I explore how gender can shape the pragmatics of speech. In some circumstances, when a woman deploys standard discursive conventions in order to produce a speech act with a specific performative force, her utterance can turn out, in virtue of its uptake, to have a quite different force—a less empowering force—than it would have if performed by a man. When members of a disadvantaged group face a systematic inability to produce a specific kind of speech act that they are entitled (...) to perform—and in particular when their attempts result in their actually producing a different kind of speech act that further compromises their social position and agency—then they are victims of what I call discursive injustice. I examine three examples of discursive injustice. I contrast my account with Langton and Hornsby's account of illocutionary silencing. I argue that lack of complete control over the performative force of our speech acts is universal, and not a special marker of social disadvantage. However, women and other relatively disempowered speakers are sometimes subject to a distinctive distortion of the path from speaking to uptake, which undercuts their social agency in ways that track and enhance existing social disadvantages. (shrink)

I explore how we negotiate sexual encounters with one another in language and consider the pragmatic structure of such negotiations. I defend three theses: Discussions of consent have dominated the philosophical and legal discourse around sexual negotiation, and this has distorted our understanding of sexual agency and ethics. Of central importance to good-quality sexual negotiation are sexual invitations and gift offers, as well as speech designed to set up safe frameworks and exit conditions. Sexual communication that goes well does not (...) just prevent harm; it enables forms of agency, pleasure, and fulfillment that would not otherwise be possible. (shrink)

I explore the role that values and interests, especially ideological interests, play in managing and balancing epistemic risks in medicine. I will focus in particular on how diseases are identified and operationalized. Before we can do biomedical research on a condition, it needs to be identified as a medical condition, and it needs to be operationalized in a way that lets us identify sufferers, measure progress, and so forth. I will argue that each time we do this, we engage in (...) epistemic risk balancing that inevitably draws upon values and interests, often including social and ideological values. My main interest here is in the conceptualization of infertility as a disease. Infertility is a rich test case for exploring the interplay between interests and epistemic risk management. There is no uncontested or standardized definition of infertility. The various definitions of it are internally ambiguous and tension-ridden, and in spectacular contradiction with one another. Many interest groups who are invested in framing infertility as a pressing problem deserving of social and medical redress are quick to insist that it is a legitimate ‘disease,’ but they cannot agree on which disease it is, what its symptoms or diagnostic markers are, or even what its basic ontology is. I suggest that there are political explanations for this epistemic mess. Indeed, I contend that there are good scientific and ethical reasons to reduce away the category of ‘infertility,’ especially understood as a scientific or medical category; I argue that we should excise the concept from our research and clinical practices. (shrink)

Mass Hysteria examines the medical and cultural practices surrounding pregnancy, new motherhood, and infant feeding. Late eighteenth century transformations in these practices reshaped mothers' bodies, and contemporary norms and routines of prenatal care and early motherhood have inherited the legacy of that era. As a result, mothers are socially positioned in ways that can make it difficult for them to establish and maintain healthy and safe boundaries and appropriate divisions between public and private space.

This paper discusses a crisis of accountability that arises when scientific collaborations are massively epistemically distributed. We argue that social models of epistemic collaboration, which are social analogs to what Patrick Suppes called a “model of the experiment,” must play a role in creating accountability in these contexts. We also argue that these social models must accommodate the fact that the various agents in a collaborative project often have ineliminable, messy, and conflicting interests and values; any story about accountability in (...) a massively distributed collaboration must therefore involve models of such interests and values and their methodological and epistemic effects. (shrink)

Ghostwriting scandals are pervasive in industry-funded biomedical research, and most responses to them have presumed that they represent a sharp transgression of the norms of scientific authorship. I argue that in fact, ghostwriting represents a continuous extension of current socially accepted authorship practices. I claim that the radically collaborative, decentralized, interdisciplinary research that forms the gold standard in medicine is in an important sense unauthored, and that this poses a serious problem in applied social epistemology. It is no easy matter (...) to find procedural or architectural solutions that can secure epistemic trust and accountability for collaborative publishing in biomedicine. (shrink)

