This article explores the philosophical concept of akrasia, also known as weakness of will, and demonstrates its relevance to clinical practice. In particular, it challenges an implicit notion of control over one’s actions that might impede recovery from substance misuse. Reflecting on three fictional case vignettes, we show how philosophical work on akrasia helps avoid this potentially harmful notion of control by supporting a holistic engagement with people for whom substance misuse is a problem. We argue that such engagement enhances (...) their prospects of recovery by focusing on agency over time, as opposed to individual lapses. (shrink)

Preterm birth is defined as delivery occurring before 37 weeks gestation.1 Infants born prematurely have increased risks of morbidity and mortality throughout life, especially during the first year. These risks increase as the gestational age at birth decreases.2 Additionally, there are significant racial and ethnic differences in preterm birth rates. In 2022, the rate of preterm birth among non-Hispanic black women was approximately 50% higher than that observed in non-Hispanic white women.1 The outcomes for these infants are also disparate–preterm birth (...) and low birth weight are the second-leading causes of infant mortality (deaths before 1 year of age). Notably, among preterm neonates, infants born to non-Hispanic black women have a mortality rate more than double that of infants born to non-Hispanic white mothers.3 Importantly, there is a small but significant group of neonates that can be classified as severely premature (those born <28 weeks). Infants born before 28 weeks have varied and uncertain outcomes. While this group accounts for only 0.4% of preterm births, it also accounts for 40% of deaths among preterm neonates.4 As noted by Romanis and Adkins, the advent of artificial amnion and placenta technology (AAPT) holds promise for its potential to address the physiologic complications and mortality risks of extreme prematurity by introducing amniotic substitutes that mimic in vivo placental oxygenation and substrate delivery. In contrast …. (shrink)

The Covid‐19 pandemic has revealed myriad social, economic, and health inequities that disproportionately burden populations that have been made medically or socially vulnerable. Inspired by state and local governments that declared racism a public health crisis or emergency, the Anti‐Racism in Public Health Act of 2020 reflects a shifting paradigm in which racism is considered a social determinant of health. Indeed, health inequities fundamentally rooted in structural racism have been exacerbated by the Covid‐19 pandemic, which calls for the integration of (...) antiracist praxis to promote ethical public health research processes. This commentary describes ways in which antiracist praxis—which emphasizes empowerment of traditionally marginalized populations—offers strategies to explicitly address power imbalance, stigmatization, and other consequences of structural racism in public health research. (shrink)

Background Noninvasive prenatal testing (NIPT) designed to screen for fetal genetic conditions, is increasingly being implemented as a part of routine prenatal care screening in the United States (US). However, these advances in reproductive genetic technology necessitate empirical research on the ethical and social implications of NIPT among populations underrepresented in genetic research, particularly Black women with sickle cell disease (SCD).Methods Forty (N = 40) semi-structured interviews were conducted virtually with Black women in the US (19 participants with SCD; 21 (...) participants without SCD) from June 2021 to January 2022. We employed a qualitative approach to examine the study participants’ perceptions of the potential advancement of NIPT for screening SCD in the fetus. Data were analyzed using NVivo 12 qualitative software.Results The themes revealed the complexities involving the intersectional lived experiences of SCD, prenatal care, lack of synergy among health providers, and NIPT decision-making. The results further revealed that even when Black women have shared commonalities in their lived experiences while navigating SCD and motherhood, their perceptions of NIPT screening technologies are divergent.Conclusion Expanding the ethical discourse on the social implications of NIPT is critical to fully elucidate how Black women perceive NIPT’s utility, particularly as NIPT advances to screen for SCD in the fetus. Neglecting to include Black women with genetic conditions in empirical studies on NIPT may contribute to ongoing health inequities and limit and constrain reproductive choices among Black women with and without SCD. (shrink)

Hastings Center Report, Volume 52, Issue S1, Page S83-S88, March‐April 2022.

Feminists witness legal worlds as they observe, document and share nothing less than the reproduction of life itself. The world of the abortion trail, where people and things move across borders to change life’s reproduction, has generated a rich variety of legal sources, figures and objects for feminist witnessing. In watching how feminist activists improvise with sources, figures and objects of legal consciousness on the abortion trail, this article seeks to contribute to critical understanding of a plurality of witnessing practice, (...) particularly as it emerges in diaspora space. Focusing on Murphy’s concept of immodest witnessing, with its attention to bodies, protocols and apparatuses as constituents of knowledge, the article thinks with the diasporic feminist performance group, Speaking of I.M.E.L.D.A., about how they used self-examination, collaboration and knowledge-sharing on the trail to repeal Ireland’s 8th Amendment. The article argues that their improvisation with legal consciousness of reproductive choice enacts ‘cheeky witnessing’. Cheeky witnessing has three dynamics as a method of observation. First, it is messy and irreverent in innovating with names to display the mixed genealogies of feminist knowledge. Second, cheeky witnessing generates novel subject-figures who make connections between different reproductive labourers as observers of the trail in diaspora space. Third, cheeky witnessing places funny objects, knickers in this instance, so as to join up particular public locations and make them more, if unevenly, comfortable for sexual and reproductive bodies. Cheeky witnessing shows us how committed and partial practices play a role in speaking across interests and experiences, in stretching the legal imagination and in sustaining the everyday grind of making a better world. (shrink)

