Nudges are small changes in the presentation of options that make a predictable impact on people's decisions. Proponents of nudges often claim that they are justified as paternalistic interventions that respect autonomy: they lead people to make better choices, while still letting them choose for themselves. However, existing work on nudges ignores the possibility of “hard choices”: cases where a person prefers one option in some respects, and another in other respects, but has no all‐things‐considered preference between the two. In (...) this paper, I argue that many significant medical decisions are hard choices that provide patients with an opportunity to exercise a distinctive sort of “formative autonomy” by settling their preferences and committing themselves to weigh their values in a particular way. Since nudges risk infringing formative autonomy by depriving patients of this opportunity, their use in medical contexts should be sensitive to this risk. (shrink)

Despite multiple axes of variation in defining wellbeing, the paper argues for the dominance of a ‘components approach’ in current research and practice. This approach builds on a well-established tradition within the social sciences of attending to categories whether for their identification, their value or their meanings and political resonance. The paper critiques the components approach and explores how to move beyond it towards conceptually integrating the various categories and dimensions through a relational and situated account of wellbeing. Drawing on (...) more fluid social sciences, wellbeing is framed as an effect, dependent on the mobilisation of resources from everyday encounters with complex assemblages of people, things and places. Through such a framing, wellbeing can be conceived of as stable and amenable to change, as individual and collective and as subjective and objective. Policy interventions then need to attend to the relationalities of particular social and spatial contexts. (shrink)

Human judgements are affected by the words in which information is presented —or ‘framed’. According to the standard gloss, ‘framing effects’ reveal counter-normative reasoning, unduly affected by positive/negative language. One challenge to this view suggests that number expressions in alternative framing conditions are interpreted as denoting lower-bounded (minimum) quantities. However, it is unclear whether the resulting explanation is a rationalising one. I argue that a number expression should only be interpreted lower-boundedly if this is what it actually means. I survey (...) how number expressions might be assigned lower-bounded meanings, due to their conventional semantics or pragmatic enrichment in context. I argue that deciding between these possibilities requires foundational philosophical input. (shrink)

As befits an emerging field of enquiry, there is on-going discussion about the scope, role and future of the medical humanities. One relatively recent contribution to this debate proposes a differentiation of the field into two distinct terrains, ‘medical humanities’ and ‘health humanities,’ and calls for a supersession of the former by the latter. In this paper, we revisit the conceptual underpinnings for a distinction between ‘the medical’ and ‘health’ by looking at the history of an analogous debate between ‘medical (...) geography’ and ‘the geographies of health’ that has, over the last few years, witnessed a re-blurring of the distinction. Highlighting the value of this debate within the social sciences for the future development of the medical humanities, we call for scholars to take seriously the challenges of critical and cultural theory, community-based arts and health, and the counter-cultural creative practices and strategies of activist movements in order to meet the new research challenges and fulfill the radical potential of a critical medical humanities. (shrink)

According to some authors, emotions can be unconscious when they are unfelt or unnoticed. According to others, emotions are always conscious because they always have a phenomenology. The aim of this paper is to resolve the ongoing debate about the possibility for emotions to be unfelt. To do so, I focus on the notion of “unconscious emotions”. While this notion appears paradoxical, by way of a distinction between two meanings of emotional consciousness I show that it is not so. These (...) meanings are both compatible with the leading views of consciousness and they do not require one to distinguish different senses of “emotions” or “consciousness”. This distinction is helpful to define how emotions can be unconscious. (shrink)

It can be hard to see where money fits in the world. Money seems both real and imaginary, since it has obvious causal powers, but is also, just as obviously, something humans have just made up. Recent philosophical accounts of money have declared it to be real, but for very different reasons. John Searle and Francesco Guala disagree over whether money is just whatever acts like money, or just whatever people believe to be money. In developing their accounts of institutions (...) as a part of social reality, each uses money as a paradigm institution, but they disagree on how institutions exist. Searle argues that the institution of money belongs to an ontological level separate from the physical world, held up by the collective intentions of a group, while Guala claims that money is a part of the ordinary physical world and is just whatever performs a “money-like function” in a group, regardless of what that group believes about it. Here, we argue that any purely functional account like Guala’s will be unable to capture the distinctive phenomenon of money, since monetary transactions are defined by the attitudes transactors hold toward them. Money will be obscured or misidentified if defined functionally. As we go on to show by examining recent work by Smit et al., belief in money does not require taking on all of Searle’s ontological commitments, but money and mental contents will stand or fall together. (shrink)

