The article investigates the significance of the so-called phenomenon of apparent faultless disagreement for debates about the semantics of taste discourse. Two kinds of description of the phenomenon are proposed. The first ensures that faultless disagreement raises a distinctive philosophical challenge; yet, it is argued that Contextualist, Realist and Relativist semantic theories do not account for this description. The second, by contrast, makes the phenomenon irrelevant for the problem of what the right semantics of taste discourse should be. Lastly, the (...) following dilemma is assessed: either faultless disagreement provides strong evidence against semantic theories; or its significance should be considerably downplayed. (shrink)

Permissivism is the view that, sometimes, there is more than one doxastic attitude that is perfectly rationalised by the evidence. Impermissivism is the denial of Permissivism. Several philosophers, with the aim to defend either Impermissivism or Permissivism, have recently discussed the value of (im)permissive rationality. This paper focuses on one kind of value-conferring considerations, stemming from the so-called “truth-connection” enjoyed by rational doxastic attitudes. The paper vindicates the truth-connected value of permissive rationality by pursuing a novel strategy which rests on (...) two main planks: first, there is a distinction between a fine-grained and a coarse-grained type-individuation of belief-forming methods. Secondly, different kinds of decision-theoretic reasoning, i.e. expected-accuracy reasoning and accuracy-domination reasoning, must be paired with a fine-grained and a coarse-grained type-individuation of methods, respectively. I argue that while the first pair is wholly irrelevant to the question of the truth-connection, the second affords the means to a permissivist explanation of the truth-connected value of rationality. (shrink)

Moral pluralism poses a foundational problem for secular clinical ethics: How can ethical dilemmas be resolved in a context where there is disagreement not only on particular cases, but further, on...

In this paper I take up the question of the nature of the doxastic attitudes we entertain while inquiring into some matter. Relying on a distinction between two stages of open inquiry, I urge to acknowledge the existence of a distinctive attitude of cognitive inclination towards a proposition qua answer to the question one is inquiring into. I call this attitude “hypothesis”. Hypothesis, I argue, is a sui generis doxastic attitude which differs, both functionally and normatively, from suspended judgement, full (...) belief, credences, and acceptance. In closing, I point to the epistemological significance of hypothesis. More specifically, I contend that holding an attitude of hypothesis enables us to respond rationally to peer disagreement, and I suggest that such an attitude offers a suitable articulation of the view, originally put forward by Philip Kitcher, that cognitive diversity in inquiry has epistemic benefits. (shrink)

The paper proposes an account of the rational response to higher-order evidence whose key claim is that whenever we acquire such evidence we ought to engage in the inquiring activity of double-checking. Combined with a principle that establishes a connection between rational inquiry and rational belief retention, the account offers a novel explanation of the alleged impermissibility of retaining one’s belief in the face of higher-order evidence. It is argued that this explanation is superior to the main competitor view which (...) appeals to the notion of defeat. (shrink)

Hastings Center Report, Volume 52, Issue 1, Page 12-14, January/February 2022.

Tradition has it that first-person thought is somehow special. It is also commonplace to maintain that the first-person concept obeys a rule of reference to the effect that any token first-person thought is about the thinker of that thought. Following Annalisa Coliva and, more recently, Santiago Echeverri, I take the specialness claim to be the claim that thinking a first-person thought comes with a certain guarantee of its pattern of reference. Echeverri maintains that such a guarantee is explained by a (...) fairly flatfooted interpretation of the thinker-reflexive rule. I argue, however, that the explanatory aspirations of the thinker-reflexive rule are fulfilled only if we accept an epistemically loaded gloss on the notion of a thinker of a thought featuring the rule. That gloss is unpacked in terms of the subject’s ability to be acquainted with the phenomenal character of their thoughts. (shrink)

