Multidrug resistance resulting from expression of an energy‐dependent drug efflux pump encoded by the human MDR1 gene is a major impediment to effective cancer therapy. Pharmacologic intervention aimed at inhibiting this multidrug transporter should improve existing chemotherapy of human cancer, but drug development has been delayed by the difficulty and expense of developing valid animal models. Using recombinant DNA technology, a transgenic mouse has been engineered whose bone marrow is protected from the toxic effects of chemotherapy by expression of the (...) MDR1 gene. This animal system allows the rapid screening of drugs which inhibit the multidrug transporter and heralds a new era of using transgenic animals for pharmacologic screening. (shrink)

I examine three attitudes: belief, faith, and hope. I argue that all three attitudes play the same role in rationalizing action. First, I explain two models of rational action—the decision-theory model and the belief-desire model. Both models entail there are two components of rational action: an epistemic component and a conative component. Then, using this framework, I show how belief, faith, and hope that p can all make it rational to accept, or act as if, p. I conclude by showing (...) how my picture can explain how action-oriented commitments can be rational over time, both in the face of counterevidence and in the face of waning affections. (shrink)

Responsible public policy making in a technological society must rely on complex scientific reasoning. Given that ordinary citizens cannot directly assess such reasoning, does this call the democratic legitimacy of technical public policies in question? It does not, provided citizens can make reliable second-order assessments of the consensus of trustworthy scientific experts. I develop criteria for lay assessment of scientific testimony and demonstrate, in the case of claims about anthropogenic global warming, that applying such criteria is easy for anyone of (...) ordinary education with access to the Web. However, surveys show a gap between the scientific consensus and public opinion on global warming in the U.S. I explore some causes of this gap and argue that democratic reforms of our culture of political discourse may be able to address it. (shrink)

Complex cognitive skills such as reading and calculation and complex cognitive achievements such as formal science and mathematics may depend on a set of building block systems that emerge early in human ontogeny and phylogeny. These core knowledge systems show characteristic limits of domain and task specificity: Each serves to represent a particular class of entities for a particular set of purposes. By combining representations from these systems, however human cognition may achieve extraordinary flexibility. Studies of cognition in human infants (...) and in nonhuman primates therefore may contribute to understanding unique features of human knowledge. 2020 APA, all rights reserved). (shrink)

Radical moral encroachment is the view that belief itself is morally evaluable, and that some moral properties of belief itself make a difference to epistemic rationality. To date, almost all proponents of radical moral encroachment hold to an asymmetry thesis: the moral encroaches on rational belief, but not on rational credence. In this paper, we argue against the asymmetry thesis; we show that, insofar as one accepts the most prominent arguments for radical moral encroachment on belief, one should likewise accept (...) radical moral encroachment on credence. We outline and reject potential attempts to establish a basis for asymmetry between the attitude types. Then, we explore the merits and demerits of the two available responses to our symmetry claim: (i) embracing moral encroachment on credence and (ii) denying moral encroachment on belief. (shrink)

The literature on faith has largely focused on the relationship between faith and belief, specifically the question: does faith entail belief? At the same time, it’s also widely held that faith involves a desire or pro-attitude, but more attention has been paid to the specifics of faith’s doxastic component than to faith’s affective component. This paper focuses on the relationship between faith and desire. I’ll argue that faith is weakly positive: while faith may not always involve a flat-out desire, faith (...) necessarily involves a positive desire-like attitude. (shrink)

Many of us are tempted by the thought that the future is open, whereas the past is not. The future might unfold one way, or it might unfold another; but the past, having occurred, is now settled. In previous work we presented an account of what openness consists in: roughly, that the openness of the future is a matter of it being metaphysically indeterminate how things will turn out to be. We were previously concerned merely with presenting the view and (...) exploring its consequences; we did not attempt to argue for it over rival accounts. That is what we will aim to do in this paper. (shrink)

