Is reasoning about religious ritual tethered to ordinary, nonreligious human reasoning about actions? E. Thomas Lawson and Robert N. McCauley’s ritual form hypothesis constitutes a cognitive approach to religious ritual – an explanatory theory that suggests people use ordinary human cognition to make specific predictions about ritual properties, relatively independent of cultural or religious particulars. Few studies assess the credibility ofrfhand further evidence is needed to generalize its predictions across cultures. Towards this end, we assessed culturally Chinese “special patient” rituals (...) in Singapore. Our findings strongly supportrfhpredictions for special patient ritual repeatability, reversibility, sensory pageantry and emotionality. (shrink)

It is well-known that people will adjust their first-order beliefs based on observations of others. We explore how such adjustments interact with second-order beliefs regarding universalism and relativism in a population. Across a range of simulations, we show that populations where individuals have a tendency toward universalism converge more quickly in coordination problems, and generate higher total payoffs, than do populations where individuals have a tendency toward relativism. Thus, in contexts where coordination is important, belief in universalism is advantageous. However, (...) we also show, across a range of simulations, that universalism will enshrine inequalities and eliminate diversity, and in these cases it seems that relativism has its own advantages. (shrink)

This book explores 'difficult conversations' in feminist theory as an integral part of social and theoretical transformations. Focussing on intersectionality within feminist theory, this book critically addresses questions of power and difference as a central feminist concern, rather than assuming that the needs and experiences of elite women apply to all women. It presents ethical, political, social, and emotional dilemmas while negotiating difficult conversations, particularly in terms of sexuality, class, 'race', ethnicity, and cross-identification between the researcher and researched. Topics covered (...) include challenging cultural relativism; queer marginalisation; research and affect; and feminism and the digital realm. This book is aimed primarily at students, lecturers and researchers interested in epistemology, research methodology, gender, identity, and social theory. The interdisciplinary nature of the book is aimed at reaching the broadest possible audience, including those engaged with feminist theory, anthropology, social policy, sociology, psychology, and geography. (shrink)

The role of epistemology in philosophy of religion has transformed the discipline by diverting questions away from traditional metaphysical issues and toward concerns about justification and warrant. Leaders responsible for these changes, including Plantinga, Alston and Draper, use methods and arguments fromScottish Enlightenment figures. In general theists use and cite techniques pioneered by Reid and non-theists use and cite techniques pioneered by Hume, a split reduplicated among cognitive scientists of religion, with Justin Barrett and Scott Atran respectively framing their (...) results in Reid’s and in Hume’s language and argument. This state of affairs sets our agenda. First we identify Reid’s use in the epistemology of religion and in the cognitive science of religion. Then we turn to Reid’s texts in an effort to assess the interpretations and extrapolations of Reid given by participants in these debates. The answers to our research questions shed light on what Reid would believe today, were he apprised of the latest research in epistemology of and cognitive science of religion. (shrink)

This study compares two autobiographical descriptions of illness – the seventeenth-century John Donne's Devotions Upon Emergent Occasions and the twentieth-century Cornelius and Kathryn Ryan's A Private Battle . I begin by identifying the basic structure in both narratives as parallel to that of the case history, and then show how each individual's experience is shaped by the conditions of illness appropriate to their respective cultures. Lastly, I discuss the way in which both authors understand and represent sickness, as well (...) as their respective therapies, in terms of a particular metaphoric construct: for Donne, it is the analogy between illness of the body and illness of the soul; for Ryan it is the analogy between Ulness and war. The stance of each towards his illness is conditioned by this metaphoric model: Donne's is one of acceptance, of conforming to the will of God; Ryan's is one of resistance, of fighting heroically until the very end. Thus these metaphors are functional as well as aesthetic: they serve as figural modalities whereby the patient/author hopes to transcend his illness. Keywords: illness, patients, autobiography CiteULike Connotea Del.icio.us What's this? (shrink)

John Martin Fischer has argued that Molinism does not constitute a response to the argument that divine foreknowledge is incompatible with human freedom. I argue that T. Ryan Byerly’s recent work on the mechanics of foreknowledge sheds light on this issue. It shows that Fischer’s claim is ambiguous, and that it may turn out to be false on at least one reading, but only if the Molinist can explain how God knows true counterfactuals of freedom.

"More recently, cognitive psychologists have used the resources of psychological science to study the foundations of religion, and to discuss and possibly illuminate issues of concern for theologians. The new field, known as the cognitive science of religion, draws from work by Ernest Thomas Lawson, Robert McCauley, Pascal Boyer and Justin Barrett, among others. Many of its scholars are inspired by a spirit of collaborative work with theologians and philosophers of religion, emphasizing the need of serious cross-training between disciplines. (...) Driven by the same spirit, the present issue of Scientia et Fides documents instances of integrative work at the intersection of psychological science and philosophical or theological knowledge, specifically centered around our understanding of what a person is. We hope that, apart from their individual worth, as a whole these contributions will stimulate further interdisciplinary studies, in order to achieve genuine science-engaged philosophy and theology, and a science that is aware of philosophical and theological discussions.". (shrink)

The dominant approach to assessing decision-making capacity in medicine focuses on determining the extent to which individuals possess certain core cognitive abilities. Critics have argued that this model delivers the wrong verdict in certain cases where patient values that are the product of mental disorder or disordered affective states undermine decision-making without undermining cognition. I argue for a re-conceptualization of what it is to possess the capacity to make medical treatment decisions. It is, I argue, the ability to track one’s (...) own personal interests at least as well as most people can. Using this idea, I demonstrate that it is possible to craft a solution for the problem cases—one that neither alters existing criteria in dangerous ways (e.g. does not open the door to various kinds of abuse) nor violates the spirit of widely accepted ethical constraints on decision-making assessment. (shrink)

What role should the physician's conscience play in the practice of medicine? Much controversy has surrounded the question, yet little attention has been paid to the possibility that disputants are operating with contrasting definitions of the conscience. To illustrate this divergence, we contrast definitions stemming from Abrahamic religions and those stemming from secular moral tradition. Clear differences emerge regarding what the term conscience conveys, how the conscience should be informed, and what the consequences are for violating one's conscience. Importantly, these (...) basic disagreements underlie current controversies regarding the role of the clinician's conscience in the practice of medicine. Consequently participants in ongoing debates would do well to specify their definitions of the conscience and the reasons for and implications of those definitions. This specification would allow participants to advance a more philosophically and theologically robust conversation about the means and ends of medicine. (shrink)

Pleasure and Desire The Case of Hedonism Reviewed.

