How do we understand the agency and significance of material forces and their interface with human bodies? What does it mean to be human in these times, with bodies that are inextricably interconnected with our physical world? Bodily Natures considers these questions by grappling with powerful and pervasive material forces and their increasingly harmful effects on the human body. Drawing on feminist theory, environmental studies, and the sciences, Stacy Alaimo focuses on trans-corporeality, or movement across bodies and nature, which (...) has profoundly altered our sense of self. By looking at a broad range of creative and philosophical writings, Alaimo illuminates how science, politics, and culture collide, while considering the closeness of the human body to the environment. (shrink)

If there are no fictional characters, how do we explain thought and discourse apparently about them? If there are, what are they like? A growing number of philosophers claim that fictional characters are abstract objects akin to novels or plots. They argue that postulating characters provides the most straightforward explanation of our literary practices as well as a uniform account of discourse and thought about fiction. Anti-realists counter that postulation is neither necessary nor straightforward, and that the invocation of pretense (...) provides a better account of the same phenomena. I outline and assess these competing theories. (shrink)

Deliberative democracy harbors a recurrent tension between full inclusion and intelligible speech. People with profound cognitive disabilities often signify this tension. While liberal deliberative theorists sacrifice inclusion for intelligibility, this exclusion is unnecessary. Instead, by analyzing deliberative locations that already include people with disabilities, I offer two ways to revise deliberative norms. First, the physical presence of disabled bodies expands the value of publicity in deliberative democracy, demonstrating that the publicity of bodies provokes new conversations similar to rational speech acts. (...) Second, the inclusion of people with profound disabilities necessitates a form of collaborative speech in which individuals make claims collaboratively. Habermas offers an ideal site to pursue this analysis because he recognizes the theoretical tension between inclusion and intelligibility and because his personal testimony reveals important insight into the lived experience of disability. (shrink)

Statements about fictional characters, such as “Gregor Samsa has been changed into a beetle,” pose the problem of how we can say something true (or false) using empty names. I propose an original solution to this problem that construes such utterances as reports of the “prescriptions to imagine” generated by works of fiction. In particular, I argue that we should construe these utterances as specifying, not what we are supposed to imagine—the propositional object of the imagining—but how we are supposed (...) to imagine. Most other theories of thought and discourse about fictional characters either fail to capture the intentionality of our imaginings, or else obscure the differences between imaginings directed toward fictional characters and those directed toward real individuals. I argue that once we have an account of prescriptions to imagine about real individuals, we can adapt the same framework to specify the contents of prescriptions to imagine about fictional characters, and thereby to account for the truth (or falsity) of statements about fictional characters. (shrink)

How does our understanding of the reality (or lack thereof ) of race as a category of being affect our understanding of racism as a social phenomenon, and vice versa? How should we envision the aims and methods of our struggles against racism? Traditionally, the Western political and philosophical tradition held that true social justice points toward a raceless future—that racial categories are themselves inherently racist, and a sincere advocacy for social justice requires a commitment to the elimination or abolition (...) of race altogether. This book focuses on the underlying assumptions that inform this view of race and racism, arguing that it is ultimately bound up in a “politics of purity”—an understanding of human agency, and reality itself, as requiring all-or-nothing categories with clear and unambiguous boundaries. Racism, being organized around a conception of whiteness as the purest manifestation of the human, thus demands a constant policing of the boundaries among racial categories. Drawing upon a close engagement with historical treatments of the development of racial categories and identities, the book argues that races should be understood not as clear and distinct categories of being but rather as ambiguous and indeterminate (yet importantly real) processes of social negotiation. As one of its central examples, it lays out the case of the Irish in seventeenth-century Barbados, who occasionally united with black slaves to fight white supremacy—and did so as white people, not as nonwhites who later became white when they capitulated to white supremacy. Against the politics of purity, Monahan calls for the emergence of a “creolizing subjectivity” that would place such ambiguity at the center of our understanding of race. The Creolizing Subject takes seriously the way in which racial categories, in all of their variety and ambiguity, situate and condition our identity, while emphasizing our capacity, as agents, to engage in the ongoing contestation and negotiation of the meaning and significance of those very categories. (shrink)

By insisting on the importance of materiality, this volume breaks new ground in philosophy, feminist theory, cultural studies, science studies, and other fields where the body and nature collide.

In Undomesticated Ground, Stacy Alaimo issues a bold call to reclaim nature as feminist space.