In this paper, we explore how the prospect of artificial placenta technology (nearing clinical trials in human subjects) should encourage further consideration of the loss experienced by individuals when their pregnancy ends unexpectedly. Discussions of pregnancy loss are intertwined with procreative loss, whereby the gestated entity has died when the pregnancy ends. However, we demonstrate how pregnancy loss can and does exist separate to procreative loss in circumstances where the gestated entity survives the premature ending of the pregnancy. In outlining (...) the value that can be attached to pregnancy beyond fetal-centric narratives, we illustrate how pregnancy loss, separate to procreative loss, can be experienced. This loss has already been recognised among parents who have experienced an unexpected early ending of their pregnancy, resulting in their child being cared for in neonatal intensive care unit. Artificial placentas, however, may exacerbate these feelings and make pregnancy loss (without procreative loss) more visible. We argue that pregnancy is an embodied state in which gestation is facilitated by the body but gestation itself should be recognised as a process—and one that could be separable from pregnancy. In demarcating the two, we explore the different ways in which pregnancy loss can be understood. Our objective in this paper goes beyond contributing to our philosophical understanding of pregnancy towards practical-orientated conclusions regarding the care pathways surrounding the artificial placenta. We make recommendations including the need for counselling and careful consideration of the language used when an artificial placenta is used. (shrink)

In this text, the authors examine the relationship between political and feminist theory, characterizing and criticizing liberalism and communitarianism from a feminist perspective.

Although there are notable exceptions, examination of nursing's participation in colonizing processes and practices has not taken hold in nursing's consciousness or political agenda. Critical analyses, based on the examination of politics and power of the structural determinants of health, continue to be marginalized in the profession. The goals of this discussion article are to underscore the urgent need to further articulate postcolonial theory in nursing and to contribute to nursing knowledge about paths to work toward decolonizing the profession. The (...) authors begin with a description of unifying themes in postcolonial theory, with an emphasis on colonized subjectivities and imperialism; the application of a critical social science perspective, including postcolonial feminist theory; and the project of working toward decolonization. Processes involved in the colonization of nursing are described in detail, including colonization of nursing's intellectual development and the white privilege and racism that sustain colonizing thinking and action in nursing. The authors conclude with strategies to increase the counter‐narrative to continued colonization, with a focus on critical social justice, human rights and the structural determinants of health. (shrink)

In this chapter, I argue that theistic belief is permissive belief. This is not a universal claim about persons or normative domains, but the claim that, for many common bodies of evidence, epistemic rationality is permissive about whether God exists. Marks of a permissive belief are rational disagreement over time, rational disagreement over persons, and powerful evidence on both sides. I argue that theistic belief fits all these criteria. I also show how considerations from divine hiddenness support permissivism about theism. (...) Then, I show how these considerations support intrapersonal permissivism about theistic belief, using Peter Van Inwagen’s (1994) Quam Dialecta as a case study. Finally, I reply to objections. (shrink)

Habit has been understood, through the work of Descartes, Kant and Sartre, as a form of mechanism that arrests and inhibits consciousness, thought and freedom. This article addresses the concept of habit through a different tradition that links it instead to an ever-moving world. In a world of constant change, habits are not so much forms of fixity and repetition as they are modes of encounter materiality and life. Habit is the point of transition between living beings and matter, enabling (...) each to be transformed through its engagement with the other. The article focuses on the work of Ravaisson, Bergson and Deleuze, who understand habit as fundamentally creative and addressed to the future rather than consolidating the past. Habit, within this tradition, is the opening of materiality to the forms of engagement required by life, and the modification of life imposed by the requirements of a material universe. It is open-ended plasticity. (shrink)

