This paper considers whether transgender women should be permitted to compete in female categories in sports. Trans* women are often criticized for competing in female categories because they are seen as having an unfair advantage. Specifically, they are seen as having high levels of testosterone that unfairly enhance their performance in comparison to cisgender competitors. In this paper, I argue that trans* women should be permitted to compete in female categories. I suggest that if we want to maintain the skill (...) thesis as a guiding principle of sports and allow trans* women to compete in female categories, then we need to take relevant genetic advantages into consideration by introducing a handicap system. I claim that a handicap system should consider both cisgender and transgender women’s effective testosterone levels. (shrink)

Eating disorders are mental illnesses that can have a significant and persistent physical impact, especially for those who are not treated early in their disease trajectory. Although many persons w...

The question of whether transgender athletes should be permitted to compete in accordance with their gender identity is an evolving debate. Most competitive sports have male and female categories. One of the primary challenges with this categorization system, however, is that some transgender athletes (and especially transgender women) may be prevented from competing in accordance with their gender identity. The reason for this restriction is because of the idea that transgender women have an unfair advantage over their cisgender counterparts; this (...) is seen as a problem since sports are typically guided a principle called ‘the skill thesis’, which suggests that sports are supposed to determine who is most skillful by maintaining a fair starting point. In this paper, I argue that if the skill thesis ought to be maintained and there continues to exist no conclusive evidence in support of unfair advantages possessed by trans women, then we may want to re-consider the gender binary in sport. Rather than having male/female categories, it may make more sense to categorize athletes based other sport-specific factors (e.g., height, weight, etc.). This may help to maintain the skill thesis while at the same time removing potentially unfair and discriminatory barriers against transgender athletes. (shrink)

Determining whether and/or how to enable older persons with disabilities to engage in sex raises several ethical considerations. With the goal of enabling the sexual functioning of older adults with disabilities, Jecker argues that sex robots could be used as a helpful tool. In her article, ‘Nothing to be Ashamed of: Sex Robots for Older Adults with Disabilities’, Jecker acknowledges the importance of sexual functioning and the fact that ageist assumptions incorrectly classify older persons as asexual. Additionally, older adults may (...) experience disabilities that negatively influence their sexual functioning, which is problematic since sex may be linked to the following capabilities: developing a meaningful life narrative; being healthy; experiencing bodily integrity; feeling and communicating emotions; affiliating with others and reflecting on and choosing a life plan.1 In accordance with Nussbaum’s capabilities approach,2 Jecker says that society has a duty to support these capabilities at a minimal threshold. And insofar as sexual functioning may be relevant to the capabilities for older adults with disabilities, then we need to respond accordingly. One way of achieving this aim is by providing access to sex robots. I agree that sex robots ought to be made available for older adults with disabilities. Nevertheless, the article inspires several areas for further exploration. As Jecker rightfully mentions, older adults are often incorrectly labelled as non-sexual. For instance, in their analysis of older individuals’ views on sex and quality of life, Gott …. (shrink)

This paper explores the ethics of deceased‐directed donation (DDD) and brings a unique perspective to this issue—the relevance of providing family‐centered care and culturally sensitive care to deceased donors, potential recipients, and their families. The significance of providing family‐centered care is becoming increasingly prevalent, specifically in pediatric healthcare settings. Therefore, this topic is especially relevant to those working with and interested in pediatrics. As the world is becoming more diverse with globalization, assessing the cultural aspect of the ethics of DDD (...) is increasingly salient. We provide a brief overview of DDD across the globe, review prominent arguments both for and against DDD, consider family‐centered and culturally specific considerations, and offer considerations for the development of a policy or guideline. We determine that the practice of DDD is ethically defensible in certain circumstances and congruent with providing both family‐centered and culturally sensitive care. Our analysis is relevant to any country with a diverse population and any healthcare provider or institution that operates under a framework of family‐centered care, such as those in pediatric hospitals. (shrink)

