While consensus exists among many practitioners of ethics consultation about the need for and identification of core competencies and standards, there has been virtually no attempt to determine how these competencies and standards are best taught and assessed. We believe that clinical ethics consultation has reached a state of sufficient maturity that expert practitioners can evaluate those who are new to the field. We will outline several steps that can facilitate the creation of a certification process for clinical ethics consultants, (...) assuring the competency and quality of consultation for the patients, families, and healthcare professionals who utilize ECSs. (shrink)

BackgroundSexual minority (SM) older adults experience mental health disparities. Psychiatric disorders and neuropsychiatric symptoms (NPS) are risk factors for cognitive decline. Although older people in same-sex (SSR) compared to mixed-sex relationships (MSR) perform more poorly on cognitive screening tests, prior studies found no differences in rates of dementia diagnosis or neuropsychological profiles. We sought to explore the role of NPS on neurocognitive outcomes for SM populations. We compared cognitive performance and structural brain parameters of older adults in SSR and MSR.MethodsData (...) were originally collected at Alzheimer's Disease Research Centers (ADRCs). Inclusion criteria were: age of 55+ years, a study partner identified as a spouse/partner, and availability of T1-MRI brain volumes/thickness. Participants were labeled as either SSR or MSR based on their/their co-participant's reported sex. We identified 1,073 participants (1,037 MSR−555 cognitively unimpaired [CU]; 36 SSR−23 CU) with structural MRI data, Mini-Mental State Exam (MMSE), and Neuropsychiatric Inventory Questionnaire (NPI-Q) scores. A subset of the overall sample completed comprehensive neuropsychological assessment (n = 939; 908 MSR−494 CU; 31 SSR−22 CU). Covariates included in statistical models were age, sex, education, total intracranial volume, and apolipoprotein E genotype.ResultsMultivariate general linear models showed significant diagnosis-by-relationship interaction effects on the left parahippocampal gyrus volume. After stratification by relationship group, only cognitively impaired (CI) MSR had significantly smaller left parahippocampal volumes than MSR-CU. The SSR group showed better episodic memory performance. Severity of neuropsychiatric symptoms was negatively associated with volume/thickness of bilateral fronto-temporal areas and with MMSE scores, predominantly in the MSR group.ConclusionIn our study, MSR participants presented with a more compromised cognitive profile than SSR participants. MSR-CI participants showed significantly smaller left medio-temporal volumes, a neural signature of AD. Neuropsychiatric symptoms predicted smaller fronto-temporal volumes in the MSR more consistently than in the SSR group. These findings may be due to unexplored protective factors against cognitive decline in SM elders. Indeed, social support has been proposed as a protective factor warranting future investigation. (shrink)

In cognitive science, there is a tacit norm that phenomena such as cultural variation or synaesthesia are worthy examples of cognitive diversity that contribute to a better understanding of cognition, but that other forms of cognitive diversity (e.g., autism, attention deficit hyperactivity disorder/ADHD, and dyslexia) are primarily interesting only as examples of deficit, dysfunction, or impairment. This status quo is dehumanizing and holds back much-needed research. In contrast, the neurodiversity paradigm argues that such experiences are not necessarily deficits but rather (...) are natural reflections of biodiversity. Here, we propose that neurodiversity is an important topic for future research in cognitive science. We discuss why cognitive science has thus far failed to engage with neurodiversity, why this gap presents both ethical and scientific challenges for the field, and, crucially, why cognitive science will produce better theories of human cognition if the field engages with neurodiversity in the same way that it values other forms of cognitive diversity. Doing so will not only empower marginalized researchers but will also present an opportunity for cognitive science to benefit from the unique contributions of neurodivergent researchers and communities. (shrink)

The increased use of human biological material for cell-based research and clinical interventions poses risks to the privacy of patients and donors, including the possibility of re-identification of individuals from anonymized cell lines and associated genetic data. These risks will increase as technologies and databases used for re-identification become affordable and more sophisticated. Policies that require ongoing linkage of cell lines to donors’ clinical information for research and regulatory purposes, and existing practices that limit research participants’ ability to control what (...) is done with their genetic data, amplify the privacy concerns. (shrink)

One important problem in cognitive science is to understand the development of cognitive processes in children and to devise computer models to explore the mechanisms that underlie these changes. Our research addresses these general goals. In particular, we are concerned with developmental changes in cognitive strategies in typical children and in children with mild mental retardation.

