Background In the ethical and clinical literature, cases of parents who want treatment for their child to be withdrawn against the views of the medical team have not received much attention. Yet resolution of such conflicts demands much effort of both the medical team and parents. Objective To discuss who can best protect a child9s interests, which often becomes a central issue, putting considerable pressure on mutual trust and partnership. Methods We describe the case of a 3-year-old boy with acquired (...) brain damage due to autoimmune-mediated encephalitis whose parents wanted to stop treatment. By comparing this case with relevant literature, we systematically explored the pros and cons of sharing end-of-life decisions with parents in cases where treatment is considered futile by parents and not (yet) by physicians. Conclusions Sharing end-of-life decisions with parents is a more important duty for physicians than protecting parents from guilt or doubt. Moreover, a request from parents on behalf of their child to discontinue treatment is, and should be, hard to over-rule in cases with significant prognostic uncertainty and/or in cases with divergent opinions within the medical team. (shrink)

Despite the widespread popularity of the Creating Shared Value discourse, its ‘business case’ and ‘win–win’ rhetoric remain problematic. This paper adds an inclusive development perspective to the debate, arguing that analysing CSV strategies through an inclusivity lens contributes to a better operationalisation of societal value; makes tensions and contradictions between economic and societal value explicit and uncovers processes of inclusion, exclusion and adverse inclusion. We illustrate this by analysing Nestlé’s CSV strategy in its cocoa supply chains in Ghana based on (...) content analysis of company documents, interviews with value chain actors and stakeholders, and focus groups with farmers. We ask how Nestlé frames and implements its CSV discourse in practice and how this relates to the social, relational and environmental dimensions of inclusive development. Findings show how the company addresses inclusive development dimensions in its corporate discourse, practices and business operations, and what trade-offs it faces. We then unmask the inherent tension between business objectives and societal interests and explain why the scope, issues addressed and societal impacts of CSV remain constrained. We conclude that CSV can help reduce a company’s impact on some persistent societal issues, but that its contribution to transformational change remains limited because the need to uphold competitive advantages and short-term financial performance narrows its ability to address all inclusivity dimensions. Legislation mandating responsible business conduct and due diligence can reduce this inherent tension by levelling the playing field between companies addressing inclusivity issues vis-à-vis those who do not. (shrink)

Patient-reported outcomes are frequently used for medical decision making, at the levels of both individual patient care and healthcare policy. Evidence increasingly shows that PROs may be influenced by patients’ response shifts and dispositions. We identify how response shifts and dispositions may influence medical decisions on both the levels of individual patient care and health policy. We provide examples of these influences and analyse the consequences from the perspectives of ethical principles and theories of just distribution. If influences of response (...) shift and disposition on PROs and consequently medical decision making are not considered, patients may not receive optimal treatment and health insurance packages may include treatments that are not the most effective or cost-effective. We call on healthcare practitioners, researchers, policy makers, health insurers, and other stakeholders to critically reflect on why and how such patient reports are used. (shrink)

Until recently, moral case deliberation (MCD) sessions have mostly been facilitated by external experts, mainly professional ethicists. We have developed a train the facilitator programme for healthcare professionals aimed at providing them with the competences needed for being an MCD facilitator. In this paper, we present the first results of a study in which we evaluated the programme. We used a mixed methods design. One hundred and twenty trained healthcare professionals and five trainers from 16 training groups working in different (...) healthcare organisations throughout the Netherlands were included. After completion of the programme, participants feel sufficiently confident and equipped to facilitate an MCD session. Feeling competent does not mean that participants have no doubts or questions left. Rather, they are aware of their limitations and see the need for continuous learning. According to the respondents, the actual exercise of facilitating MCD during and in between the training sessions contributed most to the development of competences necessary for being an MCD facilitator. Respondents without prior experience of participating in MCD sessions felt less competent after the training than those who had participated in MCD sessions before. Self-attributed competence varied between participants with different professional backgrounds. (shrink)

