ABSTRACT In this paper we set forth what we believe to be a relatively controversial argument, claiming that ‘bioethics’ needs to undergo a fundamental change in the way it is practised. This change, we argue, requires philosophical bioethicists to adopt reflexive practices when applying their analyses in public forums, acknowledging openly that bioethics is an embedded socio‐cultural practice, shaped by the ever‐changing intuitions of individual philosophers, which cannot be viewed as a detached intellectual endeavour. This said, we argue that in (...) order to manage the personal, social and cultural embeddedness of bioethics, philosophical bioethicists should openly acknowledge how their practices are constructed and should, in their writing, explicitly deal with issues of bias and conflict of interest, just as empirical scientists are required to do. (shrink)

In this paper we discuss the influence of war as a metaphor in the context of the COVID-19 pandemic. After an introduction on the traditional analysis of the war metaphor, we address the social consequences of using this metaphor, a topic that has been widely debated with regard to public communication in the context of COVID-19. We pay particular attention to a theory that many intellectuals have raised: the possibility that the use of the metaphor in this context is harmful (...) to a democratic society because it may lead citizens to accept limited civil liberties and authoritarian policies. After presenting the extensive literature on the use of the war metaphor before and during the COVID-19 pandemic, in the final section of the paper, we analyse experimental evidence of the effects of this metaphor. In the conclusion, we hint at open questions and suggest that the current evidence does not support claims of direct liberticidal influence. (shrink)

In our seventh and final piece on the theme “Good without God”, Jonathan Ives argues that reliance on God as an external source of moral authority leads to a kind of moral cowardice.

O autor, na multiplicidade de seus aspectos, detém-se em considerações sobre o Estado, mas não se limita à perspectiva dos escritos tradicionais de Teoria Geral. Recolhe momentos de sua configuração histórica, de partes relevantes de sua fisionomia jurídica e, de modo particular, emite reflexões filosóficas sobre a morfologia estrutural e o sentido ético dessa entidade. O enfoque, porém, dista de ser mero tangenciar o assunto, porquanto insere, a cada passo, proposições que exprimem sua opinião pessoal e a ideologia de quem (...) anuncia mas, sobretudo, realiza com coerência e determinação, uma pauta de condutas orientada por valores definidos e estáveis. (shrink)

In this paper, we present the first stage of an empirical bioethics project exploring the moral sources of paternal responsibilities and rights. In doing so, we present both (1) data on men's normative constructions of fatherhood and (2) the first of a two-stage methodological approach to empirical bioethics. Using data gathered from 12 focus groups run with UK men who have had a variety of different fathering experiences (n = 50), we examine men's perspectives on how paternal responsibilities and rights (...) are generated and the significance of the genetic connection within the father–child relationship. We do not attempt to explore men's experiences of fatherhood or their fathering practices; and neither is the analysis driven from a particular sociological perspective. Rather, we explore men's normative constructions of fatherhood in order to present accessible data that might be of significance to the philosophical/moral debate on the sources of paternal rights and responsibilities. (shrink)

Caracterizar a demanda de atendimento psicológico e compreender a experiência dos profissionais que atuaram na pandemia do COVID-19, em uma plataforma de atendimento psicológico on-line. Realizou-se uma análise documental e entrevista semiestruturada com 20 psicólogos que atuaram no mínimo 6 meses na plataforma entre mar/2020 à dez/2022, em que foram atendidos um total 15.963 pacientes. Dentre as demandas, prevaleceram ideação suicida com planejamento, ansiedade e depressão. O perfil prevalente dos pacientes atendidos na pandemia corresponde à literatura, em períodos não pandêmicos, (...) bem como a prevalência de sintomas ansiosos e depressivos. Porém, destacou o surgimento do alto número de pacientes com ideação suicida, o que sugere um agravamento dos transtornos mentais, despertado pela pandemia, além de uma dificuldade comum aos entrevistados, relacionada a clareza dos critérios clínicos utilizados para determinação da gravidade dos casos. Os psicólogos apontaram dificuldades no manejo destes casos graves, intensificados pelo impacto emocional pandêmico também sentido por eles, junto ao despreparo para sua atuação online, as percebendo como limitações. Apesar do despreparo, a alta demanda incitou os profissionais aderirem as especificidades da modalidade. Estes relataram ter buscado aporte teórico e apoio emocional para manterem os recursos internos, cognitivos e emocionais, necessários ao setting terapêutico. Pode-se concluir que os resultados evidenciaram a importância de se refletir sobre os critérios de avaliação clínica utilizados para compreensão da severidade dos casos, sem deixar de considerar os recursos internos dos pacientes relativos à sua capacidade de sofrer, os quais podem ser identificados quando mantida a capacidade de rêverie do profissional. (shrink)

