I explore how gender can shape the pragmatics of speech. In some circumstances, when a woman deploys standard discursive conventions in order to produce a speech act with a specific performative force, her utterance can turn out, in virtue of its uptake, to have a quite different force—a less empowering force—than it would have if performed by a man. When members of a disadvantaged group face a systematic inability to produce a specific kind of speech act that they are entitled (...) to perform—and in particular when their attempts result in their actually producing a different kind of speech act that further compromises their social position and agency—then they are victims of what I call discursive injustice. I examine three examples of discursive injustice. I contrast my account with Langton and Hornsby's account of illocutionary silencing. I argue that lack of complete control over the performative force of our speech acts is universal, and not a special marker of social disadvantage. However, women and other relatively disempowered speakers are sometimes subject to a distinctive distortion of the path from speaking to uptake, which undercuts their social agency in ways that track and enhance existing social disadvantages. (shrink)

In 2006, I was diagnosed with cancer. This began a crash course in real-world medical ethics. Having cancer was awful, but it was instructive, too. The experience gave me a new understanding of what my profession is about. Individuals in the bioethics field often address topics related to cancer, such as medical decision-making, the patient-physician relationship, clinical trials, and access to health care. Yet few engaged in this work have lived with cancer themselves. Experience as a cancer patient or family (...) caregiver extends and deepens one’s thinking about serious illness and bioethics. During my time as a cancer patient, I kept in touch with several colleagues immersed in their own cancer .. (shrink)

It is unclear whether someone’s responsibility for developing a disease or maintaining his or her health should affect what healthcare he or she receives. While this dispute continues, we suggest that, if responsibility is to play a role in healthcare, the concept must be rethought in order to reflect the sense in which many health-related behaviours occur repeatedly over time and are the product of more than one agent. Most philosophical accounts of responsibility are synchronic and individualistic; we indicate here (...) what paying more attention to the diachronic and dyadic aspects of responsibility might involve and what implications this could have for assessments of responsibility for health-related behaviour. (shrink)

Questions of what a self-driving car ought to do if it encounters a situation analogous to the ‘trolley problem’ have dominated recent discussion of the ethics of self-driving cars. This paper argues that this interest is misplaced. If a trolley-style dilemma situation actually occurs, given the limits on what information will be available to the car, the dynamics of braking and tyre traction determine that, irrespective of outcome, it is always least risky for the car to brake in a straight (...) line rather than swerve. (shrink)

Health promotion efforts are commonly directed towards encouraging people to discard ‘unhealthy’ and adopt ‘healthy’ behaviours in order to tackle chronic disease. Typical targets for behaviour change interventions include diet, physical activity, smoking and alcohol consumption, sometimes described as ‘lifestyle behaviours.’ In this paper, I discuss how efforts to raise awareness of the impact of lifestyles on health, in seeking to communicate the need for people to change their behaviour, can contribute to a climate of ‘healthism’ and promote the moralisation (...) of people’s lifestyles. I begin by summarising recent trends in health promotion and introducing the notion of healthism, as described by Robert Crawford in the 1980s. One aspect of healthism is moralisation, which I outline and suggest is facilitated by efforts to promote health via information provision and educational strategies. I propose that perceived responsibility plays a role in mediating the tendency to moralise about health and behaviour. Since I argue that states ought to avoid direct and indirect moralisation of people’s health-related behaviour, this suggests states must be cautious with regard to the use of responsibility-indicating interventions to promote health. (shrink)

