Background Despite decades of anti-racism and equity, diversity, and inclusion (EDI) interventions in academic medicine, medical racism continues to harm patients and healthcare providers. We sought to deeply explore experiences and beliefs about medical racism among academic clinicians to understand the drivers of persistent medical racism and to inform intervention design. Methods We interviewed academically-affiliated clinicians with any racial identity from the Departments of Family Medicine, Cardiac Sciences, Emergency Medicine, and Medicine to understand their experiences and perceptions of medical racism. (...) We performed thematic content analysis of semi-structured interview data to understand the barriers and facilitators of ongoing medical racism. Based on participant narratives, we developed a logic framework that demonstrates the necessary steps in the process of addressing racism using if/then logic. This framework was then applied to all narratives and the barriers to addressing medical racism were aligned with each step in the logic framework. Proposed interventions, as suggested by participants or study team members and/or identified in the literature, were matched to these identified barriers to addressing racism. Results Participant narratives of their experiences of medical racism demonstrated multiple barriers to addressing racism, such as a perceived lack of empathy from white colleagues. Few potential facilitators to addressing racism were also identified, including shared language to understand racism. The logic framework suggested that addressing racism requires individuals to understand, recognize, name, and confront medical racism. Conclusions Organizations can use this logic framework to understand their local context and select targeted anti-racism or EDI interventions. Theory-informed approaches to medical racism may be more effective than interventions that do not address local barriers or facilitators for persistent medical racism. (shrink)

Philosophers who have written about implicit bias have claimed or implied that individuals are not responsible, and therefore not blameworthy, for their implicit biases, and that this is a function of the nature of implicit bias as implicit: below the radar of conscious reflection, out of the control of the deliberating agent, and not rationally revisable in the way many of our reflective beliefs are. I argue that close attention to the findings of empirical psychology, and to the conditions for (...) blameworthiness, does not support these claims. I suggest that the arguments for the claim that individuals are not liable for blame are invalid, and that there is some reason to suppose that individuals are, at least sometimes, liable to blame for the extent to which they are influenced in behaviour and judgment by implicit biases. I also argue against the claim that it is counter-productive to see bias as something for which individuals are blameworthy; rather, understanding implicit bias as something for which we are liable to blame could be constructive. (shrink)

In this article, we suggest that the evidence regarding the social determinants of health calls for a deep re‐thinking of our understanding of distributive justice. Focusing on John Rawls's theory of distributive justice in particular, we argue that a full reckoning with the social determinants of health requires a re‐working of Rawls's principles of justice. We argue first that the social bases of health – a Rawlsian conception of the social determinants of health – should be considered a social primary (...) good. We argue second that including the social bases of health as a social primary good would lead the parties to the original position to choose an additional principle of justice and assign it lexical priority over Rawls's second principle. According to this principle, inequalities in people's share of the social bases of health are to be arranged so as to improve the health status of those least advantaged on the social health gradient. -/- . (shrink)

Can implicit biases be properly thought of as epistemic vices? I start by sketching the contours of implicit biases (1), and then turn to the recent claim, from Cassam, that implicit biases are epistemic vices (2). However, I argue that concerns about the stability of implicit biases and their role in producing behavior make for difficulties in establishing that implicit biases of individuals are epistemic vices (3). I then consider a recently developed model which prompts us to consider implicit biases (...) as properties of groups (4). This raises the question of whether implicit biases might constitute collective epistemic vice. I suggest that there is a way to make sense of this claim, but it requires rethinking how we conceptualise collective epistemic vice (5). These re-conceptualisations can be independently motivated. I close by marshalling some considerations in favour of using the terminology of vice to capture these defects of collective epistemic practice (6). (shrink)

Research programs in empirical psychology over the past few decades have led scholars to posit implicit biases. This is due to the development of innovative behavioural measures that have revealed aspects of our cognitions which may not be identified on self-report measures requiring individuals to reflect on and report their attitudes and beliefs. But what does it mean to characterise such biases as implicit? Can we satisfactorily articulate the grounds for identifying them as bias? And crucially, what sorts of cognitions (...) are in fact being measured; what mental states or processes underpin such behavioural responses? In this paper, we outline some of the philosophical and empirical issues engaged when attempting to address these three questions. Our aim is to provide a constructive taxonomy of the issues, and how they interrelate. As we will see, any view about what implicit bias is may depend on a range of prior theoretical choices. (shrink)

