Catholic hospitals and health systems have proliferated and succeeded in American healthcare; they now operate four of the largest health systems and serve nearly one in six hospital patients. Like other religious entities that Wuest and Last write about in this issue, in their article Church Against State, they have benefited by and supported the long reach of conservative efforts to undermine the administrative state.

Abstract:To date, our understanding of ethical decision making and behavior in organizations has been concentrated in the area of moral judgment, largely because of the hundreds of studies done involving cognitive moral development. This paper addresses the problem of our relative lack of understanding in other areas of human morality by applying a recently developed construct—moral approbation—to illuminate the link between moral judgment and moral action. This recent work is extended here by exploring the effect that organizations have on ethical (...) behavior in terms of the moral approbation construct. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:IntroductionLori A. Custodero and Anna NeumannIn this symposium, three scholars present the genesis, meaning, and artfulness of creative work and its realization as aesthetic experience within three educational fields. Lori A. Custodero, working out of music education, provides a perspective emanating from an aesthetic of childhood wonder and playfulness; David T. Hansen, writing out of philosophy of education, discusses how being fully present in the teaching moment leads (...) to meaningful experience; and Anna Neumann, who writes out of the field of higher education studies, represents scholars as engaged in intellectual pursuits, often framed aesthetically, and as struggling to hold on to precious time for creation. Aware of the inherent tensions in learning environments from child care centers to graduate schools, we address ways in which our research has revealed people's sustained pursuit of imagined possibilities, oftentimes amidst perceived impediments.Creative work involves imagining possibilities whereby individuals, alone and together, pose personally relevant questions and pursue fluent pathways of inquiry within the shared meanings of cultural context. At its finest, such work is artful, simultaneously responding to and emanating from immediate circumstance and past experience. It is malleable and vulnerable and compelling, fusing familiar images and surprising perceptions into new "equilibria... stable, even though moving" whereby "changes interlock and sustain one another."1 As scholars and teachers committed to learning, we strive to create and discern meaning between established understandings and emerging ideas and images. As we dance between reception and action, between insight and "onsight,"2 fully attentive to the perceived potentials in our work, we move toward synchrony, experiencing the aesthetic. The realizations that arise from experiences such as these — new or newly reconfigured words, sounds, images, movement, and ideas — express new balances of sense and feeling and, sometimes, beauty. Whether in the shared, artfully expressive vocalizations between the newborn infant and mother or in the scientist's finessing patience with elegant mathematical imagery, creative work invites a drawing together of what we know and what we struggle to know. Over time, the interplay of this work and its realization, [End Page 33] what Dewey refers to as "movement and culmination,"3 creates a momentum that serves to define lives as aesthetic.We have created this symposium as a space for considering the meanings of the aesthetic in lives — from its earliest instantiations in the experiences of infants and young children, to its developed expression in the professional (in this case, intellectual) efforts of adults pursuing scholarly careers, to its representation in teaching as intergenerational fusions of knowledge, learning, and lives. We see the aesthetic as both native and learned; as individually held and formed and felt, and as collectively created and voiced, the product of lives in intersection; as marking bounded moments in time (those instants of compelling "present-ness") and as spreading through years, well beyond bounded present-ness, perhaps as memory. Yet while striving to define the aesthetic in lives, we also strive to understand lives, individually and interactively, as lodgings for the aesthetic, as locations that give shape, form, and voice to beauty and insight, to creativity and learning. As we explore the lives in which the aesthetic finds its home, and within which it forms, we wonder about the extent to which the aesthetic may, in its turn, illuminate the strivings of those lives, including human desires to create, know, learn, understand, sense. We are then collectively concerned with the meanings of the aesthetic in lives and about the lives themselves as "moving spaces" within which the aesthetic can grow.We pursue this theme, centered on the power of the aesthetic to illuminate human lives, out of a realization that current understandings of what it means to be human — and especially what it means to learn and create — have been framed within the rubrics of the social sciences, certainly in productive ways. And yet we suggest that the artful, though powerful in its abilities to voice emotion and beauty, has not been employed as intensively as it might in efforts to understand what it means to create and learn as virtues of human existence, as perhaps the ultimate of human strivings. We hope that these symposium papers will help invigorate such... (shrink)

