In lieu of an abstract, here is a brief excerpt of the content:Philosophy, Psychiatry, & Psychology 10.3 (2003) 225-226 [Access article in PDF] Travelers in the Land of Sickness Eric J. Cassell THE PROBLEM OF knowing another person and the world in which that person lives, particularly someone with major mental illness, is addressed in this interesting and rich essay. The number of different metaphors and concepts Potter employs to describe the task of crossing into and then understanding the thoughts, (...) emotions, symptoms, constraints, context, and perspectives of another testifies to the difficulties involved.Yet, as I read the essay, it was not clear what the clinician world traveler, moral tourist, empathizer (and other categories) is supposed to do on the journey to another person. Why do we reach out to the sick person? What is it that we want to know or do that makes this trip necessary? Potter is primarily concerned with mental illness—the examples she cites are patients with schizophrenia—while my experience has in the main been with persons with physical illness, but for the moment, the differences are less important than the central lesson. The illness that the patient presents—the experience of the symptoms, the impairments, disability, and disruptions of the emotional and social existence that happen because of the disease result from an amalgam of the disease process with the specific nature of the sick person. There is no disease in pure form; there is no disease in abstract for clinicians. There is only this sick person. She correctly quotes me, because of all this, as pointing out the importance of integrating knowledge of this particular patient with the abstract knowledge of disease to understand the illness as it is expressed in this person. All to form a basis for the treatment of the patient and especially to help relieve suffering because suffering is always personal, particular, and individual. (It is important in thinking about this topic to remember that most serious diseases, psychiatric and otherwise, are chronic and take place over significant lived time. The acute schizophrenic symptoms or the acute infectious diseases, as dramatic as they are, distract attention from the importance of the place of the sick person.)In physical disease, our long (and continuing) history of separating human beings from nature and the body, and the importance medicine places on objectivity and the objective, have made the inevitable personalization of the disease and symptoms virtually invisible. After ages of explaining psychiatric diseases as the alienation of the person, and a long psychoanalytic period of finding their origins in the person, in the last 30 years these diseases have become increasingly objectified. The place of the person has been diminished as psychiatry has entered the DSM, neurotransmitter, and effective psychotropic drug era. For both physical and mental disease, however, and whatever the current ideology, the nature of person is crucial in determining the onset, diagnosis, course, treatment, and outcome of each illness. It is in order to have an impact on these crucial aspects of sickness that clinicians must come to know their patients to the degree possible. [End Page 225]But there is something more. Nancy Potter quotes a woman with schizophrenia as saying, "All that was my former self has crumbled and fallen together and a creature has emerged of whom I know nothing. She is a stranger to me... She is not real—she is not I... She is I—and because I still have myself on my hands, even if I am a maniac, I must deal with me somehow." (Potter, 2003, p. 215)Must she deal with this crazy self alone? Is that not what her doctors and caregivers are for? But how can they take care of her, protect her, keep what is left intact, and sustain her until she is (hopefully) better without knowing who she is? She makes clear in those few phrases that inside her there is a person with a past, a family, a world, a culture, a role(s) in life, relationships, a body, dreams for the future, things she does, and all the other things that make up a person. It is in... (shrink)

IN THINKING ABOUT the wonderfully helpful comments by Eric Cassell, Suzanne Jaeger, and Deborah Spitz, I find myself grappling with three central questions: How reliable a guide is world traveling? What kind of knowledge can be obtained by world traveling? and, What are the goals of treatment such that world traveling might be thought to serve a purpose? These questions arise from the insights, criticisms, and cautions the commentators provide, and I will weave together possible answers from ideas drawn from (...) the commentaries. (shrink)

Nancy Gardner Prince began writing and self-publishing A Narrative of the Life and Travels of Mrs. Nancy Prince in the 1850s, at a time when few African American women had the ability to do so. Her story tells of diaspora and of the systematic economic, cultural, and political oppression of free African Americans in the antebellum North. Raised by a mother unable to cope with the economic and emotional burden of raising eight children on her own, Prince (...) spends much of her youth working as a domestic servant in white households. After a long, mostly unsuccessful struggle to maintain family unity, Prince makes the decision to improve her circumstances, marrying sailor Nero Prince after a brief courtship and .. (shrink)

