New entrant policy, literature, and research offers an important angle for exploring where dominant agrarianism is reproduced and contested. As new entrants seek access to land, finance, and expertise, their credibility is filtered through a cultural and policy environment that favors some farming models over others. Thus, seemingly apolitical policy tools geared at getting new people into farming may carry implicit norms of who these individuals should be, how they should farm, and what their values should entail. A normative gaze (...) of farming often masks the financial, cultural, labor relation, and land tenure dimensions that are the underlying drivers of agrarian change. This paper applies social reproduction theory to explore a diversity of social labor processes that new entrant farmers practice to arrive at the point of agricultural production. Interviews with new entrant and successor farmers in Britain (excluding Northern Ireland) are presented first, followed by an analysis of new entrant policy instruments over the last two decades in Scotland. We find that new entrant policy fails to engage with a crisis of social reproduction in the food system because of a commitment to agrarian ideals of the self-sufficient and entrepreneurial farmer. By inviting newcomers into a dynamic of increasing precarious and uncompensated labor, very often by way of family relations, new entrant policy may act as a form of “predatory inclusion.” We argue that to be successful in reproducing the agricultural sector, new entrant farmer policy must be first a policy at attending to relations in the social sphere. Recognizing and supporting the diversified strategies farmers take on to assemble land for production would not only drive more just policy, but set the conditions for a more adaptive food system. (shrink)

As we begin our exploration of our relationship with animals, we come face to face with Peter Singer and his insistence that speciesism is a vice. It is important to come to know what he means by speciesism, why he regards it as a moral mistake.

Most interpreters hold that Kant rejects actually infinite tota synthetica as conceptually impossible. This view is attributed to Kant to relieve him of the charge that the first antinomy’s thesis argument presupposes transcendental idealism. I argue that important textual evidence speaks against this view, and Kant in fact affirms the conceptual possibility of actually infinite tota synthetica. While this means the first antinomy may not be decisive as an indirect argument for idealism, it gives us a better account of how (...) our ideas of the unconditioned generate the antinomies, and it allows us to see important and often overlooked elements in Kant’s account of the infinite. (shrink)

Virtue ethics is currently one of three major approaches in normative ethics. It may, initially, be identified as the one that emphasizes the virtues, or moral character, in contrast to the approach that emphasizes duties or rules (deontology) or that emphasizes the consequences of actions (consequentialism). Suppose it is obvious that someone in need should be helped. A utilitarian will point to the fact that the consequences of doing so will maximize well-being, a deontologist to the fact that, in doing (...) so the agent will be acting in accordance with a moral rule such as “Do unto others as you would be done by” and a virtue ethicist to the fact that helping the person would be charitable or benevolent. (shrink)

In On Virtue Ethics I offered a criterion for a character trait's being a virtue according to which a virtuous character trait must conduce to, or at least not be inimical to, four ends, one of which is the continuance of the human species. I argue here that this does not commit me to homosexuality's being a vice, since homosexuality is not a character trait and hence not up for assessment as a virtue or a vice. Vegetarianism is not up (...) for such assessment either, for the same reason, but, as a practice, may well be required by the virtue of compassion, and sacrificing one's life for an animal or alien may be required by courage. The clause about the continuance of the human species in my criterion does not specify a foundational value, because, following McDowell, I reject foundationalism. (shrink)

Virtue ethics is perhaps the most important development within late twentieth-century moral philosophy. Rosalind Hursthouse, who has made notable contributions to this development, here presents a full exposition and defense of her neo-Aristotelian version of virtue ethics. She shows how virtue ethics can provide guidance for action, illuminate moral dilemmas, and bring out the moral significance of the emotions.