In part I of this paper, I argue that #MeToo testimony increases epistemic value for the survivor qua hearer when experiences like hers are represented by others; for society at large when false but dominant narratives about sexual violence and sexual harassment against women are challenged and replaced with true stories; and for the survivor qua teller when her true story is believed. In part II, I argue that the epistemic significance of #MeToo testimony compels us to consider the tremendous (...) and often unappreciated costs to the individual tellers, and the increased credibility they are owed in virtue thereof. (shrink)

In _Politics with Beauvoir_ Lori Jo Marso treats Simone de Beauvoir's feminist theory and practice as part of her political theory, arguing that freedom is Beauvoir's central concern and that this is best apprehended through Marso's notion of the encounter. Starting with Beauvoir's political encounters with several of her key contemporaries including Hannah Arendt, Robert Brasillach, Richard Wright, Frantz Fanon, and Violette Leduc, Marso also moves beyond historical context to stage encounters between Beauvoir and others such as Chantal Akerman, (...) Lars von Trier, Rahel Varnhagen, Alison Bechdel, the Marquis de Sade, and Margarethe von Trotta. From intimate to historical, always affective though often fraught and divisive, Beauvoir's encounters, Marso shows, exemplify freedom as a shared, relational, collective practice. _Politics with Beauvoir_ gives us a new Beauvoir and a new way of thinking about politics—as embodied and coalitional. (shrink)

In their well-known paper, John Gardner and Stephen Shute (2000) propose a pure case of rape, in which a woman is raped while unconscious and the rape, for a variety of stipulated reasons, never comes to light. This makes the pure case a harmless case of rape, or so they argue. In this paper I show that their argument hinges on an outdated conception of trauma, one which conflates evaluative responses that arise in the aftermath of rape with the non-deliberative (...) somatic responses of a central nervous system to a threatening event. In the first part of this paper, I elaborate this objection by drawing on the neurobiological model of trauma. This gives me an opportunity to illustrate the different ways that rape harms its victims, including the central way, what I call ‘threat-circuitry harm.’ This discussion of trauma invites us to rethink the wrong of rape, and sets the groundwork for my argument, in the second part of the paper, that the wrong of rape consists in its central harm. (shrink)

This hermeneutic phenomenological study of how remote workers in global corporations experience and interpret local place is based on Heidegger’sthinking about space, place, and dwelling, Giddens’ conception of globalization as “time-space distanciation,” and recent research and theory related to remote work and architecture. Study participants are knowledge workers in the United States and Europe who work full time from home as employees of large global corporations. The analysis reveals several insights about remote workers’ lived experience of place, including the importance (...) of managing the threshold between work and home and the need to create spaces for interaction at work. Some remote workers learn to shape, choose, or create places that better suit them, while others prefer to remain in place. Some become more involved in their local communities, helping these communities become more globally-connected while retaining their unique local qualities. The analysis reveals five themes that suggest that place is both spatial and temporal. A place is a specific location within physical space that acquires personal meaning, arising from a person’s past history and evolving with ongoing or repeated experience. Individuals make meaning of place as Center (groundedness or rootedness), Setting (activity, convenience or purpose), and Source (generativity, inspiration or transcendence). We shape and respond to places; places shape us as our lives take place within them. (shrink)

I want to thank Paul Lieberman, Nancy Nyquist Potter, and Marilyn Nissim-Sabat for their very thoughtful and stimulating commentaries on my paper (Lieberman 2007; Potter 2007; Nissim-Sabat 2007). Each offers an interesting and distinct challenge to my work and I am happy for the opportunity to reply to the insights they bring to it. In this short response, I focus on what I take to be the most serious objections from each commentator, with the hopes of both clearing up some (...) ambiguities and loose ends present in my paper as well as elaborating some of my ideas in more detail. (shrink)