In a recent case, a Facebook user in Iran posted “death to Khamenei”, which the platform removed as a violation of its policy against threats and incitement. Facebook ultimately overturned the decision on the grounds that the speech, while contravening its rules, was newsworthy. Yet the company’s Oversight Board offered a distinct rationale for allowing the post: “death to Khamenei” wasn’t a threat or an incitement at all, but rather a rhetorical expression of criticism, disdain, or disgust. Who was right? (...) Drawing on longstanding distinctions in the philosophy of language, we argue that the answer depends on whether platform rules should primarily target an utterance’s illocutionary force or instead its perlocutionary effects. Using this case study to trace broader lessons for the proper governance of online speech, we argue that platforms’ rules should primarily target illocutionary force, only considering perlocutionary effects in cases where illocutionary force is ambiguous. (shrink)

In this paper, I argue that the supposition of divine omnipotence entails a contradiction: omnipotence both must and must not be intrinsic to God. Hence, traditional theism must be rejected. To begin, I separate out some theoretical distinctions needed to inform the discussion. I then advance two different arguments for the conclusion that omnipotence must be intrinsic to God; these utilise the notions of essence and aseity. Next, I argue that some necessary conditions on being omnipotent are extrinsic, and that (...) this means omnipotence cannot be intrinsic to God. I consider three different ways of resolving this conflict, but contend that each is unsuccessful. Before concluding, I explain why the type of strategy used to resolve the traditional paradoxes of omnipotence cannot be successfully employed against the paradox presented here. (shrink)

In his recent book, Frame It Again: New Tools for Rational Decision-Making, J. L. Bermúdez argues that it can be rational to evaluate the same thing differently when it is described using alternati...

It is useful on the occasion of the 21st anniversary of the ‘Cyborg Manifesto’ not only to reconsider its lessons in the context of what is frequently described as the re-engineering of ‘life itself’, but to look at Haraway’s earlier work on embryos. In this article I begin with Haraway’s analysis of embryology in the 1970s to suggest her cyborg embryo was already there, and has, if anything, gained relevance in today’s embryo-strewn society. I argue further, as the title suggests, (...) that the cyborg embryo has been crucial in defining our path to what I am calling here, building on Haraway’s notion of trans from Modest_Witness, ‘transbiology’ - broadly meaning stem cell research, cloning, tissue engineering and regenerative medicine. To illustrate this argument I draw on recent ethnographic fieldwork in a new stem cell derivation facility in the UK built adjacent to an IVF surgery. Using this example, I explore the important and paradoxical role of IVF in the emergence of stem cell science, cloning and transbiology, suggesting that Haraway’s analysis remains crucial to understanding the ironic and contradictory, and unexpectedly generative, circumstances through which the IVF-stem cell interface - the door to transbiology - came into being. (shrink)

This article discusses the nature of interprofessional ethics and some of the ethical issues and challenges that arise when practitioners from different professions work closely together in the fields of health and social care. The article draws on materials from a conference on this theme, covering issues of confidentiality and information sharing in practice and research with vulnerable people; challenges for teaching and learning about ethics in interprofessional settings; the potential of virtue ethics and an ethic of care for understanding (...) and handling ethical issues in interprofessional practice; and the extent to which interprofessional working may be about surveillance and control. It concludes that the need to understand and handle ethical issues in interprofessional working is contributing to the revitalisation of professional ethics as a dynamic field of study. (shrink)

Sarah Arnaud C’est par une affirmation provocatrice que Hacking propose un ratio pour représenter le rapport entre science et militantisme dans le façonnement des notions sur l’autisme. Selon lui, la définition et la compréhension actuelles de l’autisme proviennent à 99 % de personnes « personnellement connectées à une personne autiste » plutôt que de la science. Kendler rejette un tel point de vue en suggérant au contraire que notre compréhension de l’autisme est le résultat d’un travail scientifique approfondi, notamment (...) par la recherche en génétique. Je considère que leur désaccord se fonde sur une fausse dichotomie selon laquelle seule la recherche scientifique est à même d’envisager l’autisme de manière empirique, alors que le discours des « p-c-a » construirait au contraire une conception socioculturelle de l’autisme. J’envisage les problèmes éthiques inhérents à un tel ratio et suggère que la perspective des personnes autistes elles-mêmes représente une étape nécessaire à l’atteinte d’une validité scientifique. (shrink)

This paper suggests that autistic people relate to themselves via a third-person perspective, an objective and explicit mode of access, while neurotypical people tend to access the different dimensions of their self through a first-person perspective. This approach sheds light on autistic traits involving interactions with others, usage of narratives, sensitivity and interoception, and emotional consciousness. Autistic people seem to access these dimensions through comparatively indirect and effortful processes, while neurotypical development enables a more intuitive sense of self.

