Background Healthcare systems are increasingly struggling with resource constraints, given demographic changes, technological development, and citizen expectations. The aim of this article is to normatively analyze different suggestions regarding how publicly financed plastic surgery should be delineated in order to identify a well-considered, normative rationale. The scope of the article is to discuss general principles and not define specific conditions or domains of plastic surgery that should be treated within the publicly financed system. Methods This analysis uses a reflective equilibrium (...) approach, according to which considered normative judgements in one area should be logically and argumentatively coherent with considered normative judgements and background theories at large within a system. Results and conclusions In exploring functional versus non-function conditions, we argue that it is difficult to find a principled reason for an absolute priority of functional conditions over non-functional conditions. Nevertheless, functional conditions are relatively easier to establish objectively, and surgical intervention has a clear causal effect on treating a functional condition. Considering non-functional conditions that require plastic surgery [i.e., those related to appearance or symptomatic conditions ], we argue that the patient needs to experience some degree of suffering, which must be ‘validated’ in some form by the healthcare system. This validation is required for both functional and non-functional conditions. Functional conditions are validated by distinguishing between statistically normal and abnormal functioning. Similarly, for non-functional conditions, statistical normality represents a potential method for distinguishing between what should and should not be publicly funded. However, we acknowledge that such a concept requires further development. (shrink)

When is it morally acceptable to expose others to risk? Most moral philosophers have had very little to say in answer to that question, but here is a moral philosopher who puts it at the centre of his investigations.

Disposition ascription has been discussed a good deal over the last few decades, as has the revisionary metaphysical view of ordinary, persisting objects known as 'fourdimensionalism'. However, philosophers have not merged these topics and asked whether four-dimensional objects can be proper subjects of dispositional predicates. This paper seeks to remedy this oversight. It argues that, by and large, four-dimensional objects are not suited to take dispositional predicates.

In the first part of this paper, I clear the ground from frequent misconceptions of the relationship between fact and value by examining some uses of the adjective “natural” in ethical controversies. Such uses bear evidence to our “natural” tendency to regard nature as the source of ethical norms. I then try to account for the origins of this tendency by offering three related explanations, the most important of which is evolutionistic: if any behaviour that favours our equilibrium with the (...) environment is potentially adaptive, nothing can be more effective for this goal than developing an attitude toward the natural world that considers it as a dispenser of sacred norms that must be invariably respected. By referring to the Aristotelian notion of human flourishing illustrated in the first part of the paper, in the second I discuss as a case study some ethical problems raised by mini-chips implantable in our bodies. I conclude by defending their potential beneficial effects of such new technological instruments. (shrink)

Starting with service robotics and industrial robotics, this paper aims to suggest philosophical reflections about the relationship between body and machine, between man and technology in our contemporary world. From the massive use of the cell phone to the robots which apparently “feel” and show emotions like humans do. From the wearable exoskeleton to the prototype reproducing the artificial sense of touch, technological progress explodes to the extent of embodying itself in our nakedness. Robotics, indeed, is inspired by biology in (...) order to develop a new kind of technology affecting human life. This is a bio-robotic approach, which is fulfilled in the figure of the cyborg and consequently in the loss of human nature. Today, humans have reached the possibility to modify and create their own body following their personal desires. But what is the limit of this achievement? For this reason, we all must question ourselves whether we have or whether we are a body. (shrink)

In Searle’s social ontology, collective intentionality is an essential component of all institutional facts. This is because the latter involve the assignment of functions, namely "status functions," on entities whose physical features do not guarantee their performance, therefore requiring our acceptance that it be performed. One counter-example to that claim can be found in Carl Menger’s individualistic account of the money system. Menger’s commitment to the self-interest assumption, however, prevents him from accounting for the deontic dimensions of institutional facts.

In order to reduce the death toll of road traffic it is necessary to focus on how vehicles and roads can be improved. Like other dangerous machines, motor vehicles should be equipped with safety devices that prevent mistakes by the operator from leading to serious consequences. Speed limiters that prevent driving at illegal speeds would save many lives, and so would alcohol interlocks. Meshi Ori's proposal that most cars should be replaced by motorcycles would not lead to the moral improvement (...) that he hopes for. We need motor vehicles with better, not worse, protection of the driver and passengers than the cars presently in use. (shrink)

