Philosophical interest in disability is rapidly expanding. Philosophers are beginning to grasp the complexity of disability--as a category, with respect to well-being and as a marker of identity. However, the philosophical literature on justice and human rights has often been limited in scope and somewhat abstract. Not enough sustained attention has been paid to the concrete claims made by people with disabilities, concerning their human rights, their legal entitlements and their access to important goods, services and resources. This book discusses (...) how effectively philosophical approaches to distributive justice and human rights can support these concrete claims. It argues that these approaches often fail to lend clear support to common disability demands, revealing both the limitations of existing philosophical theories and the inflated nature of some of these demands. Moving beyond entitlements, the author also develops a unique conception of dignity, which she argues illuminates the specific indignities experienced by people with disabilities in the allocation of goods, in the common experience of discrimination and in a wide range of interpersonal interactions. Disability with Dignity offers an accessible and extended philosophical discussion of disability, justice and human rights. It provides a comprehensive assessment of the benefits and pitfalls of theories of human rights and justice for advancing justice for the disabled. It brings the moral importance of dignity to the centre, arguing that justice must be pursued in a way that preserves and promotes the dignity of people with disabilities. (shrink)

In Virtues of the Mind I object to process reliabilism on the grounds that it does not explain the good of knowledge in addition to the good of true belief. In this paper I wish to develop this objection in more detail, and will then argue that this problem pushes us first in the direction of two offspring of process reliabilism—faculty reliabilism and proper functionalism, and, finally, to a true virtue epistemology.

Philosophers and bioethicists are typically sceptical about invocations of dignity in ethical debates. Many believe that dignity is essentially devoid of meaning: either a mere rhetorical gesture used in the absence of good argument or a faddish term for existing values like autonomy and respect. On the other hand, the patient experience of dignity is a substantial area of research in healthcare fields like nursing and palliative care. In this paper, it is argued that philosophers have much to learn from (...) the concrete patient experiences described in healthcare literature. Dignity is conferred on people when they are treated as having equal status, something the sick and frail are often denied in healthcare settings. The importance of equal status as a unique value has been forcefully argued and widely recognised in political philosophy in the last 15 years. This paper brings medical ethics up to date with philosophical discussion about the value of equal status by developing an equal status conception of dignity. (shrink)

Dual loyalty issues confront health and welfare professionals in immigration detention centres in Australia. There are four apparent ways they deal with the ethical tensions. One group provides services as required by their employing body with little questioning of moral dilemmas. A second group is more overtly aware of the conflicts and works in a mildly subversive manner to provide the best possible care available within a harsh environment. A third group retreats by relinquishing employment in the detention setting. A (...) fourth group is activist in intent and actions. Derived from research and ethnography conducted in Australia, the article explores the moral dilemmas confronting those who are duty-bound by professional codes of ethics while also bound by loyalty to their employers and silenced by confidentiality statements. It provides particular focus on psychiatry, nursing and social work. We conclude by speculating whether a politics of compassion and acts of solidarity can forge a pathway through the ethical terrain. In doing so we draw upon human rights considerations as well as on the works of Joan Tronto and Elisabeth Porter. (shrink)

Individuals with ‘severe’ cognitive disabilities are primarily discussed in philosophy and bioethics to determine their moral status. In this paper it is argued that theories of moral status have limited relevance to the unjust ways in which people with cognitive disabilities are routinely treated in the actual world, which largely concerns their relegation to an inferior social status. I discuss three possible relationships between moral and social status, demonstrating that determinate answers about the moral status of individuals with ‘severe’ cognitive (...) disabilities are neither necessary nor sufficient for defending the imperative that they be treated as our social equals. (shrink)

Sometimes we should mind our own business. But at other times it would be wrong to mind one's own business. This paper explores the tension between these two claims by presenting a tendency to mind one's own business as an Aristotelian-style virtue. It is furthered argued that this is a different virtue than tolerance.

