When developing phylogenetic systematics, the entomologist Willi Hennig adopted elements from Nicolai Hartmann’s ontology. In this historical essay I take on the task of documenting this adoption. I argue that in order to build a metaphysical foundation for phylogenetic systematics, Hennig adopted from Hartmann four main metaphysical theses. These are (1) that what is real is what is temporal; (2) that the criterion of individuality is to have duration; (3) that species are supra-individuals; and (4) that there are levels of (...) reality, each of which may be subject to different kinds of law. Reliance on Hartmann’s metaphysics allowed Hennig to ground some of the main theoretical principles of phylogenetic systematics, namely that the biological categories—from the semaphoront to the highest rank—have reality and individuality despite not being universals, and that they form a hierarchy of levels, each of which may require different kinds of explanation. Hartmann’s metaphysics thereby provided a philosophical justification for Hennig’s phylogenetic systematics, both as a theory and as a method of classification. (shrink)

This paper assesses James M. Buchanan's claim of following a positive approach in stark contrast to the normative approach to public finance of Richard A. Musgrave. The goal of this paper is to shed light on the foundations of modern American public finance by analysing one aspect of the methodology of its two most prominent fathers. I show (1) that it is difficult to distinguish Musgrave's and Buchanan's theories of public goods along the positive/normative dividing line and (2) that Buchanan's (...) theory can also be considered normative. In the first three parts, I follow the Weberian methodological tradition in looking for value judgements in the theories, and by reflecting on the nature of ideal types. In the last part, I propose a broader interpretation of Buchanan's methodological stance within the academic context of the 1960s. (shrink)

This paper aims to deflate the idea that democracy would be in essence a privileged locus of civic trust. Three claims are defended: (1) there is nothing specific to democracy regarding the affirmation that trust is required for social cooperation; (2) democracy, when conceived discursively, depends on guarded epistemic trust and; (3) popular control may require, in some contexts, institutions that express and foster distrust towards a specific section of the population. The conclusion to be drawn is that the appropriateness (...) of trust for the achievement of popular control over government depends on a contextual and realist assessment. (shrink)

Moral duties are regularly attributed to groups. Does this make conceptual sense or is this merely political rhetoric? And what are the implications for these individuals within groups? Collins outlines a Tripartite Model of group duties that can target political demands at the right entities, in the right way and for the right reasons.

Argues that positive changes in perspective and deeper spiritual connections to things greater than oneself can influence the world for the better.

The politics of reconciliation, in Canada, finds its origin in judgements of the Supreme Court affirming the objective of reconciling the sui generis authority and continued distinct existence of I...

Much has been written about the need for trustworthy artificial intelligence (AI), but the underlying meaning of trust and trustworthiness can vary or be used in confusing ways. It is not always clear whether individuals are speaking of a technology’s trustworthiness, a developer’s trustworthiness, or simply of gaining the trust of users by any means. In sociotechnical circles, trustworthiness is often used as a proxy for ‘the good’, illustrating the moral heights to which technologies and developers ought to aspire, at (...) times with a multitude of diverse requirements; or at other times, no specification at all. In philosophical circles, there is doubt that the concept of trust should be applied at all to technologies rather than their human creators. Nevertheless, people continue to intuitively reason about trust in technologies in their everyday language. This qualitative study employed an empirical ethics methodology to address how developers and users define and construct requirements for trust throughout development and use, through a series of interviews. We found that different accounts of trust (rational, affective, credentialist, norms based, relational) served as the basis for individual granting of trust in technologies and operators. Ultimately, the most significant requirement for user trust and assessment of trustworthiness was the accountability of AI developers for the outputs of AI systems, hinging on the identification of accountable moral agents and perceived value alignment between the user and developer’s interests. (shrink)

A comprehensive collection of classic texts, contemporary interpretations, guidelines for activists, issue-specific information, and materials for environmentally-oriented religious practice. Sources and contributors include Basho, the Dalai Lama, Thich Nhat Hanh, Gary Snyder, Chogyam Trungpa, Gretel Ehrlich, Peter Mathiessen, Helen Tworkov (editor of Tricycle ), and Philip Glass.