Medical interventions such as methadone treatment for drug addicts or “chemical castration” for sex offenders have been used in several jurisdictions alongside or as an alternative to traditional punishments, such as incarceration. As our understanding of the biological basis for human behaviour develops, our criminal justice system may make increasing use of such medical techniques and may become less reliant on incarceration. Academic debate on this topic has largely focused on whether offenders can validly consent to medical interventions, given the (...) coercive environment of the criminal justice system. Both sides in this debate share the assumption that administering medical interventions to offenders without their valid consent would be unethical. Recently, Thomas Douglas has mounted a formidable challenge to this “consent requirement”. Essentially, his argument rests on a comparison between prison and medical interventions. Douglas asks: if the state is entitled to impose a prison sentence on a criminal without the criminal’s consent, why is consent required for the imposition of a medical intervention? The most obvious way of defending the consent requirement against Douglas’s challenge appeals to the fact that incarceration merely interferes with the right to free movement, but medical interventions interfere with the right to bodily integrity. This argument rests on what Douglas calls the “robustness claim”—the claim that the right to bodily integrity is more robust than the right to freedom of movement. In other words, the right to freedom of movement loses its protective force in a wider range of circumstances than the right to bodily integrity. Douglas’s article seeks to undermine the robustness claim, by arguing that neither case-based intuitions, nor theoretical considerations support this claim. In this article, I will attempt to raise some doubts about Douglas’s challenge to the consent requirement and the robustness claim. (shrink)

We use “I’ll be glad I did it” reasoning all the time. For example, last night I was trying to decide whether to work on this paper or go out to a movie. I realized that if I worked on the paper, then today I would be glad I did it. Whereas, if I went out to the movie, today I would regret it. This enabled me to see that I should work on the paper rather than going out to (...) a movie. This looks like excellent reasoning: Paper argument: 1. If I work on my paper, I’ll be glad I did it. 2. Therefore, I should work on my paper. When we’re having trouble making a big life decision, we often try to picture what will happen each way we might choose, and imagine how we’ll feel in that outcome. When choosing between two jobs, we might use this reasoning. Suppose you are choosing between two jobs and you know quite a lot about what the two jobs will be like. In one, you will make a lot of money but have to work eighty-hour weeks and see little of your family. In the other, you will make considerably less money—though enough to support yourself and your family. You’ll have much more time for your family. The money is attractive. But overall, you realize you’ll be glad to have the time with your family if you take the second job—you’ll be glad you made that choice. It seems this is a good way of realizing that you should take the second job. (shrink)

The bioethical principle of respect for a person’s bodily autonomy is central to biomedical and healthcare ethics. In this article, we argue that this concept of autonomy is often annulled in the maternity field, due to the maternal two-in-one body (and the obstetric focus on the foetus over the woman) and the history of medical paternalism in Western medicine and obstetrics. The principle of respect for autonomy has therefore become largely rhetorical, yet can hide all manner of unethical practice. We (...) propose that large institutions that prioritize a midwife–institution relationship over a midwife–woman relationship are in themselves unethical and inimical to the midwifery philosophy of care. We suggest that a focus on care ethics has the potential to remedy these problems, by making power relationships visible and by prioritizing the relationship above abstract ethical principles. (shrink)

This book explores the tradition of the 'science of man' in French medicine of the era 1750-1850, focusing on controversies about the nature of the 'physical-moral' relation and their effects on the role of medicine in French society. Its chief purpose is to recover the history of a holistic tradition in French medicine that has been neglected because it lay outside the mainstream themes of modern medicine, which include experimental, reductionist, and localistic conceptions of health and disease. Professor Williams also (...) challenges existing historiography, which argues that the 'anthropological' approach to medicine was a short-term by-product of the leftist politics of the French Revolution. This work argues instead that the medical science of man long outlived the Revolution, that it spanned traditional ideological divisions, and that it reflected the shared aim of French physicians, whatever their politics, to claim broad cultural authority in French society. (shrink)

