_A portion of the revenue from this book’s sales will be donated to Doctors Without Borders to assist in the fight against COVID-19._ The rapid spread of COVID-19 has had an unprecedented impact on modern health-care systems and has given rise to a number of complex ethical issues. This collection of readings and case studies offers an overview of some of the most pressing of these issues, such as the allocation of ventilators and other scarce resources, the curtailing of standard (...) privacy measures for the sake of public health, and the potential obligations of health-care professionals to continue operating in dangerous work environments. (shrink)

Discussions of both personal responsibility and the importance of trust in health-care settings are increasingly prominent in the bioethics literature. In this paper I link the two discussions and argue that health policies that include personal responsibility ought to address climates of social trust. Trust is a social good that is not always fairly distributed. Disadvantaged social groups often face default distrust. I suggest that agent-centered models in which responsibilities are negotiated do a better job of repairing social distrust than (...) authoritative models in which responsibilities are assigned. Attending to climates of trust, distrust, or antitrust is essential for addressing health inequalities. (shrink)

Non-Invasive Prenatal Testing is a technology which provides information about fetal genetic characteristics very early in pregnancy by examining fetal DNA obtained from a sample of maternal blood. NIPT is a morally complex technology that has advanced quickly to market with a strong push from industry developers, leaving many areas of uncertainty still to be resolved, and creating a strong need for health policy that reflects women’s social and ethical values. We approach the need for ethical policy-making by studying the (...) use of NIPT and emerging policy in the province of Ontario, Canada. Using an adapted version of constructivist grounded theory, we conducted interviews with 38 women who have had personal experiences with NIPT. We used an iterative process of data collection and analysis and a staged coding strategy to conduct a descriptive analysis of ethics issues identified implicitly and explicitly by women who have been affected by this technology. The findings of this paper focus on current ethical issues for women seeking NIPT, including place in the prenatal pathway, health care provider counselling about the test, industry influence on the diffusion of NIPT, consequences of availability of test results. Other issues gain relevance in the context of future policy decisions regarding NIPT, including funding of NIPT and principles that may govern the expansion of the scope of NIPT. These findings are not an exhaustive list of all the potential ethical issues related to NIPT, but rather a representation of the issues which concern women who have personal experience with this test. Women who have had personal experience with NIPT have concerns and priorities which sometimes contrast dramatically with the theoretical ethics literature. These findings suggest the importance of engaging patients in ethical deliberation about morally complex technologies, and point to the need for more deliberative patient engagement work in this area. (shrink)

Discussions of both personal responsibility and the importance of trust in health-care settings are increasingly prominent in the bioethics literature. In this paper I link the two discussions and argue that health policies that include personal responsibility ought to address climates of social trust. Trust is a social good that is not always fairly distributed. Disadvantaged social groups often face default distrust. I suggest that agent-centered models in which responsibilities are negotiated do a better job of repairing social distrust than (...) authoritative models in which responsibilities are assigned . Attending to climates of trust, distrust, or antitrust is essential for addressing health inequalities. (shrink)

Business and Society Review, Volume 127, Issue 1, Page 3-22, Spring 2022.

Business and Society Review, Volume 127, Issue 1, Page 3-22, Spring 2022.

Childhood obesity has become a public health epidemic, and currently a battle exists over how to frame and address this problem. This paper explores how public policy approaches can be employed to address obesity. We present the argument that obesity should be viewed as the consequence of a “toxic environment” rather than the result of the population failing to take enough “personal responsibility.” In order to make progress in decreasing the prevalence of obesity, we must shift our view of obesity (...) away from the medical model to a public health model . At the same time, we must be sensitive to the problem of weight bias.Potential obstacles to taking a public policy approach are identified, as well as suggestions on how to overcome them. (shrink)

Supported decision-making has been promoted at a policy level and within international human rights treaties as a way of ensuring that people with disabilities enjoy the right to legal capacity on an equal basis with others. However, little is known about the practical issues associated with implementing supported decision-making, particularly in the context of dementia. This study aimed to understand the experiences of people with dementia and their family members with respect to decision-making and their views on supported decision-making. Thirty-six (...) interviews were undertaken with fifty-seven participants across three states in Australia. Interpretative Phenomenological Analysis was used as the methodological approach, with relational autonomy as a theoretical perspective. We identified two overarching themes relating to participants’ experiences with decision-making: “the person in relationship over time” and “maintaining involvement.” Participant views on the practical issues associated with supported decision-making are addressed under the themes of “facilitating decision-making,” “supported decision-making arrangements,” “constraints on decision-making,” and “safeguarding decision-making.” While participants endorsed the principles of supported decision-making as part of their overarching strategy of “maintaining involvement” in decision-making, they recognized that progressive cognitive impairment meant that there was an inevitable transition toward greater involvement of, and reliance upon, others in decision-making. Social and contextual “constraints on decision-making” also impacted on the ability of people with dementia to maintain involvement. These themes inform our proposal for a “spectrum approach” to decision-making involvement among people living with dementia, along with recommendations for policy and practice to assist in the implementation of supported decision-making within this population. (shrink)

