A summary of the philosophical literature on trust.

The power of new medical technologies, the cultural authority of physicians, and the gendered power dynamics of many patient-physician relationships can all inhibit women's reproductive freedom. Often these factors interfere with women's ability to trust themselves to choose and act in ways that are consistent with their own goals and values. In this book Carolyn McLeod introduces to the reproductive ethics literature the idea that in reproductive health care women's self-trust can be undermined in ways that threaten their autonomy. (...) Understanding the importance of self-trust for autonomy, McLeod argues, is crucial to understanding the limits on women's reproductive freedom. -/- McLeod brings feminist insights in philosophical moral psychology to reproductive ethics, and to health-care ethics more broadly. She identifies the social environments in which self-trust is formed and encouraged. She also shows how women's experiences of reproductive health care can enrich our understanding of self-trust and autonomy as philosophical concepts. The book's theoretical components are grounded in women's concrete experiences. The cases discussed, which involve miscarriage, infertility treatment, and prenatal diagnosis, show that what many women feel toward themselves in reproductive contexts is analogous to what we feel toward others when we trust or distrust them. -/- McLeod also discusses what health-care providers can do to minimize the barriers to women's self-trust in reproductive health care, and why they have a duty to do so as part of their larger duty to respect patient autonomy. (shrink)

We characterize, more precisely than before, what Rawls calls the “analytical” method of drawing up a list of basic liberties. This method employs one or more general conditions that, under any just social order whatever, putative entitlements must meet for them to be among the basic liberties encompassed, within some just social order, by Rawls’s first principle of justice (i.e., the liberty principle). We argue that the general conditions that feature in Rawls’s own account of the analytical method, which employ (...) the notion of necessity, are too stringent. They ultimately fail to deliver as basic certain particular liberties that should be encompassed within any fully adequate scheme of liberties. To address this under-generation problem, we provide an amended general condition. This replaces Rawls’s necessity condition with a probabilistic condition and it appeals to the standard liberal prohibition on arbitrary coercion by the state. We defend our new approach both as apt to feature in applications of the analytical method and as adequately grounded in justice as fairness as Rawls articulates the theory’s fundamental ideas. (shrink)

The process of adopting a child is “not for the faint of heart.” This is what we were told the first time we, as a couple, began this process. Part of the challenge lies in fulfilling the licensing requirements for adoption, which, beyond the usual home study, can include mandatory participation in parenting classes. The question naturally arises for many people who are subjected to these requirements whether they are morally justified. We tackle this question in this paper. In our (...) view, while strong reasons exist in favour of licensing adoptive parents, these reasons support the licensing not only of adoptive parents, but of all or some subset of so-called “natural” parents as well. We therefore conclude that the status quo with respect to parental licensing, according to which only adoptive parents need to be licensed, is morally unjustified. (shrink)

Over the past decade, feminist philosophers have gone a long way toward identifying and explaining the phenomenon that has come to be known as epistemic injustice. Epistemic injustice is injustice occurring within the domain of knowledge (e.g., knowledge production and transmission), which typically impacts structurally marginalized social groups. In this paper, we argue that, as they currently work, algorithms on social media exacerbate the problem of epistemic injustice and related problems of social distrust. In other words, we argue that algorithms (...) on social media recreate and reify the conditions that lead to some groups being systematically denied the full status of knowers, thereby corrupting the epistemic terrain and, with it, systems of social trust and cooperation. We argue that algorithms do this in two ways—namely, via what we are calling algorithmic targeting and algorithmic sorting. (shrink)

Self-protection seems to be negatively correlated with integrity on the standard conception of that virtue. To be self-protective is to lose some of our integrity. In this paper, I pursue the somewhat unlikely claim that a certain amount of self-protection is consistent with integrity and is even required by it in many circumstances.

The debate concerning truth in Classical Chinese philosophy has for the most part avoided the possibility that pluralist theories of truth were part of the classical philosophical framework. I argue that the Eastern Han philosopher Wang Chong (c. 25-100 CE) can be profitably read as endorsing a kind of pluralism about truth grounded in the concept of shi 實 , or “actuality”. In my exploration of this view, I explain how it offers a different account of the truth of moral (...) and non-moral statements, while still retaining the univocality of the concept of truth (that is, that the concept amounts to more than the expression of a disjunction of various truth properties), by connecting shi with normative and descriptive facts about how humans appraise statements. In addition to providing insight into pluralist views of truth in early China, the unique pluralist view implicit in Wang’s work can help solve problems with contemporary pluralist theories of truth.  . (shrink)

A response to comments, published in this issue, on McLeod’s book, Conscience in Reproductive Health Care: Prioritizing Patient Interests (Oxford 2020).

