Journal Name: Apeiron Issue: Ahead of print.

Using 452 letters sent in 1990 to Wellesley College over a student petition objecting to the choice of Barbara Bush as the graduation speaker, this article explores how an attempt to expand the boundaries of elite women's political behavior created a cultural and symbolic battle that centered upon the content of education, women's “manners” and civility, and their implications for elite women's participation in the broader Hobbesian social contract for citizenship. The article demonstrates that social class in its (...) gendered form is essential to understanding the construction of citizenship. (shrink)

In ‘Patients, doctors and risk attitudes,’ Makins argues for ‘straightforwardly’ (Makins1 p1) extending antipaternalistic views about medical decision-making to include deferential considerations of risk attitudes that a patient might endorse. Reflecting on Makins’ important contribution to higher order attitudes in decision theory, we seek to clarify the practical applicability of his argument to specific clinical settings, namely in mental health. We argue that considering low and higher order risk preferences are not only practically difficult, but also potentially ethically fraught and (...) especially so in the provision of mental healthcare. Deferring to risk attitudes potentially mutes a more robust curiosity of patients’ preferences and desires that can promote both autonomy and beneficence but are explicitly relationally grounded. We argue that a relational understanding of autonomy is a much more robust way of thinking about the value of risk attitudes among other patient preferences, attitudes and goals. Makins rightly expounds on the challenges faced by healthcare professionals who are often required to make determinative recommendations for their patients. Providers must explain uncertain benefits in relation to uncertain risks, therefore, exploring the risk attitudes of patients, appears, prima facie, a rational, patient-centred and autonomy-promoting choice. It invariably invites discussion of Perske’s 1972 dignity of …. (shrink)

The desperate straits to which commentators are driven in attempting to explain inter impotentis et ualidos falso quiescas: ubi manu agitur, modestia ac probitas nomina superioris sunt are illustrated by a recent contributor to this journal . In the decent obscurity of a review of Büchner's fourth volume of Studien zur römischen Literatur I hazarded a suggestion that has escaped notice. The crux may be removed by reading non superioris and supposing a confusion between N ═ non and Ñ ═ (...) nomine . In war legality is dumb, and amid the squabbles of competing tribes restraint and honesty are not the marks of the winner. The Chatti were proved wiser than the children of light, for they had fought and flourished: Chattis uictoribus fortuna in sapientiam cessit. (shrink)

The present paper proposes to discuss three passages in Tacitus, Histories 3 where current interpretations have led to difficulties which can be shown to be baseless so soon as it is realized that Tacitus is willing on occasion to sacrifice truth and clarity to stylistic effect. In each of these passages the same literary device lies at the root of the matter, a device which may be labelled ‘die grouping of participles’: the juxtaposition of participles in a sentence to die (...) detriment of strict chronological order. (shrink)

This poem was written during the first COVID-19 lockdown in 2020 when many were feeling the painful impact of sudden isolation. During this time, mental health crises were increasingly attended to by local emergency services who may or may not have had relevant training to respond appropriately to vulnerable persons. The outcomes of these 911 calls concerned me, loaded as they can be with bias and...

In “Acquiescence Is Not Agreement: The Problem of Marginalization in Pediatric Decision Making,” Caruso Brown argues that clinicians and ethicists should attend to voices marginalized by hie...

Background: The law and literature about children’s consent generally assume that patients aged under-18 cannot consent until around 12 years, and cannot refuse recommended surgery. Children deemed pre-competent do not have automatic rights to information or to protection from unwanted interventions. However, the observed practitioners tend to inform young children s, respect their consent or refusal, and help them to “want” to have the surgery. Refusal of heart transplantation by 6-year-olds is accepted. Research question: What are possible reasons to explain (...) the differences between theories and practices about the ages when children begin to be informed about elective heart surgery, and when their consent or refusal begins to be respected? Research design, participants and context: Research methods included reviews of related healthcare, law and ethics literature; observations and conversations with staff and families in two London hospitals; audio-recorded semi-structured interviews with a purposive sample of 45 healthcare professionals and related experts; interviews and a survey with parents and children aged 6- to 15-years having elective surgery (not reported in this paper); meetings with an interdisciplinary advisory group; thematic analysis of qualitative data and co-authorship of papers with participants. Ethical considerations: Approval was granted by four research ethics committees/authorities. All interviewees gave their informed written consent. Findings: Interviewees explained their views and experiences about children’s ages of competence to understand and consent or refuse, analysed by their differing emphases on informed, signified or voluntary consent. Discussion: Differing views about children’s competence to understand and consent are associated with emphases on consent as an intellectual, practical and/or emotional process. Conclusion: Greater respect for children’s practical signified, emotional voluntary and intellectual informed consent can increase respectful understanding of children’s consent. Nurses play a vital part in children's practitioner-patient relationships and physical care and therefore in all three elements of consent. (shrink)

