The article explores the underlying reasons for patients’ self‐perception of being a burden (SPB) in family settings, including its impact on relationships when wishes to die (WTD) are expressed. In a prospective, interview‐based study of WTD in patients with advanced cancer and non‐cancer disease (organ failure, degenerative neurological disease, and frailty) SPB was an important emerging theme. In a sub‐analysis we examined (a) the facets of SPB, (b) correlations between SPB and WTD, and (c) SPB as a relational phenomenon. We (...) analyzed 248 interviews with 62 patients, their family caregivers, and professionals using grounded theory and interpretive phenomenological analysis. SPB appeared as important empathic concern in care situations. Patients expressed many sorts of concerns for others, but also perceived an altered self‐understanding that did not meet mutual expectations within relationships. In SPB associated with WTD three constellations were found: (a) WTD to unburden others; (b) patients decided against hastening death to prevent being a further burden to others (in these cases, the SPB counteracted the wish to die); and (c) both wishes for and against dying were sustained by SPB. These patients often felt paralyzed and suffered deeply. Family caregivers felt emotionally touched by SPB and tried to unburden patients by caring and compassion. We concluded that the impact of SPB on a WTD and the various meanings the facets of SPB have in balancing relationships need to be worked out individually. An early palliative and narrative approach is warranted. (shrink)

: Aanerud's project is to develop an account of white antiracist mothering, using a model of maternal duty to raise antiracist white children. The author sets this project in the context of historic constructions of white mothering in the twentieth century and then contrasts the need for an exploration of white mothers raising white children against the literature of white mothers' raising children of color and mothers of color raising their own children, Once this distinction is made, Aanerud uses Collins's (...) account of racial ethnic mothering as a springboard into her discussion of antiracist white mothering of white children. (shrink)

Aanerud's project is to develop an account of white antiracist mothering, using a model of maternal duty to raise antiracist white children. The author sets this project in the context of historic constructions of white mothering in the twentieth century and then contrasts the need for an exploration of white mothers raising white children against the literature of white mothers’ raising children of color and mothers of color raising their own children, Once this distinction is made, Aanerud uses Collins's account (...) of racial ethnic mothering as a springboard into her discussion of antiracist white mothering of white children. (shrink)

Aanerud's project is to develop an account of white antiracist mothering, using a model of maternal duty to raise antiracist white children. The author sets this project in the context of historic constructions of white mothering in the twentieth century and then contrasts the need for an exploration of white mothers raising white children against the literature of white mothers’ raising children of color and mothers of color raising their own children, Once this distinction is made, Aanerud uses Collins's account (...) of racial ethnic mothering as a springboard into her discussion of antiracist white mothering of white children. (shrink)

In this article, we outline a novel approach to understanding the role of responsibility in health promotion. Efforts to tackle chronic disease have led to an emphasis on personal responsibility and the identification of ways in which people can ‘take responsibility’ for their health by avoiding risk factors such as smoking and over-eating. We argue that the extent to which agents can be considered responsible for their health-related behaviour is limited, and as such, state health promotion which assumes certain forms (...) of moral responsibility should be avoided. This indicates that some approaches to health promotion ought not to be employed. We suggest, however, that another form of responsibility might be more appropriately identified. This is based on the claim that agents have prudential reasons to maintain their health, in order to pursue those things which make their lives go well—i.e. that maintenance of a certain level of health is rational for many agents, given their pleasures and plans. On this basis, we propose that agents have a self-regarding prudential responsibility to maintain their health. We outline the implications of a prudential responsibility approach to health promotion. (shrink)

Former NAACP chapter head Rachel Dolezal's attempted transition from the white to the black race occasioned heated controversy. Her story gained notoriety at the same time that Caitlyn Jenner graced the cover of Vanity Fair, signaling a growing acceptance of transgender identity. Yet criticisms of Dolezal for misrepresenting her birth race indicate a widespread social perception that it is neither possible nor acceptable to change one's race in the way it might be to change one's sex. Considerations that support transgenderism (...) seem to apply equally to transracialism. Although Dolezal herself may or may not represent a genuine case of a transracial person, her story and the public reaction to it serve helpful illustrative purposes. (shrink)

