Every year, people make decisions based on trust in the certainty of diagnoses of brain death. These decisions range from signing an organ donation card to withdrawing life support from a loved one. Two recent developments have revived concerns about medical standards for determining brain death. One is a recent study on variability in brain death policies in the United States; the other is the filing of a federal lawsuit to rescind the death certificate of Jahi McMath, a teenager who (...) appears to have survived a 2013 declaration of brain death. The author examines these developments and asks whether trust in the certainty of brain-death determinations is currently warranted. (shrink)

This book presents a radical new picture of natural order. The Newtonian idea of a cosmos ruled by universal and exceptionless laws has been superseded; replaced by a conception of nature as a realm of diverse powers, potencies, and dispositions, a 'dappled world'. There is order in nature, but it is more local, diverse, piecemeal, open, and emergent than Newton imagined. In each chapter expert authors expound the historical context of the idea of laws of nature, and explore the diverse (...) sorts of order actually presupposed by work in physics, biology, and the social sciences. They consider how human freedom might be understood, and explore how Newton's idea of a 'universal designer' might be revised, in this new context. They argue that there is not one unified totalizing program of science, aiming at the completion of one closed causal system. We live in an ordered universe, but we need to rethink the classical idea of the 'laws of nature' in a more dynamic and creatively diverse way. (shrink)

This paper is a personal account of the events associated with the author’s work at the University of Toronto’s Hospital for Sick Children on a drug, deferiprone, for the treatment of thalassaemia. Trials of the drug were sponsored by the Canadian Medical Research Council and a drug company which would have been able, had the trials been successful, to seek regulatory approval to market the drug. When evidence emerged that deferiprone might be inadequately effective in a substantial proportion of patients, (...) the drug company issued legal threats when the author proposed informing her patients and the scientific community. Until protests were made by international authorities in her field of research, the hospital and university did not adequately support the author’s academic freedom and responsibilities as a medical practitioner. It is argued that underlying cause of this, and of other similar cases, is the political philosophy which is driving the commercialisation of universities and bringing about the deregulation of drug approval procedures. Together these changes constitute a serious threat to the public good. (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)

Unruly Practices brings together a series of widely discussed essays in feminism and social theory. Read together, they constitute a sustained critical encounter with leading European and American approaches to social theory. In addition, Nancy Fraser develops a new and original socialist-feminist critical theory that overcomes many of the limitations of current alternatives. First, in a series of critical essays, she deploys philosophical and literary techniques to assess the work of Michael Foucault, the French deconstructionists, Richard Rorty, and Jürgen (...) Habermas. Then, in a group of constructive essays, she incorporates their respective strengths in a new critical theory of late-capitalist political culture. Fraser breaks new ground methodologically by integrating the previously divergent insights of poststructuralism, critical social theory, feminist theory, and pragmatism. Thematically, she deals with varied forms of dominance and subordination in modern, industrial, late-capitalist societies. These themes are integrated in an original theory of 'the politics of need interpretation.' This concept becomes the linchpin of the socialist-feminist critical theory. (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)

Targeting injustices that cut across borders, they are making the scale of justice an object of explicit struggle.Inspired by these efforts, Nancy Fraser asks: ...

What does it mean to think critically about politics at a time when inequality is increasing worldwide, when struggles for the recognition of difference are eclipsing struggles for social equality, and when we lack any credible vision of an alternative to the present order? Philosopher Nancy Fraser claims that the key is to overcome the false oppositions of "postsocialist" commonsense. Refuting the view that we must choose between "the politics of recognition" and the "politics of redistribution," Fraser argues for (...) an integrative approach that encompasses the best aspects of both. (shrink)