Standard theories define fiction in terms of an invited response of imagining or make-believe. I argue that these theories are not only subject to numerous counterexamples, they also fail to explain why classification matters to our understanding and evaluation of works of fiction as well as non-fiction. I propose instead that we construe fiction and non-fiction as genres: categories whose membership is determined by a cluster of nonessential criteria, and which play a role in the appreciation of particular works. I (...) claim that this proposal captures the intuitions motivating alternative theories of fiction. (shrink)

How does our understanding of the reality (or lack thereof ) of race as a category of being affect our understanding of racism as a social phenomenon, and vice versa? How should we envision the aims and methods of our struggles against racism? Traditionally, the Western political and philosophical tradition held that true social justice points toward a raceless future--that racial categories are themselves inherently racist, and a sincere advocacy for social justice requires a commitment to the elimination or abolition (...) of race altogether. This book focuses on the underlying assumptions that inform this view of race and racism, arguing that it is ultimately bound up in a "politics of purity"--an understanding of human agency, and reality itself, as requiring all-or-nothing categories with clear and unambiguous boundaries. Racism, being organized around a conception of whiteness as the purest manifestation of the human, thus demands a constant policing of the boundaries among racial categories. Drawing upon a close engagement with historical treatments of the development of racial categories and identities, the book argues that races should be understood not as clear and distinct categories of being but rather as ambiguous and indeterminate (yet importantly real) processes of social negotiation. As one of its central examples, it lays out the case of the Irish in seventeenth-century Barbados, who occasionally united with black slaves to fight white supremacy--and did so as white people, not as nonwhites who later became white when they capitulated to white supremacy. Against the politics of purity, Monahan calls for the emergence of a "creolizing subjectivity" that would place such ambiguity at the center of our understanding of race. The Creolizing Subject takes seriously the way in which racial categories, in all of their variety and ambiguity, situate and condition our identity, while emphasizing our capacity, as agents, to engage in the ongoing contestation and negotiation of the meaning and significance of those very categories. (shrink)

The "colorblind" society is often offered as a worthy ideal for individual interaction as well as public policy. The ethos of liberal democracy would seem indeed to demand that we comport ourselves in a manner completely indifferent to race (and class, and gender, and so on). But is this ideal of colorblindness capable of fulfillment? And whether it is or not, is it truly a worthy political goal? In order to address these questions, one must first explore the nature of (...) "race" itself. Is it ultimately real, or merely an illusion? What kind of reality, if any, does it have, and what are the practical (moral and political) consequences of its ontological status? This paper will explore the issue of colorblindness, focusing particularly on recent developments dealing with this topic in Continental philosophy. Beginning with the question of racial ontology, I will argue that race has a social reality that makes the practice of colorblindness, at least for the time being, politically untenable, and it may remain suspect even as a long-term goal. (shrink)

This poem was written based on my experiences as an ED nurse.

Georgia State University College of Law, through the Center for Law, Health & Society, developed a pair of online libraries for faculty teaching public health law in schools of law or public health. Development of these libraries was funded by a grant from the Robert Wood Johnson Foundation as part of The Future of Public Health Law Education: Faculty Fellowship Program. This article describes the goals of the program addressed by the libraries, the development process, the resources included, and how (...) faculty may benefit from the materials and provide materials benefitting other faculty across the country. (shrink)

In this essay, I examine the use of the concept of privilege within the critical theoretical discourse on oppression and liberation (with a particular focus on white privilege and antiracism in the USA). In order to fulfill the rhetorical aims of liberation, concepts for privilege must meet what I term the ‘boundary condition’, which demarcates the boundary between a privileged elite and the rest of society, and the ‘ignorance condition’, which establishes that the elite status and the advantages it confers (...) are not publicly recognised or affirmed. I argue that the dominant use of the concept of privilege cannot fulfill these conditions. As a result, while I do not advocate for the complete abandonment of the rhetoric of privilege, I conclude that it obscures as much as it illuminates, and that the critical theoretical discourse on liberation and oppression should be suspicious of its use. (shrink)

