How Doctors Think defines the nature and importance of clinical judgment. Although physicians make use of science, this book argues that medicine is not itself a science but rather an interpretive practice that relies on clinical reasoning. A physician looks at the patient's history along with the presenting physical signs and symptoms and juxtaposes these with clinical experience and empirical studies to construct a tentative account of the illness. How Doctors Think is divided into four parts. Part one introduces the (...) concept of medicine as a practice rather than a science; part two discusses the idea of causation; part three delves into the process of forming clinical judgment; and part four considers clinical judgment within the uncertain nature of medicine itself. In How Doctors Think, Montgomery contends that assuming medicine is strictly a science can have adverse side effects, and suggests reducing these by recognizing the vital role of clinical judgment. (shrink)

As someone diagnosed with severe chronic mental illness early in my adolescence, I have spent over half of my life feeling out of step with the rest of the world due to hospitalizations, treatment programs, and the disruptions caused by anxiety, anorexia, depression, and obsessive–compulsive disorder. The effect of my mental health conditions compounded by these treatment environments means I often feel that I experience time passing differently, which results in sensations of removal and isolation from those around me. The (...) global shutdown caused by the COVID-19 pandemic seemed a way for normative bodies to experience the passing of time the way I always have. In this paper, I extend Dr. Sara Wasson’s analysis of the ways in which chronic pain resists narrative coherence to my own temporal experience of chronic mental illness, specifically my embodied experience of the pandemic. I use that embodied experience as a case study for examining how the reciprocal nature of time and narrativity, as outlined by Dr. Paul Ricoeur, can create isolation for those struggling with their temporality due to chronic mental illness. To acknowledge and grapple with the ramifications of discursive and material privilege involved in such situations, I include an analysis of Robert Desjarlais’s 1994 article “Struggling Along: The Possibilities for Experience among the Homeless Mentally Ill,” in which he investigates a similar phenomenon of being outside of structured sequential narrative time in the residents of a Boston shelter for the mentally ill. (shrink)

The Catholic Tradition requires the faithful to form and follow their conscience. This is the case even with the recognition that consciences can be malformed and one can make errors in practical judgments. Water Shaping Stone examines various aspects of this tradition regarding conscience by using, among other sources, twentieth-century magisterial documents, theologians' works, and Scripture. Kathryn Lilla Cox argues that while the Magisterium retains teaching authority, and a responsibility to help form consciences through its teaching, focusing only on (...) the Magisterium leads to incomplete formation. A more holistic vision of conscience formation means considering the formation of the moral agent to be a multifaceted process that draws on, for example, teaching, prayer, rituals, Scripture, practices, and virtues, along with relationships with the Triune God and communities of accountability. This vision of conscience formation retains the magisterial teaching authority while acknowledging discipleship as the theological basis for making and assessing practical judgments of conscience. (shrink)

In Moral Passages, Kathryn Pyne Addelson presents an original moral theory suited for contemporary life and its moral problems. Her basic principle is that knowledge and morality are generated in collective action, and she develops it through a critical examination of theories in philosophy, sociology and women's studies, most of which hide the collective nature and as a result hide the lives and knowledge of many people. At issue are the questions of what morality is, and how moral theories (...) (whether traditional or feminist) are implemented. Addelson takes up a large number of historical cases and contemporary social problems, including teen pregnancy, contraception and abortion, and gay rights. These cases allow her to see how the knowledge and lives of some people are declared deviant or immoral, while those of others appear to show the public consensus. One case she uses throughout the book is Margaret Sanger's early work on birth control with the anarcho-syndicalist movement--a revisionist history that reveals rather than hides the collective nature of morality and knowledge. Addelson shows how the usual individualist philosophies promote theories which hide the authority of the professionals who make them. A collectivist approach, she argues, must show the part professionals play in collective action. Her aim is to allow professional knowledge makers to be morally and intellectually responsible. Based on Addelson's twenty years of work in feminist philosophy and interactionist sociology as well as her long-standing involvement in women's community organization, Moral Passages investigates how morality and knowledge are collectively enacted in today's world. (shrink)

The article “Revive and Refuse: Capacity, Autonomy, and Refusal of Care After Opioid Overdose,” Marshall et al. (2024) highlights the critical issue of care after an opioid overdose. “Revive and Re...

