Epistemic paternalism is the thesis that a paternalistic interference with an individual's inquiry is justified when it is likely to bring about an epistemic improvement in her. In this article I claim that in order to motivate epistemic paternalism we must first account for the value of epistemic improvements. I propose that the epistemic paternalist has two options: either epistemic improvements are valuable because they contribute to wellbeing, or they are epistemically valuable. I will argue that these options constitute the (...) foundations of a dilemma: either epistemic paternalism collapses into general paternalism, or a distinctive project of justified epistemic paternalism is implausible. (shrink)

Medical practitioners are duty-bound to tell their patients the truth about their medical conditions, along with the risks and benefits of proposed treatments. Some patients, however, would rather not receive medical information. A recent response to this tension has been to argue that that the disclosure of medical information is not optional. As such, patients do not have permission to refuse medical information. In this paper I argue that, depending on the context, the disclosure of medical information can undermine the (...) patient’s ability to exercise her autonomy or have therapeutically detrimental effects. In the light of these insights I go on to develop a context-sensitive approach to medical disclosure. The advantage of this account is that it addresses concerns on both sides of the debate; whilst it acknowledges that patients do not have an exercisable ‘right not to know,’ it allows that in some cases medical information ought to be withheld. (shrink)

In this paper, I argue that a definition of paternalism must meet certain methodological constraints. Given the failings of descriptivist and normatively charged definitions of paternalism, I argue that we have good reason to pursue a normatively neutral definition. Archard's 1990 definition is one such account. It is for this reason that I return to Archard's account with a critical eye. I argue that Archard's account is extensionally inadequate, failing to capture some cases which are clear instances of paternalism. I (...) refine each of his three conditions, ultimately providing an improved definition of paternalistic interference. This revised definition meets specific methodological constraints, offering a definition that is both neutral between anti- and pro-paternalistic intuitions, but that also explains why paternalism is normatively significant. Specifically, this definition captures the conflict between interfering with an individual's choices and treating the individual benevolently, without making paternalism permissible or impermissible by definition. (shrink)

In medical practice, the doctrine of informed consent is generally understood to have priority over the medical practitioner’s duty of care to her patient. A common consequentialist argument for the prioritisation of informed consent above the duty of care involves the claim that respect for a patient’s free choice is the best way of protecting that patient’s best interests; since the patient has a special expertise over her values and preferences regarding non-medical goods she is ideally placed to make a (...) decision that will protect her interests. In this paper I argue against two consequentialist justifications for a blanket prioritisation of informed consent over the duty of care by considering cases in which patients have imperfect access to their overall best interests. Furthermore, I argue that there are cases where the mere presentation of choice under the doctrine of informed consent is detrimental to patient best interests. I end the paper by considering more nuanced approaches to resolving the conflict between informed consent and the duty of care and consider the option of permitting patients to waive informed consent. (shrink)

Neil Manson and Onora O’Neill have recently defended an original theory of informed consent in their book Rethinking Informed Consent in Bioethics (2007). The development of their ‘waiver’ model is premised on the failings of the theory of informed consent as disclosure, which is rejected on two counts: firstly, the disclosure model’s implicit reliance upon a ‘conduit-container’ model of communication means that the regulatory requirements of informed consent can rarely be achieved; secondly, the model’s purported ethical justification via a principle (...) of respect for patient autonomy is presented as being vacuous. Despite having laudable motivations for rethinking informed consent, I argue that their theory of informed consent as waiver can be criticised on similar grounds. In order to support this thesis I object that Manson and O’Neill’s developed theory of agential communication is too intricate to easily meet the demands of informed consent as waiver. Secondly, I show that the model appears to be implicitly reliant upon a principle of respect for patient autonomy. Hence, despite improving upon the doctrine of informed consent, the waiver model needs further elucidation in order to avoid the problems mounted against the disclosure model. (shrink)