The politics of reconciliation, in Canada, finds its origin in judgements of the Supreme Court affirming the objective of reconciling the sui generis authority and continued distinct existence of I...

On doit à l’économiste américain d’origine allemande, Richard A. Musgrave, la formulation des critères d’Équité Horizontale (ÉH) et d’Équité Verticale (ÉV). Étant donnée une base fiscale, l’ÉH veut que les égaux soient traités également, alors que l’ÉV exige que les inégaux soient traités inégalement (par exemple que les plus riches payent proportionnellement plus d’impôts). Musgrave opère en 1959 une redescription créative de considérations d’équité qui ont une longue histoire de Hobbes à Buchanan, en passant notamment par la fameuse maxime de (...) Adam Smith. La reconstruction généalogique montre que l’ÉV et l’ÉH relèvent de la justice distributive au sens aristotélicien du terme. Un critère purement formel, l’équité en matière d’impôt signifie l’égalité proportionnelle dans la répartition des charges communes à tous les individus membres d’une communauté politique. À défaut d’un consensus théorique sur la manière de conceptualiser les contribuables, l’ÉH conserve tout de même une valeur de principe régulateur dans le cadre non idéal de débats de réforme fiscale.Codes JEL : H20, B11, B12, B20, B40, D63. (shrink)

The ethics of care has flourished in recent decades yet we remain without a succinct statement of its core theoretical commitment. This book uses the methods of analytic philosophy to argue for a simple care ethical slogan: dependency relationships generate responsibilities. It uses this slogan to unify, specify and justify the wide range of views found within the care ethical literature.

There is disagreement in the literature about the exact nature of the phenomenon of empathy. There are emotional, cognitive, and conditioning views, applying in varying degrees across species. An adequate description of the ultimate and proximate mechanism can integrate these views. Proximately, the perception of an object's state activates the subject's corresponding representations, which in turn activate somatic and autonomic responses. This mechanism supports basic behaviors that are crucial for the reproductive success of animals living in groups. The Perception-Action Model, (...) together with an understanding of how representations change with experience, can explain the major empirical effects in the literature. It can also predict a variety of empathy disorders. The interaction between the PAM and prefrontal functioning can also explain different levels of empathy across species and age groups. This view can advance our evolutionary understanding of empathy beyond inclusive fitness and reciprocal altruism and can explain different levels of empathy across individuals, species, stages of development, and situations. Key Words: altruism; cognitive empathy ; comparative; emotion; emotional contagion; empathy ; evolution; human; perception-action; perspective taking. (shrink)

When making decisions on behalf of someone, is asking what they would have wanted a good way to respect their autonomy? Against prevalent assumptions, I argue that in decisions about the care and treatment of those with advanced dementia, the notion of ‘what one would have wanted’ is conceptually, epistemically, and practically problematic. The problem stems from the disparity between the first-person subjectivity of the past person and that of the present person. The transformative nature of dementia renders the very (...) meaning of ‘what the patient would have wanted’ problematic. When applied to those with advanced dementia, the subjunctive notion is either (i) incoherent, (ii) fundamentally indeterminate, or (iii) normatively irrelevant. (shrink)

