BackgroundThe COVID-19 pandemic introduced new challenges to provide care and educate junior doctors (resident physicians). We sought to understand the positive and negative experiences of first-year resident physicians and describe potential ethical issues from their stories.MethodWe used narrative inquiry (NI) methodology and applied a semistructured interview guide with questions pertaining to ethical principles and both positive and negative aspects of the pandemic. Sampling was purposive. Interviews were audio recorded and transcribed. Three members of the research team coded transcripts in duplicate (...) to elicit themes. Discrepancies were resolved through discussion to attain consensus. A composite story with threads was constructed.Results11 residents participated across several programmes. Three main themes emerged from the participants’ stories: (1) complexities in navigating intersecting healthcare and medical education systems, (2) balancing public health and the public good versus the individual and (3) fair health systems planning/healthcare delivery. Within these themes, participants’ journeys through the first wave were elicited through the threads of (1) engage us, (2) because we see the need for the duty to treat and (3) we are all in this together.DiscussionCases of the ethical issues that took place during the COVID-19 pandemic may serve as a foundation on which ethics teaching and future pandemic planning can take place. Principles of clinical ethics and their limitations, when applied to public health issues, could help in contrasting clinical ethics with public health ethics.ConclusionEfforts to understand how resident physicians can navigate public health emergencies along with the ethical issues that arise could benefit both residency education and healthcare systems. (shrink)

Louise Dupin (1706–1799) was known during her lifetime as the philosophically inclined hostess of one of the most brilliant salons of Enlightenment France, where Montesquieu, Condillac, Buffon, Vol...

Abstract:In 1965 the “beautification” movement, spearheaded by “Lady Bird” Johnson, ushered in a new phase for American utility companies, under increasing pressure from environmentalists, regulatory bodies and the public, who protested against the continued expansion of energy facilities. In response, utilities such as Southern California Edison, incorporated aesthetics into their corporate strategies to manage an increasingly strained relationship with their consumer base. This ranged from painting infrastructure to launching new design models for transmission lines and converting overhead lines underground. Far (...) from universally welcomed, Southern California Edison's beautification programmes were often met with resistance in communities, due to economic costs being passed on to the consumer. This led to an extensive debate about who benefited from the aesthetics of the energy landscape: was it the utility company, the developer, the homeowner, or the communities in which they were set? Considering three distinct groups with an interest in the aesthetics of the energy landscape, Southern California Edison, federal and state regulatory bodies, and homeowner groups, this article examines how the battle over the visibility of energy infrastructure was set within the social and urban politics of Los Angeles in the late 1960s. By throwing into relief this set of competing interests, it explores how the aesthetics of the energy landscape was not unitary, but fractured along conflicting political, social, and class-based lines. It argues that energy aesthetics was less the experience of the eye alone than a reflection of broader powers struggles within community, state and nation. (shrink)

I explore how we negotiate sexual encounters with one another in language and consider the pragmatic structure of such negotiations. I defend three theses: Discussions of consent have dominated the philosophical and legal discourse around sexual negotiation, and this has distorted our understanding of sexual agency and ethics. Of central importance to good-quality sexual negotiation are sexual invitations and gift offers, as well as speech designed to set up safe frameworks and exit conditions. Sexual communication that goes well does not (...) just prevent harm; it enables forms of agency, pleasure, and fulfillment that would not otherwise be possible. (shrink)

This is a book about the harms of oppression, and about addressing these harms using the resources of liberalism and Kantianism. Its central thesis is that people who are oppressed are bound by the duty of self-respect to resist their own oppression. In it, I defend certain core ideals of the liberal tradition—specifically, the fundamental importance of autonomy and rationality, the intrinsic and inalienable dignity of the individual, and the duty of self-respect—making the case that these ideals are pivotal in (...) both understanding and counteracting oppression. I argue that if we take these ideals seriously then it follows that people who are oppressed have an obligation to themselves to resist their own oppression. (shrink)

In the current framework of international protection, refugees almost invariably live in states where they hold no formal political status: they cannot vote, they cannot run for office, and they mu...