Supported decision-making has been promoted at a policy level and within international human rights treaties as a way of ensuring that people with disabilities enjoy the right to legal capacity on an equal basis with others. However, little is known about the practical issues associated with implementing supported decision-making, particularly in the context of dementia. This study aimed to understand the experiences of people with dementia and their family members with respect to decision-making and their views on supported decision-making. Thirty-six (...) interviews were undertaken with fifty-seven participants across three states in Australia. Interpretative Phenomenological Analysis was used as the methodological approach, with relational autonomy as a theoretical perspective. We identified two overarching themes relating to participants’ experiences with decision-making: “the person in relationship over time” and “maintaining involvement.” Participant views on the practical issues associated with supported decision-making are addressed under the themes of “facilitating decision-making,” “supported decision-making arrangements,” “constraints on decision-making,” and “safeguarding decision-making.” While participants endorsed the principles of supported decision-making as part of their overarching strategy of “maintaining involvement” in decision-making, they recognized that progressive cognitive impairment meant that there was an inevitable transition toward greater involvement of, and reliance upon, others in decision-making. Social and contextual “constraints on decision-making” also impacted on the ability of people with dementia to maintain involvement. These themes inform our proposal for a “spectrum approach” to decision-making involvement among people living with dementia, along with recommendations for policy and practice to assist in the implementation of supported decision-making within this population. (shrink)

The humanitarian sector continually faces organizational and operational challenges to respond to the needs of populations affected by war, disaster, displacement, and health emergencies. With the goal of improving the effectiveness and efficiency of response efforts, humanitarian innovation initiatives seek to develop, test, and scale a variety of novel and adapted practices, products, and systems. The innovation process raises important ethical considerations, such as appropriately engaging crisis-affected populations in defining problems and identifying potential solutions, mitigating risks, ensuring accountability, sharing benefits (...) fairly, and managing expectations. This paper aims to contribute to knowledge and practice regarding humanitarian innovation ethics and presents two components related to a value-sensitive approach to humanitarian innovation. First is a mapping of how ethical concepts are mobilized in values statements that have been produced by a diverse set of organizations involved in humanitarian innovation. Analyzing these documents, we identified six primary values (do-no-harm, autonomy, justice, accountability, sustainability, and inclusivity) around which we grouped 12 secondary values and 10 associated concepts. Second are two proposed activities that teams engaged in humanitarian innovation can employ to foreground values as they develop and refine their project’s design, and to anticipate and plan for challenges in enacting these values across the phases of their project. A deliberate and tangible approach to engaging with values within humanitarian innovation design can help to ground humanitarian innovation in ethical commitments by increasing shared understanding amongst team members, promoting attentiveness to values across the stages of innovation, and fostering capacities to anticipate and respond to ethically challenging situations. (shrink)

Most of us find the surgeon's surprise at this patient' request understandable, and it is hard to imagine any surgeon acceding to this patient's demand. On the other hand, the patient is right—the surgeon is denying his technical skill because his values are different from those of the patient, whose values the surgeon does not respect. The autonomy of the patient is being limited by the values of the doctor whose own interests, other than his interest in practicing medicine according (...) to his own ethical values, would remain unaffected by his decision to provide the service. (shrink)

A series of papers in Philosophy, Ethics and Humanities in Medicine (PEHM) have recently disputed whether non-heart beating organ donors are alive and whether non-heart beating organ donation (NHBD) contravenes the dead donor rule. Several authors who argue that NHBD involves harvesting organs from live patients appeal to.

This article explores the seemingly exaggerated emphasis of Lyotard on the importance of hearing the ethical commandment in Levinas, instead of seeing or perceiving it in sensibility. Lyotard wants to read Levinas as a “Jewish thinker,” and his ethics as deeply connected to “Hebraic ethics.” Such a reading contrasts with phenomenological and Christian interpretations of Levinas, like Jean-Luc Marion’s, that focus on incarnation, the face, love, and the concrete relation to the other. Yet Lyotard outbids the rigor of commandment in (...) Levinas, insisting on the radical heterogeneity of hearing and any phenomenological seeing. Ethics is completely outside phenomenology. This article argues that, instead of reading Lyotard as misreading Levinas, his approach can be one of the names for the skeptical phase that suspends or interrupts the Levinasian Said itself, especially when it tends to become excessively Christian. (shrink)

clusions are only probably correct. On the other hand, algorithmic information theory provides a precise mathematical definition of the notion of random or patternless sequence. In this paper we shall describe conditions under which if the sequence of coin tosses in the Solovay– Strassen and Miller–Rabin algorithms is replaced by a sequence of heads and tails that is of maximal algorithmic information content, i.e., has maximal algorithmic randomness, then one obtains an error-free test for primality. These results are only of (...) theoretical interest, since it is a manifestation of the G¨ odel incompleteness phenomenon that it is impossible to “certify” a sequence to be random by means of a proof, even though most sequences have this property. Thus by using certified random sequences one can in principle, but not in practice, convert probabilistic tests for primality into deterministic ones. (shrink)