Trust among current and future patients is essential for the success of biobank research. The submission of an informed consent is an act of trust by a patient or a research subject, but a strict application of the rule of informed consent may not be sensitive to the multiplicity of patient interests at stake, and could thus be detrimental to trust. According to a recently proposed law on “genetic integrity” in Sweden, third parties will be prohibited from requesting or seeking (...) genetic information about an individual. Cumbersome restrictions on research may be lifted, thus creating a more favourable climate for medical research. (shrink)

It is common in philosophy of language to recognise two different kinds of linguistic meaning: literal or conventional meaning, on the one hand, versus communicated or conveyed meaning, on the other. However, once we recognise these two types of meaning, crucial questions immediately emerge; for instance, exactly which meanings should we treat as the literal (semantic) ones, and exactly which appeals to a context of utterance yield communicated (pragmatic), as opposed to semantic, content? It is these questions and, specifically, how (...) we should model the relationship between semantic content and utterance context, that is the topic of this chapter. We explore five contemporary answers to this modelling question, considering the benefits and challenges of each, before closing by examining some potential new directions for debates in this area. (shrink)

This chapter contains sections titled: Note.

William James is known as a nineteenth-century philosopher, psychologist, and psychical researcher. Less well-known are the medical fixations that united his multiple identities and drove his ambition to change the way American society conceived of itself in body, mind, and soul. William James, M.D. offers an account of the development and cultural significance of James's ideas and works, and establishes, for the first time, the relevance of medical themes to his major lines of thought. James lived at a time when (...) old assumptions about faith and the moral and religious possibilities for human worth and redemption were increasingly displaced by a concern with the medically "normal" and the perfectibility of the body. Woven into treatises warning of the degeneration of humanity, these ideas comprised the origins of the eugenics movement and were manifest in a growing social stigma attached to illness and invalidism, a disturbing intellectual current in which James felt personally implicated. Most chronicles of James's life have portrayed a distressed young man, a psychological or spiritual crisis, followed by the emergence of a mature thinker who threw off his pallor of mental sickness for good. In contrast, Emma Sutton draws on his personal correspondence, unpublished notebooks, and diaries to show that James considered himself a genuine invalid to the end of his days. Sutton makes the compelling case that his philosophizing was not an abstract occupation but an impassioned response to his own life experiences and challenges. To ignore the medical James is to misread James altogether. Sales points: First book to map William James's preoccupation with medical ideas, concerns, and values across the disciplinary breadth of his work Reveals how themes of invalidism, health, and healing underpinned the genesis of many of James's major philosophical, psychological, and political ideas Draws on the approximately 9,400 items of Jamesian correspondence, together with his private notes and reading lists. (shrink)

When we accept oppression of some, we feed the oppression of others, and we make space for domination driven by false ideas of inferiority and lesser worth. When we discount the inherent preciousness of animals who think and feel, we erase precious parts of ourselves. When we consider living beings as "livestock," it's no wonder we pillage the unthinking yet irreplaceable living earth. Sub-Human is a robustly researched, sharply critical yet comfortingly human call to arms, diving deeply into the theory (...) behind oppression, liberation, and the intersections within it. Exploring the history of animal consumption and commodification, this book deconstructs the current sociopolitical climate surrounding animal enterprises by looking at how we got here. Most importantly, it unravels how we can work towards a collectively liberated world. (shrink)

Political theory as a discipline has long been skeptical of computational methods. In this paper, I argue that it is time for theory to make a perspectival shift on these methods. Specifically, we should consider integrating recently developed generative large language models like GPT-4 as tools to support our creative work as theorists. Ultimately, I suggest that political theorists should embrace this technology as a method of supporting our capacity for creativity—but that we should do so in a way that (...) is mindful of the content and value of theorizing, the technical constraints of the models, and the ethical questions that the technology raises. (shrink)

This article is an attempt at a systematic account of decision making under greater uncertainty than what traditional, mathematically oriented decision theory can cope with. Four components of great uncertainty are distinguished: (1) the identity of the options is not well determined (uncertainty of demarcation) ; (2) the consequences of at least some option are unknown (uncertainty of consequences); (3) it is not clear whether information obtained from others, such as experts, can be relied on (uncertainty of reliance); and (4) (...) the values relevant for the decision are not determined with sufficient precision (uncertainty of values). Some possible strategy types are proposed for each of these components. Decisions related to environmental issues are used to illustrate the proposals. (shrink)