Black Utopias posits a concept of utopia made possible by black people's exclusion from the human and expressed through the ecstatic practices, community creation, speculative fiction and music. Jayna Brown explores the practices and works of 19th century black women mystics as well as 20th century musicians and speculative fiction writers including mystics Sojourner Truth and Rebecca Cox Jackson, musicians Alice Coltrane and Sun Ra, and writers Samuel Delany and Octavia Butler.

In this paper, I set out some desiderata for a model of implicit cognition. I present test cases and suggest that, when considered in light of them, some recent models of implicit cognition fail to satisfy these desiderata. The test cases also bring to light an important class of cases that have been almost completely ignored in philosophical discussions of implicit cognition and implicit bias. These cases have important work to do in helping us understand both the role of implicit (...) cognition in action and our attempts to combat implicit biases. (shrink)

Le transfert mitochondrial / nucléaire (M/NT) visant à éviter la transmission de maladies mitochondriales graves soulève des enjeux éthiques, juridiques et sociaux (ELS) complexes. En février 2015, le Royaume-Uni est devenu le premier pays au monde à légaliser le M/NT, rendant le débat houleux sur cette technologie encore plus pertinent. Cette revue d’interprétation critique identifie 95 articles pertinents sur les enjeux ELS du M/NT, y compris des articles de recherche originaux, des rapports gouvernementaux ou commandés par le gouvernement, des éditoriaux, (...) des lettres aux éditeurs et des nouvelles de recherche. La revue présente et synthétise les arguments présents dans la littérature quant aux thèmes les plus fréquemment soulevés: terminologie; identité, relations et parentalité; dommage potentiel; autonomie reproductive; alternatives disponibles; consentement; impact sur des groupes d’intérêt spécifiques; ressources; « pente glissante »; création, utilisation et destruction des embryons humains; et bienfaisance. La revue conclut en identifiant les enjeux ELS spécifiques au M/NT et en appelant à une recherche de suivi longitudinale clinique et psychosociale afin d’alimenter le futur débat sur les enjeux ELS de preuves empiriques. (shrink)

I argue that our acts of moral appraisal should be communicative. Praise and blame should communicate, to the appraised, information about their status and competences as moral agents; that they are recognised by the appraiser as a competent moral agent, and thus a legitimate candidate for appraisal. I argue for this thesis by drawing on empirical data about factors that can affect motivation. On the basis of such data, I formulate a constraint, and argue that two prominent models of moral (...) appraisal – a consequentialist model and Wallace’s ‘evaluative response’ model – violate this constraint. The model that I propose – the communicative conception of appraisal – does not violate this constraint. This conception, I argue, can provide a fuller picture of the role of appraisals in deepening agents’ commitment to moral norms. On this model, praise and blame has not only an evaluative component, but also communicates to the agent competence affirming information. (shrink)

Christian Leduc | : Dans le présent article, je montre que Maupertuis et Euler proposent une conception contrastée de la métaphysique de la nature. Il s’agit principalement pour eux de repositionner la cosmologie par rapport aux sciences de la nature. Au lieu de considérer la métaphysique comme étant au fondement des théories scientifiques, comme le supposent Descartes, Wolff et, d’une certaine manière, Kant, ou simplement d’interdire l’idée même d’une cosmologie, comme le stipulerait à la même époque d’Alembert, Maupertuis et (...) Euler, renversent l’ordre des disciplines pour donner aux sciences physiques une primauté sur la métaphysique. Ce repositionnement entraîne évidemment plusieurs questions : d’abord, de quelle manière les théories scientifiques peuvent-elles valider ou infirmer un principe métaphysique? Plus important encore, quel rôle incombe à la métaphysique de la nature, étant donné que les sciences possèdent non seulement une autonomie théorique, mais même une priorité sur les réflexions ontologiques. Il semblerait d’ailleurs que la métaphysique se réduise, pour ces deux philosophes, au seul domaine du cosmologique, en particulier aux questions qui concernent la force et le principe de moindre action, au statut ontologique de l’espace et du temps et aux déterminations de la matière que sont l’étendue, l’inertie, l’impénétrabilité et le mouvement. | : In this paper, I show that Maupertuis and Euler offer a contrasting conception of metaphysics of nature. It consists mainly for them in repositioning cosmology in relation to natural sciences. Instead of considering metaphysics to be at the foundation of scientific theories, as was assumed by Descartes, Wolff, and, in a certain way, Kant, or simply prohibiting the very idea of a cosmology, as d’Alembert would stipulate at the same period, Maupertuis and Euler invert the order of disciplines to give priority to physical sciences over metaphysics. This repositioning leads of course to several questions : first, how does scientific theories validate or deny metaphysical principles? Even more important, which role falls to metaphysics of nature given that sciences not only possess a theoretical autonomy, but also a priority over ontological reflections? Besides, it seems that metaphysics would be reduced, for these two philosophers, to the realm of cosmology alone, in particular to questions concerning force and the principle of least action, the ontological status of space and time, and the first constituents of matter, such as extension, inertia, impenetrability, and motion. (shrink)

