Recent survey data gathered from British medical students reveal widespread acceptance of conscientious objection in medicine, despite the existence of strict policies in the UK that discourage conscientious refusals by students to aspects of their medical training. This disconnect demonstrates a pressing need to thoughtfully examine policies that allow conscience objections by medical students; as it so happens, the USA is one country that has examples of such policies. After presenting some background on promulgated US conscience protections and reflecting on (...) their significance for conscience objections by medical students, this paper observes that the dominant approach (following the American Medical Association's conscience clause) is to allow exempted students to instead be evaluated on the basis of alternative curricular activities to learn the associated underlying content. This paper then introduces and discusses an example in which male Muslim students who believe it is wrong to touch members of the opposite sex object to performing physical examinations on female subjects in their medical training. This sort of case, it is argued, causes difficulty for a conscience clause that resolves the dilemma by granting reasonable exemptions in the form of participation in alternative curricular activities: there are cases where one must perform the ‘objectionable’ activity itself in order to learn the necessary content and underlying principles. (shrink)

This study aims to examine the neural correlates of cognitive shifting during the Dimensional Change Card Sort Task task with functional near-infrared spectroscopy. Altogether 49 children completed the DCCS tasks, and 25 children passing all items were classified into the Switch group. Twenty children committing more than one perseverative errors were grouped into the Perseverate group. The Switch group had Brodmann Area 9 and 10 activated in the pre-switch period and BA 6, 9, 10, 40, and 44 in the (...) post-switch period. In contrast, the Perseverate group had BA 9 and 10 activated in the pre-switch period and BA 8, 9, 10 in the post-switch period. The general linear model results afford strong support to the “V-shape curve” hypothesis by identifying a significant decrease–increase cycle in BA 9 and 44, the neural correlations of cognitive shifting. (shrink)

Friendships have important influences on children's well-being and future adjustment, and interpersonal forgiveness has been suggested as a crucial means for children to maintain friendships. However, existing measures of preadolescent children's forgiveness are restricted by developmental limitations to reporting emotional responses via questionnaire and inconsistent interpretations of the term “forgive.” This paper describes development and testing of concurrent and discriminant validity of a pictorial measure of children's emotional forgiveness, the Children's Forgiveness Card Set. In Study 1, 148 Australian children (...) aged 8–13 years responded to a hypothetical transgression in which apology was manipulated and completed the CFCS and extant measures of forgiveness and socially desirable responding. Following an exploratory factor analysis to clarify the structure of the CFCS, the CFCS correlated moderately with other forgiveness measures and did not correlate with socially desirable responding. Apology predicted CFCS responding among older children. In Study 2 an exploratory factor analysis broadly replicated the structure of the CFCS among a sample of N = 198 North American children aged 5–14 years. We also fitted an exploratory bi-factor model to the Study 2 data which clarified which cards best measured general forgiveness, or positive or hostile aspects of responding to transgressions. Apology once again predicted the CFCS, this time regardless of age. The CFCS appears a potentially valid measure of children's emotional forgiveness. Potential applications and differences between explicit and latent forgiveness in children are discussed. (shrink)

Various philosophers have argued that in order to be morally responsible, we need to be the "ultimate sources'' of our choices and behavior. Although there are different versions of this sort of argument, I identify a "picture'' that lies behind them, and I contend that this picture is misleading. Joel Feinberg helpfully suggested that we scale down what might initially be thought to be legitimate demands on "self-creation,'' rather than jettison the idea that we are truly and robustly responsible. I (...) follow Feinberg in rejecting various "inflated'' demands on "origination,'' "initiation,'' or ultimate sourcehood. (shrink)

Various philosophers have argued that in order to be morally responsible, we need to be the "ultimate sources'' of our choices and behavior. Although there are different versions of this sort of argument, I identify a "picture'' that lies behind them, and I contend that this picture is misleading. Joel Feinberg helpfully suggested that we scale down what might initially be thought to be legitimate demands on "self-creation,'' rather than jettison the idea that we are truly and robustly responsible. I (...) follow Feinberg in rejecting various "inflated'' demands on "origination,'' "initiation,'' or ultimate sourcehood. (shrink)