Aims:The aim of this narrative synthesis was to explore the necessary and sufficient conditions required to define moral distress.Background:Moral distress is said to occur when one has made a moral judgement but is unable to act upon it. However, problems with this narrow conception have led to multiple redefinitions in the empirical and conceptual literature. As a consequence, much of the research exploring moral distress has lacked conceptual clarity, complicating attempts to study the phenomenon.Design:Systematic literature review and narrative synthesis (November (...) 2015–March 2016).Data sources:Ovid MEDLINE®In-Process & Other Non-Indexed Citations 1946–Present, PsycINFO®1967–Present, CINAHL®Plus 1937–Present, EMBASE 1974–24 February 2016, British Nursing Index 1994–Present, Social Care Online, Social Policy and Practice Database (1890–Present), ERIC (EBSCO) 1966–Present and Education Abstracts.Review methods:Literature relating to moral distress was systematically retrieved and subjected to relevance assessment. Narrative synthesis was the overarching framework that guided quality assessment, data analysis and synthesis.Results:In all, 152 papers underwent initial data extraction and 34 were chosen for inclusion in the narrative synthesis based on both quality and relevance. Analysis revealed different proposed conditions for the occurrence of moral distress: moral judgement, psychological and physical effects, moral dilemmas, moral uncertainty, external and internal constraints and threats to moral integrity.Conclusion:We suggest the combination of (1) the experience of a moral event, (2) the experience of ‘psychological distress’ and (3) a direct causal relation between (1) and (2) together are necessary and sufficient conditions for moral distress. (shrink)

In a recent paper published in the Journal of Medical Ethics, Le Morvan and Stock claim that the kantian ideal of treating people always as ends in themselves and never merely as a means is in direct and insurmountable conflict with the current medical practice of allowing practitioners at the bottom of their “learning curve” to “practise their skills” on patients. In this response, I take up the challenge they issue is and try to reconcile this conflict. The kantian ideal (...) offered in the paper is an incomplete characterisation of Kant’s moral philosophy, and the formula of humanity is considered in isolation without taking into account other salient kantian principles. I also suggest that their argument based on “necessary for the patient” assumes too narrow a reading of “necessary”. This reply is intended as an extension to, rather than a criticism of, their work. (shrink)

With the introduction of artificial intelligence (AI) to healthcare, there is also a need for professional guidance to support its use. New (2022) reports from National Health Service AI Lab & Health Education England focus on healthcare workers’ understanding and confidence in AI clinical decision support systems (AI-CDDSs), and are concerned with developing trust in, and the trustworthiness of these systems. While they offer guidance to aid developers and purchasers of such systems, they offer little specific guidance for the clinical (...) users who will be required to use them in patient care. This paper argues that clinical, professional and reputational safety will be risked if this deficit of professional guidance for clinical users of AI-CDDSs is not redressed. We argue it is not enough to develop training for clinical users without first establishing professional guidance regarding the rights and expectations of clinical users. We conclude with a call to action for clinical regulators: to unite to draft guidance for users of AI-CDDS that helps manage clinical, professional and reputational risks. We further suggest that this exercise offers an opportunity to address fundamental issues in the use of AI-CDDSs; regarding, for example, the fair burden of responsibility for outcomes. (shrink)