Legal precedent, professional‐society statements, and even many medical ethicists agree that some situations may call for a clinician to engage in an act of lying or nonlying deception of a patient or patient's family member. Still, the moral terrain of clinical deception is largely uncharted, and when it comes to practical guidance for clinicians, many might think that ethicists offer nothing more than the rule never to deceive. This guidance is insufficient to meet the real‐world demands of clinical practice, and (...) this article endeavors to articulate a framework to help clinicians better navigate the ethics of clinical deceit. The framework articulates four morally relevant dimensions of a potential deceptive act that should be examined to better determine the moral justification that might be required: the target of the act, the nature of the information, the nature of the act, and the context of the act. (shrink)

Since the inception of bioethics, some theorists have denied that clinical ethicists have ethics expertise, understood as the ability to give justified moral recommendations in patient cases. These denials have caused considerable alarm, leading some to argue that the entire discipline needs to be fundamentally reconsidered. Although this debate has been a source of academic attention for decades, these challenges to ethics expertise can now be either resolved by showing they are based on an untenable view of moral justification or (...) dissolved by showing they result from a rash of equivocations on key phrases such as what it means to give a “moral recommendation,” or “furnish answers” in an ethics consultation. Like the blind men and the elephant, what sounds like disagreement may only be theorists describing different aspects of the same facilitation approach to clinical ethics endorsed by the American Society for Bioethics and Humanities. While the question of whether ethicists have ethics expertise can be resolved or dissolved, theorists should refocus on how much (content-thick vs. content-thin) expertise ethicists have. Here, theorists need not commit themselves to a general view but can be content-thick on some issues and content-thin on others. (shrink)

While it seems hard to deny the epistemic significance of a disagreement with our acknowledged epistemic peers, there are certain disagreements, such as philosophical disagreements, which appear to be permissibly sustainable. These two claims, each independently plausible, are jointly puzzling. This paper argues for a solution to this puzzle. The main tenets of the solution are two. First, the peers ought to engage in a deliberative activity of discovering more about their epistemic position vis-à-vis the issue at stake. Secondly, the (...) peers are permitted to do so while entertaining a sui generis doxastic attitude of hypothesis. (shrink)

This paper addresses a largely neglected question in ongoing debates over disagreement: what is the relation, if any, between disagreements involving credences and disagreements involving outright beliefs? The first part of the paper offers some desiderata for an adequate account of credal and full disagreement. The second part of the paper argues that both phenomena can be subsumed under a schematic definition which goes as follows: A and B disagree if and only if the accuracy conditions of A's doxastic attitude (...) are such that, if they were fulfilled, this would ipso facto make B's doxastic attitude inaccurate, or vice-versa. (shrink)

BackgroundThe purpose of this study is to make a philosophical argument against the phenomenological critique of standardization in clinical ethics. We used the context of clinical ethics in Saudi Arabia to demonstrate the importance of credentialing clinical ethicists.MethodsPhilosophical methods of argumentation and conceptual analysis were used.ResultsWe found the phenomenological critique of standardization to be flawed because it relies on a series of false dichotomies.ConclusionsWe concluded that the phenomenological framing of the credentialing debate relies upon two extreme views to be navigated (...) between, not chosen among, in the credentialing of clinical ethicists. (shrink)

This paper reports of a case where a physician conscientiously objected to prescribing PrEP to a bisexual patient so as not to “enable immoral sexual behavior.” The case represents an instance of conscience creep, a phenomenon whereby clinicians invoke conscientious objection in sometimes objectionable ways that extend beyond the traditional contexts of abortion, sterilization, or physician aid in dying. This essay uses a reasonability view of conscientious objection to argue that the above case represents a discriminatory instance of conscience creep (...) that should not be permitted. (shrink)