Recent calls to address racism in bioethics reflect a sense of urgency to mitigate the lethal effects of a lack of action. While the field was catalyzed largely in response to pivotal events deeply rooted in racism and other structures of oppression embedded in research and health care, it has failed to center racial justice in its scholarship, pedagogy, advocacy, and practice, and neglected to integrate anti-racism as a central consideration. Academic bioethics programs play a key role in determining the (...) field’s norms and practices, including methodologies, funding priorities, and professional networks that bear on equity, inclusion, and epistemic justice. This article describes recommendations from the Racial Equity, Diversity, and Inclusion (REDI) Task Force commissioned by the Association of Bioethics Program Directors to prioritize and strengthen anti-racist practices in bioethics programmatic endeavors and to evaluate and develop specific goals to advance REDI. (shrink)

Ce livre se consacre à la création d’une nouvelle figure rhétorique dans les œuvres des auteurs « politiques » sous Charles VI et Charles VII : celle de « la France », imaginée allégoriquement comme une femme noble. D. Delogu explore le développement de cette figure d’Eustache Deschamps et Christine de Pisan à Alain Chartier et Jean Juvénal des Ursins. Elle présente des lectures très fines d’un corpus de textes souvent négligés. Dès le début, elle démonte l’avis fréquemment répété selon (...) leque... (shrink)

One important problem in cognitive science is to understand the development of cognitive processes in children and to devise computer models to explore the mechanisms that underlie these changes. Our research addresses these general goals. In particular, we are concerned with developmental changes in cognitive strategies in typical children and in children with mild mental retardation.

This book highlights some of the most pressing safety, ethical, legal and societal issues related to the diverse contexts in which robotic technologies apply. Focusing on the essential concept of well-being, it addresses topics that are fundamental not only for research, but also for industry and end-users, discussing the challenges in a wide variety of applications, including domestic robots, autonomous manufacturing, personal care robots and drones.

Critical notice of Guy Fletcher's 'Dear Prudence: The Nature and Normativity of Prudential Discourse' and Dale Dorsey's 'A Theory of Prudence'.

Jewish law takes an approach to self-defense that differs dramatically from the conventional assumptions of Western secular legal systems. The central theme of Talmudic jurisprudence is that self-defense rests on a duty not to stand idly by while one's neighbor suffers. “Do not stand on the blood of one's neighbor,” as the point is cryptically put in Leviticus 19:16. This way of thinking about self-defense departs in two significant ways from common Western assumptions. First, it stresses that the roots of (...) self-defense are a duty rather than a right to act; second, it treats the case of third-party defense as logically prior to the first-party case of self -defense. (shrink)

Well-being occupies a central role in ethics and political philosophy, including in major theories such as utilitarianism. It also extends far beyond philosophy: recent studies into the science and psychology of well-being have propelled the topic to centre stage, and governments spend millions on promoting it. We are encouraged to adopt modes of thinking and behaviour that support individual well-being or 'wellness'. What is well-being? Which theories of well-being are most plausible? In this rigorous and comprehensive introduction to the topic, (...) Guy Fletcher unpacks and assesses these questions and many more, including: Are pleasure and pain the only things that affect well-being? Is desire-fulfilment the only thing that makes our lives go well? Can something be good for someone who does not desire it? Is well-being fundamentally connected to a distinctive human nature? Is happiness all that makes our lives go well? Is death necessarily bad for us? How is the well-being of a whole life related to well-being at particular times? Also included is a glossary of key terms, and annotated further reading and study and comprehension questions follow each chapter, making _The Philosophy of Well-Being_ essential reading for students in ethics and political philosophy, and also suitable for those in related disciplines such as psychology, politics and sociology. (shrink)

This is a new edition of Joseph Fletcher's 1966 work that ignited a firestorm of controversy at the time of its publication.