The overall aim of this thesis is to assess the legitimacy of constitutional laws and bills of rights within the framework of procedural epistemic democracy. The thesis is divided into three sections. In the first section, I discuss the relevance of an epistemic argument for democracy under the circumstances of politics: I provide an account of reasonable disagreement and explain how usual approaches to the authority of decision-making procedures fail to take it seriously. In the second part of the thesis, (...) I provide an account of the epistemic features of democracy and of the requirements of democratic legitimacy. I develop a revised pragmatist argument for democracy which relies on three presumptive aims of decision-making: justice, sustainability and concord. In the third and last section, I first argue for the desirability of constitutionalism. I then explain why constitutionalism, as it is usually understood, is incompatible with my procedural epistemic account of democratic legitimacy. In the last chapter, I offer a two-pronged solution to the apparent incompatibility of constitutionalism and epistemic democracy. I first argue for the appropriateness of political constitutionalism, as opposed to legal constitutionalism, in understanding the relationship between rights and democracy. I then provide an account of rights protection and judicial review compatible with epistemic democratic legitimacy. Finally, I use the notion of pragmatic encroachment to explain how constitutional laws can achieve normative supremacy through the increased epistemic credentials of the procedure. (shrink)

This paper offers a revised political conception of human rights informed by legal pluralism and epistemic considerations. In the first part, I present the political conception of human rights. I then argue for four desiderata that such a conception should meet to be functionally applicable. In the rest of the first section and in the second section, I explain how abstract human rights norms and the practice of specification prevent the political conception from meeting these four desiderata. In the last (...) part of the paper, I argue that full-fledged tolerance in the international order – that is tolerance-as-non-intervention and tolerance-as-respect – should be attached to (1) compliance with jus cogens norms and to; (2a) a political community recognizably organized as a community of inquiry that is; (2b) committed to the specification and incorporation or expression of the idea of human rights within its local legal system. (shrink)

Young children learn about the power of God's love and creation through simple text and illustrations.

Yann Allard-Tremblay ,Aude Bandini | : Les théories épistémiques et délibératives de la démocratie soulignent l’importance du processus de la délibération quand l’objectif poursuivi est de parvenir à de bonnes décisions. Dans cet article, nous nous intéresserons aux différents mécanismes grâce auxquels une délibération publique à la fois ouverte, libre et inclusive, peut parvenir à de bonnes décisions, avant d’envisager ce que la délibération peut apporter en cas de désaccord. Nous nous concentrerons plus particulièrement ici sur la fonction constructive (...) de la démocratie, c’est-à-dire sur cette capacité qu’a la démocratie délibérative d’identifier et de formuler, de manière épistémiquement instructive, les problèmes de justice auxquels doit faire face le corps politique. Il faudra donc d’abord expliquer comment la démocratie permet de colliger l’information et de la mettre à disposition de chacun, afin d’expliquer ensuite comment la délibération peut permettre l’émergence d’accords entre les individus. Nous verrons alors que la délibération a des limites, et pourquoi elle se révèle incapable de surmonter certains désaccords. Nous tâcherons enfin d’expliquer le rôle qu’elle joue dans la formulation des désaccords politiques. Sur ce point, nous montrerons que la délibération permet d’éviter que ne surgissent des désaccords politiques insoutenables, qui mettraient en péril l’intégrité du corps politique. | : Deliberative epistemic theories of democracy highlight the importance of deliberation for the achievement of correct decisions. The aims of this paper are to discuss the mechanisms which allow an open, free and inclusive forum of deliberation to achieve correct decisions and to discuss the impact of deliberation on disagreement. I concentrate on the constructive function of democracy which designates the capacity of deliberative democracy to identify and frame the problems of justice faced by a polity in epistemically positive ways. I first explain how democracy can pool information. This is then used to explain how deliberation can enable agreement to emerge. This is followed by a discussion of the limits of deliberation and how it is unable to resolve some disagreements. The final element of my discussion is an explanation of the role of deliberation in framing political disagreements. I argue that deliberation helps in avoiding unsustainable political disagreements which could bring about political decay. (shrink)