El fenómeno migratorio en Chile ha presentado patrones cambiantes durante los últimos años. Focalizado especialmente en la migración proveniente desde Venezuela, el presente artículo tiene por objetivo comprender el proceso de búsqueda y asentamiento residencial de mujeres venezolanas en Chile. Para ello se realizaron entrevistas cualitativas en Valparaíso y Viña del Mar, a través de las cuales se recabaron las principales dificultades que ellas deben atravesar para acceder a la vivienda, que se transforman en imbricados procesos de racialización y feminización. (...) Sin embargo, también se evidenció la existencia de múltiples estrategias de agenciamiento desplegadas para la obtención de un lugar donde vivir y cuidar de sus familias. Así, y desde un enfoque interseccional que comprende los estudios urbanos, raciales y de género, se concluye que, si bien las mujeres venezolanas migrantes deben enfrentarse a contextos de discriminación y segregación en la búsqueda de vivienda, también establecen mecanismos colaborativos que permiten su acceso, tales como el allegamiento, la cohabitación, la gestión compartida y la creación de redes. (shrink)

Ernesto Laclau and Chantal Mouffe have attempted to save the concept of ?hegemony? from its economistic and essentialist Marxist roots by incorporating the linguistic influences of post?structuralist theory. Their major Marxist detractors criticise their trajectory as a ?descent into discourse? ? a decay from well?grounded, material reality into the idealistic and problematic realm of language and discourse. Both sides of the debate seem to agree on one thing: the line from Marxism to post?Marxism is the line from the economy to (...) language, from ?reality? to discourse. This article focuses on Gramsci?s writings on language to argue against both sides of this debate. It illustrates how language is central to Gramsci?s historical materialism and that he does not oppose it to materiality. It argues that Gramsci adopted the very term hegemony substantially from his university studies in linguistics ? the debates from which Ferdinand de Saussure also developed structuralism. For Gramsci, such linguistic issues were directly related to the ?questione della lingua? and Italian unification. Moreover, language lies at the centre of Gramsci?s understanding of the relationship between coercion and consent. This not only troubles Laclau & Mouffe?s reading of Gramsci, but it illuminates a more productive conception of hegemony that can address recent debates around post?structuralism and the use of ?hegemony? to analyse globalisation and an increasingly technological and electronic world. (shrink)

Austerity, by its very nature, imposes constraints by limiting the options for action available to us because certain courses of action are too costly or insufficiently cost effective. In the context of healthcare, the constraints imposed by austerity come in various forms; ranging from the availability of certain treatments being reduced or withdrawn completely, to reductions in staffing that mean healthcare professionals must ration the time they make available to each patient. As austerity has taken hold, across the United Kingdom (...) and Europe, it is important to consider the wider effects of the constraints that it imposes in healthcare. Within this paper, we focus specifically on one theorised effect—moral distress. We differentiate between avoidable and unavoidable ethical challenges within healthcare and argue that austerity creates additional avoidable ethical problems that exacerbate clinicians’ moral distress. We suggest that moral resilience is a suitable response to clinician moral distress caused by unavoidable ethical challenges but additional responses are required to address those that are created due to austerity. We encourage clinicians to engage in critical resilience and activism to address problems created by austerity and we highlight the responsibility of institutions to support healthcare professionals in such challenging times. (shrink)

Lack of vaccine confidence can contribute to drops in vaccination coverage and subsequent outbreaks of diseases like measles and polio. Low trust in vaccines is attributed to a combination of factors, including lack of understanding, vaccine scares, flawed policies, social media and mistrust of vaccine manufacturers, scientists and decision-makers. The COVID-19 crisis has laid bare societies’ vulnerability to new pathogens and the critical role of vaccines in containing this and future pandemics. It has also put science at the forefront of (...) the response, with several governments relying on academics to help shape policy and communicate with the public. Against this backdrop, protecting public trust in scientists and scientific output is arguably more important than ever. Yet, conflicts of interest in biomedical research remain ubiquitous and harmful, and measures to curb them have had limited success. There is also evidence of bias in industry-sponsored vaccine studies and academics are voicing concerns about the risks of working in a CoI prevalent research area. Here, we set out to challenge established thinking with regard to vaccine confidence, by shifting the gaze from a deficit in public understanding towards probity in research relationships and suggesting an alternative and perhaps complementary strategy for addressing vaccine mistrust. We argue that a concerted effort needs to be made to revisit the norms that undergird contemporary vaccine research, coupled with a willingness of all stakeholders to reimagine those relationships with an emphasis on demonstrating trustworthiness and probity. (shrink)

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.