Attributor contextualism and subject-sensitive invariantism both suggest ways in which our concept of knowledge depends on a context. Both offer approaches that incorporate traditionally non-epistemic elements into our standards for knowledge. But neither can account for the fact that the social role of a subject affects the standards that the subject must meet in order to warrant a knowledge attribution. I illustrate the dependence of the standards for knowledge on the social roles of the knower with three types of examplesand (...) show why neither attributor contextualism nor subject-sensitive invariantism can explain them. I then suggest that subject-sensitive invariantism should be supplemented with insights from virtue epistemology so that it can explain the dependence of the standards of knowledge on social roles. This supplementation of subject-sensitive invariantism helps to solve a persistent problem facing that theory: the case of knowledge attributions made by those in high-stakes contexts about subjects in low-stakes contexts. (shrink)

Discussion of the role which religious experience can play in warranting theistic belief has received a great deal of attention within contemporary philosophy of religion. By contrast, the relationship between experience and atheistic belief has received relatively little focus. Our aim in this paper is to begin to remedy that neglect. In particular, we focus on the hitherto under-discussed question of whether experiences of God’s absence can provide positive epistemic status for a belief in God’s nonexistence. We argue that there (...) is good reason to accept an epistemic parity between experiences of God’s presence and experiences of God’s absence. (shrink)

This article focuses on faculty members’ allocation of time to teaching and research, conceptualizing these—and the mismatch between preferred and actual time allocations—as examples of gender inequality in academic employment. Utilizing data from the 1999 National Study of Postsecondary Faculty, I find that women faculty members prefer to spend a greater percentage of their time on teaching, while men prefer to spend more time on research, although these preferences are themselves constrained; women faculty members spend a greater percentage of their (...) workweek on teaching and a smaller percentage on research than men, gaps that cannot be explained by preferences or educational and institutional attributes; and women faculty members have larger time allocation mismatches than men—that is, their actual time allocations to both teaching and research diverge more from their preferred time allocations than those of men. These findings shed light on how gender inequality is both produced and maintained in this aspect of academic employment and have implications for job satisfaction, productivity, and the recruitment and retention of current and future faculty members, especially women. (shrink)

Scholars such as Nancy Leys Stepan, Alexandra Minna Stern, Marius Turda and Aaron Gillette have all argued that the rejection of coerced sterilization was a defining feature of “Latin” eugenic theory and practice. These studies highlight the influence of neo-Lamarckism in this development not only in Latin America but also in parts of Europe in the first half of the twentieth century. This article builds upon this historiographical framework to examine an often-neglected site of Latin American eugenic knowledge production: Chile. (...) By focusing on Chilean eugenicists’ understandings of environment and coerced sterilization, this article argues that there was no uniquely Latin objection to the practice initially. In fact, Chilean eugenicists echoed concerns of eugenicists from a variety of locations, both “mainstream” and Latin, who felt that sterilization was not the most effective way to ensure the eugenic improvement of national populations. Instead, the article contends that it was not until the implementation of the 1933 German racial purity laws, which included coerced sterilization legislation, that Chilean eugenicists began to define their objections to the practice as explicitly Latin. Using a variety of medical texts which appeared in popular periodicals as well as professional journals, this article reveals the complexity of eugenic thought and practice in Chile in the early twentieth century. (shrink)

The purpose of this paper is to review critically Julian Savulescu's principle of 'Procreative Beneficence,' which holds that prospective parents are morally obligated to select, of the possible children they could have, those with the greatest chance of leading the best life. According to this principle, prospective parents are obliged to use the technique of pre-implantation genetic diagnosis (PGD) to select for the 'best' embryos, a decision that ought to be made based on the presence or absence of both disease (...) traits and non-disease traits such as intelligence. While several articles have been written in response to Savulescu's principle, none has systematically explored its philosophical underpinnings to demonstrate where it breaks down. In this paper I argue that the examples that Savulescu employs to support his theory in fact fail to justify it. He presents these examples as analogous to PGD, when in fact they differ from it in subtle but morally relevant ways. Specifically, Savulescu fails to acknowledge the fact that his examples evoke deontological and virtue ethics concerns that are absent in the context of PGD. These differences turn out to be crucial, so that, in the end, the analogies bear little support for his theory. Finally, I lay out the implications of this analysis for reproductive ethics. (shrink)

