In 1992, the United States Supreme Court, in Planned Parenthood of Southeastern Pennsylvania v. Casey, upheld the ruling in Roe v. Wade, namely that women have a right “to choose to have an abortion before viability and to obtain it without undue interference from the State.”1 However, since this ruling, some states have imposed regulations that greatly limit this right by restricting access. Texas is a recent example of this. Two proposed restrictions in House Bill 2, which will be discussed (...) in detail below, will force all but eight clinics that are located in metropolitan areas to shut down. The U.S. Supreme Court put the proposed restrictions on hold in October 2014, allowing several clinics to remain open while the restrictions are being appealed in the U.S. Court of Appeals for the Fifth Circuit. If the restrictions are passed, however, those clinics will be forced to shut down and, as a result, many women in Texas will be required to travel more than 100 miles in order to access a safe and legal abortion. Much of the focus of these restrictions has been on women and rightly so. However, I want to turn the attention to physicians. The requirements exacerbate unfair treatment of abortion providers compared with other physicians. Abortion providers face threats from the public—some of which turn into violent attacks—and they are often ostracized by their fellow medical practitioners. There are so few abortion providers to begin with and the proposed requirements limit these physicians’ opportunities to practice the branch of medicine of their choosing. Although the HB 2 requirements may not result in an unconstitutional undue burden on physicians, the challenges created by the bill limit physicians’ abilities to provide abortions. As a result of these limits, HB 2 creates an unconstitutional undue burden for women seeking abortions by creating barriers directed at abortion providers and clinic staff who are willing and able to provide abortions. The first of the two controversial HB 2 requirements is the admitting privileges requirement: “A physician performing or inducing an abortion must, on the date the abortion is performed or induced, have active admitting privileges at a hospital that is located not further than 30 miles from the location at which the abortion is performed or induced.”2 The second requirement is the ambulatory surgical center requirement: “The minimum standards for an abortion facility must be equivalent to the minimum standards adopted under [Texas Health & Safety Code] [...] for ambulatory surgical centres.”3 In order to meet these state-mandated obligations, some abortion clinics would have to spend more than $1 million in upgrades if they wish to remain open. The District Court decided that the ambulatory surgical center requirement places an unconstitutional undue burden on women, and that the two requirements together place an undue burden on women in Texas and especially in the Rio Grande Valley where the nearest clinic is a couple hundred miles away.4 Later, the U.S. Court of Appeals for the Fifth Circuit reversed the District Court’s decision and argued, “the admitting privileges requirement is constitutional on its face.”5 While the regulations are being appealed, the Supreme Court granted a stay of injunction, allowing about twelve abortion clinics to reopen until a final decision regarding the regulations is made. The District Court ruled that the purpose of the two regulations was to create a substantial obstacle for women seeking abortions in Texas. While the defendants argued that the regulations were designed to make abortions safer and reduce risk, the Court decided that this was not the case. An abortion, especially a first-term abortion, is a very safe procedure and is safer than many other routine surgical procedures. As stated in Planned Parenthood v. Casey, “Unnecessary health regulations that have the purpose or effect of presenting a substantial obstacle to a woman seeking an abortion impose an undue burden on the right.”6 The undue burden in this case is imposed, not through restricting women’s access directly, but by restricting physicians’ freedom to perform abortions. The admitting privileges requirement has reduced the number of physicians who can perform abortions and the ambulatory surgical center requirement has reduced the number of clinics where abortions can be performed. The American Medical Association states, “[t]he Principles of Medical Ethics of the AMA do not prohibit a physician from performing an abortion in accordance with good medical practice and under circumstances that do not violate the law.”7 This means that physicians are not required to perform abortions, except in emergency situations, but can as long as the procedure is done safely and does not violate the law. The new Texas regulations, however, are so restrictive that few abortion providers, limited to only four urban areas, can legally perform abortions. Physicians do not have an absolute right to perform abortions as opposed to women who have an absolute right to have access to an abortion. Physicians do face many challenges that other professionals face in terms of obtaining qualifications and finding work. Abortion providers, however, face challenges that most other physicians do not. The restrictions imposed by these regulations exacerbate unfair treatment toward abortion providers and place further obstacles in their path in terms of providing the service they want and are qualified to provide. Both abortion clinics and abortion providers are being treated differently from other medical clinics and physicians. For instance, “grandfathering of existing facilities and the granting of waivers from specific requirements is prohibited for abortion providers, although other types of ambulatory surgical facilities are frequently granted waivers or are grandfathered.”8 Many abortion clinics cannot afford the necessary upgrades. Furthermore, it is extremely expensive to open a brand new clinic that complies with the ambulatory surgical center requirements. Being grandfathered in would be the only option available to abortion clinics that cannot afford the upgrade. However, unfair treatment of abortion clinics and providers is preventing those clinics from being grandfathered into the new system. As a result, many abortion clinics may be forced to close. Admitting privileges are proving difficult or impossible for physicians both to obtain and, for those who have already been granted privileges, to keep. Dr. Sherwood Lynn, an obstetrician-gynecologist who has performed abortions for decades, describes the process of obtaining admitting privileges and the difficulties abortion providers face. After sending in an application a physician must wait for the hospital to send them the required materials, “but if the address of the practice on the application is of an abortion provider or clinic, [the hospital] won’t send [them] the package of materials required. [They] simply can’t apply.”9 Dr. Lynn and several other physicians have surmised that hospitals are only withholding privileges from qualified physicians who perform abortions and that other physicians do not face this discriminatory treatment. Hospitals have also revoked privileges granted to physicians after learning that the physicians perform abortions. For instance, in Texas two doctors, “received notices [...] informing them that their admitting privileges to the University General Hospital of Dallas have been revoked, with the hospital’s CEO claiming the hospital was unaware they were providing abortion care and that the hospital believed such care would damage its reputation.”10 What is curious about this revocation is that, “federal and state laws [...] forbid hospitals from discriminating against doctors who perform abortions,” and yet hospitals are clearly doing just that.11 Dr. Pamela Richter, another abortion provider in Texas, had her temporary admitting privileges revoked with no explanation and because of this, the clinic where she performed abortions, Reproductive Services, can no longer provide abortions at all.12 As the hospital gave no reason for the revocation, it not clear Dr. Richter’s privileges were revoked because she performs abortions. Dr. Richter, however, has performed over 17,000 abortions and her privileges were revoked soon after HB 2 was introduced.13 According to the Texas Hospital Association, giving admitting privileges to doctors who do not work for the hospital is expensive and time-consuming but this does not account for the fact that hospitals are revoking previously granted privileges from physicians whom they learn are providing abortion services.14 As mentioned previously, the District Court found that the admitting privileges requirement and the ambulatory surgical center requirement do not further ensure the health and safety of women undergoing an abortion. Several physicians have testified to this fact. Dr. Lynn stated in an interview: The admitting privileges requirements are [...] absolutely unnecessary. If you have a number of patients waiting for procedures, and something happens and a patient needs to be transferred to a hospital, you’re not going to leave everyone else and go to the hospital. That makes no sense. You’re going to refer that person to a gynecologist at the hospital. There is no safety issue involved here. If a patient shows up with an emergency, every hospital is required to admit that patient. They have to by law.15 It is rare that complications will arise from an abortion performed in a clinic. Dr. Richter, for example, has performed more than 17,000 abortions and not once had to send a patient to a hospital because of complications resulting from the procedure. According to Dr. Lynn even if abortion providers were granted privileges to hospitals, it is unlikely that they will exercise them. In essence, having admitting privileges at a hospital does nothing to further ensure the safety of an already safe procedure. The only result of the admitting privileges requirement is to limit certain physicians’ ability to perform legal abortions. Not only do the HB 2 requirements fail to further ensure the health and safety of women, the HB 2 requirements may actually create more health risks to women who cannot access the eight remaining clinics. The first risk is that the remaining clinics would have an influx of patients that they may not be able to handle, forcing women to wait longer for an appointment. As stated by the District Court, “[e]ven assuming every woman in Texas who wants an abortion [...] could travel to one of the four metropolitan areas where abortions will still be available, the cumulative results of HB 2 are that, at most, eight providers would have to handle the abortion demand of the entire state.”16 Furthermore, “[t]hat the State suggests that these seven or eight providers could meet the demand of the entire state stretches credulity.”17 Abortion is a time sensitive procedure. It is safest when performed early in a pregnancy. The increase in patients to these remaining clinics, assuming all women in Texas can access them, will increase wait times and may force women to have abortions later in pregnancy. In the worst-case scenario, a woman would not see an abortion provider at all before viability. Such instances may be rare, but they are possible. In such cases, women’s access to legal abortions becomes impossible and thereby violate the ruling in Roe. Clinics may be able to avoid the aforementioned problems if they hire more physicians. However, there are two barriers to hiring more physicians. First, as mentioned previously, admitting privileges to Texas hospitals are difficult, if not impossible, for abortion providers to obtain. Second, given the negative treatment of abortion providers by anti-abortion groups, many physicians are not willing to perform abortions. The harassment abortion providers face is unique to those physicians and many physicians will not perform abortions for that reason. In an article published in the Austin Chronicle, anti- abortion activist Abby Johnson, “discusses how her group investigated appraisal district records to find the new location of where an Austin abortion physician plans to work.”18 Johnson states, “These abortionists are feeling the pressure from the pro-life movement in Texas. I think they feel like they’re on the run. And that’s how we want to keep it.”19 If the HB 2 requirements are passed and there remain at most eight abortion providers in Texas, these activists will concentrate on those clinics and, “the dangerous impact of their intimidation tactics will be exacerbated.”20 Even if the number of physicians needed to meet the demand in Texas can obtain admitting privileges and work at one of the remaining clinics, they may choose not to do such work because they are putting themselves at risk. The harm abortion providers face from such anti-abortion groups is not unique to Texas. There are stories from all over the country and from other countries where abortion is legal of physicians receiving death threats. Dr. George Tiller, an abortion provider in Kansas, was killed outside his church and had received numerous death threats prior to this. The HB 2 requirements are making it so that abortion providers either cannot provide their services any longer or will face increased threats and increased danger to themselves. Physicians are allowed to conscientiously object to providing medical interventions in certain circumstances for moral and religious reasons. However, there are limits on this right. According to the American Congress of Obstetricians and Gynecologists, “[w]hen conscientious refusals conflict with moral obligations that are central to the ethical practice of medicine, ethical care requires that the physician provide care despite reservations or that there be resources in place to allow the patient to gain access to care in the presence of conscientious refusal.”21 I would argue fear for one’s safety in the face of immediate threats is perhaps a stronger ground on which to refuse to provide care than a personal belief that abortion is immoral or against one’s religion. ACOG also states, “[p]roviders with moral or religious objections should either practice in proximity to individuals who do not share their views or ensure that referral processes are in place so that patients have access to the service that the physician does not wish to provide.”22 This responsibility has been largely disputed by the medical community but in cases of rape, incest, and health risks to women, referrals must be made without exception. However, under the requirements of HB 2, working in proximity to an abortion provider may not be possible because they are so geographically limited. Referrals are supposed to be made within reason. Some areas of Texas, such as the Rio Grande Valley, are up to 200 miles away from the nearest clinic that would remain open if HB 2 is passed. Referrals may simply not be feasible given the geographical distances and the decreasing number of available physicians. As mentioned above, there are two risks to the health and safety of women as a result of HB 2. The second of these is that if a woman cannot access one of the remaining clinics, she may seek out a more convenient but illegal and unsafe abortion, which is far more likely to result in a dangerous complication. Dr. Lynn states, “[b]ecause of the restrictions lawmakers impose, women will seek abortions illegally, and we’re going to see a rise in septic abortions.”23 Some areas of Texas might effectively revert back to a pre-Roe era where abortions were performed in unsanitary conditions by unqualified people resulting in dangerous medical complications far more often than legal abortion procedures do now. Physicians like Dr. Lynn who want to prevent this from happening generally cannot do so without facing legal sanction. Physicians have a duty to provide safe medical care and if they cannot obtain admitting privileges, they cannot exercise this duty. ACOG released a statement expressing their objections to the new requirements. They state that HB 2 is, “plainly intended to restrict the reproductive rights of women in Texas through a series of requirements that improperly regulate medical practice and interfere with the patient-physician relationship.”24 Executive Vice-President of ACOG, Hal C. Lawrence III stated: The Texas bills set a dangerous precedent of a legislature telling doctors how to practice medicine and how to care for individual patients. ACOG opposes legislative interference, and strongly believes that decisions about medical care must be based on scientific evidence and made by licensed medical professionals, not the state or federal government.25 Abortion is one of only a few areas of medicine where the legislature imposes so many regulations restricting particular physicians’ ability to practice medicine. Not only are abortions providers being regulated by the state, they are also facing clear discrimination from others within the medical community. The state is closing down clinics that do not meet the ambulatory surgical center requirements and hospitals are denying physicians admitting privileges because they perform abortions. In summary, abortion providers are being discriminated against both by the legislature and other members of the medical community. Other physicians who do not perform abortions are not denied admitting privileges on discriminatory grounds. Clinics that cannot afford upgrades to become an ambulatory surgical center are being grandfathered in, while abortion clinics are being forced to close down. Ob-Gyns who conscientiously object to performing abortions and who are not located in close proximity to at least one abortion provider cannot effectively fulfill their duty to refer patients. Lastly, given the barriers these regulations will create, there will likely be a rise in complications resulting from abortions provided under grossly unsafe conditions. Physicians, whose duty it is to provide safe and effective medical care, are being denied the right to exercise this duty. While this denial may not be unconstitutional, it is certainly unjust and discriminatory and creates obstacles that other physicians do not face. Most importantly, these obstacles are creating an undue burden for women. The HB 2 requirements do not increase the health and safety of abortions; all they do is create substantial obstacles for women. In light of these observations, the requirements seem to me to be in clear violation of Casey, in which it was decided that, “[u]nnecessary health regulations that have the purpose or effect of presenting a substantial obstacle to a woman seeking an abortion impose an undue burden on that right.”26 These regulations do just what Casey was meant to prohibit and this is accomplished through limiting physicians’ ability to practice safe abortions across the state of Texas. Therefore, the HB 2 requirements may not impose an undue burden on doctors but they do impose an undue burden on women. PDF available: Rachel Hill, "Texas HB 2," Voices in Bioethics. References: 1 Planned Parenthood of Southeastern Pennsylvania v. Casey, pg. 2. 2 Whole Women’s Health v. Lakey, pg. 2. 3 Ibid. 4 Ibid., 4. 5 Ibid., 2. 6 Planned Parenthood v. Casey, pg. 16 7 AMA Code of Medical Ethics, “Opinion 2.01 – Abortion,” American Medical Association. 8 Whole Women’s Health v. Lakey, pg. 10. 9 Dr. Sherwood Lynn, “A Texas Ob-Gyn Details the Horrific Consequences of Abortion Restrictions,” Cosmopolitan. 10 Feminist Newswire, “Texas Hospitals Revoke Admitting Privileges to Abortion Providers,” Feminist Majority Foundation Blog. 11 Ibid. 12 Ibid. 13 Ibid. 14 Glenn Hegar, “Texas Hospital Association’s Statement of Opposition to Section 2 of the Committee Substitute for Senate Bill 5,” Texas Hospital Association. 15 Dr. Lynn, “A Texas Ob-Gyn.” 16 Whole Women’s Health v. Lakey, pg. 10. 17 Ibid. 18 Mary Tuma, “Undercover Audio Reveals Anti-Abortion Tactics: Anti-abortion activists monitor and track providers, patients,” Austin Chronicle. 19 Ibid. 20 Ibid. 21 Committee on Ethics, “The Limits of Conscientious Refusal in Reproductive Medicine,” The American Congress of Obstetricians and Gynecologists. 22 Ibid. 23 Dr. Lynn, “A Texas Ob-Gyn.” 24 “Ob-Gyns Denounce Texas Abortion Legislation: Senate Bill 1 and House Bill 2 Set Dangerous Precedent,” The American Congress of Obstetricians and Gynecologists. 25 Ibid. 26 Planned Parenthood v. Casey, pg. 16. (shrink)

