BackgroundThe state of the world is one with scarce medical resources where longevity is not equally distributed. Given such facts, setting priorities in health entails making difficult yet unavoidable decisions about which lives to save. The business of saving lives works on the assumption that longevity is valuable and that an early death is worse than a late death. There is a vast literature on health priorities and badness of death, separately. Surprisingly, there has been little cross-fertilisation between the academic (...) fields of priority setting and badness of death. Our aim is to connect philosophical discussions on the badness of death to contemporary debates in health priorities.DiscussionTwo questions regarding death are especially relevant to health priorities. The first question is why death is bad. Death is clearly bad for others, such as family, friends and society. Many philosophers also argue that death can be bad for those who die. This distinction is important for health priorities, because it concerns our fundamental reasons for saving lives. The second question is, ‘When is the worst time to die?’ A premature death is commonly considered worse than a late death. Thus, the number of good life years lost seems to matter to the badness of death. Concerning young individuals, some think the death of infants is worse than the death of adolescents, while others have contrary intuitions. Our claim is that to prioritise between age groups, we must consider the question of when it is worst to die.ConclusionsDeprivationism provides a more plausible approach to health priorities than Epicureanism. If Deprivationism is accepted, we will have a firmer basis for claiming that individuals, in addition to having a health loss caused by morbidity, will have a loss of good life years due to mortality. Additionally, Deprivationism highlights the importance of age and values for health priorities. Regarding age, both variants of Deprivationism imply that stillbirths are included in the Global Burden of Disease. Finally, we suggest that the Time-Relative Interest Account may serve as an alternative to the discounting and age weighting previously applied in the Global Burden of Disease. (shrink)

In the Global Burden of Disease study, disease burden is measured as disability-adjusted life years (DALYs). The paramount assumption of the DALY is that it makes sense to aggregate years lived with disability (YLDs) and years of life lost (YLLs). However, this is not smooth sailing. Whereas morbidity (YLD) is something thathappens toan individual, loss of life itself (YLL) occurs when that individual’s life has ended. YLLs quantify something that involves no experience and does not take place among living individuals. (...) This casts doubt on whether the YLL is an individual burden at all. If not, then YLDs and YLLs are incommensurable. There are at least three responses to this problem, only one of which is tenable: a counterfactual account of harm. Taking this strategy necessitates a re-examination of how we count YLLs, particularly at the beginning of life. (shrink)

In recent years, it has become commonplace among the Global Burden of Disease study authors to regard the disability-adjusted life year primarily as a descriptive health metric. During the first phase of the GBD, it was widely acknowledged that the DALY had built-in evaluative assumptions. However, from the publication of the 2010 GBD and onwards, two central evaluative practices—time discounting and age-weighting—have been omitted from the DALY model. After this substantial revision, the emerging view now appears to be that the (...) DALY is primarily a descriptive measure. Our aim in this article is to argue that the DALY, despite changes, remains largely evaluative. Our analysis focuses on the understanding of the DALY by comparing the DALY as a measure of disease burden in the two most significant phases of GBD publications, from their beginning to the most recent releases. We identify numerous assumptions underlying the DALY and group them as descriptive or evaluative. We conclude that while the DALY model arguably has become more descriptive, it remains, by necessity, largely evaluative. (shrink)

Volume 19, Issue 5, May 2019, Page 31-33.

The overarching aim of this article is to scrutinize how severity can work as a qualifier for the moral impetus of malady. While there is agreement that malady is of negative value, there is disagreement about precisely how this is so. Nevertheless, alleviating disease, injury, and associated suffering is almost universally considered good. Furthermore, the strength of a diseased person’s moral claims for our attention and efforts will inevitably vary. This article starts by reflecting on what kind of moral impetus (...) malady incites. We then analyze how severity may qualify this impetus. We do so by discussing the relationship between severity and need, well-being and disvalue, death, urgency, rule of rescue, and distributive justice. We then summarize our thoughts about severity as a moral qualifier. We conclude that severity is, and should continue to be seen, as a morally significant concept that deserves continued attention in the future. (shrink)