The objective of this paper is to posit a critique of the contemporary critique of the notion of selfhood in the philosophy of mind and cognitive neuroscience. The research in artificial intelligence (AI) as the science of intelligence per se and/or of cognition, in general, has been considered and employed as a formidable theoretical tool in sustaining philosophical arguments for the denial of the existence of the Self or selfhood in the human person. It has revitalized the philosophical problematics of (...) the existence or otherwise, of consciousness, intelligence, and autonomy not only in biological systems but also in non-biological systems and the deepening of the body-soul and/or brain-mind problem in the philosophy of mind. This paper will give an exposition of the critique of selfhood in the human person, especially as expounded by Daniel Dennett. It will also posit a counter-critique of the critique of selfhood based on John Eccles’s dualistic-interactionalist philosophy of neuroscience and Karol Wojtyła’s philosophical anthropology based on the notion of suppositum. Hence, it shall defend the philosophical anthropology of the human person as a metaphysical suppositum possessing ontological subjectivity. (shrink)

This is a paper about the nature of metaphysical laws and their relation to the phenomenon of vagueness. Metaphysical laws are introduced as analogous to natural laws, and metaphysical indeterminism is modeled on causal indeterminacy. This kind of indeterminacy is then put to work in developing a novel theory of vagueness and a solution to the sorites paradox.

Suppose I hear from a trusted friend that The Shining is scary. Believing them, I decide not to watch the film. Later, we're talking about the movie and I say, “The Shining is scary!” My assertion here is misleading and inappropriate—I misrepresent myself as having seen the film and judged whether it is scary. But why is this? In this paper, I clarify the scope of the observation, discuss existing explanations of it, and argue that they are all lacking. I (...) argue that the observation is best explained as a particular instance of a general norm which holds that authorities should make assertions about matters in their authority only if they have judged those matters for themselves. Along the way, I offer a theory of judgment which distinguishes it from mere belief. (shrink)

Medical ethics would be better if people were taught to think more clearly about well-being or the concept of what is good for a person. Yet for a variety of reasons, bioethicists have generally paid little attention to this concept. Here, I argue, first, that focusing on general theories of welfare is not useful for practical medical ethics. I argue, second, for what I call the “theory-without-theories approach” to welfare in practical contexts. The first element of this approach is a (...) focus on examining important and relatively uncontroversial constituents of welfare as opposed to general theories. The second key element is a framework for thinking about choice in relation to welfare, a framework I refer to as “the mild objectivity framework.” I conclude with illustrations of the way in which the “theory without theories approach” can improve thinking in medicine. (shrink)

Research on the relationship between religious commitment and business ethics has produced widely varying results and made the impact of such commitment unclear. This study presents an empirical investigation based on a questionnaire survey of business managers and professionals in the United States yielding a database of 1234 respondents. Respondents evaluated the ethical acceptability of 16 business decisions. Findings varied with the way in which the religion variable was measured. Little relationship between religious commitment and ethical judgment was found when (...) responses were compared on the basis of broad faith categories – Catholic, Protestant, Jewish, other religions, and no religion. However, respondents who indicated that religious interests were of high or moderate importance to them demonstrated a higher level of ethical judgment (less accepting of unethical decisions) than others in their evaluations. Evangelical Christians also showed a higher level of ethical judgment. (shrink)

The question of whether chemical structure is reducible to Everettian Quantum Mechanics (EQM) should be of interest to philosophers of chemistry and philosophers of physics alike. Among the three realist interpretations of quantum mechanics, EQM resolves the measurement problem by claiming that measurements (now interpreted as instances of decoherence) have indeterminate outcomes absolutely speaking, but determinate outcomes relative to emergent worlds (Maudlin, 1995). Philosophers who wish to be sensitive to the practice of quantum chemistry (e.g. Scerri, 2016) should be interested (...) in EQM because Franklin and Seifert (2020) claim that resolving the measurement problem also resolves the reducibility of chemical structure, and EQM is the interpretation which involves no mathematical structure beyond that used by practicing scientists. Philosophers interested in the quantum interpretation debate should be interested in the reducibility of chemistry because chemical structure is precisely the kind of determinate three-dimensional fact which EQM should be able to ground if it is to be empirically coherent (see Allori, 2023). The prospects for reduction of chemical structure are poor if it cannot succeed in EQM; the prospects for EQM as a guide to ontology are poor if it cannot reduce chemical structure. -/- Unfortunately for proponents of chemical reduction and EQM, there are three serious barriers to the reduction of chemistry to EQM. The first concern is that quantum treatments of chemical structure rely on the Born-Oppenheimer approximation, which holds nuclear locations fixed while minimizing the energy of the electronic configuration (Hendry, 2022), but this approximation is not licensed by EQM. The Born-Oppenheimer approximation relies on nuclei and molecular orbitals being simultaneously present, but in the three-dimensional ontology following from the Everett interpretation these only emerge at different energy scales and are not simultaneously present (Miller, 2023). The second concern is that the emergent worlds of EQM are supposed to be decoherent at the macro-scale (A. Wilson, 2020), but the recent development of superchemistry suggests that chemical reactions can occur in coherent states (Zhang et al., 2023). The third concern is that emergent worlds are only pragmatic pseudo-processes (Wallace, 2012b), but this means EQM trades realist physics for mere instrumentalism about chemistry. Absent a commitment to chemical realism, reduction is an empty promise. The prospects for reduction of chemical structure to EQM are therefore poor. (shrink)

Over the last decade, a number of climate ethicists have turned their attention to the question of individual moral obligations to reduce greenhouse gas emissions. Important problems face their efforts, especially what is called the problem of inconsequentialism. The problems, I argue, arise largely from the failure to treat individual obligations as a matter of justice, a failure that stems from the common modern assumption that justice primarily concerns social institutions. I develop an alternative approach by appealing to the account (...) of justice as a virtue in Thomas Aquinas. This approach allows us to talk about individual obligations to reduce emissions as obligations of justice, even in the current context of institutional failure. At the same time, I argue that approaching climate change in Thomistic terms requires an important modification of Aquinas’s understanding of justice. (shrink)