The author introduces two key issues of the Ebola epidemic very clearly. However, the author could elaborate further on the objections to using experimental drugs. The author does a very good job of enumerating the reasons for using these drugs. In terms of reasons against using the drugs, the author only writes that there are regulations in place that are usually followed. Several supporting facts are given to suggest different regulations should be put in place for a crisis like Ebola. (...) Ebola is a deadly disease with no cure. At present, all we have are these experimental drugs. Ordinarily, such drugs would not be given without extensive testing. However, in this case, there is no time for that to be done. People who contract Ebola have no other alternatives, so an unapproved experimental treatment is better than nothing at all. It is important to weigh the risks and benefits. Some may argue that the risks of using an experimental drug may be too great and that we should wait to administer any experimental drug until it has been proven safe. We do not know what the long-term side effects may be. While that argument may be appropriate for other situations, in the case of Ebola epidemic, I do not think it applies. As I have said, and as the author has said, there is no cure or other treatment available for Ebola. People who contract it will likely die of the disease and these experimental treatments are their only option. In this case, the benefits outweigh the risks. As the author mentions, access to these drugs is very problematic. However, they do not elaborate enough on both sides of the issue. There are reasons supporting and reasons against giving health care workers experimental treatments first and I think including them would have added to the depth of the argument presented here. (shrink)

