrink)

Using testimonies from immigrants and examples of immigrant policies, this book proposes an interdisciplinary, feminist approach to immigration justice.

Despite the fact that the requirement to obtain informed consent for medical procedures is deeply enshrined in both U.S. moral and legal doctrine, empirical studies and anecdotal accounts show that women's rights to informed consent and refusal of treatment are routinely undermined and ignored during childbirth. For example, citing the most recent Listening to Mothers survey, Marianne Nieuwenhuijze and Lisa Kane Low state that "a significant number of women said they felt pressure from a caregiver to agree to having an (...) intervention that they did not want during birth". Specifically, Nieuwenhuijze and Low cite that "19% of women who did not have epidural analgesia felt... (shrink)

Using ethnographic data gathered at a mandated, community-based drug treatment program for women offenders, this article analyzes how gendered notions of the self and of autonomy shape penal governance. This study examines how psychological models of women's deviance, racialized visions of motherhood, and therapeutic techniques of the self come into tension with expectations of responsible, autonomous citizenship. The program prioritized therapeutic ways of governing its clients over those that emphasized economic self-reliance, rational decision making, and normalizing gender. This is because (...) staff attributed criminal and addictive behaviors to women's inadequate self-understanding and lack of emotional autonomy in personal relations. Staff discouraged women's motherhood and paid labor because they saw these external obligations as a threat to women's autonomous selfhood. This research complicates claims that contemporary forms of penal treatment manage offenders through rational incentives and personal responsibility by pointing to the ways that subject formation is a gendered process. (shrink)

In spring 2020, COVID-19 and the ensuing social distancing and stay-at-home orders instigated abrupt changes to employment and educational infrastructure, leading to uncertainty, concern, and stress among United States college students. The media consumption patterns of this and other social groups across the globe were affected, with early evidence suggesting viewers were seeking both pandemic-themed media and reassuring, familiar content. A general increase in media consumption, and increased consumption of specific types of content, may have been due to media use (...) for coping strategies. This paper examines the relationship between the stress and anxiety of university students and their strategic use of media for coping during initial social distancing periods in March-April 2020 using data from a cross-sectional survey. We examine links between specific types of media use with psychological well-being concepts, and examine the moderating roles of traits as buffers against negative relationships between stress and anxiety and psychological well-being. Our findings indicate that stress was linked to more hedonic and less eudaimonic media use, as well as more avoidant and escapist media-based coping. Anxiety, on the other hand, was linked to more media use in general, specifically more eudaimonic media use and a full range of media-based coping strategies. In turn, escapist media was linked to negative affect, while reframing media and eudaimonic media were linked to positive affect. Avoidant coping was tied to poorer mental health, and humor coping was tied to better mental health. Hedonic and need-satisfying media use were linked to more flourishing. Hope, optimism, and resilience were all predictive of media use, with the latter two traits moderating responses to stress and anxiety. The findings give a nuanced portrait of college students’ media use during a pandemic-induced shutdown, showing that media use is closely intertwined with well-being in both adaptive and maladaptive patterns. (shrink)

This chapter begins with a discussion of the “Epicurean view” — the view stating that death cannot intelligibly be regarded as an evil for the person who dies because the alleged evil lacks a subject or “recipient.” An argument is then presented in opposition to this view that possesses two key components. The first is an account of the “Values Connect with Feelings” requirement, according to which the connection need not be actual, but merely possible and that the requirement is (...) satisfied provided that the relevant object, state, or event is a possible object, even if it is not a possible cause, of the relevant feelings. The second key component is the employment of a four-dimensional framework that makes it possible to claim that temporally distant events or states, like spatially distant events, exist, and thus are possible objects of relevant feelings. (shrink)

In her book, Politics of Piety: The Islamic Revival and the Feminist Subject, Saba Mahmood analyzes the practices of the women in the mosque movement in Cairo, Egypt. Mahmood argues that in order to recognize the participants as agents, we need to question the assumption that agency entails resistance to norms; moreover, we need to question the feminist allegiance to an unquestioned ideal of freedom. In this paper, I argue that rather than giving up the ideal of freedom, we can (...) explore the possibility that there are different conceptions of freedom, and that the agency of the women in the mosque movement can be understood through a conception of freedom as a practice of connection, or belonging. I develop this alternative paradigm through discussions of four conceptions of freedom: Foucault's theory of agency as self-creation, positive freedom, communitarian freedom, and freedom as resistance. (shrink)