The archive of the Nobel Assembly for Physiology or Medicine in Solna, Sweden, is a remarkable repository that contains reports and dossiers of the Nobel Prize nominations of senior and junior physicians from around the world. Although this archive has begun to be used more by scholars, it has been insufficiently examined by historians of surgery. No other German surgeon was nominated as often as Ferdinand Sauerbruch for the Nobel Prize for Physiology or Medicine in the first half of the (...) 20th century. This contribution reconstructs why and by whom Sauerbruch was nominated, and discusses the Nobel committee evaluations of his work. Political factors did not play an obvious role in the Nobel committee discussions, in spite of the fact that Adolf Hitler in 1937 had prohibited all German citizens to accept the Nobel Prize. The main reasons why Sauerbruch ultimately was not considered prize-worthy were that Sauerbruch’s achievements were marked by scientific priority disputes, and that his work was not seen as original enough. (shrink)

Clear-cut cases of decision-making under risk (known probabilities) are unusual in real life. The gambler’s decisions at the roulette table are as close as we can get to this type of decision-making. In contrast, decision-making under uncertainty (unknown probabilities) can be exemplified by a decision whether to enter a jungle that may contain unknown dangers. Life is usually more like an expedition into an unknown jungle than a visit to the casino. Nevertheless, it is common in decision-supporting disciplines to proceed (...) as if reasonably reliable probability estimates were available for all possible outcomes, i.e. as if the prevailing epistemic conditions were analogous to those of gambling at the roulette table. This mistake can be called the tuxedo fallacy. It is argued that traditional engineering practices such as safety factors and multiple safety barriers avoid this fallacy and that they therefore manage uncertainty better than probabilistic risk analysis (PRA). PRA is a useful tool, but it must be supplemented with other methods in order not to limit the analysis to dangers that can be assigned meaningful probability estimates. (shrink)

It is almost universally acknowledged that risks have to be weighed against benefits, but there are different ways to perform the weighing. In conventional risk analysis, collectivist risk-weighing is the standard. This means that an option is accepted if the sum of all individual benefits outweighs the sum of all individual risks. In practices originating in clinical medicine, such as ethical appraisals of clinical trials, individualist risk-weighing is the standard. This implies a much stricter criterion for risk acceptance, namely that (...) the risk to which each individual is exposed should be outweighed by benefits for that same individual. The different choices of risk-weighing methods in different policy areas seem to have emerged from traditional thought patterns and social relations, rather than from explicit deliberations on possible justifications for the alternative ways to weigh risks against benefits. It is not obvious how the prevalent differences in risk-weighing practices can be reconstructed in terms of consistent underlying principles of preventive health or social priority-setting. (shrink)

A passer du temps dans des studios de danse, voilà ce qu'on peut apprendre : nous, mammifères humaines, habitantes de Terra, sommes mouvementées par une multitude de forces. Loin d'être automobiles, loin d'être contenues ou contenables dans la petite usine de nos corps, nous débordons. Les écologies scientifiques nous en convainquent, les écologies politiques nous appellent à en faire une force insurrectionnelle. Et si nous apprenions, avec les écologies somatiques, à sentir et à célébrer nos débordements plus qu'humains? A l'heure (...) où les soulèvements de la terre se multiplient, ce livre examine la manière dont certaines formes de danse (improvisations collectives, pratiques somatiques, installations chorégraphiques) tentent d'élaborer, dans les plis du monde mondialisé, des antidotes à l'anesthésie. Des manières de nouer nos gestes au-delà des fausses frontières de l'individu et de l'humain. des manières de danser-sentir- penser l'enchevêtrement de nos mouvements"--Page 4 of cover. (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.

Implant ethics is defined here as the study of ethical aspects of the lasting introduction of technological devices into the human body. Whereas technological implants relieve us of some of the ethical problems connected with transplantation, other difficulties arise that are in need of careful analysis. A systematic approach to implant ethics is proposed. The major specific problems are identified as those concerning end of life issues (turning off devices), enhancement of human capabilities beyond normal levels, mental changes and personal (...) identity, and cultural effects. (shrink)

This book asks how people understood the concept of politics in sixteenth-century France, and how those who practised it were characterised. Both concept and practitioners were referred to by the same word, politique. I trace written uses of this word as a means of studying shifts in the meaning of the concept and the figure. As much as this is a conceptual history, therefore, it is a textual, and indeed, a literary one. Part of the book's argument is that sixteenth-century (...) literary ideas and processes influenced developments in political thought and practice. It also argues that the word politique and the idea of politics hold a specific place in the literature of the period. The book is about the representation of politics and political actors in writing, the writing of politics, and writing as politics. It treats a diverse corpus, including polemical pamphlets, texts of high political thought, and works more associated with the literary canon such as Montaigne's Essais and the Satyre ménippée. (shrink)