On October 29, 2013, Texas House Bill 2 went into effect, greatly changing women’s access to an abortion in the state. This bill requires that physicians performing clinic-based abortions obtain admitting privileges at a hospital within 30 miles of the clinic. A few months later, on January 1, 2014, the Texas Health and Safety Code was amended to include the requirement that all abortion clinics must meet the standards of an ambulatory surgical centre. These requirements will result in heavy burdens (...) for women seeking an abortion. Many clinics cannot afford the upgrade and are being forced to close down. On August 29, 2014, a Federal District Court for the Western District of Texas ruling to overturned the two proposed requirements. The court deemed them unconstitutional violations of a woman’s right to obtain an abortion recognizing that their purpose was to create obstacles for women. The ruling was appealed and the Federal Appeals Court allowed for the new regulations, forcing all but eight clinics in Texas to close their doors. Before the enactment of HB2, there were approximately 40 abortion clinics serving Texas’ population of about 26 million. The new regulations would force all except eight clinics to close down. The remaining clinics are located in four cities forcing many women to travel hundreds of miles to access them. For some, it is more feasible to leave Texas to go to an abortion clinic outside the state. Even if every woman seeking an abortion was able to travel to one of the remaining clinics, the clinics could not meet the demand. Both of these requirements, the ambulatory surgical requirement and the admitting privileges requirement, constitute an undue burden for women. But what about the physicians? These requirements also place an undue burden on physicians who want to perform abortions. For affected physicians, it is difficult or impossible to obtain admitting privileges at a nearby hospital. Many hospitals are denying these privileges to physicians because the hospitals have no interest in participating in performing abortions and gain nothing by allowing it. If the majority of abortion clinics are forced to close down, physicians who want to perform abortions would have to relocate to one of the four cities mentioned previously, or even leave the state. Women seeking an abortion have to travel to the clinic once or twice. Physicians would have to relocate permanently. Much of the focus of these rulings has been on women’s rights and what constitutes an undue burden for women. In addition to this, physician’s rights should also be considered. There have been several cases of doctors facing harassment and even death threats for performing abortions. Fear of such treatment has led to many doctors to decline to perform abortions. Doctors do not have an obligation to perform abortions but it is within their rights as physicians to do so. However, given this harsh treatment by anti-abortion groups, not a lot of doctors are willing. The new regulations will leave open clinics in four cities in Texas making it more difficult for those few doctors who want to perform abortions to do so. The new regulations impose undue burdens on women and doctors alike. On Tuesday, October 14, the Supreme Court struck down the new requirements allowing thirteen clinics in Texas to reopen. (shrink)