Rosalind Hursthouse took her undergraduate degree in New Zealand and her B. Phil. and D. Phil. at Oxford. She taught in Oxford for six years before joining the Open University in 1975. As part of her work for the O.U. she has published Beginning Lives (Blackwell, 1987) on the morality of abortion; this generated Virtue theory and abortion, Philosophy and Public Affairs, 1991) which has already been reprinted five times. She has published numerous other articles on virtue ethics, the (...) most recent of which is virtue ethics and the emotions, in: Virtue Ethics, A Critical Reader, Daniel Statman (ed.) Edinburgh University Press, 1997. (shrink)

“Respirators, not furnished” is a phrase that appears in Muriel Rukeyser’s poetic sequence The Book of the Dead, addressed to the catastrophic silicosis epidemic that afflicted miners of the Hawk’s Nest Tunnel. Using the example of Rukeyser’s text, which I taught as part of a course on extractionism during the early months of the pandemic and again in its aftermath, the essay asks what it means to read on the precipice of disaster and what disasters of reading are threatened by (...) our current moment. (shrink)

Famously, Kant describes space and time as infinite “given” magnitudes. An influential interpretative tradition reads this as a claim about phenomenological presence to the mind: in claiming that space and time are given, this reading holds, Kant means to claim that we have phenomenological access to space and time in our original intuitions of them. In this paper, I argue that we should instead understand givenness as a metaphysical notion. For Kant, space and time are ‘given’ in virtue of three (...) related facts: (i) they are necessary grounds of the existence of all other spatial and temporal possibilities; (ii) in virtue of being such grounds, they are metaphysically linked to all other represented spatiotemporal things; and (iii) as representations, space and time issue from the nature of our faculty of sensibility rather than from an arbitrary act of choice. Understanding givenness in this non-epistemological way helps us recover what is plausible in both ‘intellectualist’ and ‘anti-intellectualist’ readings of the Transcendental Aesthetic. Anti-intellectualists are correct that space and time are given in mere sensibility, but intellectualists are correct that we depend on the understanding for consciousness of space and time. (shrink)

The sort of ethical theory derived from Aristotle, variously described as virtue ethics, virtue-based ethics, or neo-Aristotelianism, is becoming better known, and is now quite widely recognized as at least a possible rival to deontological and utilitarian theories. With recognition has come criticism, of varying quality. In this article I shall discuss nine separate criticisms that I have frequently encountered, most of which seem to me to betray an inadequate grasp either of the structure of virtue theory or of what (...) would be involved in thinking about a real moral issue in its terms. In the first half I aim particularly to secure an understanding that will reveal that many of these criticisms are simply misplaced, and to articulate what I take to be the major criticism of virtue theory. I reject this criticism, but do not claim that it is necessarily misplaced. In the second half I aim to deepen that understanding and highlight the issues raised by the criticisms by illustrating what the theory looks like when it is applied to a particular issue, in this case, abortion. (shrink)

BackgroundIn June 2019, the Australian state of Victoria joined the growing number of jurisdictions around the world to have legalised some form of voluntary assisted dying. A discourse of safety was prominent during the implementation of the Victorian legislation.Main textIn this paper, we analyse the ethical relationship between legislative “safeguards” and equal access. Drawing primarily on Ruger’s model of equal access to health care services, we analyse the Victorian approach to voluntary assisted dying in terms of four dimensions: horizontal equity, (...) patient agency, high quality care, and supportive social norms. We argue that some provisions framed as safeguards in the legislation create significant barriers to equal access for eligible patients.ConclusionsWhile safety is undoubtedly ethically important, we caution against an overemphasis on safeguarding in voluntary assisted dying legislation given the implications for equal access. (shrink)

Artificial intelligence is increasingly being developed for use in medicine, including for diagnosis and in treatment decision making. The use of AI in medical treatment raises many ethical issues that are yet to be explored in depth by bioethicists. In this paper, I focus specifically on the relationship between the ethical ideal of shared decision making and AI systems that generate treatment recommendations, using the example of IBM’s Watson for Oncology. I argue that use of this type of system creates (...) both important risks and significant opportunities for promoting shared decision making. If value judgements are fixed and covert in AI systems, then we risk a shift back to more paternalistic medical care. However, if designed and used in an ethically informed way, AI could offer a potentially powerful way of supporting shared decision making. It could be used to incorporate explicit value reflection, promoting patient autonomy. In the context of medical treatment, we need value-flexible AI that can both respond to the values and treatment goals of individual patients and support clinicians to engage in shared decision making. (shrink)

