Disturbances of consciousness, including fluctuations in attention and awareness, are a common and clinically important symptom in dementia with Lewy bodies. In the present study we investigate potential mechanisms of such disturbances of consciousness in a clinicopathological study evaluating specific components of the cholinergic system. [3H]Epibatidine binding to the high-affinity nicotinic receptor in the temporal cortex differentiated DLB cases with and without DOC, being 62–66% higher in those with DOC. The were no differences between DLB patients with or without DOC (...) in 125I-labeled α-bungaratoxin binding to the low-affinity nicotinic receptor, [3H]pirenzepine binding to the muscarinic M1 receptor, or in choline acetyltransferase activity. These findings provide support for the hypothesis that cholinergic activity is an important neural correlate if consciousness and suggest a mechanism of DOC in DLB involving alterations in the nicotinic receptor, composed of predominantly α4 and β2 subunits. (shrink)

One of the ethical issues that has been raised recently regarding emerging neurotherapies is that people will be coerced explicitly or implicitly in the workplace or in schools to take cognitive enhancing drugs. This article builds on this discussion by showing how the law may pressure people to adopt emerging neurotherapies. It focuses on a range of private law doctrines that, unlike the criminal law, do not come up very often in neuroethical discussions. Three doctrines—the doctrine of mitigation, the standard (...) of care in negligence, and child custody determinations in family law—are addressed to show how the law may pressure people to consent to treatment by offering a choice between accepting medical treatment and suffering a legal disadvantage. The doctrines considered in this article apply indirect pressure to submit to treatment, unlike court-ordered medical treatment, which applies direct pressure and is not addressed here. The outcome of this discussion is to show that there is a greater range of social pressures that may encourage the uptake of novel neurotherapies than one might initially think. Once treatments that were developed and offered with therapeutic benefits in mind become available, their existence gives rise to unintended legal consequences. This certainly does not mean we should cease developing new therapies that may be of tremendous benefit to patients, but it does raise some questions for physicians and for legal policy-makers. How should physicians, who are required by medical ethical principles to obtain valid consent to treatment, react to a patient’s reluctant consent that is driven by legal pressure? From the legal policy perspective, are our legal doctrines satisfactory or should they be changed because, for example, they unduly promote the collective interest over individual freedom to reject medical treatment or because they channel us toward economically efficient treatments to the detriment of more costly but potentially superior approaches of dealing with behavioural problems? (shrink)

Court D. Lewis, author of Repentance and the Right to Forgiveness, presents a rights-based theory of ethics grounded in eirenéism, a needs-based theory of rights (inspired by Nicholas Wolterstorff) that seeks peaceful flourishing for all moral agents. This approach creates a moral relationship between victims and wrongdoers such that wrongdoers owe victims compensatory obligations. However, one further result is that wrongdoers may be owed forgiveness by victims. This leads to the “repugnant implication” that victims may be wrongdoers who do (...) not forgive. Author Lewis addresses the “repugnant implication” by showing that victims are obligated to work toward forgiveness, if not forgiveness itself. Critic Gregory L. Bock argues that victims are not the only ones who can forgive, that the personal dimensions of forgiveness are overlooked, and that the force of the “repugnancy implication” may be questioned. Instead of rights-based eirenéism, Bock supports a virtue ethics framework. Instead of rights-based eirenéism, Bock encourages virtue ethics. Critic David Boersema raises questions about the binding nature of relationships, the dependency of flourishing upon forgiveness, and the nature of needs or rights. Boersema also questions the wisdom of a rights-based approach to forgiveness. Critic Jennifer Kling asks whether a rights-based approach is necessary to ground obligations to meet the needs of others: why not an ethics of care? If a rights-based approach is taken, perhaps a wrongdoer is obligated to not make forgiveness a life good. By disengaging this obligation, we avoid constraining a victim’s work toward forgiveness, especially when the wrongdoing is oppressive. Author Lewis responds to these objections. (shrink)