Proclaimed the “greenest television programme in the world,” the award-winning soap opera Coronation Street is seen as an industry success story. This paper explores how the integration of carbon literacy training led to a widespread transformational change of practice within Coronation Street. Using the theoretical lens of Communities of Practice, this study examines the nature of social learning and the enablers and barriers to change within the organization. Specifically, how boundary spanning practices, objects and people led to the transformation on (...) both a personal and group level. Based on a qualitative analysis of 22 interviews with Heads of Departments and other staff, the paper argues that CLT is a boundary practice which has evolved into a boundary spanning CoP. The importance of infrastructures supporting boundary objects and practices is highlighted as reinforcers of the CLT, both as a boundary object and a community, with the “ultimate” boundary spanning object being the show. A significant enabler in social learning and change in practice is the creation of discursive and creative space, both within CoP and across the boundaries. Findings also highlight the role of “self” in the process of social learning and organizational change. Distinct patterns emerged in the relationship between self-identity, social learning and change across a range of boundary objects, practices and communities both in the CLT and CoP. This suggests that in a diverse social learning setting such as CLT there are different transformational catalysts within the CoP and these identities can influence how knowledge is translated into practice. (shrink)

Background Achieving meaningful consent can be challenging, particularly in contexts of diminished literacy, yet is a vital part of participant protection in global health research. Method We explored the challenges and potential solutions of achieving meaningful consent through a qualitative study in a predominantly hill tribe ethnic minority population in northern Thailand, a culturally distinctive population with low literacy. Semi-structured interviews were conducted with 37 respondents who had participated in scrub typhus clinical research, their family members, researchers and other (...) key informants. A thematic analysis was conducted. Results Our analysis identified four interrelated themes surrounding participants’ ability to give consent: varying degrees of research understanding, limitations of using informal translators, issues impacting decisions to join research, and voluntariness of consent. Suggestions for achieving more meaningful consent included the use of formal translators and community engagement with research populations. Conclusions Participant’s agency in decision making to join research should be supported, but research information needs to be communicated to potential participants in a way that they can understand. We found that improved understanding about the study and its potential benefits and harms goes beyond literacy or translation and requires attention to social and cultural factors. (shrink)