A series of experiments investigated the effect of speakers’ language, accent, and race on children’s social preferences. When presented with photographs and voice recordings of novel children, 5-year-old children chose to be friends with native speakers of their native language rather than foreign-language or foreign-accented speakers. These preferences were not exclusively due to the intelligibility of the speech, as children found the accented speech to be comprehensible, and did not make social distinctions between foreign-accented and foreign-language speakers. Finally, children chose (...) same-race children as friends when the target children were silent, but they chose other-race children with a native accent when accent was pitted against race. A control experiment provided evidence that children’s privileging of accent over race was not due to the relative familiarity of each dimension. The results, discussed in an evolutionary framework, suggest that children preferentially evaluate others along dimensions that distinguished social groups in prehistoric human societies. (shrink)

This paper raises three concerns regarding self-ownership rhetoric to describe autonomy within healthcare in general and reproductive justice in specific. First, private property and the notion of “ownership” embedded in “self-ownership,” rely on and replicate historical injustices related to the initial acquisition of property. Second, not all individuals are recognized as selves with equal access to self-ownership. Third, self-ownership only justifies negative liberties. To fully protect healthcare access and reproductive care in specific, we must also be able to make claims (...) on others to respect, protect, and fulfill our positive rights. As much as nondomination remains an urgent demand for reproductive rights, it does not go far enough to ensure reproductive justice. (shrink)

The aim of this paper is to (i) examine the concept of epistemic paternalism and (ii) explore the consequences of normative questions one might ask about it. I begin by critically examining several definitions of epistemic paternalism that have been proposed, and suggesting ways they might be improved. I then contrast epistemic and general paternalism and argue that it’s difficult to see what makes epistemic paternalism an epistemic phenomenon at all. Next, I turn to the various normative questions one might (...) ask about epistemic paternalism and discuss the literature’s assumptions of epistemic consequentialism and veritism. I close by comparing and contrasting epistemic paternalism with other topics in social epistemology, such as disagreement or testimony. (shrink)

There is no prepared script for social and cultural life. People work it out as they go along. Creativity and Cultural Improvisation casts fresh, anthropological eyes on the cultural sites of creativity that form part of our social matrix. The book explores the ways creative agency is attributed in the graphic and performing arts and in intellectual property law. It shows how the sources of creativity are embedded in social, political and religious institutions, examines the relation between creativity and the (...) perception and passage of time, and reviews the creativity and improvisational quality of anthropological scholarship itself. Individual essays examine how the concept of creativity has changed in the history of modern social theory, and question its applicability as a term of cross-cultural analysis. The contributors highlight the collaborative and political dimensions of creativity and thus challenge the idea that creativity arises only from individual talent and expression. (shrink)

Matthew Strohl’s Why It’s OK to Love Bad Movies is a deeply personal, philosophically sophisticated, and thoroughly enjoyable book. Written devoid of unnecessar.

In Unsettled Thoughts, Julia Staffel argues that non-ideal thinkers should seek to approximate ideal Bayesian rationality. She argues that the more rational you are, the more benefits of rationality you will enjoy. After summarizing Staffel's main results, this paper looks more closely at two issues that arise later in the book: the relationship between Bayesian rationality and other kinds of rationality, and the role that outright belief plays in addition to credence. Ultimately, I argue that there are several roles that (...) outright belief might play, and I explore different ways that these roles for belief might fit together. (shrink)

Research on human infants, adult nonhuman primates, and children and adults in diverse cultures provides converging evidence for four systems at the foundations of human knowledge. These systems are domain specific and serve to represent both entities in the perceptible world (inanimate manipulable objects and animate agents) and entities that are more abstract (numbers and geometrical forms). Human cognition may be based, as well, on a fifth system for representing social partners and for categorizing the social world into groups. Research (...) on infants and children may contribute both to understanding of these systems and to attempts to overcome misconceptions that they may foster. (shrink)

Lauren Freeman and Heather Stewart (2024) have written a richly researched and argued, while also highly engaging and accessible, book with Microaggressions in Medicine. They argue for why microaggressions are best understood on a harm-based account and situate this view within timely examples from a range of healthcare experiences. In their view, focusing on the harms produced by microaggressions shifts the locus of concern from the agent committing a microaggression to the agent receiving it, and it enables an attribution of (...) a microaggression regardless of an agent's intent or even awareness.Freeman and Stewart leave the reader with an expanded understanding of what microaggressions are and how they function.... Read More. (shrink)