Plato’s Republic is governed by an analogy drawn between the structures of cities and souls. Because the inner workings of souls are difficult to discern, we might better find the soul’s nature and virtues by looking at the city’s nature and virtues. Despite successfully using the analogy to discern the nature of the soul, its virtues, and its proper ordering, the Republic frequently obscures the very analogy that functions as its guiding thread, and it is not at all obvious whether (...) the political material in Books V–VII has a psychological correlate. This essay develops a psychological reading of key moments in the dialogue where the city-soul analogy fades in favor of more apparently political content. Focusing on the Allegory of the Cave, it argues that when the Cave is read as a “psychic drama,” it discloses reason’s drama within the soul. Like the freed prisoner, reason must be liberated from imprisonment alongside the sub-rational elements of the soul so that it may see the truth by which it can be nourished. However, reason must also descend, like the prisoner, to the sub-rational elements of the soul in order to care for them, for its own sake and for theirs. Read this way, the Republic presents an account of reason which rules the passions in the “precise sense” of Book I, that is, for their sake, and not simply for its own liberation and well-being. (shrink)

Christie, Brusse, et al. argue that the selected effects theory of function (SE) doesn’t do what it’s supposed to do: namely, show how functions can be explanatory. They survey some well-known evolutionary dynamics such as arms races, frequency-dependent fitness, and environmental heterogeneity, some of which have been discussed in the functions literature for decades. They argue that SE only seems to work because SE theorists ignore these dynamics. Their argument fails because they misrepresent what functions are supposed to explain and (...) how they’re supposed to do so. One reason for this failure is that they overlook the role of functions in the broader conversation about teleology in biology, one that has been unfolding for over 2000 years. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Journal of the History of Philosophy 39.4 (2001) 602-603 [Access article in PDF] Paul B. Thompson and Thomas C. Hilde, editors. The Agrarian Roots of Pragmatism. The Vanderbilt Library of American Philosophy. Nashville: Vanderbilt University Press, 2000. Pp. ix + 342. Cloth, $39.95. If "racial memory" is a viable concept, then the enduring paradigm of human productivity is agriculture, whose seventy-century dominion Western industry and urbanization have eclipsed only (...) within the last two hundred years. The fifteen essays collected here explore America's distinctive form of agrarianism: where individualism, democracy, and a seemingly endless frontier transcended European quarrels over "commons" versus "containment." These values also helped forge our indigenous philosophy—pragmatism—and it is the confluence of these two distinctive American forms that intrigues each of these authors.The essays fall roughly into three groups: 1) historical queries whose connection to pragmatism is marginal, 2) expositions of the agrarian roots of pragmatism, and 3) estimates of the influence of classical pragmatism on the recent rise of neoagrarianism. The first category offers sparkling essays by Charles Taliaferro, James Campbell, Paul B. Thompson, Robert S. Corrington, and Douglas R. Anderson. Together these scholars sketch a history from colonial times to the mid-twentieth century—from Jefferson's "noble agrarian" to the agony of reconstruction, which hastened the split between Northern transcendentalists and Southern romantics. There are some surprises: Franklin outshines even Jefferson with his balanced vision of self-improvement and community weal, and Jefferson's correspondent Crèvecoueur emerges as a visionary who foresaw farming as a wholesome and integrated way of life a century before Emerson and Thoreau. Thomas C. Hilde finds an engagingly pragmatic notion of community in Josiah Royce, and Richard E. Hart discovers Dewey's sense of concrete experience in the novels of John Steinbeck. The contributions of neglected figures such as Francois Quesnay, Liberty Hyde Bailey, John Brewster, and A Whitney Griswold are also recovered.Turning to the second group, though obviously an irresistible title the notion that classical pragmatism is robustly "rooted" in agrarianism is slightly disingenuous. Peirce and James have no direct ties to agrarianism. And though Dewey's themes of innovation, social intelligence, community, and a conception of experience broadly inclusive of organisms and environments reflect obvious affinities, they do not show that pragmatism grew directly from or is a variant of agrarianism. Happily, the pieces on Dewey contributed by Larry A. Hickman and Armen Marsoobian harbor no such illusions, [End Page 602] and Dewey is specifically disassociated from the claim that agriculture is a privileged form of experience.The third, and perhaps most significant, aim of the volume is to bring pragmatic insights into the recent groundswell toward neoagrarianism. Where traditional agrarianism was polarized between the domination of nature and its romantic beatification, the movement pioneered by Wendell Berry in the 1970s portrays the farmer as a nurturer whose goal is to seek an optimal harmony in the health of the land, the family, the community, and the country. In this James A. Montmarquet finds a Deweyan respect for an encompassing "situation," a unity of fact and value in stark opposition to the "corporate" mentality of specialization and success measured in economic gain alone. For Jeffrey Burkhardt, land grant universities must renew their original commitment to the family farm by distancing themselves from the forces of positivism and scientism—the technocrats and bio-chemical engineers who have imperiled both the land and the communities who depend upon it. Neither Montmarquette nor Burkhardt are looking for handouts, or for a return to the "idyllic" life of the one-horse plow. They emphasize moral training and a combination of practices designed to support the sustainability of the smaller farm in a competitive marketplace.One author compares the mention of agrarianism in philosophical discourse to committing a rude act in public. Clearly, however, mere "respectability" is not enough. If the contributors to this volume are correct, agrarianism is a lantern that may illuminate our ongoing search for wholeness and integrity. Frank X. Ryan Kent State University... (shrink)

Governments are subject to the requirements of justice, yet often seem to go above and beyond what justice requires in order to act in ways many people think are good. These kinds of acts – examples of which include putting on celebrations, providing grants to poets, and preserving historic architecture – appear to be acts of government supererogation. In this paper, I argue that a common view about the relationship between government, coercion, and justice implies that most such acts are (...) not supererogatory, but wrong. Many will find that conclusion unattractive, but rejecting the common view that implies it raises problems, too. (shrink)

How common are corporate codes of ethics in the UK and especially among Britain's most admired companies? The author is Wicklander Professor of Professional Ethics at DePaul University, Chicago, and current President of the American Society for Business Ethics.