The use of statistics in medical research has been compared to a religion: it has its high priests, supplicants, and orthodoxy. Although the comparison may be more unfair to religion than to research, a useful lesson can nonetheless be drawn: the practice of clinical research may benefit—as does the spirit—from critical self-examination. Arguably, no aspect of the conduct of clinical trials is currently more controversial—and thus in as dire need of critical examination—than the use of placebo controls. The ethical and (...) scientific controversies associated with placebo-controlled trials, never far below the surface, have once again seized public attention. Clearly, concern about these issues within the professional community runs deep and wide, as evidenced by the volume of response generated by Kenneth Rothman and Karin Michels's recent Critique. Criticisms of the use of placebo controls in clinical research are scattered through the literatureo; our objective is to present the case against placebos in a compendious form that takes account of scientific and statistical as well as normative issues. (shrink)

Val Plumwood urged us to attend to earth others in non-dualistic ways. In this essay I suggest that such attention be promoted through what I call "engaged empathy." Engaged empathy involves critical attention to the conditions that undermine the well being or flourishing of those to whom empathy is directed and this requires moral agents to attend to things they might not have otherwise. Engaged empathy requires gaining wisdom and perspective and, importantly, motivates the empathizer to act ethically.

Advances in neuroscience research have changed the ways in which the relationship between brain and behavior are studied and conceptualized. These advances are important and suggest the possibility of new approaches to helping people with neurological and psychiatric illnesses, but they also bring with them the risk of applying supposed breakthroughs without acknowledgment of the limits and assumptions which underlie the research. As neuroscience is increasingly used to, or proposed as, a means of controlling behavior, through criminal and civil legal (...) systems, researchers have an obligation to articulate the assumptions, limits, and ecological validity of their findings. Yet, neuroscience researchers rarely describe the assumptions underlying the studies, the generalizability of the findings and most importantly, the limits of its applicability to real world behavior. (shrink)

As today's LDS women navigate a turbulent world, they must boldly face a constant barrage of messages challenging their individual worth. So when the barbs of the adversary become too much, where can these women turn for peace? In this beautiful collection of inspirational thoughts and words of reassurance, Fill Your Day with Hope reminds daughters of God of their personal worth with tender optimism. Designed to help sisters reach their full potential, these inspiring messages represent the wisdom of generations (...) of faithful women whose words will encourage young and older sisters alike to spread their wings and fly"-- Page 4 of cover. (shrink)

Duty and Healing positions ethical issues commonly encountered in clinical situations within Jewish law. The concept of duty is significant in exploring bioethical issues, and this book presents an authentic and non-parochial Jewish approach to bioethics, while it includes critiques of both current secular and Jewish literatures. Among the issues the book explores are the role of family in medical decision-making, the question of informed consent as a personal religious duty, and the responsibilities of caretakers. The exploration of contemporary ethical (...) problems in healthcare through the lens of traditional sources in Jewish law is an indispensable guide of moral knowledge. (shrink)

Gilles Deleuze and Félix Guattari’s notion of becoming-animal offers a mode of interaction that goes beyond the symbolic language and conceptual thought that are often used in the western philosophical tradition to circumscribe the limits and define the nature of an ethical engagement. They fail, however, to provide a robust account of how becoming may yield an ethical exchange between the human being and the animal other. In order for this process to generate such an outcome, it must be accompanied (...) by commitment to and care for the animal. Primatologist Barbara Smuts brings this becoming to the flesh in ways that enable a committed, caring and collaborative ethical interaction between species. (shrink)

Motivated ignorance is an incentivized absence of knowledge that arises in circumstances of unequal power relations, a self-protective non-knowing which frees individuals from having to reflect on the privileges they have in virtue of membership in a dominant social group. In philosophical discussions, the term “motivated ignorance” gets used interchangeably with “willful ignorance.” In the first half of this paper, using Charles Mills’ (2007) white ignorance as the defining case, I argue that this is a mistake. A significant swath of (...) cases of motivated ignorance are non-willful, or deep, following Rik Peels (2010). But in all cases, benefits accrued to some in virtue of their social position are gained and maintained at the expense of harms to others. In the second half of this paper, I argue that these harms are what ground attributions of culpability in cases of motivated ignorance and drive the normative requirement that the subject know better, so long as the facts in question are ordinarily and easily knowable (in a sense to be specified). Willfulness is not a necessary condition for culpability, even if it is a sufficient one. (shrink)