It is often supposed that the spectacular successes of our modern mathematical sciences support a lofty vision of a world completely ordered by one single elegant theory. In this book Nancy Cartwright argues to the contrary. When we draw our image of the world from the way modern science works - as empiricism teaches us we should - we end up with a world where some features are precisely ordered, others are given to rough regularity and still others behave (...) in their own diverse ways. This patchwork makes sense when we realise that laws are very special productions of nature, requiring very special arrangements for their generation. Combining classic and newly written essays on physics and economics, The Dappled World carries important philosophical consequences and offers serious lessons for both the natural and the social sciences. (shrink)

Hunting Causes and Using Them argues that causation is not one thing, as commonly assumed, but many. There is a huge variety of causal relations, each with different characterizing features, different methods for discovery and different uses to which it can be put. In this collection of new and previously published essays, Nancy Cartwright provides a critical survey of philosophical and economic literature on causality, with a special focus on the currently fashionable Bayes-nets and invariance methods - and it (...) exposes a huge gap in that literature. Almost every account treats either exclusively how to hunt causes or how to use them. But where is the bridge between? It's no good knowing how to warrant a causal claim if we don't know what we can do with that claim once we have it. This book will interest philosophers, economists and social scientists. (shrink)

ABSTRACT: Social robots are increasingly being deployed to address social isolation and loneliness, particularly among older adults. Clips on social media attest that individuals availing themselves of this option are pleased with their robot companions. Yet, some people find the use of social robots to meet fundamental human emotional needs disturbing. This article clarifies and critically evaluates this response. It sets forth a framework for loneliness, which characterizes one kind of loneliness as involving an affective experience of lacking human relations (...) that provide certain social goods. Next, the article discusses social robots and critically reviews the literature on the ethics of using them in light of this loneliness characterization. Third, we present a normative argument connecting the philosophical critique of loneliness-as-absence with the design and deployment of social robots. Finally, we draw out the implications of our analysis for public health and for interrogating the aims of commercial companies who make social robots. (shrink)

An international team of four authors, led by distinguished philosopher of science, Nancy Cartwright, and leading scholar of the Vienna Circle, Thomas E. Uebel, have produced this lucid and elegant study of a much-neglected figure. The book, which depicts Neurath's science in the political, economic and intellectual milieu in which it was practised, is divided into three sections: Neurath's biographical background and the socio-political context of his economic ideas; the development of his theory of science; and his legacy as (...) illustrated by his contemporaneous involvement in academic and political debates. Coinciding with the renewal of interest in logical positivism, this is a timely publication which will redress a current imbalance in the history and philosophy of science, as well as making a major contribution to our understanding of the intellectual life of Austro-Germany in the inter-war years. (shrink)

Why mediation? -- What makes bioethics mediation unique? -- Before you begin a bioethics mediation program -- The stages of bioethics mediation -- Techniques for mediating bioethics disputes -- How to write a bioethics mediation chart note -- Mediation with a competent patient : Mr. Samuels's case -- Mediation with a dysfunctional family : Mrs. Bates's case -- A complex mediation with a large and involved family : Mrs. Leonari's case -- Discharge planning for a dying patient : a role-play (...) -- An at-risk pregnancy : a role-play -- HIV and postsurgical complications in the ICU : a role-play -- Treating the dying adolescent : a role-play -- She didn't mean it : a role-play -- Don't tell mama : a role-play -- An at-risk pregnancy : a role-play transcript -- HIV and postsurgical complications in the ICU : a role-play transcript -- She didn't mean it: a role-play transcript -- Don't tell mama : a role-play transcript. (shrink)

This essay looks closely at metaphors and other figures of speech that often feature in how Americans talk about dementia, becoming part of cultural narratives: shared stories that convey ideas and values, and also worries and fears. It uses approaches from literary studies to analyze how cultural narratives about dementia may surface in conversations with family members or health care professionals. This essay also draws on research on a notable social effect of legalizing medical aid in dying: patients may find (...) it easier to bring up a range of concerns, regardless of whether they have any interest in hastening their own death. The essay proposes that health care professionals rethink an idea prominent within their own culture: that conversations about the end of a person's life are inherently difficult. This framing may make it hard for people facing dementia to bring up their concerns about what lies ahead. We suggest a different way to think about these conversations, using the metaphor of “opening the door” to represent inviting a patient to bring up issues of deepest concern. (shrink)