Wilfrid Sellars's iconic exposé of the ‘myth of the given’ taught us that experience must present the world to us as normatively laden, in the sense that the contents of experience must license inferences, rule out and justify various beliefs, and rationalize actions. Somehow our beliefs must be governed by the objects as they present themselves to us. Often this requirement is cashed out using language that attributes agent-like properties to objects: we are described as ‘accountable to’ objects, while objects (...) ‘hold us’ to standards, and so forth. But such language is either deeply anti-naturalistic or trades on a set of metaphors in need of a literal translation. We offer an explanation of how the material features of the world, as received in experience, can rationally constrain our beliefs and practices—one that makes no recourse to this imagery. In particular, we examine the structure of ostensive practices (that is, practices of directing one another's attention to objects and features of the world) and the distinctive role they play in making us jointly beholden to how things actually are. (shrink)

: The standard bioethics account is that respecting patient autonomy means ensuring patients make their own decisions. In fact, respecting patient autonomy often has more to do with the overall shape and meaning of patients' health care regimes, and sometimes, at least, patients will very reasonably defer to medical authority.

As a culture, we have a tendency to measure motherhood in terms of a set of signal moments that have become the focus of special social attention and anxiety; we interpret these as emblematic summations of women's mothering abilities. Women's performances during these moments can seem to exhaust the story of mothering, and mothers often internalize these measures and evaluate their own mothering in terms of them. "Good" mothers are those who pass a series of tests—they bond properly during their (...) routine ultrasound screening, they do not let a sip of alcohol cross their lips during pregnancy, they give birth vaginally without pain medication, they do not offer their child an artificial nipple during the first six months, they feed their children maximally nutritious meals with every bite, and so on. This reductive understanding of mothering has had counterproductive effects upon health care practice and policy, encouraging measures that penalize mothers who do not live up to cultural norms during signal moments, while failing to promote extended narratives of healthy mothering. (shrink)

Philosophers have often posited a foundational calling voice, such that hearing its call constitutes subjects as responsive and responsible negotiators of normative claims. I give the name ldquo;transcendental conscience to that which speaks in this founding, constitutive voice. The role of transcendental conscience is not – or not merely – to normatively bind the subject, but to constitute the possibility of the subject's being bound by any particular, contentful normative claims in the first place. I explore the ontological and temporal (...) status of transcendental conscience, using Heidegger's account of conscience in Being and Time as my textual touchstone. I ask what performative structure the call of conscience might have that would enable it to constitute normative responsiveness, and I raise some temporal conundrums surrounding this structure. I argue that it is incoherent to attempt to give a literal, chronological account of the origin of normative grip and response. I suggest that we can best understand the founding calls of conscience, not as literal events occurring in regular time, but as events that can only show up retrospectively, as occurring in an ever-receding, unlocalizable past, and that these calls can only be figured mythically and metaphorically. Appropriating a Derridean term, I claim that the voice of transcendental conscience must be that of a lsquo;ghost, whose call binds us by haunting us – a haunting that is no less transcendentally necessary for its inability to be translated into a literal historical event. (shrink)

Epistemologists generally think that genuine warrant that is available to anyone must be available to everyone who is exposed to the relevant causal inputs and is able and willing to properly exercise her rationality. The motivating idea behind this requirement is roughly that an objective view is one that is not bound to a particular perspective. In this paper I ask whether the aperspectivality of our warrants is a precondition for securing the objectivity of our claims. I draw upon a (...) Sellarsian account of perception in order to argue that it is not; rather, inquirers can have contingent properties and perspectives that give them access to forms of rational warrant and objective knowledge that others do not have. The universal accessibility of reasons, on my account, is not a precondition for the legitimacy of any actual warrant, but rather a regulative ideal governing inquiry and communication. (shrink)