Unconsented intimate exams on men and women are known to occur for training purposes and diagnostic reasons, mostly during gynecological surgeries but also during prostate examinations and abdominal surgeries. UIEs most often occur on anesthetized patients but have also been reported on conscious patients. Over the last 30 years, several parties—both within and external to medicine—have increasingly voiced opposition to these exams. Arguments from medical associations, legal scholars, ethicists, nurses, and some physicians have not compelled meaningful institutional change. Opposition is (...) escalating in the form of legislative bans and whistleblower reports. Aspiring to professional and scientific detachment, institutional consent policies make no distinction between intimate exams and exams on any other body part, but patients do not think of their intimate regions in a detached or neutral way and believe intimate exams call for special protections. UIEs are found to contribute to moral erosion and moral distress of medical students and compromise the sacred trust between the medical community and the general public. This paper refutes the main arguments in favor of the status quo, identifies a series of harms related to continuing the current practice, and proposes an explicit consent policy for intimate exams along with specific changes to medical school curriculum and institutional culture. Because patients are the rights-holders of their bodies, consent practices should reflect and uphold patient values which call for explicit consent for intimate exams. (shrink)

Pornography is everywhere, and it raises a host of difficult questions. What counts as pornography, first of all? When does material cross the line from being erotic to being objectionable? Where does a person's entitlement to sexual freedom end and another person's right not to feel objectified begin? How should rights be weighed against consequences in deciding what laws and policies ought to be adopted? Philosophers Andrew Altman and Lori Watson explore these and other issues in this succinct and (...) readable for-and-against volume. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:The Morality of Huck FinnCarol FreedmanA familiar refrain is that emotions threaten our capacity for moral judgment because they infringe on our ability to be impartial. Some hold that emotions lead us to serve personal rather than impersonal ends. And most Kantians argue that even when emotions influence us to pursue impartial ends, they still fail to be moral motives. Barbara Herman argues, however, that emotions can play an (...) important role in a Kantian model of moral judgment. 1 But her description of the moral role of emotions ultimately falls short. 2The problems with Herman’s argument are illustrated by a passage from Huckleberry Finn. The passage challenges a common Kantian assumption that any decision motivated by compassion or love is not a case of moral judgment. I contend that there is good reason to interpret Huck’s decision to help his friend Jim as an instance of moral judgment, even though it is also a case of acting from compassion and love. And though Herman’s theory offers a Kantian way of supporting my reading of Huck, her model fails to do justice to Huck’s case. But there is much that we can learn from the way it fails.IHuckleberry Finn is a story “which details some passages in the life of an ignorant village boy... [who has] run away from his persecuting father, and from a persecuting, good widow, who wishes to make a nice, truth-telling, respectable boy of him....” 3 The journey that follows, in which Huck is accompanied by the widow’s runaway slave, Jim, becomes a symbol of a boy’s attempt to grow up, discover his own identity, make his own decisions. In the part of the journey that has come to be known [End Page 102] as Huck’s “crisis of conscience,” we find him trying to decide whether he should help Jim escape from a slaveholder who has just captured him, or whether he should write to Miss Watson to tell her the where-abouts of her slave (pp. 168–69). On the face of it, Huck seems torn between the voices of conscience and temptation. Writing to Miss Watson, as he describes it, is “the right thing and the clean thing.” To do otherwise would just confirm his “wickedness”: “stealing a poor old woman’s nigger,” he says, “who hadn’t ever done me no harm.” But Huck also loves Jim. He says: “I couldn’t seem to strike no places to harden me against him, but only the other kind.” So Huck seems torn between his sense of what’s right and his compassion. When, in exas-peration, he finally decides not to write the letter, but chooses instead “to go to hell,” it sounds like compassion triumphs over conscience. 4But is it necessarily the case that just because Huck acts from compassion that he does not conceive of what he’s doing as right—that he does not engage in moral judgment? I think it is most plausible to say that when Huck finally decides not to turn Jim in, he comes to a more heart-felt conception of what’s right, not that he does what he believes is wrong.Even though Huck describes helping Jim as “stealing,” and sinful, and the sort of thing for which he will “go to hell,” it is not clear that he thinks it is the wrong thing to do. Huck’s deliberation is tied up with thoughts of social condemnation and eternal punishment. He is obsessed with the pain he will endure if he does not write to Miss Watson. His thoughts begin with the pain of social condemnation (“And then think of me! It would get all around, that Huck Finn helped a nigger to get his freedom”); but they quickly turn to the pain of eternal punishment (“And at last, when it hit me all of a sudden that here was the plain hand of Providence slapping me in the face and letting me know my wickedness was being watched all the time from up there in heaven... I most dropped in my tracks I was so scared”). But Huck describes the... (shrink)