Det er muligens ikke lenger et spørsmål om, men når mennesker med Downs syndrom ikke lenger finnes blant oss. Moderne medisinsk teknologi brukt i masseundersøkelser av gravide, tilsier at det nesten ikke behøver å bli født mennesker med Downs syndrom i fremtiden. I den politiske debatten i flere av de nordiske landene er dette kontroversielt. Det handler om et samfunn der det er plass til alle, hevdes det. På samme tid tas moderne genteknologi i bruk for bl.a. å forhindre at (...) mennesker disponert for Huntingtons sykdom eller arvelig brystkreft blir født. Om noen generasjoner kan slike sykdommer være utryddet. Dette påkaller imidlertid ikke henvisninger til «sortering» og «seleksjon». I denne artikkelen undersøkes de viktigste forutsetningene for hvorfor fosterdiagnostikk på noen indikasjoner vekker etisk debatt, mens det ikke skjer i andre tilfeller. Det argumenteres for at den medisinske forståelsen av alvorlighetsgrad ved en sykdom/funksjonshemming ikke gir oss nøkkelen til å forstå den etiske bekymringen rundt seleksjon. Identitets- og anerkjennelsesproblematikk, hevdes det, er kjernen i kontroversene rundt fosterdiagnostikk i Norden. Derfor står det noe vesentlig på spill i fosterdiagnostikkdebatten. Men bare for noen grupper. (shrink)

The welfare of the child is the prevailing principle and concern regarding access to assisted reproduction in Western countries today, and there is a wish to avoid harm to future children. New research fields have developed in order to provide scientific evidence on the welfare of children living with different “types” of parents. Assisted reproductive technologies (ART) seems to be heading in a responsible direction where the care and concern for future children is vital. However, the claim of this article (...) is that the principle of the welfare of the child confuses the ethical framing of ART. Several philosophers in the past have argued that potential people must be regarded as outside the moral domain, and therefore cannot be harmed or benefitted. This message has not reached the policymakers, probably because the welfare of the child principle seems to fit so elegantly with common sense. In this article a different ethical framing of ART is proposed. The author argues that “futile care” and not “the welfare of the child” should be the guiding principle for eventually rejecting access to ART. The desired goal of ART treatment should be understood to be the production of functional families. Assisted reproduction is primarily about us, actual people in an actual society, and how potential children may affect us. (shrink)

Adopting the methods of Ethnomethodology and Conversation Analysis, this article aims to add to our knowledge of the dynamics and resistance in professional-client encounters. It does this by examining the argumentative function of second-hand assessments in the setting of vocational rehabilitation. In the situated negotiation of appropriate work-targeted initiatives, the practice of reporting second-hand assessments functions either as ‘opposing’ the professional’s investigations, or, when used in initiating turns, as ‘promoting’ the client’s case. Regarding the first, second-hand assessments provide opportunities to (...) oppose and redirect the institutional agenda. That is, the issue introduced by the professional is fended off more or less openly through second-hand accounts, which provide a presumptive better grasp on the matter at hand. (shrink)

Few sports-related events have generated as much controversy as the steroid crisis in baseball. Both ardent fans and casual observers wonder why professional baseball players would choose to use such substances when their use was viewed as outside the bounds of fair play. This article attempts to answer that question by applying concepts from the area of organizational culture. Understanding the culture of baseball and the ways leaders embedded and strengthened that culture adds insight into the decisions by athletes to (...) engage in steroid use. In general, such use was consistent with the already-existing culture. In addition, key decisions and events likely created the conditions in which steroid use was more likely. (shrink)

Families have a right to privacy, but we know little about how the public–private boundary is negotiated at the micro level in educational settings. Adopting ethnomethodology, the paper examines how talk about the home situation was occasioned and managed in ten parent–teacher conferences in early childhood education and care (ECEC), with a special focus on the ECEC teacher’s strategies for eliciting family information. The paper demonstrates a continuum of interactional practices which, in various degrees, make parents accountable for providing family (...) information. The analysis shows that parents both volunteer and provide the pursued information, thus actively orienting to the norm of visibility in child rearing. However, although both parties orient to questioning and fishing as business as usual, the parents’ accounts sometimes had an excusing quality or they adopted a reserved communication style, suggesting a certain ambivalence as well. The paper outlines different ways of understanding the present partnership ideal in parent–teacher teacher cooperation with implications for the negotiation of privacy. The paper also addresses training, which can contribute to staff and student reflections on the management of the public–private boundary. (shrink)