The empirical basis for this article is threeyears of experience with ethical rounds atUppsala University Hospital. Three standardapproaches of ethical reasoning are examined aspotential explanations of what actually occursduring the ethical rounds. For reasons given,these are not found to be satisfyingexplanations. An approach called ``imaginativeethics'', is suggested as a more satisfactoryaccount of this kind of ethical reasoning. Theparticipants in the ethical rounds seem to drawon a kind of moral competence based on personallife experience and professional competence andexperience. By listening to (...) other perspectivesand other experiences related to one particularpatient story, the participants imaginealternative horizons of moral experience andexplore a multitude of values related toclinical practice that might be at stake. Inhis systematic treatment of aesthetics in theCritique of Judgement, Kant made use ofan operation of thought that, if applied toethics, will enable us to be more sensitive tothe particulars of each moral situation. Basedon this reading of Kant, an account ofimaginative ethics is developed in order tobring the ethical praxis of doctors and nursesinto sharper relief. The Hebraic and theHellenic traditions of imagination are used inorder to illuminate some of the experiences ofethical rounds. In conclusion, it is arguedthat imaginative ethics and principle-basedethics should be seen as complementary in orderto endow a moral discourse with ethicalauthority. Kantian ethics will do the job if itis remembered that Kant suggested only amodest, negative role of principle-baseddeliberation. (shrink)

This paper examines the concept of medical necessity as it relates to mental health care rationing, arguing that the normal functioning model of medical necessity is insufficient because it fails to cohere with an important aim and function of mental health care, which is to provide support for individuals in abusive or otherwise difficult personal relationships.

Descartes's Fictions traces common movements in early modern philosophy and literary method. Emma Gilby reassesses the significance of Descartes's writing by bringing his philosophical output into contact with the literary treatises, exempla, and debates of his age. She argues that humanist theorizing about poetics represents a vital intellectual context for Descartes's work. She offers readings of the controversies to which this poetic theory gives rise, with particular reference to the genre of tragicomedy, questions of verisimilitude or plausibility, and the (...) figures of Guez de Balzac and Pierre Corneille. Drawing on what Descartes says about, and to, his many contemporaries and correspondents embedded in the early modern republic of letters, this volume shows that poetics provides a repository of themes and images to which he returns repeatedly: fortune, method, error, providence, passion, and imagination, for instance. Like the poets and theorists of his age, Descartes is also drawn to the forms of attention that people may bring to his work. This interest finds expression in the mature Cartesian metaphysics of the Meditations, as well as, later, in the moral philosophy of his correspondence with Elisabeth of Bohemia or the Passions of the Soul. This volume thus bridges the gap between Cartesian criticism and late-humanist literary culture in France. (shrink)

It is common in philosophy of language to recognise two different kinds of linguistic meaning: literal or conventional meaning, on the one hand, versus communicated or conveyed meaning, on the other. However, once we recognise these two types of meaning, crucial questions immediately emerge; for instance, exactly which meanings should we treat as the literal (semantic) ones, and exactly which appeals to a context of utterance yield communicated (pragmatic), as opposed to semantic, content? It is these questions and, specifically, how (...) we should model the relationship between semantic content and utterance context, that is the topic of this chapter. We explore five contemporary answers to this modelling question, considering the benefits and challenges of each, before closing by examining some potential new directions for debates in this area. (shrink)

Law schools are failing both their staff and students by requiring them to prize reason and rationality and to suppress or ignore emotions. Despite innovations in terms of both content and teaching techniques, there is little evidence that emotions are effectively acknowledged or utilised within legal education. Instead law schools are clinging to an out-dated and erroneous perception of emotions as, at best, irrational, and at worst dangerous. In contrast to this, educational and scientific developments have demonstrated that emotions are (...) a fundamental, inescapable part of learning, teaching and skills development. Harnessing these emotions will therefore have a transformative effect on legal education and enable it to adapt to the needs and demands of the 21st century. This book provides a theoretical overview of the role played by emotions in all aspects of the life of the law school. It explores the relationship between emotions and key traditional and contemporary approaches to legal education, the ways in which emotions can be conceptualised, their interaction with the politics and policies of legal education and their role within teaching and learning. The book also considers the importance of emotional wellbeing for both law students and legal academics Overall, this book argues for a more holistic form of legal education in which emotions play a valuable (and valued) role. This requires a new vision for law schools, in which emotions are acknowledged and embedded at all levels, institutional and personal. (shrink)