Boorse’s biostatistical theory states that diseases should be defined in ways that reflect disturbances of biological function and that are objective and value free. We use three examples from contemporary medicine that demonstrate the complex issues that arise when defining the boundaries of disease: polycystic ovary syndrome, chronic kidney disease, and myocardial infarction. We argue that the biostatistical theory fails to provide sufficient guidance on where the boundaries of disease should be drawn, contains ambiguities relating to choice of reference class, (...) and is out of step with medical processes for identifying disease boundaries. Although proponents of the biostatistical theory might regard these practical issues as irrelevant to the aim of providing a theoretical account of disease, we take them to indicate the need for a theoretical account that is adequate for current needs—including limiting new forms of medicalization that are driven by the identification of disease based on dysfunction. Our processes for determining the boundaries for disease need to recognize that there is no value-free method for making these decisions. (shrink)

The early literature on base of the pyramid strategies argued that multinational enterprises can contribute significantly to poverty alleviation of the poorest population in the world. An emergent perspective suggests that the solution to poverty lies within the BOP itself. Here, entrepreneurship within the BOP population is seen as the more credible solution to poverty. In this Special Issue introduction, we briefly present how the literature has further shifted the discussion of BOP strategies toward issues such as innovation, networks, business (...) models, and sustainability at the BOP. This analysis signals a gap in our knowledge related to the success factors in business models of BOP entrepreneurs, with attention to economic, social, and environmental impacts. We present the five articles accepted for publication in this Special Issue, of which three contribute to our knowledge of BOP business models and two to our knowledge of sustainability at the BOP. In conclusion, we propose several avenues for future research. (shrink)

Public education is not just a way to organise and fund education. It is also the expression of a particular ideal about education and of a particular way to conceive of the relationship between education and society. The ideal of public education sees education as an important dimension of the common good and as an important institution in securing the common good. The common good is never what individuals or particular groups want or desire, but always reaches beyond such particular (...) desires towards that which societies as a whole should consider as desirable. This does, of course, put the common good in tension with the desires of individuals and groups. Neo-liberal modes of governance have, over the past decades, put this particular educational set up under pressure and have, according to some, eroded the very idea of the common good. This set of contributions reflects on this state of affairs, partly through an exploration of the idea of publicness itself – how it can be rearticulated and regained – and partly through reflections on the current state of education in the ‘north’ and the ‘south.’. (shrink)

The aim of this study is to provide a discussion on the definitions and conceptual dimensions of Responsible Research and Innovation based on findings from the literature. In the study, the outcomes of a literature review of 235 RRI-related articles were presented. The articles were selected from the EBSCO and Google Scholar databases regarding the definitions and dimensions of RRI. The results of the study indicated that while administrative definitions were widely quoted in the reviewed literature, they were not substantially (...) further elaborated. Academic definitions were mostly derived from the institutional definitions; however, more empirical studies should be conducted in order to give a broader empirical basis to the development of the concept. In the current study, four distinct conceptual dimensions of RRI that appeared in the reviewed literature were brought out: inclusion, anticipation, responsiveness and reflexivity. Two emerging conceptual dimensions were also added: sustainability and care. (shrink)

Graphical AbstractSocial learning and culture occur in a wide variety of animal species and across many different types of community structures. In article number 1900060, Jenny A. Allen present an overview of social learning in species across a spectrum of community structures, providing the necessary infrastructure to allow a comparison of studies that will help move the field of animal culture forward. Art designer: Emma Hilton.

It has become increasingly clear that social learning and culture occur much more broadly, and in a wider variety of animal communities, than initially believed. Recent research has expanded the list to include insects, fishes, elephants, and cetaceans. Such diversity allows scientists to expand the scope of potential research questions, which can help form a more complete understanding of animal culture than any single species can provide on its own. It is crucial to understand how culture and social learning present (...) in different communities, as well as what influences community structure and culture may have on one another, so that the results across these different studies may most effectively inform one another. This review presents an overview of social learning in species across a spectrum of community structures, providing the necessary infrastructure to allow a comparison of studies that will help move the field of animal culture forward. (shrink)