In welfare encounters, clients may from time to time report about other peoples’ doings in ways that are heard as more or less downgrading. This article examines how these reports are brought off in Norwegian vocational rehabilitation encounters, and especially, how the professional party aligns. Do such practices represent what Levinson calls ‘allowable contributions’ in the vocational rehabilitation meeting or are they treated as matter out of place? The analysis of five data extracts suggests that it is very important for (...) the reception that the report is well contextualized and attuned to the institutional agenda. The counsellors displayed a neutral but cooperative alignment to reports integrated neatly in the business-at-hand in a top-down fashion. Here, the reports served as a tool to inform the recipient about the client’s own character and/or her experience of the rehabilitation process. However, in the two latter cases, where the client had a more initiating role, the reports appeared to have a more humorous or entertaining function. In response, the counsellors did not display alignment but searched for institutional relevance before re-contextualizing the report into a proper context. This suggests that out-of-frame reports about other people delivered on a humorous footing do not straightforwardly fall into the category of ‘allowable contributions’ in this setting. (shrink)

In a recent paper— The disvalue of death in the global burden of disease 1—we question the commensurability of the two components of the disability-adjusted life year (DALY)— years lived with disability (YLDs) and years of life lost (YLLs)—and offer a tentative solution to this problem. In an exciting and constructive reply— Is consistency overrated? 2—philosopher S Andrew Schroeder argues that our concern about the DALY may be missing the mark by accepting the DALY as what he refers to as (...) an index reflecting nothing ‘beyond the importance we place in each (DALY component)’. According to Schroeder, our consistency requirement is then made redundant. Recall our main argument: the DALY is the arithmetical sum of two components, YLDs and YLLs. The YLDs represents the individual disease burden that occurs while we are alive, while YLLs represents the individual disease burden resulting from our death. ‘Death’, in this context, is not the process of dying, which happens within life and which is captured by YLDs, but rather the incidence in which the life of a person has ended. Understood this way, the DALY is the aggregate of life and death, and we argue that these are incommensurables. Why are YLDs and YLLs incommensurables? In our article, we present several reasons for this. Briefly, YLDs measure disease burden that happens to an individual, whether it be painful experiences or loss of function. YLDs have a duration and are usually something we experience, such as pain. YLLs, on the other hand, are instantly generated when the life of that individual has expired. We do not experience YLLs, and they happen where we are not. When YLLs are generated, the life in question has already ended. On a secular account, death is the irreversible cessation of the mind and the senses, and …. (shrink)

We describe our clinical experience in treating patients with Tourette syndrome and other tic disorders using infra-low frequency neurofeedback, often in conjunction with cognitive behavior therapy. Following a narrative description of our approach, we present outcome data for 100 successive cases. Many of the children and adolescents that we have treated since 2005 did not derive sufficient benefit from standard treatment for Tourette syndrome and other tic disorders. In our clinical experience, based on extensive before- and after- testing and symptom (...) tracking, this patient group derived significant additive benefit from complementary neurofeedback treatment. The majority of trainees attained a higher level of functioning and were able to live up to their potential in a way they were not able to prior to neurofeedback treatment. (shrink)

Dette nummeret av Etikk i praksis er i utgangspunktet ikke et temanummer. Profesjonsetiske utfordringer synes likevel å utgjøre et gjennomgangstema i de fleste av artiklene som utgis i dette nummeret. Det er en påminnelse om at en aldri blir ferdig med etiske problemstillinger innenfor et fagfelt, siden fagfeltene og profesjonelle oppgaver samt forventninger til profesjonen forandres hele tiden.

Advances in neonatology have led to improved survival for periviable infants. Immaturity still carries a high risk of short- and long-term harms, and uncertainty turns provision of life support int...

Death is something we mourn or fear as the worst thing that could happen―whether the deaths of close ones, the deaths of strangers in reported accidents or tragedies, or our own. And yet, being dead is something that no one can experience and live to describe. This simple truth raises a host of difficult philosophical questions about the negativity surrounding our sense of death, and how and for whom exactly it is harmful. The question of whether death is bad has (...) occupied philosophers for centuries, and the debate emerging in philosophical literature is referred to as the "badness of death." Are deaths primarily negative for the survivors, or does death also affect the deceased? What are the differences between death in fetal life, just after birth, or in adolescence? In order to properly evaluate deaths in global health, we must find answers to these questions. -/- In this volume, leading philosophers, medical doctors, and economists discuss different views on how to evaluate death and its relevance for health policy. This includes theories about the harm of death and its connections to population-level bioethics. For example, one of the standard views in global health is that newborn deaths are among the worst types of death, yet stillbirths are neglected. This raises difficult questions about why birth is so significant, and several of the book's authors challenge this standard view. -/- This is the first volume to connect philosophical discussions on the harm of death with discussions on population health, adjusting the ways in which death is evaluated. Changing these evaluations has consequences for how we prioritize different health programs that affect individuals at different ages, as well as how we understand inequality in health. (shrink)