In Moral Passages, Kathryn Pyne Addelson presents an original moral theory suited for contemporary life and its moral problems. Her basic principle is that knowledge and morality are generated in collective action, and she develops it through a critical examination of theories in philosophy, sociology and women's studies, most of which hide the collective nature and as a result hide the lives and knowledge of many people. At issue are the questions of what morality is, and how moral theories (...) (whether traditional or feminist) are implemented. Addelson takes up a large number of historical cases and contemporary social problems, including teen pregnancy, contraception and abortion, and gay rights. These cases allow her to see how the knowledge and lives of some people are declared deviant or immoral, while those of others appear to show the public consensus. One case she uses throughout the book is Margaret Sanger's early work on birth control with the anarcho-syndicalist movement--a revisionist history that reveals rather than hides the collective nature of morality and knowledge. Addelson shows how the usual individualist philosophies promote theories which hide the authority of the professionals who make them. A collectivist approach, she argues, must show the part professionals play in collective action. Her aim is to allow professional knowledge makers to be morally and intellectually responsible. Based on Addelson's twenty years of work in feminist philosophy and interactionist sociology as well as her long-standing involvement in women's community organization, Moral Passages investigates how morality and knowledge are collectively enacted in today's world. (shrink)

It is argued that the question of whether or not one is required to be or become a strict vegetarian depends, not upon a rule or ideal that endorses vegetarianism on moral grounds, but rather upon whether one's own physical, biological nature is adapted to maintaining health and well-being on a vegetarian diet. Even if we accept the view that animals have rights, we still have no duty to make ourselves substantially worse off for the sake of other rights-holders. Moreover, (...) duties to others, such as fetuses and infants, may require one to consume meat or animal products. Seven classes of individuals who are not required to be or become vegetarians are identified and their examption is related to nutritional facts; these classes comprise most of the earth's population. The rule of vegetarianism defines a special or provisional duty rather than any general or universal rule, since its observance it based upon the biological capacities of individual humans whose genetic constitution and environment makes them suitably herbivorous. It is also argued that generalizing the vegetarian ideal as a social goal for all would be wrongful because it fails to consider the individual nutritional needs of humans at various stages of life, according to biological differences between the sexes, and because it would have the eugenic effect of limiting the adaptability of the human species. The appeal to the natural interests of omnivores will not justify any claim that humans may eat amounts of meat or animal products in excess of a reasonable safety margin since animals have rights-claims against us. (shrink)

This paper proposes that public health is the sort of institution that has a role in producing structures of virtue in society. This proposal builds upon work that describes how virtues are structured by the practices of institutions, at the collective or whole-of-society level. This work seeks to fill a gap in public health ethics when it comes to virtues. Mainstay moral theories tend to incorporate some role for virtues, but within public health ethics this role has not been fully (...) articulated. Two recent papers have proposed ways in which the virtues might be incorporated: working from a structural account, Rozier suggests that public health could work to instil virtues, like temperance, in the public in order to achieve its health-related goals; Nihlén Fahlquist suggests that compassion is among three virtues that practitioners of public health should cultivate in order to do their work well. In the end, both accounts recommend incorporating virtues at the level of individuals, among the public and among practitioners. I propose a third kind of role for virtue in public health that focuses on structures. Public health activities take place at the population level, and a public health virtue ethics must also be suitably population-focussed. (shrink)

Culture, health, and medicine intersect in various ways—and not always without friction. This paper examines how liberal multicultural states ought to interact with diverse communities which hold different health-related or medical beliefs and practices. The debate is fierce within the fields of medicine and bioethics as to how traditional medicines ought to be regarded. What this debate often misses is the relationship that medical traditions have with cultural identity and the value that these traditions can have beyond the confines of (...) the clinical setting. This paper will attempt to bring some clarity to the discussion. In so doing, it will delve into some controversial areas: (1) the debate around whether liberal states ought to embrace multiculturalism, (2) the existence and nature of group-differentiated rights, (3) the question of whether healthcare systems ought to embrace medical pluralism, and (4) what this would entail for policymakers, clinicians, and patients. Ultimately, I argue that liberal democratic states with multicultural populations ought to recognize medical pluralism as a matter of respecting group-differentiated and individual human rights. (shrink)

