In this article, we outline a novel approach to understanding the role of responsibility in health promotion. Efforts to tackle chronic disease have led to an emphasis on personal responsibility and the identification of ways in which people can ‘take responsibility’ for their health by avoiding risk factors such as smoking and over-eating. We argue that the extent to which agents can be considered responsible for their health-related behaviour is limited, and as such, state health promotion which assumes certain forms (...) of moral responsibility should be avoided. This indicates that some approaches to health promotion ought not to be employed. We suggest, however, that another form of responsibility might be more appropriately identified. This is based on the claim that agents have prudential reasons to maintain their health, in order to pursue those things which make their lives go well—i.e. that maintenance of a certain level of health is rational for many agents, given their pleasures and plans. On this basis, we propose that agents have a self-regarding prudential responsibility to maintain their health. We outline the implications of a prudential responsibility approach to health promotion. (shrink)

Thomas Reid thought of himself as a critic of the representative theory of perception, of what he called the ‘theory of ideas’ or ‘the ideal theory’.2 He had no kind words for that theory: “The theory of ideas, like the Trojan horse, had a specious appearance both of innocence and beauty; but if those philosophers had known that it carried in its belly death and destruction to all science and common sense, they would not have broken down their walls to (...) give it admittance.”3 Many have supposed that his opposition to the representative theory was grounded in his direct realism.4 A direct realist theory of perception holds that perception of external objects is not mediated by any mental entity whose intrinsic character licenses a move from the mental entity to the external object presented in perception. Reid himself, in an oration of 1759, delivered at graduation ceremonies over which he presided as regent and professor of philosophy at King’s College in Aberdeen, said that he did not “understand what need there is of an intermediate object for thought about something to be possible.”5 Hence, if Reid was not a direct realist, philosophers and historians would have to ask whether and to what degree Reid was what he thought himself to be. (shrink)

The COVID-19 pandemic has led a number of countries to introduce restrictive ‘lockdown’ policies on their citizens in order to control infection spread. Immunity passports have been proposed as a way of easing the harms of such policies, and could be used in conjunction with other strategies for infection control. These passports would permit those who test positive for COVID-19 antibodies to return to some of their normal behaviours, such as travelling more freely and returning to work. The introduction of (...) immunity passports raises a number of practical and ethical challenges. In this paper, we seek to review the challenges relating to various practical considerations, fairness issues, the risk to social cooperation and the impact on people’s civil liberties. We make tentative recommendations for the ethical introduction of immunity passports. (shrink)

Subject perspectives : the missing element in research ethics -- Personal knowledge and study participation -- The everyday ethics of human research -- The hidden world of subjects : rule-breaking in clinical trials -- Participants as partners in genetic research -- Terminally ill patients and the right to try experimental drugs -- Embedded ethics in developing country research -- Research subjects as literary subjects -- How to hear subjects.

Human beings with diminished decision-making capacities are usually thought to require greater protections from the potential harms of research than fully autonomous persons. Animal subjects of research receive lesser protections than any human beings regardless of decision-making capacity. Paradoxically, however, it is precisely animals’ lack of some characteristic human capacities that is commonly invoked to justify using them for human purposes. In other words, for humans lesser capacities correspond to greater protections but for animals the opposite is true. Without explicit (...) justification, it is not clear why or whether this should be the case. Ethics regulations guiding human subject research include principles such as respect for persons—and related duties—that are required as a matter of justice while regulations guiding animal subject research attend only to highly circumscribed considerations of welfare. Further, the regulations guiding research on animals discount any consideration of animal welfare relative to comparable human welfare. This paper explores two of the most promising justifications for these differences␣between the two sets of regulations. The first potential justification points to lesser moral status for animals on the basis of their lesser capacities. The second potential justification relies on a claim about the permissibility of moral partiality as␣found in common morality. While neither potential justification is sufficient to justify the regulatory difference as it stands, there is possible common ground between supporters of some regulatory difference and those rejecting the current difference. (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)

In the UK, it has been proposed that alongside the current advice to abstain from alcohol completely in pregnancy, there should be increased screening of pregnant women for alcohol consumption in order to prevent instances of fetal alcohol spectrum disorder. The Scottish Intercollegiate Guidelines Network published guidelines in 2019 recommending that standardised screening questionnaires and associated use of biomarkers should be considered to identify alcohol exposure in pregnancy. This was followed in 2020 by the National Institute for Health and Care (...) Excellence Draft Quality Standard, which recommended that pregnant women should have information on their alcohol consumption recorded throughout their pregnancy and this information transferred to the child’s health records. Most recently, Public Health England has stated that the alcohol intake of all women should be recorded throughout pregnancy, not just at the initial booking appointment and that tools such as blood biomarkers and meconium testing should be researched in order to determine true prevalence rates of alcohol in pregnancy. We argue that this proposed enhanced screening undermines women’s autonomy and their legal right to be sufficiently informed to consent to screening. We argue that there is no evidence that this kind of screening will result in a reduction of fetal harm and there is a danger that undermining the autonomy of women and the trust relationship between women and healthcare professionals may even increase harm to future children. (shrink)