In the Politics of Black Joy, Lindsey Stewart develops Hurston's contributions to political theory and philosophy of race by introducing the politics of joy as a refusal of neoabolitionism, a political tradition that reduces southern Black life to tragedy or social death.

I am persuaded both by the theory of evil advanced by Claudia Card in The Atrocity Paradigm and by the idea that there are evils done to the environment; however, I argue that the theory of evil she describes has difficulty living up to her claim that it "can make sense of ecological evils the victims of which include trees and even ecosystems" (2002, 16). In this paper, I argue that Card's account of evil does not accommodate the kinds of (...) harms inflicted on ecosystems and such nonhuman individuals as trees. I consider the possibility that Card intends a much broader version of evils than the language of the atrocity paradigm lets on, with its attention to sentience and dignity. I'm so persuaded by the atrocity paradigm, however, that I retain the centrality of suffering and introduce the idea that atrocities are intuitively massive, that is, done to groups or generations and not an individual person, animal or tree, so that the paradigm encourages us to think of evil as it relates to far more holistic entities which include the sentient. Evil may require the sort of suffering that only sentience can give rise to, which is not to say we let out trees but says rather that it is impossible to identify wrongs to ecosystems and groups that are not also intertwined with the fates of their sentient dependents. I conclude that Card is right to emphasize victims' suffering as a chief component of evil, and that the ontology of what constitutes a victim must be interpreted broadly, not the notion of suffering. (shrink)

Pretty much everyone knows that our genes have at least something to do with how able or how high achieving we are. Some believe that we should not speak of this common knowledge, nor inquire into how genetic influence works or what it might mean. If we do not keep an open mind to the fact of genetic influence on academic achievement, however, then we cannot explore its possible implications. And if we do not consider the implications, then we cannot, (...) as a society, harness any potential benefits or avoid possible pitfalls. So that's what this essay is about—exploring what behavioral genetics research might be able to offer to educational theory, policy, and practice.We cannot yet use biological information to make accurate predictions for all children. We do know, however, that academic achievement is heritable, which is to say that differences between individuals are influenced by differences in their DNA. If genes are part of the problem for some pupils (to take the negative spin on this), then it seems likely that studying them could be part of a solution. And that's what behavioral geneticists are trying to do—to chart and understand pathways from DNA to behavior and to identify interventions that can maximize outcomes for all. The fact is, though, that we have an awfully long way to go. (shrink)

This article highlights the extent to which finding a job without actively searching sustains workplace sex segregation. We suspect that unsolicited information from job informants that prompts fortuitous job changes is susceptible to bias about gender “fit” and segregates workers. Results from analyses of 1,119 respondents to the 1996 and 1998 waves of the National Longitudinal Survey of Youth are generally consistent with this expectation. Gender “misfits”—individuals employed in gender-atypical work groups— are more likely to move into gender-typical work groups (...) than neutral ones. Women misfits are more likely to move into male-dominated than neutral work groups without a job search, but they join mostly desegregated occupations and receive lower job rewards than men misfits who change jobs without searching. We conclude that the nonsearch process serves as an important mechanism that sustains sex segregation and workplace inequality. (shrink)

Sometimes form-meaning mappings in language are not arbitrary, but iconic: they depict what they represent. Incorporating iconic elements of language into a compositional semantics faces a number of challenges in formal frameworks as evidenced by the lengthy literature in linguistics and philosophy on quotation/direct speech, which iconically portrays the words of another in the form that they were used. This paper compares the well-studied type of iconicity found with verbs of quotation with another form of iconicity common in sign languages: (...) classifier predicates. I argue that these two types of verbal iconicity can, and should, incorporate their iconic elements in the same way using event modification via the notion of a context dependent demonstration. This unified formal account of quotation and classifier predicates predicts that a language might use the same strategy for conveying both, and I argue that this is the case with role shift in American Sign Language. Role shift is used to report others’ language and thoughts as well as their actions, and recently has been argued to provide evidence in favor of Kaplanian “monstrous” indexical expressions. By reimagining role shift as involving either quotation for language demonstrations or “body classifier” predicates for action demonstrations, the proposed account eliminates one major argument for these monsters coming from sign languages. Throughout this paper, sign languages provide a fruitful perspective for studying quotation and other forms of iconicity in natural language due to their lack of a commonly used writing system which is otherwise often mistaken as primary data instead of speech, the rich existing literature on iconicity within sign language linguistics, and the ability of role shift to overtly mark the scope of a language report. In this view, written language is merely a special case of a more general phenomenon of sign and speech demonstration, which accounts more accurately for natural language data by permitting more strict or loose verbatim interpretations of demonstrations through the context dependent pragmatics. (shrink)