In mental health ethics, it is generally assumed that coercive measures are sometimes justified when persons with mental illness endanger themselves or others. Coercive measures are regarded as ethically justified only when certain criteria are fulfilled: for example, the intervention must be proportional in relation to the potential harm. In this paper, we demonstrate shortcomings of this established ethical framework in cases where people with mental illness experience structural racism. By drawing on a case example from mental healthcare, we first (...) demonstrate that biases in assessing whether the coercive intervention is proportional are likely, for example, due to an overestimation of dangerousness. We then show that even if proportionality is assessed correctly, and the specific coercive intervention would thus be regarded as ethically justified according to the standard framework, coercion may still be ethically problematic. This is because the standard framework does not consider how situations in which coercive measures are applied arise. If structural racism causally contributes to such situations, the use of coercion can compound the prior injustice of racist discrimination. We conclude that the ethical analysis of coercion in mental healthcare should consider the possibility of discriminatory biases and practices and systematically take the influence of structural discrimination into account. (shrink)

This article argues for an emendation in Aristotle's Metaphysics A 10, 993a13–15. The emendation is based on a hitherto overlooked reading preserved in Alexander of Aphrodisias’ commentary on A 7. First, the article problematizes the reading of the Metaphysics manuscripts in terms of syntax, diction and content. Second, it shows that Alexander's reading is free of all three problems. Third, it argues for the originality of Alexander's reading according to the principle utrum in alterum abiturum erat? and based on the (...) fact that the new reading reveals a subtle didactic link between A 7 and A 10 that sheds new light on the argumentative architecture of Metaphysics Book A. (shrink)

The desire to self-improve is probably as old as humanity: most of us want to be smarter, more athletic, more beautiful, or more talented. However, in the light of an ever increasing array of possibilities to enhance our capacities, clarity about the purpose and goal of such efforts becomes crucial. This is especially true when decisions are made for children, who are exposed to their parents’ plans and desires for them under a notion of increasing wellbeing. In recent years, cognitive (...) enhancement has become a popular candidate for the promotion of wellbeing; welfarists even impose a moral duty on parents to cognitively enhance their children for the sake of their wellbeing. In this article, I aim to show that welfarists are mistaken in inferring such a moral obligation from the potential benefit of cognitive enhancement. In support of this, I offer three arguments: the vagueness of wellbeing as a theoretical concept means it becomes impossible to apply in practice; the link between cognition and wellbeing is far from unequivocal; and quantification issues with regard to cognition make a duty impossible to discharge. In conclusion, I reject the welfarist approach as a justification for a parental moral obligation to cognitively enhance children. (shrink)

Definition of the problemFeminist approaches to medical ethics are well established in international discourses. By contrast, in the German-speaking medical ethical discourse, they still seem to be rather marginal. In this article, we analyze which feminist perspectives are prominent in German medical ethics and suggest new approaches.ArgumentsWe present our results from a systematized review of the literature, in which we identify existing feminist approaches within the German-speaking medical ethics discourse as well as research gaps. Based on the review, our preliminary (...) research and discussions in the working group “Feminist perspectives in bio and medical ethics”, we defend three hypotheses aimed at advancing the German feminist medical ethical discourse. We posit that (1) feminist medical ethics aim at (epistemic) justice, (2) feminist medical ethics are critical and context-sensitive, and (3) intersectional and postcolonial approaches within feminist medical ethics may contribute to epistemically just, critical, and context-sensitive medical ethics.ConclusionWe argue that feminist perspectives should be implemented as a fundamental perspective in medical ethics because they can bring together key dimensions such as epistemically just, critical, context-sensitive, intersectional, and postcolonial thinking. (shrink)