Until recently, struggles for justice proceeded against the background of a taken-for-granted frame: the bounded territorial state. With that "Westphalian" picture of political space assumed by default, the scope of justice was rarely subject to open dispute. Today, however, human-rights activists and international feminists join critics of structural adjustment and the World Trade Organization in challenging the view that justice can only be a domestic relation among fellow citizens. Targeting injustices that cut across borders, they are making the scale of (...) justice an object of explicit struggle. Inspired by these efforts, Nancy Fraser asks: What is the proper frame for theorizing justice? Faced with a plurality of competing scales, how do we know which one is truly just? In exploring these questions, Fraser revises her widely discussed theory of redistribution and recognition. She introduces a third, "political" dimension of justice—representation—and elaborates a new, reflexive type of critical theory that foregrounds injustices of "misframing." Engaging with thinkers such as Jürgen Habermas, John Rawls, Michel Foucault, and Hannah Arendt, she envisions a "postwestphalian" mapping of political space that accommodates transnational solidarity, transborder publicity, and democratic frame-setting, as well as emancipatory projects that cross borders. The result is a sustained reflection on who should count with respect to what in a globalizing world. (shrink)

" Nancy Bauer begins her book by asking: "Then what kind of a problem does being a woman pose?

Refuting the argument to choose between "the politics of recognition" and the "politics of redistribution," _Justice Interruptus_ integrates the best aspects of both. ********************************************************* ** What does it mean to think critically about politics at a time when inequality is increasing worldwide, when struggles for the recognition of difference are eclipsing struggles for social equality, and when we lack any credible vision of an alternative to the present order? Philosopher Nancy Fraser claims that the key is to overcome the (...) false oppositions of "postsocialist" commonsense. Refuting the view that we must choose between "the politics of recognition" and the "politics of redistribution," Fraser argues for an integrative approach that encompasses the best aspects of both. (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)

As average lifespans stretch to new lengths, how are human values impacted? Should our values change over the course of our ever-increasing lifespans? Nancy S. Jecker introduces a new concept, the life stage relativity of values, which holds that at different life stages, different ethical concerns should take center stage. For Jecker, the privileging of midlife values raises fundamental problems of fairness, and reveals large gaps in ethical principles and theories. Jecker introduces a new philosophical framework that reflects the (...) life stage relativity of values and shows its relevance to practice and policy. (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)

Calls are increasing for American health care to be organized as a learning health care system, defined by the Institute of Medicine as a health care system “in which knowledge generation is so embedded into the core of the practice of medicine that it is a natural outgrowth and product of the healthcare delivery process and leads to continual improvement in care.” We applaud this conception, and in this paper, we put forward a new ethics framework for it. No such (...) framework has previously been articulated. The goals of our framework are twofold: to support the transformation to a learning health care system and to help ensure that learning activities carried out within such a system are conducted in an ethically acceptable fashion. (shrink)

Do neurosurgical procedures ever result in the patient prior to the procedure not being identical with the individual who wakes up postsurgery in the hospital bed? We address this question by offering an analysis of the persistence of persons that emphasizes narrative, rather than numerical, identity. We argue that a narrative analysis carries the advantage of highlighting what matters to patients in their ordinary lives, explaining the varying degrees of persistence of personal identity, and enhancing our understanding of patients' experiences. (...) We illustrate these points in cases involving temporal lobectomy for treatment of refractory epilepsy and deep brain stimulation for refractory Parkinson's disease. (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.

It is widely assumed that informing prospective subjects about the risks and possible benefits of research not only protects their rights as autonomous decisionmakers, but also empowers them to protect their own interests. Yet interviews with patient‐subjects conducted under the auspices of the Advisory Committee on Human Radiation Experiments suggest this is not always the case. Patient‐subjects often trust their physician to guide them through decisions on research participation. Clinicians, investigators, and IRBs must assure that such trust is not misplaced.

We historically and conceptually situate distributed cognition by drawing attention to important similarities in assumptions and methods with those of American ?functional psychology? as it emerged in contrast and complement to controlled laboratory study of the structural components and primitive ?elements? of consciousness. Functional psychology foregrounded the adaptive features of cognitive processes in environments, and adopted as a unit of analysis the overall situation of organism and environment. A methodological implication of this emphasis was, to the extent possible, the study (...) of cognitive and other processes in the natural (real world) contexts in which they occur. We therefore emphasize commonalities and differences between functional psychology and D-Cog. One purpose of the comparison is to consider the extent to which criticisms directed at functional psychology are relevant to D-Cog. We also examine the relation between functional psychology and philosophical pragmatism and conclude that D-Cog's conceptual framework would be strengthened through more explicit adoption of philosophical pragmatism, consistent with the eventual trajectory of functional psychology. (shrink)

