Recent developments in the field of neurosurgery, specifically those dealing with the modification of mood and affect as part of psychiatric disease, have led some researchers to discuss the ethical implications of surgery to alter personality and personal identity. As knowledge and technology advance, discussions of surgery to alter undesirable traits, or possibly the enhancement of normal traits, will play an increasingly larger role in the ethical literature. So far, identity and enhancement have yet to be explored in a neurosurgical (...) context, despite the fact that 1) neurological disease and treatment both potentially alter identity, and 2) that neurosurgeons will likely be the purveyors of future enhancement implantable technology. Here, we use interviews with neurosurgical patients to shed light on the ethical issues and challenges that surround identity and enhancement in neurosurgery. The results provide insight into how patients approach their identity prior to potentially identity-altering procedures and what future ethical challenges lay ahead for clinicians and researchers in the field of neurotherapeutics. (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)

The principle of informed consent obligates physicians to explain possible side effects when prescribing medications. This disclosure may itself induce adverse effects through expectancy mechanisms known as nocebo effects, contradicting the principle of nonmaleficence. Rigorous research suggests that providing patients with a detailed enumeration of every possible adverse event—especially subjective self-appraised symptoms—can actually increase side effects. Describing one version of what might happen (clinical “facts”) may actually create outcomes that are different from what would have happened without this information (another (...) version of “facts”). This essay argues that the perceived tension between balancing informed consent with nonmaleficence might be resolved by recognizing that adverse effects have no clear black or white “truth.” This essay suggests a pragmatic approach for providers to minimize nocebo responses while still maintaining patient autonomy through “contextualized informed consent,” which takes into account possible side effects, the patient being treated, and the particular diagnosis involved. (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)

Dr. Elisabeth Kübler-Ross is credited as one of the first clinicians to formalize recommendations for working with patients with advanced medical illnesses. In her seminal book, On Death and Dying,...

This chapter explores two kinds of testimonial trust, what we call ‘evidential trust’ and ‘non-evidential trust’ with the aim of asking how testimonial trust could provide epistemic reasons for belief. We argue that neither evidential nor non-evidential trust can play a distinctive role in providing evidential reasons for belief, but we tentatively propose that non-evidential trust can in some circumstances provide a novel kind of epistemic reason for belief, a reason of epistemic facilitation. The chapter begins with an extensive discussion (...) of standard accounts of both kinds of trust and criticises especially the standard accounts of non-evidential trust. A new account of non-evidential trust is offered that avoids a number of difficulties that plague the standard accounts by rejecting what we call ‘attitude-liability assumptions’. (shrink)

Heidegger’s engagement with the poet Friedrich Hölderlin often dwells on the issue of temporality. For Heidegger, Hölderlin is the most futural thinker (zukünftigster Denker) whose poetry is necessary for us now and must be wrested from being buried in the past. Heidegger frames his reading of Hölderlin in terms of past, present, and future and, more importantly, describes him as being able to poetize time. This paper examines what it means to poetize time and why Hölderlin’s poetry in particular allows (...) us to understand temporality as the interplay of presence and non-presence. (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)

Contadini—peasant farmers—are central figures of belonging in a Northern Italian winegrowing community. The skills and languages in which contadini are fluent and who is recognized as one of them organize the values attached to various roles in this world. I show how the immigrant vineyard workers who maintain local landscapes engage with this identity, producing new selves through the labor of caring for vines. Earning the title of contadino allows some immigrants to cross social boundaries usually policed by strict ethnic (...) lines in Italy, generating recognition and benefits unavailable from the state. At the same time, Italian employers’ relation to the land changes as they hand off ways of knowing and doing to categorical outsiders. ‘Traditional’ labor and products are what pull these two groups into a collaborative encounter, but rather than simply keeping the past in practice, immigrants and Italians also generate new forms of personhood and value. (shrink)

This paper explores the ethics of deceased‐directed donation (DDD) and brings a unique perspective to this issue—the relevance of providing family‐centered care and culturally sensitive care to deceased donors, potential recipients, and their families. The significance of providing family‐centered care is becoming increasingly prevalent, specifically in pediatric healthcare settings. Therefore, this topic is especially relevant to those working with and interested in pediatrics. As the world is becoming more diverse with globalization, assessing the cultural aspect of the ethics of DDD (...) is increasingly salient. We provide a brief overview of DDD across the globe, review prominent arguments both for and against DDD, consider family‐centered and culturally specific considerations, and offer considerations for the development of a policy or guideline. We determine that the practice of DDD is ethically defensible in certain circumstances and congruent with providing both family‐centered and culturally sensitive care. Our analysis is relevant to any country with a diverse population and any healthcare provider or institution that operates under a framework of family‐centered care, such as those in pediatric hospitals. (shrink)