Every day, in many situations, we use expressions which seem only vaguely to provide us with information. The weather forecaster tells us that "some showers are likely in Northern regions during the night", a statement which is vague with respect to number of showers, location, and time. Yet such messages are informative, and often it is not possible for the producer of the message to be more precise. A tutor tells his students that "only a few students fail their exams (...) outright". This does not give a precise incidence. Yet it might be equally misleading to do so. For example, to say that 12% failed outright last year says nothing about other years, while to say an average of 8% over the last five years says nothing about variability. We argue that a precise, numerical statement can be sometimes more misleading in reality than a vague statement. Many researchers in psychology have attempted to capture the meaning of quantities by relating them to scales of quantity. The book explores this idea in detail and shows with original studies how these expressions also serve to control attention and to convey information about the expectations held by those involved in the communication. The book works towards a psychological theory of the meaning of quantifiers and similarly vague terms. New links are drawn between formal theories of quantification and psychological experimentation. (shrink)

This paper explores ethical questions arising from the work of health practitioners in immigration detention centres in Australia. It raises questions about the roles of professional disciplines and the ways in which they confront dual loyalty issues. The exploration is guided by interviews conducted with health professionals who have worked in asylum seeker detention and an examination of the outsider advocacy role undertaken by the social work profession. The paper discusses the stance taken by individuals and professional associations on participation (...) in controlled settings, including as participant, bystander and advocate, and asks when the provision of care becomes collusion with oppression. (shrink)

This essay presents a moral argument for the rationality of theistic belief. If all I have to go on morally are my own moral intuitions and reasoning and those of others, I am rationally led to skepticism, both about the possibility of moral knowledge and about my moral effectiveness. This skepticism is extensive, amounting to moral despair. But such despair cannot be rational. It follows that the assumption of the argument must be false and I must be able to rely (...) on more than my own human powers and those of others in attempting to live a moral life. The Christian God has such a function. Hence, if it is rational to attempt a moral life, it is rational to believe in the Christian God. (shrink)

Hojjat Soofi develops a modified version of Martha Nussbaum’s capability approach, which he offers as a conception of dignity for people living with dementia.1 He argues that this modified version can address what he identifies as four main criticisms of the concept of dignity. The first and most substantial criticism was developed by Macklin: that appeals to ‘dignity’ add little to moral debates or to the rich field of existing moral values.1 Soofi’s account of dignity does not evade this criticism: (...) to the contrary, it represents another clear example of what Macklin complained about, namely, a moral proposal in which the concept of ‘dignity’ plays no substantive role. We have much to learn from Soofi’s rich account of how to ensure the flourishing or well-being of people living with dementia, but it has little to do with dignity as such. According to Soofi, Macklin’s argument is that ‘dignity’ is just another word for respect for persons or their autonomy. This is a rather truncated representation of Macklin’s argument, which is in fact broader. Her argument is that the concept of ‘dignity’ adds nothing to the vast array of rich moral values that already populate the field of ethics, mainly because it is a less precise restatement of these existing values.2 She explicitly …. (shrink)

Particular conceptions of reconciliation vary across a number of dimensions. As section 1 explains, the kind of relationship at issue in a specific context affects the type of improvement in relations that might be necessary in order to qualify as reconciliation. Reconciliation is widely taken to be a scalar concept. Section 2 discusses the spectrum of intensity along which kinds of improvement in relationships fall, and indicates why, in particular contexts, theorists often disagree about the point along this spectrum that (...) is morally or politically most significant. Section 3 provides an overview of the processes commonly cited as contributing to reconciliation. These processes are often controversial; those praised by some commentators as appropriate and constructive responses to past conflict are dismissed by others as undermining the moral or political conditions for just and peaceful relations. Section 4 concentrates on the relationship between reconciliation and justice. While some see these values as compatible and mutually supporting, others argue that, especially in the immediate wake of conflict, parties must often choose between reconciliation and justice. (shrink)

This essay examines the ethics of boycotting as a social response to injustice or wrongdoing. The boycotts in question are collective actions in which private citizens withdraw from or avoid consumer or cultural interaction with parties perceived to be responsible for some transgression. Whether a particular boycott is justified depends, not only on the reasonableness of the underlying moral critique, but also on what the boycotters are doing in boycotting. The essay considers four possible interpretations of the kind of act (...) in which boycotting consists: the avoidance of complicity, protest speech, social punishment, or social coercion. Each interpretation provides a plausible account of at least some cases of boycotting, yet each raises distinct challenges to justifying boycotting activities. (shrink)