Canada is six years into a new era of legalized medical assistance in dying (MAiD). The law continues to evolve, following a pattern in which Canadian courts rule that legal restrictions on eligibility for MAiD are unconstitutional and Parliament responds by gradually expanding eligibility for MAiD. The central tension underlying this dialogue between courts and government has focused on two conceptions of how to best promote and protect the interests of people who are vulnerable by virtue of intolerable and irremediable (...) suffering due to an illness, disease, or disability. Do we, as a society, have a duty to protect vulnerable people from seeking certain medical procedures that are contrary to their interests, as those are perceived by others? Or do we have a duty to uphold their rights to autonomy, including the right to make choices within a range that may be constrained by many factors, some of which may be socially unjust? This is a recurrent problem in bioethics and medical law, which we explore through the lens of how Canadian courts and Parliament have grappled with defining eligibility for MAiD. (shrink)

This article draws on the suggestion that modern technology is “autonomous” in that our social control mechanisms are unable to control technology and instead merely adapt society to integrate new technologies. In this article, I suggest that common law judges tend systematically to support the integration of novel technologies into society. For example, courts sometimes require parties seeking compensation for serious injuries to submit to medical technologies to which the parties object for genuine reasons of fear or moral objection. Where (...) a novel technology alters the environment in some way, courts sometimes legitimize that alteration by refusing to recognize harm and instead characterizing avoidance of the technology as self-imposed harm. The examples selected in this article were chosen to support the hypothesis in one way or another, and future work will aim to look for counter examples and to conduct a more complete assessment of the hypothesis. (shrink)

This study explored relations between willingness to disclose in 5 psychotherapy scenarios and 2 independent variables. Scenarios involved suicidal, gravely disabled, physically abusive, and sexually abusive patients, and a police officer patient who shot a suspect. For each of the 5 scenarios, participants in the privilege condition had significantly higher willingness-to-disclose scores than participants in the no-privilege condition. There were no significant differences between willingness-to-disclose scores of participants with and without therapy experience; neither was there a significant interaction between privilege (...) condition and therapy experience. Privilege condition was more predictive of willingness to disclose than personal characteristics or therapy experience. Results provide empirical support for the U.S. Supreme Court's recognition of the psychotherapist-patient privilege in Jaffee v. Redmond. (shrink)

This paper argues that judges assessing the scientific validity and the legal admissibility of forensic science techniques ought to privilege testing over explanation. Their evaluation of reliability should be more concerned with whether the technique has been adequately validated by appropriate empirical testing than with whether the expert can offer an adequate description of the methods she uses, or satisfactorily explain her methodology or the theory from which her claims derive. This paper explores these issues within two specific contexts: latent (...) fingerprint examination and the use of breath tests for the detection of alcohol. Especially in the forensic science arena, I suggest courts have often been seduced by superficially plausible explanations and descriptions of a technique or method, and permitted these to serve as a substitute for empirical testing. Thinking through these two examples illustrates both why evaluating the extent of testing should be the most important method by which courts assess reliability, and why, when other forms of explanatory evidence are readily available, we may nonetheless elect to make use of them. This paper suggests that these descriptions and explanations may at times usefully supplement evidence of testing, but should not generally be substituted for it. Finally, this paper embraces a kind of evidentiary pragmatism, in which the quantum of evidence required to establish legal reliability is determined not in the abstract, but in relation to the evidence that is, or ought to be, available as a result of reasonable research and investigation. (shrink)

This chapter explains how a single scene in the Star Wars saga serves to reflect a popular and problematic contemporary view about people. The scene in question occurs in Return of the Jedi when Jabba the Hutt holds Princess Leia captive in his court on Tatooine. Using the philosophy of Susan Bordo, Jean‐Paul Sartre, and Michel Foucault, the chapter examines how Leia's captivity scene reflects modern society's hatred of fat and its preoccupation with the control of bodies, particularly the (...) female body. In contrast with Jabba and his uncontrolled appetite, Leia operates as a model of control. She becomes flesh's master rather than its slave. She finds her freedom by fighting fat. Fear of the flesh and a desire to control bodies are expressive of a deeper anxiety regarding embodiment that has been culturally conferred upon women more than men due to the cultural association of women with the body. (shrink)

