Several foundational documents of bioethics mention the special obligation researchers have to vulnerable research participants. However, the treatment of vulnerability offered by these documents often relies on enumeration of vulnerable groups rather than an analysis of the features that make such groups vulnerable. Recent attempts in the scholarly literature to lend philosophical weight to the concept of vulnerability are offered by Luna and Hurst. Luna suggests that vulnerability is irreducibly contextual and that Institutional Review Boards (Research Ethics Committees) can only (...) identify vulnerable participants by carefully examining the details of the proposed research. Hurst, in contrast, defines the vulnerable as those especially at risk of incurring the wrongs to which all research ethics participants are exposed. We offer a more substantive conception of vulnerability than Luna but one that gives rise to a different rubric of responsibilities from Hurst's. While we understand vulnerability to be an ontological condition of human existence, in the context of research ethics, we take the vulnerable to be research subjects who are especially prone to harm or exploitation. Our analysis rests on developing a typology of sources of vulnerability and showing how distinct sources generate distinct obligations on the part of the researcher. Our account emphasizes that the researcher's first obligation is not to make the research participant even more vulnerable than they already are. To illustrate our framework, we consider two cases: that of a vulnerable population involved in international research and that of a domestic population of people with diminished capacity. (shrink)

Financial and nonfinancial conflicts of interest in medicine and surgery are troubling because they have the capacity to skew decision making in ways that might be detrimental to patient care and well-being. The recent case of the Articular Surface Replacement (ASR) hip provides a vivid illustration of the harmful effects of conflicts of interest in surgery.

Many observers have argued that the US health care system could be more efficient, and achieve better outcomes if providers focused more on improving the community's health, not just the welfare of individual patients. The passage of the Affordable Care Act in 2010 seemed to herald the promise of such reforms, and greater integration of the health care and public systems. In this article, we reassess the quest for integration, a quest we call the “integration project.” After examining the modest (...) steps taken so far toward integration, we consider some conceptual barriers to integration as well as some of the risks it might portend for the public health system. Our assessment contributes to wide-ranging debates among public health advocates, practitioners, and policymakers as to the health care system's role in protecting public health, and how the public health system can best be organized to meet expected population health challenges. (shrink)

Department of Medical Education, Flinders University of South Australia, GPO Box 2100, Adelaide SA 5001. Tel. : +61-8-7225-1111; Fax: +61-8-8204-5675; Email: lee0359{at}flinders.edu.au ' + u + '@ ' + d + ' '/ /- ->.This paper analyses the role of communication strategies in pandemic influenza planning. Our central concern is with the extent to which nations are using communication to address issues of social justice. Issues associated with disadvantage and vulnerability to infection in the event of an influenza pandemic raise (...) distinct questions about how well less well off groups will be protected. The potential for a public health emergency of this type to exacerbate existing inequalities, making those in less well off positions worse off, makes social justice an important consideration for pandemic planners. National PI plans offer insights into the ways that nations may use communication to address issues of disadvantage, thereby providing a way of examining how communication strategies are presented and their potential to mitigate inequities. Our research reviewed 12 national PI plans and assessed the extent to which nations are using communication to assist and limit possible harms to less well off groups. We outline in this paper some important issues and considerations associated with social justice and flu planning, in particular if and how plans are addressing inequalities. CiteULike Connotea Del.icio.us What's this? (shrink)

The second of five commentaries on “Bloomberg's Health Legacy: Urban Innovator or Meddling Nanny?” from the September‐October 2013.

Nursing faces an uncertain future as technological developments, structural changes within health systems and rapidly evolving health needs create new and challenging possibilities. This article draws on the results of a qualitative study undertaken with a range of Queensland nurse leaders to explore their perceptions of these changes. The study re‐surfaced, and allows for a re‐examination of, four issues that have long created tension within nursing and which continue to have a negative impact on the profession as a whole. These (...) are as follows: professionalisation; preparation of graduates; myths and narratives of nursing; and leadership. We provide a metaphor that imagines all of these tensions operating in dynamic interplay. The image is that of a Newton's Cradle – a model for energy and momentum. The metaphor allows one to see the wide context of changes affecting nursing and the significance of the interconnections. If tensions within nursing maintain their own integrity through containment, understanding and development, they remain in alignment, and energy is conserved rather than wasted or misdirected. It suggests that with increased awareness and attention paid to internal challenges, and by taking a broad‐based approach to systemic improvements, nursing could become more effective, progressive and proactive in shaping its own future. (shrink)

The aim of the following paper is, firstly, to provide the reader with a brief exposition of the critical response offered by some current french feminists of the largely American, compensatory approach to feminist historiography. Secondly, I wish to show why the french feminist alternative itself provides an inadequate methodology for the resolution of the problems that it raises in its critique. Lastly, I shall suggest that the Wittgensteinian concept of ‘family resemblance’ contains the seeds of a plausible alternative to (...) either the compensatory or the french structuralist approach to feminist historiography. The upshot of this latter claim is that the historical subject may be most fruitfully conceived genealogically, that is, as the dynamic product of an inexhaustible complex of historical and contextual resemblances constructed on the behalf of a specific interpretational task. (shrink)

I argue for a Wittgensteinian reading of Judith Butler's performative conception of identity in light of Marilyn Frye's analysis of lesbian as nonexistent and Butler's analysis of abject. I suggest that the attempt to articulate a performative lesbian identity must take seriously the contexts within which abjection is vital to maintaining gender, exposing the intimate link between context and the formulation of intention, and shedding light on possible lesbian identities irreducible to abjection.