Mothers serve as an important layer of the health-care system, with special responsi-bilities to care for the health of families and nations. In our social discourse, we tend to treat maternal “choices” as though they were morally and causally Self-contained units of influence with primary control over children's health. In this essay, I use infant feeding as a lens for examining the ethical contours of mothers’ caretaking practices and responsibilities, as they are situated within cultural meanings and institutional pressures. I (...) give a close critical reading of the content and strategy of the new breastfeeding advocacy campaign sponsored by the United States Department of Health and Human Services. I argue that the campaign is unlikely to substantially increase breastfeeding rates, unresponsive and even hostile to many women's actual concerns about breastfeeding, and well positioned to produce shame and compromise agency among the women it targets. (shrink)

Over the last several years, as cesarean deliveries have grown increasingly common, there has been a great deal of public and professional interest in the phenomenon of women 'choosing' to deliver by cesarean section in the absence of any specific medical indication. The issue has sparked intense conversation, as it raises questions about the nature of autonomy in birth. Whereas mainstream bioethical discourse is used to associating autonomy with having a large array of choices, this conception of autonomy does not (...) seem adequate to capture concerns and intuitions that have a strong grip outside this discourse. An empirical and conceptual exploration of how delivery decisions ought to be negotiated must be guided by a rich understanding of women's agency and its placement within a complicated set of cultural meanings and pressures surrounding birth. It is too early to be 'for' or 'against' women's access to cesarean delivery in the absence of traditional medical indications – and indeed, a simple pro- or con- position is never going to do justice to the subtlety of the issue. The right question is not whether women ought to be allowed to choose their delivery approach but, rather, taking the value of women's autonomy in decision-making around birth as a given, what sorts of guidelines, practices, and social conditions will best promote and protect women's full inclusion in a safe and positive birth process. (shrink)

This volume explores the relationship between Kant's aesthetic theory and his critical epistemology as articulated in the Critique of Pure Reason and the Critique of the Power of Judgment. The essays, written specially for this volume, explore core elements of Kant's epistemology, such as his notions of discursive understanding, experience, and objective judgment. They also demonstrate a rich grasp of Kant's critical epistemology that enables a deeper understanding of his aesthetics. Collectively, the essays reveal that Kant's critical project, and the (...) dialectics of aesthetics and cognition within it, is still relevant to contemporary debates in epistemology, philosophy of mind, and the nature of experience and objectivity. The book also yields important lessons about the ineliminable, yet problematic place of imagination, sensibility and aesthetic experience in perception and cognition. (shrink)

: Mothers serve as an important layer of the health-care system, with special responsibilities to care for the health of families and nations. In our social discourse, we tend to treat maternal "choices" as though they were morally and causally self-contained units of influence with primary control over children's health. In this essay, I use infant feeding as a lens for examining the ethical contours of mothers' caretaking practices and responsibilities, as they are situated within cultural meanings and institutional pressures. (...) I give a close critical reading of the content and strategy of the new breastfeeding advocacy campaign sponsored by the United States Department of Health and Human Services. I argue that the campaign is unlikely to substantially increase breastfeeding rates, unresponsive and even hostile to many women's actual concerns about breastfeeding, and well positioned to produce shame and compromise agency among the women it targets. (shrink)

: The principle of equipoise traditionally is grounded in the special obligations of physician-investigators to provide research participants with optimal care. This grounding makes the principle hard to apply in contexts with limited health resources, to research that is not directed by physicians, or to non-therapeutic research. I propose a different version of the principle of equipoise that does not depend upon an appeal to the Hippocratic duties of physicians and that is designed to be applicable within a wider range (...) of research contexts and types—including health services research and research on social interventions. I consider three examples of ethically contentious research trials conducted in three different social settings. I argue that in each case my version of the principle of equipoise provides more plausible and helpful guidance than does the traditional version of the principle. (shrink)

: The way patients make health care decisions is much more complicated than is often recognized. Patient autonomy allows both that patients will sometimes defer to clinicians and that they should sometimes be active inquirers, ready to question their clinicians and do some independent research. At the same time, patients' active inquiry requires clinicians' support.