Previous research has suggested that corporate social performance is positively related to firms’ attractiveness as employers. The authors propose and test an alternative model whereby job applicants’ familiarity with employers mediates the relationship between corporate social performance and organizational attractiveness. Applicants’familiarity with firms may serve as a signal of firms’suitability as employers, with more familiar firms considered more attractive. Furthermore, a firm’s overall level of corporate social activity (whether “good deeds” or “ misdeeds”) may contribute directly to firm familiarity and (...) indirectly to attractiveness through familiarity. The authors’ results support this model; firm familiarity completely mediates the relationship between corporate social performance and organizational attractiveness. (shrink)

Psychiatry uncomfortably spans biological, psychological, and social perspectives on mental illness. As a branch of medicine, psychiatry is under pressure to conform to a biomedical model, according to which diseases are characterized primarily in biological terms. But psychiatry also draws on the psychotherapeutic tradition, which explains mental distress in terms of life experience and social influences.These approaches ought to complement each other, but historically this has not happened. With no theory creating global, systematic links between the two approaches, psychiatry is (...) divided... (shrink)

The early church did not provide us with any normative statement on wealth and poverty, but it did give us clear witness to the hazards of wealth and to the abiding necessity of alms for the poor.

This volume is fourth in the series of annuals created under the auspices of The Association for Feminist Ethics and Social Theory. The topics covered herein—from peacekeeping and terrorism, to sex trafficking and women's paid labor, to poverty and religious fundamentalism—are vital to women and to feminist movements throughout the world.

This essay examines the determination by Cartesians to explain the maternal imagination's alleged role in the formation of birthmarks and the changing notion of monstrosity. Cartesians saw the formation of birthmarks as a challenge through which to demonstrate the heuristic capacity of mechanism. Descartes claimed to be able to explain the transmission of a perception from the mother's imagination to the fetus' skin without having recourse to the little pictures postulated by his contemporaries. La Forge offered a detailed account stating (...) that the failure to explain the maternal imagination's impressions would cast doubt on mechanism. Whereas both characterized the birthmark as a deformation or monstrosity in miniature, Malebranche attributed a role to the maternal imagination in fashioning family likenesses. However, he also charged the mother's imagination with the transmission of original sin. (shrink)

Just over a decade ago, I began teaching medical students in the required preclinical course ethics and professionalism. The point of the course was to introduce basic ethical and professional norms through a small number of large group sessions, but mostly small group tutorials of 10 or 12 students engaging in weekly sessions combining readings from the literature and case scenarios highlighting real-life ethical tensions they either had, or would most likely, encounter in the future. The students wrote perceptively and (...) thoughtfully each week, and class was topical and lively. Some students went on to complete longer essays for a school-wide ethics competition and even to win. By all accounts a resounding... (shrink)

Our lead article in this issue of the Kennedy Institute of Ethics Journal, Jonathan Kaplan’s “Self-Care as Self-Blame Redux: Stress as Personal and Political,” opens up an entirely new and clearly important topic for bioethicists: the concept and role of ‘self-care.’ Advice for ‘self-care’ is everywhere, and often this advice takes the form of a kind of moral imperative: we owe ourselves self-care and have a responsibility to care for ourselves. Meanwhile, typical suggested self-care practices focus on individual behaviors and (...) purchases, rather than social interventions. Moreover, they very often require quite a bit of time, money, organization, and energy to complete. These include yoga classes, meditation, diet... (shrink)

Although data sharing platforms host diverse data types the features of these platforms are well-suited to facilitating biomarker research. Given the current state of biomarker discovery, an innovative paradigm to accelerate biomarker discovery is to utilize platforms such as Vivli to leverage researchers' abilities to integrate certain classes of biomarkers.

Ethical sensitivity is a precursor to mora1 judgment in that a person must recognize the existence of an ethical problem before such a problem can be resolved. It is an important concept, yet it has received little attention from ethics scholars. This preliminary and exploratory study indicates that ethical sensitivity can be identified in viewers' reactions to and evaluations of ethically controversial television news stories, that diferent levels of ethical sensitivity are evident in discussions of television news stories, and that (...) there are at least 3 dimensions by which ethnic sensitivity may be evaluated: time, breadth, and depth. (shrink)

Volume 19, Issue 7, July 2019, Page 69-71.