The Principle of Procreative Beneficence claims that we have a moral obligation, where choice is possible, to choose to create the best child we can. The existence of this moral obligation has been proposed by John Harris and Julian Savulescu and has proved controversial on many levels, not least that it is eugenics, asking us to produce the best children we can, not for the sake of that child's welfare, but in order to make a better society. These are strong (...) claims that require robust justification that can be open to scrutiny and debate. This article argues that robust justifications are currently lacking in the work of Savulescu and Harris. The justifications provided for their conclusions about this obligation to have the best child possible rely heavily on Derek Parfit's Non-Identity Problem and the intuitive response this provokes in many of us. Unfortunately Harris and Savulescu do not embrace the entirety of the Non-Identity Problem and the puzzle that it presents. The Non-Identity Problem actually provides a refutation of PPB. In order to establish PPB as a credible and defendable principle, Harris and Savulescu need to find what has eluded Parfit and many others: a solution to the Non-Identity Problem and thus an overturning of the refutation it provides for PPB. While Harris and Savulescu do hint at possible but highly problematic solutions to the Non-Identity Problem, these are not developed or defended. As a result their controversial is left supported by little more than intuition. (shrink)

Mass Hysteria examines the medical and cultural practices surrounding pregnancy, new motherhood, and infant feeding. Late eighteenth century transformations in these practices reshaped mothers' bodies, and contemporary norms and routines of prenatal care and early motherhood have inherited the legacy of that era. As a result, mothers are socially positioned in ways that can make it difficult for them to establish and maintain healthy and safe boundaries and appropriate divisions between public and private space.

The revised Common Rule adopts the reasonable person standard to guide research disclosure. Some members of the research community contend that the standard is confusing and ill-suited to the research oversight system. Yet the revised rule is not as radical as it might seem. During the 1970s, judges started using the standard to evaluate negligence claims brought by injured patients who said doctors had failed to obtain informed consent to the harmful procedures. In its influential Belmont Report, the National Commission (...) recommended application of a “reasonable volunteer standard” to guide IRBs evaluating research disclosures. Evidence also suggests that IRBs often invoke the reasonable person standard in deliberations about consent forms. But past application of the standard has been informal and uneven. Robust application of the reasonable person standard will require researchers and IRBs to learn more about what ordinary people want and need to know about the studies they are invited to join. Input from people with personal experience as study participants could be particularly useful to this effort. (shrink)

This essay explores the theorization of moral valuation outlined in Stefan Bargheer’s Moral Entanglements: Conserving Birds in Britain and Germany when extended to the climate crisis. It considers, first, how ‘nature’ is valued when it confronts people and societies as a source of threat, rather than of recreation or resources. Second, the essay critically examines the role of moral discourse in the collective work of addressing climate change and its relationship to practice.

Translational science is a 21st century mission. Government officials and industry leaders are making huge investments in an attempt to transform more basic science discoveries into therapeutic applications. Scientists and policymakers express great excitement about the medical advances that could come with the current bench-to-bedside campaign.A key step in translational science is the move from animal and other preclinical studies to initial human testing. Researchers ability to predict human effects is limited, and first-in-human tests present significant uncertainty. Participants in this (...) form of research face risks and can experience serious, even lethal, harm. Well-known incidents involving Jolee Mohr and Jesse Gelsinger, as well as subjects in the 2006 study of the investigational agent TGN1412, show the dangers that can arise in early human research.The bench-to-bedside campaign will need many volunteers to participate in early human testing. Investigators and regulators must not allow the policy enthusiasm for translational science to overshadow the commitment to protect human subjects. Participants in exploratory research are diverse and as a group lack characteristics usually associated with vulnerable populations, such as impaired decisional ability or economic or educational disadvantage. (shrink)

The term “therapeutic misconception” was coined in 1982 by Paul Appelbaum, Loren Roth, and Charles Lidz. Appelbaum and his colleagues interviewed participants in several psychiatric studies, including a drug trial with a placebo control arm. Appelbaum's group found that many people were unaware of the differences between participating in a study and receiving treatment in the clinical setting. Rather than understanding these differences, study participants tended to believe that therapy and research were governed by the same primary goal: to advance (...) the individual patient's best interests. Appelbaum's group labeled this mistaken belief the therapeutic misconception. (shrink)

Most patients suffering from progressive dementia have thoughts, emotions, perspectives, and perceptions of a world of experience. Decisions about life‐sustaining treatment should incorporate a principled approach to evaluating what life is like for these patients.