The meaning of dignity in health care has been primarily explored using interviews and surveys with various patient groups, as well as with health care practitioners. Philosophical analysis of dignity is largely avoided, as the existing philosophical literature is complex, multifaceted and of unclear relevance to health care settings. The aim of this paper is to develop a straightforward philosophical concept of dignity which is then applied to existing qualitative research. In health care settings, a patient has dignity when he (...) or she is able to live in accordance with his or her standards and values. Accordingly, health care practitioners respect a patient's dignity when they refrain from transgressing the patient's standards and values, or refrain from forcing the patient to transgress his or her standards and values. This concept is shown to explain and illuminate most of the key qualitative findings. It therefore provides a more coherent and synthesised concept of dignity in health care. (shrink)

This article explores the nature of "the phenomenological attitude," which is understood as the process of retaining a wonder and openness to the world while reflexively restraining pre-understandings, as it applies to psychological research. A brief history identifies key philosphical ideas outlining Husserl's formulation of the reductions and subsequent existential-hermeneutic elaborations, and how these have been applied in empirical psychological research. Then three concrete descriptions of engaging the phenomenological attitude are offered, highlighting the way the epoché of the natural sciences, (...) the psychological phenomenological reduction and the eidetic reduction can be applied during research interviews. Reflections on the impact and value of the researcher's stance show that these reductions can be intertwined with reflexivity and that, in this process, something of a dance occurs—a tango in which the researcher twists and glides through a series of improvised steps. In a context of tension and contradictory motions, the researcher slides between striving for reductive focus and reflexive self-awareness; between bracketing pre-understandings and exploiting them as a source of insight. Caught up in the dance, researchers must wage a continuous, iterative struggle to become aware of, and then manage, pre-understandings and habitualities that inevitably linger. Persistance will reward the researcher with special, if fleeting, moments of disclosure in which the phenomenon reveals something of itself in a fresh way. (shrink)

This paper focuses on disagreement spaces fused with emotion. Following Gilbert’s emotional mode of argumentation (1997), further expansions of the mode are made here, specifically for the purposes of being able to classify different types of emotional arguments. First, general concerns with arguments that stray from the traditional approach are addressed. Then a classification system for different types of emotional arguments is developed. Some of the criteria that help determine emotional arguments include dialogue types, arguers involved, as well as the (...) use of emotion. (shrink)

BRISKIN L. Nursing Inquiry 2012; 19: 285–296 Resistance, mobilization and militancy: nurses on strikeDrawing on nurses’ strikes in many countries, this paper explores nurse militancy with reference to professionalism and the commitment to service; patriarchal practices and gendered subordination; and proletarianization and the confrontation with healthcare restructuring. These deeply entangled trajectories have had a significant impact on the work, consciousness and militancy of nurses and have shaped occupation‐specific forms of resistance. They have produced a pattern of overlapping solidarities – occupational (...) solidarity, gendered alliances and coalitions around healthcare restructuring – which have supported, indeed promoted, militancy among nurses, despite the multiple forces arrayed against them. The professional commitments of nurses to the provision of care have confronted healthcare restructuring, nursing shortages, intensification of work, precarious employment and gendered hierarchies with a militant discourse around the public interest, and a reconstitution and reclamation of ‘caring’, what I call the politicisation of caring. In fact, nurses’ dedication to caring work in the late twentieth and early twenty‐first centuries may encourage rather than dissuade them from going on strike. This paper uses a trans‐disciplinary methodology, qualitative material in the form of strike narratives constructed from newspaper archives, and references to the popular and scholarly literature on nursing militancy. (shrink)

abstract In this paper I argue that the genetic manipulation of sexual orientation at the embryo stage could have a detrimental effect on the subsequent person's later capacity for autonomous agency. By focussing on an example of sexist oppression I show that the norms and expectations expressed with this type of genetic manipulation can threaten the development of autonomous agency and the kind of social environment that makes its exercise likely.

