Understanding the components of clinical care that work best is a cornerstone of improving health care. And yet, the more we improve the quality of quality improvement and move to continuous learning about clinical care more broadly, the more we find ourselves in a regulatory environment that makes evaluation more difficult, expensive, and, in some situations, impossible. In their paper on the ethical underpinnings of the distinction between research and treatment, Ruth Faden and colleagues raise important implications for a wide (...) array of situations. These points give reason to rethink the definition of routine clinical operations to include evaluation of the processes and outcomes of care and dissemination of findings. We concur with the assertion by Faden and colleagues, and with previous work from The Hastings Center, that conducting continuous improvement activities such as these is an obligation of health systems and clinicians. We believe that rigorous, systematic evaluation should be considered part of normal, expected operations, rather than exceptional behavior that requires extraordinary regulatory control. (shrink)

The fearful ape hypothesis proposes that heightened fearfulness in humans is adaptive. However, despite its attractive anthropocentric narrative, the evidence presented for greater fearfulness in humans versus other apes is not sufficient to support this claim. Conceptualization, context, and comparison are strongly lacking in Grossmann's proposal, but are key to understanding variation in the fear response among individuals and species.

The final section of the book considers two features of the world which transcend the categories, existence and negation.

Originally published in 1992. The history of Western philosophy can be seen as a battle between those that insist that the "physical universe" exists and those would claim that there is a much larger "world" which contains atemporal and nonspatial things as well. The central part of this book, and the battle, concerns the existence of universals. Starting with the mediaeval definition of the issue found in Porphry and Boethius, the author then considers modern and contemporary versions of the battle. (...) He concludes that what is at stake between naturalists and ontologists is the existence and nature of a number of important categories, like structures, relations, sets, numbers and so on. (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)

The article seeks to understand Hannah Arendt's political thinking by relating it to an issue which is crucial to the thinking of the later Heidegger, i.e., the problem of originality ( Anfänglichkeit) and history. In opposition to Hegel's thesis of the “end of art,” Heidegger envisages in “great art” such as Hölderlin's poetry a new origin of thinking and history. The end of art, which Hegel holds to be necessary, is in Heidegger's view to be overcome precisely because art, for (...) him, entails an origin which is not a “Not yet” of a teleological perfection in Hegel's sense, but a “Not yet” of a future history. However, Heidegger's orientation towards a “pure” origin qua future leads him to poietically escape the realm of the Political and the questions of praxis and practical rationality.Like Heidegger, Arendt is taken with the problem of origin; but in contrast to her former teacher, she tries to regain what Heidegger thought he could leave, viz., the dimension of the genuine Political and of acting. The original sense of acting (for Arendt, the capability of human beings to make a new beginning) can be observed in the Greek polis as well as in the American Revolution in modern times: The revolutionary act of a total new beginning elucidates, according to Arendt, what “acting” means in the full and truly political sense. However, Arendt's notion of an epochal beginning seems one-sided, and her abstract concept of acting seems to foster a mere actionism and anarchy. Therefore, contrary to Arendt's claims, the concept of the Political which she shapes in accordance with the extraordinary experiences of an epochal acting has apolitical consequences. The task of thinking after Heidegger and Arendt thus remains one of determining the political character of action in a convincing manner. In this respect, the paper pleads for a rethinking of Hegel's concept of ethical life ( Sittlichkeit). (shrink)

Die Rede von Metaphysik ist, zumal im gegenwärtigen Diskussionskontext, umstritten. Wo nachmetaphysische Theorieentwürfe unterschiedlichster Provenienz Konjunktur haben, gilt Metaphysik als ein verschrieener Name (Kant). Daß heutigem Philosophieren zwar nicht länger die Optionen großer Erzählungen offenstehen, diese aber dennoch denkwürdig bleiben, suchen die Beiträge dieses Bandes in Auseinandersetzung mit Hegel und Heidegger zu verdeutlichen. Im Bezug auf die Thematik einer Metaphysik der praktischen Welt erörtern sie Perspektiven auf Recht und Staat, Geschichte und Kunst, Ethik und Politik, Philosophie und Praxis.