Our daily experience, dominated by the corporate clock that so many of us contort ourselves to fit inside, is destroying us. It wasn't built for people, it was built for profit. This is a book that tears open the seams of reality as we know it-the way we experience time itself-and rearranges it, reimagining a world not centered around work, the office clock, or the profit motive. Explaining how we got to the point where time became money, Odell offers us (...) new models to live by--inspired by pre-industrial cultures, ecological, and geological time--that make a more humane, more hopeful way of living seem possible. In this dazzling, subversive, and deeply hopeful reframing of time, Jenny Odell takes us on a journey through other temporal habitats. As planet-bound animals, we live inside shortening and lengthening days, alongside gardens growing, birds migrating, and cliffs eroding. The stretchy quality of waiting and desire, the way the present may suddenly feel marbled with childhood memory, the slow but sure procession of a pregnancy, or the time it takes to heal from injuries--physical or emotional. Odell urges us to become stewards of these different rhythms of life, to imagine a life, identity, and source of meaning outside of the world of work and profit, and to understand that the trajectory of our lives--or the life of the planet--is not a foregone conclusion. In that sense, "saving" time-recovering its fundamentally irreducible and inventive nature-could also mean that time saves us. (shrink)

Bilateral investment treaties constitute an important instrument to facilitate global investment. Recent discussions in political theory have highlighted several normative concerns raised by bilateral investment treaties. One worry is that investment treaties undermine national self‐determination as they grant investors far‐reaching protections that can be legally enforced. Another worry is that the benefits and burdens entailed in bilateral investment treaties are distributed unfairly in a way that benefits investors at the expense of states and disadvantaged groups within states. Instead of critiquing (...) bilateral investment treaties from a perspective of global (distributive) justice, in this article I develop a class‐based critique. This involves a twofold departure. First, the article shifts the focus from distributions to the power relations that are built into the global capitalist economy and that come into sharp relief in the practice of global investment. Second, rather than focusing on the relation between states and investors, I claim that in a class‐based critique the relation between workers and investors should take centre stage. I argue that bilateral investment treaties are effectively an instrument of class domination, insofar as they reproduce and increase the power of transnational corporations while at the same time decreasing the power of workers. (shrink)

Although scars never disappear completely, in time most people will basically get used to them. In this paper I explore what it means to habituate to scars against the background of the phenomenological concept of incorporation. In phenomenology the body as Leib or corps vécu functions as a transcendental condition for world disclosure. Because of this transcendental reasoning, phenomenology prioritizes a form of embodied subjectivity that is virtually dis-embodied. Endowing meaning to one’s world through getting engaged in actions and projects (...) is most successful indeed when one’s body is “absent,” “transparent,” or, at least, if it is not in the center of one’s attention. This taken-for-granted nature can be disturbed by discomfort, disability, and disfigurement. Incorporation, so I explain, aims at maintaining or restoring the body’s taken-for-grantedness. My analysis of the case of a woman who successfully habituated to her mastectomy scar demonstrates, however, that habituation to a perceptible scar can only be understood partly in terms of incorporation. Next to a decrease of explicit attention for the scar and the discomfort it produces, the scar should also stop being a sign that refers to something else than itself. This is only possible, I argue, by taking the body’s materiality seriously, rather than it being wiped out as a result of transcendental reasoning. (shrink)

Alexander of Aphrodisias's commentary (about AD 200) is the earliest extant commentary on Aristotle's Metaphysics, and it is the most valuable indirect witness to the Metaphysics text and its transmission. Mirjam Kotwick's study is a systematic investigation into the version of the Metaphysics that Alexander used when writing his commentary, and into the various ways his text, his commentary, and the texts transmitted through our manuscripts relate to one another. Through a careful analysis of lemmata, quotations, and Alexander's discussion (...) of Aristotle's argument Kotwick shows how to uncover and partly reconstruct a Metaphysics version from the second century AD. Kotwick then uses this version for improving the text that came down to us by the direct manuscript tradition and for finding solutions to some of the puzzles in this tradition. Through a side-by-side examination of Alexander's text, his interpretation of Aristotle's thought, and the directly transmitted versions of the Metaphysics, Kotwick reveals how Alexander's commentary may have influenced the text of our manuscripts at different stages of the transmission process. This study is the first book-length examination of a commentary as a witness to an ancient philosophical text. This blend of textual criticism and philosophical analysis both expands on existing methodologies in classical scholarship and develops new ones. (shrink)

