Biomedical ontologies not only capture a wealth of biological knowledge but also provide a representational system to support the integration and retrieval of biological information that shed light...

The Christian and Islamic doctrine of the VIRGIN BIRTH claim God asexually impregnated the Virgin Mary with Jesus, Mary’s impregnation was fully consensual (VIRGIN CONSENT), and God never acts immorally (DIVINE GOODNESS). First, I show that God’s actions and Mary’s background beliefs undermine her consent by virtue of coercive incentives, Mary’s comparative powerlessness, and the generation of moral conflicts. Second, I show that God’s nondisclosure of certain reasonably relevant facts undermines Mary’s informed consent. Third, I show that a recent attempt (...) by Jack Mulder to rescue VIRGIN CONSENT fails. As DIVINE GOODNESS and VIRGIN CONSENT are more central to orthodoxy, Christians and Muslims have powerful reason to reject VIRGIN BIRTH. (shrink)

In a recent article, Jack Mulder, Jr., gives a Plantinga-style defense of the Virgin Mary’s free consent to bear Jesus at the Annunciation. Against Mulder, I argue that a theodicy (rather than a defense) is necessary to undermine my arguments, that Mulder’s Catholic appeal to Mary’s Immaculate Conception amounts to a kind of freedom-undermining metaphysical grooming, and therefore Marian consent remains invalid.

Throughout Mary Shelley’s early life, she was exposed to numerous well-known and influential people regarding cultural, political, and socio-economic matters. As she began writing, these influences undoubtedly played a role in her narrative. Her novel, _Frankenstein_, written during the time of the first Industrial Revolution in Britain, was one such novel that exhibited her political and economic influences through science fiction. This article addresses many of those influences, including the introduction of the machine into manufacturing. It further addresses how Frankenstein’s (...) Monster may have been one of the first created forms of artificial intelligence (AI). We further expound upon many economic concepts that have persisted through time and are relevant today given the faciliatory aspects, as well as the uncertainty, of AI. We relate these through the literary piece _Frankenstein_ to explore how a two-century-year-old tale provides a blueprint for understanding the conflict among humans and machines and provides a roadmap for harmonization in the past, present, and future. (shrink)

We report the identification of a recurrent, 520-kb 16p12.1 microdeletion associated with childhood developmental delay. The microdeletion was detected in 20 of 11,873 cases compared with 2 of 8,540 controls and replicated in a second series of 22 of 9,254 cases compared with 6 of 6,299 controls. Most deletions were inherited, with carrier parents likely to manifest neuropsychiatric phenotypes compared to non-carrier parents. Probands were more likely to carry an additional large copy-number variant when compared to matched controls. The clinical (...) features of individuals with two mutations were distinct from and/or more severe than those of individuals carrying only the co-occurring mutation. Our data support a two-hit model in which the 16p12.1 microdeletion both predisposes to neuropsychiatric phenotypes as a single event and exacerbates neurodevelopmental phenotypes in association with other large deletions or duplications. Analysis of other microdeletions with variable expressivity indicates that this two-hit model might be more generally applicable to neuropsychiatric disease. © 2010 Nature America, Inc. All rights reserved. (shrink)

The current debate over systematicity concerns the formal conditions a scheme of mental representation must satisfy in order to explain the systematicity of thought.1 The systematicity of thought is assumed to be a pervasive property of minds, and can be characterized (roughly) as follows: anyone who can think T can think systematic variants of T, where the systematic variants of T are found by permuting T’s constituents. So, for example, it is an alleged fact that anyone who can think the (...) thought that John loves Mary can think the thought that Mary loves John, where the latter thought is a systematic variant of the former. (shrink)