Should the state punish its disadvantaged citizens who have committed crimes? Duff has recently argued that where disadvantage persists the state loses its authority to hold individuals to account and to punish for criminal wrongdoings. I here scrutinize Duff’s argument for the claim that social justice is a precondition for the legitimacy of state punishment. I sharpen an objection to Duff’s argument: with his framework, we seem unable to block the implausible conclusion that where disadvantage persists the state lacks the (...) authority to punish any citizen for any crime. I then set out an alternative line of argument in support of the claim that social deprivation can threaten the states legitimate punitive authority. I argue that a penal system must incorporate certain proportionality principles, and that these principles cannot both be met where citizens suffer from deprivation. (shrink)

Open peer commentary on the article “Developing a Dialogical Platform for Disseminating Research through Design” by Abigail C. Durrant, John Vines, Jayne Wallace & Joyce Yee. Upshot: The experimental conference format described by Durrant et al. is intended to create an open platform for dissemination and knowledge creation. The field of open design, in which designers create structures to support creative action by others, offers relevant insights and alternative approaches. For example: while it is logical to see openness as open (...) choice, it can be productive to instead think of openness as constructed through a balance of structure and choice. (shrink)

L’actualité, comme toujours, suscite la réflexion historique. Devant le déchaînement de la violence en Algérie, CLIO avait programmé, dès sa fondation en 1995, un numéro consacré aux Femmes d’Algérie où se seraient exprimés des chercheurs (euses) d’Algérie. C’était pour son comité de rédaction une façon de dire, comme il le pouvait, sa solidarité à ceux qui vivaient dans la quotidienneté de la terreur. Il a demandé à Djamila Amrane, titulaire depuis 1994 du poste d’« Histoire des Femmes et de...

Divisé en 3 parties et en 9 chapitres, l'ouvrage de Giulia Sissa est constitué dans ses deux premières parties par des articles publiés entre 1983 et 1991. Il faut toutefois se garder d'en conclure qu'il s'agit d'un florilège à butiner et prêter attention à l'introduction. L'âme est un corps de femme y est présenté comme un « tout » dont les anciennes composantes ont été repensées et remaniées à partir de trois ancrages nouveaux (pp. 188-189) : les travaux de J. (...) Derrida sur Platon (en... (shrink)

In this paper, I show that Maupertuis and Euler offer a contrasting conception of metaphysics of nature. It consists mainly for them in repositioning cosmology in relation to natural sciences. Instead of considering metaphysics to be at the foundation of scientific theories, as was assumed by Descartes, Wolff, and, in a certain way, Kant, or simply prohibiting the very idea of a cosmology, as d’Alembert would stipulate at the same period, Maupertuis and Euler invert the order of disciplines to give (...) priority to physical sciences over metaphysics. This repositioning leads of course to several questions : first, how does scientific theories validate or deny metaphysical principles? Even more important, which role falls to metaphysics of nature given that sciences not only possess a theoretical autonomy, but also a priority over ontological reflections? Besides, it seems that metaphysics would be reduced, for these two philosophers, to the realm of cosmology alone, in particular to questions concerning force and the principle of least action, the ontological status of space and time, and the first constituents of matter, such as extension, inertia, impenetrability, and motion. (shrink)