Emerging from the internationally recognised Theorising Normalcy and the Mundane conference series, the chapters in this book offer wide-ranging critiques of that most pervasive of ideas, 'normal'. In particular, they explore the precarious positions we are presented with and, more often than not, forced into by 'normal', and its operating system, 'normalcy' (Davis, 2010). They are written by activists, students, practitioners and academics and offer related but diverse approaches. Importantly, however, the chapters also ask, what if increasingly precarious encounters with, (...) and positions of, marginality and non-normativity offers us a chance (perhaps the chance) to critically explore the possibilities of 'imagining otherwise'? The book questions the privileged position of 'non-normativity'; in youth and unpacks the expectation of the 'normal' student in both higher and primary education. It uses the position of transable people to push the boundaries of 'disability', interrogates the psycho-emotional disablism of box-ticking bureaucracy and spotlights the 'urge to know' impairment. It draws on cross-movement and cross-disciplinary work around disability to explore topics as diverse as drug use, The Bible and relational autonomy. Finally, and perhaps most controversially, it explores the benefits of (re)instating 'normal'. By paying attention to the opportunities presented amongst the fissures of critique and defiance, this book offers new applications and perspectives for thinking through the most ordinary of ideas, 'normal'. (shrink)

Was passiert mit Universalsemantiken wie der Ästhetik oder der Ethik um 1900, als die deutsche Gesellschaft den Umbruch von einer stratifiktorischen hin zu einer funktionalen Differenzierungsform vollzieht? Die Studie diskutiert anhand von Ästhetiken damaliger Denkrichtungen die Denkfiguren, auf denen sich der Universalanspruch ästhetisch-moralischer Kommunikation aufbaut. Am Beispiel der Debatte um Schmutz und Schund zeigt sie, wie die meisten Diskutanten die >Rede über Kunst.

In this article, I apply the concept of solidarity to collective knowledge practices in healthcare. Generally, solidarity acknowledges that people are dependent on each other in many respects, and it captures those support practices that people engage in out of concern for others in whom they recognise a relevant similarity. Drawing on the rich literature on solidarity in bioethics and beyond, this article specifically discusses the role that epistemic solidarity can play in healthcare. It thus focuses, in particular, on solidarity’s (...) relationship with justice and injustice. In this regard, it is argued (1) that justice and solidarity are two equally important and complementary values that should both be considered in healthcare practices and institutions and (2) that solidarity often arises in unjust situations and can be a means to bring about justice. I transfer these ‘general’ insights about solidarity to knowledge practices in healthcare and link them to the discussion about epistemic injustices in healthcare and how to overcome them. I argue that epistemic solidarity can play an important role in overcoming epistemic injustices as well as—and independently from its contribution to justice—in knowledge production in medicine more generally. To demonstrate how epistemic solidarity can add to our understanding of collective knowledge practices, I discuss two examples: patients sharing their medical data for research purposes and healthcare professionals’ engagement with patients to better understand their afflictions. (shrink)

The coronavirus pandemic has stirred interest in viruses. This has been accompanied by a proliferation of popular works trying to explain how viruses fit into the Christian worldview. In an anthropocentric perspective, viruses are easily regarded as malicious entities. This article, however, shows that a proper understanding of the biology of viruses actually adds another level of complexity to our perception of good and evil. Interestingly, this additional layer of complexity might help us solve some of the most urgent difficulties (...) in the discussion about good and evil, if we recognize the subjective nature of what we call natural evil. We need to be more nuanced not merely in our theological discussion about good and evil, but also in the way we talk about viruses. (shrink)