Many philosophers, psychologists, and medical practitioners believe that killing is no worse than letting die on the basis of James Rachels's Bare-Difference Argument. I show that his argument is unsound. In particular, a premise of the argument is that his examples are as similar as is consistent with one being a case of killing and the other being a case of letting die. However, the subject who lets die has both the ability to kill and the ability to let die (...) while the subject who kills lacks the ability to let die. Modifying the latter example so that the killer has both abilities yields a pair of cases with morally different acts. The hypothesis that killing is worse than letting die is the best explanation of this difference. (shrink)

Kopeikin (forthcoming a, forthcoming b) and Rachels’ (1975) bare-difference cases elicit the intuition that killing is no different than letting die. Hill’s (2018) bare-difference cases elicit the intuition that killing is worse than letting die. At least one of the intuitions must be mistaken. This calls for an error theory. Hill has an error theory for the intuition elicited by the Kopeikin/Rachels’ cases. Kopeikin and Rachels have an error theory for the intuition elicited by Hill’s cases. A (...) natural thought is that we are at an impasse. There is no plausible basis for preferring one error theory to the other. I argue that this natural thought is mistaken. Not all error theories are equal. Preliminary considerations favor Hill’s error theory and disfavor the Kopeikin/Rachels error theory. But preliminary considerations are not decisive. The way forward in the bare-difference debate is not to evaluate intuitions. The intuitions are in. What is left to do now is evaluate the comparative status of the Hill and the Kopeikin/Rachels error theories. (shrink)

Este livro inclui as palestras apresentadas no XIII Congresso Internacional de Estética, ocorrido em Belo Horizonte em outubro de 2017, cujo título, “Os fins da arte”, explora o duplo sentido do termo “fim” que, polissêmico, indica término, conclusão e epílogo, assim como o propósito, a meta, o objetivo, a motivação, e ainda o limite e a decadência. O uso plural desse termo amplifica, ainda, suas possibilidades de interpretação. Os textos deste livro mostram de modo evidente o quanto a questão do (...) “fim” contribui de maneira estratégica para pensar a arte durante o último século e o início deste. O livro conta com textos dos filósofos e filósofas da arte Márcia Ferreira Gonçalves, Gunter Gebauer, Rosa Gabriella Gonçalves, Giorgia Cecchinato, Alessandro Bertinetto, Cliff Hill Kormann, Rodrigo Duarte, Rita Velloso e do filósofo francês David Lapoujade, um dos principais nomes da filosofia na atualidade. (shrink)

ABSTRACT Hill [AJP, 2018] argues that Rachels’s famous bare-difference argument for the moral irrelevance between killing and letting die fails. In this paper, I argue that certain features in Hill’s cases might lead our intuitions astray. I propose new cases and suggest that they support the conclusion that, in itself, intentional killing is morally equivalent to intentional letting-die.

ABSTRACT Hill [AJP, 2018] argues that Rachels’s famous bare-difference argument for the moral irrelevance between killing and letting die fails. In this paper, I argue that certain features in Hill’s cases might lead our intuitions astray. I propose new cases and suggest that they support the conclusion that, in itself, intentional killing is morally equivalent to intentional letting-die.

1. Animal Cruelty Industrial farming is appallingly abusive to animals. Pigs. In America, nine-tenths of pregnant sows live in “gestation crates. ” These pens are so small that the animals can barely move. When the sows are first crated, they may flail around, in an attempt to get out. But soon they give up. Crated pigs often show signs of depression: they engage meaningless, repetitive behavior, like chewing the air or biting the bars of the stall. The sows live like (...) this for four months. Gestation crates will be phased out in Europe by the end of 2012, but they will still be used in America.1 In nature, pigs nurse their young for about thirteen weeks. But in industrial farms, piglets are taken from their mothers after about ten days. Because the piglets are weaned prematurely, they develop a lifelong craving to suck and chew. But the farmers don’t want them sucking and chewing on other pigs’ tails. So the growers routinely snip off the tails of all their pigs. They do this with a pair of pliers and no anesthetic. However, the whole tail is not removed; a tender stump remains. The point is to render the area sensitive, so the pigs being chewed on will fight back. Which they do.2 Over 113 million pigs are slaughtered each year in America.3 Typically, these pigs are castrated, their needle teeth are clipped, and one of their ears is notched for identification —all without pain relief.4 In nature, pigs spend up to three quarters of their waking hours foraging and exploring their environment.5 But in the factory farms, “tens of thousands of hogs spend their entire lives ignorant of earth or straw or sunshine, crowded together beneath a metal roof standing on metal slats suspended over a septic tank. ”6 Bored, and in constant pain, the pigs must perpetually inhale the fumes of their own waste. These pigs often get sick, and their ill health is exacerbated by the overcrowding. In 2000, the U.S. Department of Agriculture compared hog farms containing over 10,000 pigs—which is the norm—with farms containing under 2,000 pigs. (shrink)

This stimulating collection of essays in ethics eschews the simple exposition and refinement of abstract theories. Rather, the author focuses on everyday moral issues, often neglected by philosophers, and explores the deeper theoretical questions which they raise. Such issues are: Is it wrong to tell a lie to protect someone from a painful truth? Should one commit a lesser evil to prevent another from doing something worse? Can one be both autonomous and compassionate? Other topics discussed are servility, weakness of (...) will, suicide, obligations to oneself, snobbery, and environmental concerns. A feature of the collection is the contrast of Kantian and utilitarian answers to these problems. The essays are crisply and lucidly written and will appeal to both teachers and students of philosophy. (shrink)