This paper presents a conception of corruption informed by epistemic democratic theory. I first explain the view of corruption as a disease of the political body. Following this view, we have to consider the type of actions that debase a political entity of its constitutive principal in order to assess corruption. Accordingly, we need to consider what the constitutive principle of democracy is. This is the task I undertake in the second section where I explicate democratic legitimacy. I present democracy (...) as a procedure of social inquiry about what ought to be done that includes epistemic and practical considerations. In the third section, I argue that the problem of corruption for a procedural conception of democracy is that the epistemic value of the procedure is diminished by corrupted agents’ lack of concern for truth. Corruption, according to this view, consists in two deformities of truth: lying and bullshit. These deformities corrupt since they conceal private interests under the guise of a concern for truth. In the fourth section, I discuss the difficulties a procedural account may face in formulating solutions to the problem of corruption. (shrink)

The Russian philosopher Nikolai Onufrievich Lossky adhered to an evolutionary metaphysics of reincarnation according to which the world is constituted of immortal souls or monads, which he calls ‘substantival agents.’ These substantival agents can evolve or devolve depending on the goodness or badness of their behavior. Such evolution requires the possibility for monads to reincarnate into the bodies of creatures of a higher or of a lower level on the scala perfectionis. According to this theory, a substantival agent can evolve (...) by being gradually reincarnated multiple times through a sort of process of metamorphosis from the level of the most elementary particles all the way up to the level of human beings or even higher. In ‘Ученiе Лейбница о перевоплощенiи какъ метаморфозѣ’, Lossky argues that the works of Leibniz contain scattered elements of such a systematic evolutionary doctrine of reincarnation as metamorphosis and he attempts to reconstitute this doctrine. The present article is intended as an historical introduction to the translation of Lossky’s ‘Leibniz’s Doctrine of Reincarnation as Metamorphosis.’. (shrink)

In this article, we extend the research on the public interest to non-audit engagements performed by accounting firms and public accountants. Our thesis is that non-audit engagements, as private goods, require a distinct approach to the public interest than auditing. We suggest that a public value perspective can be used conceptually to provide substantial criteria for designing non-audit engagements conducive to public value creation and greater accountability. We illustrate the applicability and consequences of a public value perspective by analyzing and (...) contrasting the decision of two judicial opinions deciding whether Deloitte and the lead partner of a consulting engagement failed to act in the public interest in engineering the sale of collapsed British carmaker MG Rover. We advocate for a significant change in ethical codes of conduct by defining public interest obligations, not only in terms of professional attributes, but also in terms of outcomes. Our approach also suggests a requirement regarding planning a non-audit engagement, including establishing a public value proposition detailing the planned nature of the engagement, and extent of the assessment of the intended public value creation. We discuss the aspirational function of codes of conduct to provide accountability other than in terms of technical output, and to maintain the legitimacy and purpose of the profession. (shrink)

Many meta-ethicists are alethists: they claim that practical considerations can constitute normative reasons for action, but not for belief. But the alethist owes us an account of the relevant difference between action and belief, which thereby explains this normative difference. Here, I argue that two salient strategies for discharging this burden fail. According to the first strategy, the relevant difference between action and belief is that truth is the constitutive standard of correctness for belief, but not for action, while according (...) to the second strategy, it is that practical considerations can constitute motivating reasons for action, but not for belief. But the former claim only shifts the alethist's explanatory burden, and the latter claim is wrong—we can believe for practical reasons. Until the alethist can offer a better account, then, I argue that we should accept that there are practical reasons for belief. (shrink)

How should a political society be structured so as to legitimately distribute political power? One principle advanced to answer this question is the principle of subsidiarity. According to this principle, the default locus of political power is with the lowest competent political unit. This article argues that subsidiarity is a structural principle of a conception of political legitimacy informed by epistemic considerations. Broadly, the argument is that political societies organised according to the principle of subsidiarity can more effectively achieve political (...) decisions that can justifiably appear to be correct from the point of view of those subject to them. The article presents two considerations in order to establish a pro tanto case for acting separately before presenting five additional epistemic considerations that establish a prima facie case for acting separately. The article then shows that political legitimacy and the epistemic aim of decision-making can sometimes be served more effectively and efficiently by allowing higher-level political units to assist lower-level political units. (shrink)