There are scenarios in which letting one’s own views on the question whether p direct one’s inquiry into that question brings about individual and collective epistemic benefits. However, these scenarios are also such that one’s evidence doesn’t support believing one’s own views. So, how to vindicate the epistemic benefits of directing one’s inquiry in such an asymmetric way, without asking one to hold a seemingly irrational doxastic attitude? To answer this question, the paper understands asymmetric inquiry direction in terms of (...) having one’s inquiry be guided by a doxastic attitude, which I call hypothesis, that’s governed by the following norm: One’s hypothesis that p is rational just in case it is a manifestation of the best feasible way to form a doxastic attitude regarding p that promotes the best feasible ways to advance towards settling the question of p’s (or of any other suitably related proposition’s) truth-value. (shrink)

Our aim in this article is to bring some clarity to the clinical ethics expertise debate by critiquing and replacing the taxonomy offered by the Core Competencies report. The orienting question for our taxonomy is: Can clinical ethicists offer justified, normative recommendations for active patient cases? Views that answer “no” are characterized as a “negative” view of clinical ethics expertise and are further differentiated based on (a) why they think ethicists cannot give justified normative recommendations and (b) what they think (...) ethicists can offer, if they cannot offer recommendations. Views that answer “yes” to the orienting question are characterized as a “positive” view of clinical ethics expertise. Positive views are distinguished according to four additional questions. First (P1), how are those recommendations generated? Second (P2), what is the nature of the recommendations? Third (P3), we ask, how are the recommendations justified? And finally (P4), how are the recommendations communicated? (shrink)

The paper argues that the view to the effect that one should suspend judgment in the face of a disagreement with a recognised epistemic peer results in a puzzle when applied to disagreements in which one party is agnostic. The puzzle is this: either the agnostic party retains her suspension of judgment, or she suspends it. The former option is discarded by proponents of the agnostic response; the latter leads the agnostic response to undermine itself.

In recent work, J. Adam Carter argues that truth-relativism should be compatible with the so-called conformist response to peer disagreement about taste to the effect that subjects should revise their opinions. However, Carter claims that truth-relativism cannot make sense of this response since it cannot make sense of the idea that when two subjects are recognised as epistemic peers, they should acknowledge that they are equally likely to be right about the targeted issue. The main aim of this paper is (...) a modest one: to argue that truth-relativists should not be worried about their alleged incompatibility with conformism for they should be non-conformists. (shrink)

In this paper I aim to illuminate the significance of thought insertion for debates about the first-person concept. My starting point is the often-voiced contention that thought insertion might challenge the thesis that introspection-based self-ascriptions of psychological properties are immune to error through misidentification relative to the first-person concept. In the first part of the paper I explain what a thought insertion-based counterexample to this immunity thesis should be like. I then argue that various thought insertion-involving scenarios do not give (...) rise to successful counterexamples to the immunity of the target class of self-ascriptions. In the second part of the paper I turn to defend a Metasemantic Explanation of why the immunity thesis holds. The Metasemantic Explanation rests on a reference-fixing story about the mental ‘I’ whose key contention is that introspective impressions play an essential role in fixing its reference. It is part of my argument in favour of the proposed reference-fixing story, as well as of the Metasemantic Explanation, that they respect the paradigmatic features of self-ascriptions of inserted thoughts. (shrink)

The paper explores the idea that some singular judgements about the natural numbers are immune to error through misidentification by pursuing a comparison between arithmetic judgements and first-person judgements. By doing so, the first part of the paper offers a conciliatory resolution of the Coliva-Pryor dispute about so-called “de re” and “which-object” misidentification. The second part of the paper draws some lessons about what it takes to explain immunity to error through misidentification. The lessons are: First, the so-called Simple Account (...) of which-object immunity to error through misidentification to the effect that a judgement is immune to this kind of error just in case its grounds do not feature any identification component fails. Secondly, wh-immunity can be explained by a Reference-Fixing Account to the effect that a judgement is immune to this kind of error just in case its grounds are constituted by the facts whereby the reference of the concept of the object which the judgement concerns is fixed. Thirdly, a suitable revision of the Simple Account explains the de re immunity of those arithmetic judgements which are not wh-immune. These three lessons point towards the general conclusion that there is no unifying explanation of de re and wh-immunity. (shrink)

This paper focuses on the phenomenon of forming one’s judgement about epistemic matters, such as whether one has some reason not to believe false propositions, on the basis of the opinion of somebody one takes to be an expert about them. The paper pursues three aims. First, it argues that some cases of expert deference about epistemic matters are suspicious. Secondly, it provides an explanation of such a suspiciousness. Thirdly, it draws the metaepistemological implications of the proposed explanation.