It has been argued by disability advocates that supported decision-making must replace surrogate, or substituted, decision-making for people with cognitive disabilities. From a moral perspective surrogate decision-making it is said to be an indefensible form of paternalism. At the heart of this argument against surrogate decision-making is the belief that such paternalistic action expresses something fundamentally disrespectful about those upon whom it is imposed: that they are inferior, deficient or child-like in some way. Contrary to this widespread belief, I will (...) argue that surrogate decision-making sometimes expresses more respect for people with life-long, ‘severe’ or ‘profound’ cognitive disabilities than does the adoption of supported decision-making.. Specifically, I argue that in some cases supported decision-making can arguably express that people with severe or profound cognitive disabilities lack equal moral value. I also argue that supported decision-making for people with profound cognitive disabilities can arguably express that they lack complex and rich inner lives. If our aim is to ensure our behaviour and practices express respect for people with life-long ‘severe’ or ‘profound’ cognitive disabilities, then sometimes surrogate rather than supportive decision-making will be a better option. (shrink)

This paper describes the lifeworld of one individual, Ann, in an attempt to elucidate the existential impact of early stage multiple sclerosis. Drawing on Ann's own reflections captured in a relatively unstructured interview, I construct a narrative around her first year of living with the diagnosis. Then, existential-phenomenological analysis reveals how Ann's life - lived in and through a particular body and lifeworld context - is disrupted. The unity between her body and self can no longer be taken for granted. (...) The existential possibilities inherent in her lived body are diminished and have to be renegotiated. Her sense of identity, project, relations with others and present/future plans are threatened. Ann's illness is encountered in the context of her life activities and relationships. This is the intertwining of body, self and world. To live with multiple sclerosis is to experience a global sense of disorder - a disorder which incorporates a changed relation with one's body, a transformation in the surrounding world, a threat to the self, and a change in one's relation to others. (shrink)

The last twenty-five years or so of thought about tort law have been remarkably productive and dynamic, as the dominance of the law and economics model has been challenged by theories that reintroduce the language of corrective justice. Over this same time period, theorizing about corrective justice has sprung up in response to a wide range of social, political and moral issues. I have in mind work on restorative theories in criminal justice; on postwar justice; on truth commissions, political reconciliation (...) and transitional justice in contexts of regime change; on official apologies as responses to international crises, institutionalized abuse and historical injustices; and on interpersonal apology, the making of amends, and forgiveness as responses to everyday moral transgressions. In these writings, theorists explore what people owe to one another in the aftermath of various kinds of wrongdoing, and thereby subtly challenge our ideas about what should be included under the heading of corrective justice. One new strand of thought, which appears in many of these debates, suggests that corrective justice requires a form of reconciliation or relational repair. My goal in this chapter is to introduce this idea and explore what it might offer to the philosophy of tort law. (shrink)

It may appear that there are grounds for an alliance between opponents of enhancement and disability advocates. People from both camps condemn parents who aspire to improve the physical and psychological traits their children would otherwise be born with, a condemnation often expressed as an accusation of eugenics. Despite these superficial appearances, the author will argue that disability advocates have nothing to applaud in Michael Sandel’s critique of enhancement, which is based on false and sometimes pernicious claims about the value (...) of ‘normal’ human beings. However, they will also argue that disability advocates fail to provide convincing reasons for condemning parental decisions to avoid or eliminate certain traits their children would otherwise be born with. Contrary to what disability advocates and opponents of enhancement suggest, it is often a violation rather than an instantiation of parental virtue to abandon judgements about whether one’s children’s biological givens should be changed. (shrink)

Just what sort of a theory is psychoanalytic theory? -- Did Kant precede Freud on a-rational thought? -- Why primary process is hard to know -- Representational a-rational thinking : a proper function account for phantasy and wish -- Drive theory and primary process -- Phantasies, neurotic-beliefs, and beliefs-proper -- Desire and the readiness-to-act -- Compare and contrast : Gardner, Lear, Cavell, and Brakel.