In response to the obesity epidemic, much discussion in the public health and child advocacy communities has centered on restricting food and beverage marketing practices directed at children. A common retort to appeals for government regulation is that such advertising and marketing constitutes protected commercial speech under the First Amendment. This perception has allowed the industry to function largely unregulated since the Federal Trade Commission 's foray into the topic, termed KidVid, was terminated by an act of Congress in 1981. (...) The FTC has since focused on self-regulation as a potential solution to such concerns. However, this method of control has proven ineffective to protect children, and has led to growing recognition that federal regulation may be necessary.Since KidVid, the evidence has only mounted that children are uniquely vulnerable to the effects of advertising. Over the same time period, the exposition of commercial speech jurisprudence has plateaued, as the Supreme Court has not decided a pure commercial speech case since 2002. (shrink)

In this introduction to a special section on the philosophy of Bat-Ami Bar On, guest editor Court Lewis introduces Jennifer Kling’s article on equitable resettlement of refugees, Wim Laven’s article on meaningful political citizenship, and his own work on the analysis of the violent threat of citizen culture-warriors.

I explore both the potential and the perils of Twitter as a space for constituting a Deweyan public aimed at transforming how "we" (here, I mean not only citizens of the United States but global citizens) affectively receive and thereby respond to and resist sexual violation. In the course of this brief exploration, I operate with a pragmatic notion of "truth," namely, as democratically formulating a hypothesis concerning the nature of a social problem that enables fruitful amelioration of the problem. (...) I specifically focus on the viral #WhyIDidntReport Twitter campaign provoked by Brett Kavanaugh's Supreme Court hearing. (shrink)

This article explores the relationship between neoconservative values and neoliberalism in American jurisprudence through a critique of the US Supreme Court’s Hobby Lobby decision. The article uncovers how the Court imposes market-oriented logic on religious expression and in the process spiritualizes economic activity. In this way neoliberal rationality is intertwined with neoconservative values. For example, exercising religion through corporatization can be understood as a neoconservative moderation of the corrupting influence of excessive neoliberal individualism. Finally, while the decision furthers (...) employer control of workers’ reproduction, the Court’s proposed workaround—a direct government contraceptives program—would undermine that control and points to another, more emancipatory response to the problems of neoliberalism. (shrink)

Obesity is a public health problem in the United States. Experts have identified the regulation of food marketing as a policy strategy to address obesity and poor nutrition. However, the First Amendment can be a barrier to reducing exposure to problematic food marketing. In recent years, courts have become increasingly protective of speech, and particularly of “commercial speech,” or advertising, which can make it more difficult to regulate certain marketing practices.

A 16 year old Hodgkin lymphoma patient refuses to have his blood specimen drawn, thus canceling his scheduled oncologic treatment. As a 16 year old, he has no legal standing as an adult. His parents are split over his decision. One supports his right to choose; the other wishes the specimen to be drawn and the chemotherapy reinstated. The physicians at the hospital are seeking legal redress to have the court order the blood specimens to be taken.

The First Amendment to the US Constitution protects commercial speech from government interference. Commercial speech has been defined by the US Supreme Court as speech that proposes a commercial transaction, such as marketing and labeling. Companies that produce products associated with public health harms, such as alcohol, tobacco, and food, thus have a constitutional right to market these products to consumers. This article will examine the evolution of US law related to the protection of commercial speech, often at the (...) expense of public health. It will then identify outstanding questions related to the commercial speech doctrine and the few remaining avenues available in the United States to regulate commercial speech including the use of government speech and addressing deceptive and misleading commercial speech. (shrink)

In a “mixed bag” 2023-2024 session, the U.S. Supreme Court issued a series of decisions both favorable and antithetical to public health and safety. Taking on tough constitutional issues implicating gun control, misinformation, and homelessness, the Court also avoided substantive reviews in favor of procedural dismissals in key cases involving reproductive rights and government censorship.