In this paper I want to analyse the meaning of education for democracy and thinking as this is generally understood by Philosophy for Children. Although we may be inclined to applaud Philosophy for Children's emphasis on children, critical thinking, autonomy and dialogue, there is reason for scepticism too. Since we are expected as a matter of course to subscribe to the basic assumptions of Philosophy for Children, we seem to become tied, as it were, to the whole package, without reservation. (...) Following ideas of Hannah Arendt, I draw attention to the instrumentalised nature of Philosophy for Children and the loss of originality that this instrumentalisation means. This does not mean that I wish to abandon Philosophy for Children. The point is rather that I want to examine whether or not another kind of philosophy for children is possible. (shrink)

We lay groundwork for applying ethnographic methods in philosophy of science. We frame our analysis in terms of two tasks: to identify the benefits of an ethnographic approach in philosophy of science and to structure an ethnographic approach for philosophical investigation best adapted to provide information relevant to philosophical interests and epistemic values. To this end, we advocate for a purpose-guided form of cognitive ethnography that mediates between the explanatory and normative interests of philosophy of science, while maintaining openness and (...) independence when framing such an investigation to achieve robust unbiased results. (shrink)

This article sets forth a solidaristic approach to global distribution of vaccines against the SARS‐CoV‐2 virus. Our approach draws inspiration from African ethics and from the characterization of the Covid‐19 crisis as a syndemic, a convergence of biosocial forces that interact with one another to produce and exacerbate clinical disease and prognosis. The first section elaborates the twin ideas of syndemic and solidarity. The second section argues that these ideas lend support to global health alliances to distribute vaccines beyond national (...) borders. The third section introduces ethical criteria to guide global distribution, emphasizing priority to low‐ and middle‐income countries, which have the least ability to obtain vaccines on their own. It also justifies giving priority to people at high risk of infection and high risk of severe disease and death. (shrink)

Clinical ethics consultation has become an important resource, but unlike other health care disciplines, it has no accreditation or accepted curriculum for training programs, no standards for practice, and no way to measure effectiveness. The Clinical Ethics Credentialing Project was launched to pilot‐test approaches to train, credential, privilege, and evaluate consultants.

Cognition in work teams has been predominantly understood and explained in terms of shared cognition with a focus on the similarity of static knowledge structures across individual team members. Inspired by the current zeitgeist in cognitive science, as well as by empirical data and pragmatic concerns, we offer an alternative theory of team cognition. Interactive Team Cognition (ITC) theory posits that (1) team cognition is an activity, not a property or a product; (2) team cognition should be measured and studied (...) at the team level; and (3) team cognition is inextricably tied to context. There are implications of ITC for theory building, modeling, measurement, and applications that make teams more effective performers. (shrink)

Public health ethics in the future will be distinguished from public health ethics in the past by this new subfield being labeled as such, acknowledged, and called upon for service. Ethical dilemmas have been present throughout the history of public health. The question of whether to force Henning Jacobson to be immunized in 1905 in accordance with the 1902 Massachusetts smallpox vaccination law was one of ethics as well as law. How Thomas Parran, Surgeon General in 1936, chose to respond (...) to a raging syphilis epidemic in the United States in the early part of the 2W century raised considerable moral debate in determining the appropriate public health response for a government? More recently, questions have arisen concerning the appropriate reach of government in controlling HIV banning smoking, or promoting healthy lifestyles. Debates over government infringement, morality, and justice recur throughout the history of public health. (shrink)

Public engagement in ethically laden pandemic planning decisions may be important for transparency, creating public trust, improving compliance with public health orders, and ultimately, contributing to just outcomes. We conducted focus groups with members of the public to characterize public perceptions about social distancing measures likely to be implemented during a pandemic. Participants expressed concerns about job security and economic strain on families if businesses or school closures are prolonged. They shared opposition to closure of religious organizations, citing the need (...) for shared support and worship during times of crises. Group discussions elicited evidence of community-mindedness, while some also acknowledged strong self-interest. Participants conveyed desire for opportunities for public input and education, and articulated distrust of government. Social distancing measures may be challenging to implement and sustain due to strains on family resources and lack of trust in government. (shrink)

Is it time to ditch the concept of “person” from practical fields, like bioethics? Blumenthal-Barby (2024) answers in the affirmative. They urge leaving personhood out of practical debates at the f...