This book looks at business ethics from the perspective of the business practitioner, but with the rigour of the moral philosopher. Intended for introductory students of business, commerce and management studies, Business Ethics at Work begins by setting business clearly in the context of creating value for its owners, and develops a practical ethical decision model which can be simply and relevantly applied to the hard moral choices with which business people are faced day to day. Against this background, some (...) of the major ethical issues which arise in business are explored, for example, in human resource management, finance, marketing and advertising, the management of the environment and corporate governance. In conclusion the book looks at the nature of ethical audit and argues that for the business of the future, the identification of its ethical values and their integration into its policies and practices will be a crucial ingredient of success. (shrink)

A growing number of theorists have launched an epistemic challenge against retributive punishment. This challenge involves the core claim that it is wrong (intentionally) to inflict serious harm on someone unless the moral argument for doing so has been established to a high standard of credibility. Proponents of this challenge typically argue that retributivism fails to meet the required epistemic standard, because retributivism relies on a contentious conception of free will, about whose existence we cannot be sufficiently certain. However, the (...) scope of the epistemic challenge should not be limited to doubts about free will or retributivism. In this article, I argue that the epistemic challenge should be expanded beyond the original focus on justifications of punishment. By “expanding the epistemic challenge” I mean demanding that other purported justifications for serious (intentional) harm be held to a high standard of credibility. To provide a focus for the argument, I will concentrate on the “Public Health Quarantine Model” defended by Gregg Caruso, but my arguments have wider implications beyond this model. A growing number of “abolitionist” theorists believe that punishment is wrong in principle. If retributive punishment, or punishment in general, were abandoned, we would need to ask, “how else should we respond to crime?”. My arguments suggest that all such abolitionists will have to face the same epistemic standard as penal theorists if they wish to replace punishment with the intentional imposition of non-punitive severe coercive measures. (shrink)

What counts as an individual in the living world? What does it mean for a living thing to remain the same through time, while constantly changing? Immunology answers these questions with its theory of "self" and "nonself" which has dominated the field since the 1940s. Thomas Pradeu argues that this theory is inadequate, because immune responses to self constituents and immune tolerance of foreign entities are the rule, not the exception.

Process models are valuable conceptual tools to help in understanding the approaches to value creation in social enterprises. This teaching case illustrates the application of a process model about creating, building, and sustaining a social enterprise with a mission to provide clean water to communities in need. The social enterprise generates revenue in support of community water projects and works with community stakeholders in different locations throughout the world to provide sustainable clean water solutions. The case study uses primary data (...) from semi-structured interviews, direct observations of a community project, and archival sources to demonstrate application of the process model. The study shows how the social enterprise developed as a promising idea; was implemented through an operating model with resources to support social impact; and continues to build and evolve while guided by the social mission. The paper concludes with a discussion and teaching note on ways to use the case for educational purposes to enhance learning about the social value creation process. (shrink)