ABSTRACT Iris Murdoch's novel The Bell considers the nature of “utopian work”—not simply the kind of work that provides material support for community but rather the kind of “inner” work that reorients individual ethical and political sensibilities, and moves one toward a spiritual maturity that makes frank community with others possible. Drawing from Murdoch's philosophical work, Wagner-Lawlor examines Murdoch's promotion of the “work” that art does in educating our moral sensibilities over the kinds of work her Imber Court communitarians (...) engage in. Murdoch suggests that the real work of utopia is the working of the individual spirit toward an imaginative sympathy that lies at the heart of her conception of a utopian sensibility. (shrink)

When ethics committees are consulted about patients who have or need court-appointed guardians, they lack empirical evidence about several common issues, including the relationship between guardianship and prolonged, potentially medically unnecessary hospitalizations for patients. To provide information about this issue, we conducted quantitative and qualitative analyses using a retrospective cohort from Veterans Healthcare Administration. To examine the relationship between guardianship appointment and hospital length of stay, we first compared 116 persons hospitalized prior to guardianship appointment to a comparison group (...) (n = 348) 3:1 matched for age, diagnosis, date of admission, and comorbidity. We then compared 91 persons hospitalized in the year following guardianship appointment to a second matched comparison group (n = 273). Mean length of stay was 30.75 days (SD = 46.70) amongst those admitted prior to guardianship, which was higher than the comparison group (M = 7.74, SD = 9.71, F = 20.75, p. (shrink)

This July 2022 issue of the JME contains several articles addressing ethical issues related to COVID-19 as well as reproductive ethics—a timely topic, given the leaked U.S. Supreme Court document, anticipating the overturn of Roe v. Wade. On the COVID-19 front, original articles in this issue include an analysis of ethical issues related to sharing research samples and data between low/middle-income countries and high-income countries,1 a retrospective analysis of European scientific societies’ triage policies early in the pandemic,2 an assessment (...) of the fairness of the allocation framework used by the WHO for their COVID-19 Vaccines Global Access Facility,3 balancing physicians’ freedom to express opinions on medical matters with public interest when they run contrary to each other,4 and a survey of Americans’ views on race-based and place-based COVID-19 vaccine prioritisation.5 The articles include a mix of looking back and …. (shrink)

This article examines disciplinary proceedings about sexual misconduct by lawyers. Sexual misconduct in a professional relationship is harmful and unacceptable and should result in immediate disciplinary action to protect victims, future victims and the public. However, there is no explicit offence of sexual misconduct in Australian disciplinary legislation regarding lawyers. Rather, sexual misconduct must be linked to the statutory offences. While the Australian Solicitors’ Conduct Rules guide the interpretation of the offences, there is only express reference to sexual harassment. We (...) examined tribunal and court legal disciplinary cases from 2000 to 2020 across all Australian jurisdictions in which sexual misconduct had occurred. Decision makers typically only considered sexual misconduct sufficiently egregious to meet the required standard of a disciplinary offence when accompanied by a criminal conviction. The conduct was often portrayed as a result of character flaws, rather than harmful to victims and the public. Thus, decision makers failed to locate the behaviour in the wider incidence of violence against women. The profession’s failure to acknowledge sexual misconduct reflects narrow professional norms which do not robustly protect victims. Explicit acknowledgement of sexual misconduct in disciplinary proceedings is essential. These amendments would signify the importance, frequency and impact of sexual misconduct. (shrink)

As a victim of child abuse who proved my claims in a landmark civil suit, there have been many attempts to silence and discredit me. This article provides an overview of my court case and its effects.

In another tumultuous term of the United States Supreme Court in 2022-2023 a series of critical cases implicate instant and forthcoming changes in multiple fronts that collectively shift the national public health law and policy environment.

The consistent sentencing of white collar criminals does not exist in today's judicial system. Guidelines for sentencing individuals and corporations have already been developed by the U.S. Sentencing Commission but have not yet been implemented in the courts. Pros and cons of the guidelines are given, as is the extent and form of sentencing deemed appropriate for the individual or corporation. The activities of the sentencing commission are depicted by a timeline.