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

Après avoir relevé quelques traces d’une réception de Fichte dans la littérature française du xixe siècle, visant à établir que la référence à Fichte touche un public excédant largement les milieux académiques, on s’attachera à étudier de façon systématique et non historique la réception française de la Doctrine de la Science à cette époque, considérant trois ordres de difficultés, liées 1) au langage (polyglottisme, ironie), 2) à la méthode (déconstruction de l’illusion transcendantale) et 3) au contenu (assimilation à un idéalisme (...) subjectif). Il apparaîtra que cet examen de la réception revient à la chronique d’une non-rencontre. (shrink)

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

This paper responds to the commentaries from Stacy Carter and Alan Cribb. We pick up on two main themes in our response. First, we reflect on how the process of setting standards for empirical bioethics research entails drawing boundaries around what research counts as empirical bioethics research, and we discuss whether the standards agreed in the consensus process draw these boundaries correctly. Second, we expand on the discussion in the original paper of the role and significance of the concept of (...) ‘integrating’ empirical methods and ethical argument as a standard for research practice within empirical bioethics. (shrink)

Este artigo examina alguns aspectos da “querela sobre o ateísmo” entre F. H. Jacobi e Fichte. Em 1799, Jacobi redige a Carta a Fichte, na qual a doutrina da ciência é designada como niilista. Especial atenção será dada à resposta pouco conhecida e não publicada de Fichte Rükerinnerungen, Antworten, Fragen (Reminiscências, respostas, perguntas) e ao fragmento de uma carta que Fichte envia a Jacobi e Reinhold. Ali, Fichte ressalta a oposição entre sua filosofia e a de Jacobi, que equivale à (...) oposição entre o ponto de vista da vida e da especulação. Embora ambos sejam contrários, podem coexistir com igual direito, desde que um não queira legislar sobre o outro. (shrink)

The definition of metabolic syndrome has been, and still is, extremely controversial. My purpose is not to give a solution to the associated debate but to argue that the controversy is at least partially due to the different ‘causal content’ of the various definitions: their theoretical validity and practical utility can be evaluated by reconstructing or making explicit the underlying causal structure. I will therefore propose to distinguish the alternative definitions according to the kinds of causal content they carry: definitions (...) grounded on associations, definitions presupposing a causal model built upon statistical associations, and definitions grounded on underlying mechanisms. I suggest that analysing definitions according to their causal content can be helpful in evaluating alternative definitions of some diseases. I want to show how the controversy over MetS suggests a distinction among three kinds of definitions based on how explicitly they characterise the syndrome in causal terms, and on the type of causality involved. I will call ‘type 1 definitions’ those definitions that are purely associative; ‘type 2 definitions’ the definitions based on statistical associations, plus generic medical and causal knowledge; and ‘type 3 definitions’ the definitions based on mechanisms. These kinds of definitions, although different, can be related to each other. A definition with more specific causal content may be useful in the evaluation of definitions characterised by a lower degree of causal specificity. Moreover, the identification of the type of causality involved is of help to constitute a good criterion for choosing among different definitions of a pathological entity. In section I introduce the controversy about MetS, in section I propose some remarks about medical definitions and their ‘causal import’, and in section I suggest that the different attitudes towards the definition of MetS are relevant to evaluate their explicative power. (shrink)

Cet article examine le rôle joué par la notion d'intelligence dans la poésie de Xénophane et de Parménide. L'auteur soutient que ces deux philosophes, en modifiant les attributs traditionnels du noos humain et divin, répondent aux problèmes posés par le pessimisme gnoséologique de la tradition poétique archaïque, dans laquelle les mortels sont inéluctablement condamnés à l'ignorance. Comme le montre le cas d'Hésiode, même l'inspiration divine ne garantit pas d'acquérir la connaissance, parce que la divinité peut communiquer, à son gré, le (...) vrai ou le faux et que le poète est dépourvu de moyens pour établir la validité de la révélation. Chez Xénophane en revanche, la régularité de l'ordre naturel fondé sur l'immuable noos du dieu offre aux hommes la possibilité effective d'améliorer leur compréhension du monde, tandis que dans le poème de Parménide, la déduction des attributs de l'Être donne aux mortels l'accès à cette vérité qui était auparavant une prérogative exclusive des dieux. (shrink)