On September 22, 1998, California Governor Pete Wilson signed Senate Bill 1785 into law, dramatically affecting the entire California animal sheltering community. Dubbed the "Hayden law" by the animal protection community after the bill's sponsor, it represents the state of California's attempt to legislate a solution to both the companion animal overpopulation problem and the friction between the agencies trying to end it. The persistence of the bill's primary supporters, a Los Angeles veterinarian and a UCLA law school professor and (...) the overall lack of opposition to it helped SB 1785 sail through the California legislature. Because of the scope of the bill and the immense cost of implementation, its passage shocked many in the sheltering community. This case study highlights the consequences of legislation that was crafted based on worse case scenarios and over which there was little collaborative effort. It concludes with suggestions that might be useful to other states contemplating similar such legislation. (shrink)

In this inspirational discourse, scholar Sarah Wider and Buddhist leader Daisaku Ikeda celebrate the great spiritual and literary figures, East and West, who have inspired their own work as educators, poets, and peace builders, including both the men and the women of the American Renaissance. They reserve their highest praise, though, for the lesser-known influences, especially teachers and mothers, whose humble, compassionate actions provide the truest foundation for the realization of ever-greater peace. Ultimately, the book is a tribute to (...) the bonds that give life meaning. These bonds are the ones built between friends and family; those who teach and those we might learn from; with the great thinkers of the past who live on in books, poetry, and art; with nature; and most of all with the best version of ourselves. (shrink)

Cognitive functions are directly related to interactions between the brain's functional networks. This functional organization changes in the autism spectrum disorder (ASD). However, the heterogeneous nature of autism brings inconsistency in the findings, and specific pattern of changes based on the cognitive theories of ASD still requires to be well-understood. In this study, we hypothesized that the theory of mind (ToM), and the weak central coherence theory must follow an alteration pattern in the network level of functional interactions. The main (...) aim is to understand this pattern by evaluating interactions between all the brain functional networks. Moreover, the association between the significantly altered interactions and cognitive dysfunctions in autism is also investigated. We used resting-state fMRI data of 106 subjects (5–14 years, 46 ASD: five female, 60 HC: 18 female) to define the brain functional networks. Functional networks were calculated by applying four parcellation masks and their interactions were estimated using Pearson's correlation between pairs of them. Subsequently, for each mask, a graph was formed based on the connectome of interactions. Then, the local and global parameters of the graph were calculated. Finally, statistical analysis was performed using a two-sample t-test to highlight the significant differences between autistic and healthy control groups. Our corrected results show significant changes in the interaction of default mode, sensorimotor, visuospatial, visual, and language networks with other functional networks that can support the main cognitive theories of autism. We hope this finding sheds light on a better understanding of the neural underpinning of autism. (shrink)

This article examines how migration impacts power dynamics and gender norms for women left behind living in rural Southern Punjab, Pakistan, a site where patriarchal customs and religion are interwoven to confine women’s mobility and agency. Based on qualitative interviews and focus groups with women left behind from 2015 through 2018, this article explores how local rural-to-urban male migration patterns impact the decision-making powers of women who are left behind and must make sense of the family structure and gender dynamics (...) in their homes after their husbands’ exit. This study finds that in the absence of her migrant husband, a woman left behind is still subject to patriarchal norms and surveillance by the remaining in-laws, including other women. Citing specific examples from the field, I explain why women left behind remain close to the very families that confine and monitor their movement, and why, in some cases, women left behind turn a blind eye toward their husband’s second or third marriage. Through an examination of behind-the-scenes negotiations that women left behind make, I argue that women maintain for themselves at surface level the gendered expectations that patriarchy sets for them, but given the opportunity, they can negotiate and bargain their positionality in subtle ways without disrupting the status quo that could otherwise jeopardize their physical safety and social reputation. (shrink)