Absolute needs (as against instrumental needs) are independent of the ends, goals and purposes of personal agents. Against the view that the only needs are instrumental needs, David Wiggins and Garrett Thomson have defended absolute needs on the grounds that the verb ‘need’ has instrumental and absolute senses. While remaining neutral about it, this article does not adopt that approach. Instead, it suggests that there are absolute biological needs. The absolute nature of these needs is defended by appeal to: their (...) objectivity (as against mind-dependence); the universality of the phenomenon of needing across the plant and animal kingdoms; the impossibility that biological needs depend wholly upon the exercise of the abilities characteristic of personal agency; the contention that the possession of biological needs is prior to the possession of the abilities characteristic of personal agency. Finally, three philosophical usages of ‘normative’ are distinguished. On two of these, to describe a phenomenon or claim as ‘normative’ is to describe it as value-dependent. A description of a phenomenon or claim as ‘normative’ in the third sense does not entail such value-dependency, though it leaves open the possibility that value depends upon the phenomenon or upon the truth of the claim. It is argued that while survival needs (or claims about them) may well be normative in this third sense, they are normative in neither of the first two. Thus, the idea of absolute need is not inherently normative in either of the first two senses. (shrink)

We argue that Maclaurin and Dyke's recent critique of non-naturalistic metaphysics suffers from difficulties analogous to those that caused trouble for earlier positivist critiques of metaphysics. Maclaurin and Dyke say that a theory is naturalistic iff it has observable consequences. Depending on the details of this criterion, either no theory counts as naturalistic or every theory does.

Currently, the preferred accommodation for conscientious objection to abortion in medicine is to allow the objector to refuse to accede to the patient’s request so long as the objector refers the patient to a physician who performs abortions. The referral part of this arrangement is controversial, however. Pro-life advocates claim that referrals make objectors complicit in the performance of acts that they, the objectors, find morally offensive. McLeod argues that the referral requirement is justifiable, although not in the way (...) that people usually assume. (shrink)

Modality and Anti-Metaphysics critically examines the most prominent approaches to modality among analytic philosophers in the twentieth century, including essentialism. Defending both the project of metaphysics and the essentialist position that metaphysical modality is conceptually and ontologically primitive, Stephen McLeod argues that the logical positivists did not succeed in banishing metaphysical modality from their own theoretical apparatus and he offers an original defence of metaphysics against their advocacy of its elimination. -/- Seeking to assuage the sceptical worries which underlie (...) modal anti-realism, McLeod provides an original contribution to essentialist epistemology, engaging with current debates about modality and suggesting that standard essentialist approaches to some issues in the philosophies of logic and language require revision. -/- This book offers valuable insights to professional philosophers, postgraduates and advanced undergraduates interested in metaphysics, philosophy of logic or the history of twentieth-century analytic philosophy. (shrink)

Some of the duties of individuals and organisations involve responsiveness to need. This requires knowledge of need, so the epistemology of need is relevant to practice. The prevailing contention among philosophers who have broached the topic is that one can know one’s own needs (as one can know some kinds of desires) by feeling them. The article argues against this view. The main positive claims made in the article are as follows. Knowledge of need, in both first‐person and second‐person cases, (...) is a type of knowledge‐that with no basic epistemological source. Needs, like medical conditions, have signs and symptoms. Knowledge of these, with inference, results in knowledge of need. Finally, it is argued that need is akin to, but not a special case of, metaphysical necessity de re. Some implications of this for the epistemology of need are explained. (shrink)

A basic thrust behind Alvin Plantinga's position that belief in God is properly basic is an analogy between certain non-religious beliefs such as ‘I see a tree’ and theistic beliefs such as ‘God made this flower’. Each kind of belief is justified for a believer, argues Plantinga, when she finds herself in a certain set of conditions. Richard Grigg challenges this claim by arguing that while the non-religious beliefs are confirmed, beliefs about God are not. I wish to explore this (...) challenge, clarify it and suggest that on one understanding it is irrelevant and on another it is false. (shrink)