I present a puzzle about inquiry and discuss two potential solutions. The puzzle stems from two equally compelling sets of data suggesting that, on the one hand, there’s something epistemically defective with inquiring into questions that don’t have true answers. On the other hand, however, there can be scenarios in which we are epistemically permitted to inquire into questions that don’t have true answers. How is it that inquiries into questions that don’t have true answers can both be defective and (...) permissible from an epistemic point of view? The first solution I consider maintains that inquiries into questions that don’t have true answers are always impermissible but can be excusable. The second solution maintains that inquiries into questions that don’t have true answers are bad inquiries that can be conducted by inquirers we can legitimately trust. I argue against the former and in favor of the latter. (shrink)

Cognitive enhancement refers to any technology that raises some aspect of cognition beyond the species-typical level. It is often considered distinct from and less controversial than cognitive therapy, which raises the cognition of a deficient individual to the species-typical level. The debate over CE is a result of the excitement surrounding the potential of neuroscience to one day enable us to enhance our own cognition in significant ways. Some of the aspects of cognition targeted by enhancement and therapeutic technologies include (...) wakefulness, focus, memory, and executive function, or the ability to plan, organize, and complete tasks. We all regularly use cognitive enhancers without... (shrink)

Introduces a scheme of machine aesthetics, including classical industrial machines, high technology, and decaying machines, and then explores the rhetorical ...

This paper investigates the question of how to correctly capture the scope of singular thinking. The first part of the paper identifies a scope problem for the dominant view of singular thought maintaining that, in order for a thinker to have a singular thought about an object o, the thinker has to bear a special epistemic relation to o. The scope problem has it is that this view cannot make sense of the singularity of our thoughts about objects to which (...) we do not or cannot bear any special epistemic relation. The paper focuses on a specific instance of the scope problem by addressing the case of thoughts about the natural numbers. Various possible solutions to the scope problem within the dominant framework are assessed and rejected. The second part of the paper develops a new theory of singular thought which hinges on the contention that the constraints that need to be met in order to think singularly vary depending on the kind of object we are thinking about. This idea is developed in detail by discussing the difference between the somewhat standard case of thoughts about spatio-temporal medium-sized inanimate objects and the case of thoughts about the natural numbers. It is contended that this new Pluralist theory of singular thought can successfully solve the scope problem. (shrink)

Several philosophers maintain that outright belief exists because it plays a reasoning simplifying role (Holton 2008; Ross and Schroeder 2014; Staffel 2019; Weisberg 2020). This claim has been recently contested, on the grounds that credences also can simplify reasoning (Dinges 2021). This paper takes a step back and asks: what features of an attitude explain its alleged ability to simplify reasoning? The paper contrasts two explanations, one in terms of dispositions and the other in terms of representation, arguing in favour (...) of the latter and against the former. The proposed explanation yields two interesting results: first, both belief and other attitudes, such as acceptance and imagination, can play a reasoning simplifying role; second, credences do not simplify our reasoning. (shrink)

Contemporary epistemology devotes much attention to disagreements among epistemic peers, that is, disagreements in which subjects take themselves to be equals with respect to the evidence that bears on the matter at issue as well as general intellectual virtues. The crucial question is: what should you do when you disagree with an epistemic peer? The paper pursues three goals. First, it clarifies some as of yet unexplained details of the problem of peer disagreement. Second, it distinguishes between Invariantist and Contextualist (...) Treatments of the problem. Third, it provides an assessment of Contextualist Treatments. These are attractive because they seem to have the resources to capture the intuition that the rational response to peer disagreement varies across contexts. However, this paper argues that Contextualist Treatments don’t fare any better than their Invariantist rivals. (shrink)

Bioethics, Volume 36, Issue 4, Page 367-373, May 2022.