The authors examine the nature of the relationship between social science and philosophy and address the sort of work social science should do, and the role and sorts of claims that an accompanying philosophy should engage in. In particular, the authors reintroduce the question of ontology, an area long overlooked by philosophers of social science, and present a cricital engagement with the work of Roy Bhaskar. The book argues against the excesses of philosophising and commits itself to a philosophical approach (...) more deeply grounded in the social sciences. (shrink)

In “Post‐Liberation Feminism,” Ladelle McWhorter raises the question of what practices will be helpful to further feminist goals if we are no longer in a state of domination, but are still oppressed. McWhorter finds resources in Michel Foucault's concept of “practices of freedom” to begin to answer this question. I build upon McWhorter's insight while recalling Angela Davis's Blues Legacies and Black Feminism: namely, that sexual love, as conceived in hoodoo and the blues, became a terrain upon which newly emancipated (...) blacks worked out what their newfound freedom meant. In this essay, I consider what practices of freedom would look like within a life‐giving nexus of hoodoo, blues, and sexual love. Not only does the image of the hoodoo woman, prevalent within the blues, emerge through an interaction of race, class, region, gender, sexuality, and spiritualty, but analyzing sexual love within this hoodoo–blues coupling will help us track how sexual love was transformed into a practice of freedom. I will argue that sexual love within this hoodoo–blues coupling reveals an important dimension of emancipatory work that both defies categorization as resistance and is crucial to the development of capacities for resistance. (shrink)

Alice Walker claims that the “advantageous heritage” of Black southern life is replete with intellectual meat for thinking and writing. How might the insights found in this “advantageous heritage” enrich our discussions of Black feminism in philosophy? Taking stock of this “advantageous heritage” is no mean feat in the discipline of philosophy as it sits at the intersection of two subfields that are already marginalized: Black feminist philosophy and southern philosophy. To help situate southern Black feminist philosophy, I draw upon (...) Kristie Dotson's model of “inheritance maps,” or an “attempt to take stock of what one has been given in a particular project and what one inherits as work yet to do.” Focusing primarily on the theme of refusal, I develop an “inheritance map” that lays out aspects of southern Black feminism that I have inherited from Angela Davis's Blues Legacies and Black Feminism. (shrink)

Our experiences with many sorts of evils yield debates about the role of forgiveness as a possible moral response. These debates include (1) the preliminary question whether evils are, by definition, unforgivable, (2) the contention that evils may be forgivable but that forgiveness cannot entail reconciliation with one’s evildoer, (3) the concern that only direct victims of evils are in a position to decide if forgiveness is appropriate, (4) the conceptual worry that forgiveness of evil may not be genuine or (...) complete if hard feelings recur, (5) the interest of many in holding that forgiveness is never required, and (6) the concern that analyses of evil ought to prioritize the suffering, and credit the perspectives, of victims of evils, in tension with the possibility that forgiveness concerns the well-being of offenders. In this paper, I critically evaluate these concerns from the perspective of nonideal theory. I conclude that crediting victims’ perspectives is importantly basic to empirically informed moral theory, and that objections to forgiveness including (1) evil’s unforgivability ignore victims’ differing accounts. When we take actualities and experiences to be informative and central, some of the usual debates become less pressing, perhaps even moot. (shrink)