In jurisdictions where voluntary assisted dying is legal, eligibility assessments, prescription and administration of a VAD substance are commonly performed by senior doctors. Junior doctors’ involvement is limited to a range of more peripheral aspects of patient care relating to VAD. In the Australian state of Victoria, where VAD has been legal since June 2019, all health professionals have a right under the legislation to conscientiously object to involvement in the VAD process, including provision of information about VAD. While this (...) protection appears categorical and straightforward, conscientious objection to VAD-related care is ethically complex for junior doctors for reasons that are specific to this group of clinicians. For junior doctors wishing to exercise a conscientious objection to VAD, their dependence on their senior colleagues for career progression creates unique risks and burdens. In a context where senior colleagues are supportive of VAD, the junior doctor’s subordinate position in the medical hierarchy exposes them to potential significant harms: compromising their moral integrity by participating, or compromising their career progression by objecting. In jurisdictions intending to provide all health professionals with meaningful conscientious objection protection in relation to VAD, strong specific support for junior doctors is needed through local institutional policies and culture. There are no data in this work. (shrink)

Rosalind Hursthouse; IV*—A False Doctrine of the Mean, Proceedings of the Aristotelian Society, Volume 81, Issue 1, 1 June 1981, Pages 57–72, https://doi.org/10.

In this unconventional article, Sarah Banet-Weiser, Rosalind Gill and Catherine Rottenberg conduct a three-way ‘conversation’ in which they all take turns outlining how they understand the relationship among postfeminism, popular feminism and neoliberal feminism. It begins with a short introduction, and then Ros, Sarah and Catherine each define the term they have become associated with. This is followed by another round in which they discuss the overlaps, similarities and disjunctures among the terms, and the article ends with how each (...) one understands the current mediated feminist landscape. (shrink)

This paper argues for a new understanding of Strawson’s distinction between personal, impersonal, and self-reactive attitudes. Many Strawsonians take these basic reactive attitude types to be distinguished by two factors. Is it the self or another who is treated with good- or ill-will? And is it the self or another who displays good- or ill-will? On this picture, when someone else wrongs me, my reactive attitude is personal; when someone else wrongs someone else, my reactive attitude is impersonal; and when (...) I wrong someone else, my attitude is self-reactive. Against this account, I argue that the basic reactive attitude types are better distinguished according to whether they express partial or impartial concern. This fits Strawson’s discussion in “Freedom and Resentment”, and it allows us to see an important point that the alternative approach obscures. Namely, while attitudes like resentment, gratitude, shame, and pride can arise as responses to our own treatment and behavior, they can also arise as third-party responses to the treatment and behavior of our family members, romantic partners, and close friends. Similarly, attitudes like moral indignation and disapprobation also have a wider scope than is often acknowledged; they can arise as responses to others’ treatment, but they can also arise as responses to our own treatment when we react impartially to circumstances involving ourselves. (shrink)

Using “big data” from sensors worn continuously outside the lab, researchers have observed patterns of objective physiology that challenge some of the long-standing theoretical concepts of emotion and its measurement. One challenge is that emotional arousal, when measured as sympathetic nervous system activation through electrodermal activity, can sometimes differ significantly across the two halves of the upper body. We show that traditional measures on only one side may lead to misjudgment of arousal. This article presents daily life and controlled study (...) data, as well as existing evidence from neuroscience, supporting the influence of multiple emotional substrates in the brain causing innervation on different sides of the body. We describe how a theory of multiple arousals explains the asymmetric EDA findings. (shrink)