On the 13th June 2014, the Centre for the Humanities and Health (CHH) at King’s College London hosted a one-day workshop on ‘Parentalism and Trust.’ This workshop was the sixth in a series of workshops whose aim is to provide a new model for high-quality open interdisciplinary engagement between medical professionals and philosophers. The term ‘Parentalism’ rather than paternalism is chosen and used throughout because of some of the derisory and unfortunate gender connotations associated with paternalism (and/or its counterpart ‘maternalism’). (...) Medical Parentalism is the position that unwanted interference with a patient’s choices and actions in order to protect and promote her best interests is morally justified. Whilst there are many problems with its justification and implementation, the workshop addressed how such interference depends on a trusting relationship between the doctor and patient, and the extent to which parentalist interferences might undermine this trust. (shrink)

On 27 September 2013, the Centre for the Humanities and Health (CHH) at King's College London hosted a 1-day workshop on ‘Medical knowledge, Medical Duties’. This workshop was the fifth in a series of five workshops whose aim is to provide a new model for high-quality, open interdisciplinary engagement between medical professionals and philosophers. This report identifies the key points of discussion raised throughout the day and the methodology employed.

The acquisition of fully informed consent presents a central ethical problem for the procurement and storage of human tissue in biobanks. The tension lies between the apparent necessity of obtaining informed consent from potential research subjects and the projected future use of the tissue. Specifically, under the doctrine of informed consent medical researchers are required to inform their potential research subjects about the relevant risks and purposes of the proposed research (Declaration of Helsinki, 2008, “Section 24.” Accessed November 1, 2009. (...) http://www.wma.net/en/30publications/10policies/b3/index.html). However, because human tissue – when stored in biobanks – can be put to multifarious uses, the information that medical researchers are expected to divulge to their subjects is epistemologically inaccessible. Biobank researchers are thus thought to be unable to obtain informed consent from their subjects, making the practice ethically suspicious. We propose that such suspicions of ethical failure should be reconsidered by presenting two possible solutions. Firstly we argue that the epistemological difficulty might be partially solved by adopting the “waiver model” of informed consent. Secondly, we put forward an argument that individual consent can be supplemented by group ethical models. We thus conclude that while informed consent is problematic for biobank researchers, alternative ethical solutions are available. (shrink)

A governing principle in medical ethics is respect for patient autonomy. This principle is commonly drawn upon in order to argue for the permissibility of assisted dying. In this paper I explore the proper role that respect for patient autonomy should play in this context. I argue that the role of autonomy is not to identify a patient’s best interests, but instead to act as a side-constraint on action. The surprising conclusion of the paper is that whether or not it (...) is in the best interests for the patient to die is a morally objective matter. This allows for the possibility that it can be in the best interests of the patient to die even if she autonomously considers it to be in her best interest to continue living. I argue that concerns about ‘mandatory’ euthanasia can be met when patient autonomy is respected as a side-constraint on action. Ultimately, this means that assisted dying is permissible, not because the autonomous patient views her suffering to be unbearable, but because it is in her objective best interests and she permitted it via her consent. (shrink)

Minimal Semantics asks what a theory of literal linguistic meaning is for - if you were to be given a working theory of meaning for a language right now, what would you be able to do with it? Emma Borg sets out to defend a formal approach to semantic theorising from a relatively new type of opponent - advocates of what she call 'dual pragmatics'. According to dual pragmatists, rich pragmatic processes play two distinct roles in linguistic comprehension: as (...) well as operating in a post-semantic capacity to determine the implicatures of an utterance, they also operate prior to the determination of truth-conditional content for a sentence. That is to say, they have an integral role to play within what is usually thought of as the semantic realm. Borg believes dual pragmatic accounts constitute the strongest contemporary challenge to standard formal approaches to semantics since they challenge the formal theorist to show not merely that there is some role for formal processes on route to determination of semantic content, but that such processes are sufficient for determining content. Minimal Semantics provides a detailed examination of this school of thought, introducing readers who are unfamiliar with the topic to key ideas like relevance theory and contextualism, and looking in detail at where these accounts diverge from the formal approach. Borg's defence of formal semantics has two main parts: first, she argues that the formal approach is most naturally compatible with an important and well-grounded psychological theory, namely the Fodorian modular picture of the mind. Then she argues that the main arguments adduced by dual pragmatists against formal semantics - concerning apparent contextual intrusions into semantic content - can in fact be countered by a formal theory. The defence holds, however, only if we are sensitive to the proper conditions of success for a semantic theory. Specifically, we should reject a range of onerous constraints on semantic theorizing (e.g., that it answer epistemic or metaphysical questions, or that it explain our communicative skills) and instead adopt a quite minimal picture of semantics. (shrink)