Book synopsis: New work on a hot topic by an outstanding team of authors At the intersection of several central areas of philosophy It is the linguistic job of singular terms to pick out the objects that we think or talk about. But what about singular terms that seem to fail to designate anything, because the objects they refer to don't exist? We can employ these terms in meaningful thought and talk, which suggests that they are succeeding in fulfilling their (...) representational task. A team of leading experts presents new essays on the much-debated problem of empty reference and thought. In the 1960s and 1970s Keith Donnellan, David Kaplan, Saul Kripke and Hilary Putnam initiated a revolution in the then standard conception of reference—a concept at the core of philosophical inquiry. The repercussions of the revolution, particularly felt in metaphysics and epistemology, were soon refined by other influential writers such as Tyler Burge, Gareth Evans, and John Perry. They argued that some linguistic and mental representations have contents individuated by what they are about—by ordinary referents of expressions such as proper names, indexicals, definite descriptions and common nouns, i.e. by planets, people or natural kinds. The view was at odds with a central philosophical presumption at that time: that cognitive and linguistic access to objective reality is indirect and accidental, mediated by general descriptive characterizations, the only constitutive semantic feature of the expressions; hence its ontological and epistemological repercussions. A turning-point in the debate about how linguistic and mental representation reach external contents concerned the nature of empty mental and linguistic representations, framed by means of the very same expressions crucially invoked in the Donnellan-Kaplan-Kripke-Putnam arguments. The papers in this volume address different aspects of reference and thought about the non-existent. (shrink)

I argue that judgments of what is ‘true in a fiction’ presuppose the Reality Assumption: the assumption that everything that is true is fictionally the case, unless excluded by the work. By contrast with the more familiar Reality Principle, the Reality Assumption is not a rule for inferring implied content from what is explicit. Instead, it provides an array of real-world truths that can be used in such inferences. I claim that the Reality Assumption is essential to our ability to (...) understand stories, drawing on a range of empirical evidence that demonstrates our reliance on it in narrative comprehension. However, the Reality Assumption has several unintuitive consequences, not least that what is fictionally the case includes countless facts that neither authors nor readers could ever consider. I argue that such consequences provide no reason to reject the Reality Assumption. I conclude that we should take fictions, like non-fictions, to be about the real world. (shrink)

In his Critique of Dialectical Reason , Sartre argues that it is the milieu of scarcity that generates human conflict. His account of scarcity is rather ambiguous however, and at points he seems to claim that conflict is inevitable given the context of scarcity. In this article I provide a brief account of Sartre's position, and offer a critical evaluation of that position. Finally, I argue that Sartre's claims regarding the necessity of conflict are excessive, and that the resources provided (...) in the Critique offer a means to re-evaluate our relationship to scarcity. (shrink)

Two assumptions are common in discussions of the paradox of tragedy: (1) that tragic pleasure requires that the work be fictional or, if non-fiction, then non-transparently represented; and (2) that tragic pleasure may be provoked by a wide variety of art forms. In opposition to (1) I argue that certain documentaries could produce tragic pleasure. This is not to say that any sad or painful documentary could do so. In considering which documentaries might be plausible candidates, I further argue, against (...) (2), that the scope of tragic pleasure is limited to works that possess certain thematic and narrative features. (shrink)

It is widely taken for granted that fictions, including both literature and film,influence our attitudes toward real people, events, and situations. Philosopherswho defend claims about the cognitive value of fiction view this influence in apositive light, while others worry about the potential moral danger of fiction.Marketers hope that visual and aural references to their products in movies willhave an effect on people’s buying patterns. Psychologists study the persuasiveimpact of media. Educational books and films are created in the hopes of guidingchildren’s (...) and adult’s preferences toward socially acceptable norms.The influencesdiscussed by marketers, psychologists, educators, and philosophers tend to be bothcognitive and affective. It seems that we can be “emotionally persuaded”: ourpreferences can be changed, our feelings about particular people or events can beinfluenced, and so forth. (shrink)

Philosophers and other scholars have often claimed that the arts are not only cognitively valuable but also morally improving (e.g., Nussbaum, 1997). However, their arguments often proceed with little attention to empirical evidence. At the same time, filmmakers and media creators deliberately use devices to direct their audience’s attention, with the intention of impacting viewers’ cognitive, affective, and neurological responses in meaningful ways (Carroll & Seeley, 2013). Whether these devices have the desired effects, and on whom, also remains largely untested. (...) If we want to understand the ways that film and media can have moral impacts, we must step out of our disciplinary siloes. It is not enough for film experts, philosophers, and experimentalists to merely take note of each other’s work; collaborative interdisciplinary research is required, both to improve methods and to examine questions that have not yet been empirically explored. In this article we propose a model for this kind of research, focusing on how media can influence moral understanding. We first outline the challenges that must be met for such research to be successful, including clarifying and operationalizing concepts, measuring moral understanding, and applying empirical methods to media and the arts. We then describe the advantages of interdisciplinary collaboration for meeting these challenges, in the context of some recent examples of interdisciplinary projects on related themes. (shrink)