This paper presents an analysis of emotional and affectively toned discourse in biomedical engineering researchers’ accounts of their problem solving practices. Drawing from our interviews with scientists in two laboratories, we examine three classes of expression: explicit, figurative and metaphorical, and attributions of emotion to objects and artifacts important to laboratory practice. We consider the overall function of expressions in the particular problem solving contexts described. We argue that affective processes are engaged in problem solving, not as simply tacked onto (...) reasoning but as integral to it. The examples we present illustrate the close relation of emotion to problem solving and experimentation; they also implicate social and cultural dimensions of emotion expression. The analysis underscores a need to consider emotional expression to be intimately and importantly tied to the cognitive achievements and social negotiations of laboratory practices. (shrink)

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)

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)

Societal aging raises challenging ethical questions regarding the just distribution of health care between young and old. This article considers a proposal for age-based rationing of health care, which is based on the prudential life span account of justice between age groups. While important objections have been raised against the prudential life span account, it continues to dominate scholarly debates. This article introduces a new objection, one that develops out of the well-established disability critique of social contract theories. I show (...) the implications of this critique for the prudential life span account and for the special case of age-group justice. The result is that age-based rationing based on the prudential life span approach is not supported, and that the prudential life span approach itself is not the best way to think about allocating health care between age groups. I propose an alternative approach that avoids the disability objection, and consider its implications for specific proposals for age-based rationing of health care. (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)

In the course of the last thirty years, feminist theories of gender have shifted from quasi-Marxist, labor-centered conceptions to putatively “post-Marxist”culture- and identity-based conceptions. Reflecting a broader political move from redistribution to recognition, this shift has been double-edged. On the one hand, it has broadened feminist politics to encompass legitimate issues of representation, identity, and difference. Yet, in the context of an ascendant neoliberalism, feminist struggles for recognition may be serving to less to enrich struggles for redistribution than to displace (...) the latter. I aim to resist that trend. In this essay, I propose an analysis of gender that is broad enough to house the full range of feminist concerns, those central to the old socialist-feminism as well as those rooted in the cultural turn. I also propose a correspondingly broad conception of justice, capable of encompassing both distribution and recognition, and a non-identitarian account of recognition, capable of synergizing with redistribution. I conclude by examining some practical problems that arise when we try to envision institutional reforms that could redress gender maldistribution and gender misrecognition simultaneously. (shrink)

In Gender, Class, and Freedom in Modern Political Theory, Nancy Hirschmann demonstrates not merely that modern theories of freedom are susceptible to gender and class analysis but that they must be analyzed in terms of gender and class in order to be understood at all. Through rigorous close readings of major and minor works of Hobbes, Locke, Rousseau, Kant, and Mill, Hirschmann establishes and examines the gender and class foundations of the modern understanding of freedom. Building on a social (...) constructivist model of freedom that she developed in her award-winning book The Subject of Liberty: Toward a Feminist Theory of Freedom, she makes in her new book another original and important contribution to political and feminist theory. Despite the prominence of "state of nature" ideas in modern political theory, Hirschmann argues, theories of freedom actually advance a social constructivist understanding of humanity. By rereading "human nature" in light of this insight, Hirschmann uncovers theories of freedom that are both more historically accurate and more relevant to contemporary politics. Pigeonholing canonical theorists as proponents of either "positive" or "negative" liberty is historically inaccurate, she demonstrates, because theorists deploy both conceptions of freedom simultaneously throughout their work. (shrink)

Research participants may not adequately understand the research in which they agree to enroll. This could be due to a myriad of factors. Such a missing link in the informed consent process contravenes the requirement for an.