Adults who are incapacitated and alone, having no surrogates, may be known as “unbefriended.” Decision-making for these particularly vulnerable patients is a common and vexing concern for healthcare providers and hospital ethics committees. When all other avenues for resolving the need for surrogate decision-making fail, patients who are incapacitated and alone may be referred for “public guardianship” or guardianship of last resort. While an appropriate mechanism in theory, these programs are often under-staffed and under-funded, laying the consequences of inadequacies on (...) the healthcare system and the patient him or herself. We describe a qualitative study of professionals spanning clinical, court, and agency settings about the mechanisms for resolving surrogate consent for these patients and problems therein within the state of Massachusetts. Interviews found that all participants encountered adults who are incapacitated and without surrogates. Four approaches for addressing surrogate needs were: work to restore capacity; find previously unknown surrogates; work with agencies to obtain surrogates; and access the guardianship system. The use of guardianship was associated with procedural challenges and ethical concerns including delays in care, short term gains for long term costs, inabilities to meet a patient’s values and preferences, conflicts of interest, and ethical discomfort among interviewees. Findings are discussed in the context of resources to restore capacity, identify previously unknown surrogates, and establish improved surrogate mechanisms for this vulnerable population. (shrink)

As the United States emerges from the worst public health threat it has ever experienced, the Supreme Court is poised to reconsider constitutional principles from bygone eras. Judicial proposals to roll back rights under a federalism infrastructure grounded in states’ interests threaten the nation’s legal fabric at a precarious time. This column explores judicial shifts in 3 key public health contexts — reproductive rights, vaccinations, and national security — and their repercussions.

The overwhelming weight of legal authority in the USA and Canada holds that consent is not required for brain death testing. The situation in England and Wales is similar but different. While clinicians in England and Wales may have a prima facie duty to obtain consent, lack of consent has not barred testing. In three recent cases where consent for brain death testing was formally presented to the court, lack of consent was not determinative, and in one case the (...) court questioned whether the clinicians were even required to seek consent from the parents of a child at all. (shrink)

A strong record of human rights protections is an important factor for a state to maintain a positive international reputation. In this article, we suggest that states will use compliance with human rights treaties as a mechanism by which to improve their reputations to help achieve their foreign policy goals. We hypothesize that international human rights compliance is a means to improve a state’s reputation in three specific situations: when the state is facing regional pressures as the result of a (...) desire to join a regional organization; when the state is facing regional pressures not to run afoul of a court within a regional organization; or when a state seeks foreign assistance from an entity with human rights requirements for the receipt of such assistance. We examine our theory by analyzing human rights reports regarding state compliance with specific treaty obligations outlined in the Convention Against Torture (CAT). While the evidence for our hypotheses is mixed, we do find some support for our assertion that state compliance is linked to reputational concerns. In particular, states comply with the CAT when they are part of a regional organization that has a human rights court, and when they are receiving conditional aid from the European Union. (shrink)

After more than a dozen years of activity, some 161 indictments, 64 arrests, and 47 surrenders, the International Criminal Tribunal for the former Yugoslavia (ICTY) has accomplished a good deal in terms of its primary task of prosecution. Nonetheless, there is still much debate over the state of transitional justice in the Balkans and what has been accomplished. We cannot forget that the ICTY was created with broad political and social purposes in mind, specifically to contribute to the restoration and (...) maintenance of peace. Using a comparative framework, we develop benchmarks of transitional justice outcomes to examine these vague but important and ambitious goals. Although conventional wisdom says that the ICTY is used instrumentally by Balkan leaders who are fundamentally opposed to the court’s existence, we demonstrate that there is also evidence of broader political and social change throughout the region. Thus, we contend that Balkan countries have indeed moved beyond mere prosecution. (shrink)

This is a conversation held at the book launch for Christopher Insole’s Kant and the Divine: From Contemplation to the Moral Law (Oxford: Oxford University Press, 2020), hosted jointly, in November 2020, by the Centre for Catholic Studies, Durham University, and the Australian Catholic University. The conversation covers the claim made by Insole that Kant believes in God, but is not a Christian, the way in which reason itself is divine for Kant, and the suggestion that reading Kant can open (...) up new possibilities for dialogue between Christian thinkers and contemporary forms of secular religiosity. (shrink)