What does feminist disability studies contribute to feminist methods? Feminist disability scholars interweave life-writing about their experiences of disability or caring for a disabled person to challenge ableist stereotypes. As such, they foreground their own vulnerability to build disability identity and community. This style of life-writing, while essential, tends to calcify the dichotomy between the disabled and abled—a binary that the field of feminist disability studies aims to destabilise. Building on new work in feminist disability studies, I show how some (...) scholars use life-writing to cultivate an estranging sensitivity. This new sensitivity builds on prior feminist disability studies scholarship to estrange us from 1) the idea that disability is a cohesive identity and community, 2) that disability is always a socially desirable position, and 3) that allegiance to disability rights insulates us from ableist anxiety. By embracing the tension between solidifying and destabilising the meaning of disability, feminist disability scholars can leverage life-writing as a tool of resistance and thereby lessen the threat of conformity that life narratives tend to produce. (shrink)

The currently standard approach to fiction is to define it in terms of imagination. I have argued elsewhere that no conception of imagining is sufficient to distinguish a response appropriate to fiction as opposed to non-fiction. In her contribution Kathleen Stock seeks to refute this objection by providing a more sophisticated account of the kind of propositional imagining prescribed by so-called ‘fictive utterances’. I argue that although Stock's proposal improves on other theories, it too fails to provide an adequate criterion (...) of fictionality. I conclude by sketching an alternative account according to which fiction is a genre. (shrink)

Book synopsis: The most debated issue in aesthetics today Written by an international team of leading experts Addresses growing methodological concerns in the field Includes an extensive introduction which illuminates key issues Through much of the twentieth century, philosophical thinking about works of art, design, and other aesthetic products has emphasized intuitive and reflective methods, often tied to the idea that philosophy's business is primarily to analyze concepts. This 'philosophy from the armchair' approach contrasts with methods used by psychologists, sociologists, (...) evolutionary thinkers, and others who study the making and reception of the arts empirically. How far should philosophers be sensitive to the results of these studies? Is their own largely a priori method basically flawed? Are their views on aesthetic value, interpretation, imagination, and the emotions of art to be rethought in the light of best science? The essays in this volume seek answers to these questions, many through detailed studies of problems traditionally regarded as philosophical but where empirical inquiry seems to be shedding interesting light. No common view is looked for or found in this volume: a number of authors argue that the current enthusiasm for scientific approaches to aesthetics is based on a misunderstanding of the philosophical enterprise and sometimes on misinterpretation of the science; others suggest various ways that philosophy can and should accommodate and sometimes yield to the empirical approach. The editors provide a substantial introduction which sets the scene historically and conceptually before summarizing the claims and arguments of the essays. (shrink)

Love is a recurring theme in bell hooks' thought, where it is explicitly linked to her understanding of freedom and liberation. In this essay, I will bring together some of hooks' most important writings on love in order to clarify her account of the relationship between love and liberation. I will argue that, for hooks, the practice of love and the practice of freedom are inextricably connected, and any liberatory project must be undertaken within the context of an ethics of (...) love. (shrink)

Business schools around the globe are seeking effective ways of incorporating business ethics into their programs. Indications from both the market and accrediting bodies suggest best-practice programs will include ethics education. However, the debate continues as to whether meaningful learning is best achieved through stand-alone ethics experiences or via an integrated theme across the program of study. While many examples of required ethics-experiences can be found, to date, there is only one business school that we are aware of that has (...) implemented a required full-term postgraduate ethics course based on the Giving Voice To Values philosophy and content.The purpose of this article is to share the tacit knowledge gained in the authors’ experience of implementing such a course at the University of Western Australia’s Business School. (shrink)