Although tissue plasminogen activator (tPA) is the only medication approved by the United States Food and Drug Administration (FDA) for acute ischemic stroke, there is no consensus about the need for informed consent for its use. As a result, hospitals throughout the U.S. have varying requirements regarding obtaining informed consent from patients for the use of tPA, ranging from no requirement for informed consent to a requirement for verbal or written informed consent. We conducted a study to (1) determine current (...) beliefs about obtaining patients’ informed consent for tPA among a large group of stroke clinicians and (2) identify the ethical, clinical, and organizational factors that influence tPA consent practices. Semi-structured interviews were conducted by trained and experienced investigators and research staff to identify key barriers to implementing acute stroke services. Part of the interview explored current beliefs and practices around informed consent for tPA.This was a multicenter study that included 38 Veterans Health Administration (VHA) hospital locations. Participants were 68 stroke team clinicians, serving primarily on the neurology (35 percent) or emergency medicine (41 percent) service. We conducted thematic analysis based on principles of grounded theory to identify codes about consent for tPA. We used interpretive convergence to ensure consistency among the individual investigators’ codes and to ensure that all of the investigators agreed on coding and themes.We found that 38 percent of the stroke clinicians did not believe any form of consent was necessary for tPA, 47 percent thought that some form of consent was necessary, and 15 percent were unsure. Clinicians who believed tPA required informed consent were divided on whether consent should be written (40 percent) or verbal (60 percent). We identified three factors describing clinicians’ attitudes about consent: (1) legal and policy factors, (2) ethical factors, and (3) medical factors.The lack of consensus regarding consent for tPA creates the potential for delays in treatment, uneasiness among clinicians, and legal liability. The identified factors provide a potential framework to guide discussions about developing a standard of care for acquiring the informed consent of patients for the administration of tPA. (shrink)

As medical technology becomes more sophisticate the ability to manipulate nature and manage disease forces the dilemma of when can becomes ought. Indeed, most bioethical discourse is framed in terms of balancing the values and interests and the benefits and burdens that inform principled decisions about how, when, and whether interventions should occur. Yet, despite advances in science and technology, one caregiver mandate remains as constant and compelling as it was for the earliest shaman—the relief of pain. Even when cure (...) is impossible, the physician's duty of care includes palliation. Moreover, the centrality of this obligation is both unquestioned and universal, transcending time and cultural boundaries.Although universally acknowledged, pain is a complex phenomenon for both the patient and the caregiver, influenced as much by personal values and cultural traditions as by physiological injury and disease. (shrink)

Jean Hampton argues that we can detect exploitation in personal relationships by thinking about what we would agree to were we to set aside the emotional benefits we receive from those relationships. Hampton calls her account "feminist contractarianism," but it has recently been critiqued as decidedly unfeminist, on the grounds that it is hostile to women's interests and women's values. Furthermore, Hampton's requirement that we imaginatively distance ourselves from our emotional connections to our loved ones--the key element in her contractarian (...) test--is simply ad hoc. In this essay, I will evaluate these objections and offer a new justification for Hampton's test. I conclude that feminist contractarianism is not only a useful tool for detecting exploitation in the family, it is also deserving of its feminist label. (shrink)

In this paper I argue that there are two kinds of epistemic reasons. One kind is irreducibly first personal -- what I call deliberative reasons. The other kind is third personal -- what I call theoretical reasons. I argue that attending to this distinction illuminates a host of problems in epistemology in general and in religious epistemology in particular. These problems include (a) the way religious experience operates as a reason for religious belief, (b) how we ought to understand religious (...) testimony, (c) how religious authority can be justified, (d) the problem of religious disagreement, and (e) the reasonableness of religious conversion. (shrink)

Do future generations of a wrongdoing group have a responsibility to preserve the memory of the past? If so, what manner of responsibility is it? In this essay, I critically examine the categories of forward-looking and backward-looking collective responsibility to see what they might offer to this discussion. I argue that these concepts of responsibility are ambiguous in ways that threaten to prevent important questions from being raised. I draw my examples from contemporary German practices of preserving the memory of (...) the Holocaust and World War II, especially the stolpersteine, which are memorial plaques for individual victims embedded in the sidewalks of German cities. (shrink)