Human Rights Education (HRE) has traditionally been articulated in terms of cultivating better citizens or world citizens. The main preoccupation in this strand of HRE has been that of bridging a gap between universal notions of a human rights subject and the actual locality and particular narratives in which students are enmeshed. This preoccupation has focused on ‘learning about the other’ in order to improve relations between plural ‘others’ and ‘us’ and reflects educational aims of national identity politics in citizenship (...) education. The article explores the learning of human rights through narratives in relations, drawing on Hannah Arendt and Sharon Todd. For this re-thinking of relations in learning human rights, the article argues that HRE needs to address both competing historical narratives on the drafting of the Universal Declaration on Human Rights (UDHR) as well as unique life narratives of learners. (shrink)

In Working Virtue: Virtue Ethics and Contemporary Moral Problems, leading figures in the fields of virtue ethics and ethics come together to present the first ...

Biological ontologies are used to organize, curate, and interpret the vast quantities of data arising from biological experiments. While this works well when using a single ontology, integrating multiple ontologies can be problematic, as they are developed independently, which can lead to incompatibilities. The Open Biological and Biomedical Ontologies Foundry was created to address this by facilitating the development, harmonization, application, and sharing of ontologies, guided by a set of overarching principles. One challenge in reaching these goals was that the (...) OBO principles were not originally encoded in a precise fashion, and interpretation was subjective. Here we show how we have addressed this by formally encoding the OBO principles as operational rules and implementing a suite of automated validation checks and a dashboard for objectively evaluating each ontology’s compliance with each principle. This entailed a substantial effort to curate metadata across all ontologies and to coordinate with individual stakeholders. We have applied these checks across the full OBO suite of ontologies, revealing areas where individual ontologies require changes to conform to our principles. Our work demonstrates how a sizable federated community can be organized and evaluated on objective criteria that help improve overall quality and interoperability, which is vital for the sustenance of the OBO project and towards the overall goals of making data FAIR. Competing Interest StatementThe authors have declared no competing interest. (shrink)

This paper argues that there exists a collective epistemic state of ‘Broad Medical Uncertainty’ regarding the effectiveness of many medical interventions. We outline the features of BMU, and describe some of the main contributing factors. These include flaws in medical research methodologies, bias in publication practices, financial and other conflicts of interest, and features of how evidence is translated into practice. These result in a significant degree of uncertainty regarding the effectiveness of many medical treatments and unduly optimistic beliefs about (...) the benefit/harm profiles of such treatments. We argue for an ethical presumption in favour of openness regarding BMU as part of a ‘Corrective Response’. We then consider some objections to this position, including concerns that public honesty about flaws in medical research could undermine trust in healthcare institutions. We suggest that, as it stands, the Anti-Corrective Response is unconvincing. (shrink)

Recent theoretical models suggest that the difference between human and nonhuman primate life-history patterns may be due to a reliance on complex foraging strategies requiring extensive learning. These models predict that children should reach adult levels of efficiency faster when foraging is cognitively simple. We test this prediction with data on Meriam fishing, spearfishing, and shellfishing efficiency. For fishing and spearfishing, which are cognitively difficult, we can find no significant amount of variability in return rates because of experiential factors correlated (...) with age. However, for shellfish collecting, which is relatively easy to learn, there are strong age-related effects on efficiency. Children reach adult efficiency more quickly in fishing as compared to shellfish collecting, probably owing to the size and strength constraints of the latter. (shrink)

The 'Gamer's Dilemma' is the problem of why some actions occurring in video game contexts seem to have similar, albeit attenuated, kinds of moral significance to their real-world equivalents, while others do not. In this paper, I argue that much of the confusion in the literature on this problem is not ethical but metaphysical. The Gamer's Dilemma depends on a particular theory of the virtual, which I call 'inflationary', according to which virtual worlds are a metaphysical novelty generated almost exclusively (...) by video games. Actions performed in virtual worlds really belong to the kinds of action they appear to—'virtual murder' is a kind of murder. Inflationary theories are contrasted with 'deflationary' theories which, in effect, consider video games purely as systems for generating images, and thus the gamer as a consumer of media images. Inflationary theories struggle to explain why video games produce this unique metaphysical novelty; deflationary theories fail to do justice to the intuition that there is some significant difference between the gamer and the consumer of other media forms. In place of either, I sketch a theory of the gamer as performer, primarily by analogy with stage and cinema actors, which I suggest captures more of the moral complexity of the gamer's action. (shrink)