I defend the principle of alternative possibilities against what are sometimes known as buffer cases, which are supposed by some to be counterexamples to the principle. I develop an existing problem with the claim that standard buffer cases are counterexamples to PAP, before responding to a recent attempt by Michael McKenna to modify the cases in a way that circumvents this problem. While McKenna’s strategy does avoid the problem, I argue that it faces a different difficulty. I conclude that buffer (...) cases pose no threat to PAP. (shrink)

Background Ethical climate refers to the shared perception of ethical norms and sets the scope for what is ethical and acceptable behaviour within teams. Aim This paper sought to explore perceptions of ethical climate amongst healthcare workers as measured by the Ethical Climate Questionnaire (ECQ), the Hospital Ethical Climate Survey (HECS) and the Ethics Environment Questionnaire (EEQ). Methods A systematic review and meta-analysis was utilised. PSYCINFO, CINAHL, WEB OF SCIENCE, MEDLINE and EMBASE were searched, and papers were included if they (...) sampled healthcare workers and used the ECQ, HECS or EEQ. Ethical consideration Ethical approval was not required. Results The search returned 1020 results. After screening, 61 papers were included ( n = 43 HECS, n = 15 ECQ, n = 3 EEQ). The overall sample size was over 17,000. The pooled mean score for the HECS was 3.60. Mean scores of individual studies ranged from 2.97 to 4.5. For the HECS studies, meta-regression was carried out. No relationship was found between the country of the studies, the study setting (ICU v non-ICU settings) or the mean years of experience that the sample had. For the ECQ, sub-scales had mean scores ranging from 3.41 (instrumental) to 4.34 (law) and were all observed to have significant and substantial heterogeneity. Three studies utilised the EEQ so further analysis was not carried out. Conclusions The above results provide insight into the variability of scores as measured by the HECS, ECQ and EEQ. To some extent, this variability is not surprising with studies carried out across 21 countries and in a range of healthcare systems. Results also suggest that it may be that more local and context specific factors are more important when it comes to predicting ethical climate. (shrink)

We carry out most of our epistemic projects as groups. Networks of individuals work together to identify questions, accumulate evidence, and settle on answers that lie beyond the ken of individual knowers. This is particularly important for controversial issues. And when it comes to ideologically contested issues, groups that are ideologically diverse in their membership are epistemically superior to groups that are ideologically homogenous. That’s because ideologically diverse groups are better at (a) identifying a representative sample of important questions, (b) (...) developing a wider range of potential answers, and (c) evaluating the evidence for and against each option. Awareness of this point produces a competence defeater for the relevant outputs of ideologically homogenous groups: they don’t deserve the high level of trust we often grant them. That, among other things, goes a long way towards justifying the public’s decreased trust in institutions like social networks, journalism, and universities. (shrink)

Discourses of ‘internationalisation’ of the curriculum of Western universities often describe the philosophies and paradigms of ‘Western’ and ‘Eastern’ scholarship in binary terms, such as ‘deep/surface’, ‘adversarial/harmonious’, and ‘independent/dependent’. In practice, such dichotomies can be misleading. They do not take account of the complexities and diversity of philosophies of education within and between their educational systems. The respective perceived virtues of each system are often extolled uncritically or appropriated for contemporary economic, political or social agendas. Critical thinking, deep learning, lifelong (...) and lifewide learning are heralded as the outcomes of Western education but these concepts are often under‐theorised or lack agreed meanings. Equally fuzzy concepts such as ‘Asian values’ or ‘Confucian education’ are eulogised as keys to successful teaching and learning when Asia prospers economically. They are also used to explain perceived undesirable behaviour such as plagiarism and uncritical thinking when Asian economies do not do so well. We argue that in general, educationists should be aware of the differences and complexities within cultures before they examine and compare between cultures. This paper uses the Confucian‐Western dichotomy as a case study to show how attributing particular unanalysed concepts to whole systems of cultural practice leads to misunderstandings and bad teaching practice. (shrink)

The use of a ‘human-centred’ artificial intelligence approach (HCAI) has substantially increased over the past few years in academic texts (1600 +); institutions (27 Universities have HCAI labs, such as Stanford, Sydney, Berkeley, and Chicago); in tech companies (e.g., Microsoft, IBM, and Google); in politics (e.g., G7, G20, UN, EU, and EC); and major institutional bodies (e.g., World Bank, World Economic Forum, UNESCO, and OECD). Intuitively, it sounds very appealing: placing human concerns at the centre of AI development and use. (...) However, this paper will use insights from the works of Michel Foucault (mostly _The Order of Things_) to argue that the HCAI approach is deeply problematic in its assumptions. In particular, this paper will criticise four main assumptions commonly found within HCAI: human–AI hybridisation is desirable and unproblematic; humans are not currently at the centre of the AI universe; we should use humans as a way to guide AI development; AI is the next step in a continuous path of human progress; and increasing human control over AI will reduce harmful bias. This paper will contribute to the field of philosophy of technology by using Foucault's analysis to examine assumptions found in HCAI [it provides a Foucauldian conceptual analysis of a current approach (human-centredness) that aims to influence the design and development of a transformative technology (AI)], it will contribute to AI ethics debates by offering a critique of human-centredness in AI (by choosing Foucault, it provides a bridge between older ideas with contemporary issues), and it will also contribute to Foucault studies (by using his work to engage in contemporary debates, such as AI). (shrink)

Suppose the only difference between the effects of two actions is to whom they apply: either to parties who would -- or would not -- exist if the actions were not performed. Is this a morally significant difference? This is one of the central questions raised by the Non-Identity Problem. Derek Parfit answers no, defending what he calls the ‘No-Difference View’. I argue that Parfit is mistaken and that sometimes this difference is morally significant. I do this by formulating a (...) familiar kind of example in a new way. I make use of some findings in social psychology to help deflect counterexamples to my view. I then show how my view withstands Parfit's latest argument in favour of the No-Difference View. I conclude with a brief discussion of some questions my argument raises for consequentialist moral theory. (shrink)