The Infectious Diseases Act entered into force officially on 14 November 2018 in Bangladesh. The Act is designed to raise awareness of, prevent, control, and eradicate infectious or communicable diseases to address public health emergencies and reduce health risks. A novel coronavirus disease was first identified in Bangladesh on 8 March 2020, and the Ministry of Health and Family Welfare issued a gazette on 23 March, listing COVID-19 as an infectious disease and addressing COVID-19 as a public health emergency. The (...) gazette empowers the government to monitor the spread of infection. Despite there being an infrastructure of research ethics committees in almost all hospitals in Bangladesh, a lack of such committees in the clinical setting often forces healthcare professionals to allocate scarce healthcare resources to the task. These personnel are often either influenced by materialistic matters or guided by the emergency policies, without reaching a consensus on how to allocate scarce resources in times of need, especially in the time of the COVID-19 pandemic. Ethical dilemmas often arise when a number of patients with COVID-19, especially in poor and middle-class areas, are denied care while elites are prioritized to receive such scarce resources. Resource allocation in healthcare during the COVID-19 pandemic in Bangladesh appears to be unethical and in direct conflict with the biomedical principles of non-maleficence and procedural justice. The findings of this study suggest that the Act needs substantive changes in the stipulation of policy directing hospitals in the provision of resource allocation framework. Furthermore, parliament should produce guidance outlining how to successfully implement the law with the aim of protecting public health in times of emergency, especially the COVID-19 pandemic. (shrink)

The goal of this study was to determine if the level of preservice teachers’ economic literacy might serve as a gatekeeper to teaching economics competencies. The participants ( n=84) were teacher candidates in an elementary education program in their final methods courses prior to their teacher internship. The findings supported the intuitive belief that elementary teachers lack the economic literacy and confidence needed to teach economics concepts in the elementary curriculum. This deficit can serve as a gatekeeper to teaching economics (...) competencies leading to curricular disjuncture between the established curriculum and actual practice in the classroom. (shrink)

Ghostwriting scandals are pervasive in industry-funded biomedical research, and most responses to them have presumed that they represent a sharp transgression of the norms of scientific authorship. I argue that in fact, ghostwriting represents a continuous extension of current socially accepted authorship practices. I claim that the radically collaborative, decentralized, interdisciplinary research that forms the gold standard in medicine is in an important sense unauthored, and that this poses a serious problem in applied social epistemology. It is no easy matter (...) to find procedural or architectural solutions that can secure epistemic trust and accountability for collaborative publishing in biomedicine. (shrink)

This paper argues that there exists a collective epistemic state of ‘Broad Medical Uncertainty’ regarding the effectiveness of many medical interventions. We outline the features of BMU, and describe some of the main contributing factors. These include flaws in medical research methodologies, bias in publication practices, financial and other conflicts of interest, and features of how evidence is translated into practice. These result in a significant degree of uncertainty regarding the effectiveness of many medical treatments and unduly optimistic beliefs about (...) the benefit/harm profiles of such treatments. We argue for an ethical presumption in favour of openness regarding BMU as part of a ‘Corrective Response’. We then consider some objections to this position, including concerns that public honesty about flaws in medical research could undermine trust in healthcare institutions. We suggest that, as it stands, the Anti-Corrective Response is unconvincing. (shrink)

Philosophers have often posited a foundational calling voice, such that hearing its call constitutes subjects as responsive and responsible negotiators of normative claims. I give the name ldquo;transcendental conscience to that which speaks in this founding, constitutive voice. The role of transcendental conscience is not – or not merely – to normatively bind the subject, but to constitute the possibility of the subject's being bound by any particular, contentful normative claims in the first place. I explore the ontological and temporal (...) status of transcendental conscience, using Heidegger's account of conscience in Being and Time as my textual touchstone. I ask what performative structure the call of conscience might have that would enable it to constitute normative responsiveness, and I raise some temporal conundrums surrounding this structure. I argue that it is incoherent to attempt to give a literal, chronological account of the origin of normative grip and response. I suggest that we can best understand the founding calls of conscience, not as literal events occurring in regular time, but as events that can only show up retrospectively, as occurring in an ever-receding, unlocalizable past, and that these calls can only be figured mythically and metaphorically. Appropriating a Derridean term, I claim that the voice of transcendental conscience must be that of a lsquo;ghost, whose call binds us by haunting us – a haunting that is no less transcendentally necessary for its inability to be translated into a literal historical event. (shrink)