Epistemic trustworthiness is defined as a complex character state that supervenes on a relation between first- and second-order beliefs, including beliefs about others as epistemic agents. In contexts shaped by unjust power relations, its second-order components create a mutually supporting link between a deficiency in epistemic character and unjust epistemic exclusion on the basis of group membership. In this way, a deficiency in the virtue of epistemic trustworthiness plays into social/epistemic interactions that perpetuate social injustice. Overcoming that deficiency and, along (...) with it, normalized practices of epistemic exclusion, requires developing a self-critical perspective on the partial, socially-located character of one's perspective and the consequent epistemic value of inclusiveness. (shrink)

The activities of the life sciences are essential to provide solutions for the future, for both individuals and society. Society has demanded growing accountability from the scientific community as implications of life science research rise in influence and there are concerns about the credibility, integrity and motives of science. While the scientific community has responded to concerns about its integrity in part by initiating training in research integrity and the responsible conduct of research, this approach is minimal. The scientific community (...) justifies itself by appealing to the ethos of science, claiming academic freedom, self-direction, and self-regulation, but no comprehensive codification of this foundational ethos has been forthcoming. A review of the professional norms of science and a prototype code of ethics for the life sciences provide a framework to spur discussions within the scientific community to define scientific professionalism. A formalization of implicit principles can provide guidance for recognizing divergence from the norms, place these norms within a context that would enhance education of trainees, and provide a framework for discussing externally and internally applied pressures that are influencing the practice of science. The prototype code articulates the goal for life sciences research and the responsibilities associated with the freedom of exploration, the principles for the practice of science, and the virtues of the scientists themselves. The time is ripe for scientific communities to reinvigorate professionalism and define the basis of their social contract. Codifying the basis of the social contract between science and society will sustain public trust in the scientific enterprise. (shrink)

This book collects John Gardner's celebrated essays on the theory of private law, alongside two new essays. Together they range across the central puzzles in understanding the significance of outcomes, the role of justice in private law, strict liability, the reasonable person standard, and the role of public policy in tort law.

Mechanisms are now taken widely in philosophy of science to provide one of modern science’s basic explanatory devices. This has raised lively debate concerning the relationship between mechanisms, laws and explanation. This paper focuses on cases where a mechanism gives rise to a ceteris paribus law, addressing two inter-related questions: What kind of explanation is involved? and What is going on in the world when mechanism M affords behavior B described in a ceteris paribus law? We explore various answers offered (...) by ‘new mechanists’ and others before setting out and explaining our own answers: mechanistic explanations are a species of oldfashioned covering-law explanation and this often accounts in part for their explanatory power; and B is what it takes for some set of principles that govern the features of M’s parts in their arrangement in M all to be instanced together. (shrink)

The last few decades have seen a steady growth of interest in doing philosophy with children and young people in educational settings. Philosophy with children is increasingly offered as a solution to the problems associated with what is seen by many as a disoriented, cynical, indifferent and individualistic society. It represents for its practitioners a powerful vehicle that teaches children and young people how to think about particular problems in society through the use of interpretive schemes and procedures especially designed (...) for this. It typically conceives of truth-telling as the work of dialogical reasoning, which is understood in turn as leading to increasing awareness of mental and methodological processes. This article starts from another point of view. What is at stake, I shall argue, is not so much the question of how to think for oneself in an appropriate way. Rather, in line with Michel Foucault, I want to identify philosophy as a practice oriented by the care of the self and of transformation of the self by the self. From this angle, philosophy with children will not be understood as something that orients us towards valid knowledge claims, but as an act of becoming present in the present. This way of conceiving of philosophy with children will be explored in the context of a concrete philosophical experiment with children that I planned and carried out in Cambodia. (shrink)

Who, over the age of 20, hasn’t experienced a serendipitous event: unexpected information that yields some unintended but potential value later on? Sitting next to a stranger on a plane who becomes a business partner? Stumbling onto an article in a journal or newspaper that helps tackle a nagging problem? Creating a new drug by accident?