We apply an action-oriented approach to business ethics education, Giving Voice to Values (GVV), to the topic of sustainability. The increasingly problematic impact of unsustainable economic activity is demanding actionable responses from business. However, traditional business ethics education has focussed on awareness and decision-making and neglected action-oriented methods. The GVV curriculum offers an applied and process-driven ethics approach thatcomplements more analytical ethics pedagogies. Because of its focus on action and expressing personal values, GVV can be thought of as largely applicable (...) to the micro-level of interpersonal interactions. This paper illustrates GVV’s potential for much broader application by presenting two caselettes spanning the micro-level of workplace refurbishment to the global-level of the mass dumping of electronic waste. Ways of crafting conversations around these sustainability issues are presented and implications of the GVV approach for both the teaching and practice of sustainability ethics are discussed. (shrink)

Business schools around the globe are seeking effective ways of incorporating business ethics into their programs (Melé 2008, Swanson 2004). Indications from both the market and accrediting bodies suggest best-practice programs will include ethics education. However, the debate continues as to whether meaningful learning is best achieved through stand-alone ethics experiences or via an integrated theme across the program of study (Tesfayohannes & Driscoll 2010, Wilhelm 2005). While many examples of required ethics-experiences can be found, to date, there is only (...) one business school that we are aware of that has implemented a required full-term postgraduate ethics course based on the Giving Voice To Values (GVV) (Gentile 2008) philosophy and content.The purpose of this article is to share the tacit knowledge gained in the authors’ experience of implementing such a course at the University of Western Australia’s Business School. (shrink)

Analytic aesthetics has had little to say about academic schools of criticism, such as Freudian, Marxist, feminist, or postcolonial perspectives. Historicists typically view their interpretations as anachronistic; non-historicists assess all interpretations according to formalist criteria. Insofar as these strategies treat these interpretations as on a par, however, they are inadequate. For the theories that ground the interpretations differ in the claims they make about the world. I argue that the interpretations of different critical schools can be evaluated according to the (...) truth or epistemic merit of these claims. (shrink)

Overdiagnosis is an emerging problem in health policy and practice: we address its definition and ethical implications. We argue that the definition of overdiagnosis should be expressed at the level of populations. Consider a condition prevalent in a population, customarily labelled with diagnosis A. We propose that overdiagnosis is occurring in respect of that condition in that population when the condition is being identified and labelled with diagnosis A in that population ; this identification and labelling would be accepted as (...) correct in a relevant professional community; but the resulting label and/or intervention carries an unfavourable balance between benefits and harms. We identify challenges in determining and weighting relevant harms, then propose three central ethical considerations in overdiagnosis: the extent of harm done, whether harm is avoidable and whether the primary goal of the actor/s concerned is to benefit themselves or the patient, citizen or society. This distinguishes predatory, misdirected and tragic overdiagnosis; the degree of harm moderates the justifiability of each type. We end with four normative challenges: methods for adjudicating between professional standards and identifying relevant harms and benefits should be procedurally just; individuals, organisations and states are differently responsible for addressing overdiagnosis; overdiagnosis is a matter for distributive justice: the burdens of both overdiagnosis and its prevention could fall on the least-well-off; and communicating about overdiagnosis risks harming those unaware that they may have been overdiagnosed. These challenges will need to be addressed as the field develops. (shrink)