This article provides an exploration of the relationships between a procedural account of epistemic democracy, illegitimate laws and judicial review. I first explain how there can be illegitimate laws within a procedural account of democracy. I argue that even if democratic legitimacy is conceived procedurally, it does not imply that democracy could legitimately undermine itself or adopt grossly unjust laws. I then turn to the legitimacy of judicial review with regard to these illegitimate laws. I maintain that courts do not (...) have a moral privilege on the overthrow of illegitimate laws; in this respect the refusal of royal assent has the same status. I also explain how the rule of the clear mistake fails to restrict the action of courts to only illegitimate laws. Finally, I argue for the positive epistemic inputs of weak judicial review. (shrink)

I aim to explain why majority voting can be assumed to have an epistemic edge over lottery voting. This would provide support for majority voting as the appropriate decision mechanism for deliberative epistemic accounts of democracy. To argue my point, I first recall the usual arguments for majority voting: maximal decisiveness, fairness as anonymity, and minimal decisiveness. I then show how these arguments are over inclusive as they also support lottery voting. I then present a framework to measure accuracy so (...) as to compare the two decision mechanisms. I go over four arguments for lottery voting and three arguments for majority voting that support their respective accuracy. Lottery voting is then shown to have, compared to majority voting, a decreased probability of discrimination. That is, I argue that with lottery voting it is less probable under conditions of normal politics that if the procedure selects X, X is reasonable. I then provide two case scenarios for each voting mechanism that illustrate my point. (shrink)

On a Humean account, a person's reasons for action are determined by her desires---in the broadest sense of 'desires', that is, noncognitive pro-attitudes. In four essays, I defend this account against several prominent objections. The first essay addresses the concern that the Humean cannot account for rationalizing reasons . The next three essays concern justifying reasons : reasons for action that are more fully normative than those that merely make action intelligible. Instrumental reasons, prudential reasons, and intrinsic reasons are three (...) different sorts of reasons to which an agent can appeal in justifying her action. ;Each essay focuses on a specific attack against the Humean account. In the second essay I argue that the normatively of instrumental reasons is brute ; and that, contrary to the received view, this is compatible with Humeanism. In the third essay I consider prudential reasons and defend the Humean claim that all and only present concerns provide normative reasons for action. In the final essay I address the fundamental question considerations of deliberative relevance: what makes certain desires and considerations relevant to a specific decision-making context, that is, what puts them among a person's present active reasons. ;In addition to defending a broadly Humean account of practical reasons, I am concerned to expand the components of a plausible form of Humeanism. Specifically, I argue that desires alone are not always sufficient to ground an agent's reasons, and that affective states are sometimes also necessary. I call this view "thick Humeanism". In essays one and four especially, I urge that a central place be given to affective states in determining practical reasons. I also invoke recent studies in cognitive psychology to support my claims about the role of the emotions in practical deliberation. (shrink)

In this collected volume, the authors analyze the deficiencies of existing theory and present alternate explanations of Third World foreign policy behavior. The essays show how examining Third World experience can broaden our understanding of how and why states and non-state actors interact in the international system.

Organizations do moral wrong. States pursue unjust wars, businesses avoid tax, charities misdirect funds. Our social, political, and legal responses require guidance. We need to know what we’re responding to and how we should respond to it. We need a metaphysical and moral theory of wrongful organizations. This book provides a new such theory, paying particular attention to questions that have been underexplored in existing debates. These questions include: where are organizations located as material objects in the natural world? What’s (...) the metaphysical relation between organizations and their members? Can organizations be blameworthy for attitudes and character traits, as well as for actions? What about feelings of guilt, remorse, and shame—can organizations feel these emotions and why does this matter? How and why are members implicated in organizations’ wrongs? How should organizations’ reparative costs be apportioned among members? The book answers these questions. It argues that organizations are material objects with humans as material parts—much like how a pizza is a material object with slices as material parts. This picture helps us make sense of organizations’ blameworthiness, including blame for organization-level actions, attitudes, and character traits. The book argues that organizations can experience moral self-awareness—a crucial component of guilt, remorse, and shame. Members can be implicated in organizations’ actions in numerous ways—and, it is argued, members’ level of implication should determine their share of organizations’ reparative burdens. (shrink)