This interdisciplinary book examines the work of several female artists since 1960 in the areas of dance, music, installation, photography, architecture, poetry, literature, theater, film, and performance art. Each chapter is primarily devoted to an important work by a single artist, seen within its historical context, and with particular attention to how each artist incorporated gender issues or feminist thought into her respective art form. Laurie Anderson, Gwendolyn Brooks, Jane Campion, Judy Chicago, Zaha Hadid, Pauline Oliveros, Yvonne Rainer, Cindy Sherman, (...) Amy Tan, and Paula Vogel have each made groundbreaking contributions to their fields. As a group, they represent a tremendous diversity of approaches to art making: from accessible to opaque, from overtly feminist to apolitical, from emotive to cool, from controversial to mainstream. (shrink)

In the following essay, I argue for an alternative anthropocentrism that, eschewing failed appeals to traditional moral principle, takes (a) as its point of departure the cognitive, perceptual, emotive, somatic, and epistemic conditions of our existence as members of Homo sapiens, and (b) one feature of our experience of/under these conditions particularly seriously as an avenue toward articulating this alternative, the capacity for aesthetic appreciation. To this end, I will explore, but ultimately reject philosopher Allen Carlson's ecological aesthetics, and I (...) will adopt with modification aspects of the work of Ronnie Hawkins, Val Plumwood, and Donna Haraway. My central claim is that, equipped with a better understanding of our interdependent relationship to/within human and nonhuman nature, an understanding made especially available to those who occupy situations imbued by subjugation, we can come to understand our human-centeredness not as a justification of entitlement, but as an opportunity for critical self-reflection upon those actions which endanger the ecological conditions of human and nonhuman being. I suggest, then, that developing criteria for an aesthetic appreciation ground in such a centeredness can make a vital contribution to a more ecologically defensible moral and political activism. (shrink)

Our social role/biosocial theory provides a more adequate account of aggression sex differences than does Archer's sexual selection theory. In our theory, these sex differences arise flexibly from sociocultural and ecological forces in interaction with humans' biology, as defined by female and male physical attributes and reproductive activities. Our comments elaborate our theory's explanations for the varied phenomena that Archer presents.

The ultimate causes of sex differences in human aggressive behavior can lie mainly in evolved, inherited mechanisms that differ by sex or mainly in the differing placement of women and men in the social structure. The present commentary contrasts Campbell's evolutionary interpretation of aggression sex differences with a social structural interpretation that encompasses a wider range of phenomena.

Schmitt's findings provide little evidence that sex differences in sociosexuality are explained by evolved dispositions. These sex differences are better explained by an evolutionary account that treats the psychological attributes of women and men as emergent, given the biological attributes of the sexes, especially female reproductive capacity, and the economic and social structural aspects of societies.

We agree with Faunce’s proposal that academic legitimacy is important in ensuring that whistle-blowing is included in medical curricula. We disagree, however, with the assertion that this is best achieved by means of an over-arching theoretical foundation for health care whistle-blowing of the kind suggested by Faunce. We propose that systematic theoretical justification is neither the sole nor the main determinant of academic legitimacy when it comes to matters for inclusion in medical school curricula, and outline an alternative view, together (...) with a practical example of a healthcare whistle-blowing topic. (shrink)

Plato has received his share of bad press in this century. A number of significant schools of thought, like existentialism and phenomenology, have openly expressed impatience with Platonic ‘essentialism.’ He has even been blamed for fascism. Perhaps the problem goes back to Nietzsche’s call, at the turn of the century, to be true to the earth, our common mother. His message was aimed at otherworldly, pious Christians who, with a spiritualism worthy of the Platonists, regarded contemplative thought as the way (...) to truth. Like a doubleedged sword Nietzsche’s call was also directed against metaphysics, dogmatism and intellectualism, the fruits of which he confronted in the weighty tomes for which German scholars then were justifiably renowned. It is not surprising that in the Soviet empire, built on Marxist-Leninist atheism, Nietzsche’s words fell on receptive ears. Not only were philosophers who dared openly to identify themselves as ‘Platonist’ or ‘idealist’ banned, exiled or executed. The teaching of classical antiquity, too, was almost entirely removed from the curriculum; the ancients could be considered only from a highly restricted point of view, via Democritus, Lucretius, or Aristotle. (shrink)

Lloyd (2009) contends that climate models are confirmed by various instances of fit between their output and observational data. The present paper argues that what these instances of fit might confirm are not climate models themselves, but rather hypotheses about the adequacy of climate models for particular purposes. This required shift in thinking—from confirming climate models to confirming their adequacy-for-purpose—may sound trivial, but it is shown to complicate the evaluation of climate models considerably, both in principle and in practice.