The rule books, though they claimed to heed only the call of logic, were nonetheless bound by their historical context: punctuation guidelines have been heavily indebted to intellectual, cultural, and aesthetic trends. No matter what analytical authority rule books claimed, their codifications had at least as much to do with their historical context as with syntax. When punctuation is properly contextualized, it can yield insight into problems that transcend disciplinary boundaries: it asks us to consider how we communicate within the (...) disciplines and beyond them and how disciplines create and maintain interpretive norms. It is this account of punctuation that I begin to develop here.I want to track the much-maligned semicolon and its fellow punctuation marks as rules for their usage were established and evolved. I consider the consequences of the nineteenth-century explosion of systems of grammar rules by way of the story of a semicolon in a statute that deprived Bostonians of late-night liquor from 1900–1906. The “Semicolon Law,” as it came to be known, exemplifies problems of interpretation still live in legal theory. I contrast the demands of legal formalism with the expectations of close reading in the humanities and social sciences. I conclude by attending to the inheritance left to us by nineteenth-century grammarians' impassioned attempts to bring order to English: The Chicago Manual of Style. I raise some critical questions about our attitudes towards rules, and consider how those attitudes influence our approach to punctuation and our passions about semicolons. (shrink)

Understanding in Epistemology Epistemology is often defined as the theory of knowledge, and talk of propositional knowledge has dominated the bulk of modern literature in epistemology. However, epistemologists have recently started to turn more attention to the epistemic state or states of understanding, asking questions about its nature, relationship … Continue reading Understanding in Epistemology →.

Philosophers often assume that folk hold pain to be a mental state – to be in pain is to have a certain kind of feeling – and they think this state exhibits the classic Cartesian characteristics of privacy, subjectivity, and incorrigibility. However folk also assign pains (non-brain-based) bodily locations: unlike most other mental states, pains are held to exist in arms, feet, etc. This has led some (e.g. Hill 2005) to talk of the ‘paradox of pain’, whereby the folk notion (...) of pain is inherently conflicted. Recently, several authors have rejected the paradox view, arguing instead that folk hold a univocal, bodily view (i.e. pains are properties of various body parts, not of minds). This paper presents six objections to the bodily view of the folk concept of pain. We then outline a direction for future research – the ‘polyeidic approach’ – whereby the folk notion of pain is held to encompass various divergent (potentially conflicting) strands and we suggest that certain problems surrounding the treatment and communication of pain might be usefully be viewed through the lens of the polyeidic approach. (shrink)

In this article, we aim to map out the complexities which characterise debates about the ethics of vaccine distribution, particularly those surrounding the distribution of the COVID-19 vaccine. In doing so, we distinguish three general principles which might be used to distribute goods and two ambiguities in how one might wish to spell them out. We then argue that we can understand actual debates around the COVID-19 vaccine – including those over prioritising vaccinating the most vulnerable – as reflecting disagreements (...) over these principles. Finally, we shift our attention away from traditional discussions of distributive justice, highlighting the importance of concerns about risk imposition, special duties, and social roles in explaining debates over the COVID-19 vaccine. We conclude that the normative complexity this article highlights deepens the need for decision-making bodies to be sensitive to public input. (shrink)

Two types of Judeo-Christian perspective stress the imperative to act to relieve suffering and transcend violence: liberation theology and the "religious humanitarian perspective." Both link ethics and action; both influence political debate.

Lynch addresses the return to Immanuel Kant—a "prophet of progressive international reform"—and examines the relationship between the Kantian system of ethics and the development of international law in the post-Cold War era.