Scientific explanations are widely recognized to have instrumental value by helping scientists make predictions and control their environment. In this paper I raise, and provide a first analysis of, the question whether explanatory proofs in mathematics have analogous instrumental value. I first identify an important goal in mathematical practice: reusing resources from existing proofs to solve new problems. I then consider the more specific question: do explanatory proofs have instrumental value by promoting reuse of the resources they contain? In general, (...) I argue that the answer to this question is “no” and demonstrate this in detail for the theory of mathematical explanation developed by Marc Lange. (shrink)

van der Pijl et al 1 argue that if ‘stakes are high’ and there is ‘clear conviction by the care provider’ that it is ‘necessary’, episiotomy may be given after ‘opt-out consent’. Here I caution against the applicability of their approach to vaginal examination (VE): another routine intervention in birth to which they suggest their discussion may apply. I highlight three concerns: first, the subjective and unjustified nature of assessments of ‘necessity’; second, the inadequacy of current consent practices in relation (...) to VE; and third, the significant risk of perpetuating under-recognised harms associated with unwanted or unconsented VE. I argue that opt-out consent cannot be ethically justified for VE. Its use would result in further weakening of consent practices, circumvention of individuals’ autonomy, and greater harm for women and birthing people. At the outset, it is important to recognise that the authors do not claim that their approach should be applied to VE, merely that their discussion may have relevance to consent for other interventions beyond episiotomy ‘where consent is also frequently lacking, and which are under-researched’, including VE.1 Nonetheless, it is easy to assume that episiotomy and VE are sufficiently similar that their analysis might be transferred wholesale. I disagree. There are similarities: both interventions are performed on ‘the most intimate and socially sensitive body parts’1; …. (shrink)

Many countries tightly ration access to publicly funded fertility treatments such as in vitro fertilisation. One basis for excluding people from access to IVF is their body mass index. In this paper, I consider a number of potential justifications for such a policy, based on claims about effectiveness and cost-efficiency, and reject these as unsupported by available evidence. I consider an alternative justification: that those whose subfertility results from avoidable behaviours for which they are responsible are less deserving of treatment. (...) I ultimately stop short of endorsing or rejecting such a justification, though highlight some reasons for thinking it is unlikely to be practicable. (shrink)

By analyzing descriptions of illusory and nonillusory figures, Richer called into question the common assumption that illusory and nonillusory perceptions were experientially the same and differed only in terms of their accuracy. The present study attempted to replicate Richer's work with a focus on identifying within the subjects' descriptions any orienting attitudes corresponding to these two forms of perception. Nineteen student volunteers were asked to describe two illusory figures and a nonillusory control of similar complexity. The descriptions revealed consistent differences (...) between the two forms. However, the Hering and Zollner figures were not always described in illusory terms, and surprisingly, several subjects described the control as if it were illusory. Further, perceptual accuracy was not guaranteed by nonillusory experience. Subjects described the figures from within one of three different orienting attitudes-atomizing, representational, and geometrical-organizing. The latter attitude appeared necessary for the phenomena of illusory perception and experience. Though the present findings confirmed Richer's distinction between illusory and nonillusory experience, they also indicate the need for further differentiation- illusory perception versus illusory experience. Finally, the findings also supported Luria's and Segall, Campbell, and Herskovits's position on the importance of particular cultural and educational experiences and codes in relation to perceptual illusions. (shrink)

In this issue, Paul Menzel and M. Colette Chandler‐Cramer propose a novel advance directive. Besides giving competent people the opportunity to refuse future life‐prolonging medical interventions, they say, advance directives should give people the opportunity to refuse ordinary food and water if they later experience severe dementia.This proposal is both appealing and unsettling. It is appealing because it offers some relief to people seeking to avoid the prolonged decline and extreme incapacity they have witnessed in relatives and friends with advanced (...) dementia. But does it sufficiently protect patients? Menzel and Chandler‐Cramer want to empower competent persons to impose potential discomfort and distress on a later self who cannot understand the reasons for that choice. In this situation, the price of respecting autonomy is paid by a frail incapacitated patient who has no idea why food and water are no longer offered to her. (shrink)