Open peer commentary on the article “Developing a Dialogical Platform for Disseminating Research through Design” by Abigail C. Durrant, John Vines, Jayne Wallace & Joyce Yee. Upshot: The experimental conference format described by Durrant et al. is intended to create an open platform for dissemination and knowledge creation. The field of open design, in which designers create structures to support creative action by others, offers relevant insights and alternative approaches. For example: while it is logical to see openness as open (...) choice, it can be productive to instead think of openness as constructed through a balance of structure and choice. (shrink)

In this study we examine college cheating behaviors of business students compared to non-business students, and investigate possible antecedents to cheating in an effort to better understand why and when students cheat. We specifically examine power values; we found that they were positively related to academic cheating in our sample, and that choice of major (business or non-business) partially mediated the relationship between power values and cheating. We also considered the extent to which students provide justifications for their cheating, and (...) found that business students were more likely to justify (rationalize) their cheating behaviors. Finally, we update the literature in terms of the ways students cheat. We assess newer forms of academic cheating, as increased accessibility to information via the Internet and smartphones may have changed the ways and ease with which students cheat – a particularly relevant topic currently, as many classes have moved online during the COVID-19 pandemic. In our study, cheating was especially prevalent when taking quizzes or tests or completing homework online. We found that only 10% of participants reported never engaging in any of the cheating behaviors we examined. (shrink)

Relational conceptions of autonomy attempt to take into account the social aspects of autonomous agency. Those views that incorporate not merely causally, but constitutively necessary relational conditions, incorporate a condition that has the form: A necessary condition for autonomous agency is that the agent stands in social relations S. I argue that any account that incorporates such a condition cannot play one of autonomy’s key normative roles: identifying those agents who ought to be protected from paternalistic intervention. I argue, against (...) objections from Oshana, that there are good reasons for maintaining the notion of autonomy in this role, and thus that such relational conceptions should not be accepted. This rejection goes beyond that from John Christman, which holds only for those relational conditions which are value-laden. (shrink)

It is not usually morally permissible to desire the suffering of another person, or to act so as to satisfy this desire; that is, to act with the aim of bringing about suffering. If the retributive emotions, and the retributive responses of which they are a part, are morally permitted or even required, we will need to see what is distinctive about them. One line of argument in this paper is for the conclusion that a retributive desire for the suffering (...) of the wrong-doer, and the aim to bring this about, can (contra recent arguments from Hanna 2008) be morally justified. -/- It has been suggested that by reflecting on the role of the retributive emotions in interpersonal relationships, and the alleged legitimacy of the aim for the suffering of the wrong-doer within them, support can be garnered for retributive practices of punishment by the state (Duff 1986 and 2001, Bennett 2002 and 2003). The conclusion of the second line of argument in the paper is that whilst the retributive responses can permissibly aim at suffering, the way in which this is so in interpersonal relationships cannot provide support for retributive state punishment. (shrink)

I here focus on two debates about the conditions for self-governance. In one, the metaphysical debate, theorists are concerned with the potential threat that causal determinism poses to self-governance. In another, the relational debate, theorists are concerned with the potential threat that certain social conditions—especially those that are oppressive to certain social groups—pose to self-governance. MacKenzie and Stoljar have suggested (2000) that the concerns of these two debates do not intersect. In this chapter, I draw out the connections between the (...) two debates, arguing that certain views in the relational debate are in tension with certain commitments in the metaphysical debate. I look at a relational condition for autonomous agency from Paul Benson (1994), extrapolate from the cases discussed by Langton (1993) in the literature on speech acts some relational conditions for autonomous action, and examine the formulation of relational conditions for autonomous choice (Stoljar 2000). I argue that each of these views sits in tension with positions in the metaphysical debate (hard determinism, libertarianism, and (more broadly) incompatibilism, respectively). Thus the concerns of the two debates do intersect. Moreover, if these tensions cannot be resolved, then the relational debate brings to bear important considerations in assessing the plausibility of the views in the metaphysical debate. (shrink)

The target article highlights the role of the anterior cingulate cortex (ACC) in conflict monitoring, but ACC function may be better understood in terms of the hierarchical organization of behavior. This proposal suggests that the ACC selects extended goal-directed actions according to their learned costs and benefits and executes those behaviors subject to depleting resources.