Building upon Thornton's (1991) work on teachers as “curricular-instructional gatekeepers,” the author explores what guided the curricular decision-making for one novice teacher concerning controversial issues that center on race, social class, and lesbian, gay, bisexual, and transgender (LGBT) issues. Qualitative case study revealed context, student demographics, and teacher positionality as influencing this teacher's choices regarding these themes in her curriculum. Findings indicated that this teacher was willing and able to challenge racist views in her classroom when she was a student (...) teacher and her students more closely mirrored her own race and social class. When she was a full-time teacher of students who were of a different racial and class background, she was unable to similarly challenge their homophobic beliefs. Implications for teacher education are discussed. (shrink)

This paper imagines what the liberatory possibilities of (full) ectogenesis are, insofar as it separates woman from female reproductive function. Even before use with human infants, ectogenesis productively disrupts the biological paradigm underlying current gender categories and divisions of labour. I begin by presenting a theory of women’s oppression drawn from the radical feminisms of the 1960s, which sees oppression as deeply rooted in biology. On this view, oppressive social meanings are overlaid upon biology and body, as artefacts of culture (...) and history. I then argue that ectogenesis should be pursued to replace two modes of assisted gestation that can be seen as outgrowths of oppressive assumptions about women's function, ectogenesis should be pursued to replace two modes of assisted gestation. These are gestational surrogacy and uterine transplant, which arise partly from gendered, pronatalist, and geneticist norms. These practices are supported by assumptions about women’s identity and value. Pursuing technologies such as ectogenesis, which weaken the presumed link between biology and gender, is beneficial to (trans-inclusionary radical) feminist aims, as part of a broad project of challenging dominant power relations resting on and maintaining gender categories. By allowing the conceptual separation of female reproductive function from ‘woman’, ectogenesis raises questions about how we determine who counts in this gender identity, and also how we value those who claim the identity ‘woman’. I conclude that ectogenesis has the potential to challenge traditional patriarchal family structures, and thence all other male-dominated structures (of work, education, cultural production), allowing a reimagining of the family and society in more radical ways than we have yet achieved. (shrink)

Concerns over the organising of food are widespread, stemming from unsustainable production practices that focus on extractive ‘use’ of resources that privilege wealth creation over planetary flourishing, care and well-being. We propose a conceptual framework based on _ecologies of care_ to assist in the re-entanglement of food systems. The concept of ecologies of care brings together theoretical understandings of relationality, ecology and care, along with an Aotearoa New Zealand indigenous Māori perspective. We examine how food production can be underpinned by (...) interdependent webs of relationships (whanaungatanga), stewardship (kaitiakitanga), and care and support (manaakitanga) with healthy land and healthy people at the core of organising. (shrink)

The United States considers educating all students to a threshold of adequate outcomes to be a central goal of educational justice. The No Child Left Behind Act introduced evidence-based policy and accountability protocols to ensure that all students receive an education that enables them to meet adequacy standards. Unfortunately, evidence-based policy has been less effective than expected. This article pinpoints under-examined methodological problems and suggests a more effective way to incorporate educational research findings into local evidence-based policy decisions. It identifies (...) some things educators need to know and do to determine whether available interventions can play the right casual role in their setting to produce desired effects. It examines the value and limits of educational research, especially randomized controlled trials, for this task. (shrink)

How Doctors Think defines the nature and importance of clinical judgment. Although physicians make use of science, this book argues that medicine is not itself a science but rather an interpretive practice that relies on clinical reasoning. A physician looks at the patient's history along with the presenting physical signs and symptoms and juxtaposes these with clinical experience and empirical studies to construct a tentative account of the illness. How Doctors Think is divided into four parts. Part one introduces the (...) concept of medicine as a practice rather than a science; part two discusses the idea of causation; part three delves into the process of forming clinical judgment; and part four considers clinical judgment within the uncertain nature of medicine itself. In How Doctors Think, Montgomery contends that assuming medicine is strictly a science can have adverse side effects, and suggests reducing these by recognizing the vital role of clinical judgment. (shrink)

How has sovereignty come to be understood in our contemporary world of nation-states? If Natasha Wheatley’s The Life and Death of States begins with a big question, it offers us a big answer, too....

Overpopulation, overexploitation of natural resources, overconsumerism, the predictions of environmental experts do not bode well for us.