This discussion paper considers how seldom recognised theories influence clinical ethics committees. A companion paper examined four major theories in social science: positivism, interpretivism, critical theory and functionalism, which can encourage legalistic ethics theories or practical living bioethics, which aims for theory–practice congruence. This paper develops the legalistic or living bioethics themes by relating the four theories to clinical ethics committee members’ reported aims and practices and approaches towards efficiency, power, intimidation, justice, equality and children’s interests and rights. Different approaches (...) to framing ethical questions are also considered. Being aware of the four theories’ influence can help when seeking to understand and possibly change clinical ethics committee routines. The paper is not a research report but is informed by a recent study in two London paediatric cardiac units. Forty-five practitioners and related experts were interviewed, including eight members of ethics committees, about the work of informing, preparing and supporting families during the extended process of consent to children’s elective heart surgery. The mosaic of multidisciplinary teamwork is reported in a series of papers about each profession, including this one on bioethics and law and clinical ethics committees’ influence on clinical practice. The qualitative social research was funded by the British Heart Foundation, in order that more may be known about the perioperative views and needs of all concerned. Questions included how disputes can be avoided, how high ethical standards and respectful cooperation between staff and families can be encouraged, and how minors’ consent or refusal may be respected, with the support of clinical ethics committees. (shrink)

Background This analysis is about practical living bioethics and how law, ethics and sociology understand and respect children’s consent to, or refusal of, elective heart surgery. Analysis of underlying theories and influences will contrast legalistic bioethics with living bioethics. In-depth philosophical analysis compares social science traditions of positivism, interpretivism, critical theory and functionalism and applies them to bioethics and childhood, to examine how living bioethics may be encouraged or discouraged. Illustrative examples are drawn from research interviews and observations in two (...) London paediatric cardiac units. This paper is one of a series on how the multidisciplinary cardiac team members all contribute to the complex mosaic of care when preparing and supporting families’ informed consent to surgery. Results The living bioethics of justice, care and respect for children and their consent depends on theories and practices, contexts and relationships. These can all be undermined by unseen influences: the history of adult-centric ethics; developmental psychology theories; legal and financial pressures that require consent to be defined as an adult contract; management systems and daily routines in healthcare that can intimidate families and staff; social inequalities. Mainstream theories in the clinical ethics literature markedly differ from the living bioethics in clinical practices. Conclusion We aim to contribute to raising standards of respectful paediatric bioethics and to showing the relevance of virtue and feminist ethics, childhood studies and children’s rights. (shrink)

Five symposia from the 25th annual Oberlin Colloquium in Philosophy focus on cognitive suicide, the explanatory role of content, Cartesian error and the objectivity of perception, social content and psychological content, and belief attribution and context.

This paper studies the attempts (and failure) of Russian revolutionaries to mobilize the peasantry in the decade leading to the Soviet revolution of 1917. Peasants, who had been emancipated from serfdom only four decades earlier, in 1861, were still largely propertyless and poor. This would, at first glance, make them a ripe target for revolutionary activity. But peasants were largely refractory. We explain this lack of revolutionary spirit through two models. First, despite their lack of education and political awareness, the (...) peasants were rational in their refusal to participate in revolutionary activity; they engaged in a cost–benefit calculus which pushed them away from revolt and political organization. Second, based on the Wildavsky–Thompson cultural types, Russian peasants were largely fatalist: they believed they had no influence on the world, so it was not worth attempting to change it. This paper sheds light on some aspects of the Russian revolution, but also encourages further research in history and economic sociology on the interaction between culture and incentives. (shrink)

Continuing the exploration of a theme that has figured prominently in previous issues of this journal, articles translated for the present issue illuminate various aspects of the fate of philosophy in twentieth-century Russia. The development of philosophy in Russia has encountered extraordinary institutional obstacles for nearly two centuries. Following the Decembrist Revolt of 1825, the tsarist authorities banned the teaching of philosophy in university classrooms as a potential source of revolutionary ideas. The ban was partially modified in 1863 only to (...) permit commentary on certain specified texts of ancient philosophy and was not lifted until 1889. During the 1920s, the Bolsheviks in authority gradually enforced increasingly strict ideological controls on the teaching and publishing of philosophy, so that by the early 1930s no doctrine other than the Marxist-Leninist orthodoxy could be taught or advocated in print. (shrink)

It is generally acknowledged that there were two schisms in the early history of the phenomenological movement. The first, the Great Phenomenological Schism, started between 1905 and 1913, as many of his younger contemporaries, for example Pfänder, Scheler, Reinach, Stein, and Ingarden, rejected Husserl’s transformation of phenomenology from the descriptive psychology of the Logical Investigations into the transcendental idealism of Ideas I. The second, the Phenomenological-Existential Schism, happened between 1927 and 1933, as it emerged that with Being and Time Heidegger’s (...) philosophy had moved away from Husserl’s transcendental phenomenology of consciousness toward an ontological analytic of human existence as the way to an interpretation of the question of the meaning of Being. This paper is about neither the first schism per se nor the second schism per se but about the relationship between the two. It suggests that the first schism anticipated the second and the second recapitulated the first, so that, although the first could have occurred without the second, the second would not have happened as it did without the first. It also indicates that the second schism lies temporally much closer to the first schism than has been hitherto appreciated. Above all, the paper seeks an answer to this question: How do the Great Phenomenological Schism and the Phenomenological-Existential Schism illuminate one another philosophically? (shrink)