Engagement with fiction often inspires emotional responses. We may pity Sethe while feeling ambivalent about her actions (in Beloved), fear for Ellen Ripley as she battles monstrous creatures (in Alien), get angry at Okonkwo for killing Ikemefuna (in Things Fall Apart), and hope that Kiyoaki and Satoko find love (in Spring Snow). Familiar as they are, these reactions are puzzling. Why do I respond emotionally if I do not believe that these individuals exist or that the events occurred? If I (...) merely imagine that my best friend has betrayed me, I do not become angry with him; if I did, I would be considered irrational. Yet although beliefs seem to be necessary for emotions in other contexts, we respond to fiction without the relevant beliefs. These observations prompt two questions about our emotional responses to fiction (henceforth: fictional emotions). The first is descriptive: Should fictional emotions be classified as the same kind of emotions we experience in other contexts? The second is normative: Are fictional emotions irrational or otherwise inappropriate? I take each of these debates in turn. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:277 HUME'S IMPRESSIONS OF BELIEF Introduction Hume's theory of belief is often taken to be fully stated in his opening remarks on the subject in A Treatise of Human Nature, Book I, Part III, Section VII: "An opinion, therefore, or belief may be most accurately defin'd, A LIVELY IDEA RELATED TO OR ASSOCIATED WITH A PRESENT IMPRESSION."1 Taking this definition as Hume's final account leaves the reader with many (...) problems. What is it for an idea to be lively? How is an idea related to or associated with an impression? Is belief really so simple a phenomenon? I argue that Hume's theory of belief is much more complex than this, and that the Treatise contains only a rough, preliminary account of belief. By the time he wrote An Enquiry Concerning the Human Understanding, Hume had developed his theory in full detail. As I show, in this latter account a belief is an intentional state involving a combination of Humean ideas and impressions. The nature of these ideas and impressions allows the mind to take note of a belief as something quite different from its other perceptions. In the Treatise, however, Hume did not have a clear understanding of how the mind could distinguish beliefs from other perceptions. He could only go so far as to say that an idea believed is livelier than other ideas. He argued that a present impression is capable of calling to mind an idea of something that has been associated with that impression in the past, and of transferring some of its own vivacity to that idea. As we look at the account of belief in the Treatise, we will see how the preliminary concepts of force and liveliness and a transference of vivacity lay the foundation for his 278 final account, yet point to a need for a fuller explication of the difference the mind notes between beliefs and other perceptions. We will see that in the Appendix to the Treatise Hume tried to work out this difference in terms of 'feeling' but this was unsuccessful without the notion of an intentional act. Finally, we will see that Hume concluded in the Enquiry that a belief is an intentional state in which a new impression of reflection arises about the idea believed. This new impression is the feeling of belief by which beliefs are distinguished from other 2 perceptions of the mind. The Account in the Treatise We begin our explication of Hume's theory of belief by looking at the account in A Treatise of Human Nature. Here Hume maintains that it is ideas which are believed, and that these beliefs differ from other ideas only in their "force and vivacity" (T 96). This force and vivacity is a result of the believed idea's relation to an impression. These theses lead us to the familiar Treatise definition of belief as "A LIVELY IDEA RELATED TO OR ASSOCIATED WITH A PRESENT IMPRESSION" (T 96). Hume begins his analysis of belief in Section VII of the Treatise by stating that "the idea of an object is an essential part of the belief of it, but not the whole" (T 94). The suggestion is that there is more to being in a state of belief than merely entertaining the idea believed. The simple phrase "belief o_f_ an object" leads us to presume that it is ideas that are believed, or that we have beliefs o_f ideas. We will need to examine Hume's meaning of 'idea' in enough depth to understand the role it plays in the theory of belief. 279 Hume gives some examples of the way we may conceive ideas without believing them: Suppose a person present with me, who advances propositions, to which I do not assent, that Caesar dy'd in his bed, that silver is more fusible than lead, or mercury heavier than gold; 'tis evident, that notwithstanding my incredulity, I clearly understand his meaning, and form all the same ideas, which he forms (T 95). Note that Hume says one may form all the same ideas as another. Yet the ideas one forms are just what Hume had earlier called the propositions one... (shrink)

Most discussions of proper names in fiction concern the names of fictional characters, such as ‘Clarissa Dalloway’ or ‘Lilliput.’ Less attention has been paid to referring names in fiction, such as ‘Napoleon’ (in Tolstoy’s War and Peace) or ‘London’ (in Orwell’s Nineteen Eighty-Four). This is because many philosophers simply assume that such names are unproblematic; they refer in the usual way to their ordinary referents. The alternative position, dubbed Exceptionalism by Manuel García-Carpintero, maintains that referring names make a distinctive semantic (...) contribution in fiction. In this paper I offer a positive argument for Non-Exceptionalism, relying on the claim that works of both fiction and non-fiction can express the same singular propositions. I go on to defend my account against García-Carpintero’s objections. (shrink)

The empirical turn in bioethics and the deliberative turn in democracy theory occurred at around the same time, one at the intersection of bioethics and social science,1 2 the other at the intersection of political philosophy and political science.3–5 Empirical bioethics and deliberative democratic approaches both engage with immediate problems in policy and practice with normative intent, so it was perhaps inevitable that they would eventually find one another,6–8 and that deliberative research would become more common in bioethics.9 This commentary (...) responds to a paper by Ford et al, who ran a single jury of 18 people in Brighton in the UK in June 2018.10 The jury were asked to consider whether secondary research use of non-structured, free-text data from medical records should be permitted. I will consider three issues: the effort required in deliberative work, the challenge of sampling and selection of jurors and the basis for drawing normative conclusions from deliberative research. First: this report makes clear the effort involved in running a jury. These researchers contracted an external agency experienced in the method, established an oversight committee of policy-makers with power to act, developed expert witness briefs, selected witnesses and coordinated their testimony, and created a questionnaire to measure participants’ views, activities to support their understanding, and a scenario for consideration. …. (shrink)