Background: Caregivers and administrators in long-term facilities have fragile moral work in caring for residents with dementia. Residents are susceptible to barriers and vulnerabilities associated with the most intimate aspects of their lives, including how they express themselves sexually. The conditions for sexual agency are directly affected by caregivers’ perceptions and attitudes, as well as facility policies. Objective: This article aims to clarify how to approach capacity determinations as it relates to sexual activity, propose how to theorize about patient autonomy (...) in this context, and suggest some considerations for finding an ethically responsible and practically feasible way to respect the sexual rights of this population. Research Design: The focus is on residents with early to moderate dementia in states of daily dependency on professional caregivers. The article critically examines existing empirical research on sexuality among persons with dementia, caregivers’ attitudes, and institutional roadblocks to enabling residents’ sexuality. A relational lens and insights from disability studies are used in the philosophical analysis. Participants and Research Context: No research participants were part of this analysis. Ethical Considerations: This article offers a conceptual analysis and normative framework only. Findings: The analysis highlights the delicate balance that capacity assessments for sexual activity have to strike; while caregivers should protect those who cannot give adequate consent, the denial of sexuality among residents can cause deep, long-ranging harms. Sexual agency features into an ongoing sense of self for many individuals with dementia, and the imposition of inappropriate standards and expectations for sexual autonomy can lead to unwarranted obstacles to sexual activity. Discussion: Recommendations include developing clear and inclusive institutional policies and practices of care, providing education for caregivers on how to discuss and document residents’ sexual preferences over time, and taking advantage of ethics consultation services. Conclusion: This analysis establishes the need for more research and discussion on this sensitive topic. Future research should investigate the specific responsibilities of caregivers in furthering the sexual interests of residents, how exactly to modify existing capacity instruments, and how best to support historically marginalized patients in their sexual identities. (shrink)

Narrative is now a commonly used term in medical education, ethics, and practice. Yet the concept of narrative defies singular definition, and definitional and functional pluralism about narrative in health care remains underappreciated. Diverse conceptualizations of narrative are generically grouped under umbrella terms like “medical humanities” or “narrative medicine.” Such broad grouping risks undermining attention to relevant differences in use, meaning, or theory of narrative, overestimating the scope of certain criticisms of narrative practice or use, while overlooking more insidious concerns. (...) This essay moves toward a conceptual clarification of narrative in medicine through a process of naming and sorting. Narrative conceptualizations are grouped into narrative premises which include descriptive and normative claims about narrative, and narrative practices, which put narrative into action as process, method, or tool. A philosophical pragmatist approach to narrative in medicine reworks narrative anxieties about fact and fiction, truth or falsehood, in terms of the justifiability of belief, the inclusion or exclusion of experience, and the rationality of practices that are never perfect and always up for revision. (shrink)

Attempts to unify Marxist and feminist social critique have been vexed by the fact that ‘patriarchy’ predates the advent of capitalism (its transhistorical status). Feminists within the Marxist, socialist, and materialist traditions have responded to this point by either granting patriarchy a certain autonomy relative to capitalism (the ‘dual/triple systems’ approach), or by suggesting that patriarchal relations have a foundational and necessary status in the history of capitalist development (which we term the ‘origins-subsistence’ approach). This paper offers an alternative account (...) of the relationship between capitalism and the transhistorical status of ‘patriarchy’. In aid of a ‘unitary theory’ of Marxist Feminism, we argue that the transhistorical status of patriarchy is better understood through an application of Marx’s concepts of formal and real subsumption. A modified version of these concepts can illuminate not only capitalist appropriation of antecedent social and economic forms, but also its capacity to produce new forms of gendered exploitation and oppression. (shrink)

This book offers new essays exploring concepts and applications of nonideal theory in bioethics. Nonideal theory refers to an analytic approach to moral and political philosophy (especially in relation to justice), according to which we should not assume that there will be perfect compliance with principles, that there will be favorable circumstances for just institutions and right action, or that reasoners are capable of being impartial. Nonideal theory takes the world as it actually is, in all of its imperfections. Bioethicists (...) have called for greater attention to how nonideal theory can serve as a guide in the messy realities they face daily. Although many bioethicists implicitly assume nonideal theory in their work, there is the need for more explicit engagement with this theoretical outlook. A nonideal approach to bioethics would start by examining the sociopolitical realities of healthcare and the embeddedness of moral actors in those realities. How are bioethicists to navigate systemic injustices when completing research, giving guidance for patient care, and contributing to medical and public health policies? When there are no good options and when moral agents are enmeshed in their sociopolitical viewpoints, how should moral theorizing proceed? What do bioethical issues and principles look like from the perspective of historically marginalized persons? These are just a few of the questions that motivate nonideal theory within bioethics. This book begins in Part I with an overview of the foundational tenets of nonideal theory, what nonideal theory can offer bioethics, and why it may be preferable to ideal theory in addressing moral dilemmas in the clinic and beyond. In Part II, authors discuss applications of nonideal theory in many areas of bioethics, including reflections on environmental harms, racism and minority health, healthcare injustices during incarceration and detention, and other vulnerabilities experienced by patients from clinical and public health perspectives. The chapters within each section demonstrate the breadth in scope that nonideal theory encompasses, bringing together diverse theorists and approaches into one collection. (shrink)