Wish to die statements are becoming a frequent phenomenon in terminally ill patients. Those confronted by these statments need to understand the complexity of such wishes, so they can respond competently and compassionately to the requests. If misunderstood, the statements can be taken at face-value and the practitioner may not recognise that a patient is in fact experiencing ambivalent feelings at the end of life, or they may misinterpret the expressed wish to die as a sign of clinical depression. Public (...) debate about the morality and ethics of various end-of-life care options has exploded in recent years. However, it has never been sensitive to the finer aspects of clinical reality or the experiences of patients. The Patient's Wish to Die: Research, Ethics, and Palliative Care brings together that reality and the patient's voice, combining them with different research approaches. It presents the best available knowledge and research methodologies about patients' wishes at the end-of-life, together with a series of ethical views and a discussion about the clinical implications for palliative care. The book presents material in an open and unbiased manner whilst remaining sensitive to the spiritual and existential dimensions of dying, and to the different cultural views that provide meaning to the individual. Written by the best specialists and ethics scholars from around the world, including palliative care practitioners and end-of-life scholars from countries where assisted dying practices are legalized and from those where it isn't, The The Patient's Wish to Die: Research, Ethics, and Palliative Care will prove essential reading for all those working or studying in the field of palliative care. (shrink)

The postmodern criticism of music analysis remains unwittingly preoccupied with a false image of ‘the Whole’, or with the construction of unity precisely through privileging its opposite. At the centre of this discourse there often emerges a split between two things—analysis/aesthetics, part/whole, subject/object—where the question then becomes one of reconciliation: how can the analytical methods be subsumed into aesthetic discussions of subjectivity to better represent the ‘thing itself’? This problem is now a cross-disciplinary one, with criticism favouring the application of (...) ‘external’ disciplines to complement the ‘internal’ act of music analysis. This article takes Žizek’s comments on the difference between modernism and postmodernism as alienation and separation as its starting point in order to reconsider the effects of the supposedly postmodern concept of interdisciplinarity for music analysis. Through a critique of existing musico-psychoanalytic literature, it demonstrates the ways in which the interdisciplinary relation currently seems to occupy the space of an objet petit a in scholarship that is therefore marked by a failure restricted to the principles of alienation. If read alongside Žižek’s phenomenology of the subject however, rather than become a fetishized unity, this relation could be seen to construct the space for a self-reflexive musical subject, able to avoid false reconciliation through critical self- awareness, and could also therefore hold greater significance for an interdisciplinary musicology. (shrink)

My particular focus in this article is on getting clearer about what Nietzsche’s experimentalism entails. Some immediate resistance may form in response to this proposal, based on my use of the term experimentalism. As Walter Kaufmann has pointed out in a discussion of experimentalism, Nietzsche himself does not discuss his work using this concept; in the original German, Nietzsche uses the terms “Experiment” and “Versuch.”1 In light of this, two main concerns may be raised about my proposal that experimentalism is (...) worth some of our time and attention: whether it is necessary or helpful to focus discussion on yet another “ism” within Nietzsche scholarship and given that experimentalism is not Nietzsche’s.. (shrink)

van der Pijl et al 1 argue that if ‘stakes are high’ and there is ‘clear conviction by the care provider’ that it is ‘necessary’, episiotomy may be given after ‘opt-out consent’. Here I caution against the applicability of their approach to vaginal examination (VE): another routine intervention in birth to which they suggest their discussion may apply. I highlight three concerns: first, the subjective and unjustified nature of assessments of ‘necessity’; second, the inadequacy of current consent practices in relation (...) to VE; and third, the significant risk of perpetuating under-recognised harms associated with unwanted or unconsented VE. I argue that opt-out consent cannot be ethically justified for VE. Its use would result in further weakening of consent practices, circumvention of individuals’ autonomy, and greater harm for women and birthing people. At the outset, it is important to recognise that the authors do not claim that their approach should be applied to VE, merely that their discussion may have relevance to consent for other interventions beyond episiotomy ‘where consent is also frequently lacking, and which are under-researched’, including VE.1 Nonetheless, it is easy to assume that episiotomy and VE are sufficiently similar that their analysis might be transferred wholesale. I disagree. There are similarities: both interventions are performed on ‘the most intimate and socially sensitive body parts’1; …. (shrink)