Due to COVID-19’s strain on health systems across the globe, triage protocols determine how to allocate scarce medical resources with the worthy goal of maximising the number of lives saved. However, due to racial biases and long-standing health inequities, the common method of ranking patients based on impersonal numeric representations of their morbidity is associated with disproportionately pronounced racial disparities. In response, policymakers have issued statements of solidarity. However, translating support into responsive COVID-19 policy is rife with complexity. Triage does (...) not easily lend itself to race-based exceptions. Reordering triage queues based on an individual patient’s racial affiliation has been considered but may be divisive and difficult to implement. And while COVID-19 hospital policies may be presented as rigidly focused on saving the most lives, many make exceptions for those deemed worthy by policymakers such as front-line healthcare workers, older physicians, pregnant women and patients with disabilities. These exceptions demonstrate creativity and ingenuity—hallmarks of policymakers’ abilities to flexibly respond to urgent societal concerns—which should also be extended to patients of colour. This paper dismantles common arguments against the confrontation of racial inequity within COVID-19 triage protocols, highlights concerns related to existing proposals and proposes a new paradigm to increase equity when allocating scarce COVID-19 resources. (shrink)

New Jersey's Baby M case has thrust the issue of surrogate motherhood on state legislatures throughout the country. Like artificial insemination in the 1950s and 1960s, this new reproductive technology is evoking legislative responses ranging from horrified prohibition to cautious facilitation.

Prologue -- Paris, August 1, 1990 -- What happened next -- Live in it -- Africa, 2008 -- Paris, revisited.

This paper has two major goals: First, I argue that Catharine MacKinnon’s and Andrea Dworkin’s anti-pornography activism was an act of public reason and their arguments public reasons arguments. Thus, MacKinnon’s argument that pornography is best understood as a practice of sex discrimination is a public reason argument—and so can be defended as grounded in liberal political principles. Political liberalism, as I defend it, can support MacKinnon’s approach to pornography as embodied in a civil rights ordinance. By way of contrast, (...) I will take up another feminist position on pornography, Drucilla Cornell’s, that differs from, and in fact is quite critical of, the MacKinnon/Dworkin anti-pornography position. My primary aim here is to show that Cornell’s arguments fail—as they stand—as public reason arguments, and thus further highlight the crucial aspects of MacKinnon’s feminist approach that are compatible with public reason, and so with liberal political principles. This is not to say that one could not provide a public reason argument for a position like Cornell’s. However, as she offers it, her position is not compatible with the norms of public reason. Second, I show why the obscenity route to the regulation of pornographic material—the traditional liberal approach—is actually antithetical to the version of political liberalism I am interested in defending. The conclusion of these arguments is that contrary to the mainstream view, liberalism is hospitable to the arguments of MacKinnon and Dworkin, and so as liberals we have not only good reason to take their arguments very seriously, but even stronger their arguments flow from fundamental liberal political values. (shrink)