This essay aims to elucidate how multiple voices and traditions should interact with one another in the practice of ethics. First, it explores some of the major ways in which questions of bodily autonomy function in secular feminist and Jewish bioethical discourses. It then uses case studies to illuminate ways each discourse's concepts of bodily autonomy can be deeply problematic, and argues that the strengths in each discourse can serve as important correctives for the weaknesses in the other. It suggests (...) that some formal features of rabbinic texts can serve as a model for a discourse of constant and animated mutual correction. Finally, it examines two case studies in light of this model. (shrink)

The article “Extending Research Protections to Tribal Communities” examines whether it is appropriate to extend the Belmont Report’s ethical principles beyond the individual...

Revitalizing Classrooms brings together six diverse essays with the central purpose of providing a venue for scholar teachers from a number of disciplines to convey their individual journeys in pedagogical innovation.

This paper presents an original use of Twitter to interpret and rewrite the poems of Francesco Petrarca's Rerum vulgarium fragmenta implemented within the Oregon Petrarch Open Book OPOB). This activity was partially inspired by the idea of Twitterature developed by Alexander Aciman and Emmett Rensin; we believe with them that our digital time should develop new and more functional ways of addressing literary texts but at the same time we are convinced that the "burdensome duty of hours spent reading" cannot (...) be eliminated. On the contrary, the new ways of reading in the digital era as we envisage them are the result and consequence of broader and deeper reading activities. We conceived the project of writing 366 tweets, out of the 366 poems that make the last form of Petrarca’s Rvf, as the result of different philological activities, from reading the texts in the original language to consulting manuscripts, translations and intersemiotic renderings of the texts. Before writing the 140 characters that make one tweet we also elaborated paraphrases, summaries and keywords related to the individual poems. Students created the first version of the tweets during the 2011 UO seminar on Re-reading Petrarca’s Rvf in the Digtal Era. The second version was elaborated in the context of a seminar on the same topic during Winter 2014. This paper presents the two versions of the Twitter Edition of Petrarca's Rvf now available in the OPOB and focuses on the philology connected to the latest edition that provided an English translation of the original tweets written in Italian. The actual Italian and English 366 tweets are published in the Appendix to the article. (shrink)

L’ouvrage d’Arlette Gautier, Les Sœurs de Solitude, publié en 1985 et aujourd’hui réédité, reste l’étude de référence sur la vie des femmes esclaves africaines dans les Antilles françaises. Sa recherche, associant une solide maîtrise de la démographie à l’histoire culturelle des pratiques sexuées en France, en Afrique et aux Antilles a résisté à l’épreuve du temps. Introduite par une préface d’Olivier Pétré-Grenouilleau, la nouvelle édition est augmentée d’une postface conséquente de l’auteur...

Interviews with 111 African-American and European-Americans investigated racial differences in viewer evaluations of ethically controversial TV news stories. The study focused on judgments of whether three news stories (Genniger Flowers's alleged affair with Bill Clinton, a hit-and-run accident, and racial discrimination by Realtors) should be aired, the criteria applied in reaching those judgements, and the indications of reasons to attend to or to reject each story. No simple relationship was found between race and judgments of whether the stories should be (...) aired, but when story relevance was considered, the relationship became clearer. There appears to be a complex relationship between the viewers' lived experience, story content, and story evaluation. (shrink)

This essay is part of a special issue celebrating 50 years of Political Theory. The ambition of the editors was to mark this half century not with a retrospective but with a confabulation of futures. Contributors were asked: What will political theory look and sound like in the next century and beyond? What claims might political theorists or their descendants be making in ten, twenty-five, fifty, a hundred years’ time? How might they vindicate those claims in their future contexts? How (...) will the consistent concerns of political theorists evolve into the questions critical for people decades or centuries from now? What new problems will engage the political theorists (or their rough equivalents) of the future? What forms might those take? What follows is one of the many confabulations published in response to these queries. (shrink)

In 2004, the agricultural economies of many rural communities in the United States were impacted by the cessation of a price-support and supply-control program for tobacco production. Tobacco was not only an important livelihood, but also was central to social and cultural life. Using a social–ecological systems lens and the adaptive cycle metaphor, we examine the reorganization of agriculture in communities that previously produced tobacco under the program. Specifically, we seek to understand how transitional policy that provided financial support to (...) tobacco farmers interacted with other social, cultural, physical and human capitals to condition system reorganization. We conducted semi-structured interviews with farmers, extension agents, and policy makers in Kentucky as well as examined trends in income and number of farmers before and after the transition as indicators of reorganization. We determined that the financial support was perceived as helpful in supporting the transition and that tobacco farmers reorganized their livelihoods primarily around existing, remnant assets and endogenous capacities. In addition, we determined that though the agricultural system may be reorganizing economically, it is not necessarily supportive of the same social bonds and values that co-existed with tobacco economy. Understanding agricultural economies as part of complex social–ecological systems that consist of interconnected values, identities, ecology and social ties is important for developing policies to support systems and communities through economic transitions. (shrink)