The sort of ethical theory derived from Aristotle, variously described as virtue ethics, virtue-based ethics, or neo-Aristotelianism, is becoming better known, and is now quite widely recognized as at least a possible rival to deontological and utilitarian theories. With recognition has come criticism, of varying quality. In this article I shall discuss nine separate criticisms that I have frequently encountered, most of which seem to me to betray an inadequate grasp either of the structure of virtue theory or of what (...) would be involved in thinking about a real moral issue in its terms. In the first half I aim particularly to secure an understanding that will reveal that many of these criticisms are simply misplaced, and to articulate what I take to be the major criticism of virtue theory. I reject this criticism, but do not claim that it is necessarily misplaced. In the second half I aim to deepen that understanding and highlight the issues raised by the criticisms by illustrating what the theory looks like when it is applied to a particular issue, in this case, abortion. (shrink)

Bonnie Steinbock argues that Peter Singer has made an important contribution to remind us that animals deserve very special consideration, but that he fails to make a compelling case against "speciesism.".

Models for clinical ethics case consultation often make reference to ‘balancing’ or ‘weighing’ moral considerations, without further detail. In this paper, we investigate balancing in clinical ethics case consultation. We suggest that, while clinical ethics services cannot resolve ongoing deep philosophical debates about the nature of ethical reasoning, clinical ethicists can and should be more systematic and transparent when balancing considerations in case consultations. We conceptualise balancing on a spectrum from intuitive to deliberative, and argue that good balancing in case (...) consultation involves articulating reasons for giving something more or less weight. We develop a framework of four practical strategies for better balancing in clinical ethics case consultation: intuitions as a launchpad, drilling down, pairwise comparison and group deliberation. (shrink)

Clinical ethics has been developing in paediatric healthcare for several decades. However, information about how paediatricians use clinical ethics case consultation services is extremely limited. In this project, we analysed a large set of case records from the clinical ethics service of one paediatric hospital in Australia. We applied a paediatric-specific typology to the case referrals, based on the triadic doctor–patient–parent relationship. We reviewed the 184 cases referred to the service in the period 2005–2014, noting features including the type of (...) case, the referring department(s) and the patient9s age at referral. The two most common types of referral involved clinician uncertainty about the appropriate care pathway for the child (26% of total referrals) and situations where the child9s parents disagreed with the doctors’ recommendations for the child9s care (22% of total referrals). Referrals came from 28 different departments. Cancer, cardiology/cardiac surgery and general medicine referred the highest numbers of cases. The most common patient age groups were children under 1, and 14–15 years old. For three controversial areas of paediatric healthcare, clinicians had initiated processes of routine review of cases by the clinical ethics service. These insights into the way in which one very active paediatric clinical ethics service is used further our understanding of the work of paediatric clinical ethics, particularly the kinds of ethically challenging cases that paediatricians view as appropriate to refer for clinical ethics support. (shrink)

This introductory textbook is ideally suited to newcomers to philosophy and ethical problems. Rosalind Hursthouse carefully introduces the three standard approaches in current ethical theory: utilitarianism, rights, and virtue ethics. She links each chapter to readings from key exponents such as Peter Singer and Mary Midgley and asks students to think critically about these readings for themselves. Key features include clear activities and activities, chapter summaries and guides to further reading.

This paper reviews the ethical literature on conflicts between health professionals and parents about medical decision-making for children. We present the results of a systematic review which addressed the question ‘when health professionals and parents disagree about the appropriate course of medical treatment for a child, under what circumstances is the health professional ethically justified in overriding the parents’ wishes?’ We identified nine different ethical frameworks that were put forward by their authors as applicable across various ages and clinical scenarios. (...) Each of these frameworks centred on a different key moral concept including harm, constrained parental autonomy, best interests, medically reasonable alternatives, responsible thinking and rationality. (shrink)

Cover -- Half Title -- Title -- Copyright -- Original Title -- Original Copyright -- Contents -- Acknowledgments -- 1 The philosophical context -- 2 Structuralism -- 3 Semiology as a science of signs -- 4 S/Z -- 5 Marxism, language, and ideology -- 6 On the subject of Lacan -- 7 The critique of the sign -- 8 Conclusion -- Bibliography -- Index.