One way to silence the powerless, Langton has taught us, is to pre-emptively disable their ability to do things with words. In this paper I argue that speakers can be silenced in a different way. You can let them speak, and obscure the meaning of their words afterwards. My aim is to investigate this form of silencing, that I call retroactive distortion. In a retroactive distortion, the meaning of the words of a speaker is distorted by the effect of a (...) subsequent speech act by a different speaker. After introducing this notion, I explore some reasons why retroactive distortions can be difficult to challenge and argue that, besides constituting a communicative injustice, they can eliminate topics from public consideration and therefore erode public debate. (shrink)

The article introduces the problematics of the classical two-valued logic on which Western thought is generally based, outlining that under the conditions of its logical assumptions the subject I is situated in a world that it cannot address. In this context, the article outlines a short history of cybernetics and the shift from first- to second-order cybernetics. The basic principles of Gordon Pask’s 1976 Conversation Theory are introduced. It is argued that this second-order theory grants agency to others through a (...) re-conception of living beings as You logically transcending the I. The key principles of Conversation Theory are set in relation to the poetic forms of discourse that played a key role in art as well as philosophical thinking in China in the past. Second-order thinking, the article argues, is essentially poetic. It foregoes prediction in favour of the potentiality of encountering tomorrow’s delights. (shrink)

The editorial introduces issue 21.1 of Technoetic Arts via a critical reflection on the artificial intelligence hype (AI hype) that emerged in 2022. Tracing the history of the critique of Large Language Models, the editorial underscores that there are substantial ethical challenges related to bias in the training data, copyright issues, as well as ecological challeges which the technology industry has consistently downplayed over the years. -/- The editorial highlights the distinction between the current AI technology’s reliance on extensive pre-existing (...) human-generated data for pattern recognition and the performative process inherent in art practice. Patterns of creative output can be replicated without a thorough understanding of underlying concepts. In contrast, the performative process of art practice, as explored through the conceptual frameworks of creativity by Noam Chomsky, Charles Sanders Peirce, and Roger T. Ames and with reference to an earlier publication of the editorial’s author, creates concepts and continually ‘strives to extend itself towards the unknown.’ -/- Following this introductory section, the editorial provides an overview of the ten articles featured in this issue of Technoetic Arts. The first four texts engage with emerging technologies from various perspectives in art and design. The subsequent six articles, part of a special section titled 'Perspectives from Chandigarh,' reflect a quest for meaningful existence within colonial, patriarchal, and biopolitical structures that frame everyday practices of exclusion and oppression. (shrink)

Statements such as “X is beautiful but I don’t like how it looks” or “I like how X looks but it is not beautiful” sound contradictory. How contradictory they sound might however depend on the object X and on the aesthetic adjective being used (“beautiful”, “elegant”, “dynamic”, etc.). In our study, the first sentence was estimated to be more contradictory than the latter: If we describe something as beautiful, we often intend to evaluate its appearance, whereas it is less counterintuitive (...) to appreciate an appearance without finding it beautiful. Furthermore, statements including “beautiful” appeared more contradictory than those including “elegant” and “dynamic”, pointing to its greater evaluative component. When related to artworks, sentences could appear less contradictory due to readers’ consideration of the divergence between conventional beauty and art-related sensory pleasures that can even include negative valence. Such ambivalence might be more frequent in art-objects than in other artefacts. Indeed, in our study, sentences referring to artworks were estimated to be less contradictory compared to sentences referring to other artefacts. Meanwhile, an additional small group of graphic design students showed a less clear difference between art-related and non-art-related sentences. We discuss the potential influence of art experience and interest as well as theoretical and methodological challenges like the conceptualization of beauty. (shrink)

Addressing studying as a distinct educational concept and phenomenon in its own right, the essays in this volume consider study and studying from a range of perspectives. Countering dominant educational discourses, which place a heavy emphasis on learning and instruction, the contributors explore questions such as: What does it mean to study something? How is studying something different from being taught about it, or learning something about it? What does the difficulty demanded by study mean for the one who studies (...) and for the teacher? What mode of existence does study induce? The book highlights the significance of study not only, or even primarily, for its educational outcome, but as a human activity. (shrink)

Clinical Ethics Consultation (CEC) has grown significantly in the last decade, and efforts are being made to professionalize the practice. The American Society for Bioethics and Humanities (ASBH) has been instrumental in this process, having published the _Code of Ethics and Professional Responsibilities for Healthcare Ethics Consultants_ and founded and endorsed the creation of the _Healthcare Ethics Consultant Certified (HCEC) Certification Commission._ The ASBH also published “core competencies” for healthcare ethics consultants and has delineated a clear identity and role of (...) such consultants distinct from that other healthcare professionals. In addition, more enter the field armed with advanced degrees (MA and PhD) or certification in clinical ethics consultation. While some have questioned the trend toward professionalization, the momentum is clearly in its favor. This paper explores three questions: Does the professionalization of healthcare ethics consultation expose those engaged in the field to the types of liability claims faced by professionals in other fields? What specific liabilities could affect a healthcare ethics consultant? And finally, what should healthcare ethics consultants do to protect themselves against liability claims? We conclude that while the risk of liability remains low, those engaged in the field should accept that risk just as part of their status as professionals and, like those in allied professions, seek appropriate protection in the form of liability insurance. (shrink)