A joke is amusing if and only if it’s fitting to be amused by it; an act is regrettable if and only if it’s fitting to regret it. Many philosophers accept these biconditionals and hold that analogous ones obtain between a wide range of additional evaluative properties and the fittingness of corresponding responses. Call these the _fit–value biconditionals_. The biconditionals give us a systematic way of recognizing the role of fit in our ethical practices; they also serve as the bedrock (...) of various metaethical projects, such as fitting-attitude analysis of value and the ‘fittingness first’ approach. Yet despite the importance of the biconditionals, there is very little discussion of their proper interpretation. This paper argues that any plausible interpretation of the fit_–_value biconditionals must disarm several kinds of apparent counterexample. For instance, that an achievement is pride-worthy doesn’t imply it is fitting for me to take pride in it because the achievement might not be mine or that of anyone close to me; that a joke is amusing doesn’t imply it is fitting for me to be amused by it for six straight months; and that a person is loveable doesn’t imply it is fitting for me to love him romantically because that person might be my sibling. We consider possible responses to such counterexamples and develop what we consider the most promising interpretation of the biconditionals. The upshot is that certain widespread assumptions about fit and its relation to value and reasons should be reconsidered. (shrink)

Respect, Pluralism, and Justice is a series of essays which sketches a broadly Kantian framework for moral deliberation, and then uses it to address important social and political issues. Hill shows how Kantian theory can be developed to deal with questions about cultural diversity, punishment, political violence, responsibility for the consequences of wrongdoing, and state coercion in a pluralistic society.

What words we use, and what meanings they have, is important. We shouldn't use slurs; we should use 'rape' to include spousal rape (for centuries we didn’t); we should have a word which picks out the sexual harassment suffered by people in the workplace and elsewhere (for centuries we didn’t). Sometimes we need to change the word-meaning pairs in circulation, either by getting rid of the pair completely (slurs), changing the meaning (as we did with 'rape'), or adding brand new (...) word-meaning pairs (as with 'sexual harassment'). A problem, though, is how to do this. One might worry that any attempt to change language in this way will lead to widespread miscommunication and confusion. I argue that this is indeed so, but that's a feature, not a bug of attempting to change word-meaning pairs. The miscommunications and confusion such changes cause can lead us, via a process I call transformative communicative disruption, to reflect on our language and its use, and this can be further, rather than hinder, our goal of improving language. (shrink)

The modal account of luck is the predominant account of luck in epistemology and ethics. In the first half of this paper, I discuss three possible interpretations of the modal account and raise objections to each. I then raise an objection to all plausible versions of the modal account, that is, that whether an event is lucky or the extent to which it is a matter of luck will depend on what initial conditions or features of the event one holds (...) constant across nearby possible worlds. However, there is often reasonable disagreement about what the relevant initial conditions of an event are, and the modal account of luck has no means of determining which description of the event is correct. As such, the modal account is subject to a kind of reference class problem, and the view cannot actually tell us the extent to which certain events are a matter of luck. (shrink)

On the traditional relationalist conception of singular thought, a thought has singular content when it is based on an ‘information relation’ to its object. Recent work rejects relationalism and suggests singular thoughts are distinguished from descriptive thoughts by their inferential role: only thoughts with singular content can be employed in ‘direct’ inferences, or inferences that ‘trade on identity’. Firstly this view is insufficiently clear, because it conflates two distinct ideas—one about a kind of inference, the other a kind of process (...) that grounds inferences—under the title, ‘trading on identity’. Secondly, this leaves us without a notion that can be used as an alternative to relationalism about singular thought. The first notion is no more applicable to singular than to descriptive thought. The second may help us better understand singular thought, but does so, not by replacing the view that singular thoughts are information-based, but by helping us understand the nature of information-based thought. (shrink)

Scholars have critiqued mainstream economic approaches to environmental valuation for decades. These critiques have intensified with the increased prominence of environmental valuation in decision-making. This paper has three goals. First, we summarise prominent critiques of monetary valuation, drawing mostly on the work of Clive Spash, who worked extensively on cost–benefit analysis early in his career and then became one of monetary valuation's most thorough and ardent critics. Second, we, as a group of scholars who study relational values, describe how relational (...) values research engages with and addresses many of the critiques of monetary valuation. Third, we offer suggestions for relational values research that continues and deepens its ability to respond to critiques of monetary valuation and contributes to transformative change towards sustainability. (shrink)

Increasingly, metaphors are the target of political critique: Jewish groups condemn Holocaust imagery; mental health organizations, the metaphorical exploitation of psychosis; and feminists, “rape metaphors.” I develop a novel model for making sense of such critiques of metaphor.

Despite the increased prevalence of bioethics research that seeks to use empirical data to answer normative research questions, there is no consensus as to what an appropriate methodology for this would be. This review aims to search the literature, present and critically discuss published Empirical Bioethics methodologies.