The unknown nature of tomorrow’s research makes informed consent in biobank research a challenge. Whether the consent given by biobank participants is ‘broad’ or ‘narrow’, the ever present question remains the same: are new activities covered by the original consent? In this article, we focus on the meaning of, and the relation between, broad consent and re-consent in biobank research. We argue that broad consent should be understood as consenting to a framework—a framework which covers aims, core conditions for acceptable (...) use, governance and how these affect participants. Changes that alter the framework in a fundamental way call for re-consent. Three biobank cases of current international interest are used to debate when re-consent is an ethical necessity: whole-genome sequencing, data sharing and commercial utilization. These reflections give us a more nuanced view on what consent is for. We claim that the introduction of broad consents in biobank research has not represented a betrayal of individual participant interests, as some critics have asserted. Broad consents combined with the possible use of re-consent are in certain settings not inferior, but rather ethically superior to narrow consents. In population-based research biobanks, they allow for a reconciliation between individual interest and public matters in society at large. (shrink)

The aim of this article is to study the relationship between Epicureanism and pandemic priority-setting and to explore whether Epicurus's philosophy is compliant with the later developed utilitarianism. We find this aim interesting because Epicurus had a different way of valuing death than our modern society does: Epicureanism holds that death—understood as the incident of death—cannot be bad (or good) for those who die (self-regarding effects). However, this account is still consistent with the view that a particular death can be (...) bad for everyone else but those who die, such as family, friends, and society (other-regarding effects). During the pandemic, the focus has been on the number of deaths more than on the suffering and reduced well-being of those infected and the rest of society. However, since the pandemic requires prioritization, it is, on a utilitarian account, important to consider priorities that do the most good overall. In this article, we approach the harm of death from an Epicurean point of view, seeking to flesh out potential implications for pandemic priority-setting, and healthcare in general, using a case study of COVID-19 priority-setting. We also explore whether this would conflict with utilitarianism. We conclude that an Epicurean pandemic priority-setting approach would be different but, surprisingly, not radically different from many of the actual priority-setting decisions we saw under the COVID-19 pandemic. (shrink)

John McDowell and Hubert L. Dreyfus are philosophers of world renown, whose work has decisively shaped the fields of analytic philosophy and phenomenology respectively. Mind, Reason, and Being-in-the-World: The McDowell-Dreyfus Debate opens with their debate over one of the most important and controversial subjects of philosophy: is human experience pervaded by conceptual rationality, or does experience mark the limits of reason? Is all intelligibility rational, or is there a form of intelligibility at work in our skilful bodily rapport with the (...) world that eludes our intellectual capacities? McDowell and Dreyfus provide a fascinating insight into some fundamental differences between analytic philosophy and phenomenology, as well as areas where they may have something in common. Fifteen specially commissioned chapters by distinguished international contributors enrich the debate inaugurated by McDowell and Dreyfus, taking it in a number of different and important directions. Fundamental philosophical problems discussed include: the embodied mind, subjectivity and self-consciousness, intentionality, rationality, practical skills, human agency, and the history of philosophy from Kant to Hegel to Heidegger to Merleau-Ponty. With the addition of these outstanding contributions, Mind, Reason, and Being-in-the-World is essential reading for students and scholars of analytic philosophy and phenomenology. (shrink)

Published in 1721 by the prominent Puritan clergyman Cotton Mather, The Christian Philosopher was the first comprehensive book on science to be written by an American. Building on natural theology, Mather demonstrated the harmony between religion and the new science associated with Sir Isaac Newton. His survey of all the known sciences from astronomy and physics to human anatomy presented evidence that both celestial and terrestrial phenomema imply an intelligent designer. Winton Solberg's introduction places Mather's treatise in its widest (...) historical context. In addition to tracing the origins and sources of Mather's work, Solberg analyzes the book's contents, its reception, and its significance in American intellectual and cultural history. This edition affirms Mather's importance to American thought as a deeply religious intellectual who introduced the Enlightenment to America. (shrink)

Criminologists have long acknowledged the link between a number of cognitive deficits, including low intelligence and impulsivity, and crime. A new wave of research has demonstrated that pharmacological intervention can restore or improve cognitive function, particularly executive function, and restore neural plasticity. Such restoration and improvement can allow for easier acquisition of new skills and as a result, presents significant possibilities for the criminal justice system. For example, studies have shown that supplements of Omega-3, a fatty acid commonly found in (...) food such as tuna, can decrease frequency of violent incidents in an incarcerated population. Research has also begun to explore the use of selective serotonin reuptake inhibitors to reduce impulsivity in some violent offenders. However, there are significant legal and ethical implications when moving from dietary supplements to prescription pharmaceuticals and medical devices for cognitive intervention. This paper will explore the legal and ethical issues surrounding the use of pharmacological intervention on prisoners as an effort to reduce crime and recidivism. (shrink)