Das ethische Prinzip des Respekts vor der Autonomie des Patienten/Probanden hat in der modernen Medizin mittlerweile weltweit Bedeutung erlangt. Die Betonung der Autonomie des Patienten und Probanden in allen in der letzten Zeit verabschiedeten internationalen Deklarationen gibt dieser Tendenz unmissverständlich Ausdruck. Doch wenngleich diese Entwicklung unstrittig positiv ist, wirft sie dennoch eine Reihe von Fragen auf, die mit der Kodifizierung, Interpretation, Reichweite und Anwendung dieses universalen Prinzips verbunden sind. Die Antworten auf diese Fragen entscheiden darüber, ob Autonomie als hilfreiches, emanzipatorisches (...) oder als überforderndes, gar hegemoniales Prinzip begriffen wird. Diese normativen Probleme werden anhand von Beispielen aus der globalen Medizinethik verdeutlicht. Was in modernen Gesellschaften als Autonomie bezeichnet und für die Praxis fruchtbar gemacht wird, ist als ein soziales Konstrukt zu verstehen, nicht im Sinne einer Schimäre, sondern im Sinne einer soziokulturellen Leistung, die auf komplexen, historisch gewachsenen und kulturell geprägten Interaktionen von Gesellschaften, Institutionen und Individuen beruht. (shrink)

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)

Das ethische Prinzip des Respekts vor der Autonomie des Patienten/Probanden hat in der modernen Medizin mittlerweile weltweit Bedeutung erlangt. Die Betonung der Autonomie des Patienten und Probanden in allen in der letzten Zeit verabschiedeten internationalen Deklarationen gibt dieser Tendenz unmissverständlich Ausdruck. Doch wenngleich diese Entwicklung unstrittig positiv ist, wirft sie dennoch eine Reihe von Fragen auf, die mit der Kodifizierung, Interpretation, Reichweite und Anwendung dieses universalen Prinzips verbunden sind. Die Antworten auf diese Fragen entscheiden darüber, ob Autonomie als hilfreiches, emanzipatorisches (...) oder als überforderndes, gar hegemoniales Prinzip begriffen wird. Diese normativen Probleme werden anhand von Beispielen aus der globalen Medizinethik verdeutlicht. Was in modernen Gesellschaften als Autonomie bezeichnet und für die Praxis fruchtbar gemacht wird, ist als ein soziales Konstrukt zu verstehen, nicht im Sinne einer Schimäre, sondern im Sinne einer soziokulturellen Leistung, die auf komplexen, historisch gewachsenen und kulturell geprägten Interaktionen von Gesellschaften, Institutionen und Individuen beruht. (shrink)

Since René Descartes famously separated the concepts of body and mind in the seventeenth century, western philosophy and theory have struggled to conceptualize the interconnectedness of minds, bodies, environments and cultures. While environmental psychology and the cognitive sciences have shown that spatial perception is 'embodied' and depends on the aforementioned concepts' interconnectedness, architectural design practice, for example, has rarely incorporated these insights. The article presents research on the epistemological foundations that frame the communication between design theory and practice and juxtaposes (...) it with scientific research on embodied experience. It further suggests that Asian aesthetics, with its long history in conceiving relations and art as interactive, could create a bridge between recent scientific insights and design practice. The article outlines an approach to the interconnectedness of minds, bodies, environments, the sciences and cultures, in favour of a future that is governed by creative wisdom rather than 'smart' efficiency. (shrink)

In recent times, phenomena of conversational asymmetry have become a lively object of study for linguists, philosophers of language and moral philosophers—under various labels: illocutionary disablement and silencing, discursive injustice :440–457, 2014; Lance and Kukla in Ethics 123:456–478, 2013), illocutionary distortion. The common idea is that members of underprivileged groups sometimes have trouble performing particular speech acts that they are entitled to perform: in certain contexts, their performative potential is somehow undermined, and their capacity to do things with words is (...) distorted or even annulled. In this paper I will assess this idea, focusing on Rebecca Kukla’s and Rae Langton’s accounts; in particular, I will criticize the role the notion of uptake plays in their accounts, and claim that it may ultimately undermine the very idea of discursive injustice. While, according to Kukla and Langton, members of disadvantaged groups are victims of a kind of uptake failure, leading to illocutionary disablement and even silencing, in the account I present they are victims of a kind of communicative disablement. My overall aim is to develop a notion of discursive injustice that is more plausible and more effective for our broader purposes of criticising the structures of power and oppression. (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.