Bioethics, Volume 36, Issue 4, Page 434-444, May 2022.

Asymptomatic COVID‐19 testing programmes are being introduced in higher education institutions, but stakeholder views regarding the acceptability of mandating or incentivizing participation remain little understood. A mixed‐method study (semi‐structured interviews and a survey including open and closed questions) was undertaken in a case study university with a student testing programme. Survey data were analysed descriptively; analysis for interviews was based on the framework method. Two hundred and thirty‐nine people participated in the study: 213 in the survey (189 students, 24 staff), (...) and 26 in interviews (19 students, 7 staff). There was majority (62%) but not universal support for voluntary participation, with a range of concerns expressed about the potentially negative effects of mandating testing. Those who supported mandatory testing tended to do so on the grounds that it would protect others. There was also majority (64%) opposition to penalties for refusing to test. Views on restricting access to face‐to‐face teaching for non‐participants were polarized. Three‐quarters (75%) supported incentives, though there were some concerns about effectiveness and unintended consequences. Participants emphasized the importance of communication about the potential benefits of testing. Preserving the voluntariness of participation in student asymptomatic testing programmes is likely to be the most ethically sound policy unless circumstances change. (shrink)

We propose a way in which Barsalou could strengthen his position and at the same time make a considerable dent in the category/abstraction problem (that he suggests remains unsolved). There exists a class of connectionist models that solves this problem parsimoniously and provides a mechanistic underpinning for the promising high-level architecture he proposes.

Smith et al. demonstrate the viability of animal metacognition research. We commend their effort and suggest three avenues of research. The first concerns whether animals are explicitly aware of their metacognitive processes. The second asks whether animals have metaknowledge of their own uncertain responses. The third issue concerns the monitoring/control distinction. We suggest some ways in which these issues elucidate metacognitive processes in nonhuman animals.

In face of the multiple controversies surrounding the DSM process in general and the development of DSM-5 in particular, we have organized a discussion around what we consider six essential questions in further work on the DSM. The six questions involve: 1) the nature of a mental disorder; 2) the definition of mental disorder; 3) the issue of whether, in the current state of psychiatric science, DSM-5 should assume a cautious, conservative posture or an assertive, transformative posture; 4) the role (...) of pragmatic considerations in the construction of DSM-5; 5) the issue of utility of the DSM – whether DSM-III and IV have been designed more for clinicians or researchers, and how this conflict should be dealt with in the new manual; and 6) the possibility and advisability, given all the problems with DSM-III and IV, of designing a different diagnostic system. Part 1 of this article took up the first two questions. Part 2 took up the second two questions. Part 3 now deals with Questions 5 & 6. Question 5 confronts the issue of utility, whether the manual design of DSM-III and IV favors clinicians or researchers, and what that means for DSM-5. Our final question, Question 6, takes up a concluding issue, whether the acknowledged problems with the earlier DSMs warrants a significant overhaul of DSM-5 and future manuals. As in Parts 1 & 2 of this article, the general introduction, as well as the introductions and conclusions for the specific questions, are written by James Phillips, and the responses to commentaries are written by Allen Frances. (shrink)

Nineteenth-century optical toys that showcase illusions of motion such as the phenakistoscope, zoetrope, and praxinoscope, have enjoyed active “afterlives” in the twentieth and twenty-first centuries. Contemporary incarnations of the zoetrope are frequently found in the realms of fine art and advertising, and they are often much larger than their nineteenth-century counterparts. This article argues that modern-day optical toys are able to conjure feelings of wonder and spectacle equivalent to their nineteenth-century antecedents because of their adjustment in scale. Exploring a range (...) of contemporary philosophical toys found in arts, entertainment, and advertising contexts, the article discusses various technical adjustments made to successfully “scale up” optical toys, including the replacement of hand-spun mechanisms with larger sources of motion and the use of various means such as architectural features and stroboscopic lights to replace traditional shutter mechanisms such as the zoetrope’s dark slots. Critical consideration of scale as a central feature of these installations reconfigures the relationship between audience and device. Large-scale adaptations of optical toys revise the traditional conception of the user, who is able to tactilely manipulate and interact with the apparatus, instead positing a viewer who has less control over the illusion’s operation and is instead a captive audience surrounded by the animation. It is primarily through their adaptation of scale that contemporary zoetropes successfully elicit wonder as scientific spectacles from their audiences today. (shrink)

Kant's Critique of Judgement analyses our experience of the beautiful and the sublime in relation to nature, morality, and theology. Meredith's classic translation is here lightly revised and supplemented with a bilingual glossary. The edition also includes the important First Introduction.