Sex and dementia is becoming an increasingly important topic in applied ethics. By the year 2030, more than 74.7 million people are expected to be diagnosed with dementia worldwide; many of these people may want to engage in sex. The question of how to manage cases of sex and dementia is occurring more frequently in practical cases because of our aging population. The primary reason that sex and dementia is ethically complex is because sexual consent is both legally and morally (...) significant, yet many people with dementia may be unable to consent in accordance with current standards. In this dissertation, I introduce three frameworks that could be used to approach cases of sex and dementia. The first framework is that of relational autonomy and supported decision-making; this framework tries to enable people with dementia to make autonomous sexual decisions with support. The next approach is a framework of advance sexual consent, which considers the relevance of prior autonomous sexual decisions. The third framework focuses on prioritizing well-being above a person’s capacity to make autonomous decisions and to consent to sex. I assess each framework and consider their positive and negative nuances. The overall goal is to balance the right to sexuality while at the same time protecting people with dementia from undue harm. Ultimately, this dissertation shows that cases of sex and dementia ought to be managed on a case-by-case basis; one framework will not work for every context. In order to approach situations on a case-by-case basis, I contend that a process of weighing and balancing norms and principles is necessary. I use Beauchamp and Childress’s method of weighing and balancing to propose a systematic procedure. This process takes various factors into account in order to determine how to proceed in an ethically defensible manner. According to an approach of weighing and balancing, sexual acts would not be immediately barred based on a person’s inability to consent; rather, a person’s present convictions, the sexual activity to which they want to participate, the possibility of experiencing undue harm, their prior wishes and values, their capacity to make autonomous decisions with support, etc. would all be considered. Overall, this dissertation contributes to the complex topic of sex and dementia and offers a starting point for further discussion on how to approach these cases in practice. (shrink)

We live in a culture which, while largely dependent on science for its material welfare, is largely ignorant of the new ideas and perspectives on which science is based. This book examines the true significance of science and technology for society over the last three hundred years. Professor Hanbury Brown's insight and experience have resulted in a novel approach to the discussion of the cultural role of science. After reviewing the history of how science grew to be both useful (...) to, and feared by society, the book traces the same period in the context of new ideas and concepts in scientific research. Later chapters deal with society's current view of science and the need for attitudes to be changed, and then a discussion of the religious dimensions of science. This book aims to clear away some of the popular misconceptions about science and to put in their place a wider and deeper understanding of the nature of science and its value to society. (shrink)

Respect for autonomy grounds common ethical judgments about why people should be allowed to make decisions for themselves. Under this assumption, it is concerning that a number of feminist conceptions of autonomy present challenges for people with intellectual disabilities. This paper explores some of the most philosophically influential feminist accounts of autonomy and demonstrates how these accounts exclude persons with intellectual disabilities. As a possible solution to these accounts, Laura Davy’s inclusive design approach is presented, which is a revised conception (...) of autonomy that accommodates intellectual disabilities. While Davy’s approach to autonomy views people with intellectual disabilities as autonomous, it encounters limitations in regard to sexual autonomy, which incorporates certain judgments that are intuitively at odds with her recommendations. The remainder of this paper describes some complexities of sexual autonomy and determines why these are problematic for Davy’s account. After analyzing some of the challenges that sexual autonomy presents, I suggest a potential modification for consideration. This modification will allow Davy’s account to address the topic of sexual autonomy for persons with intellectual disabilities. My proposal is a matter of theory following practice. (shrink)

This case study considers the ethical defensibility of recommending weight loss as a treatment for patients with higher body mass indexes. Recommending weight loss may be motivated by clinicians’ biases toward people living in larger bodies, misperceptions about weight and its relevancy to overall health, and a failure to consider other ethical factors such as those related to equity and the social determinants of health.

Volume 14, Issue 2, May 2020, Page 279-281.

Canada’s Medical Assistance in Dying (MAID) legislation changed in 2021; persons without a reasonably foreseeable natural death (RFND) could now be eligible for MAID and would have to wait at least 90 days before their intervention. This legislative change caused a new ethically complex question to arise, which we explore in this commentary, namely: Where should individuals without a RFND wait (for 90 days) in a publicly funded health system?

The purpose of this commentary is to present and respond to the gap that currently exists in providing culturally inclusive residential long-term care options for Indigenous peoples in Ontario. After presenting statistics regarding the Indigenous population and long-term care options, we argue that we have an ethical responsibility to offer more culturally inclusive long-term care.