My favorite opponent in this debate once made a remarkable concession, not that it interfered with business as usual:No sensible social scientist believes any particular specification, coefficient estimate, or standard error. Social science theories ... imply that specifications and parameters constant over situations do not exist ... One searches for qualitative theory ... not for quantitative specifications Achen (1987, p.149). . With Hooke's law and the like, we are estimating parameters in specifications that are constant across time—at least to a (...) very good degree of approximation But see Cartwright (1983). . What are the social scientists doing when they estimate non-existent parameters, and put standard errors on the output? How can that help them search for qualitative theory? Those are among the first of my questions, and I never get answers. (shrink)

In this comprehensive introduction to animal ethics, Lori Gruen weaves together poignant and provocative case studies with discussions of ethical theory, urging readers to engage critically and empathetically reflect on our treatment of other animals. In clear and accessible language, Gruen provides a survey of the issues central to human-animal relations and a reasoned new perspective on current key debates in the field. She analyses and explains a range of theoretical positions and poses challenging questions that directly encourage readers (...) to hone their ethical reasoning skills and to develop a defensible position about their own practices. Her book will be an invaluable resource for students in a wide range of disciplines including ethics, environmental studies, veterinary science, women's studies, and the emerging field of animal studies and is an engaging account of the subject for general readers with no prior background in philosophy. (shrink)

"In Entangled Empathy, scholar and activist Lori Gruen argues that rather than focusing on animal rights, we ought to work to make our relationships with animals right by empathetically responding to their needs, interests, desires, vulnerabilities, hopes, and unique perspectives. Pointing out that we are already entangled in complex and life-altering relationships with other animals, Gruen guides readers through a new way of thinking about and practicing animal ethics. Lori Gruen is Professor of Philosophy and Coordinator of Wesleyan (...) Animal Studies at Wesleyan University. She is the author of Ethics and Animals and co-editor, with Carol Adams, of Ecofeminism: Feminist Intersections with Animals and the Earth."--Back cover. (shrink)

In this article, we reflect on our personal experience of acting as ‘independent academic experts’ in an European Union policy forum, to reflect on how the EU utilises gender to legitimise certain policy discourses in combating sex trafficking. Starting from our personal experience, we draw on wider feminist research on gender expertise and on Fraser’s new reflexive theory of political injustice, to consider how the EU structures debates in this area to determine ‘who’ is entitled to speak and be heard (...) on this issue. In a context in which sex trafficking policy intersects with a variety of competing agendas on – among other things – law and order, organised crime, immigration, asylum and border security policy, our argument will suggest that the exclusion of critical feminist voices and lack of alternative perspectives permits much scope for continuing inequality and injustice. (shrink)

There have been many efforts to infer causation from association byusing statistical models. Algorithms for automating this processare a more recent innovation. In Humphreys and Freedman[(1996) British Journal for the Philosophy of Science 47, 113–123] we showed that one such approach, by Spirtes et al., was fatally flawed. Here we put our arguments in a broader context and reply to Korb and Wallace [(1997) British Journal for thePhilosophy of Science 48, 543–553] and to Spirtes et al.[(1997) British Journal for (...) the Philosophy of Science 48, 555–568]. Their arguments leave our position unchanged: claims to have developed a rigorous engine for inferring causation from association are premature at best, the theorems have no implications for samples of any realistic size, and the examples used to illustrate the algorithms are indicative of failure rather than success. The gap between association and causation has yet to be bridged. (shrink)

The purpose of this study was to describe the extent to which nurses perceive the ethical dimensions of clinical practice situations involving patients, families and health care professionals. Using the composite theory of basic moral principles and the professional standard of care established by legal custom as a framework, situations involving ethical dilemmas were gleaned from the nursing literature. They were reviewed for content validity, clarity and representativeness in a two-stage process by expert panels. The situations were presented in a (...) written format to a convenience sample of nurses (n = 125), who were primarily staff nurses (65.6%). Respondents' judgements about whether the main issue of each situation concerned ethics ranged from a low of 0.8% to a high of 40%. From analyses of the categories into which the majority of subjects placed each situation, it was concluded that these nurses generally perceived ethics as the main issue in situations that directly involve patients' autonomy. Analysis yielded unanticipated findings about the themes in ethical situations to which nurses in practice may respond. (shrink)