"Beyond Promises" is a memoir of sorts by Ron Corbett, who became the youngest speaker of the Iowa House of Representatives and who now is finishing up his eighth year as mayor of Iowa's second largest city, Cedar Rapids. In the late 1990s, Corbett was considered a possible Republican candidate for Congress or governor. Then he surprised many and resigned from the Legislature so he wouldn't have to spend so much time away from home and his growing family. (...) He headed the local Chamber of Commerce for six years, a period in which he led a community campaign to rebuild schools, another to redevelop the Cedar Rapids riverfront and a third that brought professional management to Cedar Rapids city government. Corbett's tenure as Cedar Rapids mayor coincided with the city's recovery from a devastating flood in 2008, the costliest natural disaster in Iowa history. Can someone who was a leading Republican voice in much of Iowa reclaim statewide prominence and be elected governor? In 2017, that's the elephant in the room-the unstated question lingering in the backdrop of "Beyond Promises." This book is Corbett's first-person account of where he came from and what shaped him, as well as a chronicle of doing, not simply promising. (shrink)

This book presents an approach to spirituality based on direct personal experience of the sacred. Using the language and insights of depth psychology, Corbett outlines the intimate relationship between spiritual experience and the psychology of the individual, unveiling the seamless continuity between the personal and transpersonal dimensions of the psyche. His discussion runs the gamut of spiritual concerns, from the problem of evil to the riddle of pain and suffering. Drawing upon his psychotherapeutic practice as well as on the (...) experiences of characters from our religious heritage, Corbett explores the various portals through which the sacred presents itself to us: dreams, visions, nature, the body, relationships, psychopathology, and creative work. Referring extensively to Jung's writings on religion, but also to contemporary psychoanalytic theory, Corbett gives form to the new spirituality that is emerging alongside the world's great religious traditions. For those seeking alternative forms of spirituality beyond the Judeo-Christian tradition, this volume will be a useful guide on the journey. (shrink)

This paper contributes to inquiries into the genealogy of governmentality and the nature of secularization by arguing that pastoralism continues to operate in the algorithmic register. Drawing on Agamben’s notion of signature, I elucidate a pair of historically distant yet archaeologically proximate affinities: the first between the pastorate and algorithmic control, and the second between the absconded God of late medieval nominalism and the authority of algorithms in the cybernetic age. I support my hypothesis by attending to the signaturial kinships (...) between, on the one hand, temporality and authority in our contemporary conjuncture, and, on the other, obedience and submission in Christian thought from late antiquity and the late Middle Ages. I thereby illustrate the hidden genealogical continuities between theological-pastoral technologies of power and technocratic-algorithmic modalities of governance. I conclude by suggesting that medieval counter-conducts may be redeployed in our present circumstances for emancipatory ends. (shrink)

This volume brings together twenty original essays on the changes and continuities in gender relations and intersecting politics of sexuality, race, class and location. The book is located in debates about contemporary culture at a moment of rapid technological change, global interconnectedness and the growing cultural dominance of neoliberalism and postfeminism. The collection traverses disciplines, spaces and approaches. It is marked by an extraordinarily wide focus, ranging from analyses of celebrity magazines and makeover shows to examinations of the experiences of (...) young female migrants, 'mail order brides' and young women who repudiate feminism. The contributions are united by their attempts to think through the ways in which experiences and representations of femininity are changing in the twenty-first century. Are we seeing new femininities? Are neoliberalism and postfeminism constructing new identities and subjectivities? What kinds of analytic tools and cultural politics are needed to critically engage with the current moment? This book will be of interest to everyone studying gender, media or cultural studies. (shrink)