El resultado investigativo se centra en una de las prioridades de la línea del polo científico territorial y nacional: la necesidad de rescatar el papel de la intelectualidad cubana durante la República. Se analiza el papel de la cultura y la cubanía en la cosmovisión filosófica de Juan Marinello. El método empleado presupone un análisis dialéctico de la realidad, sustentado en una perspectiva crítica que permite interpretar y enriquecer la concepción sobre los hechos y procesos históricos. Desde una visión holística (...) del pensamiento filosófico cubano se revela la complejidad de un fenómeno multifactorial, la cubanía, como construcción cultural, a partir de la articulación de la concepción martiana y marxista de la cultura y los valores, lo que constituye un acierto del quehacer teórico - práctico marinelliano. El conocimiento de esta perspectiva enriquece los estudios sobre la obra de este intelectual y contribuye a dilucidar el devenir ideo-artístico y cultural cubano. The result of the research focuses on one of the priorities of the territorial and national scientific pole line: the need to recover the role of Cuban intellectuals during the Republic. The role of culture and Cubanism in Juan Marinello's philosophical world view is analyzed. The method used presupposes a dialectical analysis of reality, based on a critical perspective which allows to interpret and enrich the understanding of events and historical processes. From a holistic point of view of the Cuban philosophical thinking, Cubanism, a complex multifactorial phenomenon, is revealed as a cultural construction, starting from the articulation of Marti's and Marx's conception of culture and values, which is a good result of Marinello's theoretical-practical work. The knowledge of this perspective enriches the studies on the work of this intellectual and contributes to the clarification of the Cuban ideo-artistic and cultural evolution. (shrink)

RESUMEN Juan Marinello Vidaurreta, eminente trabajador de las letras, que no cambió la pluma por la política, sino que hizo de la política incesante gestión de creación espiritual. Vivió tres etapas decisivas de Cuba: los rezagos de la colonia española; la República mediatizada, que combatió; y el socialismo, que ayudó a consolidar. El objetivo es demostrar la confluencia del pensamiento martiano y marxista desde el análisis de la cultura en la obra de Juan Marinello Vidaurreta. Se asumió la concepción dialéctica (...) materialista como metodología general para conocer el objeto de investigación en sus antecedentes y tendencias actuales. Además permitió ampliar el conocimiento sobre el tema objeto de estudio, a través del análisis de texto, el contenido y el discurso; la crítica de fuentes posibilitó extraer inferencias a partir de la teoría preexistente y la información empírica acopiada. El pensamiento marinelliano se fue formando como resultado de la influencia del movimiento progresista cubano, del pensamiento martiano y marxista-leninista, lo más avanzado del pensamiento latinoamericano y universal. Subyace en su obra una concepción integradora y totalizadora de la cultura, de base martiana y marxista. ABSTRACT Juan Marinello Vidaurreta eminent worker of the letters that did not change the pen by the policy, but that made of the policy, incessant management of spiritual creation. He lived three decisive stages of Cuba: the lags of the Spanish colony; the mediated Republic, which fought; and socialism, which helped to consolidate. The objective is to demonstrate the confluence of Marti's and Marxist thinking from the analysis of culture in the work of Juan Marinello Vidaurreta. The dialectical materialist conception was assumed as general methodology to know the object of research in its antecedents and current trends. In addition it allowed expanding the knowledge on the subject under study, through the analysis of text, content and discourse; the critique of sources made it possible to draw inferences from the preexisting theory and the empirical information collected. Marinellian thought was formed as a result of the influence of the Cuban progressive movement, of Marti and Marxist-Leninist thought, the most advanced of Latin American and universal thought. It underlies in his work an integrative and totalizing conception of the culture, of Marti base and marxist. (shrink)

First published in 1999. Routledge is an imprint of Taylor & Francis, an informa company.

BackgroundClinical ethics consultations can be complex interventions, involving multiple methods, stakeholders, and competing ethical values. Despite longstanding calls for rigorous evaluation in the field, progress has been limited. The Medical Research Council proposed guidelines for evaluating the effectiveness of complex interventions. The evaluation of CEC may benefit from application of the MRC framework to advance the transparency and methodological rigor of this field. A first step is to understand the outcomes measured in evaluations of CEC in healthcare settings. ObjectiveThe primary (...) objective of this review was to identify and map the outcomes reported in primary studies of CEC. The secondary objective was to provide a comprehensive overview of CEC structures, processes, and roles to enhance understanding and to inform standardization.MethodsWe searched electronic databases to identify primary studies of CEC involving patients, substitute decision-makers and/or family members, clinicians, healthcare staff and leaders. Outcomes were mapped across five conceptual domains as identified a priori based on our clinical ethics experience and preliminary literature searches and revised based on our emerging interpretation of the data. These domains included personal factors, process factors, clinical factors, quality, and resource factors. ResultsForty-eight studies were included in the review. Studies were highly heterogeneous and varied considerably regarding format and process of ethical intervention, credentials of interventionist, population of study, outcomes reported, and measures employed. In addition, few studies used validated measurement tools. The top three outcome domains that studies reported on were quality, process factors, and clinical factors. The majority of studies examined multiple outcome domains. All five outcome domains were multidimensional and included a variety of subthemes.ConclusionsThis scoping review represents the initial phase of mapping the outcomes reported in primary studies of CEC and identifying gaps in the evidence. The confirmed lack of standardization represents a hindrance to the provision of high quality intervention and CEC scientific progress. Insights gained can inform the development of a core outcome set to standardize outcome measures in CEC evaluation research and enable scientifically rigorous efficacy trials of CEC. (shrink)