This book addresses how Plato, Kant, and Iris Murdoch view the connection aesthetic experience has to morality. While offering an examination of Iris Murdoch’s philosophy, it analyses deeply the suggestive links between Plato’s and Kant’s philosophies. Meredith Trexler Drees considers not only Iris Murdoch’s concept of unselfing, but also its relationship with Kant’s view of Achtung and Plato’s view of Eros. In addition, Trexler Drees suggests an extended, and partially amended, version of Murdoch’s view, arguing that it is more (...) compatible with a religious way of life than Murdoch herself realized. This leads to an expansion of the overall argument to include Kant’s affirmation of religion as an area of life that can be improved through Plato’s and Murdoch’s vision of how being good and being beautiful can be part of the same life-task. (shrink)

A classic problem in cognitive science concerns how listeners perceive and understand speech as comprised of discrete words. We propose a Syllable Inference account of spoken word recognition and segmentation, under which alternative hierarchical models of syllables, words, and phonemes are dynamically posited from cues that include current and past speech rate, with a goal of maximal prediction of sensory input. Three experiments using the Visual World eye‐tracking paradigm provide evidence supporting our proposal.

Humour is a prevalent feature in any form of human interaction, regardless of language modality. This article explores in detail how humour is negotiated in conversations among deafblind Australians who are fluent users of tactile Australian Sign Language. Without access to the visual or auditory cues that are normally associated with humour, there is a risk that deafblind interactants will misconstrue humorous utterances as serious, or be unsure whether their conversation partner has got the joke. In this article, we explore (...) how humorous utterances unfold in tactile signed interactions. Drawing on Conversation Analytic principles, we outline the ad hoc and more conventionalised signals deafblind signers use to signal amusement. Looking at humour in these conversations contributes to a greater understanding of how humour is conveyed across language modalities and further support for humour’s centrality to interactional solidarity. (shrink)

This essay explores the phenomenon of common sense through a contextual analysis of Hannah Arendt’s political application of Kant’s Critique of Judgment. I begin by tracing the development of Arendt’s thinking on judgment and common sense during the 1950s which led her to turn to the third Critique. I then consider the justification of her move by examining the philosophical context and political applications of the third Critique, arguing that within it Kant made an original and profound discovery: that the (...) phenomenon of common sense contains a hidden faculty that may anchor moral and political judgments. I conclude by arguing that Arendt was on firmer ground than is often thought in adapting Kantian common sense to politics, a fact that may afford new possibilities for the practice of moral and political thought. (shrink)

_Wittgenstein, Mind and Meaning_ offers a provocative re-reading of Wittgenstein's later writings on language and mind, and explores the tensions between Wittgenstein's ideas and contemporary cognitivist conceptions of the mental. This book addresses both Wittgenstein's later works as well as contemporary issues in philosophy of mind. It provides fresh insight into the later Wittgenstein and raises vital questions about the foundations of cognitivism and its wider implications for psychology and cognitive science.

Similarly to other accounts of disease, Christopher Boorse’s Biostatistical Theory (BST) is generally presented and considered as conceptual analysis, that is, as making claims about the meaning of currently used concepts. But conceptual analysis has been convincingly critiqued as relying on problematic assumptions about the existence, meaning, and use of concepts. Because of these problems, accounts of disease and health should be evaluated not as claims about current meaning, I argue, but instead as proposals about how to define and use (...) these terms in the future, a methodology suggested by Quine and Carnap. I begin this article by describing problems with conceptual analysis and advantages of “philosophical explication,” my favored approach. I then describe two attacks on the BST that also question the entire project of defining “disease.” Finally, I defend the BST as a philosophical explication by showing how it could define useful terms for medical science and ethics. (shrink)

In this article I set out an argument that skins and screens, once distinctly different types of surface, are merging. I show how in contemporary highly mediatized worlds skins are required to be visually expressive while also noting a parallel movement whereby screens are becoming more affective. Using the ‘designer vagina’ – specifically labiaplasty – as a case study I show how ideal bodies exist simultaneously as screen and as skin, as image and as affect. In turn, I argue that (...) two-dimensional images and three-dimensional ‘real life’ bodies are blending in ways that parallel skin–screen mergers. (shrink)