The claim that we have a moral obligation, where a choice can be made, to bring to birth the 'best' child possible, has been highly controversial for a number of decades. More recently Savulescu has labelled this claim the Principle of Procreative Beneficence. It has been argued that this Principle is problematic in both its reasoning and its implications, most notably in that it places lower moral value on the disabled. Relentless criticism of this proposed moral obligation, however, has been (...) unable, thus far, to discredit this Principle convincingly and as a result its influence shows no sign of abating. I will argue that while criticisms of the implications and detail of the reasoning behind it are well founded, they are unlikely to produce an argument that will ultimately discredit the obligation that the Principle of Procreative Beneficence represents. I believe that what is needed finally and convincingly to reveal the fallacy of this Principle is a critique of its ultimate theoretical foundation, the notion of impersonal harm. In this paper I argue that while the notion of impersonal harm is intuitively very appealing, its plausibility is based entirely on this intuitive appeal and not on sound moral reasoning. I show that there is another plausible explanation for our intuitive response and I believe that this, in conjunction with the other theoretical criticisms that I and others have levelled at this Principle, shows that the Principle of Procreative Beneficence should be rejected. (shrink)

Questions of what a self-driving car ought to do if it encounters a situation analogous to the ‘trolley problem’ have dominated recent discussion of the ethics of self-driving cars. This paper argues that this interest is misplaced. If a trolley-style dilemma situation actually occurs, given the limits on what information will be available to the car, the dynamics of braking and tyre traction determine that, irrespective of outcome, it is always least risky for the car to brake in a straight (...) line rather than swerve. (shrink)

Mathematicians judge proofs to possess, or lack, a variety of different qualities, including, for example, explanatory power, depth, purity, beauty and fit. Philosophers of mathematical practice have begun to investigate the nature of such qualities. However, mathematicians frequently draw attention to another desirable proof quality: being motivated. Intuitively, motivated proofs contain no "puzzling" steps, but they have received little further analysis. In this paper, I begin a philosophical investigation into motivated proofs. I suggest that a proof is motivated if and (...) only if mathematicians can identify (i) the tasks each step is intended to perform; and (ii) where each step could have reasonably come from. I argue that motivated proofs promote understanding, convey new mathematical resources and stimulate new discoveries. They thus have significant epistemic benefits and directly contribute to the efficient dissemination and advancement of mathematical knowledge. Given their benefits, I also discuss the more practical matter of how we can produce motivated proofs. Finally I consider the relationship between motivated proofs and proofs which are explanatory, beautiful and fitting. (shrink)

In 1837, Dirichlet proved that there are infinitely many primes in any arithmetic progression in which the terms do not all share a common factor. Modern presentations of the proof are explicitly higher-order, in that they involve quantifying over and summing over Dirichlet characters, which are certain types of functions. The notion of a character is only implicit in Dirichlet’s original proof, and the subsequent history shows a very gradual transition to the modern mode of presentation. In this essay, we (...) describe an approach to the philosophy of mathematics in which it is an important task to understand the roles of our ontological posits and assess the extent to which they enable us to achieve our mathematical goals. We use the history of Dirichlet’s theorem to understand some of the reasons that functions are treated as ordinary objects in contemporary mathematics, as well as some of the reasons one might want to resist such treatment. We also use these considerations to illuminate the formal treatment of functions and objects in Frege’s logical foundation, and we argue that his philosophical and logical decisions were influenced by many of the same factors. (shrink)