In Utopophobia: On the Limits (If Any) of Political Philosophy, David Estlund defends against utopophobia in political philosophy. Estlund claims that it is no defect in a theory of justice if it sets a high standard that has little chance of being achieved by any society. The book does not, however, give similar permission to argue for unrealistically optimistic political proposals. Going beyond Estlund, I consider the possibility that some utopian thinking is warranted not just in the context of formulating (...) a theory of justice, but in the practical context, too. Sometimes theorizers ought to argue for and pursue political proposals that seem unrealistically optimistic. (shrink)

Environmental epigenetics is increasingly employed to understand the health outcomes of communities who have experienced historical trauma and structural violence. Epigenetics provides a way to think about traumatic events and sustained deprivation as biological “exposures” that contribute to ill-health across generations. In Australia, some Indigenous researchers and clinicians are embracing epigenetic science as a framework for theorising the slow violence of colonialism as it plays out in intergenerational legacies of trauma and illness. However, there is dispute, contention, and caution as (...) well as enthusiasm among these research communities.In this article, we trace strategies of “refusal” (Simpson, 2014) in response to epigenetics in Indigenous contexts. Drawing on ethnographic fieldwork conducted in Australia with researchers and clinicians in Indigenous health, we explore how some construct epigenetics as useless knowledge and a distraction from implementing anti-colonial change, rather than a tool with which to enact change. Secondly, we explore how epigenetics narrows definitions of colonial harm through the optic of molecular trauma, reproducing conditions in which Indigenous people are made intelligible through a lens of “damaged” bodies. Faced with these two concerns, many turn away from epigenetics altogether, refusing its novelty and supposed benefit for Indigenous health equity and resisting the pull of postgenomics. (shrink)

The relatively new discipline of risk analysis promises to provide objective guidance in some of the most controversial issues in modern high‐technology societies. Four conditions are discussed that must be satisfied for this promise to be fulfilled. Since none of these conditions is satisfied, risk analysis does not keep its promise. In its attempts to reduce genuinely political issues to technocratic calculations, it neglects many of the factors that should influence decisions on risk acceptance. A list of tentative guidelines is (...) given for numerical decision support that encourages democratic decision‐making instead of trying to evade it. (shrink)

Microaggressions are seemingly negligible slights that can cause significant damage to frequently targeted members of marginalized groups. Recently, Scott O. Lilienfeld challenged a key platform of the microaggression research project: what’s aggressive about microaggressions? To answer this challenge, Derald Wing Sue, the psychologist who has spearheaded the research on microaggressions, needs to theorize a spectrum of aggression that ranges from intentional assault to unintentional microaggressions. I suggest turning to Bonnie Mann’s “Creepers, Flirts, Heroes and Allies” for inspiration. Building from Mann’s (...) richer theoretical framework will allow Sue to answer Lilienfeld’s objection and defend the legitimacy of the concept, ‘microaggression’. (shrink)

Writing Migration through the Body builds a study of the body as a mutable site for negotiating and articulating the transnational experience of mobility. At its core stands a selection of recent migration stories in Italian, which are brought into dialogue with related material from cultural studies and the visual arts. Occupying no single disciplinary space, and drawing upon an elaborate theoretical framework ranging from phenomenology to anthropology, human geography and memory studies, this volume explores the ways in which the (...) skin itself operates as a border, and brings to the surface the processes by which a sense of place and self are described and communicated through the migrant body. Through investigating key concepts and practices of transnational embodied experience, the book develops the interpretative principle that the individual bodies which move in contemporary migration flows are the primary agents through which the transcultural passages of images, emotions, ideas, memories - and also histories and possible futures - are enacted. (shrink)

Pedagogical Peculiarities: Conversations at the edge of university teaching and learning explores the peculiarities characterising university teaching cultures through a consideration of the implications, tensions and impacts associated with academic development in higher education. This is achieved through a series of deliberative dialogues, involving experts in pedagogy and academics working within specific disciplinary and institutional contexts. The chapters provide an important and currently missing critique of the peculiarity of teaching practice and the idealisation of teaching excellence in higher education. As (...) a result, the volume's major contribution lies in the advancement of a unique discourse of pedagogy in higher education, comprised of multiple contexts. Ultimately Pedagogical Peculiarity's distinctiveness lies in its articulation of different pedagogical identities. These emanate from, and are characterized by different teaching and learning environments, across different institutions and sectors. This, in turn, serves to illuminate the current contexts and challenges across higher education as they relate and respond to ideology, values, policy and changes in the organization of the sector. In essence, Pedagogical Peculiarities explores what it means to be a contemporary academic. (shrink)