In the debate over clinicians’ conscience, there is a greater ethical, legal, and scholarly focus on negative, rather than positive, claims of conscience. This asymmetry produces a seemingly unjustified double standard with respect to clinicians’ conscience under the law. For example, a Roman Catholic physician working at a secular institution may refuse to provide physician-aid-in-dying on the basis of conscience, but a secular physician working at a Roman Catholic institution may not insist on providing physician-aid-in-dying on the basis of conscience. (...) This article outlines arguments against this asymmetry and critiques them for failing to distinguish between positive claims of conscience as positive or negative rights. I suggest the asymmetry debate should be focused on whether positive claims of conscience as positive rights ought to enjoy the same protections as negative claims of conscience. Clarifying the debate in this way helps elucidate some of the best reasons for the asymmetry, which these arguments have not addressed. This article does not take a definitive position on whether the asymmetry is justified, but attempts to bring some focus to the debate by directing arguments against the asymmetry to address the significant differences between positive claims of conscience as positive rights and negative claims of conscience. (shrink)

Volume 20, Issue 3, March 2020, Page 50-52.

In the debate over clinicians’ conscience, there is a greater ethical, legal, and scholarly focus on negative, rather than positive, claims of conscience. This asymmetry produces a seemingly unjustified double standard with respect to clinicians’ conscience under the law. For example, a Roman Catholic physician working at a secular institution may refuse to provide physician-aid-in-dying on the basis of conscience, but a secular physician working at a Roman Catholic institution may not insist on providing physician-aid-in-dying on the basis of conscience. (...) This article outlines arguments against this asymmetry and critiques them for failing to distinguish between positive claims of conscience as positive or negative rights. I suggest the asymmetry debate should be focused on whether positive claims of conscience as positive rights ought to enjoy the same protections as negative claims of conscience. Clarifying the debate in this way helps elucidate some of the best reasons for the asymmetry, which these arguments have not addressed. This article does not take a definitive position on whether the asymmetry is justified, but attempts to bring some focus to the debate by directing arguments against the asymmetry to address the significant differences between positive claims of conscience as positive rights and negative claims of conscience. (shrink)

Hinge epistemology has to dispel the worry that disagreeing over hinges is rationally inert. Building on a companion piece (Coliva and Palmira 2020), this paper offers a constitutivist solution to the problem of rational inertia by maintaining that a Humean sceptic and a hinge epistemologist disagree over the correct explication of the concept of epistemic rationality. The paper explores the implications of such a solution. First, it clarifies in what sense a disagreement over hinges would be a conceptual disagreement. (...) Secondly, it uses considerations about the (alleged) rational inertia of hinge disagreement to offer a test whereby to demarcate genuine hinges from merely entrenched beliefs. Thirdly, it offers a response to the challenge of explaining why we have reason to engage in the epistemic practices that hinges are constitutive of in the first place. Fourthly, it argues that the constitutivist approach to hinge disagreement does not result in a relativist view. (shrink)

What is the proper role of a clinical ethics consultant’s religious beliefs in forming recommendations for clinical ethics consultation? Where Janet Malek has argued that religious belief should have no influence on the formation of a CEC’s recommendations, Clint Parker has argued a CEC should freely appeal to all their background beliefs, including religious beliefs, in formulating their recommendations. In this paper, I critique both their views by arguing the position envisioned by Malek puts the CEC too far from religion (...) and the position envisioned by Parker puts the CEC too close. For a CEC to give recommendations about what is morally prohibited, permissible, or obligatory in the clinic, I propose a view of the CEC that is neither religious nor non-religious but quasi-religious. I argue that a quasi-religious approach avoids the problems of both religious and non-religious views while preserving their benefits. Additionally, a quasi-religious view resists the marginalization of “religious” traditions that occurs when secular ethicists come to think of their approach as somehow distinctly non-religious. (shrink)

In his 2010 paper “Philosophical Naturalism and Intuitional Methodology”, Alvin I. Goldman invokes the Condorcet Jury Theorem in order to defend the reliability of intuitions. The present note argues that the original conditions of the theorem are all unrealistic when analysed in connection to the case of intuitions. Alternative conditions are discussed.