Abstract The artwork of Joseph Beuys was provocative in his time. Although he was very successful on the international art scene and on the art market, the larger The public is still bewildered by his Fat Chair or his installations and his performances. The article shows the evolution of his artwork from classical materials (stone, steel) to soft materials (animals, products of animals) and further to his concept of “social sculpture” and to programmatic diagrams (with words and graphics). A special (...) point of interest is the transition towards language (phonic and conceptual), the philosophy of art exposed in his drawings, and diagrams and the relation between art and science in his artwork. (shrink)

The nineteenth-century British historian Lucy Aikin's ambitious four-part poem Epistles on Women (1810) marks both her first important contribution to women's historiography and a compelling example of Enlightenment feminist historiography. To some extent, Aikin is building on the work of male Enlightenment historians who had evaluated the status of women in different times and places and correlated it to social progress. However, she not only restricts her focus exclusively to women, but also makes a concerted effort to resolve some of (...) the tensions apparent in previous accounts of the relationship between women and social progress. Especially striking is her mediation of two distinct historical models of femininity, which I have called the republican and commercial models of femininity, the outlines of both of which we can trace in the work of male Enlightenment historians. By suggesting that through proper education women might combine the best aspects of each model, Aikin strategically advances the project of controversial feminists like Catherine Macaulay and Mary Wollstonecraft, who had taken inspiration from the republican model of femininity in their demands for improvements to female education. ☆ Revised for the History of European Ideas, October 2, 2004 by Kathryn Ready. (shrink)

The authors examine the nature of the relationship between social science and philosophy and address the sort of work social science should do, and the role and sorts of claims that an accompanying philosophy should engage in. In particular, the authors reintroduce the question of ontology, an area long overlooked by philosophers of social science, and present a cricital engagement with the work of Roy Bhaskar. The book argues against the excesses of philosophising and commits itself to a philosophical approach (...) more deeply grounded in the social sciences. (shrink)

The article “Revive and Refuse: Capacity, Autonomy, and Refusal of Care After Opioid Overdose,” Marshall et al. (2024) highlights the critical issue of care after an opioid overdose. “Revive and Re...

Challenges current claims that humans ought to be vegetarians because animals have moral standing.

During a year when there is much tumult around the world and in the United States in particular, it might be surprising to encounter a paper about patience and argumentation. In this paper, I explore the notion of deep disagreement, with an eye to moral and political contexts in particular, in order to motivate the idea that patience is an argumentative virtue that we ought to cultivate. This is particularly so because of the extended nature of argumentation and the slow (...) rate at which we change our minds. I raise a concern about how calls for patience have been misused in the past and argue that if we accept patience as an argumentative virtue, we should hold people in positions of power, in particular, to account. (shrink)

Artificial intelligence (AI) has attracted an increasing amount of attention, both positive and negative. Its potential applications in healthcare are indeed manifold and revolutionary, and within the realm of medical imaging and radiology (which will be the focus of this paper), significant increases in accuracy and speed, as well as significant savings in cost, stand to be gained through the adoption of this technology. Because of its novelty, a norm of keeping humans “in the loop” wherever AI mechanisms are deployed (...) has become synonymous with good ethical practice in some circles. It has been argued that keeping humans “in the loop” is important for reasons of safety, accountability, and the maintenance of institutional trust. However, as the application of machine learning for the detection of lumbar spinal stenosis (LSS) in this paper’s case study reveals, there are some scenarios where an insistence on keeping humans in the loop (or in other words, the resistance to automation) seems unwarranted and could possibly lead us to miss out on very real and important opportunities in healthcare—particularly in low-resource settings. It is important to acknowledge these opportunity costs of resisting automation in such contexts, where better options may be unavailable. Using an AI model based on convolutional neural networks developed by a team of researchers at NUH/NUS medical school in Singapore for automated detection and classification of the lumbar spinal canal, lateral recess, and neural foraminal narrowing in an MRI scan of the spine to diagnose LSS, we will aim to demonstrate that where certain criteria hold (e.g., the AI is as accurate or better than human experts, risks are low in the event of an error, the gain in wellbeing is significant, and the task being automated is not essentially or importantly human), it is both morally permissible and even desirable to kick the humans out of the loop. (shrink)