Joseph Beuys, Andy Warhol, Yves Klein, and Marcel Duchamp form an unlikely quartet, but they each played a singular role in shaping a new avant-garde for the 1960s and beyond. Each of them staged brash, even shocking, events and produced works that challenged the way the mainstream art world operated and thought about itself. Distinguished philosopher Thierry de Duve binds these artists through another connection: the mapping of the aesthetic field onto political economy. Karl Marx provides the red thread tying (...) together these four beautifully written essays in which de Duve treats each artist as a distinct, characteristic figure in that mapping. He sees in Beuys, who imagined a new economic system where creativity, not money, was the true capital, the incarnation of the last of the proletarians; he carries forward Warhol’s desire to be a machine of mass production and draws the consequences for aesthetic theory; he calls Klein, who staked a claim on pictorial space as if it were a commodity, “The dead dealer”; and he reads Duchamp as the witty financier who holds the secret of artistic exchange value. Throughout, de Duve expresses his view that the mapping of the aesthetic field onto political economy is a phenomenon that should be seen as central to modernity in art. Even more, de Duve shows that Marx—though perhaps no longer the “Marxist” Marx of yore—can still help us resist the current disenchantment with modernity’s many unmet promises. An intriguing look at these four influential artists, _Sewn in the Sweatshops of Marx_ is an absorbing investigation into the many intertwined relationships between the economic and artistic realms. (shrink)

Alderson critiques our recent book on the basis that it overlooks children’s own views about their medical treatment. In this response, we discuss the complexity of the paediatric clinical context and the value of diverse approaches to investigating paediatric ethics. Our book focuses on a specific problem: entrenched disagreements between doctors and parents about a child’s medical treatment in the context of a paediatric hospital. As clinical ethicists, our research question arose from clinicians’ concerns in practice: What should a clinician (...) do when he or she thinks that parents are choosing a treatment pathway that does not serve the child’s best interests? Alderson’s work, in contrast, focuses on the much broader issue of children’s role in decision-making about treatment and research. We argue that these different types of work are zooming in on different aspects of paediatric ethics, with its complex mix of agents, issues and relationships. Paediatric ethics overall needs a rich mix of approaches,... (shrink)

In the Australian state of Victoria, legislation allowing voluntary assisted dying (VAD) passed through parliament in November 2017. There was then an eighteen-month period before the start date for patient access to VAD, referred to as the “implementation period.” The implementation period was intended to allow time for the relevant government department and affected organizations to develop processes before the Act came into effect in June 2019. This qualitative interview study investigates the perspectives of a multidisciplinary sample of twelve clinicians (...) from a single metropolitan hospital during this implementation period. Maximum variation sampling was utilized to ensure breadth across discipline (medical, nursing, allied health), speciality, and stated level of support for the VAD legislation. Four key themes were identified from the interview data: preparing for the unknown, ethical diversity within the organization, building a respectful culture, and concerns about the inability of the legislated approach to capture clinical nuances. Overall, these clinicians’ workplace experiences during the implementation period were shaped by the ethical diversity within their organization and a sense of uncertainty about how the VAD legislation would integrate with the practical realities of their clinical setting. The concept of “ethical diversity” could be a useful one for supporting staff in an organization during a VAD implementation period. (shrink)

This article explores gender inequities and sexual double standards in teens’ digital image exchange, drawing on a UK qualitative research project on youth ‘sexting’. We develop a critique of ‘postfeminist’ media cultures, suggesting teen ‘sexting’ presents specific age and gender related contradictions: teen girls are called upon to produce particular forms of ‘sexy’ self display, yet face legal repercussions, moral condemnation and ‘slut shaming’ when they do so. We examine the production/circulation of gendered value and sexual morality via teens’ discussions (...) of activities on Facebook and Blackberry. For instance, some boys accumulated ‘ratings’ by possessing and exchanging images of girls’ breasts, which operated as a form of currency and value. Girls, in contrast, largely discussed the taking, sharing or posting of such images as risky, potentially inciting blame and shame around sexual reputation (e.g. being called ‘slut’, ‘slag’ or ‘sket’). The daily negotiations of these new digitally mediated, heterosexualised, classed and raced norms of performing teen feminine and masculine desirability are considered. (shrink)