Professor Card is not disposed to object to the main argument of my paper, which was intended to reply to Professor Lyons’ suggestion that a utilitarian cannot explain how legal rights have moral force, and at the same time to urge that the particular form of utilitarianism espoused by Professor Hare in his recent work does seem to be open to the difficulty Professor Lyons alleges. Professor Card says she is ‘not dissatisfied’ with this reasoning. I suspect that (...) Card views my criticism of Professors Lyons and Hare as part of an in-house squabble among philosophers all of whom have utilitarian leanings of one sort or another; and she is not disposed to intervene in this. She does, however, have serious reservations about utilitarian views of rights in general, and about mine in particular; her paper consists almost entirely of her statement of these reservations. I find her remarks very welcome, since they express some objections which may be widely felt, and a response to which may therefore contribute to philosophers’ thinking about these issues. (shrink)

From the editor: On behalf of the editors of FPQ, I thank our colleagues for providing us their public addresses at the Celebration of Life of Professor Claudia Falconer Card of the University of Wisconsin-Madison, who died on Saturday, September 12, 2015. Claudia Card was the author of over one hundred articles and books, key works of moral and feminist philosophy including Confronting Evils: Terrorism, Torture, Genocide, The Atrocity Paradigm: A Theory of Evil, and The Unnatural Lottery: Character (...) and Moral Luck. She was the president of the Central division of the APA 2010-2011, which she often described as her favorite division of the APA. She earned her BA from UW-Madison, and her PhD in 1969 from Harvard University, as the advisee of John Rawls, whom she spoke of with affection as one of the most sensitive and generous of philosophers. I remain grateful to Claudia for being the sort of philosopher who helped her students, colleagues, and readers to confront our responsibilities, and the responsibilities of others, as she lived her own philosophy of taking responsibility for one’s own identity. K.J. Norlock. (shrink)

What distinguishes evils from ordinary wrongs? Is hatred a necessarily evil? Are some evils unforgivable? Are there evils we should tolerate? What can make evils hard to recognize? Are evils inevitable? How can we best respond to and live with evils? Claudia Card offers a secular theory of evil that responds to these questions and more. Evils, according to her theory, have two fundamental components. One component is reasonably foreseeable intolerable harm -- harm that makes a life indecent and (...) impossible or that makes a death indecent. The other component is culpable wrongdoing. Atrocities, such as genocides, slavery, war rape, torture, and severe child abuse, are Card's paradigms because in them these key elements are writ large. Atrocities deserve more attention than secular philosophers have so far paid them. They are distinguished from ordinary wrongs not by the psychological states of evildoers but by the seriousness of the harm that is done. Evildoers need not be sadistic:they may simply be negligent or unscrupulous in pursuing their goals. Card's theory represents a compromise between classic utilitarian and stoic alternatives (including Kant's theory of radical evil). Utilitarians tend to reduce evils to their harms; Stoics tend to reduce evils to the wickedness of perpetrators: Card accepts neither reduction. She also responds to Nietzsche's challenges about the worth of the concept of evil, and she uses her theory to argue that evils are more important than merely unjust inequalities. She applies the theory in explorations of war rape and violence against intimates. She also takes up what Primo Levi called "the gray zone", where victims become complicit in perpetrating on others evils that threaten to engulf themselves. While most past accounts of evil have focused on perpetrators, Card begins instead from the position of the victims, but then considers more generally how to respond to -- and live with -- evils, as victims, as perpetrators, and as those who have become both. (shrink)

This essay argues that current advocacy of lesbian and gay rights to legal marriage and parenthood insufficiently criticizes both marriage and motherhood as they are currently practiced and structured by Northern legal institutions. Instead we would do better not to let the State define our intimate unions and parenting would be improved if the power presently concentrated in the hands of one or two guardians were diluted and distributed through an appropriately concerned community.

This book argues that a conscientiously objecting medical professional should receive an exemption only if the grounds of an objector's refusal are reasonable. It defends a detailed, contextual account of public reasonability suited for healthcare, which builds from the overarching concept of Rawlsian public reason. The author analyzes the main competing positions and maintains that these other views fail precisely due to their systematic inattention to the grounding reasons behind a conscientious objection; he argues that any such view is plausible (...) to the extent that it mimics the 'reason-giving requirement' for conscience objections defended in this work. Only reasonable objections can defeat the prior professional obligation to assign primacy to patient well-being, therefore one who refuses a patient's request for a legally available, medically indicated, and safe service must be able to explain the grounds of their objection in terms understandable to other citizens within the public institutional structure of medicine. The book further offers a novel policy proposal to deploy the Reasonability View: establishing conscientious objector status in medicine. It concludes that the Reasonability View is a viable and attractive position in this debate. A New Theory of Conscientious Objection in Medicine: Justification and Reasonability will be of interest to researchers and advanced students working in bioethics, medical ethics, and philosophy of medicine, as well as thinkers interested in the intersections between law, medical humanities, and philosophy. (shrink)