Bioethics increasingly recognizes the impact of discriminatory practices based on social categories such as race, gender, sexual orientation or ability on clinical practice. Accordingly, major bioethics associations have stressed that identifying and countering structural discrimination in clinical ethics consultations is a professional obligation of clinical ethics consultants. Yet, it is still unclear how clinical ethics consultants can fulfill this obligation. More specifically, clinical ethics needs both theoretical tools to analyze and practical strategies to address structural discrimination within clinical ethics consultations. (...) Intersectionality, a concept developed in Black feminist scholarship, is increasingly considered in bioethical theory. It stresses how social structures and practices determine social positions of privilege and disadvantage in multiple, mutually co-constitutive systems of oppression. This article aims to investigate how intersectionality can contribute to addressing structural discrimination in clinical ethics consultations with a particular focus on mental healthcare. To this end, we critically review existing approaches for clinical ethics consultants to address structural racism in clinical ethics consultations and extend them by intersectional considerations. We argue that intersectionality is a suitable tool to address structural discrimination within clinical ethics consultations and show that it can be practically implemented in two complementary ways: 1) as an analytic approach and 2) as a critical practice. (shrink)

One famous debate in contemporary epistemology considers whether there is always one unique, epistemically rational way to respond to a given body of evidence. Generally speaking, answering “yes” to this question makes one a proponent of the Uniqueness thesis, while those who answer “no” are called “permissivists”. Another influential recent debate concerns whether non-truth-related factors can be the basis of epistemic justification, knowledge, or rational belief. Traditional theories answer “no”, and are therefore considered “purists”. However, more recently many theorists have (...) argued to the contrary, claiming that impurist factors, such as practical stakes, can sometimes encroach or even override truth-related considerations. This paper bridges the two debates by presenting and defending what I call “Impurist Permissivism”. I support Impurist Permissivism by showing how it can resist Roger White’s famous Argument from Arbitrariness (2005). (shrink)

In light of the summer 2020 protests and their subsequent backlash, questions about the prospective timeline for achieving a racially just society have taken on renewed significance. This article investigates Du Bois’s writings between 1920 and 1940 as a lens through which to examine the temporality of social change. I argue that Du Bois’s turn to the role of white unreason explains the dual temporality of his political vision and the dual strategies that ensue. According to Du Bois, white supremacy (...) is upheld not only by ignorance, but also by white unreason, reproduced through generations of institutional conditioning. Du Bois therefore turns to propaganda for transforming white unreason, thereby making a racially just society possible. But because the transformation of white unreason through propaganda is a slow process, Du Bois argues that Black Americans must ensure their survival through voluntary self-segregation. By presenting us with a framework of social change, Du Bois models how advocates of racial justice might navigate defeat without devolving into defeatism. (shrink)

Braun explores the use of digital twin technology in medicine with a particular emphasis on the question of how such simulations can represent a person.1 In defining some first conditions for ethically justifiable forms of representation of digital twins, he argues that digital twins do not threaten an embodied person, as long as that person retains control over their simulated representation via dynamic consent, and ideally with the option to choose both form and usage of the simulation. His thoughtful elaboration (...) provides insight into the challenges inherent in interactions between a person and their digital twin, emphasising the modes of control required to respect personal modes of freedom. This individual-centric approach to the question of representation leaves out the important ethical consideration of ensuring that all, not merely some, can be represented. Braun describes dynamic consent as a necessary mode of control, arguing that where a person is unable to give consent, ‘such simulations threaten to become illegitimate representations. They would then shift the kind of interaction from representation to illegitimate forms of prediction or surveillance and thereby could lead to infringements to individual modes of freedom.’ Consequently, the implementation of digital twin technology in healthcare would seem to exclude the most vulnerable members of society from participation in and benefiting from medical innovation, …. (shrink)

In this essay, I argue that to create a genomics that offers more gifts than weights, central attention must be paid to questions of justice. This will require expanding bioethical imaginations so that they grasp and can respond to questions of structural inequity. It will necessitate building novel coalitions and collaborations that turn the attention of bioethical governance away from narrow individual questions such as, “Do I consent?” and toward the broader collective question, is this just? What kind of lives (...) and collectivities are made possible? What rights and principles should govern them? The essay ends with one example of this novel coalition building arising from the Science and Justice Research Center at the University of California, Santa Cruz. It draws lessons from this effort to build new alliances that bridge the social sciences and natural sciences, arts and engineering, to create new kinds of training and thinking that create a genomics that more adequately responds to fundamental questions of justice. (shrink)