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)

We can understand objectivity, in the broadest sense of the term, as epistemic accountability to the real. Since at least the 1986 publication of Sandra Harding’s The Science Question in Feminism, so-called standpoint epistemologists have sought to build an understanding of such objectivity that does not essentially anchor it to a dislocated, ‘view from nowhere’ stance on the part of the judging subject. Instead, these theorists have argued that a proper understanding of objectivity must recognize that different agential standpoints offer (...) different access to objective truths, with some standpoints holding better epistemic potential than others. As Harding puts it, standpoint epistemology calls for “a critical evaluation of which social situations tend to generate the most objective knowledge claims” so as to identify those standpoints that “produce empirically more accurate descriptions and theoretically richer explanations” (1991, 142, 149). Which standpoints enable the most objectivity with respect to a particular inquiry is, for the standpoint theorists, always an empirical at least as much as a conceptual question; it requires attention to the actual, material relationship between knowers, knowledge practices, and objects known. Standpoint epistemology was developed primarily by self-identiªed feminist epistemologists. Virtually all developments of standpoint episte-. (shrink)

There is an obvious affinity between virtue ethics and particularism. Both stress the complexify of the moral life, the inadequacy of rule-following as a guide to moral deliberation, and the importance of judgement in discerning the morally relevant features of particular situations. Yet it remains an open question how deep the affinity goes. I argue that the radical form of particularism defended by Jonathan Dancy has surprisingly strong implications for virtue ethics. Adopting such a view would require the virtue theorist (...) either to adopt an unattractive model of moral motivation or to embrace a fairly strong version of the unity of the virtues. (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)

Bernard Reginster has argued that in "Nietzsche's terminology, 'experimentation [Versuch]' is a paradigmatic exercise of curiosity."1 According to Reginster, the kind of curiosity in question, as far as Nietzsche's concept of the free spirit is concerned, is not the state of knowing or of being certain of the truth of some proposition, but is rather a matter of the activity or process of truth seeking and of inquiry.2 My own view is very similar: I have argued that experimentalism is a (...) form of virtue for Nietzsche.3 Specifically, as I have suggested, Nietzsche employs experimentalism in two main ways: as a strategy for philosophical engagement, for example through his use of diverse writing styles and authorial... (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)

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)

I welcome the efforts described by Neal Dickert and his colleagues in “Partnering with Patients to Bridge Gaps in Consent for Acute Care Research” (Dickert et al. 2020). I am a long-time supporter...

Feminism is an antiauthoritarian movement that has sought to unmask many traditional “authorities” as ungrounded. Given this, it might seem as if feminists are required to abandon the concept of authority altogether. But, we argue, the exercise of authority enables us to coordinate our efforts to achieve larger social goods and, hence, should be preserved. Instead, what is needed and what we provide for here is a way to distinguish legitimate authority from objectionable authoritarianism.

It is observed that in ordinary everyday causal explanations often just one causal factor is mentioned. One causal factor carries the explanatory burden, even if there are several causal factors that are responsible for the event to be explained. This paper deals with the question of how to account for this explanatory selection. I argue for a pragmatic stance towards explanation, that we must attend to the question–answer situation as a whole and the context of the explanation. The context of (...) an explanation includes the inquirer's and the explainer's beliefs and presuppositions relevant for the explanation-seeking question, and these are encoded in a reference class. Furthermore I argue that the explanation-giving answer contains an implicit counterfactual claim, the explanation-giving counterfactual. The solution to the problem of explanatory selection is to be found in the presuppositions encoded by the reference class and the eg-counterfactual. In short we select as explanatory that factor which, together with the presupposition encoded in the reference class we believe will make the eg-counterfactual true. (shrink)

Studies with humans have failed to produce evidence that any direct causal relation exists between the asymmetry of one function in an individual and the asymmetry of a different function in that individual. Without such evidence, factors external to an individual's nervous system, such as social interactions, may play crucial roles in explaining the directions of all asymmetries at all levels.