William Blake and Zadie Smith reached strikingly similar critical positions towards philosophical trends current in their respective eras. Both excoriate those who, for selfish ends, disparage beauty and in so doing sabotage justice, love, joy and genuine freedom. Smith’s On Beauty, like Blake’s America: A Prophecy and Visions of the Daughters of Albion, indicts the reprehensible intellectual discourses of the day that undermine human happiness and corrupt the social order. Whereas Blake critiqued the rights revolutions set in (...) motion by Thomas Paine, William Godwin, Mary Wollstonecraft and others from a more broadly moral and future-oriented angle than has generally been recognized (as Saree Makdisi has shown), Smith wittily dramatizes that same vision through a huge range of up-to-date ideological discourses and antagonisms–many of them descended from Paine et al.–to refurbish Blake’s particular brand of radical antinomianism and to celebrate much the same optimistic spirit that Blake invested in America and Visions. Indeed, Smith’s novel anticipates and critiques ab ovo the sweepingenthusiasms that are animating current uprisings worldwide. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Philosophy of Music Education Review 12.1 (2004) 67-70 [Access article in PDF] Response to Mary J. Reichling, "Intersections: Form, Feeling, and Isomorphism" David Stevenson Vassalboro, Maine Mary J. Reichling's essay regarding the three concepts, form, feeling, and isomorphism, is lucid, well structured, and aptly supported by research of other music education philosophers. She states her purpose in the opening paragraph: "to examine and to elucidate various aspects of these (...) three concepts in her [Susanne Langer's] writing, as they are fundamental to an understanding of her aesthetic theory and to the construction of a philosophy of music and music education."A philosophy of music education must be the focus in all ensuing debate, and must remain of paramount importance. Arguments, especially dialectic arguments, are not won or lost; they merely strip away the outer garments until more and more of the truth is exposed. My thoughts regarding Reichling's essay are offered in this vein.Reichling amply makes the point that music is a dynamic moving form. She asserts that "Langer argues that form is not separable from content," clarifying further by saying that "By content Langer is designating the form's import or meaning." And she offers other examples of dynamic, moving forms, among them, "forms created by movements of clouds or fog through the mist and early light." [End Page 67]At this point, perhaps interjecting the notion of perception is in order. I would suggest that the cloud formations offer no content or meaning outside of the viewer's perceptions or imagination. Music (art), being the nebulous subject that it is, ensconced in subjectivity and steeped in perception, both interpersonal and intrapersonal at the same time, exists to be taken by individuals, each at his or her own level of accomplishment, understanding, and interest. Therefore, does the meaning inhere in the form, as Langer and Reichling assert, or is it assigned by the listener (in the case of music) or by the viewer (in the case of the cloud formation)? "If the doors of perception were cleansed every thing would appear to man as it is: infinite."1 William Blake's observation notwithstanding, the truth is that perception is the only thing that we have with which to view our existence. I believe that there is such a thing as absolute truth, and that reality does exist. However, we mere mortals lack the ability to view the world through anything other than our own perceptions. The knowledge or meaning gained through contemplation of the form is, in all likelihood, quite different for each observer.Likewise, imagination and conceptual ability play a role in interpreting what the senses have perceived. Langer, and by quotation, Reichling, offers the notion of a red dot placed on the rim of a spinning wheel that appears to the viewer as a red circle. "When the spinning stops, the form, the red circle, evaporates. Did it really exist? Does it have ontological status? Is it merely an illusion?" I asked my students to close their eyes and imagine a spinning wheel with a red dot placed on the rim. I asked them, "As the wheel spins, do you see the dot?" The answer was that they saw a red circle. Did they really see a red circle, or even a spinning wheel? Of course not, we were in a music classroom. Yet they were able to conceptualize or imagine the image, and I would suggest that that carries more weight in the realm of art than does actual ontological status.The problem with the experiment of the preceding paragraph is that "Langer argues that form is not separable from content, writing that it is not possible 'to divorce the logical form from its one embodiment or expression.'" In the subsequent paragraph Reichling states, When the music stops, when the ballet is concluded, when the play ends, when the wheel stops spinning, memory may remain but the content (content as meaning-my parenthetical interjection), the feeling, the red circle, the image the dancer created is gone. Is this illogical or has knowledge... (shrink)

The article explores how digital images of hands are used as a symbolic representation of intimacy and intimate emotions in influencer communication on Instagram. Based on digital ethnography with female influencers in the Czech Republic, the analysis focuses on three categories of communicative practices, where hands function as a visual representation of intimacy—creating community, a sense of vulnerability, and the notion of rawness and openness. The analysis points to the gendered nature of influencer communication. It explores how intimacy is established (...) specifically by women influencers who need to navigate vulnerability with the need to protect themselves against gender-based online violence in the form of hate comments and sexualized hate speech. (shrink)

In [12], P. Scowcroft and L. van den Dries proved a cell decomposition theorem for p-adically closed fields. We work here with the notion of P-minimal fields defined by D. Haskell and D. Macpherson in [6]. We prove that a P-minimal field K admits cell decomposition if and only if K has definable selection. A preprint version in French of this result appeared as a prepublication [8].

This editorial presents a special issue gathering four contributions about the patient’s lived experience in the context of deep-brain stimulation. It aims at clarifying the meaning of such an experience and its scope for medical practice, the health system and its legal frame.