For people to live together in pluralistic communities, they must find someway to cope with the practices of others that they abhor. For that reason, tolerance has always seemed an appealing medium of accommodation. But tolerance also has its critics. One wing charges that the tolerant are too easygoing. They are insensitive to evil in their midst. At the same time, another wing attacks the tolerant for being too weak in their sentimentsof respect. “The Christian does not wish to be (...) tolerated,” as T. S. Eliot said; and by this he meant to claim, presumably, that the Christian desires respect and acceptance, and not merely the forbearance suggested by “tolerance.” To make the case for tolerance, we must engage in a three-front campaign: first, against intolerance; second, against the moral failing of indifference; and third, against the desirability of respecting and accepting everyone. The central claim in making this case will be that unlike these three competing sentiments, tolerance is a complex attitude toward the behavior and beliefs of others. Its complexity consists in both moral disapproval and the avoidance of interference. If there is a case to be made for tolerance, it must derive from this peculiar complexity. After surveying its alternatives, I will argue that the complex sentimentof tolerance is more readily praised than its alternatives. (shrink)

So-called theories of well-being (prudential value, welfare) are under-represented in discussions of well-being. I do four things in this article to redress this. First, I develop a new taxonomy of theories of well-being, one that divides theories in a more subtle and illuminating way. Second, I use this taxonomy to undermine some misconceptions that have made people reluctant to hold objective-list theories. Third, I provide a new objective-list theory and show that it captures a powerful motivation for the main competitor (...) theory of well-being (the desire-fulfilment theory). Fourth, I try to defuse the worry that objective-list theories are problematically arbitrary and show how the theory can and should be developed. (shrink)

Philosophers have long theorized about what makes people's lives go well, and why, and the extent to which morality and self-interest can be reconciled. However, we have spent little time on meta-prudential questions, questions about prudential discourse—thought and talk about what is good and bad for us; what contributes to well-being; and what we have prudential reason, or prudentially ought, to do. This situation is surprising given that prudence is, prima facie, a normative form of discourse and cries out for (...) further investigation of what it is like and whether it has problematic commitments. It also marks a stark contrast from moral discourse, about which there has been extensive theorizing, in meta-ethics. -/- Dear Prudence: The Nature and Normativity of Prudential Discourse has three broad aims. Firstly, Guy Fletcher explores the nature of prudential discourse. Secondly, he argues that prudential discourse is normative and authoritative, like moral discourse. Thirdly, Fletcher aims to show that prudential discourse is worthy of further, explicit, attention both due to its intrinsic interest but also for the light it sheds on the meta-normative more broadly. (shrink)

Professor Fletcher challenges the traditional account of the development of tort doctrine as a shift from an unmoral standard of strict liability for directly causing harm to a moral standard based on fault. He then sets out two paradigms of liability to serve as constructs for understanding competing ideological viewpoints about the proper role of tort sanctions. He asserts that the paradigm of reciprocity, which looks only to the degree of risk imposed by the parties to a lawsuit on (...) each other, and to the existence of possible excusing conditions, provides greater protection of individual interests than the paradigm of reasonableness, which assigns liability instrumentally on the basis of a utilitarian calculus. Finally, Professor Fletcher examines stylistic differences between the two paradigms which may explain the modern preference for the paradigm of reasonableness. (shrink)

This chapter is divided into three parts. First I outline what makes something an objective list theory of well-being. I then go on to look at the motivations for holding such a view before turning to objections to these theories of well-being.

Taking a critical look at some of the recent controls over human life, health, and death, Fletcher draws a vivid picture of contemporary biological needs and ethical responsibility. Genetic engineering, fetal research, abortion, suicide, human experimentation, infanticide, and euthanasia are some of the issues explored.

The concept of well-being is one of the oldest and most important topics in philosophy and ethics, going back to ancient Greek philosophy and Aristotle. Following the boom in happiness studies in the last few years it has moved to centre stage, grabbing media headlines and the attention of scientists, psychologists and economists. Yet little is actually known about well-being and it is an idea often poorly articulated. The Routledge Handbook of Philosophy of Well-Being provides a comprehensive, outstanding guide and (...) reference source to the key topics and debates in this exciting subject. Comprising over forty chapters by a team of international contributors, the Handbook is divided into six parts: well-being in the history of philosophy current theories of well-being, including hedonism, and perfectionism examples of well-being and its opposites, including friendship and virtue and pain and death theoretical issues such as well-being and value, harm, identity and well-being and children well-being in moral and political philosophy well-being and related subjects including law, economics, and medicine. Essential reading for students and researchers in ethics and political philosophy, it will also be an invaluable resource for those in related disciplines such as psychology, politics and sociology. (shrink)

Recent work on the hole argument in general relativity by Weatherall has drawn attention to the neglected concept of models’ representational capacities. I argue for several theses about the structure of these capacities, including that they should be understood not as many-to-one relations from models to the world, but in general as many-to-many relations constrained by the models’ isomorphisms. I then compare these ideas with a recent argument by Belot for the claim that some isometries “generate new possibilities” in general (...) relativity. Philosophical orthodoxy, by contrast, denies this. Properly understanding the role of representational capacities, I argue, reveals how Belot’s rejection of orthodoxy does not go far enough, and makes better sense of our practices in theorizing about spacetime. (shrink)