The opportunities to become a good person are not the same for everyone. Modern European ethical theory, especially Kantian ethics, assumes the same virtues are accessible to all who are capable of rational choice. Character development, however, is affected by circumstances, such as those of wealth and socially constructed categories of gender, race, and sexual orientation, which introduce factors beyond the control of individuals. Implications of these influences for morality have, since the work of Williams and Nagel in the seventies, (...) raised questions in philosophy about the concept of moral luck. In The Unnatural Lottery, Claudia Card examines how luck enters into moral character and considers how some of those who are oppressed can develop responsibility. Luck is often best appreciated by those who have known relatively bad luck and have been unable to escape steady comparison of their lot with those of others. The author takes as her paradigms the luck of middle and lower classes of women who face violence and exploitation, of lesbians who face continuing pressure to hide or self-destruct, of culturally Christian whites who have ethnic privilege, and of adult survivors of child abuse. How have such people been affected by luck in who they are and can become, the good lives available to them, the evils they may be liable to embody? Other philosophers have explored the luck of those who begin from privileged positions and then suffer reversals of fortune. Claudia Card focuses on the more common cases of those who begin from socially disadvantaged positions, and she considers some who find their good luck troubling when its source is the unnatural lottery of social injustice. (shrink)

Nel Noddings, in Caring: A Feminine Approach to Ethics and Moral Education, presents and develops an ethic of care as an alternative to an ethic that treats justice as a basic concept. I argue that this care ethic is unable to give an adequate account of ethical relationships between strangers and that it is also in danger of valorizing relationships in which carers are seriously abused.

What distinguishes evils from ordinary wrongs? Are some evils unforgivable? How should we respond to evils? Card offers a secular theory of evil--representing a compromise between classic utilitarian and stoic approaches--that responds to these and other questions.

This essay reflects on issues raised by commentators regarding my book, The Atrocity Paradigm: A Theory of Evil (Oxford 2002). They are (1) Robin Schott's observation of the tension between my discussion of forgiveness and of castration fantasies; (2) Bat-Ami Bar On's questions regarding whether evil is ethical, political, or both; (3) Adam Morton's queries regarding the relative seriousness of evils and injustices; and (4) María Pía Lara's concerns regarding what is valuable in Kant's ethics.

In this paper I defend the Reasonability View: the position that medical professionals seeking a conscientious exemption must state reasons in support of their objection and allow those reasons to be subject to evaluation. Recently, this view has been criticized by Jason Marsh as proposing a standard that is either too difficult to meet or too easy to satisfy. First, I defend the Reasonability View from this proposed dilemma. Then, I develop this view by presenting and explaining some of the (...) central criteria it uses to assess whether a conscientious objection is proper grounds for extending an exemption to a medical practitioner. (shrink)

In this contribution to philosophical ethics, Claudia Card revisits the theory of evil developed in her earlier book The Atrocity Paradigm, and expands it to consider collectively perpetrated and collectively suffered atrocities. Redefining evil as a secular concept and focusing on the inexcusability - rather than the culpability - of atrocities, Card examines the tension between responding to evils and preserving humanitarian values. This stimulating and often provocative book contends that understanding the evils in terrorism, torture and genocide (...) enables us to recognise similar evils in everyday life: daily life under oppressive regimes and in racist environments; violence against women, including in the home; violence and executions in prisons; hate crimes; and violence against animals. Card analyses torture, terrorism and genocide in the light of recent atrocities, considering whether there can be moral justifications for terrorism and torture, and providing conceptual tools to distinguish genocide from non-genocidal mass slaughter. (shrink)

Gray zones, which develop wherever oppression is severe and lasting, are inhabited by victims of evil who become complicit in perpetrating on others the evils that threaten to engulf themselves. Women, who have inhabited many gray zones, present challenges for feminist theorists, who have long struggled with how resistance is possible under coercive institutions. Building on Primo Levi's reflections on the gray zone in Nazi death camps and ghettos, this essay argues that resistance is sometimes possible, although outsiders are rarely, (...) if ever, in a position to judge when. It also raises questions about the adequacy of ordinary moral concepts to mark the distinctions that would be helpful for thinking about how to respond in a gray zone. (shrink)

This essay examines how rape of women and girls by male soldiers works as a martial weapon. Continuities with other torture and terrorism and with civilian rape are suggested. The inadequacy of past philosophical treatments of the enslavement of war captives is briefly discussed. Social strategies are suggested for responding and a concluding fantasy offered, not entirely social, of a strategy to change the meanings of rape to undermine its use as a martial weapon.