While many Catholic hospitals permit the prescription of the emergency contraception drug levonorgestrel for rape victims, some continue to prohibit this practice as a matter of institutional conscience. While the standard approach to this issue has been to offer an argument that levonorgestrel either is or is not morally permissible, we have taken a different tack. We begin by briefly describing and acknowledging that reasonable disagreement exists on this question (part one), and then arguing that the reasonable disagreement itself can (...) serve as a compelling basis for Catholic leadership at hospitals that prohibit emergency contraception for rape victims to accommodate physicians who wish to provide levonorgestrel as a matter of conscience (part two). We end by anticipating and responding to some objections. (shrink)

In the original publication of the article, the funding information was inadvertently missed out. The information is provided in this Correction.

Douglas Diekema has argued that it is not the best interest standard, but the harm principle that serves as the moral basis for ethicists, clinicians, and the courts to trigger state intervention to limit parental authority in the clinic. Diekema claims the harm principle is especially effective in justifying state intervention in cases of religiously motivated medical neglect in pediatrics involving Jehovah’s Witnesses and Christian Scientists. I argue that Diekema has not articulated a harm principle that is capable of justifying (...) state intervention in these cases. Where disagreements over appropriate care are tethered to metaphysical disagreements, it is moral-metaphysical standards, rather than merely moral standards, that are needed to provide substantive guidance. I provide a discussion of Diekema’s harm principle to the broader end of highlighting an inconsistency between the theory and practice of secular bioethics when overriding religiously based medical decisions. In a secular state, ethicists, clinicians, and the courts are purportedly neutral with respect to moral-metaphysical positions, especially regarding those claims considered to be religious. However, the practice of overriding religiously based parental requests requires doffing the mantle of neutrality. In the search for a meaningful standard by which to override religiously based parental requests in pediatrics, bioethicists cannot avoid some minimal metaphysical commitments. To resolve this inconsistency, bioethicists must either begin permitting religiously based requests, even at the cost of children’s lives, or admit that at least some moral-metaphysical disputes can be rationally adjudicated. (shrink)

In a recent issue of the Journal of Medicine and Philosophy, several scholars wrote on the topic of ethics expertise in clinical ethics consultation. The articles in this issue exemplified what we consider to be two troubling trends in the quest to articulate a unique expertise for clinical ethicists. The first trend, exemplified in the work of Lisa Rasmussen, is an attempt to define a role for clinical ethicists that denies they have ethics expertise. Rasmussen cites the dependence of ethical (...) expertise on irresolvable meta-ethical debates as the reason for this move. We argue against this deflationary strategy because it ends up smuggling in meta-ethical assumptions it claims to avoid. Specifically, we critique Rasmussen’s distinction between the ethical and normative features of clinical ethics cases. The second trend, exemplified in the work of Dien Ho, also attempts to avoid meta-ethics. However, unlike Rasmussen, Ho tries to articulate a notion of ethics expertise that does not rely upon meta-ethics. Specifically, we critique Ho’s attempts to explain how clinical ethicists can resolve moral disputes using what he calls the “Default Principle” and “arguments by parity.” We show that these strategies do not work unless those with the moral disagreement already share certain meta-ethical assumptions. Ultimately, we argue that the two trends of attempting to avoid meta-ethics by denying that clinical ethicists have ethics expertise, and attempting to articulate how ethics expertise can be used to resolve disputes without meta-ethics both fail because they do not, in fact, avoid doing meta-ethics. We conclude that these trends detract from what clinical ethics consultation was founded to do and ought to still be doing—provide moral guidance, which requires ethics expertise, and engagement with meta-ethics. To speak of ethicists without ethics expertise leaves their role in the clinic dangerously unclear and unjustified. (shrink)

The target article by Kyle Fritz draws attention to the asymmetry debate, an under-analyzed issue within the broader debate over the proper role of physician conscience in healthcare. The as...