Sebastian Gardner competently tackles one of Sartre's more complex and challenging works in this new addition to the Reader's Guides series.

Contemporary accounts of individual self-formation struggle to articulate a mode of subjectivity not determined by relations of power. In response to this dilemma, Foucault's late lectures on the ancient ethical practices of "fearless speech" (parrhesia) offer a model of ethical self-governance that educates individuals to ethical and political engagement. Rooted in the psychological capacities of curiosity and resolve, such self-governance equips individuals with a "disposition to steadiness" that orients individuals in the face of uncertainty. The practices of parrhesia accomplish this (...) task without fabricating a distinction between internal soul and external body; by creating not a "body of knowledge" but a "body of practices"; and without reference to an external order such as nature, custom, tradition, or religion. The result is an "expressive subject" defined through expressive practices sustained by a simultaneous relationship to herself and to others. Individuals develop themselves not through their ability to "dare to know" but as those who "dare to act.". (shrink)

Philosophers of science have had little to say about ‘middle-range theory’ although much of what is done in science and of what drives its successes falls under that label. These lectures aim to spark an interest in the topic and to lay groundwork for further research on it. ‘Middle’ in ‘middle range’ is with respect to the level both of abstraction and generality. Much middle-range theory is about things that come under the label ‘mechanism’. The lectures explore three different kinds (...) of mechanism: struc tural mechanisms or underlying systems that afford causal pathways; causal-chain mechanisms that are represented in what in policy contexts are called ‘theories of change’ and for which I give an extended account following the causal process theory of Wesley Salmon; and middle-range-law mechanisms like those discussed by Jon Elster, which I claim are —and rightly are— rampant throughout the social sciences. The theory of the democratic peace, that democracies do not go to war with democracies, serves as a running example. The discussions build up to the start of, first, an argument that reliability in social (and natural) science depends not so much on evidence as it does on the support of a virtuous tangle of practices (without which there couldn’t even be evidence), and second, a defence of a community-practice centred instrumentalist understanding of many of the central basic principles that we use (often successfully) in social (and in natural) science for explanation, prediction and evaluation. (shrink)

Mary Astell’s theory of friendship has been interpreted either as a version of Aristotelian virtue friendship, or as aligned with a Christian and Platonist tradition. In this paper, I argue that Astell’s theory of friendship is determinedly anti-Aristotelian; it is a theory of spiritual friendship offered as an alternative to Aristotelian virtue friendship. By grounding her conception of friendship in a Christian–Platonist metaphysics, I show that Astell rejects the Aristotelian criteria of reciprocity and partiality as essential features of the friendship (...) bond and that she develops a theory of friendship that is neither reciprocal nor partial. Further, I argue that Astell’s theory of friendship advances her feminist aims by providing a justification for female–female spiritual bonds in contradistinction to female–male marriage bonds. Astell argues that the female–female bond of spiritual friendship is sanctioned by God, and is, therefore, a divinely authorized alternative to the male–female bond of marriage. Through her theory of spiritual friendship, Astell marks out a central place for female–female bonds and provides women with a justification for resisting marriage. (shrink)

Ethical challenges in public health can have a significant impact on the health of communities if they impede efficiencies and best practices. Competing needs for resources and a plurality of values can challenge public health policymakers and practitioners to make fair and effective decisions for their communities. In this paper, the authors offer an analytic framework designed to assist policymakers and practitioners in managing the ethical tensions they face in daily practice. Their framework is built upon the following set of (...) six considerations: determining population-level utility of the proposed action; demonstrating evidence of need and effectiveness of actions; establishing fairness of goals and proposed implementation strategies; ensuring accountability; and, assessing expected efficiencies and costs associated with the proposed action. Together, these considerations create a structured guide to assist decision-makers in identifying potential ethical challenges and in assessing the moral considerations that underlie public health practice - and possibly even, if the conditions are met, reduce the creation of ethical tension. Although the authors’empirical experiences provide the basis for the framework advanced here, their approach remains to be tested and evaluated by public health practitioners. (shrink)