When Sandra Harding called for an epistemology of science whose systematic attention to the gendered Status of epistemic agents renders it ‘less partial and distorted’ than ‘traditional’ epistemologies, some commentators recoiled in horror. Propelled by ‘a mad form of the genetic fallacy’ they said, she descends ‘the slide to an arational account of science.’ On a less melodramatic reading, feminist epistemologies such as Harding's advocate not irrationalism, but senses of rationality more expanded than those which they associate with ‘traditional’ epistemology.

We can understand objectivity, in the broadest sense of the term, as epistemic accountability to the real. Since at least the 1986 publication of Sandra Harding’s The Science Question in Feminism, so-called standpoint epistemologists have sought to build an understanding of such objectivity that does not essentially anchor it to a dislocated, ‘view from nowhere’ stance on the part of the judging subject. Instead, these theorists have argued that a proper understanding of objectivity must recognize that different agential standpoints offer (...) different access to objective truths, with some standpoints holding better epistemic potential than others. As Harding puts it, standpoint epistemology calls for “a critical evaluation of which social situations tend to generate the most objective knowledge claims” so as to identify those standpoints that “produce empirically more accurate descriptions and theoretically richer explanations” (1991, 142, 149). Which standpoints enable the most objectivity with respect to a particular inquiry is, for the standpoint theorists, always an empirical at least as much as a conceptual question; it requires attention to the actual, material relationship between knowers, knowledge practices, and objects known. Standpoint epistemology was developed primarily by self-identiªed feminist epistemologists. Virtually all developments of standpoint episte-. (shrink)

Pragmatism has enjoyed a major resurgence in Anglo-American philosophy over the course of the last decade or two, and Robert Brandom’s work – particularly his 1994 tome Making it Explicit (MIE) – has been at the vanguard of this resurgence (Brandom 1994).2 But pragmatism comes in several surprisingly distinct flavours. Authors such as Hubert Dreyfus find their roots in certain parts of Heidegger and in phenomenologists such as Merleau-Ponty, and they privilege embodied, preconceptual skills as opposed to discursive practices as (...) the basic sites of meaning and agency (Dreyfus 1991; Dreyfus 1992; Todes 2001). With strong inheritances from Dewey and Wittgenstein, Richard Rorty has championed a pragmatism whose core emphasis is on the rejection of transcendental truth and high metaphysical theorizing (Rorty 1982), and this anti-theoretical banner has been taken up by several prominent ethicists, among others. For his part, Brandom, who purports to offer a systematic theory of language and meaning grounded on a foundation of pragmatic normative relationships between speakers, looks back instead to Sellars and Quine for his stripe of pragmatism. Near the start of MIE, he writes: The explanatory strategy pursued here is to begin with an account of social practices, identify the particular structure they must exhibit in order to qualify as specifically linguistic practices, and then consider what different sorts of semantic contents those practices can confer on states, performances, and expressions caught up in them in suitable ways. (Brandom 1994, xiii) Despite his professed pragmatism, Brandom is no foe of high theory or metanarratives, and he is vastly more interested in language and theoretical reason than in the rest of human bodily activity. For Brandom, inferentially articulated discourse forms an autonomous domain of normativity, while our bodily encounters with the world in perception and in action serve as language entry and exit points respectively.. (shrink)

Truth-telling is a project that is both gripping and problematic for Rousseau, as he is both captured by an ideal of telling as complete, undistorted discernment, documentation and communication, and also haunted by the fear that telling can never be this innocent. For Rousseau, as for Kant, telling does not leave the told untouched; rather, telling gives us a type of contact with objects that is marked and mediated by the process of telling itself, and hence the possibility of immediately (...) grasping objects through telling is forever lost to us. The drive to capture things in themselves, which originates, according to Kant, in a formal principle of reason, shows up in Rousseau's writings as a nostalgia that governs and animates inquiry. I will read Rousseau, and the traumas of truth-telling he articulates, as important pretexts for Kant's critical epistemology. Rousseau discloses tensions that infect his truth-telling practices. Kant seeks to neutralize these tensions, not by dissolving them, but rather by translating them into the terms of transcendental philosophy and thus showing how they can be defused and rendered harmless in their empirical form, so as to secure the possibility of proper truth-telling. (shrink)