A popular definition of epistemic peerage maintains that two subjects are epistemic peers if and only if they are equals with respect to general epistemic virtues and share the same evidence about the targeted issue. In this paper I shall take up the challenge of defending the necessity of the evidential equality condition for a definition of epistemic peerage from criticisms that can be elicited from the literature on peer disagreement. The paper discusses two definitions that drop this condition and (...) argues that they yield implausible verdicts about the instantiation of the epistemic peerage relation. (shrink)

Reductionist realist accounts of certain entities, such as the natural numbers and propositions, have been taken to be fatally undermined by what we may call the problem of arbitrary identification. The problem is that there are multiple and equally adequate reductions of the natural numbers to sets (see Benacerraf, 1965), as well as of propositions to unstructured or structured entities (see, e.g., Bealer, 1998; King, Soames, & Speaks, 2014; Melia, 1992). This paper sets out to solve the problem by canvassing (...) what we may call the arbitrary reference strategy. The main claims of such strategy are 2. First, we do not know which objects are the referents of proposition and numerical terms since their reference is fixed arbitrarily. Second, our ignorance of which object is picked out as the referent does not entail that no object is referred to by the relevant expression. Different articulations of the strategy are assessed, and a new one is defended. (shrink)

The national standards for clinical ethics consultation set forth by the American Society for Bioethics and Humanities endorse an “ethics facilitation” approach, which characterizes the role of the ethicist as one skilled at facilitating consensus within the range of ethically acceptable options. To determine the range of ethically acceptable options, ASBH recommends the standard model of decision-making, which is grounded in the values of autonomy, beneficence, nonmaleficence, and justice. H. Tristram Engelhardt Jr. has sharply criticized the standard model for presuming (...) contentful moral claims in circumscribing the range of ethically acceptable options, which, he argues, cannot be rationally justified in a pluralistic context. Engelhardt’s solution is a secular clinical ethics based on a contentless principle of permission. The first part of this article lays out Engelhardt’s negative claim, that reason cannot establish contentful moral claims, and his positive claim, that secular clinical ethics ought to be based on a contentless principle of permission. The second part critiques these negative and positive claims. The purpose of this paper is to defend secular clinical ethics expertise—defined as the ability of ethicists to offer justified moral recommendations grounded in consensus positions endorsed by the American Society for Bioethics and Humanities—from the radical critiques of Engelhardt, who argues that no moral or metaphysical claims, and hence no bioethical consensus, can be rationally justified. Engelhardt’s critiques have caused some to worry that secular clinical ethics is in a state of theoretical crisis; this article concludes that Engelhardt’s view is an unstable basis for that worry. (shrink)

According to a standard account of patient decision-making capacity, patients can provide ethically valid consent or refusal only if they are able to understand and appreciate their medical c...

This article examines the relationship between Puerto Rico's export-oriented development program and the demand for women workers in the manufacturing sector from 1952 to 1980. Its central proposition is that the consistently high proportion of women in the manufacturing sector was the result of an employment structure characterized by specialization in assembly-type activities and low wages. Although the Puerto Rican government pursued a development strategy designed to increase job opportunities for men, the manufacturing industries attracted to the island by its (...) export-oriented industrialization policies generated a strong demand for women workers. The apparent contradiction between the employment practices of manufacturing establishments and government policies is due to the restructuring of the global economy and the emergence of a new international division of labor that brought increasing numbers of women into the labor market. (shrink)