Is a woman ever morally obligated to forgo an abortion for the sake of the man who has impregnated her? In “Fathers and Fetuses,” George Harris contends that in some situations women are so obligated. Harris argues that a woman who lies to her partner about her desire to have children, becomes pregnant, and then decides to abort, will, if she acts on this decision, violate her partner’s autonomy and harm him in so far as she will harm his fetus. (...) To avoid these wrongs, a woman must therefore carry this fetus to term. I argue that this conclusion depends on a principle for which Harris offers no argument, namely that the conditions under which a fetus is to be considered a man’s are the same conditions under which a fetus is to be considered a woman’s. Evaluating this principle andconsidering related cases leads to important conclusions about a parent’s relationship with the fetus. Specifically, I challenge the notion that we should ever consider a fetus ‘his’ or even ‘hers.’. (shrink)

Volume 24, Issue 8, August 2024, Page 37-40.

Traditionally reproduction, gestation and childbirth have all been regarded as being primarily a woman's domain. As natural reproduction occurs inside a woman's body, respect for autonomy and bodily integrity requires the pregnant woman to have the conclusive say over the fate of the embryo/fetus growing within her. Thus traditionally the ethics and law of reproduction is dominated by the importance of respecting women's reproductive choices. This paper argues that emerging technologies demand a radical rethink of ethics and law in the (...) area of reproduction. The creation and storing of embryos outside of a woman's body and maintaining a pregnancy in a brain dead woman's body and future possibilities such as ectogenesis and male pregnancy raise important issues that cannot simply be answered by appealing to the rights of women to control their bodies. There are those who argue that when reproduction or reproductive products exist outside of a woman's body each gamete donor should have an equal say over the fate of the embryo/fetus. Others, however, argue that giving an equal say to gamete donors in practice usually means allowing the male donor to veto the reproductive enterprise and this is unacceptable. As a result it has been suggested that women should be favoured when it comes to such reproductive choices. This paper examines both sides of this debate in order to answer the fundamental ethical and policy question: 'Is there any reason why women should necessarily retain control over reproduction rather than simply over their own bodies?'. (shrink)

This paper explores the integration of environmental concern into the workplace by combining insights from the literature on governmentality with work that focuses on the role of emotion in organisational contexts. I build on work by Hargreaves (2008) and Butler (2010) to show that environmental concern is an emerging form of workplace governance which acts by and through the emotions and which intersects with pre-existing forms of power in surprising and complex ways. I conclude by reflecting on some additional theoretical (...) approaches which may offer some tools for developing forms of workplace governance that are more socially and environmentally sustainable. (shrink)

Although the teaching of medical ethics and law in medical education is an old story that has been told many times in medical literature, recent studies show that medical students and physicians lack confidence when faced with ethical dilemmas and medico-legal issues. The adverse events rates and medical lawsuits are on the rise whereas many medical errors are mostly due to negligence or malpractices which are preventable. While it is true that many medical schools teach their students medical law and (...) ethics, there are wide variations in what is being taught because there is no universally agreed syllabus. Yet the knowledge of medical law and ethics is closely relevant to the medical profession and that failure in abiding the law may result in serious civil or even criminal consequences. While this paper does not propose to lay detailed analysis of the relevant areas of law or ethics, it proposes to cover some legal areas so as to highlight and bring to attention the need for a medical law and ethics course. This article also considers the problems faced and recommendation as to future directions to be taken with respect to teaching medical law and ethics. It concludes with a suggested course outline for the teaching of medical law and ethics. (shrink)

Qualitative longitudinal research (QLR) provides temporal understanding of the human response to health, illness, and the life course. However, little guidance is available for conducting QLR in the nursing literature. The purpose of this review is to describe the methodological status of QLR in nursing. With the assistance of a medical librarian, we conducted a thorough search circumscribed to qualitative, longitudinal nursing studies of patients’ and care‐givers’ experiences published between 2006 and 2016. The methodological quality of the 74 reviewed studies (...) varied tremendously; many reports lacked sufficient detail in reporting on sampling and attrition, retention strategies, and data collection and analysis, making it difficult for readers to evaluate the credibility and transferability of study findings. Based on the strengths and limitations of the studies reviewed and findings in the literature, we provide recommendations for enhancing the reporting of the research process as a supplement to the standards for qualitative research more broadly. These recommendations are offered in the spirit of encouraging dialogue among colleagues and assisting journal reviewers and editors in their evaluation of QLR. (shrink)

Machine generated contents note: -- Acknowledgements Introduction: From Passions to Language: The Transformation of the ImaginationLocke: Metaphorical Romances Behn: Romance from the Stage to the Letter Shaftesbury: Conversation and the Psychology of Romance Hume: Reading Romances, Writing the Self Richardson: How to Read Romance NotesBibliographyIndex.