With the growth of precision medicine research on health data and biospecimens, research institutions will need to build and maintain long-term, trusting relationships with patient-participants. While trust is important for all research relationships, the longitudinal nature of precision medicine research raises particular challenges for facilitating trust when the specifics of future studies are unknown. Based on focus groups with racially and ethnically diverse patients, we describe several factors that influence patient trust and potential institutional approaches to building trustworthiness. Drawing on (...) these findings, we suggest several considerations for research institutions seeking to cultivate long-term, trusting relationships with patients: Address the role of history and experience on trust, engage concerns about potential group harm, address cultural values and communication barriers, and integrate patient values and expectations into oversight and governance structures. (shrink)

Before the Darwinian revolution species were thought to be universals. Since then, numerous attempts have been made to propose new definitions. The twentieth-century German philosopher Nicolai Hartmann defined 'species' as an individual system of processes and a process of life of a higher-order. To provide a clear understanding of Hartmann's conception of species, I first present his method of definition. Then I look at Hartmann's Philosophie der Natur (1950) to present his concepts of "organism" and "species." And I end the (...) paper by pointing out two possible systematic inconsistencies. (shrink)

While popular cultural representations portray the “new father” of the past two decades as more involved, more nurturing, and capable of coparenting, many argue that actual fathering conduct has not kept pace. Others, however, question the extent to which the culture of fatherhood does indeed support involved fathering and, if so, what this involvement entails. This study aims to contribute to the exploration of the culture of fatherhood through an analysis of a yearlong Canadian newspaper series dedicated to family issues. (...) Findings suggest that through representations of parental guilt, parental responsibility, work—family balance issues, and hegemonic masculinity, mothers continue to be positioned as primary parents. Support for father involvement, to the extent that it exists, occurs within the framework of fathers as part-time, secondary parents whose relationship with children remains less important than mothers'. (shrink)

This chapter argues that the best way for a non-naturalist to explain why the normative supervenes on the natural is to claim that, while there are some sui generis normative properties whose essences cannot be fully specified in non-normative terms and do not specify any non-normative sufficient conditions for their instantiation, there are certain hybrid normative properties whose essences specify both naturalistic sufficient conditions for their own instantiation and sufficient conditions for the instantiation of certain sui generis normative properties. This (...) is the only metaphysical explanation for supervenience on offer, the chapter argues, that can both clearly maintain the pre-theoretical commitments of non-naturalism, and provide a metaphysical explanation not just for supervenience, but for all metaphysical necessities involving natural and normative properties. (shrink)

Individuals sometimes pass their duties on to collectives, which is one way in which collectives can come to have duties. The collective discharges its duties by acting through its members, which involves distributing duties back out to individuals. Individuals put duties in and get (transformed) duties out. In this paper we consider whether (and if so, to what extent) this general account can make sense of states' duties. Do some of the duties we typically take states to have come from (...) individuals having passed on certain individual duties? There are complications: states can discharge their duties by contracting fulfilment out to non-members; states seem able to dissolve the duties of non-members; and some of states' duties are not derived in this way. We demonstrate that these complicate, but do not undermine, the general account and its application to states. And the application has an interesting upshot: by asking which individuals robustly participate in this process of duty transfer-and-transformation with a given state, we can begin to get a grip on who counts as a member of that state. (shrink)