Three approaches to intertextual writing are available to college instructors: mechanical, ethical, and rhetorical. The mechanical approach, a staple of writing instruction, teaches the use of citation styles such as MLA or APA; methods of citing sources; and the conventions of quotation. The ethical approach is primarily concerned with the character of individual writers and their adherence to community standards categorized as “academic integrity.” The great majority of source-based writing instruction attends to one or both of these approaches. A third (...) approach, rhetorical intertextuality, is overshadowed by the ethical concerns that currently permeate educational institutions. Rhetorical intertextuality does promote textual ethics, but in a positive way, through instruction in building meaning in a target text through collaboration with source texts. Rhetorical intertextuality brings the source texts themselves to life and aims to engage the audience in a conversation with target text and source texts. Drawing on Citation Project data, we advocate instruction in intertextual writing that hails students as authors, not transgressors. Rhetorical intertextuality can provide a positive frame for college instruction in intertextual writing, one that facilitates deep engagement with texts; intellectual approaches to paraphrasing and summarizing; and an emphasis on the rhetorical choices that writers make as they encounter and respond to the ideas of others. The objective of such instruction is a dialogic interface between writer, audience, and sources—a conversation. (shrink)

In the UK, it has been proposed that alongside the current advice to abstain from alcohol completely in pregnancy, there should be increased screening of pregnant women for alcohol consumption in order to prevent instances of fetal alcohol spectrum disorder. The Scottish Intercollegiate Guidelines Network published guidelines in 2019 recommending that standardised screening questionnaires and associated use of biomarkers should be considered to identify alcohol exposure in pregnancy. This was followed in 2020 by the National Institute for Health and Care (...) Excellence Draft Quality Standard, which recommended that pregnant women should have information on their alcohol consumption recorded throughout their pregnancy and this information transferred to the child’s health records. Most recently, Public Health England has stated that the alcohol intake of all women should be recorded throughout pregnancy, not just at the initial booking appointment and that tools such as blood biomarkers and meconium testing should be researched in order to determine true prevalence rates of alcohol in pregnancy. We argue that this proposed enhanced screening undermines women’s autonomy and their legal right to be sufficiently informed to consent to screening. We argue that there is no evidence that this kind of screening will result in a reduction of fetal harm and there is a danger that undermining the autonomy of women and the trust relationship between women and healthcare professionals may even increase harm to future children. (shrink)

The Principle of Procreative Beneficence claims that we have a moral obligation, where choice is possible, to choose to create the best child we can. The existence of this moral obligation has been proposed by John Harris and Julian Savulescu and has proved controversial on many levels, not least that it is eugenics, asking us to produce the best children we can, not for the sake of that child's welfare, but in order to make a better society. These are strong (...) claims that require robust justification that can be open to scrutiny and debate. This article argues that robust justifications are currently lacking in the work of Savulescu and Harris. The justifications provided for their conclusions about this obligation to have the best child possible rely heavily on Derek Parfit's Non-Identity Problem and the intuitive response this provokes in many of us. Unfortunately Harris and Savulescu do not embrace the entirety of the Non-Identity Problem and the puzzle that it presents. The Non-Identity Problem actually provides a refutation of PPB. In order to establish PPB as a credible and defendable principle, Harris and Savulescu need to find what has eluded Parfit and many others: a solution to the Non-Identity Problem and thus an overturning of the refutation it provides for PPB. While Harris and Savulescu do hint at possible but highly problematic solutions to the Non-Identity Problem, these are not developed or defended. As a result their controversial is left supported by little more than intuition. (shrink)

It is unclear whether someone’s responsibility for developing a disease or maintaining his or her health should affect what healthcare he or she receives. While this dispute continues, we suggest that, if responsibility is to play a role in healthcare, the concept must be rethought in order to reflect the sense in which many health-related behaviours occur repeatedly over time and are the product of more than one agent. Most philosophical accounts of responsibility are synchronic and individualistic; we indicate here (...) what paying more attention to the diachronic and dyadic aspects of responsibility might involve and what implications this could have for assessments of responsibility for health-related behaviour. (shrink)

In medias res: the life of Claude de Seyssel -- The scholar diplomat -- The translator of histories -- Seyssel in Italy : a scholar looks at war -- The scholar and the state -- Seyssel, the church, and the ideal prelate.