Photo ID 222412412 © US Navy Medicine | Dreamstime.com ABSTRACT In a non-military setting, the answer is clear: it would be unethical to treat someone based on non-medical considerations such as nationality. We argue that Battlefield Triage is a moral tragedy, meaning that it is a situation in which there is no morally blameless decision and that the demands of justice cannot be satisfied. INTRODUCTION Medical resources in an austere environment without quick recourse for resupply or casualty evacuation are often (...) limited. The shortage extends not only to supplies like blood products and drugs, but physicians and other medical personnel. In the midst of a mass casualty scenario, such as a battle that includes intense ground fighting, the medical staff will stretch scarce resources and triage casualties according to specific criteria. Typically, they proceed by providing care for the most severely wounded first, referred to here as conventional triage. At times, though, the staff may reverse the triage so that soldiers with minor wounds can return to the fight. In a mass casualty situation, when medical personnel apply conventional triage and treat casualties from opposing forces, a dilemma may arise. We argue that it can be permissible for military physicians to prioritize their own soldiers over enemy combatants in a mass casualty triage, where reverse triage does not apply. The case we will focus on is as follows: Battlefield Triage: During combat operations on a remote island in the Pacific Ocean, a compatriot soldier and an enemy combatant arrive at the compatriot soldier country’s medical treatment facility. Both have similar gunshot wounds to the abdomen, and they arrive with similar conditions. Both have low oxygen saturation and excessive blood loss. The sole physician only has enough time to stabilize one person. The scenario is brief, and we are aware that medical rules of eligibility will most often dictate how the physician proceeds,[1] but this scenario is useful in setting up the question we focus on in this paper: would it be wrong to favor the stabilization of a soldier just because the soldier is the physician’s compatriot? In other words, can nationality serve as an ethically justified tiebreaker in a situation such as Battlefield Triage?[2] In a non-military setting, the answer is clear: it would be unethical to treat someone based on non-medical considerations such as nationality. The AMA’s Code of Medical Ethics asserts that physicians have “ethical obligations to place patients’ welfare above their self-interest and above obligations to other groups.”[3] The World Medical Association’s Declaration of Tokyo affirms that “no motive, whether personal, collective or political, shall prevail against this higher purpose” of alleviating distress.[4] Physicians are taught early on that triage decisions must be medically indicated and made without consideration of factors such as race, ethnicity, religion, social status, and nationality. They are taught that public trust and obligations of justice grounded in equality demand that only medical indications be considered. But military physicians in a military setting are beholden to obligations, duties, and responsibilities as members of the military, and when these obligations, duties, and responsibilities conflict, as they do in Battlefield Triage, which loyalties win out and why?[5] Critics of partiality on national grounds argue that partiality undermines public trust in medicine and justice because everyone should be treated equally regardless of nationality.[6] Proponents of partiality argue that military obligations supersede equality and that justice requires partiality in such cases.[7] Despite the critics’ disagreement, both agree that there is a morally right, perhaps even blameless, course of action. Drawing on insights from virtue ethics, we argue that Battlefield Triage is a moral tragedy in which justice is unattainable and there is no action without moral cost. The assumption that there is a morally right choice is flawed. We argue that while no decision in this scenario is free from moral blame, there are reasons to favor treating one’s soldiers over enemy combatants. I. The Case Against Partiality There is a common assumption that there is a morally right or just decision in Battlefield Triage. A number of organizations and scholars claim that it is wrong for military physicians to favor their own soldiers on the grounds of nationality or some form of ‘group membership.’ (In a conflict involving service members from multiple nations working as a coalition, a soldier from an allied country may receive the same priority as the US service member due to ‘group membership.’) The World Medical Association’s WMA Declaration of Lisbon on the Rights of the Patient, which was reaffirmed in 2015, posits that, “[i]n circumstances where a choice must be made between potential patients for a particular treatment that is in limited supply, all such patients are entitled to a fair selection procedure for that treatment. That choice must be based on medical criteria and made without discrimination.”[8] This echoes what was set forth in Article 12 of the Geneva Conventions, which states that “[o]nly urgent medical reasons will authorize priority in the order of treatment to be administered.”[9] The argument for impartiality in Battlefield Triage is that every person is morally equal, and equality entails that medical distribution is, “based on a combination of medical need and urgency.”[10] This is in keeping with the bioethical principles that are generally applied.[11] II. The Case for Partiality On the other side, there are arguments that favoritism is the ethically right decision in Battlefield Triage.[12] The argument asserts that members of the military form a morally significant community of friends and participation in these relationships demands partiality. Just as parents have strong ethical duties to their children and not just any children, military personnel have ethical duties to their group, a group that involves an affirmation of mutual aid and support. Some have termed these ‘associative duties. According to Michael Gross, obligations of friendship, care, and solidarity “leave very little room for generally applicable principles of justice that would obligate a medic to treat enemy or non-compatriot wounded ahead of their compatriots.”[13] This is true in Battlefield Triage, but it may also be true even if the enemy’s soldier were more seriously wounded: “the ethics of small group cohesion, largely an ethics of care, mostly replaces the demands of impartial justice.”[14] In a more recent article, Gross explains that preferential treatment is ethically justified based on fighting capability and “the special obligations people owe friends, family, and, no less, comrades-in-arms.”[15] To not show partiality to the US soldier would be morally wrong on the grounds of friendship and mutual care.[16] III. The Moral Tragedy of Battlefield Triage Defenders and critics of Battlefield Triage favoritism based on nationality both frame their position as just or fair. For example, Justin List argues that physicians are “bound to practice medical neutrality,”[17] Marcus Adams denies that physicians “possess special ethical obligations” to enemy combatants because of their profession.[18] These perspectives assume that there is a morally right decision and that justice is attainable. The assumption that there is or can be a morally right Battlefield Triage decision, and we need to put our heads together to figure it out, remains strongly entrenched. However, the facts of the situation should give us pause; there are too many people and too few resources, and this demands a decision-making process that determines who will receive scarce resources. By its very nature, a battlefield triage decision has to be made based on some characteristic or value, a characteristic or value that will inevitably favor some at the expense of others. This is precisely why competing analyses “in the military context struggle to resolve these conflicts satisfactorily.”