The volume collects classics of Marxist historiography of science, including a new translation of Boris Hessen's “The Social and Economic Roots of Newton's ...

This article considers the question ‘What makes hope rational?’ We take Adrienne Martin’s recent incorporation analysis of hope as representative of a tradition that views the rationality of hope as a matter of instrumental reasons. Against this tradition, we argue that an important subset of hope, ‘fundamental hope’, is not governed by instrumental rationality. Rather, people have reason to endorse or reject such hope in virtue of the contribution of the relevant attitudes to the integrity of their practical identity, which (...) makes the relevant hope not instrumentally but intrinsically valuable. This argument also allows for a new analysis of the reasons people have to abandon hope and for a better understanding of non-fundamental, ‘prosaic’ hopes. (shrink)

The paper emphasizes the inadequacy of formal semantics, the classical paradigm in semantics, in treating contextual dependence. Some phenomena of contextual dependence threaten one central assumption of the classical paradigm, namely the idea that linguistic expressions have a fixed meaning, and utterances have truth conditions well defined. It is possible to individuate three forms of contextual dependence: the one affecting pure indexicals, the one affecting demonstratives and "contextual expressions", and the one affecting all linguistic expressions. The third type of dependence (...) is top-down: context, and not only linguistic material, shows which variables must be instantiated, relying on context itself. The generalization of underdetermination to all linguistic expressions is in fact a kind of metadependence: the mode of dependence itself depends on context. (shrink)

I argue for a novel answer to the question “What is hope?”. On my view, rather than aiming for a compound account, i.e. analysing hope in terms of desire and belief, we should understand hope as an irreducible concept. After criticizing influential compound accounts of hope, I discuss Segal and Textor's alternative of describing hope as a primitive mental state. While Segal and Textor argue that available developments of the standard definition do not offer sufficient conditions for hope, I question (...) the deep‐seated idea that desire and belief are even necessary conditions for hope. My suggestion is that we should take seriously the fact that we hope in a great variety of ways and should question the search for elements that are common to all cases. A promising alternative follows the Wittgensteinian idea that cases of hope are related in terms of family resemblance, i.e. are multiply realizable on the ontological level while falling under the non‐definable concept of hope. (shrink)

This essay argues that current advocacy of lesbian and gay rights to legal marriage and parenthood insufficiently criticizes both marriage and motherhood as they are currently practiced and structured by Northern legal institutions. Instead we would do better not to let the State define our intimate unions and parenting would be improved if the power presently concentrated in the hands of one or two guardians were diluted and distributed through an appropriately concerned community.

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)

Nel Noddings, in Caring: A Feminine Approach to Ethics and Moral Education, presents and develops an ethic of care as an alternative to an ethic that treats justice as a basic concept. I argue that this care ethic is unable to give an adequate account of ethical relationships between strangers and that it is also in danger of valorizing relationships in which carers are seriously abused.

ABSTRACT Truth-conditions are systematically determined when they are the output of an algorithmic procedure that takes as input a set of semantic and contextual features. Truth-conditional sceptics have cast doubts on the thesis that truth-conditions are systematic in this sense. Against this form of scepticism, Schoubye and Stokke : 759–793) and Dobler : 451–474.) have provided systematic analyses of utterance truth-conditions. My aim is to argue that these theories are not immune to the kind of objections raised by truth-conditional sceptics. (...) In particular, I argue that the use of Questions Under Discussion and ways of being is problematic. (shrink)

Following the traces of Margaret Mead’s statement that emphasized that the first photographic images of the Earth from space presented notions of fragility, the article contextualizes the recent critique of the dominant representation of the Earth as a globe that emerged in conjunction with the discourse on the Anthropocene. It analyses the globe as an image and the sentiments that accompanied it since the first photographs of our planet from space were published in 1968. The article outlines how the cultural (...) meaning of the whole Earth representation changed in parallel with the appropriation of the image by the large technological enterprises that emerged from America’s counterculture. It returns to the possibility of a coexistence of ‘views from within’ and ‘views from without’ following a detour with Gregory Bateson via Bali and proposes a Cybernetics of Grace as a practice of resistance against pure exteriority. The article concludes by linking the Cybernetics of Grace with the second-order conversations of Gordon Pask. (shrink)