Women tend to earn less than their male colleagues. Furthermore, women tend to earn less than men who hold jobs that are nominally different but relevantly similar to their own. Advocates of ‘comparable worth’ protest these facts. Their protest sometimes takes this form: Those differences in pay between men and women are undeserved . The argument for this claim is simple. Some facts are relevant to the wage one deserves for performing a given job; some are not. In the vast (...) majority of cases, the argument continues, gender is not relevant to the wage one deserves; relevant are, say, the skill, responsibility, and working conditions required by the job. When jobs are comparable with respect to these facts, those who work in them deserve equal pay. Therefore, women and men who work the very same jobs deserve equal pay; likewise for women and men whose jobs are nominally different but relevantly similar. (shrink)

In the fourth book of Achilles Tatius' romance the young and beautiful heroine Leucippe collapses suddenly. When she is approached by the hero Clitophon she leaps to her feet, strikes his face, kicks his friend, and has to be overpowered and tied up. Several chapters later we learn that this behaviour had in fact been caused by an overdose of an unnamed aphrodisiac. In the meantime, however, bystanders, consisting of members of an Egyptian military force, have decided thatμανία τιςis the (...) trouble, and proceed to diagnose with all the confidence of laymen the cause of her madness.Their diagnosis takes the form of an ostensibly straightforward physiological explanation in carefully ordered phrases and employing technical terms. (shrink)

"Chapter One lays out the dominant views of self, agency, and moral responsibility in early Chinese Philosophy. The reason for this is that these views inform the ways early Chinese thinkers approach mental illness, as well as the role they see it playing in self-cultivation as a whole. In this chapter I offer a view of a number of dominant conceptions of mind, body, and agency in early Chinese thought, through a number of philosophical and medical texts"--.

Conscience in Reproductive Health Care responds to the growing worldwide trend of health care professionals conscientiously refusing to provide abortions and similar reproductive health services in countries where these services are legal and professionally accepted. Carolyn McLeod argues that conscientious objectors in health care should prioritize the interests of patients in receiving care over their own interest in acting on their conscience. She defends this "prioritizing approach" to conscientious objection over the more popular "compromise approach" without downplaying the importance (...) of health care professionals having a conscience or the moral complexity of their conscientious refusals. McLeod's central argument is that health care professionals who are gatekeepers of services such as abortions are fiduciaries for their patients and for the public they are licensed to serve. As such, they owe a duty of loyalty to these beneficiaries and should give primacy to their beneficiaries' interests in accessing care. This conclusion is informed by what McLeod believes is morally at stake for the main parties to the conflicts generated by conscientious refusals: the objector and the patient. What is at stake, according to McLeod, depends on the relevant socio-political context, but typically includes the objector's integrity and the patient's interest in avoiding harm. (shrink)

To reconcile true claims of de re necessity with the supposedly contingent existence of the concrete objects those claims are typically about, Kripkean essentialists invoke weak necessity. The claim that a is necessarily F is held to be equivalent to the claim that necessarily, if a exists then a is F. This strategy faces a barrage of serious objections a proper subset of which shows that the strategy fails to achieve its intended purpose. Relief can be provided via recourse to (...) a markedly non-Kripkean version of essentialism.1. (shrink)

This book is a study of the methodological, metaphysical, and epistemological work of the Eastern Han Dynasty period scholar Wang Chong. It presents Wang’s philosophical thought as a unique and syncretic culmination of a number of ideas developed in earlier Han and Warring States philosophy. Wang’s philosophical methodology and his theories of truth, knowledge, and will and determinism offer solutions to a number of problems in the early Chinese tradition. His views also have much to offer contemporary philosophy, suggesting new (...) ways of thinking about familiar problems. While Wang is best known as a critic and skeptic, Alexus McLeod argues that these aspects of his thought form only a part of a larger positive project, aimed at discerning truth in a variety of senses. (shrink)

An introduction to a special issue of Bioethics edited by McLeod and called Understanding and Protecting Reproductive Autonomy.