Wrestling with God in the modern West -- Understanding Christian wrestling about ethics -- Wrestling with the violence of conquest -- Wrestling with war in a modern world -- Wrestling with the violence of oppression -- Wrestling with violence and injustice abroad and at home -- Has anyone prevailed?

Emma Borg examines the relation between semantics and pragmatics, and assesses recent answers to fundamental questions of how and where to draw the divide between the two. She argues for a minimal account of the interrelation between them--a 'minimal semantics'--which holds that only rule-governed appeals to context can influence semantic content.

Both patients and clinicians frequently report problems around communicating and assessing pain. Patients express dissatisfaction with their doctors and doctors often find exchanges with chronic pain patients difficult and frustrating. This chapter thus asks how we could improve pain communication and thereby enhance outcomes for chronic pain patients. We argue that improving matters will require a better appreciation of the complex meaning of pain terms and of the variability and flexibility in how individuals think about pain. We start by examining (...) the various accounts of the meaning of pain terms that have been suggested within philosophy and suggest that, while each of the accounts captures something important about our use of pain terms, none is completely satisfactory. We propose that pain terms should be viewed as communicating complex meanings, which may change across different communicative contexts, and this in turn suggests that we should view our ordinary thought about pain as similarly complex. We then sketch what a view taking seriously this variability in meaning and thought might look like, which we call the “polyeidic” view. According to this view, individuals tacitly occupy divergent stances across a range of different dimensions of pain, with one agent, for instance, thinking of pain in a much more “bodycentric” kind of way, while another thinks of pain in a much more "mindcentric” way. The polyeidic view attempts to expand the multidimensionality recognised in, e.g., biopsychosocial models in two directions: first, it holds that the standard triumvirate— dividing sensory/cognitive/affective factors— needs to be enriched in order to capture important distinctions within the social and psychological dimensions. Second, the polyeidic view attempts to explain (at least in part) why modulation of experience by these social and psychological factors is possible in the first place. It does so by arguing that because the folk concept of pain is complex, different weightings of the different parts of the concept can modulate pain experience in a variety of ways. Finally, we argue that adopting a polyeidic approach to the meaning of pain would have a range of measurable clinical outcomes. (shrink)

Screen time has become a hot button issue in psychology with researchers fiercely debating its mental effects. If we want to understand the psychological dynamics of technology use, however, a numerical conceptualization of screen time will lead us to gloss over crucial distinctions. To make this point, the present article takes a hermeneutic approach to a negative form of screen time known as ‘phubbing’, which is the practice of snubbing conversational partners in favor of one’s phone. Using interview data, it (...) is demonstrated that whether or not phone use amounts to phubbing, that is, whether or not it tips over and becomes harmful, depends on a host of contextual factors such as relation (who), content (what), purpose (why), timing (when), and communication (how). These findings demonstrate that not all screen time is created equal: what is harmful and inappropriate in one context is benign in another, and vice versa. Simply put, screen time is not a numerical entity whose causal effects we can measure and explain, but a meaningful activity that we must try to understand. (shrink)

This study supports the idea that fields form around issues, and describes the roles of various stakeholders in the structuring, shaping, and legitimating of the emerging field of Corporate Social Responsibility (CSR). A model of the institutional history of the CSR field is outlined, of which a key stage is the appearance of CSR rating agencies as the significant players and Institutional Entrepreneurs of the field. We show to which extent the creation and further development of CSR rating agencies, and (...) the activism of other significant stakeholders of the field (typically portrayed as “standard setters” and “regulatory agents”), contribute to the institutionalization of CSR. With this in mind, among various stakeholders that legitimate the field of CSR, we present the efforts of global and local stakeholders such as the European Union, the United Nations, the International Organization for Standardization, and governments and their interactions. We suggest that the different paths of CSR development and institutionalization in France and in the United States depend on the nature of local and global stakeholders’ involvement in this process and their interactions. (shrink)

Scientists, philosophers, and policymakers disagree about how to define microaggression. Here, we offer a taxonomy of existing definitions, clustering around (a) the psychological motives of perpetrators, (b) the experience of victims, and (c) the functional role of microaggression in oppressive social structures. We consider conceptual and epistemic challenges to each and suggest that progress may come from developing novel hybrid accounts of microaggression, combining empirically tractable features with sensitivity to the testimony of victims.