[19] Drawing on the insights of virtue ethics, we suggest that Battlefield Triage is a moral tragedy. Virtue ethics suggests that morality is about acting virtuously, which is to say that we should do what a virtuous person would do in the situation. Ethics is about figuring out how a just, wise, compassionate, loving, and fair person would act, and then doing that, as one grows in virtue. But life is not always clear cut, and it is possible that virtuous people may find themselves in a moral tragedy, a situation in which, through no fault of one’s own, a person must make a morally objectionable decision. After the action the virtuous person “emerges having done a terrible thing, the very sort of thing that the callous, dishonest, unjust, or in general vicious agent would characteristically do.”[20] Stated differently, a moral tragedy presents a virtuous person with two or more courses of action, all of which have a moral cost.[21] In Battlefield Triage, no matter how the physician goes about deciding, there is going to be defensible concern from those not saved. The fact that there are more people than can be helped fosters competing values in battlefield triage: maximize lives saved, treat people equally, treat the worse off, and support the war effort. Treating people equally may create tension between treating the worse off, maximizing lives saved, and supporting the war effort. Reverse triage is a case in point, as supporting the war effort conflicts with treating the worse off first, as is a fair lottery system since deploying a lottery may not maximize lives saved or support the war effort. There can be reasons why one person is selected over another, to be sure. Yet, there are reasons for making a decision, and that the decision is subject to legitimate moral concern is another. To recognize the moral tragedy of Battlefield Triage is to recognize the impossibility of acting blamelessly in the situation. In this situation, the virtuous military physician is going to have to sacrifice important values such as justice, compassion, and respect for others, even with a defensible criterion in hand. The physician will grieve this sacrifice accordingly. The physician may find her decision difficult or stressful, and rightly so, because of what her circumstances require of her. This kind of moral tragedy results “in actions which betray and violate the rights of persons to whom there may be a strong duty of care. When this happens, it properly triggers an appropriate moral emotion since our moral integrity has been violated and this affects how we think of ourselves and what we have become.”[22] Rather than view her triage decision as the morally superior choice, the virtuous military physician will view her decisions in these circumstances in a different light: it is the least bad option in a terrible situation, and she did something ethically problematic, something that is contrary to her moral character. She deeply regrets the circumstances in which she had to act. IV. Virtue Ethics A virtue ethicist has insight into how one should go about deciding what to do in a moral tragedy, although virtue ethics may not be as helpful as one may hope. The goal of the virtuous military physician in Battlefield Triage is to adopt the best course of action or the action that she feels she ought to do, all things considered. This does not make her choice devoid of serious wrongdoing—a decision must be made, but that does not make it just. The virtuous military physician will approach the situation with courage, responsibility, and insight. She will think about the decision carefully, wisely, and conscientiously; she will weigh the goods and harms of the choices before her, in conjunction with a proper conception of the good life, human worth, and understanding of her obligations to others—including chain of command, fellow soldiers, and the medical community. She is attuned to the value of human life and has a reasonable idea of the various ways her decisions will affect others. She recognizes that she is in this non-ideal situation through no fault of her own: she is not the one fighting in battles; she is serving her country as a physician, whose job it is to save lives, treat everyone justly, and promote military objectives. She regrets the decision she is forced to make in battlefield triage, acting “with immense regret and pain,” Hursthouse explains, “instead of indifferently or gladly.”[23] This is because, no matter what decision is made, the virtuous military physician “does something terrible or horrible,” something she otherwise would not do and is contrary to her values.[24] V. A Resolvable Moral Tragedy Instead of asking whether there is a morally right decision, in which a decision is morally blameless and above reproach, the virtue ethicist asks whether there is a decision with a convincing rationale, knowing that a decision can have a clear rationale but still be morally tragic. It is perfectly reasonable to think that different virtuous persons will arrive at different courses of action: “two virtuous agents, in the same situation,” Hursthouse writes, “may act differently” in irresolvable moral tragedies, in cases in which there is no clear course of action.[25] Because a person must act in a moral tragedy, one goal is to identify reasons for choosing the chosen action. Some decisions are clearly indefensible—treating neither the compatriot soldier nor the enemy combatant in Battlefield Triage would be wrong—and some decisions are more problematic than others. If the military physician selects to treat the soldier because she does not like the enemy combatant’s skin color, such a reason would be deeply problematic. But much of the debate over how to act in a moral tragedy is not over clearly indefensible or problematic criteria. Instead, the literature is largely about different standards or implementations of justice. Some scholars defend nation-impartial triage as right, while others defend nation-aware triage as right, and each argues that the other side is promoting an unjust or otherwise wrong solution to Battlefield Triage. We suggest that Battlefield Triage is a resolvable moral tragedy and that virtue ethics offers convincing reasons to prefer the treatment of the compatriot soldier rather than the enemy combatant on the grounds of national identity. Virtues are integral to living a good life, a flourishing life, but as Aristotle observed long ago, human beings are inherently social, interdependent and interconnected in profound ways.[26] This goes beyond the obvious fact that we need each other to survive day to day (one person makes clothes, another farms, and another makes tools); the claim is that a good or flourishing life depends in large part on one’s social network or community. This is why many of Aristotle’s moral virtues are other facing: justice, friendship, generosity, and magnanimity, to name a few. Courage, a typically self-facing virtue, is understood by Aristotle to be the virtue that regards one’s fear of death in battle, a battle fought on behalf of one’s city.[27] All of this remains true today. Namely, there is an important sense in which our community matters to our lives: it is easier to live a good, flourishing life if one is part of a good, flourishing community. Our community is made up of smaller groups, and it is more accurate to say that we are simultaneous members of different groups within a broader community. A person may be part of a family, friend group, research team, large state university, city, state, and nation. Groups can function well or not, as we all have experienced, and this suggests that there are virtues or excellences that groups can instantiate. Good groups are unified in purpose, with each member doing their duty alongside others for the attainment of that purpose. Good groups manifest solidarity among their members. Although Aristotle does not list solidarity as a virtue, a number of modern-day virtue ethicists have begun examining how group solidarity can be a virtue that contributes to a good or flourishing life.