In _Aesthetics and Material Beauty_, Jennifer A. McMahon develops a new aesthetic theory she terms Critical Aesthetic Realism - taking Kantian aesthetics as a starting point and drawing upon contemporary theories of mind from philosophy, psychology, and cognitive science. The creative process does not proceed by a set of rules. Yet the fact that its objects can be understood or appreciated by others suggests that the creative process is constrained by principles to which others have access. According to her (...) update of Kantian aesthetics, beauty is grounded in indeterminate yet systematic principles of perception and cognition. However, Kant’s aesthetic theory rested on a notion of indeterminacy whose consequences for understanding the nature of art were implausible. McMahon conceptualizes "indeterminacy" in terms of contemporary philosophical, psychological, and computational theories of mind. In doing so, she develops an aesthetic theory that reconciles the apparent dichotomies which stem from the tension between the determinacy of communication and the indeterminacy of creativity. Dichotomies such as universality and subjectivity, objectivity and autonomy, cognitivism and non-cognitivism, and truth and beauty are revealed as complementary features of an aesthetic judgment. (shrink)

This essay revisits Elizabeth Anscombe's ‘Modern Moral Philosophy' with two goals in mind. The first is to recover and reclaim its radical vision, by setting forth a unified account of its three guiding theses. On the interpretation advanced here, Anscombe's three theses are not independently intelligible; their underlying unity is the perceived necessity of absolute prohibitions for any sound account of practical reason. The second goal is to show that Anscombe allows for a thoroughly unmodern sense of ‘moral' that applies (...) to human actions; the paper concludes with some reasons to think that this unmodern sense of ‘moral' is worthy of further philosophical attention and defense. (shrink)

Augustine famously claimed that the virtues of pagan Rome were nothing more than splendid vices. This critique reinvented itself as a suspicion of acquired virtue as such, and true Christian virtue has, ever since, been set against a false, hypocritical virtue alleged merely to conceal pride. _Putting On Virtue_ reveals how a distrust of learned and habituated virtue shaped both early modern Christian moral reflection and secular forms of ethical thought. Jennifer Herdt develops her claims through an argument of (...) broad historical sweep, which brings together the Aristotelian tradition as taken up by Thomas Aquinas with the early modern thinkers who shaped modern liberalism. In chapters on Luther, Bunyan, the Jansenists, Mandeville, Hume, Rousseau, and Kant, she argues that efforts to make a radical distinction between true Christian virtue and its tainted imitations actually created an autonomous natural ethics separate from Christianity. This secular value system valorized pride and authenticity, while rendering graced human agency less meaningful. Ultimately, _Putting On Virtue_ traces a path from suspicion of virtue to its secular inversion, from confession of dependence to assertion of independence. (shrink)

Recent research in the humanities and social sciences suggests that individuals who understand themselves as belonging to something greater than the self--a family, community, or religious or spiritual group--often feel happier, have a deeper sense of purpose or meaning in their lives, and have overall better life outcomes than those who do not. Some positive and personality psychologists have labeled this location of the self within a broader perspective "self-transcendence." This book presents and integrates new, interdisciplinary research into virtue, happiness, (...) and the meaning of life by re-orienting these discussions around the concept of self-transcendence. The essays are organized around three broad themes connected to self-transcendence. First, they investigate how self-transcendence helps us to understand aspects of the moral life as it is studied within psychology, including the development of wisdom, the practice of moral praise, and psychological well-being. Second, they explore how self-transcendence is linked to virtue in different religious and spiritual traditions including Judaism, Islam, Christianity, Buddhism, and Confucianism. Finally, they ask how self-transcendence can help us theorize about Aristotelean and Thomist conceptions of virtue, like hope and piety, and how this helps us to re-conceptualize happiness and meaning in life. (shrink)

This paper treats the political and ethical issues associated with the new caretaking technologies. Given the number of feminists who have raised serious concerns about the future of care work in the United States, and who have been critical of the degree to which society “free rides” on women's caretaking labor, I consider whether technology may provide a solution to this problem. Certainly, if we can create machines and robots to take on particular tasks, we may lighten the care burden (...) that women currently face, much of which is heavy and repetitious, and which results in injury and care “burnout” for many female caretakers. Yet, in some contexts, I argue that high-tech robotic care may undermine social relationships, cutting individuals off from the possibility of social connectedness with others. (shrink)