This book explores the dynamic relationship between myth and philosophy in the Presocratics, the Sophists, and in Plato - a relationship which is found to be more extensive and programmatic than has been recognized. The story of philosophy's relationship with myth is that of its relationship with literary and social convention. The intellectuals studied here wanted to reformulate popular ideas about cultural authority and they achieved this goal by manipulating myth. Their self-conscious use of myth creates a self-reflective philosophic sensibility (...) and draws attention to problems inherent in different modes of linguistic representation. Much of the reception of Greek philosophy stigmatizes myth as 'irrational'. Such an approach ignores the important role played by myth in Greek philosophy, not just as a foil but as a mode of philosophical thought. The case studies in this book reveal myth deployed as a result of methodological reflection, and as a manifestation of philosophical concerns. (shrink)

While acknowledging Hannah Arendt's keen philosophical and political insights, Kathryn T. Gines claims that there are some problematic assertions and oversights regarding Arendt’s treatment of the "Negro question." Gines focuses on Arendt's reaction to the desegregation of Little Rock schools, to laws making mixed marriages illegal, and to the growing civil rights movement in the south. Reading them alongside Arendt's writings on revolution, the human condition, violence, and responses to the Eichmann war crimes trial, Gines provides a systematic analysis (...) of anti-black racism in Arendt’s work. (shrink)

A significant portion of the scholarship in analytic philosophy of psychiatry has been devoted to the problem of what kind of kind psychiatric disorders are. Efforts have included descriptive projects, which aim to identify what psychiatrists in fact refer to when they diagnose, and prescriptive ones, which argue over that to which diagnostic categories should refer. In other words, philosophers have occupied themselves with what I call “diagnostic kinds”. However, the pride of place traditionally given to diagnostic kinds in psychiatric (...) research has recently come under attack, most notably by a recent initiative of the National Institute of Mental Health, the Research Domain Criteria Project, that seeks to exclude diagnostic categories from experimental designs and focus on other sorts of psychiatric kinds. I argue that philosophical accounts privileging diagnostic kinds must respond to this new line of criticism, and conclude that philosophers need to either counter psychiatrists’ growing suspicion about the hegemony of diagnostic categories in the clinic and the laboratory, or join in redirecting their efforts toward the development of robust accounts of other sorts of psychiatric objects and processes. (shrink)

Although the American Philosophical Association has more than 11,000 members, there are still fewer than 125 Black philosophers in the United States, including fewer than thirty Black women holding a PhD in philosophy and working in a philosophy department in the academy.1The following is a “musing” about how I became one of them and how I have sought to create a positive philosophical space for all of us.

Online shaming is a subject of import for social philosophy in the Internet age, and not simply because shaming seems generally bad. I argue that social philosophers are well-placed to address the imaginal relationships we entertain when we engage in social media; activity in cyberspace results in more relationships than one previously had, entailing new and more responsibilities, and our relational behaviors admit of ethical assessment. I consider the stresses of social media, including the indefinite expansion of our relationships and (...) responsibilities, and the gap between the experiences of those shamed and the shamers’ appreciation of the magnitude of what they do when they shame; I connect these to the literature suggesting that some intuitions fail to guide our ethics. I conclude that we each have more power than we believe we do or than we think carefully about exerting in our online imaginal relations. Whether we are the shamers or the shamed, we are unable to control the extent to which intangible words in cyberspace take the form of imaginal relationships that burden or brighten our self-perceptions. (shrink)

Boys and men tend to underperform in language education, and they are also underrepresented in language-related fields. Research suggests that stereotypes can affect students’ performance and sense of belonging in academic subjects and test settings via stereotype threat. For example, girls and women sometimes underperform on math tests following reminders that math is for boys. We sought to test whether stereotypes that women have better language skills than men would affect men. In a series of four experiments (N = 542), (...) we tested the effect of explicit stereotype threats on men’s performance in language-related tasks, and their sense of belonging to language-related domains. We found little evidence for stereotype threat effects on men in language. Bayesian analysis suggested that the null hypothesis was consistently more likely than the alternative, and mini-meta analyses showed effect sizes near zero. Future research should explore other explanations for gender gaps in language. (shrink)

We have argued that the neurocognitive representation of large-scale, navigable three-dimensional space is anisotropic, having different properties in vertical versus horizontal dimensions. Three broad categories organize the experimental and theoretical issues raised by the commentators: (1) frames of reference, (2) comparative cognition, and (3) the role of experience. These categories contain the core of a research program to show how three-dimensional space is represented and used by humans and other animals.