Bringing together 20 foundational texts in contemporary modernist criticism in one accessible volume, this book explores the debates that have transformed the field of modernist studies at the turn of the millennium and into the 21st century. The New Modernist Studies Reader features chapters covering the major topics central to the study of modernism today, including: Feminism, gender and sexuality; Empire and race; Print and media cultures; Historical and geographical debates. Each text includes an introductory summary of its historical and (...) intellectual contexts, as well as guides to further reading to help students and teachers explore the ideas further. Includes essential texts by leading critics such as: Pascale Casanova, Anne Anlin Cheng, Brent Hayes Edwards, Rita Felski, Susan Stanford Friedman, Mark Goble, Miriam Hansen, Andreas Huyssen, David James, Fredric Jameson, Heather K. Love, Douglas Mao, Mark S. Morrisson, Michael North, Jessica Pressman, Lawrence Rainey, Paul K. Saint-Amour, Bonnie Kime Scott, Urmila Seshagiri, Robert Spoo, and Rebecca Walkowitz. (shrink)

Dr Hay is Honorary Senior Research Fellow at the University of Aberdeen. A zoologist by profession, his research has been guided by the hypothesis that religious or spiritual awareness is biologically natural to the human species and has been selected for in the process of organic evolution because it has survival value. Although naturalistic, this hypothesis is not intended to be reductionist with regard to religion. Nevertheless it does imply that all people, including those who have no religious belief, have (...) a spiritual life. His research has included a number of national and in-depth surveys of reports of religious or spiritual experience in the United Kingdom.. (shrink)

When Sandra Harding called for an epistemology of science whose systematic attention to the gendered Status of epistemic agents renders it ‘less partial and distorted’ than ‘traditional’ epistemologies, some commentators recoiled in horror. Propelled by ‘a mad form of the genetic fallacy’ they said, she descends ‘the slide to an arational account of science.’ On a less melodramatic reading, feminist epistemologies such as Harding's advocate not irrationalism, but senses of rationality more expanded than those which they associate with ‘traditional’ epistemology.

: The principle of equipoise traditionally is grounded in the special obligations of physician-investigators to provide research participants with optimal care. This grounding makes the principle hard to apply in contexts with limited health resources, to research that is not directed by physicians, or to non-therapeutic research. I propose a different version of the principle of equipoise that does not depend upon an appeal to the Hippocratic duties of physicians and that is designed to be applicable within a wider range (...) of research contexts and types—including health services research and research on social interventions. I consider three examples of ethically contentious research trials conducted in three different social settings. I argue that in each case my version of the principle of equipoise provides more plausible and helpful guidance than does the traditional version of the principle. (shrink)

Transformative experiences are epistemically and personally transformative: prior to having the experience, agents cannot predict the value of the experience and cannot anticipate how it will change their core values and preferences. Paul (2014, 2015) argues that these experiences pose a puzzle for standard decision-making procedures because values cannot be assigned to outcomes involving transformative experience. Responding philosophers are quick to point out that decision procedures are built to handle uncertainty, including the uncertainty generated by transformative experience. My paper enters (...) here and contributes two points. First, religious experiences are transformative experiences that are especially resistant to these responses. Second, a procedure that appeals to voluntarist reasons—reasons arising from an act of the will—can allow an agent to rationally decide to undergo or avoid an outcome involving transformative experience. Combining these two points results in some interesting implications with respect to practical aspects of religion. (shrink)

This paper will consider the extent to which patients' dependence on clinical expertise when making medical decisions threatens patient autonomy. I start by discussing whether or not dependence on experts isprima facietroubling for autonomy and suggest that it is not. I then go on to consider doctors' and other healthcare professionals' status as ‘medical experts’ of the relevant sort and highlight a number of ways in which their expertise is likely to be deficient. I then consider how this revised picture (...) of medical expertise should lead us to view the potential threat to patient autonomy that results from depending on such ‘experts’. I argue that, whether or not patients are aware of the limitations of medical expertise, in practice it is difficult to do other than defer to medical advice, and this presents a threat to patient autonomy that should be addressed. I conclude by suggesting some ways in which this threat to autonomy might be mitigated. (shrink)