Some demonstrative expressions, those we might term ‘bare demonstratives’, appear without any appended descriptive content (e.g. occurrences of ‘this’ or ‘that’ simpliciter). However, it seems that the majority of demonstrative occurrences do not follow this model. ‘Complex demonstratives’ is the collective term I shall use for phrases formed by adjoining one or more common nouns to a demonstrative expression (e.g. ‘that cat’, ‘this happy man’) and I will call the combination of predicates immediately concatenated with the demonstrative in such phrases (...) the ‘matrix’ of the expression. The question, then, is how we should construe the logical form of such expressions within a semantic theory for our language; and I wish to suggest that some recent answers to this question are, in fact, mistaken. The structure of the paper is as follows: first, I wish to highlight two (often underlying) assumptions about the nature of noun phrases in general, and suggest that, if they are both adopted, they apparently constrain the possible accounts of the logical form of complex demonstratives to just three options. The second and third parts of the paper will be concerned with expanding these options and arguing that none of them are adequate; thus the major part of the paper is concerned with the negative claim that the most obvious moves to make in this area must actually fail on closer inspection. The fourth and final section will then (very briefly) sketch the positive thesis of the paper: that we can deliver a clear and cohesive account of complex demonstratives, armed simply with elements which we will draw from David Kaplan’s theory of demonstratives, but only at the cost of rejecting (or at least refining) one assumption we recognised initially. (shrink)

‘Pragmaticist’ positions posit a three-way division within utterance content between: (i) the standing meaning of the sentence, (ii) a somewhat pragmatically enhanced meaning which captures what the speaker explicitly conveys (following Sperber and Wilson 1986, I label this the ‘explicature’), and (iii) further indirectly conveyed propositions which the speaker merely implies. Here I re-examine the notion of an explicature, asking how it is defined and what work explicatures are supposed to do. I argue that explicatures get defined in three different (...) ways and that these distinct definitions can and do pull apart. Thus the notion of an explicature turns out to be ill-defined. (shrink)

Applying Fineman’s vulnerability theory, this paper will explore the role of emotions within the legal profession and the specific vulnerabilities that arise from their traditional and contemporary treatment within law. It will consider how the notion of professionalism in law has traditionally disregarded or excluded emotions as irrelevant or even dangerous in a manner which is philosophically and psychologically flawed as well as damaging to mental health and wellbeing. This approach has created longstanding unacknowledged vulnerabilities for the profession as a (...) whole and individual practitioners. It will then explore how the shifting legal services landscape, and the resultant evolution of the profession, has led to a growing contemporary interest in the use of emotional competencies (often characterised as ‘soft skills’ or ‘emotional intelligence’). These are now increasingly exploited as tools to enhance profitability. However, this leads to a dichotomy as, despite their increasing utilisation, emotions are still not fully acknowledged or incorporated within law’s core professional values. This generates further individual and institutional vulnerabilities around mental health and wellbeing which require urgent attention to ensure the health of the contemporary profession. The paper concludes with suggestions for reforms to alleviate these vulnerabilities and promote greater future resilience within law. (shrink)

This chapter explores the concept of knowing as a contested terrain within the education. It takes, as its starting point, the classical philosophical distinction between knowing how, knowing that and the lesser-attended-to notion of knowing by acquaintance. Charting key historical debates pertaining to knowing that and knowing how, the chapter considers the extent to which conceptions of these forms of knowing evident in educational policy and practice are often limited and reductive. The chapter then explores how contemporary work within the (...) philosophy of education has served to challenge too-stringent conceptions of propositional and practical knowledge – often by reference to the Aristotelian conception of phronesis. With a view to building on this literature and taking it in a new direction, the chapter ends by exploring what might need to be at stake in a richer conception of knowledge for education. In connection with this, it offers a sketch of a renewed account of knowing by acquaintance, developed in relation to the phenomenological philosophy of Martin Heidegger. (shrink)