This creative-critical piece reflects on the practices of recording, communicating, and caring that took place on social media and in digital spaces during the COVID-19 pandemic. Using my own experience of contracting COVID-19 as a starting point, the piece looks at the ways in which epidemics have often been recorded in collaborative ways, with the personal, professional, and familial converging in historical texts that could be used as sources of medical authority. COVID-19 has similarly been immortalized across a variety of (...) forms and by different communities. The piece particularly explores the ways in which collective epidemic experience has been represented online through autopathographical Tweets, TikTok cures, and group chat messages and the future purposes that such collaborative patient narratives can serve. (shrink)

The recent interest in systematic review methods in bioethics has highlighted the need for greater transparency in all literature review processes undertaken in bioethics projects. In this article, I articulate features of a good bioethics literature review that does not aim to be systematic, but rather to capture and analyse the key ideas relevant to a research question. I call this a critical interpretive literature review. I begin by sketching and comparing three different types of literature review conducted in bioethics (...) scholarship. Then, drawing on Dixon-Wood's concept of critical interpretive synthesis, I put forward six features of a good critical interpretive literature review in bioethics: answering a research question, capturing the key ideas relevant to the research question, analysing the literature as a whole, generating theory, not excluding papers based on rigid quality assessment criteria, and reporting the search strategy. (shrink)

Given advances in the science of fertility preservation and the link between fertility choices and wellbeing, it is time to reframe our ethical thinking around fertility preservation procedures for children and young people with cancer. The current framing of fertility preservation as a possible offer may no longer be universally appropriate. There is an increasingly pressing need to discuss the ethics of failing to preserve fertility, particularly for patient groups for whom established techniques exist. I argue that the starting point (...) for deliberating about a particular patient should be a rebuttable presumption that fertility preservation ought to be attempted. Consideration of the harms applicable to that specific patient may then override this presumption. I outline the benefits of attempting fertility preservation; these justify a presumption in favour of the treatment. I then discuss the potential harms associated with fertility preservation procedures, which may justify failing to attempt fertility preservation in an individual patient's particular case. Moving from a framework of offer to one of rebuttable presumption in favour of fertility preservation would have significant implications for medical practice, healthcare organizations and the state. (shrink)

In their analysis of the eligibility criteria for assisted dying in Canada, Downie and Schuklenk put forward a strong argument for the ethical defensibility of including mental illnesses and disabilities as underlying conditions driving a person’s request for assisted dying.1 In this commentary, we add a view on these debates from our home state of Victoria, Australia, where voluntary assisted dying has been legal since June 2019. We highlight the more conservative approach to eligibility in our setting compared with Canada, (...) and argue for debates about eligibility criteria to be conceptualised as part of a broader discussion about access to assisted dying that includes clinicians’ roles and perspectives. In our view, clinicians’ perspectives may have a significant impact on individuals’ ability to access assisted dying, regardless of legislative or other changes made to any system. ‘Voluntary assisted dying’ is the terminology used in our context, rather than Medical Assistance in Dying, so we will use that term when referring to the Victorian system. There are several key differences between the Canadian and Victorian approaches that are important in relation to the debates addressed by Downie and Schuklenk. First, the emphasis in Victoria is on patient self-administration of the VAD …. (shrink)

Bioethics, Volume 35, Issue 7, Page 696-703, September 2021.

Is it coherent to defend nuclear deterrence from an ethical and just-war point of view, given the likely devastating effects of an actual nuclear exchange? This article holds that the salutary effe...

This article considers the experiences of health consumers who have undergone testing for human immunodeficiency virus antibodies, T cells, and viral load. These HIV-related tests are deployed for the purposes of making definitive diagnoses; yet some test consumers experience ambiguous outcomes. Drawing on an analysis of differing end-user experiences of these tests, where consumers' knowledge reflected the multiplicity and heterogeneity in test design, the author explores how these experiences reflect particular knowledges about these tests. The article contributes to efforts analyzing (...) how health consumers are active end users co-constructing the social meaning of technologies in mutual relationship with other users. The author discusses how this new knowledge can be used to delineate a greater role for consumer evaluation of medical testing within a broader understanding of test design and performance. Relevant links are made to issues such as genetic testing and assessing claims about the efficacy of medical tests. (shrink)