Journal of Philosophy of Education, Volume 56, Issue 1, Page 22-28, February 2022.

Within recent years, an increasing number of people and researchers in the Global North have become interested in psychedelic substances and their therapeutic application. While much of the current media attention and research effort mainly concentrate on the therapeutic potential and actions of the individual's acute psychedelic experience, this article explores the user-perceived, therapeutic dynamics of psychedelics in a more long-term perspective by charting the lived experiences and practices of ‘integration’ among psychedelic users in Denmark. Based on ethnographic fieldwork from (...) November 2020 to June 2021, I offer a dual typology of self-related integration as narrative and experiential-somatic. Combining the two, I argue that psychedelic integration in contemporary Denmark can be viewed as a processual self-transformation of the users' experiential orientation where understandings and/or modes of being from the acute psychedelic experience are woven into, prolonged, and/or embodied in their everyday existence. (shrink)

RésuméCet article propose une réflexion théorique et méthodologique permettant de décrire et d’interpréter lestextscapesà des fins d’analyse communicationnelle. L’objectif consiste à tester le concept sémiotique detextscapelinguistique pour analyser la mise en scène des langues dans la communication des organisations sur le web. Le cadre théorique fait appel aux études du paysage linguistique (Linguistic Landscape Studies) et à la théorie des paysages textuels (textscapes). Le corpus est composé de 100 sites web d’organisations économiques (chambres de commerce,clusterséconomiques, entreprises) qui revendiquent un positionnement (...) à l’échelle transfrontalière européenne. L’étude est menée d’un point de vue statistique (analyse de métadonnées) et qualitatif (analyse sémiotique dutextscapelinguistique) en vue de préciser la place et les fonctions communicationnelles dutextscapelinguistique dans la communication multilingue. Les résultats ont permis de dégager les profils d’expression, un scénario sémiotique typique des sites web observés et surtout de localiser les (dés)équilibres communicationnels. (shrink)

This report characterizes the state of affairs in the field of business ethics in Central and Eastern Europe. It reveals the major problems and challenges brought about by the profound reforms to these societies and economies. It also offers some results of surveys looking at public opinion on morals and ethics, as well as on current business practices. In order to give a complex picture, it presents brief lessons from the history of particular countries. The author, devoting the most attention (...) to the Czech Republic, tries to describe not only the development of business ethics in the theoretical arena but also the first steps taken by the business world itself. (shrink)

How can the use of testimonies, as representations of suffering, be understood in education? What kind of potential can the use of testimonies have for pedagogical transformation? In this article, drawing on Mollenhauer and Sontag, I discuss the problem of representation as selection in education as it is easier to opt out of that which is difficult to face, to describe and to understand. As an alternative, I see what happens if representations of suffering are related to voices and remnants (...) from the past, drawing on Agamben, and as something that stands between what is possible to say and what is impossible to say, in any language. The article also draws on Spivak's theory of a representational idea based on literary reading, hacking and suturing, which urges ‘us’ to regard testimonies as relational and to listen to different voices from the past and to make room for them within our own language. (shrink)

For the past three decades, notebooks and note?taking practices have elicited growing interest in various fields of research: anthropology, media and literature studies, history of the book, history of science. In this renewal, however, scientific travelers? notes have not received all the attention they deserve. To be sure, historians of discovery and exploration are used to considering travel diaries and field notes as a principal resource, on the basis of which they can assess a traveler?s accomplishment or document his itinerary. (...) From a different perspective, field journals offer rich material to literary scholars, critics, and specialists of travel writing. Notebooks of well?known travelers like Bougainville or Humboldt are thus scrutinized in their poetic and aesthetic dimensions, from the perspective of the genesis of travel writing. Still, few studies have taken up the task, a rather mundane and down?to?earth endeavor, to look at travel notebooks for their own sake, as material objects, made of paper and cardboard, and meant to store observational data and to insure their availability through time and space. The paper sets out to do just that: to take a set of manuscript notebooks written by eighteenth? and early nineteenth?century French, German, and Swiss naturalist travelers and scientists on the move together with the techniques at work in their writing, as the focus of a historical investigation. (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)