The Routledge Companion to Bioethics is a comprehensive reference guide to a wide range of contemporary concerns in bioethics. The volume orients the reader in a changing landscape shaped by globalization, health disparities, and rapidly advancing technologies. Bioethics has begun a turn toward a systematic concern with social justice, population health, and public policy. While also covering more traditional topics, this volume fully captures this recent shift and foreshadows the resulting developments in bioethics. It highlights emerging issues such as climate (...) change, transgender, and medical tourism, and re-examines enduring topics, such as autonomy, end-of-life care, and resource allocation. (shrink)

Fertile grounds for theoretical inquiry can be found in the oddest corners. Contemporary television programming provides viewers with several talk shows of the grotesque, as I will call them, in which the aim of each episode is to put some monstrous human phenomenon on display with the help of a host and a participating studio audience. In this paper I will try to support the unlikely claim that these talk shows, which include The Jerry Springer Show and Sally Jesse Raphael (...) (among others), provide remarkably fruitful foci for theoretical attention. My plan is to give a reading of the ideological structure of talk shows of the grotesque. In particular, my interest lies in a relatively recent strand of ideological theory that has treated questions concerning the nature and reproduction of ideology as serious ontological questions: questions that go to the heart of our philosophical understanding of subjectivity, autonomy, and the metaphysics of belief and other intentional attitudes. Here I take the work of Louis Althusser, Judith Butler, and Slavoj i ek as paradigmatic and seminal representatives of this type of theorizing. My eye, in this paper, will be turned toward showing how the contemporary talk show of the grotesque provides us with a case study through which we can productively interrogate this new theoretical turn in our understanding of ideology. After spending a substantial amount of time laying down some theoretical groundwork, during which I take a selective and usurious tour through recent theories of ideology, performativity, and the constitution of subjectivity, I will analyze the talk show phenomenon by dividing it into four levels of participatory activity: those of the host, the guests, the studio audience, and the television audience. I will argue.. (shrink)

In this book, Paul Redding argues both that Hegel’s thought is making a resurgence in some quarters of analytic philosophy, and that such a resurgence is well-deserved and will bear future fruit. He begins with Bertrand Russell’s story of analytic philosophy as born out of a rejection of Hegelian thought, and traces the development of an alternative path through analytic philosophy that moves through Frege, Wittgenstein, Sellars, and Evans, and finds its fullest contemporary form in Brandom and McDowell. This alternative (...) path, he claims, has important historical roots in Hegel, although not in Russell’s caricatured version of him.Redding reads Hegel as the direct inheritor of Kant and Aristotle, especially with respect to logic, the role of the singular in thought, and the nature of evaluative judgment, and he argues that Hegel gives us the materials with which to overcome Sellars’ myth of the given productively. He also gives extended readings of Hegel’s principle of determinate negation and rejection of the principle of non-contradiction, as well as of the ontology of Hegelian Spirit as the unity of substance and subject, all designed to reveal these components of Hegelian thought as productive resources for analytic philosophers. (shrink)

Three years ago, as my fortieth birthday disappeared into the far distance in my rearview mirror, driven by a combination of vanity and fear of my own mortality and decrepitude, I committed to getting in shape.I’ve always been fairly active: I have always walked a lot, commuted by bike when that was plausible, avoided driving whenever possible, and just generally been high energy. But a childhood full of failure at team sports and a lack of innate gifts in the coordination (...) department scared me off for decades from formal physical activity. Indeed, I was convinced that I hated working out—that I would always hate it, no matter what, and that it would always take a tremendous and ongoing act of sheer will power to do... (shrink)