Faultless disagreement and faultless retraction have been taken to motivate relativism for predicates of personal taste, like ‘tasty’. Less attention has been devoted to the question of what aspect of their meaning underlies this relativist behavior. This paper illustrates these same phenomena with a new category of expressions: appearance predicates, like ‘tastes vegan’ and ‘looks blue’. Appearance predicates and predicates of personal taste both fall into the broader category of experiential predicates. Approaching predicates of personal taste from this angle suggests (...) that their relativist behavior is due to their experience-sensitivity, rather than their evaluative meaning. Furthermore, appearance predicates hold interest beyond what they can teach us about predicates of personal taste. Examination of a variety of uses of appearance predicates reveals that they give rise to relativist behavior for a variety of reasons—including some that apply also to other types of expressions, such as epistemic modals and comparative terms. This paper thus serves both to probe the source of relativist behavior in discourse about personal taste, as well as to map out this kind of behavior in the rich and under-explored discourse about appearances. (shrink)

Epistemologists of testimony have focused almost exclusively on the epistemic dynamics of simple testimony. We do sometimes testify by ways of simple, single sentence assertions. But much of our testimony is narratively structured. I argue that narrative testimony gives rise to a form of epistemic dependence that is far richer and more far reaching than the epistemic dependence characteristic of simple testimony.

Hate speech and misinformation are rife. How to respond? Counterspeech proposals say: with more and better speech. This paper considers the treatment of counterspeech in Maxime Lepoutre’s Democratic Speech In Divided Times. Lepoutre provides a nuanced defence of counterspeech. Some counterspeech, he grants, is flawed. But, he says: counterspeech can be debugged. Once we understand why counterspeech fails – when fail it does – we can engineer more effective counterspeech strategies. Lepoutre argues that the failures of counterspeech can be theorised (...) using the ideology of salience. Negative counterspeech fails because it reinforces the salience of the very ideas or associations that it contests. His solution? Positive counterspeech – a form of counterspeech which avoids the salience trap. I argue that the salience paradigm is ill-suited to theorise the failures of counterspeech. I suggest some alternatives. Further, I show that these alternative paradigms make importantly different practical recommendations – recommendations concerning how we ought to engineer our counterspeech – from those issued by the salience paradigm. (shrink)

Simple claims with the verb ‘seem’, as well as the specific sensory verbs, ‘look’, ‘sound’, etc., require the speaker to have some relevant kind of perceptual acquaintance (Pearson, 2013; Ninan, 2014). But different forms of these reports differ in their perceptual requirements. For example, the copy raising (CR) report, ‘Tom seems like he’s cooking’ requires the speaker to have seen Tom, while its expletive subject (ES) variant, ‘It seems like Tom is cooking’, does not (Rogers, 1972; Asudeh and Toivonen, 2012). (...) This contrast has led some theorists to hold that the matrix subject in CR constructions is uniformly interpreted as the perceptual source (p-source) (Asudeh and Toivonen, 2012; Rett and Hyams, 2014). Others, based on examples of CR reports that seem not to require perception of the referent of the matrix subject, have taken the p-source interpretation instead to be non-uniform across CR reports (Landau, 2011; Doran, 2015). We reconsider these theoretical approaches to copy raising in light of new experimental work probing the sensitivity of these requirements to the matrix verb, the embedded ‘like’-clause, and the context. While we find some motivation for a non-uniform p-source analysis, it comes from importantly different cases than those others have relied on. Furthermore, our findings cast doubt on the prevalent assumption that the perceptual requirements of CR reports are to be captured solely by the presence or absence of the p-source interpretation. We suggest that the data motivating a non-uniform p-source view are better captured by an alternative approach, which makes use of a more minimal evidential source role, in place of the perceptual source role. We close by considering the relationship between English copy raising and evidential constructions cross-linguistically. (shrink)

The Beloved Self is about the holy grail of moral philosophy, an argument against egoism that proves that we all have reasons to be moral. Part One introduces three different versions of egoism. Part Two looks at attempts to prove that egoism is false, and shows that even the more modest arguments that do not try to answer the egoist in her own terms seem to fail. But in part Three, Hills defends morality and develops a new problem for egoism, (...) an epistemological problem. She shows that it is not epistemically rational to believe the most plausible versions of egoism. The first part of the book will be most relevant to those interested in moral theory, as it contains detailed discussions of recent interpretations of virtue ethics and especially of Kant's moral theory. The second and third part of the book turn to epistemology, particularly moral epistemology, and include an account of the relationship between knowledge and action, a new theory of moral understanding, and a discussion of the epistemically rational response to various kinds of disagreement. Hills also defends a new account of virtue and of morally worthy action. (shrink)

This paper offers three objections to Leslie’s recent and already influential theory of generics :375–403, 2007a, Philos Rev 117:1–47, 2008): her proposed metaphysical truth-conditions are subject to systematic counter-examples, the proposed disquotational semantics fails, and there is evidence that generics do not express cognitively primitive generalisations.

This Element presents a philosophical exploration of the concept of the 'model organism' in contemporary biology. Thinking about model organisms enables us to examine how living organisms have been brought into the laboratory and used to gain a better understanding of biology, and to explore the research practices, commitments, and norms underlying this understanding. We contend that model organisms are key components of a distinctive way of doing research. We focus on what makes model organisms an important type of model, (...) and how the use of these models has shaped biological knowledge, including how model organisms represent, how they are used as tools for intervention, and how the representational commitments linked to their use as models affect the research practices associated with them. This title is available as Open Access on Cambridge Core. (shrink)

Kevin Hill presents a highly original study of Nietzsche's thought, the first book to examine in detail his debt to the work of Kant. Hill argues that Nietzsche is a systematic philosopher who knew Kant far better than is commonly thought, and that he can only be properly understood in relation to him. Nietzsche's Critiques will be of great value to scholars and students with interests in either of these philosophical giants, or in the history of ideas generally.