A surfeit of research confirms that people activate personal, affective, and conceptual representations when perceiving the states of others. However, researchers continue to debate the role of self–other overlap in empathy due to a failure to dissociate neural overlap, subjective resonance, and personal distress. A perception–action view posits that neural-level overlap is necessary during early processing for all social understanding, but need not be conscious or aversive. This neural overlap can subsequently produce a variety of states depending on the context (...) and degree of common experience and emotionality. We outline a framework for understanding the interrelationship between neural and subjective overlap, and among empathic states, through a dynamic-systems view of how information is processed in the brain and body. (shrink)

Growing interest in embedded research approaches—where research is incorporated into clinical care—has spurred numerous studies to generate knowledge relevant to the real-world needs of patients and other stakeholders. However, it also has presented ethical challenges. An emerging challenge is how to understand the nature and extent of investigators’ obligations to patient-subjects. Prior scholarship on investigator duties has generally been grounded upon the premise that research and clinical care are distinct activities, bearing distinct duties. Yet this premise—and its corresponding implications—are challenged (...) when research and clinical care are deliberately integrated. After presenting three case studies from recent pragmatic clinical trials, we identify six differences between explanatory trials and embedded research that limit the application of existing scholarship for ascertaining investigator duties. We suggest that these limitations indicate a need to account for the implications of usual care and to move beyond a narrow focus on the investigator-subject dyad, one that better reflects the team- and institution-based nature of contemporary health systems. (shrink)

Business and Society Review, Volume 127, Issue S1, Page 283-298, Spring 2022.

Noninvasive, prenatal whole genome sequencing may be a technological reality in the near future, making available a vast array of genetic information early in pregnancy at no risk to the fetus or mother. Many worry that the timing, safety, and ease of the test will lead to informational overload and reproductive consumerism. The prevailing response among commentators has been to restrict conditions eligible for testing based on medical severity, which imposes disputed value judgments and devalues those living with eligible conditions. (...) To avoid these difficulties, we propose an unrestricted testing policy, under which prospective parents could obtain information on any variant of known significance after a careful informed consent process that uses an interactive decision aid to deliver a mandatory presentation on the purposes, techniques, and limitations of genomic testing, as well as optional resources for reflection and consultation. This process would encourage thoughtful, informed deliberation... (shrink)

Classic statements of research ethics advise against permitting physician-investigators to obtain consent for research participation from patients with whom they have preexisting treatment relationships. Reluctance about “dual-role” consent reflects the view that distinct normative commitments govern physician–patient and investigator–participant relationships, and that blurring the research–care boundary could lead to ethical transgressions. However, several features of contemporary research demand reconsideration of the ethics of dual-role consent. Here, we examine three arguments advanced against dual-role consent: that it creates role conflict for the (...) physician-investigator; that it can compromise the voluntariness of the patient-participant’s consent; and that it promotes therapeutic misconceptions. Although these concerns have merit in some circumstances, they are not dispositive in all cases. Rather, their force—and the ethical acceptability of dual-role consent—varies with features of the particular study. As research participation more closely approximates usual care, it becomes increasingly acceptable, or even preferable, for physicians to seek consent for research from their own patients. It is time for a more nuanced approach to dual-role consent. (shrink)

Unconsented pelvic exams under anesthesia are assaults cloaked in defense of healthcare education. Preemptive linguistic qualifiers “presumed” or “implied” attempt to justify such violations with flippancy toward their oxymoronic implications: to suggest a priori that consent can be assumed undermines its otherwise standalone social, ethical, and medico-legal reverence. In this paper I conceptualize “medical sexual assault” and argue that presumed consent for intimate exams exemplifies its definition. By bluntly describing pelvic exams as “penetration,” this work aims to reify the intimate (...) reality of the clinical label “pelvic exam” and to call attention to cisheteronormative and androcentric assumptions involved in its practice. Additionally, this scholarship seeks to create a foundation toward broader work in conceptualizing clinical rape culture. Given recent national survey data indicating a surprising frequency of unconsented intimate exams, detailed language as to their problematics is necessary for ongoing legal and ethical efforts. Explicit consent for intimate exams must be the standard of care for conscious and unconscious patients. (shrink)