This paper addresses the likely impact on women of being denied emergency contraception (EC) by pharmacists who conscientiously refuse to provide it. A common view—defended by Elizabeth Fenton and Loren Lomasky, among others—is that these refusals inconvenience rather than harm women so long as the women can easily get EC somewhere else nearby. I argue from a feminist perspective that the refusals harm women even when they can easily get EC somewhere else nearby.

Some accounts of the fiduciary relationship place trust and autonomy at odds with one another, so that trusting a fiduciary to act on one’s behalf reduces one’s ability to be autonomous. In this chapter, we critique this view of the fiduciary relationship (particularly bilateral instances of this relationship) using contemporary work on autonomy and ‘relational autonomy’. Theories of relational autonomy emphasize the role that interpersonal trust and social relationships play in supporting or hampering one’s ability to act autonomously. We argue (...) that fiduciary relationships, understood through the lens of relational autonomy, can provide a means of enhancing, rather than diminishing, beneficiaries’ autonomy. (shrink)

The Einstellung effect occurs when the first idea that comes to mind, triggered by familiar features of a problem, prevents a better solution being found. It has been shown to affect both people facing novel problems and experts within their field of expertise. We show that it works by influencing mechanisms that determine what information is attended to. Having found one solution, expert chess players reported that they were looking for a better one. But their eye movements showed that they (...) continued to look at features of the problem related to the solution they had already thought of. The mechanism which allows the first schema activated by familiar aspects of a problem to control the subsequent direction of attention may contribute to a wide range of biases both in everyday and expert thought - from confirmation bias in hypothesis testing to the tendency of scientists to ignore results that do not fit their favoured theories. (shrink)

Debate has raged in Canada recently over whether in vitro fertilization should be funded through public health insurance. Such a move would require that the provinces classify IVF as a medically necessary service. In this paper, I defend the position I have taken publicly—especially in Ontario, my own province—that IVF is not medically necessary. I contend that, by funding IVF on grounds of medical necessity, governments like Ontario's violate their commitments to equality and fairness, and cause harm. They do the (...) last by suggesting that the lives of people who forgo procreation, and perhaps have children in other ways, will be stunted. (shrink)

The initial surge of COVID19 patients in New York, created a surge of unprecedented numbers in the largest integrated hospital system of the New York City and surrounding Long Island region. Due to innovation and clinician ingenuity ventilator allocation was going to have an easier solution than alleviating the moral distress of overworked and understaffed clinicians. Through the innovative work of clinicians, leadership and the leadership of Governor Cuomo and hospital executives, the need for triaging ventilators did not become a (...) reality. Yet the need for ethicists to support and aid clinicians in the discernment and need for escalation for scarce ICU resources and personnel was key. The transition from an allocation strategy of ventilators organically occurred as rapidly as the surge of COVID19 as it became clear that addressing clinician distress was imperative to maintain the level of human capital. An allocation strategy was envisioned that would assess the urgency of need for intensive care resources utilizing established decision aid calculators. In a mixed method quantitative and qualitative review, this article utilizes descriptive data to illustrate the lessons learned from utilizing ethics consultants to review pandemic decision making and alleviate clinician moral distress. (shrink)

By the lights of a central logical positivist thesis in modal epistemology, for every necessary truth that we know, we know it a priori and for every contingent truth that we know, we know it a posteriori. Kripke attacks on both flanks, arguing that we know necessary a posteriori truths and that we probably know contingent a priori truths. In a reflection of Kripke's confidence in his own arguments, the first of these Kripkean claims is far more widely accepted than (...) the second. Contrary to received opinion, the paper argues, the considerations Kripke adduces concerning truths purported to be necessary a posteriori do not disprove the logical positivist thesis that necessary truth and a priori truth are co-extensive. (shrink)

‘Quantified pure existentials’ are sentences (e.g., ‘Some things do not exist’) which meet these conditions: (i) the verb EXIST is contained in, and is, apart from quantificational BE, the only full (as against auxiliary) verb in the sentence; (ii) no (other) logical predicate features in the sentence; (iii) no name or other sub-sentential referring expression features in the sentence; (iv) the sentence contains a quantifier that is not an occurrence of EXIST. Colin McGinn and Rod Girle have alleged that standard (...) first-order logic cannot adequately deal with some such existentials. The article defends the view that it can. (shrink)