However far we are from either in practice, basic global and intergenerational justice, including climate change mitigation, are taken to be theoretically compatible. If population grows as predicted, this could cease to be the case. This paper asks whether that tragic legacy can now be averted without hard or even tragic choices on population policy. Current generations must navigate between: a high-stakes gamble on undeveloped technology; violating human rights; demanding unbearable sacrifices of the already badly off; institutional unfairness across adults; (...) institutional unfairness across children; failing to protect children’s basic interests; and threatening the autonomy of the family. We are not yet forced to choose between bequeathing a tragic choice and making one, by adopting basically unjust measures. However, even the remaining options present a morally hard choice. The fact we face it is yet another damning indictment on the combined actions and collective failures of the global elite. (shrink)

The astute reviews by Hamlin and by Revencu and Csibra provide compelling arguments and evidence for the early emergence of moral evaluation, communication, and pedagogical learning. I accept these conclusions but not the reviewers' claims that infants' talents in these domains depend on core systems of moral evaluation or pedagogical communication. Instead, I suggest that core knowledge of people as agents and as social beings, together with infants' emerging understanding of their native language, support learning about people as moral agents, (...) moral patients, communicators, and teachers. These issues are open, however, and our competing views invite further testing. (shrink)

the issue of liberal neutrality, a topic suggested by the work of Catharine MacKinnon. I discuss two kinds of neutrality: neutrality at the level of justifying liberalism itself, and state neutrality in political decision-making. Both kinds are contentious within liberal theory. Rawls’s argument for justice as fairness has been criticized for non-neutrality at the justificatory level, a problem noted by Rawls himself in Political Liberalism . I will defend a qualified account of neutrality at the justificatory level, taking an epistemic (...) approach to argue for the exclusion of certain doctrines from the justificatory process. I then argue that the justification process I describe offers a justificatory stance supportive of the feminist rejection of state-sponsored gender hierarchy. Further, I argue that liberal neutrality at the level of political decision-making will have surprising implications for gender equality. Once the extent of the state’s involvement in the apparently private spheres of family and civil society is recognized, and the disproportionate influence of a sexist conception of the good on those structures—and concomitant promotion of that ideal—is seen, state neutrality implies substantive change. While—as Susan Moller Okin avowed—Rawls himself may have remained ambiguous on how to address gender inequality, his theory implies that the state must seek to create substantive, not merely formal, equality. I suggest that those substantive changes will not conflict with liberal neutrality but instead be required by it. (shrink)

Citing grounds of conscience, pharmacists are increasingly refusing to fill prescriptions for emergency contraception, or the "morning-after pill." Whether correctly or not, these pharmacists believe that emergency contraception either constitutes the destruction of post-conception human life, or poses a significant risk of such destruction. We argue that the liberty of conscientious refusal grounds a strong moral claim, one that cannot be defeated solely by consideration of the interests of those seeking medication. We examine, and find lacking, five arguments for requiring (...) pharmacists to fill prescriptions. However, we argue that in their professional context, pharmacists benefit from liberty restrictions on those seeking medication. What would otherwise amount to very strong claims can be defeated if they rest on some prior restriction of the liberty of others. We conclude that the issue of what policy should require pharmacists to do must be settled by way of a theory of second best. Asking "What is second best?" rather than "What is best?" offers a way to navigate the liberty restrictions that may be fixed obstacles to optimality. (shrink)