"Change is not merely necessary to life--it is life." That's Alvin Toffler, characteristically stating the profound in a profoundly direct way. And yes, even when we see change coming--as we're about to graduate from school, take a new job, get married--it's still not so easy to accept. And when we don't see it coming--oof, we have an even harder time. Here to help us embrace change and defuse its unsettling power is Change Happens, a full-color illustrated gift book to consult, (...) to share, to give, and to keep on a night table. Curated by Kathryn and Ross Petras, the ultimate connoisseurs of quotes whose books and calendars have over 4.5 million copies in print, these words of wisdom inspire us to be open to change and remind us that nothing positive in life ever happens without it. Arranged alphabetically by subject--including Adapting, Curveballs, Faith, Letting Go, Regrets, Second Chances, Vulnerability--it's a book to turn to in moments of need, when offering advice to a friend or loved one, when urging a child to find the courage to take a step, when marking an important occasion. (shrink)

The author develops her account of Claudia Card's ethical work as nonideal ethical theory (NET). She clarifies Card's role in ethical theorizing of the recent past, partly in order to brief the unfamiliar reader on Card's ethics and nonideal theory, and partly to enter Card's contributions into the story of nonideal theory's emergence in philosophy. She then recommends, to other NET philosophers, the prioritization of (i) Card's rejection of the "administrative point of view", and (ii) Card's focus on "intolerable harms" (...) as critical to excellent ethical theorizing. She ends with the observation that NET may helpfully point toward reasons to take a pessimistic stance toward moral progress as elaborated in some classic texts in political philosophy; her appreciation of Card's insights yields a variety of pessimism that Card herself did not share. (shrink)

Emerging research suggests that an organization’s ability to sustain a competitive advantage is increasingly linked to its successful pursuit of a business strategy that generates mutual benefit where the business is both profitable and functional for the common good. The question remains, however: What are the attributes of decision makers that enable them to realize mutually beneficial outcomes? This dissertation argues that one critical key to solving this question is a better understanding of moral imagination in organizational decision making. To (...) test this hypothesis, a new vignette-based cognitive measure for moral imagination in organizational decision making was created to explore empirically the relationship between moral imagination and mutually beneficial decision making. Overall, findings from 180 respondents supported the hypothesis that individuals, who exercise moral imagination, including the ability for discerning moral issues and developing a range of possible outcomes during the decision-making process, are indeed more likely to generate a mutually beneficial outcome for a situation compared to those who do not exercise moral imagination. Implications and directions for future research are discussed. (shrink)

In “Post-Liberation Feminism,” Ladelle McWhorter raises the question of what practices will be helpful to further feminist goals if we are no longer in a state of domination, but are still oppressed. McWhorter finds resources in Michel Foucault's concept of “practices of freedom” to begin to answer this question. I build upon McWhorter's insight while recalling Angela Davis's Blues Legacies and Black Feminism: namely, that sexual love, as conceived in hoodoo and the blues, became a terrain upon which newly emancipated (...) blacks worked out what their newfound freedom meant. In this essay, I consider what practices of freedom would look like within a life-giving nexus of hoodoo, blues, and sexual love. Not only does the image of the hoodoo woman, prevalent within the blues, emerge through an interaction of race, class, region, gender, sexuality, and spiritualty, but analyzing sexual love within this hoodoo–blues coupling will help us track how sexual love was transformed into a practice of freedom. I will argue that sexual love within this hoodoo–blues coupling reveals an important dimension of emancipatory work that both defies categorization as resistance and is crucial to the development of capacities for resistance. (shrink)