PurposeSocial media has increased as a marketing channel, and Facebook is the biggest social media company globally. Facebook contains both positive and negative information about companies; therefore, it is important for companies to manage their Facebook page to best serve their own interests. Although most users are familiar with business and marketing activities on Facebook, they use it primarily for fun and personal purposes. The most effective methods for companies to use Facebook have not been clear. The personal nature of (...) Facebook presents unique challenges for companies by raising ethical and social responsibility issues that are important to users. The purpose of this paper is to discover how companies can optimize their use of Facebook as a marketing channel.Design/methodology/approachA survey was conducted. The respondents were 158 users of Facebook in Sweden; complete answers were provided by all respondents. In a series of specific questions and comments, the respondents were asked to describe an optimal marketing solution on Facebook for companies. They rated different functions, which were illustrated with pictures, to help in the cognitive process and to avoid misunderstandings.FindingsMost users who have an opinion on the issue accept marketing on Facebook, but only in the right amount. There are basically two groups: those who think that companies have no place on Facebook and those who want companies to be active on Facebook. The latter group emphasizes the importance of meaningful posts without unsolicited sales messages, and would prefer to search for the companies themselves rather than being bombarded by company messages. By far, status updates and pictures/images were found to be the most important functions to respondents.Research limitations/implicationsThe sample consisted of only Swedish users. Another limitation was that, since many Facebook users do not normally think about the implications of being exposed to marketing on Facebook, they have difficulty taking a position on many issues related to the service.Practical implicationsThe results give companies a clear idea of how to effectively use Facebook in their marketing efforts.Originality/valueA large number of companies are currently asking themselves, “How can we use Facebook in an optimal way?” The results in this study answer this question and lead directly to saving time and resources for these companies. (shrink)

It is common to cite the child’s “right to an open future” in discussions of how parents and the state may and should treat children. However, the right to an open future can only be useful in these discussions if we have some method for deriving the content of the right. In the paper in which he introduces the right to an open future Joel Feinberg seems to provide such a method: he derives the right from the content of adult (...) autonomy rights. In this paper I argue that his argument fails. If it is to give us guidance about the content of the child’s right to an open future, then the right should be interpreted as a right to a maximally open future. But this strong interpretation is unjustified: the arguments that can be found in Feinberg in favor of the right are invalid, and, in any case, this interpretation has implausible implications. A moderate interpretation of the right to an open future, according to which children have a right to acquire some reasonable range of skills and options, is more plausible. However, if a moderate interpretation is correct, there is not only no argument in Feinberg to support it, there is also no method for deriving the content of the right. Without such a method we have to bring in other moral considerations in order to work out the limits on parental discretion and what children are owed. The right to an open future then does no normative work. (shrink)

(1) The average Mum has 2.4 children. (2) The number of Argle’s fingers equals the number of Bargle’s toes. (3) There are two possible ways in which Joe could win this chess game. In the right contexts, and outside the philosophy room, all the above sentences may be completely uncontroversial. For instance, if we know that Joe could win either by exchanging queens and entering an endgame, or by initiating a kingside attack then, if ignorant of Quine’s work on ontology, (...) we would take (3) to be uncontroversially true. (shrink)

Minkoff et al. (2024) discuss the potential deprivation of medical liberties against pregnant persons following Dobbs v. Jackson Women’s Health. Another consideration is how Dobbs may impact physic...

Norway’s liberal abortion law allows for abortion on social indications, yet access to screening for fetal abnormalities is restricted. Norwegian regulation of, and public discourse about prenatal screening and diagnosis has been exceptional. In this study, we wanted to investigate whether the exceptional regulation is mirrored in public attitudes. An electronic questionnaire with 11 propositions about prenatal screening and diagnosis was completed by 1617 Norwegian adults (response rate 8.5%). A majority of respondents supports increased access to prenatal screening with ultrasound (...) (60%) and/or full genome sequencing of fetal DNA (55%) available for all pregnant women. Significant minorities indicate, however, that a public offer of prenatal screening for all pregnant women would signal that people with Down syndrome are unwanted (46%) or could be criticized for contributing to a ‘sorting society’ (48%). Results indicate deeper ambivalences and a cultural sensitivity to the ethical challenges of prenatal screening and subsequent abortions. The specific diagnosis of Down syndrome and the fear of becoming a ‘sorting society’ which sorts human life due to diagnoses, appear to play prominent roles in citizen deliberations. The low response rate means that a non-response bias cannot be excluded, yet reasons why results are still likely to be of value are discussed. (shrink)