Telephone survey of 293 TV viewers in Minneapolis-St. Paul investigated how viewers evaluate ethical issues and problematic content in TV news and entertainment programs, and attitudes toward methods of controlling TV content. In rating eight hypothetical news and entertainment scenarios, viewers appeared more willing to accept ethical breaches in entertainment than in news programs. In evaluating the severity of general problems in TV programming, most viewers considered violence, adult themes, and a lack of family values to be big problems. Different (...) methods of controlling potentially problematic content were evaluated, with viewers overwhelmingly endorsing a system of ratings or warnings, as well as restricting content to certain times or channels. Governmental regulation as a form of controlling TV content was strongly rejected. This article demonstrates the usefulness and appropriateness of empirical research in involving the audience in an active role in the study of media ethics. (shrink)

Nietzsche was a severe critic of German Idealism, but what exactly is the relation between his thought and theirs? Papers from leading specialists in Kant, Hegel, Schelling, Schopenhauer, Kierkegaard and Nietzsche contribute to a clearer understanding of the differences and affinities between Nietzsche's philosophy and that of his predecessors.".

This paper exhorts geographers to become more active in debate about ethical research practice. It also suggests that ethical theory, practical problems, and lessons learned from postmodern thought make the prospects of establishing prescriptive codes of ethics unlikely. Instead, flexible prompts for moral contemplation might be used to encourage careful thought on matters of ethics. Because the practical feasibility of moral prompts rests on the existence of moral imaginations, it is vital to consider ways in which those imaginations might be (...) stimulated and nurtured. Professional associations and university academics have significant roles to play in this. Geographers must position themselves as effective agents in the processes by which professional research ethics are shaped rather than awaiting the potentially inappropriate outcomes of other agencies ' deliberations. (shrink)

Ethical sensitivity is a precursor to mora1 judgment in that a person must recognize the existence of an ethical problem before such a problem can be resolved. It is an important concept, yet it has received little attention from ethics scholars. This preliminary and exploratory study indicates that ethical sensitivity can be identified in viewers' reactions to and evaluations of ethically controversial television news stories, that diferent levels of ethical sensitivity are evident in discussions of television news stories, and that (...) there are at least 3 dimensions by which ethnic sensitivity may be evaluated: time, breadth, and depth. (shrink)

Volume 24, Issue 6, September 2019, Page 676-679.

It gives me great pleasure to introduce the December 2013 issue of the Kennedy Institute of Ethics Journal—our ninety-second!—and to introduce myself as the new Editor-in-Chief of the journal. For almost a quarter of a century, from its special vantage point in Washington, D.C., and at Georgetown University’s Joseph and Rose Kennedy Institute of Ethics, the KIEJ has served as a leading source for practically engaged, policy-relevant philosophical work in bioethics, broadly construed. Under the expert stewardship of Robert Veatch and (...) Carol Spicer, the journal built a top-quality research legacy. It is with pride and anticipation that I take the helm.While I am committed to honoring and building on our past, I am .. (shrink)

Our lead article in this issue of the Kennedy Institute of Ethics Journal, Jonathan Kaplan’s “Self-Care as Self-Blame Redux: Stress as Personal and Political,” opens up an entirely new and clearly important topic for bioethicists: the concept and role of ‘self-care.’ Advice for ‘self-care’ is everywhere, and often this advice takes the form of a kind of moral imperative: we owe ourselves self-care and have a responsibility to care for ourselves. Meanwhile, typical suggested self-care practices focus on individual behaviors and (...) purchases, rather than social interventions. Moreover, they very often require quite a bit of time, money, organization, and energy to complete. These include yoga classes, meditation, diet... (shrink)

Let us first thank the four commentators who have taken the time to read and thoughtfully reflect on our paper. In that paper, we discuss how responsibility concepts must be sensitive to the temporal ( diachronic ) and social ( dyadic ) aspects of health-related behaviour, if responsibility is to play a role in health policy. This ‘if’ is a big one, and Hanna Pickard rightly challenges our position of neutrality with regard to whether or not responsibility should be incorporated (...) into health policy.1 Pickard proposes that responsibility should play a forward-looking role in health policy—used as a tool to facilitate and encourage healthy behaviours where it is reasonable to expect people to adopt such behaviours. While the conditions for such responsibility are similar to those involved in the backward-looking, desert-based responsibility we invoke, they do not warrant responses such as praise, blame, reward and punishment that may follow from desert-based responsibility. Pickard argues that even asking the question of ‘what would desert-based responsibility look like in these health contexts’ risks encouraging moralisation, stigma and blame, all of which have no place in healthcare. We agree that forward-looking responsibility could be an important tool in healthcare. We have offered …. (shrink)