abstract It is standardly taken for granted in the literature on the morality of abortion that adoption is almost always an available and morally preferable alternative to abortion — one that does the same thing so far as parenthood is concerned. This assumption pushes proponents of a woman's right to choose into giving arguments that are based almost exclusively around the physicality of pregnancy and childbirth. On the other side of the debate, the assumption that adoption is a real alternative (...) seems to strengthen the contention that a woman who wishes to abort is morally deficient, whatever the status of the foetus: that she is selfish or short‐sighted in her refusal to bear the temporary physical burden of pregnancy. In this article, I will argue that adoption is not a genuine alternative to abortion. It does not ‘do the same thing’, even setting aside the physicality of pregnancy. I will show that on the most successful model of parental obligation — a causal account that formalises the distinction between parent: progenitor, and parent: carer — birth mothers and fathers remain obliged, life‐long, to their birth children even when the child is adopted out. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:Christology and EthicsLindsey EsbensenChristology and Ethics Edited by F. Leron Shults and Brent Waters Grand Rapids, Mich.: Eerdmans, 2010. 231 pp. $28.00.This collection of essays is a welcome venture into the often-neglected relationship between Christology and ethics. The book stresses that the reciprocal relationship between Christology and Christian moral discernment needs greater attention as well as creative reformulation. The essays produce a variety of models of how other (...) disciplines provide the critical and constructive developments that can strengthen the bond between Christology and the Christian moral life. Rather than a definitive resolution to the “problem” of these Christian disciplines, the book is an invitation to further inquiry, an offer to join the conversation.Although the contributors to this anthology present disparate analyses, they share the goal of integrating interdisciplinary developments in the engagement of Christology and ethics. While each author shares similar departure points for these essays, the conclusions are vastly diverse for each contributor. This is in part because the essays draw from a broad range of sources, from the theological to the scientific. One chapter incorporates developments in the field of psychoanalysis in a discussion of the Christian emphasis on participation in the “new creation” through Jesus Christ, who is akin to the psychoanalytic “third” (121). Another chapter applies evolutionary epistemology and evolutionary ethics to a discussion of the ongoing social mediation and cultural reinterpretation of what it means to “do as Jesus did” (178). Underlying all the expositions is an affirmation that ethics and Christology mutually instruct and challenge each other (98). [End Page 211]Despite the integral connection among the essays, some underlying tensions remain. For instance, Brent Waters’s “The Incarnation and the Moral Life” strongly emphasizes the distinction between the civil community and the church, between the City of Man and the City of God (30). The church is the body of Christ that ministers to the world; therefore, “the singular ministry of the baptized engages, evangelizes, and orders the world in the name and under the authority of Jesus Christ” (21). All moral discernment outside of that with Christological foundations falls short of its goal. Conversely, Jan-Olav Henriksen’s “The Surprise of Judgment and Justice” suggests a much more inclusive view of non-Christian (and non-Christological) contributions to ethics in his interpretation of Matthew 25. Using the imago Dei as the springboard for his analysis, the world is envisioned as God’s gift, and the other (the neighbor) is the imago Dei who calls for recognition. Henriksen contends, “Because Christ is the true image of God, all of humanity is related to him, and is in some sense represented in him.... Christ is the face of every other human—as the one who calls us to mercy, compassion, and love” (142). Christian moral action, then, “is not only determined by you, it is determined by them and their calling of you” (141). In this sense, then, the church does not minister to the world, but the world ministers to the church in helping her to recognize the world as God’s gift and to see the image of God in the neighbor.While the emphases of the various proposals in this collection of essays may produce tensions, the strain is actually a positive contribution to the overall project. The anthology seeks to examine the most significant issues in the relationship between Christology and ethics without necessarily providing a conclusive resolution to how these disciplines mutually inform and reinforce each other. This collection of essays begins a conversation and invites further investigation of the various lines of inquiry.As with any anthology, each essay will have a greater or lesser appeal to the reader according to his interests. Nonetheless, this collection of essays is a unique contribution to systematic and moral theology, and it is an indispensable anthology for those pursuing Christology or ethics for their future endeavors. [End Page 212]Lindsey EsbensenUniversity of Notre DameCopyright © 2012 Society of Christian Ethics... (shrink)

Many critics of the legalization of physician‐assisted death oppose it in part because they fear it will further disadvantage those who are already economically disadvantaged. This argument points to a serious problem of how economic considerations can influence medical decisions, but in the context of PAD, the concern is not borne out. We will provide empirical evidence suggesting that concerns about money influence medical decisions throughout the full course of illness, but at the end of life, financial pressure is much (...) more likely to influence a decision to pursue or reject aggressive life‐extending care than it is to influence a request for PAD. We will also address the question of whether financial pressure as a result of being poor—particularly in the context of an inadequate social safety net—robs people of their autonomy, rendering their informed request and consent invalid. We argue that it does not. We will emphasize the impracticality and injustice of rejecting the role of poverty as a legitimate factor in decision‐making, the irrational distinction between PAD and withdrawal of life‐sustaining care, and the more appropriate focus on the great flaws in the American health care system. (shrink)