This study explores how and why simulation training facilitates professional learning by investigating how simulators and simulations are used and conceptualized in two professional domains, nursing and maritime navigation, and offer a reconceptualization. Our aim is to move beyond past theorizing of simulators and simulations that has mainly centered on representational issues like validity, fidelity, and authenticity. Instead, we approach simulators as epistemic objects and simulations as epistemic practices. These concepts offer a lens to examine the situated and sociomaterial practices (...) that make simulators into simulations and simulations into entry points to the epistemic culture of a profession. As a result, we pinpoint three central mechanisms for transforming the simulation experience into an event that facilitates the enrollment of students into their future profession. The first mechanism involves the instructional practice of “filling in” aspects of the work context that might be missing in the simulator. The second mechanism, sometimes labeled the “as-if” mode of simulations, manifests through the participants’ ongoing commitment to treat the simulation as-if it was a real professional encounter. The third relates to how simulation-based learning activities afford a crucial pedagogical orientation towards defining what constitutes exemplary professional practice in specific training situations. (shrink)

The nature of biological order.--The deployment of biological order.--The hierarchical continuity of biological order.--Bibliography (p. xvi-xvii).

Particularism's model of explanation is challenged on the ground that a sensible intelligibility principle requires that there must be an explanation for the difference between a good and a bad action. Raz is concerned with what it is to be guided by reason, as well as with the results of the fact that reason can often undermine particular outcomes. What determines the moral status of an action must extend beyond what the agent's reason for acting is. It is argued that (...) there is a clear distinction between the evaluative and guiding functions of reasons. (shrink)

Rosamond Rhodes and John Harris have both recently argued that we all have a general moral duty to participate in medical research. However, neither Rhodes' nor Harris' arguments in support of this obligation stand up to scrutiny, and severe and convincing criticism has been levelled against their case. Still, to refute their arguments is not to refute the conclusion. There seems to be some truth in the view that when people are asked to take part in medical research, their choice (...) is not completely morally neutral. In this article, we argue that the proper question to ask is when, rather than if, a certain moral duty to volunteer for medical research can be appealed to. To answer this question, we need a denser description of relevant research projects and their context rather than just describing medical research in general. Drawing on our study of participants in the Norwegian HUNT biobank, we use the normative implications of the Norwegian concept «dugnad» as an analogy to discuss the requirement of providing neutral information to potential biobank participants in order to promote their free and informed decision as to whether or not to take part. We suggest that normative recruitment is not just a question of principles and ethics. It is also a question of research design and the creation of the common good in the community where the research takes place. (shrink)

The legalization of physician-assisted suicide (PAS) in various U.S. states draws into question the interpretation of the cardinal virtues of medicine, including beneficence, non-maleficence, auton...

It is sometimes argued that medical professionals should protect a future child's rights by prohibiting disabled parents from using technology to deliberately have a disabled child because disability is taken as an inevitable, severe threat to a child's otherwise “open” future. I will first argue that the open future that allegedly protects a child's future autonomy is precluded by the very conditions needed to develop that future autonomy. Any child's future will be narrowed as they are socialized in a way (...) that gives them the capacity for autonomous choice. However, oppressive master narratives can diminish a future child's autonomy by distorting their narrative identity and constricting their agency. In fact, the open future argument does just this by advancing one of the most damaging master narratives about disability: that disability inevitably and severely restricts a person's autonomy and closes their future. (shrink)

Citing some recent experimental findings, I argue for the surprising claim that in some cases the less time you have the more you know. More specifically, I present some evidence to suggest that our ordinary knowledge ascriptions are sometimes sensitive to facts about an epistemic subject's truth-irrelevant time constraints such that less is more. If knowledge ascriptions are sensitive in this manner, then this is some evidence of pragmatic encroachment. Along the way, I consider comments made by Jonathan Schaffer and (...) Jennifer Nagel to construe a purist contextualist and a strict invariantist explanation of the data respectively, before giving reasons to resist them in favor of an account that indicates pragmatic encroachment. If successful, this may suggest a new way to argue for the controversial thesis that there is pragmatic encroachment on knowledge. (shrink)