In this volume, Brakel raises questions about conventions in the study of mind in three disciplines—psychoanalysis, philosophy of mind, and experimental philosophy. She illuminates new understandings of the mind through interdisciplinary challenges to views long-accepted. Here she proposes a view of psychoanalysis as a treatment that owes its successes largely to its biological nature—biological in its capacity to best approximate the extinction of problems arising owing to aversive conditioning. She also discusses whether or not "the mental" can have any real (...) ontological standing, arguing that a form of reductive physicalism can be sufficient ontologically, but that epistemological considerations require a branch of non-reductive physicalism. She then notes the positive implications of this view for psychiatry and psychoanalysis, Finally, she investigates the role of "consistency" in method and content, toward which experimental philosophers strive. In essence, Brakel articulates the different sets of challenges pertaining to: a) ancient dilemmas such as the mind/body problem; b) longstanding debates about the nature of therapeutic action in psychoanalysis; and c) new core questions arising in the relatively young discipline of experimental philosophy. (shrink)

In this paper I give a theological foundation to a radical type of virtue ethics I call motivation-based. In motivation-based virtue theory all moral concepts are derivative from the concept of a good motive, the most basic component of a virtue, where what I mean by a motive is an emotion that initiates and directs action towards an end. Here I give a foundation to motivation-based virtue theory by making the motivations of one person in particular the ultimate foundation of (...) all moral value, and that person is God. The theory is structurally parallel to Divine Command Theory, but has a number of advantages over DC theory without the well-known problems. In particular, DM theory does not face a dilemma parallel to the famous Euthyphro problem, nor does it have any difficulty answering the question whether God could make cruelty morally right. Unlike DC theory, it explains the importance of Christology in Christian ethics, and it has the advantage of providing a unitary account of all evaluative properties, divine and human. I call the theory Divine Motivation Theory. (shrink)

In this commentary on Stanovich & West (S&W) we call attention to two points: (1) Freud's original dual process theory, which antedates others by some seventy-five years, deserves inclusion in any consideration of dual process theories. His concepts of primary and secondary processes (Systems 1 and 2, respectively) anticipate significant aspects of current dual process theories and provide an explanation for many of their characteristics. (2) System 1 is neither rational nor irrational, but instead a-rational. Nevertheless, both the a-rational System (...) 1 and the rational System 2 can each have different roles in enhancing evolutionary fitness. Lastly, System 1 operations are incorrectly deemed “rational” whenever they increase evolutionary fitness. (shrink)

In this paper I present an argument that there can be no more than one God in a way which allows me to give the doctrine ofthe Trinity logical priority over the attributes traditionally used in arguments for God’s unicity. The argument that there is at most one God makes no assumptions about the particular attributes included in divinity. It uses only the Identity of Indiscemibles and a Principle of Plenitude. I then offer a theory on the relationship between individuals (...) and kinds which allows me to offer an interpretation of the Trinity. (shrink)

Bi-intuitionistic logic is the union of intuitionistic and dual intuitionistic logic, and was introduced by Rauszer as a Hilbert calculus with algebraic and Kripke semantics. But her subsequent ‘cut-free’ sequent calculus has recently been shown to fail cut-elimination. We present a new cut-free sequent calculus for bi-intuitionistic logic, and prove it sound and complete with respect to its Kripke semantics. Ensuring completeness is complicated by the interaction between intuitionistic implication and dual intuitionistic exclusion, similarly to future and past modalities in (...) tense logic. Our calculus handles this interaction using derivations and refutations as first class citizens. We employ extended sequents which pass information from premises to conclusions using variables instantiated at the leaves of refutations, and rules which compose certain refutations and derivations to form derivations. Automated deduction using terminating backward search is also possible, although this is not our main purpose. (shrink)

The recent literature on criminal justice has yielded an intriguing suggestion: that someone who does wrong has a right to make amends. In this essay, I evaluate arguments for and against this claim with regard to cases of both criminal wrongdoing and private wrongs. I conclude that the balance of arguments speaks in favor of a right to make amends. This conclusion has ramifications for the just design of criminal sanctions, and these will also be addressed here.