ABSTRACT:COVID-19 revealed health-care systems in crisis. Intersecting crises of stress, overwork, and poor working conditions have led to workforce strain, under-staffing, and high rates of job turnover. Bioethics researchers have responded to these conditions by investigating the ethical challenges of pandemic response for individuals, institutions, and health systems. This essay draws on pandemic findings to explore how empirical bioethics can inform post-pandemic translational bioethics. Borrowing from the concept of translational science in medicine, this essay proposes that translational bioethics should communicate (...) knowledge about ethical challenges in health-care work to support health systems change. The authors draw from their experience with the Study to Examine Physicians' Pandemic Stress (STEPPS), an interdisciplinary research project that investigates physicians' experiences at the front lines of the COVID-19 pandemic. Using STEPPS as an example of empirical bioethics with potential for translation, the authors review their research and discuss the ongoing process for translating their findings, focusing on how bioethics research and practice can contribute to supporting the health-care workforce. (shrink)

Peter Gardner; Religious Upbringing and the Liberal Ideal of Religious Autonomy, Journal of Philosophy of Education, Volume 22, Issue 1, 30 May 2006, Pages 89–1.

This commentary responds to “Home Care in America: The Urgent Challenge of Putting Ethical Care into Practice,” by Coleman Solis and colleagues, in the May‐June 2023 issue of the Hastings Center Report. More specifically, we respond to the authors’ call for “inquiry into the nature, value, and practice” of home care. We argue that the most urgently needed normative reset for thinking about care work is the replacement of dominant individualistic thinking with systemic thinking. Deepening a focus on the social, (...) economic, and historical forces that shape the state of contemporary care work will help bioethicists to argue more effectively for improvements to working conditions. In turn, better working conditions will ease the oppositional stance between caregivers and receivers that has been set up by the current system, enabling all parties involved to better pursue the feminist ethical ideal of care. (shrink)

In parts I and II, this article briefly sketches two approaches to virtue ethics – those taken by Aristotle and the contemporary exemplarist moral theory of Linda Zagzebski – with an eye to providing resources for miliary educators. Each section concludes with remarks about the pros and cons of the author’s experiences of teaching these theories to undergraduates. Part III deals with the social articulation of morality and its implications for war crimes. The social articulation of morality is the idea (...) that moral principles cannot be applied in the abstract, but must be interpreted in terms of social backgrounds and norms. This draws on War Crimes: Causes, Excuses, and Blame (2019) by Talbert and Wolfendale, who consider how social articulations of morality led the military in various countries to commit war crimes in the mistaken belief that they were acting in accordance with moral principles. Democratic countries have commitments to free speech that enable us to resist such abuses. The implications for military education are that virtues such as intellectual discernment should be joined with discussions of ethical issues to ensure that future military leaders do not fall prey to false moral narratives. (shrink)

There are a wide variety of potential applications of artificial intelligence (AI) in Defence settings, ranging from the use of autonomous drones to logistical support. However, limited research exists exploring how the public view these, especially in view of the value of public attitudes for influencing policy-making. An accurate understanding of the public’s perceptions is essential for crafting informed policy, developing responsible governance, and building responsive assurance relating to the development and use of AI in military settings. This study is (...) the first to explore public perceptions of and attitudes towards AI in Defence. A series of four focus groups were conducted with 20 members of the UK public, aged between 18 and 70, to explore their perceptions and attitudes towards AI use in general contexts and, more specifically, applications of AI in Defence settings. Thematic analysis revealed four themes and eleven sub-themes, spanning the role of humans in the system, the ethics of AI use in Defence, trust in AI versus trust in the organisation, and gathering information about AI in Defence. Participants demonstrated a variety of misconceptions about the applications of AI in Defence, with many assuming that a variety of different technologies involving AI are already being used. This highlighted a confluence between information from reputable sources combined with narratives from the mass media and conspiracy theories. The study demonstrates gaps in knowledge and misunderstandings that need to be addressed, and offers practical insights for keeping the public reliably, accurately, and adequately informed about the capabilities, limitations, benefits, and risks of AI in Defence. (shrink)