The paper considers nonviolence, not merely as a set of tactics for demonstrations and protests, but as a broad ethical ideal governing attitudes as well as conduct. I argue that the meanings of nonviolence—its relationship to personal and political honor and integrity—may differ with one’s level of privilege and social authorization to employ violence. Furthermore, the moral and attitudinal commitments prominent in some strands of nonviolence theory are in some ways at odds with the needs of survivors of violent abuse—particularly (...) of the kinds typically committed by men against women and children in intimate contexts. There isthus an apparent tension between some of the commitments of nonviolence theory and our obligation to demonstrate solidarity with survivors. Recognizing and resolving this apparent tension is a necessary further step in the development of nonviolence theory. (shrink)

This essay examines the determination by Cartesians to explain the maternal imagination's alleged role in the formation of birthmarks and the changing notion of monstrosity. Cartesians saw the formation of birthmarks as a challenge through which to demonstrate the heuristic capacity of mechanism. Descartes claimed to be able to explain the transmission of a perception from the mother's imagination to the fetus' skin without having recourse to the little pictures postulated by his contemporaries. La Forge offered a detailed account stating (...) that the failure to explain the maternal imagination's impressions would cast doubt on mechanism. Whereas both characterized the birthmark as a deformation or monstrosity in miniature, Malebranche attributed a role to the maternal imagination in fashioning family likenesses. However, he also charged the mother's imagination with the transmission of original sin. (shrink)

In the early 1970s, a World Health Organization‐initiated and United States‐funded project released lab‐reared mosquitoes outside New Delhi in the first large‐scale field trials of the genetic control of mosquitoes. Despite partnering with the Indian Council of Medical Research and investing significantly in outreach to local communities at the release sites, the project was embroiled in controversy and became an object of vehement debate within the Indian parliament and diplomatic contretemps between the United States and India. This early episode of (...) genetic control research demonstrates how a scientific collaboration was entangled in geopolitics and shaped by the legacy of colonialism. This historical case study has implications for public deliberation in the present, pointing to the challenges of shared decision‐making in the context of structural inequality, the way that a backdrop of military interest in a technology can impede trust, and the long‐term consequences of projects that foster mistrust. (shrink)

Children’s fine motor skills link to cognitive development, however, research on their involvement in language processing, also with adults, is scarce. Lexical items are processed differently depending on the degree of sensorimotor information inherent in the words’ meanings, such as whether these imply a body-object interaction or a body-part association. Accordingly, three studies examined whether lexical processing was affected by FMS, BOIness, and body-part associations in children and adults. Analyses showed a differential link between FMS and lexical processing as a (...) function of age. Whereas response latencies indicated that children’s FMS were associated with “hand” words, adults’ FMS linked to the broader concept of BOI. Findings have implications for shared activation theories positing that FMS support lexical processing. (shrink)

Soltis' analysis of signal functions of young infants' cries stimulates testable questions regarding abuse, neglect, and infanticide. Nevertheless, his evolutionary perspective oversimplifies the cry event, and does little to promote developmental analysis of crying during infancy. Studies of the cry in its behavioral and developmental context are needed if we are to understand the proximate causes of optimal and suboptimal care.

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)

Book review: James Souter, Asylum as Reparation: Refuge and Responsibility for the Harms of Displacement. London: Palgrave Macmillan.

Philosophies of Difference engages with the concept of difference in relation to a number of fundamental philosophical and political problems. Insisting on the inseparability of ontology, ethics and politics, the essays and interview in this volume offer original and timely approaches to thinking nature, sexuate difference, racism, and decoloniality. The collection draws on a range of sources, including Latin American Indigenous ontologies and philosophers such as Henri Bergson, Jacques Derrida, Luce Irigaray, Immanuel Kant, Maurice Merleau-Ponty, Charles Mills, and Eduardo Viveiros (...) de Castro. -/- The contributors think embodiment and life by bringing continental philosophy into generative dialogue with fields including plant studies, animal studies, decoloniality, feminist theory, philosophy of race, and law. Affirming the importance of interdisciplinarity, Philosophies of Difference contributes to a creative and critical intervention into established norms, limits, and categories. Invoking a conception of difference as both constitutive and generative, this collection offers new and important insights into how a rethinking of difference may ground new and more ethical modes of being and being-with. Philosophies of Difference unearths the constructive possibilities of difference for an ethics of relationality, and for elaborating non-anthropocentric sociality. -/- The chapters in this book were originally published in a special issue in Australian Feminist Law Journal. (shrink)

It is the great honor of the Kennedy Institute of Ethics Journal to present this special issue celebrating the career and bioethical contributions of LeRoy Walters. Professor Walters is the former Director of the Kennedy Institute of Ethics, which he has been affiliated with since its inception in 1971 until his recent retirement from his position as Joseph P. Kennedy, Sr. Professor of Christian Ethics. Trained as a philosopher and a theologist, LeRoy Walters was also a lifelong political activist, fighting (...) for social justice and protections for the vulnerable. He was also a visionary who played a substantial role in creating and building the field of bioethics, and in bridging the divide between academia and the... (shrink)