In this book, McMahon argues that a reading of Kant’s body of work in the light of a pragmatist theory of meaning and language leads one to put community reception ahead of individual reception in the order of aesthetic relations. A core premise of the book is that neo-pragmatism draws attention to an otherwise overlooked aspect of Kant’s "Critique of Aesthetic Judgment," and this is the conception of community which it sets forth. While offering an interpretation of Kant’s aesthetic theory, (...) the book focuses on the implications of Kant’s third critique for contemporary art. McMahon draws upon Kant and his legacy in pragmatist theories of meaning and language to argue that aesthetic judgment is a version of moral judgment: a way to cultivate attitudes conducive to community, which plays a pivotal role in the evolution of language, meaning, and knowledge. (shrink)

The ethical naturalist asks us to take seriously the idea that practical norms are a species of natural norms, such that moral goodness is a kind of natural goodness. The ethical naturalist has not demonstrated, however, how it is possible for a power of reason to be governed by natural norms, because her own attempts to do this have led her into a dilemma. If she takes the first horn and stresses that ethical naturalism provides objective, natural norms of the (...) species, then she fails to show how such norms are practical, or operative from a deliberative point of view. If she takes the second horn and stresses that ethical naturalism yields a picture of knowledge of human life that is practical because it comes through virtuous dispositions of intellect and will, then she fails to have an account of how it is knowledge of facts about a life form, potentially accessible to a non-human knower. In this paper, I argue that one potential resolution to this dilemma can be found in the writings of Thomas Aquinas. On a broadly Thomist account of practical reason, the first principles of practical reason are our common human ends or goods, which are constitutive of a good human life. The work of practical reason on this naturalistic account is twofold: to conceive and order these ends into some general conception of how to live, and to apply this general conception to the particular situations of one’s life in order to realize one’s vision of the good life, here and now. (shrink)

Increasingly, the role of health research in improving the discrepancies in health outcomes between Indigenous and non-Indigenous populations in developed countries is being recognised. Along with this comes the recognition that health research must be conducted in a manner that is culturally appropriate and ethically sound. Two key documents have been produced in Australia, known as The Road Map and The Guidelines, to provide theoretical and philosophical direction to the ethics of Indigenous health research. These documents identify research themes considered (...) critical to improving the health of the nation’s Indigenous peoples. They also provide values that, from an Indigenous perspective, are foundational to an ethical research process. This paper examines these research themes and values within the context of a current longitudinal birth cohort study of Indigenous infants and children in south-west Sydney: the Gudaga Study. Considerable time and effort have been invested in being true to the values stated in these documents: reciprocity; respect; equality; responsibility; survival and protection; and spirit and integrity. We have learnt that it is vital to be true to these values when conducting Indigenous health research—to quite literally “walk the talk”. (shrink)

This book analyzes practices in the home health care industry and concludes that they are highly exploitative of both workers and patients. Under the existing system, underpaid workers are expected to perform tasks for which they are inadequately trained, in unreasonably short periods of time. This situation harms workers and puts home health care patients at risk. To the extent that the majority of patients and workers in home health care are women, I turn to feminist ethics for an alternative (...) approach. Through an understanding of individuals as social beings with obligations to others, and of home health care as a public good, I explain how to develop the social benefits of good home health care and increase the role of government in providing financial support and regulatory oversight. (shrink)

Jennifer Johnston’s fiction presents the conditions of Irish culture and society by exploring the separations between interior and exterior realms and past and present temporalities persisting within the insulating privacy of the familial home space. In _The Christmas Tree_ (1981), the home is both haven and prison for Johnston’s heroine. In this paper, I argue that the home—which assumes the form of the individual body and the familial home—is paradoxical. The protagonist leaves 1950s Ireland because of the country’s rigid (...) gender roles in order to pursue an autonomous life as a writer in England, but she is unable to publish her writing within the confines of the patriarchal publishing world. The home of her body becomes paradoxical when she becomes a single mother as an avenue for creativity but is then diagnosed with terminal cancer. She returns to her father’s home to die, which she re-orders and reclaims through the disorder of the uncanny—represented by her non-conformity and illness brought into the patriarchal home. By writing her life story and creating a brief, alternative maternal relationship with her young caretaker, the protagonist confronts her own ambivalence toward her parents, who also represent aspects of oppressive heteronormative gender expectations. (shrink)