Audio features such as inharmonicity, noisiness, and spectral roll-off have been identified as correlates of “noisy” sounds. However, such features are likely involved in the experience of multiple semantic timbre categories of varied meaning and valence. This paper examines the relationships of stimulus properties and audio features with the semantic timbre categories raspy/grainy/rough, harsh/noisy, and airy/breathy. Participants rated a random subset of 52 stimuli from a set of 156 approximately 2-s orchestral instrument sounds representing varied instrument families, registers, and both (...) traditional and extended playing techniques. Stimuli were rated on the three semantic categories of interest, as well as on perceived playing exertion and emotional valence. Correlational analyses demonstrated a strong negative relationship between positive valence and perceived physical exertion. Exploratory linear mixed models revealed significant effects of extended technique and pitch register on valence, the perception of physical exertion, raspy/grainy/rough, and harsh/noisy. Instrument family was significantly related to ratings of airy/breathy. With an updated version of the Timbre Toolbox, we used 44 summary audio features, extracted from the stimuli using spectral and harmonic representations, as input for various models built to predict mean semantic ratings for each sound on the three semantic categories, on perceived exertion, and on valence. Random Forest models predicting semantic ratings from audio features outperformed Partial Least-Squares Regression models, consistent with previous results suggesting that non-linear methods are advantageous in timbre semantic predictions using audio features. Relative Variable Importance measures from the models among the three semantic categories demonstrate that although these related semantic categories are associated in part with overlapping features, they can be differentiated through individual patterns of audio feature relationships. (shrink)

Marketers use autobiographical advertising as a means to create nostalgia for their products. This research explores whether such referencing can cause people to believe that they had experiences as children that are mentioned in the ads. In Experiment 1, participants viewed an ad for Disney that suggested that they shook hands with Mickey Mouse as a child. Relative to controls, the ad increased their confidence that they personally had shaken hands with Mickey as a child at a Disney resort. The (...) increased confidence could be due to a revival of a true memory or the creation of a new, false one. In Experiment 2, participants viewed an ad for Disney that suggested that they shook hands with an impossible character (e.g., Bugs Bunny). Again, relative to controls, the ad increased confidence that they personally had shaken hands with the impossible character as a child at a Disney resort. The increased confidence is consistent with the notion that autobiographical referencing can lead to the creation of false or distorted memory. ᭧ 2002 John Wiley & Sons, Inc. (shrink)

There is conflicting experimental evidence about whether the “stakes” or importance of being wrong affect judgments about whether a subject knows a proposition. To date, judgments about stakes effects on knowledge have been investigated using binary paradigms: responses to “low” stakes cases are compared with responses to “high stakes” cases. However, stakes or importance are not binary properties—they are scalar: whether a situation is “high” or “low” stakes is a matter of degree. So far, no experimental work has investigated the (...) scalar nature of stakes effects on knowledge: do stakes effects increase as the stakes get higher? Do stakes effects only appear once a certain threshold of stakes has been crossed? Does the effect plateau at a certain point? To address these questions, we conducted experiments that probe for the scalarity of stakes effects using several experimental approaches. We found evidence of scalar stakes effects using an “evidence seeking” experimental design, but no evidence of scalar effects using a traditional “evidence-fixed” experimental design. In addition, using the evidence-seeking design, we uncovered a large, but previously unnoticed framing effect on whether participants are skeptical about whether someone can know something, no matter how much evidence they have. The rate of skeptical responses and the rate at which participants were willing to attribute “lazy knowledge”—that someone can know something without having to check—were themselves subject to a stakes effect: participants were more skeptical when the stakes were higher, and more prone to attribute lazy knowledge when the stakes were lower. We argue that the novel skeptical stakes effect provides resources to respond to criticisms of the evidence-seeking approach that argue that it does not target knowledge. (shrink)