This paper focuses on the centrality of permaculture design courses as the principal sociopolitical strategy of the permaculture community in Canada to transform local food production practices. Building on the work of Antonio Gramsci and political agroecology as a framework of analysis, we argue that permaculture instruction remains deeply embedded within market and colonial relations, which orients the pedagogy of permaculture trainings in such a way as to reproduce the basic elements of the colonial capitalist economy among its practitioners. In (...) the specific case of eastern Ontario, this embeddedness had the effect of diluting the transformative capacity of permaculture practitioners who were unable to create its own social movement organization. The paper then highlights key elements of the agroecological pedagogy used by the Brazilian Landless Rural Workers Movement and the Escola Latinoamericana de Agroecología in Paraná, Brazil. The objective is to draw lessons from these inspiring experiences, in a rather unique context of struggles that can help to critically assess the pedagogical practices and principles presently informing permaculture communities in Canada and in advanced industrialized countries more generally. We then conclude by reiterating the key arguments and lessons drawn from the Brazilian pedagogical experiences, pointing out the importance of engagement and coalition-building with established rural and urban movements, as well as progressive farmer, Indigenous, and rural associations to foster a just and sustainable transformation of agri-food systems, starting at the local and regional levels. It also emphasizes the need for the most marginalized sectors to lead the way towards an agroecological transition. (shrink)

Contributing to both ageing research and queer-feminist scholarship, this article introduces feminist philosopher Margrit Shildrick’s queer notion of the monstrous to the subject of ageing and the issue of dealing with frailty within ageing research. The monstrous, as a norm-critical notion, takes as its point of departure that we are always already monstrous, meaning that the western ideal of well-ordered, independent, unleaky, rational embodied subjects is impossible to achieve. From this starting point the normalizing and optimizing strategies of ageing research (...) – here exemplified through the concept of successful ageing and the treatment of Alzheimer’s disease – can be problematized. The notion of the monstrous instead suggests a view on ageing and ‘monstrous’ embodiment which provides room for other, different ways of being recognized as an embodied subject, and for dealing with difference, vulnerability and frailty. (shrink)

L’apport de la phénoménologie allemande à l’éthique a souvent été réduit aux intentionnalités et aux vécus axiologiques et affectifs, tels qu’ils furent décrits par Husserl. Or, cet apport est limité du fait que Husserl définissait d’abord l’intentionnalité comme un rapport à un objet dont nous sommes conscients. Dans ce qui suit, nous proposons d’emprunter une autre voie pour penser l’apport de la phénoménologie à l’éthique, en étudiant la phénoménologie des actes sociaux que les phénoménologues munichois développèrent en réponse à la (...) phénoménologie husserlienne. Cette phénoménologie des actes sociaux permet de considérer, de juger et de critiquer, d’un point de vue éthique, les façons dont nous entrons en relation intentionnelle non pas avec des objets éthiques, mais avec autrui. Notre propos suivra principalement les idées développées par Reinach, Pfänder, Daubert et Scheler, et prendra pour fil directeur les actes d’adresser un impératif et une invitation à autrui. (shrink)

The Textual Criticism of Sumerian Literature. By Paul Delnero. The Journal of Cuneiform Studies Supplemental Series, vol. 3. Boston: American Schools of Oriental Research, 2012. Pp. viii + 230. $89.95. [Distributed by ISD, Bristol, Conn.].

ZusammenfassungViele Menschen erwarten Dankbarkeit von den Geflüchteten, die in Europa aufgenommen werden. Nun kann mit dem Satz „Geflüchtete sollen dankbar sein“ eine moralische Pflicht oder ein Ratschlag gemeint sein. Mein Essay zeigt in einem ersten Schritt, dass es keine Pflicht zur Dankbarkeit geben kann. Dankbarkeit ist vielmehr Supererogation, nämlich eine moralisch wertvolle Handlungsweise, die keine Pflicht sein kann. Das gilt auch für Geflüchtete. Anschließend zeige ich, dass Dankbarkeit als sympathischer Ausdruck einer Tugendhaltung jedermann anzuraten ist. Wer sich für erwiesene Wohltaten (...) dankbar zeigt, wird gemocht und geschätzt. Das gilt wiederum auch für Geflüchtete. Mein Essay schließt mit einem kurzen Ausblick zu der Frage, wofür und in welchem Umfang Geflüchteten Dankbarkeit anzuraten ist. (shrink)

This book argues that human rights cannot go global without going local. This important lesson from the winding debates on universalism and particularism raises intricate questions: what are human rights after all, given the dissent surrounding their foundations, content, and scope? What are legitimate deviances from classical human rights and where should we draw “red lines”? Making a case for balancing conceptual openness and distinctness, this book addresses the key human rights issues of our time and opens up novel spaces (...) for deliberation. It engages philosophical reasoning with law, politics, and religion and demonstrates that a meaningful relativist account of human rights is not only possible, but a sorely needed antidote to dogmatism and polarization. (shrink)