As scholars integrate empirical approaches to ethical questions in healthcare, relational autonomy theory must inform research design and change practice. Qualitative approaches are well suited to issues where patient values play a central role, and they can be combined with relational autonomy theory to investigate the factors influencing autonomy-rich experiences. This paper draws upon my experience conducting bioethics research related to clinical trial decision-making to develop a systematic method for applying relational autonomy as a theoretical lens to qualitative health research. (...) The resultant practical guide utilizes Susan Sherwin’s theory of relational autonomy and presents an empirical method responsive to autonomy-relevant questions. (shrink)

In this paper, I will argue that there is a deep connection between home-based care, technology, and the self. Providing the means for persons to receive care at home is not merely a kindness that respects their preference to be at home: it is an important means of extending their selfhood and respecting the unique selves that they are. Home-based technologies like telemedicine and robotic care may certainly be useful tools in providing care for persons at home, but they also (...) have important implications for sustaining selfhood in ways that are of value to individuals and those who care for them. I will argue, by appealing to Hilde Lindemann’s notion of “holding” persons’ identities in place, that technological interventions are not only useful tools for improving and sustaining health and good care at home, but that they may also help to extend our personal identities and relational capacities in ways that are practically and ethically good. Because of these important goods, I will claim that there is a prima facie moral duty to do this “holding” work and that it is best done by family members and loved ones who are well suited to the job because of their history and relationship with the individual that needs to be “held” in place. (shrink)

Hearers of the Sermon on the Mount are called to become children of their heavenly father by loving as God loves. Surprisingly, though, God's love is depicted here as impersonal and indiscriminate, as similar to or even simply as a force of nature, even if a life-giving force: God `makes his sun to rise on the evil and the good, and sends rain on the just and the unjust' (Matthew 5:45). Anders Nygren used this verse as core support for his (...) dubious characterization of agape as `indifferent to value'. How should we hear it today? (shrink)

Eudaimonism is often regarded as egoistic. If it recommends that agents pursue their own good because it is their own good, it is guilty as charged. But excellence‐prior eudaimonism offers a non‐egoistic alternative to this welfare‐prior eudaimonism. Excellence‐prior eudaimonism recommends that an agent live in a way that is in fact good for the agent, but it does not regard the agent’s own good as necessarily that for the sake of which the agent acts, nor does it regard living well (...) as justified by the fact that it is good for the agent, but simply because it is good. The Christian eudaimonisms of Augustine and Aquinas are best understood as deepened forms of excellence‐prior eudaimonism. (shrink)

In this thesis I argue that the received view of autonomy is insufficient for both biomedical ethics and feminist theory. I begin with an examination of the received view of autonomy; I then indicate the way in which this view of autonomy has been applied to health care ethics. A feminist relational approach to autonomy is explored: I argue that such an approach has many strengths in that it gives us a more accurate picture of the self-in-relationships and that it (...) recognizes many social and structural conditions that may impede an individual's attempts to be autonomous. ;This feminist relational approach to autonomy, once defined, is applied to the medical/social practices of cosmetic surgery and contract motherhood. I do this to show the practical implications of this contextual approach to autonomy. (shrink)

Very little research into women farmers in developed countries has been produced by economists, but much of what has been studied by scholars in other disciplines has economic implications. This article reviews such research produced by scholars in all disciplines to explore to what extent women farmers are becoming more equal to men farmers and to suggest further contributions to the literature. As examples, topics that has been widely researched in developing countries but have received almost no attention in developed (...) countries include comparisons of men and women farmers’ productivity and their access to and use of resources. Discoveries in these and other areas will be important not only for their insights into the agricultural industry in developed countries, but also because they will inform, and be informed by, research on women farmers in developing countries. (shrink)