Les grands genies sont certes inepuisables, mais ils ne sont tels que par la mediation de leurs interpretes, veritables createurs a la seconde puissance qui les eveillent a une vie nouvelle. Henri Gouhier possedait une etonnante capacite de detecter dans chacun des auteurs qu'il analysait, de Descartes a Bergson, en passant par Pascal, Malebranche, Rousseau, Comte - pour ne citer qu'eux! - ce quelque chose de different par quoi il donnait aux lecteurs de les voir autrement. La dimension du speculaire (...) est ici fondamentale, qui s'articule a celle du speculatif. Les metaphores optiques sont recurrentes dans son lexique, et revelent, proprement, sa methode. Tel un photographe, il avait l'obsession de la mise au point. Une philosophie, disait-il, n'a de sens que par reference a une certaine vision du monde dont elle est l'expression. (shrink)

S’agissant de la réparation des préjudices résultant d’un accident de la circulation, le droit prospectif de la responsabilité civile oscille entre rafistolage déceptif et procrastination pusillanime, alors qu’un véritable chamboulement eût été le bienvenu.

Rolande Trempé vient de nous quitter alors qu’elle allait avoir 100 ans. Rolande? La figure charismatique, la plus singulière et la plus populaire, la plus engagée et la plus consensuelle de la section d’histoire et de la Faculté de Lettres de Toulouse (devenue depuis l’Université Jean Jaurès) entre 1964, date de sa nomination au poste d’assistante en Histoire contemporaine et 1983, date de sa retraite. Après avoir soutenu – brillamment – sa thèse (commencée en 1952) sur les Mineurs de Carm...

It is usually appropriate for adults to make significant decisions, such as about what kinds of medical treatment to undergo, for themselves. But sometimes impairments are suffered - either temporary or permanent - which render an individual unable to make such decisions. The Mental Capacity Act 2005 sets out the conditions under which it is appropriate to regard an individual as lacking the capacity to make a particular decision (and when provisions should be made for a decision on their behalf). (...) -/- To what extent does having capacity require the endorsement of certain values? Drawing on Owens et al (2009), I assess the extent to which understanding relevant information and weighing it in coming to a decision requires certain evaluative commitments. With reference to literature on anorexia nervosa and decisions informed by religious beliefs, I argue that it is difficult to avoid the conclusion that the conditions for capacity are value-laden, and that if this is so it is important to open discussion about which patterns of distorted valuing undermine capacity, and why. (shrink)

Substantive accounts of autonomy place value constraints on the objects of autonomous choice. According to such views, not all sober and competent choices can be autonomous: some things simply cannot be autonomously chosen. Such an account is developed and appealed to, by Thomas Hill Jr, in order to explain the intuitively troubling nature of choices for deferential roles. Such choices are not consistent with the value of self-respect, it is claimed. In this paper I argue that Hill's attempt to explain (...) the problem with such a choice, and Marcia Baron's interpretation and defence of his view, fail in this task. The troubling nature of some choices for deference cannot be explained in terms of a substantive self-respect condition for autonomy. (shrink)

The term 'implicit bias' has very swiftly been incorporated into philosophical discourse. Our aim in this paper is to scrutinise the phenomena that fall under the rubric of implicit bias. The term is often used in a rather broad sense, to capture a range of implicit social cognitions, and this is useful for some purposes. However, we here articulate some of the important differences between phenomena identified as instances of implicit bias. We caution against ignoring these differences: it is likely (...) they have considerable significance, not least for the sorts of normative recommendations being made concerning how to mitigate the bad effects of implicit bias. (shrink)

The paper aims at analyzing Lambert’s conception of empirical knowledge that is part of scientific learning. Indeed, in the Neues Organon, he claims that science is obtained with the help of both a priori and a posteriori knowledge. Lambert’s originality lies on the application of the analytic and synthetic methods of reasoning, which are traditionally used in formal disciplines, to the realm of experience. Transforming common knowledge into scientific a posteriori knowledge is mainly based on the employment of such demonstrative (...) methods. This allows Lambert to introduce some important theoretical tools in his theory of experience, in particular about the search for the conditions of observations and experimentations as well as the establishment of hypothesis. For Lambert, the synthetic method in empirical deductions requires the use of conjectures and probable principles. (shrink)