It is commonly claimed that reliance upon moral testimony is problematic in a way not common to reliance upon non-moral testimony. This chapter provides a new explanation of what the problem consists in—one that enjoys advantages over the most widely accepted explanation in the extant literature. The main theses of the chapter are as follows: that many forms of normative deference beyond the moral are problematic, that there is a common explanation of the problem with all of these forms of (...) deference—an explanation that is based on the connection between the relevant judgments and desire-like attitudes, and that this explanation is compatible with moral realism. (shrink)

Stephen Hawking, among others, has proposed that the topological stability of a property of space-time is a necessary condition for it to be physically significant. What counts as stable, however, depends crucially on the choice of topology. Some physicists have thus suggested that one should find a canonical topology, a single ‘right’ topology for every inquiry. While certain such choices might be initially motivated, some little-discussed examples of Robert Geroch and some propositions of my own show that the main candidates—and (...) each possible choice, to some extent—faces the horns of a no-go result. I suggest that instead of trying to decide what the ‘right’ topology is for all problems, one should let the details of particular types of problems guide the choice of an appropriate topology. (shrink)

Hastings Center Report, Volume 52, Issue S1, Page S3-S11, March‐April 2022.

Philosophers have long theorized about which things make people’s lives go well, and why, and the extent to which morality and self-interest can be reconciled. Yet little time has been spent on meta-prudential questions, questions about prudential discourse. This is surprising given that prudence is, prima facie, a normative form of discourse and, as such, cries out for further investigation. Chapter 4 takes up two major meta-prudential questions. It first examines whether there is a set of prudential reasons, generated by (...) evaluative prudential properties, and defends the view that evaluative well-being facts generate agent-relative reasons for the relevant agent. It also investigates whether prudential discourse is normative. It is proposed that prudential discourse is normative by arguing that prudential judgements are normative judgements. The case for this is presented by analogy with moral discourse by showing that the features of moral judgements that metaethicists appeal to when articulating, explaining, and justifying the claim that moral judgements are normative are also possessed by prudential judgements. Various objections to the analogy are also considered. (shrink)

Can quantum theory provide examples of metaphysical indeterminacy, indeterminacy that obtains in the world itself, independently of how one represents the world in language or thought? We provide a positive answer assuming just one constraint of orthodox quantum theory: the eigenstate-eigenvalue link. Our account adds a modal condition to preclude spurious indeterminacy in the presence of superselection sectors. No other extant account of metaphysical indeterminacy in quantum theory meets these demands.

Intertheoretic reduction in physics aspires to be both to be explanatory and perfectly general: it endeavors to explain why an older, simpler theory continues to be as successful as it is in terms of a newer, more sophisticated theory, and it aims to relate or otherwise account for as many features of the two theories as possible. Despite often being introduced as straightforward cases of intertheoretic reduction, candidate accounts of the reduction of general relativity to Newtonian gravitation have either been (...) insufficiently general or rigorous, or have not clearly been able to explain the empirical success of Newtonian gravitation. Building on work by Ehlers and others, I propose a different account of the reduction relation that is perfectly general and meets the explanatory demand one would make of it. In doing so, I highlight the role that a topology on the collection of all spacetimes plays in defining the relation, and how the selection of the topology corresponds with broader or narrower classes of observables that one demands be well-approximated in the limit. (shrink)

The Grammar of Criminal Law is a 3-volume work that addresses the field of international and comparative criminal law, with its primary focus on the issues of international concern, ranging from genocide, to domestic efforts to combat terrorism, to torture, and to other international crimes. The first volume is devoted to foundational issues. The Grammar of Criminal Law is unique in its systematic emphasis on the relationship between language and legal theory; there is no comparable comparative study of legal language. (...) Written in the spirit of Fletcher's classic Rethinking Criminal Law, this work is essential reading in the field of international and comparative law. (shrink)

The replication or reproducibility crisis in psychological science has renewed attention to philosophical aspects of its methodology. I provide herein a new, functional account of the role of replication in a scientific discipline: to undercut the underdetermination of scientific hypotheses from data, typically by hypotheses that connect data with phenomena. These include hypotheses that concern sampling error, experimental control, and operationalization. How a scientific hypothesis could be underdetermined in one of these ways depends on a scientific discipline’s epistemic goals, theoretical (...) development, material constraints, institutional context, and their interconnections. I illustrate how these apply to the case of psychological science. I then contrast this “bottom-up” account with “top-down” accounts, which assume that the role of replication in a particular science, such as psychology, must follow from a uniform role that it plays in science generally. Aside from avoiding unaddressed problems with top-down accounts, my bottom-up account also better explains the variability of importance of replication of various types across different scientific disciplines. (shrink)