Defenders of medical professionals’ rights to conscientious objection (CO) regarding emergency contraception (EC) draw an analogy to CO in the military. Such professionals object to EC since it has the possibility of harming zygotic life, yet if we accept this analogy and utilize jurisprudence to frame the associated public policy, those who refuse to dispense EC would not have their objection honored. Legal precedent holds that one must consistently object to all forms of the relevant activity. In the case at (...) hand, then, I argue that these professionals must also oppose morally innocuous practices that may prevent pregnancy after fertilization. These results reveal that such objectors cannot offer a plausible and consistent objection to harming zygotic life. Additionally, there are good reasons to reject the analogy itself. In either case, these findings call into question the case supporting refusals of EC based on scruples. (shrink)

This paper builds upon previous work in which I argue that we should assess a provider's reasons for his or her objection before granting a conscientious exemption. For instance, if the medical professional's reasoned basis involves an empirical mistake, an accommodation is not warranted. This article poses and begins to address several deep questions about the workings of what I call a reason-giving view: What standard should we use to assess reasons? What policy should we adopt in order to evaluate (...) the reasons offered by medical practitioners in support of their objections? I argue for a reasonability standard to perform the essential function of assessing reasons, and I offer considerations in support of a policy establishing conscientious objector status in medicine. (shrink)

This article argues that practitioners have a professional ethical obligation to dispense emergency contraception, even given conscientious objection to this treatment. This recent controversy affects all medical professionals, including physicians as well as pharmacists. This article begins by analyzing the option of referring the patient to another willing provider. Objecting professionals may conscientiously refuse because they consider emergency contraception to be equivalent to abortion or because they believe contraception itself is immoral. This article critically evaluates these reasons and concludes that (...) they do not successfully support conscientious objection in this context. Contrary to the views of other thinkers, it is not possible to easily strike a respectful balance between the interests of objecting providers and patients in this case. As medical professionals, providers have an ethical duty to inform women of this option and provide emergency contraception when this treatment is requested. (shrink)

Fifteen essays address subjects ranging from the history of feminist ethics to the logic of pluralist feminism and present feminist perspectives on such topics as terrorism, bitterness, women trusting other women, and survival and ethics. Paper edition, $14.95. Annotation copyrighted by Book News, Inc., Portland, OR.

This chapter develops the hypothesis that social death is utterly central to the evil of genocide, not just when a genocide is primarily cultural but even when it is homicidal on a massive scale. It is social death that enables us to distinguish the peculiar evil of genocide from the evils of other mass murders. The evil of genocide falls not only on men and boys but also on women and girls, typically unarmed, untrained in defense against violence, and often (...) also responsible for care of the wounded, the sick, the disabled, babies, children, and the elderly. The damage of war and terrorism is commonly assessed in terms of its ruin of individual careers, body counts, statistics on casualties, and material costs of rebuilding. An injustice becomes an evil when it inflicts harms that make victims' lives unbearable, indecent, or impossible, or that make victims' deaths indecent. (shrink)

A little more than a decade ago, a powerful short book appeared with what was then the provocative title: Rape Warfare: The Hidden Genocide in Bosnia‐Herzegovina and Croatia. It was written by Beverly Allen. In that book she introduced the term "genocidal rape" to describe rapes that were done as policy for the purpose of genocide by Serb military forces in Bosnia‐Herzegovina and Croatia in the early 1990s. This chapter examines the paradox that Allen articulated and places it in the (...) context of the general question of how war rape can be genocidal, whether aimed at pregnancy or not. Drawing on Allen's amazing insight that sperm so used can and should be regarded as a weapon of biological warfare, it discusses a way to show how rape aimed at enforced pregnancy could indeed be genocidal. (shrink)