The so-called ‘mental files theory’ in the philosophy of mind stems from an analogy comparing object-concepts to ‘files’, and the mind to a ‘filing system’. Though this analogy appears in philosophy of mind and language from the 1970s onward, it remains unclear to many how it should be interpreted. The central commitments of the mental files theory therefore also remain unclear. Based on influential uses of the file analogy within philosophy, I elaborate three central explanatory roles for mental files. Next, (...) I outline several common criticisms of the file picture, which have been a source of resistance to the view. Finally, I outline several interpretations of the theory, thus highlighting that the best interpretation of the file-theory's central analogy remains a live issue. (shrink)

Philosophers have long been interested in love and its general role in morality. This volume focuses on and explores the complex relation between love and justice as it appears within loving relationships, between lovers and their wider social context, and the broader political realm. Special attention is paid to the ensuing challenge of understanding and respecting the lovers’ personal autonomy in all three contexts. Accordingly, the essays in this volume are divided into three thematic sections. Section I aims at shedding (...) further light on conceptual and practical issues concerning the compatibility or incompatibility of love and justice within relationships of love. For example, are loving relations inherently unjust? Might love require justice? Or do love and justice belong to distinct moral domains? The essays in Section II consider the relation between the lovers on the one hand and their broader societal environment on the other. Specifically, how exactly are love and impartiality related? Are they compatible or not? Is it unjust to favor one’s beloved? Finally, Section III looks at the political dimensions of love and justice. How, for instance, do various accounts of love inform how we are to relate to our fellow citizens? If love is taken to play an important role in fostering or hindering the development of personal autonomy, what are the political implications that need to be addressed, and how? In addressing these questions, this book engenders a better understanding both of conceptual and practical issues regarding the relation between love, justice, and autonomy as well as their broader societal and political implications. It will be of interest to advanced students and scholars working on the philosophy of love from ethical, political, and psychological angles. (shrink)

We offer a novel account of metalinguistic comparatives, such as 'Al is more wise than clever'. On our view, metalinguistic comparatives express comparative commitments to conventions. Thus, 'Al is more wise than clever' expresses that the speaker has a stronger commitment to a convention on which Al is wise than to a convention on which she is clever. This view avoids problems facing previous approaches to metalinguistic comparatives. It also fits within a broader framework—independently motivated by metalinguistic negotiations and convention-shiftingexpressions— (...) that gives linguistic conventions a role in the semantics. (shrink)

Husserl and Cantor were colleagues and close friends during the last 14 years of the nineteenth century, when Cantor was at the height of his creative powers and Husserl in the throes of an intellectual struggle during which he drew apart from people and writings to whom he owed most of his intellectual training and drew closer to the ideas of thinkers whose writings he had not been able to evaluate properly and had consulted too little. I study ways in (...) which Husserl and Cantor might be said to have been alike, while pointing to dissimilarities between them. In particular, I discuss how their ideas overlapped and crisscrossed with regard to mathematics and philosophy, Platonic idealism, abstraction, empiricism, psychologism, actual consciousness and pure logic, Frege’s reviews of their works, metaphysics and mysticism, sets, arithmetization, strange and imaginary numbers and manifolds. I conclude that Cantor was among those of his mentors from whose ideas Husserl drew away and Lotze and Bolzano were among those to whose ideas he drew closer. (shrink)

Epistemic accounts of luck define luck’s chanciness condition relative to a subject’s epistemic position. This could be put in terms of a subject’s evidence or knowledge about whether the event will occur. I argue that both versions of the epistemic account fail. In §2, I give two types of counterexamples to the evidence-based approach. In §3, I argue—contrary to the knowledge-based view—that an event can be a matter of good or bad luck for a subject even if she knows that (...) it will occur. In §4, I argue that epistemic accounts cannot explain some instances of constitutive luck. Because of these problems, luck’s chanciness condition cannot be adequately defined in epistemic terms. (shrink)

This paper examines what it is for a condition to be a disease. It falls into two sections. In the first I examine the best existing account of disease (as proposed by Christopher Boorse) and argue that it must be rejected. In the second I outline a more acceptable account of disease. According to this account, by disease we mean a condition that it is a bad thing to have, that is such that we consider the afflicted person to have (...) been unlucky, and that can potentially be medically treated. All three criteria must be fulfilled for a condition to be a disease. The criterion that for a condition to be a disease it must be a bad thing is required to distinguish the biologically different from the diseased. The claim that the sufferer must be unlucky is needed to distinguish diseases from conditions that are unpleasant but normal, for example teething. Finally, the claim that for a condition to be a disease it must be potentially medically treatable is needed to distinguish diseases from other types of misfortune, for example economic problems and legal problems. (shrink)

Rachel Cohon offers an original interpretation of the moral philosophy of David Hume, focusing on two areas.

Classifying Madness (Springer, 2005) concerns philosophical problems with the Diagnostic and Statistical Manual of Mental Disorders, more commonly known as the D.S.M. The D.S.M. is published by the American Psychiatric Association and aims to list and describe all mental disorders. The first half of Classifying Madness asks whether the project of constructing a classification of mental disorders that reflects natural distinctions makes sense. Chapters examine the nature of mental illness, and also consider whether mental disorders fall into natural kinds. The (...) second half of the book addresses epistemic worries. Even supposing a natural classification system to be possible in principle, there may be reasons to be suspicious of the categories included in the D.S.M. I examine the extent to which the D.S.M. depends on psychiatric theory, and look at how it has been shaped by social and financial factors. I aim to be critical of the D.S.M. without being antagonistic towards it. Ultimately, however, I am forced to conclude that although the D.S.M. is of immense practical importance, it is unlikely to come to reflect the natural structure of mental disorders. (shrink)