This article draws attention to the importance of enchantment in business ethics research. Starting from a Weberian understanding of disenchantment, as a force that arises through modernity and scientific rationality, we show how rationalist business ethics research has become disenchanted as a consequence of the normalization of positivist, quantitative methods of inquiry. Such methods absent the relational and lively nature of business ethics research and detract from the ethical meaning that can be generated through research encounters. To address this issue, (...) we draw on the work of political theorist and philosopher, Jane Bennett, using this to show how interpretive qualitative research creates possibilities for enchantment. We identify three opportunities for reenchanting business ethics research related to: moments of novelty or disruption; deep, meaningful attachments to things studied; and possibilities for embodied, affective encounters. In conclusion, we suggest that business ethics research needs to recognize and reorient scholarship towards an appreciation of the ethical value of interpretive, qualitative research as a source of potential enchantment. (shrink)

Sujetos y subjetividad en la construcción metodológica / Hugo Zemelman / - El magma constitutivo de la historicidad / Emma León / - Trabajo y mundo de vida / Enrique de la Garza Toledo / - Subjetividades emergentes, psiquismo y proyecto colectivo / Lidia Fernández / - Hacia una sociedad del sujeto : democracia y sociedad civil / Carlos Guerra Rodríguez / - Medios de comunicación, gobierno de la población y sujetos / María del Carmen de la Peza C. (...) / - El espacio íntimo en la construcción intersubjetiva / Medardo Tapia Uribe. (shrink)

To investigate possible cognitive factors influencing the cross-cultural incidence of spirit possession concepts and to develop a more refined understanding of the precise contours of 'intuitive mind-body dualism', two studies were conducted that explored adults' intuitions about the relationship between minds and bodies. Specifically, the studies explored how participants reason about the effects of a hypothetical mind-migration across a range of behaviours. Both studies used hypothetical mind-transfer scenarios in which the mind of one person is transferred into the body of (...) another person. Participants were asked to reason about the new post-transfer person's behaviours and aptitudes. In Study 1, participants were provided with a scale on which they indicated their answers; in Study 2, participants responded to open-ended questions. In both studies, the majority of participants reasoned that while the post-transfer person's performance on physical tasks would be similar to the host performance on mental tasks would be similar to the person whose mind has been transferred. Further, participants tended to assume a complete displacement of minds, such that the post-transfer person's performance on mental task items was reasoned to be identical to incoming person's performance normally. The relevance of these findings for explaining the variable incidence and spread of different possession concepts is discussed. (shrink)

We report the results of a cross-cultural investigation of person-body reasoning in the United Kingdom and northern Brazilian Amazon (Marajó Island). The study provides evidence that directly bears upon divergent theoretical claims in cognitive psychology and anthropology, respectively, on the cognitive origins and cross-cultural incidence of mind-body dualism. In a novel reasoning task, we found that participants across the two sample populations parsed a wide range of capacities similarly in terms of the capacities’ perceived anchoring to bodily function. Patterns of (...) reasoning concerning the respective roles of physical and biological properties in sustaining various capacities did vary between sample populations, however. Further, the data challenge prior ad-hoc categorizations in the empirical literature on the developmental origins of and cognitive constraints on psycho-physical reasoning (e.g., in afterlife concepts). We suggest cross-culturally validated categories of “Body Dependent” and “Body Independent” items for future developmental and cross-cultural research in this emerging area. (shrink)

Ethics codes of a number of scientific societies across different disciplines promulgate ethical standards for responsible conduct in research and other professional activities. The content of these codes of ethics are compared on key dimensions of research, service or practice, and teaching in terms of the range and specificity of the activities these codes cover, and in the degree to which they are educational, aspirational or regulatory in purpose. The role of professional associations in educating, regulating, monitoring, and sanctioning their (...) membership is also discussed. (shrink)