[28] Solidarity is not conceptualized as an individual virtue, a virtue possessed by a person in isolation of others; instead, it is a collective virtue, a virtue that is shared among members of a defined group with particular ends.[29] “A group has solidarity to the extent that its members are disposed to: (1) share values, aims, or goals; (2) care about those values, aims, or goals; (3) act in accordance with those values, aims, or goals; (4) trust the testimony of other group members with respect to those values, aims, and goals; and (5) feel a sense of belonging to the group.”[30] The virtue of collective or group solidarity involves individuals having special concern for each other, shared aims and values, trust, loyalty, and a sense of belonging with these specific others. There is a oneness to the group in the pursuit of a definite goal or purpose, involving mutual support and affirmation of each member. As such, the group has ends and goods above and beyond the good of each individual person. Sometimes solidarity requires personal sacrifice for the collective (for example, a father sacrificing food so his child can eat). The virtue of collective or group solidarity is important to the military and medical community at every level, and for clear reasons. In the military, there is a clear hierarchy of command, unity of purpose and end, mutual trust and support in complex settings, and so on. Soldiers need to know they can count on one another, and solidarity grounds a soldier’s ability to trust others and be assured of mutual aid. In medicine, solidarity maintains self-regulation of the profession, shared values and goals, as well as public support, not to mention that day-to-day operations require physician trust, engagement, and effort toward the ends of clinical care. Physicians need to work together, along with others, in pursuit of health, and disunity is sowed when there is mistrust, selfishness, or disengagement among the healthcare team and organization. Importantly, just as we are all members of various groups and hence may manifest group solidarity in different settings, the virtuous military physician instantiates collective solidarity with both the medical profession and the military. Her dual loyalty contributes to the moral difficulty of acting in Battlefield Triage. The military physician has competing obligations to distinct groups and cannot satisfy all obligations in Battlefield Triage. Solidarity with the military supports the consideration of favoring the soldier for reasons of national identity, whereas solidarity with the medical community does not. Something has to give, which is why it is a moral tragedy. The virtuous military physician, therefore, must weigh the costs of each course of action. To fulfill her obligations to the medical community would require that she does not use nationality and other non-medical considerations in Battlefield Triage. Since the soldier and enemy combatant are equally injured, justice would demand a random process, perhaps a flip of the coin. Although this may satisfy obligations the military physician has to the medical community, this would be costly to the physician’s military group. If word gets out that the physician decides who to treat based on a coin toss, soldiers, families, and citizens may become frustrated and angry. Soldier morale may go down if it becomes known that a coin flip led to the preventable death of a soldier and the saving of an enemy combatant who had killed (or attempted to kill) other soldiers. As Gross highlights, military solidarity involves a mutual aid promise that military personnel promise to help one another.[31] A military physician is part of the military and, as such, is part of the mutual aid promise, which would appear to be violated if the physician flips a coin. Treating a member of one’s own team may be psychologically more beneficial than treating an enemy combatant and may lead to less moral distress.[32] Finally, treating soldiers rather than enemy combatants promotes broader military and social aims, including returning soldiers to health, maintaining unity of purpose, and minimizing community suffering from a soldier’s death. Favoring members of one’s group, that is, triage based on nationality in Battlefield Triage, would fulfill obligations of military group loyalty, which is contrary to the values and duties of medicine. It does not seem as though showing favoritism in this particular situation is very costly to the medical community or general public, but this is because there is recognition that the physician is in the military. Medicine is impartial to non-medical indications partly because of fairness and to promote public trust in medicine. However, Battlefield Triage is unique, as medicine is being practiced in a non-public, wartime setting. In ordinary circumstances, a patient’s identity is irrelevant, and physicians ought not play favorites. Since Battlefield Triage is not an ordinary circumstance, decisions based on patient identity may not undermine public trust in medicine. In addition, it is contestable that fairness in Battlefield Triage requires that no consideration be paid to one’s nationality. Fairness is about giving each person their due, what is owed to them, and the case can be made that soldiers who place themselves in danger for the sake of the common good or a just cause are owed special attention when they suffer harm in the line of duty. In other words, soldiers voluntarily undergo risk to themselves for the greater good, and society owes them for this sacrifice. This plausibly includes preferential treatment in a situation such as Battlefield Triage. So, while the medical community affirms justice demands non-preferential treatment, the military community can affirm the opposite. The demands of fairness are unclear at best or in conflict in this situation: demands of physician justice decry favoritism, while demands of military justice support favoritism. Triage not based on nationality is arguably unfair and triage based on nationality may not undermine public trust, after all. All things considered, there is a clear rationale for favoring nationality-based preferential treatment in Battlefield Triage. Adopting a nationality-based preference in this situation is more defensible than not. This does not make such a decision ethically right or just. Preference based on nationality is the least bad decision, but it is not morally blameless. It involves one in a serious moral wrong, a wrong otherwise avoided and contrary to one’s character. The virtuous military physician is in a situation in which obligations conflict, and we disagree with Gross, who posits that care of fellow soldiers “is important to the near exclusion of all else.”[33] Gross fails to appreciate the collective virtue of solidarity as applied to those in medicine. The military physician has duties to fellow soldiers but also to fellow physicians, to the medical community, and humanity. To favor a soldier on grounds of nationality violates her duties and responsibilities to this latter group. She is involved in a moral tragedy and can only seek the most just action given the circumstances, yet, at least in virtue ethics, the action remains far from blameless. CONCLUSION We argue that Battlefield Triage is a moral tragedy, meaning that it is a situation in which there is no morally blameless decision and that the demands of justice cannot be satisfied. As such, the virtuous military physician incurs a moral cost to acting as she does—there is a moral residue. However, despite being a moral tragedy, there are clear reasons to act in favor of treating one’s own, considering group solidarity. As such, these kinds of tragedies are resolvable: virtuous military physicians should favor treatment of their own, although they would do so with sorrow. - [1] Militaries set forth medical rules of eligibility or guidelines used to determine whether a person qualifies for specific medical interventions or treatments in certain circumstances, and these guidelines are binding for a military physician. For example, despite opposition from medical organizations, militaries have