This article offers a hybrid rhetorical-qualitative discourse analysis of the FDA’s 2011 Avastin Hearing, which considered the revocation of the breast cancer indication for the popular cancer drug Avastin. We explore the multiplicity of stakeholders, the questions that motivated deliberations, and the kinds of evidence presented during the hearing. Pairing our findings with contemporary scholarship in rhetorical stasis theory, Mol’s (2002) construct of multiple ontologies, and Callon, Lascoumes, and Barthe’s (2011) “hybrid forums,” we demonstrate that the FDA’s deliberative procedures elides (...) various sources of evidence and the potential multiplicity of definitions for “clinical benefit.” Our findings suggest that while the FDA invited multiple stakeholders to offer testimony, there are ways that the FDA might have more meaningfully incorporated public voices in the deliberative process. We conclude with suggestions for how a true hybrid forum might be deployed. (shrink)

The purpose of this commentary is to consider circumstances under which it may be ethical to permit patients to use licit substances in rehabilitation contexts. While the content of this commentary may be transferable to other healthcare spaces, our focus on rehabilitation is based on some important distinctions that exist between rehabilitation and acute care spaces.

The pervasive use of contracts in healthcare is a source of unease for many healthcare ethicists and patient advocates. This commentary examines the use of such contracts with individuals in rehabilitation settings who have complex medical and behavioural issues. The goals of this paper are to examine the many factors that can lead to contract use, to discuss some legal and ethical implications of contract use, and to assess contract use in light of concerns about health equity. The paper concludes (...) with some practical alternatives to the use of such contracts, and refers specifically to tools that might be borrowed from the field of behavioural therapy. (shrink)

This note argues for a previously unnoticed allusion in Terence's Andria to Odysseus and the Sirens, in a wish expressed by the play's old man that his son will escape the alluring clutches of the sex-labourer next door.

L’articolo si propone di chiarire uno dei punti oscuri della biografia di Giordano Bruno. Nel 1571 il Capitolo generale dei Domenicani di Roma lo assegnò come studente formale allo Studio di Andria. Secondo i suoi più importanti biografi, il Nolano non ci sarebbe mai andato. Attraverso l’accurata analisi dei documenti relativi al corso di studi, e il riscontro delle citazioni contenute in alcune opere, l’ipotesi che Bruno abbia soggiornato ad Andria per circa un anno appare, invece, estremamente probabile. (...) The article tries to clarify one of the obscure points of Giordano Bruno’s biography. In 1571 the General Chapter of the Dominicans in Rome assigned him, as a formal student, to the Study of Andria. According to his most important biographers, the Nolan never went there. However, through the careful analysis of the documents relating to his course of studies, and the comparison of the quotations contained in some of his works, the hypothesis that Bruno stayed in Andria for about a year appears extremely probable. (shrink)

The traces of real, that is, ancient, rival versions of Terence's lines are not so pronounced as of Plautus' lines. Professor Lindsay has drawn attention to a possible instance at Hec. 468 . Another seems to be Andr. 532 , if I am right in supposing that the text used by Donatus had ipsum Chremem. A trace of the variant survives in the unmetrical δ-setting ipsum obuiam Chremem DGL. The text of the other minuscule MSS. has ipsum obuiam. A is (...) not in evidence for this part of Andria. Had it too ipsum Chremem ? (shrink)

Inquiry will be made here into a specific challenge facing writers offabulae palliatae, namely the interior scene, which they had not always the same means to display as did the poets of the νέα they adapted. One of them, Terence, will be seen to have reacted by eliminating the interior scenes that he found in his models.