Joan Tronto’s new paradigm of caring democracy bases citizenship on the need to ensure that all people receive and provide care equitably. But how exactly are citizens motivated to take up these caring responsibilities? The writings of Alcoholics Anonymous (AA) co-founder William ‘Bill’ Wilson provide one answer: he pathologizes the alcoholic – dooming him to inevitable relapse and death – to compel AA members to accept shared vulnerability and mutual care as the bedrock of sobriety and AA society. Wilson returns (...) repeatedly to the threat of death to convince AA members to carry out their newfound caring and democratic responsibilities. We use Wilson’s thinking, as well as Michel Foucault’s work on biopower, to forward the concept of biocaring democracy, in which the acceptance of shared pathology compels people to care for each other but also limits their democratic responsibilities. More broadly, our analysis suggests how hinging democracy to shared vulnerability may constrain the radical possibilities that Tronto envisions. (shrink)

This paper explores how scientific knowledge is used in a criminal case. I examine materials from an admissibility hearing in a murder trial and discuss the dynamics of contesting expert scientific opinion and evidence. The research finds that a purported form of “science” in the relevant scientific community is filtered through, tested by, and subjected to legal standards, conceptions, and procedures for determining admissibility. The paper details how the opposing lawyers, the expert witness, and the judge vie to contingently work (...) out what will count in court as appropriate scientific authority, methods and evidence, and as a scientifically valid and legally admissible account of “reasonable fear.” When science becomes enmeshed in legal controversies, science does not trump law. Rather, it is the court’s canons of proper procedure and measures of substantive adequacy that take precedence. (shrink)

In this commentary, I explore the ethically relevant dimensions of menu labelling. The evidence that menu labelling changes purchasing or consumption behaviour is contentious and inconclusive; there is some suggestion that menu labelling may preferentially influence the behaviour of healthier and wealthier citizens. Some suggest that menu labelling is unjust, as it fails to direct resources towards those who most need them. An alternative is to see menu labels as just one of a set of strategies that can increase people’s (...) real opportunities to be healthy. Complementing strategies will be necessary to ensure that all citizens can consider and value food choices, which may include becoming a more critical consumer in the food marketplace. Menu labels may also have the potential to shift our attention from people to food, reallocate responsibility in the food environment and facilitate structural change. It would be a mistake to expect too much of menu labels alone: rather, they should be integrated into a broader programme that supports health opportunities, especially for the least well off. (shrink)

In September 2009, the First Circuit Court of Appeals decided Blue Cross & Blue Shield v. AstraZeneca Pharmaceuticals LP, part of the class action suit known as In re Pharmaceutical Industry Average Wholesale Price Litigation. The First Circuit upheld a Massachusetts District Court finding that AstraZeneca violated Massachusetts’ consumer protection laws by manipulating the “average wholesale price” of its physician-administered injectable cancer drug Zoladex, leading to overpayment by the government, third-party payers, and consumers. This case, which highlights the persistent tension (...) between pharmaceutical pricing flexibility and consumer protection, has important implications for similar pending class actions.Between 1991 and 2003, Medicare, as well as many private insurance companies, pegged reimbursement for certain pharmaceutical products to a national “average wholesale price” for each drug. Although the amended 1991 Medicare Part B regulations3 that introduced the term “average wholesale price” failed to define it explicitly, there is some indication in the legislative history that AWP was intended to refer to the prices that physicians and pharmacists actually pay to the drug manufacturers. (shrink)

In the past several years, the Office of Inspector General, the branch of the Department of Health and Human Services that combats fraud and abuse, has begun enforcing a little-used provision that allows the government to exclude owners and managers of sanctioned entities based on their position in the company. The OIG's exclusion authority under 42 USC § 1320a-7 is not unique in applying strict liability to individual executives as a tool to halt corporate misconduct, but it represents a startling (...) change for health care executives who could now face exclusion for their company's misdeeds. While the OIG has expanded its use of this statute, it has indicated some hesitancy in exercising the full scope of its statutory power.Pursuant to §1128 and §1156 of the Social Security Act, the OIG can exclude individuals and entities from participating in federal healthcare programs. The OIG has both mandatory and permissive exclusion power, based on the circumstances of the offense. (shrink)