adopted reverse triage guidelines for military physicians to follow. For ethical discussion, see Falzone, Elisabeth, P. Pasquier, C. Hoffmann, O. Barbier, M. Boutonnet, A. Salvadori, A. Jarrassier, J. Renner, B. Malgras, and S. Mérat. "Triage in military settings." Anaesthesia Critical Care & Pain Medicine 36, no. 1 (2017): 43-51. https://doi.org/10.1016/j.accpm.2016.05.004 [2] There are issues that are related to this, including the triage of civilians and allied soldiers. We set related issues aside for purposes of this paper [3] American Medical Association, Code of Medical Ethics: Current Opinions with Annotations, 2004–2005 ed. (Chicago, IL: AMA, 2004), 300. [4] American Medical Association, Code of Medical Ethics: Current Opinions with Annotations, 2004–2005 ed. (Chicago, IL: AMA, 2004), 300. [5] This is termed the “dual loyalty” dilemma in military medicine and has been described at length elsewhere: Institute of Medicine (US) Board on Health Sciences Policy. Military Medical Ethics: Issues regarding Dual Loyalties: Workshop Summary. Washington (DC): National Academies Press (US); 2008. Toward a Framework for Resolving Dual Loyalties. Available from: https://www.ncbi.nlm.nih.gov/books/NBK214853/ [6] See Kenneth G. Swan and K.G. Swan, Jr., “Triage: The Past Revisited,” Military Medicine 161:8 (1996): 448–452. https://doi.org/10.1093/milmed/161.8.448; Jerome A. Singh, “American Physicians and dual loyalty obligations in the ‘war on terror,’” BMC Medical Ethics 4.4 (2003): 1–10. https://doi.org/10.1186/1472-6939-4-4; Beam, Thomas E. "Medical Ethics on the Battlefield." Military Medical Ethics: Sect. IV. Medical ethics in the military. Medical ethics on the battlefield: the crucible of military medical ethics 2 (2003): 369-402; Hereth, Blake. "Health justice for unjust combatants." Journal of Military Ethics 20, no. 1 (2021): 67-81. https://doi.org/10.1080/15027570.2021.1949782. [7] See Adams, Marcus P. "Triage priorities and military physicians." In Physicians at war: The dual-loyalties challenge, pp. 215-236. Dordrecht: Springer Netherlands, 2008. Gross, Michael L. "Comradery, community, and care in military medical ethics." Theoretical medicine and bioethics 32 (2011): 337-350. https://doi.org/10.1007/s11017-011-9189-6. Gross, Michael L. "The limits of impartial medical treatment during armed conflict." In Military medical ethics for the 21st century, pp. 71-84. Routledge, 2016. [8] World Medical Association, WMA Declaration of Lisbon on the Rights of the Patient. 5 December 2022, https://www.wma.net/policies-post/wma-declaration-of-lisbon-on-the-rights-of-the-patient/ [9] Geneva Convention for the Amelioration of the Condition of Wounded, Sick in Armed Forces in the Field. 12 August 1949. https://www.un.org/en/genocideprevention/documents/atrocity-crimes/Doc.30_GC-I-EN.pdf. [10] List, Justin M. "Medical neutrality and political activism: physicians' roles in conflict situations." In Physicians at war: The dual-loyalties challenge, pp. 237-253. Dordrecht: Springer Netherlands, 2008. 240 [11] Beauchamp, T., and J. Childress. 2013. Principles of Biomedical Ethics, 7th ed. Oxford, United Kingdom: Oxford University Press. [12] Adams, Marcus P. "Triage priorities and military physicians." In Physicians at war: The dual-loyalties challenge, pp. 215-236. Dordrecht: Springer Netherlands, 2008. [13] Gross, "Comradery, community, and care in military medical ethics," 347. [14] Gross, “Comradery, community, and care in military medical ethics,” 349. [15] Gross, Michael L. "When medical ethics and military ethics collide." Narrative inquiry in bioethics 13, no. 3 (2023): 199-204. 202 https://dx.doi.org/10.1353/nib.2023.a924191 [16] Our argument draws on virtue ethics, from which care ethics derives, and it is worth clarifying how our argument relates to Gross’s. We do not think that the virtue of friendship grounds triage decisions, for we think it is unlikely that the physician and wounded soldier are friends. Instead, as explained below, we think the collective virtue of group solidarity better captures the moral significance of group loyalty and that Gross would agree with us. But since military physicians are part of distinct groups, with competing obligations, the military physician will be forced to sacrifice a value in battlefield triage cases. In other words, we think Gross downplays the dual group membership of a military physician. [17] List,”Medical neutrality and political activism,” 250. [18] Adams,”Triage priorities and military physicians,” 235. [19] London, Leslie, Leonard S. Rubenstein, Laurel Baldwin-Ragaven, and Adriaan Van Es. "Dual loyalty among military health professionals: human rights and ethics in times of armed conflict." Cambridge Quarterly of Healthcare Ethics 15, no. 4 (2006): 381-391. 383. [20] Hursthouse, R. On Virtue Ethics. OUP 1999. 74 [21] Nussbaum, Martha C. "The costs of tragedy: Some moral limits of cost-benefit analysis." The Journal of Legal Studies 29, no. S2 (2000): 1005-1036, 1007. [22] De Wijze, S. (2005). Tragic-remorse–the anguish of dirty hands. Ethical theory and moral practice, 7(5), 453-471, 457. https://doi.org/10.1007/s10677-005-6836-x [23] Hursthouse, 73 [24] Hursthouse, 81 [25] Hursthouse, 72 [26] Aristotle, Politics 1253a8. Reeve, C. D. C., Indianapolis: Hackett Publishing Co., 2017 [27] Aristotle, Nicomachean Ethics. III.6.114a, 34-35. 2002, Nicomachean Ethics, Christopher Rowe (trans.), Oxford: Oxford University Press [28] Byerly, T. Ryan, and Meghan Byerly. "Collective virtue." The Journal of Value Inquiry 50, no. 1 (2016): 33-50. https://doi.org/10.1007/s10790-015-9484-y; Federico, Veronica. "Conclusion: solidarity as a public virtue." Solidarity as a Public Virtue (2018): 495-542. https://doi.org/10.5771/9783845290058. Rehg, William. "Solidarity and the common good: An analytic framework." Journal of Social Philosophy 38, no. 1 (2007): 7-21. https://doi.org/10.1111/j.1467-9833.2007.00363.x [29] Byerly and Byerly. "Collective virtue." 43 [30] Battaly, Heather. "Solidarity: Virtue or vice?." In Social virtue epistemology, pp. 303-324. Routledge, 2022. 304 [31] Ibid., 2011: 341 [32] It might be thought that displaying altruism by helping an enemy combatant at the expense of one’s fellow soldier may be psychologically satisfiying. For evidence that military physicians find it difficult to treat enemy combatants, see Lundberg, Kristina, Sofia Kjellström, Anders Jonsson, and Lars Sandman. "Experiences of Swedish military medical personnel in combat zones: adapting to competing loyalties." Military medicine 179, no. 8 (2014): 821-826. https://doi.org/10.7205/MILMED-D-14-00038. Lamblin, Antoine, Clément Derkenne, Marion Trousselard, and Marie-Ange Einaudi. "Ethical challenges faced by French military doctors deployed in the Sahel (Operation Barkhane): a qualitative study." BMC Medical Ethics 22 (2021): 1-13. https://doi.org/10.1186/s12910-021-00723-2 [33] Ibid., 2011: 344. (shrink)

I examine a property of theories called "background-independence" that Einsteinian gravitation is thought to exemplify. This concept has figured in the work of Rovelli (2001, 2004), Smolin (2006), Giulini (2007), and Belot (2011), among others. I propose and evaluate a few candidates for background-independence, and I show that there is something chimaerical about the concept. I argue, however, that there is a proposal that clarifies the feature of Einsteinian gravitation that motivates the concept.

Most adult persons with anorexia satisfy the existing criteria widely used to assess decision-making capacity, meaning that incapacity typically cannot be used to justify coercive intervention. After rejecting two other approaches to justification, Professor Radden concludes that it is most likely not possible to justify coercive medical intervention for persons with anorexia in liberal terms, though she leaves it open whether some other framework might succeed. I shall assume here that the standard approach to assessing decisionmaking capacity is adequate.1 The (...) question then is whether we can justify—within a liberal framework—coercive intervention with the decision of a competent... (shrink)