Abstract:I raise several concerns with Earp and colleagues' analysis of enhancement through neurochemical modulation of love as a key issue in contemporary neuroethics. These include: (i) strengthening their deflation of medicalization concerns by showing how the objection that love should be left outside of the scope of medicine would directly undermine the goal of medicine; (ii) developing stronger analysis of the social and political concerns relevant to neurochemical modulation of love, by exploring and suggesting possible counters to ways in which (...) 'wellbeing' may be used as a tool of oppression; (iii) providing reasons to support a broad need for ecological investigation of, and indeed ecological education concerning, neurotechnology; (iv) suggesting ways in which philosophy, and the humanities more broadly, remain directly relevant to responding effectively to issues in contemporary neuroethics. (shrink)

Irigaray's critique of the phallocentric subject's implicit dependence on the maternal-feminine “outside” is compelling. Her postulation of nonhierarchical sexual difference gives the relational world of woman specificity and Irigaray brings the subject's worldview to earth as merely the relation of the male human to the world. But the focus of her transvaluation remains largely anthropocentric; and she maintains too many aspects of the privilege of the subject's sovereignty as proper to male subjectivity. I suggest that, we need to extend Irigaray (...) and to think sexual difference beyond the human. Drawing from Elizabeth Grosz, Gilles Deleuze, Henri Bergson and Jakob Von Uexküll, I argue that we need to think life beyond the constitution of the organism as the continuous enmeshment of different milieus. Sexual difference is a force of differentiation that articulates relationships between organisms and organs as crucial aspects of many milieus that make up the Earth. Along with the sexually differentiated aspects of milieus, there are rhythms of difference constitutive of milieus that are not sexed. The first section of the essay describes Irigaray's conceptualization of sexual difference between humans. Then I turn to her engagement with the status of nonhuman animals in “Animal Compassion.” I suggest her approach in this essay is too anthropocentric and move to a discussion of Uexküll's thinking on milieus as a way to extend the concepts of difference and sexual difference into posthuman contexts. The essay concludes by reading Irigaray's concept of difference with Deleuze and Bergson. (shrink)

Much of the public debate over laboratory animal use has focused on either the scientist's demand for absolute freedom of inquiry, or the abolitionist's demand for an end to animal use in science. Yet many recent proposals for reform seek instead to balance the interests of laboratory animals in avoiding harm against the interests of research beneficiaries in continued animal use. This essay is an analysis of the intermediate reform positions and their underlying ethical principles. Keywords: animal research, animal experimentation, (...) ethics CiteULike Connotea Del.icio.us What's this? (shrink)

Bioethics, Volume 36, Issue 5, Page 500-510, June 2022.

Approaches to supporting autonomy in medicine need to be able to support complex and sensitive decision-making, incorporating reflection on the patient's values and goals. This should involve deliberation in partnership between physician and patient, allowing the patient to take responsibility for her decision. Nowhere is this truer than in decisions around pregnancy and Caesarean section where maternal autonomy can seem to directly conflict with foetal interests. Medical and societal expectations and norms such as the expectations of a ‘mother’, constraints of (...) making decisions in an emergency, and the role of technology in viewing the foetus as a separate patient and surgery as a guarantor of results can all act to limit a woman's autonomy. In considering decisions about Caesarean section, maternal interests in bodily integrity can be dismissed as being less important than the foetus's own interests and the mother's duties to it, despite the inherent risks and impacts of such a major surgical procedure... (shrink)

For all the young women and girls sitting in philosophy class wondering where the women are, this is the book for you. This collection of 21 chapters, each on a prominent woman in philosophy, looks at the impact that women have had on the field throughout history. From Hypatia to Angela Davis, The Philosopher Queens will be a guide to these badass women and how their amazing ideas have changed the world. This book is written both for newcomers to philosophy, (...) as well as all those professors who know that they could still learn a thing or two. This book is also for those many people who have told us that there are no great women philosophers. Please pledge, read this book and then feel free to get back to us. (shrink)