Leibniz’s universal characteristic is a fundamental aspect of his theory of cognition. Without symbols or characters it would be difficult for the human mind to define several concepts and to achieve many demonstrations. In most disciplines, and particularly in mathematics, the mind must then focus on symbols and their combinatorial rules rather than on mental contents. For Leibniz, mental perception is most of the time too confused for attaining distinct notions and valid deductions. In this paper, I argue that the (...) functions of symbolization differ depending upon the kind of concepts that are replaced with characters. In my view, most commentators did not sufficiently underline the distinction between two main functions of formal substitution in Leibniz’s characteristic: either increasing our knowledge or simply structuring it. In the first case, we complete our knowledge because formal substitution makes sensible and imaginary concepts more distinct. In the second case, symbolization helps to organize contents that are already conceived of by reason. Thus the process of substitution is not always identically applicable, for symbols replace different types of concepts. (shrink)

The term 'implicit bias' has very swiftly been incorporated into philosophical discourse. Our aim in this paper is to scrutinise the phenomena that fall under the rubric of implicit bias. The term is often used in a rather broad sense, to capture a range of implicit social cognitions, and this is useful for some purposes. However, we here articulate some of the important differences between phenomena identified as instances of implicit bias. We caution against ignoring these differences: it is likely (...) they have considerable significance, not least for the sorts of normative recommendations being made concerning how to mitigate the bad effects of implicit bias. (shrink)

The philosophical orientation of Gadamerian hermeneutic phenomenology is explored in this paper. Gadamer offers a hermeneutics of the humanities that differs significantly from models of the human sciences historically rooted in scientific methodologies. In particular, Gadamer proposes that understanding is first a mode of being before it is a mode of knowing; what this effectively offers is an alternative to the traditional way of understanding in the human sciences. This paper details why the work of hermeneutics is not to develop (...) a procedure for understanding, but to clarify the conditions of understanding. In this explication, the author examines the hermeneutic experience and, in the process, relates it to both the practical and the historical horizons of the lifeworld of health professionals, particularly nurses. Indo-Pacific Journal of Phenomenology<, Volume 7, Edition 2 September 2007. (shrink)

Philosophers have had a lot to say about blame, much less about praise. In this paper, I follow some recent authors in arguing that this is a mistake. However, unlike these recent authors, the reasons I identify for scrutinising praise are to do with the ways in which praise is, systematically, unjustly apportioned. Specifically, drawing on testimony and findings from social psychology, I argue that praise is often apportioned in ways that reflect and entrench existing structures of oppression. Articulating what (...) is going wrong here helps us to see what to do about it. (shrink)

In the Traité des systèmes, Condillac analyses a plurality of systematic metaphysical doctrines, specifically, those of Spinoza, Malebranche and Leibniz. Commentators have mainly interpreted this plurality as a way for Condillac to illustrate his criticisms and to raise doubts about the main contemporary systems while using the same criteria for interpretation. However, I note that his analytic tools differ according to which philosopher or philosophical system he analyses. This paper focuses on the criticism of Leibniz’s system, and aims to show (...) that Condillac operated from subsequent reconstructions. In order to raise criticisms against the Leibnizian system, Condillac gave it an architectonic structure that is borrowed mainly from Wolff. (shrink)

Our focus here is on whether, when influenced by implicit biases, those behavioural dispositions should be understood as being a part of that person’s character: whether they are part of the agent that can be morally evaluated.[4] We frame this issue in terms of control. If a state, process, or behaviour is not something that the agent can, in the relevant sense, control, then it is not something that counts as part of her character. A number of theorists have argued (...) that individuals do not have control, in the relevant sense, over the operation of implicit bias. We will argue that this claim is mistaken. We articulate and develop a notion of control that individuals have with respect to implicit bias, and argue that this kind of control can ground character-based evaluation of such behavioural dispositions. (shrink)