An advertising firm''s ethical culture (as defined by the firm''s managerial and peer ethical behaviors) may affect the employees'' comfort levels and ethical behaviors. In this research, scenarios were used to describe advertising firms with various ethical cultures. Respondents'' perceived comfort levels in working for the firms described in the scenarios and the respondents'' behavioral intentions when faced with various advertising situations were assessed. Results of the study indicate that peer ethical behavior exerts a strong influence on the comfort or (...) discomfort level and the ethical behavioral intentions of potential advertising employees. Further, the strong influence exerted by peers seems to transcend the ethical behavior of the manager and carry over to the attitude toward the entire corporate advertising environment. This study provides insights for firms and researchers interested in assessing the impact of an advertising firm''s ethical culture on potential employees. (shrink)

In this article I reply to four critics. Responding to Linda Alcoff, I contend that my original two-dimensional framework discloses the entwinement of economic and cultural strands of subordination, while also illuminating the dangers of identity politics. Responding to James Bohman, I maintain that, with the addition of the third dimension of representation, my approach illuminates the structural exclusion of the global poor, the relation between justice and democracy, and the status of comprehensive theorizing. Responding to Nikolas Kompridis, I defend (...) a view of recognition that prioritizes the critique of institutionalized injustice. Responding to Rainer Forst, I argue that such a critique is better formulated in participation-theoretic than justification-theoretic terms. (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)

This unique volume presents a debate between four of the top feminist theorists in the US today, discussing the key questions facing contemporary feminist theory, responding to each other, and distinguishing their views from others.

Clinical gene transfer research has both a unique history and a complex and layered system of research oversight, featuring a unique review body, the Recombinant DNA Advisory Committee. This paper briefly describes the process of decision-making about clinical GTR, considers whether the questions, problems, and issues raised in clinical GTR are unique, and concludes by examining whether the RAC's oversight is a useful model that should be reproduced for other similar areas of clinical research.Clinical GTR is governed by the same (...) oversight system as most clinical trials, with a significant addition: the RAC. Like other research with human subjects, GTR, if it is affiliated with a federally funded institution, must be approved by an institutional review board whose activities are governed by the common rule, that is, the federal regulations for protection of human subjects in research. Like other research intended to produce a drug, device, or biologic to be marketed in the United States, GTR is also overseen by the Food and Drug Administration. (shrink)

Should you wash your hands? -- Are workarounds ethical? -- Turfing, bending, and gaming -- Dirty hands and the semiclear conscience -- Problems of humanity -- Ethics without heroics : foreseeing moral problems in complex systems.

"... Fraser and Bartky have brought the encounter between U.S. and French feminism to a new level of seriousness." —Ethics In the last decade, elements of French feminist discourse have permeated and transformed the larger feminist culture in the United States. This volume is the first sustained attempt to revalue French feminism and answer the question: What has been gained and what has been lost as a result of this intercultural encounter? Interviews with Simone de Beauvoir open the book; essays (...) by French feminists Sarah Kofman and Luce Irigaray follow; the North American contributors are Judith Butler, Nancy Fraser, Diana J. Fuss, Nancy J. Holland, Eleanor H. Kuykendall, Dorothy Leland, Diana T. Meyers, Andrea Nye, and Margaret A. Simons. (shrink)

What does it mean to say that this person at this time is 'the same' as that person at an earlier time? If the brain is damaged or the memory lost, how far does a person's identity continue? In this book two eminent philosophers develop very different approaches to the problem.

Advance directives have been lauded by scholars and supported by professional organizations, Congress, and the United States Supreme Court. Despite this encouragement, only a small number of capable patients execute living wills or appoint health care agents. When patients do empower proxies, doctors may be uncertain about the scope of their duties and obligations to these persons who, in theory, stand in the shoes of the patient. This article argues for a conscious focus on the ethical duties, emotional supports, and (...) guidance owed by physicians to health care agents. (shrink)

Are the laws of nature consistent with contingency about what happens in the world? That depends on what the laws of nature actually are, but it also depends on what they are like. The latter is the concern of this chapter, which looks at three views that are widely endorsed: ‘Humean’ regularity accounts, laws as relations among universals, and disposition/powers accounts. Given an account of what laws are, what follows about how much contingency, and of what kinds, laws allow? In (...) all three cases, the authors argue, the root idea of what laws are does not settle the issue of whether they allow contingency. Advocates of the different accounts may argue for one view or another on the issue, but this will be an add-on rather than a consequence of the basic view about what laws are. -/- . (shrink)