BackgroundThe number of autistic students graduating is increasing; however, little is known regarding their transition out of university. Understanding this transition is particularly pertinent with regard to the employment of autistic graduates. It is vital that we understand autistic people’s experiences of the transition and identify what support would be beneficial during this time.MethodThirty-four autistic graduates from the United Kingdom took part in a mixed-methods study exploring their transition experience. Both quantitative and qualitative questions were used to obtain in-depth information (...) concerning participants’ experiences. Participants completed questions regarding their experiences and emotions in relation to the transition, the support they received for the transition, and their career and post-graduation plans.ResultsParticipants reported high levels of fear and low preparedness for the transition. They did not feel well supported in preparing for the transition or for their future career. In the 6 months pre-graduation, 59% of participants had accessed emotion-related transition support and 70% accessed career-related support. Post-graduation, one-third accessed emotion-related or career-related support. Perspectives on this accessed support were mixed, as were transition experiences. Additional support desired included preparation for life changes, career planning, employment accessibility, and autism-specific support. Advice for future students centered on forward planning.ConclusionThese results highlight the importance of supporting autistic students with the transition out of university. Service provision should be tailored to autistic students’ needs and support early planning for the transition. (shrink)

A Vaiṣṇava Poet in Early Modern Bengal: Kavikarṇapūra’s Splendour of Speech. By Rembert Lutjeharms. Oxford Theology and Religion Monographs. Oxford: Oxford University Press, 2018. Pp. 360. $99.

With the help of the current experiment, we wanted to learn more about the impact of visually demanding vs. cognitively demanding secondary tasks on the attention allocation of older pedestrians during the phase of traffic perception within the process of road crossing. For this purpose, we used two different road crossing tasks as well as two different secondary tasks. The road crossing “stop task” was a signal detection task, where an approaching car had to be detected. The road crossing “go (...) task” was a dynamic visual search task, where the resolution of a busy road situation had to be identified. The visual secondary task was a static visual search task and the cognitive secondary task was a 1-back task. One younger group and one older group of participants completed the tasks as single vs. dual-tasks in all possible combinations. Performance was measured through errors and response time; in addition, the subjective workload was assessed via NASA-TLX. Analyses show that the visual secondary task reduces performance in the road crossing more strongly than the cognitive task, while the visual task itself is less impaired by the road crossing tasks than is the cognitive task. Overall, performance diminishes from single to dual-task completion. Results further indicate age effects in terms of increased errors and response time for older compared to younger participants. In addition to these age effects, age-specific dual-task effects emerge for response time in the go task along with the visual task as well as for response time in the cognitive task along with the go task. Subjective workload is higher in the dual-task conditions than in the single tasks. Findings are discussed with regard to theoretical and practical implications. (shrink)

Name der Zeitschrift: Nietzsche-Studien Jahrgang: 43 Heft: 1 Seiten: 195-199.

This article tells the story of an anthropologist and a research subject who encountered each other in the middle of the 20th century on an island in the southwestern Pacific. In the midst of an intensive spate of evidence gathering for his dissertation, anthropologist Melford Spiro noted that one of his would-be interlocutors, a man named Tarev – notable for failing all of his psychological tests – still managed to contribute a different form of evidence: if his views could not (...) be amalgamated in numbers via test scores, they could still be rendered as a case. Tarev’s personality study, ‘A Psychotic in the South Seas’, counted as one of many cases contributing to a broad, worldwide effort to explore the meaning of suffering – specifically psychological illnesses – in non-Western cultures. This article examines Tarev’s rejected test-response ‘data’ and the ways in which his answers did not fit the epistemological and geopolitical frameworks that provoked them. The encounter between anthropologist and interlocutor, today, allows an investigation into how mid-20th-century scholars amassed ambitious data sets meant to revolutionize the sciences that dealt with human beings as psycho-social entities. What sorts of data made it into their archives and what sorts did not? How was the data of happiness, sadness and other fleeting emotional states collected from whole islands newly under US naval occupation? (shrink)