Nāgārjuna, the famous founder of the Madhyamika School, proposed the positive catuṣkoṭi in his seminal work, Mūlamadhyamakakārikā: ‘All is real, or all is unreal, all is both real and unreal, all is neither unreal nor real; this is the graded teaching of the Buddha’. He also proposed the negative catuṣkoṭi: ‘“It is empty” is not to be said, nor “It is non-empty,” nor that it is both, nor that it is neither; [“empty”] is said only for the sake of instruction’ (...) and the no-thesis view: ‘No dharma whatsoever was ever taught by the Buddha to anyone’. In this essay, I adopt Gricean pragmatics to explain the positive and negative catuṣkoṭi and the no-thesis view proposed by Nāgārjuna in a way that does not violate classical logic. For Nāgārjuna, all statements are false as long as the hearer understands them within a reified conceptual scheme, according to which substance is a basic categorical concept; substances have svabhāva, and names and sentences have svabhāva. (shrink)

Bioethics increasingly recognizes the impact of discriminatory practices based on social categories such as race, gender, sexual orientation or ability on clinical practice. Accordingly, major bioethics associations have stressed that identifying and countering structural discrimination in clinical ethics consultations is a professional obligation of clinical ethics consultants. Yet, it is still unclear how clinical ethics consultants can fulfill this obligation. More specifically, clinical ethics needs both theoretical tools to analyze and practical strategies to address structural discrimination within clinical ethics consultations. (...) Intersectionality, a concept developed in Black feminist scholarship, is increasingly considered in bioethical theory. It stresses how social structures and practices determine social positions of privilege and disadvantage in multiple, mutually co-constitutive systems of oppression. This article aims to investigate how intersectionality can contribute to addressing structural discrimination in clinical ethics consultations with a particular focus on mental healthcare. To this end, we critically review existing approaches for clinical ethics consultants to address structural racism in clinical ethics consultations and extend them by intersectional considerations. We argue that intersectionality is a suitable tool to address structural discrimination within clinical ethics consultations and show that it can be practically implemented in two complementary ways: 1) as an analytic approach and 2) as a critical practice. (shrink)

Given his known predilection for ontological parsimony, Ockham’s ontology of artifacts is unsurprisingly reductionist: artifacts are nothing over and above their existing and appropriately ordered parts. However, the case of artifacts is notable in that they are real objects that human artisans produce by bringing about a real change: they spatially rearrange existing natural thing(s) or their parts for the sake of some end. This article argues that the human contribution to the nature and production of artifacts is two-fold: (1) (...) the artisan’s cognitive grasp of her expertise and her decision to deploy that expertise are the two efficient causes necessary to explain the existence of an artifact, and (2) the purpose that the artisan had in mind when she decided to make an artifact fixes the function(s) of the artifact such that an artisan’s purpose is the final cause necessary to explain what an artifact is. Artifacts indeed exist, owing what they are and that they are to intelligent and volitional human activity, which Ockham never denies. The article submits that a myopic focus on Ockham’s indisputable reductionism does not exhaust what is metaphysically interesting and relevant about artifacts. (shrink)

"As a doctor, I make every effort to strengthen the belief in immortality, especially with older patients when such questions come threateningly close. For, seen in correct psychological perspective, death is not an end but a goal, and life's inclination towards death begins as soon as the meridian is past."--C.G. Jung, commentary on The Secret of the Golden FlowerHere collected for the first time are Jung's views on death and immortality, his writings often coinciding with the death of the most (...) significant people in his life. The book shows many of the major themes running throughout the writings, including the relativity of space and time surrounding death, the link between transference and death, and the archetypes shared among the world's religions at the depths of the Self. The book includes selections from "On Resurrection," "The Soul and Death," "Concerning Rebirth," "Psychological Commentary on The Tibetan Book of the Dead" from the Collected Works, "Letter to Pastor Pfafflin" from Letters, and "On Life after Death.". (shrink)