The status quo on parental licensing in most Western jurisdictions is that licensing is required in the case of adoption but not in the case of assisted or unassisted biological reproduction. To have a child via adoption, one must fulfill licensing requirements, which, beyond the usual home study, can include mandatory participation in parenting classes. One is exempt from these requirements, however, if one has a child via biological reproduction, including assisted reproduction involving donor gametes or a contract pregnancy. In (...) an earlier paper, we challenged this system of parental licensing by showing that arguments in favour of it do not succeed. One argument we failed to consider, however, is that prospective biological parents have a right to reproduce that protects them against the sort of state interference that is involved in parental licensing. According to this argument, because prospective adoptive parents do not exercise a similar right when attempting to become parents, they are not similarly protected. In this paper, we argue that this reproductive rights argument, like other arguments in favour of the status quo on parental licensing, is flawed. We also question whether people in fact have a right to reproduce, and in doing so distinguish this right from others that we think are legitimate, including a right to become a parent and a right to bodily autonomy. (shrink)

Background: Visual technologies are central to youth culture and are often the preferred communication means of adolescents. Although these tools can be beneficial in fostering relations, adolescents’ use of visual technologies and social media also raises ethical concerns. Aims: We explored how school public health nurses identify and resolve the ethical challenges involved in the use of visual technologies in health dialogues with adolescents. Research design: This is a qualitative study utilizing data from focus group discussions. Participants and research context: (...) We conducted focus group discussions using two semi-structured discussion guides with seven groups of public health nurses working in Norwegian school health services. The data were collected during January and October 2016. Discussions were audio recorded, transcribed, and coded into themes and subthemes using systematic text condensation. Ethical considerations: The leader of the public health nursing service who agreed to provide access for the study and the Norwegian Center for Research Data that reviewed and approved the study. All participants gave informed consent. Findings: In adolescents’ use of visual materials with public health nurses, ethical concerns were raised regarding suicide ideations, socially unacceptable content, violation of privacy, and presentations of possible child neglect. The nurses utilized their professional knowledge and experience when identifying and navigating these ethical dilemmas; they resolved ethical uncertainties through peer discussion and collaboration with fellow nurses and other professionals. Discussion: We discussed the findings in light of Annemarie Mol’s interpretation of the ethics of care. Mol expands the notion of ethical care to include the action of technologies. Conclusion: Although the increasing use of visual technologies offered benefits, school nurses faced ethical challenges in health dialogues with adolescents. To address and navigate these ethical issues, they relied on their experience and caring practices based on their professional ethics. Uncertainties were resolved through peer dialogue and guidance. (shrink)

This book offers an interpretation of the philosophical thought of the ancient Maya, in the classic and postclassic periods. Alexus McLeod adopts philosophical methodology, comparative philosophy, and history of philosophy to reveal and understand the ancient Maya by engaging with Maya thought as philosophy.

This paper comes out of a panel honoring the work of Anne Donchin (1940-2014), which took place at the 2016 Congress of the International Network on Feminist Approaches to Bioethics (FAB) in Edinburgh. My general aim is to highlight the contributions Anne made to feminist bioethics, and to feminist reproductive ethics in particular. My more specific aim, however, is to have a kind of conversation with Anne, through her work, about whether reproductive justice could demand insurance coverage for in vitro (...) fertilization. I quote liberally from Anne’s work for this purpose, but also to shower the reader with her words, reminding those of us who knew her well what a wonderful colleague she was. (shrink)

A peer commentary on an AJOB article by Kyle Fritz called "Unjustified Asymmetry: Positive Claims of Conscience and Heartbeat Bills.".

Infertility can be an agonizing experience, especially for women. And, much of the agony has to do with luck: with how unlucky one is in being infertile, and in how much luck is involved in determining whether one can weather the storm of infertility and perhaps have a child in the end. We argue that bad luck associated with being infertile is often bad moral luck for women. The infertile woman often blames herself or is blamed by others for what (...) is happening to her, even when she cannot control or prevent what is happening to her. She has simply had bad luck. We focus on the self-blame of infertile women and show how it stems from pro-natalism that targets women. We also argue that overall for women, regret is a better moral response to infertility than self-blame. (shrink)