Ch. G. Bardili (1761-1808) ist der Begrunder des rationalen Realismus mit dem Ziel eines von der Materialitat ausgehenden Gottesbeweises. Heute nur noch als von den Zeitgenossen fast einhellig abgelehnter Denker bekannt, bietet sein Schaffen in der enormen Spannbreite von Wissenschaftsreflexionen, Ethik, Philosophiegeschichte und Logik doch ein interessantes, facettenreiches und in seiner Radikalitat anregendes Gesamtkonzept. Dieses Werk erstmals in vollem Umfang zu erschliessen, das ganze System Bardilis in seiner Entwicklung und seinen Inhalten nachzuzeichnen sowie in seinen Grundzugen, die fur die Debatten (...) der Zeit, etwa mit Fichte, Schelling und Reinhold, bedeutsam sind, aufzuweisen, ist die Absicht des vorliegenden Bandes.'Bislang liegt uber Bardili keine nennenswerte Literatur vor. [.] Diese Lucke schliesst nun die vorgelegte Monographie, [.] um so ein Werk vorzustellen, das zwar heute weitgehend in den Hintergrund geruckt oder oft schlicht vergessen ist, das es gleichwohl - wie die Vf. uberzeugend zu zeigen vermag - verdient hat, wieder starkere Beachtung zu finden, weil es zu zentralen Fragestellungen, wie sie im Bereich der klassischen deutschen Philosophie wichtig und bestimmend geworden sind, eine haufig zweifellos eigenwillige, aber trotzdem wegen seines hohen Grades an Originalitat und seiner radikalen, wenn auch bisweilen exzentrisch anmutenden, Alternativstellung bedenkenswerte Anstosse bietet. [.] Insgesamt leistet die Vf. mit ihrer Monographie Hervorragendes und Vorbildliches: Sie zeichnet den Denkweg und das System Bardilis in ihrer Entwicklung und ihren Inhalten nach. Die wesentlichen Grundzuge, die sich fur die Debatten, Streitgesprache und [.] philosophischen Konstellationen der Zeit als so bedeutsam erwiesen, werden pragnant aufgewiesen und mit denkerisch hochster Souveranitat durchdrungen.' Dirk Cursgen, Philosophische Rundschau. (shrink)

This paper sketches an account of reparative justice for climate refugees, focusing on total land loss due to sea-level rise. I begin by outlining the harm of this loss in terms of self-determination and cultural heritage. I then consider, first, who is owed these reparations? Second, who should pay such reparations? Third, in what form should the reparations be paid? I end with thoughts on the project of reparative justice more generally, arguing that such obligations do not depend upon a (...) perfect account of how reparations might be fulfilled; we simply have an obligation to shoot the arrow as close to the target as we can. (shrink)

Previous work in Game Studies has centered on several loci of investigation in seeking to understand virtual gameworlds. First, researchers have scrutinized the concept of the virtual world itself and how it relates to the idea of “the magic circle”. Second, the field has outlined various forms of experienced “presence”. Third, scholarship has noted that the boundaries between the world of everyday life and virtual worlds are porous, and that this fosters a multiplicity of identities as players identify both with (...) themselves-offline and themselves-in-game. Despite widespread agreement that these topics are targets for research, so far those working on these topics do not have mutually agreed-upon framework. Here we draw upon the work of Alfred Schutz to take up this call. We provide a phenomenological framework which can be used to describe the phenomena of interest to Game Studies, as well as open new avenues of inquiry, in a way acceptable and useful to all. This helps to distinguish the core of the field from the supplemental theoretical and critical commitments which characterize diverse approaches within the field. (shrink)

Extensively employed in reproductive science, the term fetal–maternal interface describes how maternal and fetal tissues interact in the womb to produce the transient placenta, purporting a theory of pregnancy where ‘mother’, ‘fetus’, and ‘placenta’ are already-separate entities. However, considerable scientific evidence supports a different theory, which is also elaborated in feminist and new materialist literatures. Informed by interviews with placenta scientists as well as secondary sources on placental immunology and the developmental origins of health and disease, I explore evidence not (...) of interfacing during pregnancy, but of intra-action, or the mutual emergence of entities in simultaneous practices of differentiation and connection. I argue that attending to evidence that can be figured as intra-action enables us to recognize, account for, and attend to diffuse responsibilities for fetal–maternal outcomes that extend beyond mothers to the biosocial milieus of pregnancy. In reimaging the intra-action of placentas, a new understanding of what constitutes a ‘healthy pregnancy’ becomes possible. (shrink)