Philosophical works on actual causation make wide use of thought experiments. The principal aim of this paper is to show how thought experiments are used in the contemporary debate over actual causation and to discuss their role in relation to formal approaches in terms of causal models. I claim that a recourse to thought experiments is not something old fashioned or superseded by abstract models, but it is useful to interpret abstract models themselves and to use our intuitions to judge (...) the results of the model. Recent research on actual causation has stressed the importance of integrating formal models with some notion of normality; I suggest that thought experiments can be useful in eliciting intuitions where normality is not intended in a statistical sense. The first expository part gives a short presentation of the notion of actual causation, summarising some typical problems of counterfactual approaches and how they are treated in causal and structural models. The second part focuses on the problems of model isomorphism and criticises some radical ideas opposing the role of thought experiments, claiming that they may also be of use in evaluating formal models. (shrink)

Philosophical works on actual causation make wide use of thought experiments. The principal aim of this paper is to show how thought experiments are used in the contemporary debate over actual causation and to discuss their role in relation to formal approaches in terms of causal models. I claim that a recourse to thought experiments is not something old fashioned or superseded by abstract models, but it is useful to interpret abstract models themselves and to use our intuitions to judge (...) the results of the model. Recent research on actual causation has stressed the importance of integrating formal models with some notion of normality; I suggest that thought experiments can be useful in eliciting intuitions where normality is not intended in a statistical sense. The first expository part gives a short presentation of the notion of actual causation, summarising some typical problems of counterfactual approaches and how they are treated in causal and structural models. The second part focuses on the problems of model isomorphism and criticises some radical ideas opposing the role of thought experiments, claiming that they may also be of use in evaluating formal models. (shrink)

Philosophical works on actual causation make wide use of thought experiments. The principal aim of this paper is to show how thought experiments are used in the contemporary debate over actual causation and to discuss their role in relation to formal approaches in terms of causal models. I claim that a recourse to thought experiments is not something old fashioned or superseded by abstract models, but it is useful to interpret abstract models themselves and to use our intuitions to judge (...) the results of the model. Recent research on actual causation has stressed the importance of integrating formal models with some notion of normality; I suggest that thought experiments can be useful in eliciting intuitions where normality is not intended in a statistical sense. The first expository part gives a short presentation of the notion of actual causation, summarising some typical problems of counterfactual approaches and how they are treated in causal and structural models. The second part focuses on the problems of model isomorphism and criticises some radical ideas opposing the role of thought experiments, claiming that they may also be of use in evaluating formal models. (shrink)

In this paper, we will analyse the language used by a group of Tourism ESP students on WhatsApp. The data will be analysed from different perspectives: a) the grammatical mistakes made, and b) the students´ degree of adaptation to the most common linguistic features in text messages. The results indicate that these students continue to make some basic grammatical mistakes they should have already overcome. Moreover, many linguistic features of text messages were encountered in their interventions such as punctuation overuse (...) and deletion and overuse of sounds. Finally, they insert many emojis in their messages to express different meanings. (shrink)

Cette contribution vise à répertorier les traces d’une influence de la mystique dans le corpus fichtéen et à définir un cadre interprétatif pour expliquer le recours par Fichte à un langage mystique dans L’Initiation à la vie bienheureuse. Un examen attentif des diverses sources laisse apparaître que la tradition mystique et Jacob Böhme en particulier, portés par un puissant souffle poétique, peuvent remplir à l’égard de la philosophie un rôle propédeutique par leur capacité à élever le public au suprasensible, mais (...) doivent également y borner leurs prétentions. Fichte dénonce en effet sur un plan philosophique leur caractère dogmatique et ne leur accorde de valeur qu’éclairés par la critique. (shrink)

Le but de cette contribution est d’identifier la place du langage dans l’architectonique du système fichtéen. Il est apparu (1) que la déduction du langage appartient de droit à la partie principielle du système ; (2) que l’intégration de cette déduction dans la partie principielle s’est faite, comme pour la doctrine de l’intersubjectivité, par la prise en compte de considérations initalement développées dans un écrit ne relevant pas directement de la Doctrine de la Science ; (3) qu’en tant que support (...) de la sollicitation, le langage joue un rôle crucial dans la genèse de la conscience, dont il constitue la condition suprême et (4) qu’il est directement lié à la solution proposée par Fichte pour remédier à l’« inachèvement du système kantien ». (shrink)