Whether in characterizing Catharine MacKinnon's theory of gender as itself pornographic or in identifying liberalism as unable to make good on its promises, Wendy Brown pursues a central question: how does a sense of woundedness become the basis for a sense of identity? Brown argues that efforts to outlaw hate speech and pornography powerfully legitimize the state: such apparently well-intentioned attempts harm victims further by portraying them as so helpless as to be in continuing need of governmental protection. "Whether (...) one is dealing with the state, the Mafia, parents, pimps, police, or husbands," writes Brown, "the heavy price of institutionalized protection is always a measure of dependence and agreement to abide by the protector's rules." True democracy, she insists, requires sharing power, not regulation by it; freedom, not protection.Refusing any facile identification with one political position or another, Brown applies her argument to a panoply of topics, from the basis of litigiousness in political life to the appearance on the academic Left of themes of revenge and a thwarted will to power. These and other provocations in contemporary political thought and political life provide an occasion for rethinking the value of several of the last two centuries' most compelling theoretical critiques of modern political life, including the positions of Nietzsche, Marx, Weber, and Foucault. (shrink)

Journal of Political Philosophy, Volume 29, Issue 4, Page 429-455, December 2021.

Much ink has been spilled on the pros and cons of U.S. president Barack Obama's decision not to strike the regime of Syrian president Bashar al-Assad after that regime launched a deadly chemical weapons attack in 2013. Often missing from those debates, however, are the perspectives of Syrians themselves. While not all Syrians oppose Assad, and not all opponents endorsed intervention, many Syrian oppositionists resolutely called for Obama to uphold his “red line” militarily. As part of the roundtable “The Ethics (...) of Limited Strikes,” this essay analyzes diverse expressions of such opinion and finds that they highlight three dimensions of the ethical case for limited strikes against Assad. First, they remind us that the ethical context of the red line question was many Syrians’ sense of abandonment by the international community. Second, they emphasize the ethical stakes of the limited strikes; namely an opportunity to hold the Syrian regime accountable, weaken it from within, and thus change the equation of the war. Third, they make sense of the ethical consequences of the nonintervention outcome, and especially its effect in deepening civilians’ despair, accelerating extremism, and convincing Assad and his allies that they could kill with impunity. These views controvert both legalistic arguments precluding military intervention and assumptions that U.S. intervention is always imperialist and warmongering. In this case, consideration of the case for military intervention from the viewpoint of those on whose behalf the intervention would have taken place challenges us to think deeply about circumstances in which limited strikes might be not only ethically justified but also imperative. (shrink)

Tolerance is generally regarded as an unqualified achievement of the modern West. Emerging in early modern Europe to defuse violent religious conflict and reduce persecution, tolerance today is hailed as a key to decreasing conflict across a wide range of other dividing lines-- cultural, racial, ethnic, and sexual. But, as political theorist Wendy Brown argues in Regulating Aversion, tolerance also has dark and troubling undercurrents. Dislike, disapproval, and regulation lurk at the heart of tolerance. To tolerate is not to (...) affirm but to conditionally allow what is unwanted or deviant. And, although presented as an alternative to violence, tolerance can play a part in justifying violence--dramatically so in the war in Iraq and the War on Terror. Wielded, especially since 9/11, as a way of distinguishing a civilized West from a barbaric Islam, tolerance is paradoxically underwriting Western imperialism. Brown's analysis of the history and contemporary life of tolerance reveals it in a startlingly unfamiliar guise. Heavy with norms and consolidating the dominance of the powerful, tolerance sustains the abjection of the tolerated and equates the intolerant with the barbaric. Examining the operation of tolerance in contexts as different as the War on Terror, campaigns for gay rights, and the Los Angeles Museum of Tolerance, Brown traces the operation of tolerance in contemporary struggles over identity, citizenship, and civilization. (shrink)

Wendy Brown's work commands widespread attention and respect, and there has been considerable interest as to how it would develop after "States of Injury." This book will not disappoint.

To study Earth’s climate, scientists now use a variety of computer simulation models. These models disagree in some of their assumptions about the climate system, yet they are used together as complementary resources for investigating future climatic change. This paper examines and defends this use of incompatible models. I argue that climate model pluralism results both from uncertainty concerning how to best represent the climate system and from difficulties faced in evaluating the relative merits of complex models. I describe how (...) incompatible climate models are used together in ‘multi-model ensembles’ and explain why this practice is reasonable, given scientists’ inability to identify a ‘best’ model for predicting future climate. Finally, I characterize climate model pluralism as involving both an ontic competitive pluralism and a pragmatic integrative pluralism. (shrink)

Arguments in environmental ethics often appeal to information from environmental science, such as information about the causes of environmental problems. Contemporary work in philosophy of science can shed light on the practice of environmental science as well as some of the challenges it faces. This chapter surveys some of this work, focusing on three interrelated topics: the nature of scientific evidence, including connections with uncertainty and consensus; the use and evaluation of scientific models; and values and objectivity in scientific practice. (...) A better understanding of these topics can help to ensure that scientific information is used appropriately and effectively in ethical argumentation. (shrink)