Simulations, in which healthcare professionals are observed in dialogue with role-played patients, are widely used for assessing professional skills. Medical education research suggests simulations should be as authentic as possible, but there remains a lack of linguistic research into how far such settings authentically reproduce talk. This article presents an analysis of a corpus of general practice simulations in the United Kingdom, comparing this to a dataset of real-life general practitioner consultations. Combining corpus linguistic and conversation analytic methodologies, key interactional (...) features of the simulations are identified, particularly those associated with successful/unsuccessful performance in terms of the examiner’s grading. The corpus analysis identifies various forms of the phrase ‘tell me more about’ to occur significantly more frequently in the simulations compared to real GP consultations, typically in the opening sequences and most frequently in successful cases. It falls to a conversation analysis of the data, examining this phrase within the interactional context of these opening sequences, to better understand the actions it performs. Successful candidates in the simulations are found to perform a consistent sequential pattern, often incorporating this phrase. Although simulated, these interactions have real professional consequences for those being assessed. Linguistic findings about what constitutes successful interaction or differences to real-life practice therefore have important implications for professional education and assessment. (shrink)

Since the mid-nineteenth century, women in Europe, North America and elsewhere have played an increasing role in the workforce. Women started pursuing jobs in factories, offices and businesses instead of being dependent on men for their livelihood. However, along with this significant improvement in the status of women, they still face obstacles, such as the gender pay gab and harassment in the workplace. Although both males and females experience harassment, the available literature clearly suggests that females are more likely to (...) be harassed. Much of the research concerning workplace harassment against women has been conducted in the West while little is known about this phenomenon in workplaces across the Arab and Muslim countries. In fact, gender relations and the nature of workplaces in Arab countries vary significantly from the Western workplace due to religious, social and cultural traditions. Muslim women live in the midst of patriarchal cultures where women’s honour is believed to be sacred. The ideology of women’s seclusion and subordination resulted in the restriction of their ability to participate in the labour force even where females are in urgent need of earned income. In this regard, harassment considers a crucial subject on various international agendas. The Convention on the Elimination of all Forms of Discrimination Against Women (CEDAW) for instance, reinforces the implementation of legislation that protects women against gender discrimination. Islam in a similar manner respects women and acknowledges their major role within a society. Therefore, as women living in Muslim communities where issues related to sexuality are sensitive, and people are reluctant to discuss such questions in public, this paper aims to discuss women seclusion, the situation of Muslim women with regard to harassment in the workplace, how international human rights deals with harassment as well as the relation between the Islamic jurisprudence and the international human rights with regard harassment in the workplace. (shrink)

Proper attention to the theme of corporeality is crucial for understanding Derrida’s analysis of Hegel in “The Pit and the Pyramid.” This article argues that Derrida’s essay compels us to face the impossibility of giving a wholly coherent account of embodiment. The _Aufhebung_ supposedly unites the exteriority of the corporeal with interiority in a higher unity that cancels and preserves them both; Hegel’s own text reveals, however, that meaning is primordially absent from the body that was thought to incarnate it. (...) And it is this absence of ideal meaning that is originary: Differance conditions the body as it conditions speech, rendering the body other than itself such that it is not categorizable as flesh that is the self or as an object that is not the self. I am and am not my body because the dichotomy between interiority and exteriority breaks down even at the level of the body. Indeed, I am and am not my self; the embodied self is disrupted from the start, never self-contained. Thus embodiment always already testifies to the other. (shrink)

Sarah A. Mattice develops a comparative intervention in contemporary metaphilosophy. Drawing on resources from hermeneutics, cognitive linguistics, aesthetics, and Chinese philosophy, she explores how philosophical language is deeply intertwined with the definition and practice of the discipline.

This synthetic review aims to unite a seemingly disjoint collection of studies over the past 3 decades around their shared examination of sexism in an often overlooked U.S. population, namely girls attending private Christian schools. This undertaking reveals substantial harms that I categorize as those of immediacy and potentiality, which are occurring behind the protective wall separating church and state. Contra the majority of philosophers of education and researchers in this area, these studies lead me to argue that the state (...) has the obligation and legal ability to intervene in this private domain. Notably, this study begins to flesh out a notion of educational harm that may be robust enough for state policy making and legal action in private schools. Based on a legalized understanding of sexist harm, I conclude with a detailed analysis of Constitutional provisions and court decisions relative to state intervention and freedom of religious practice. (shrink)

Academic women experience working in higher education differently to their male counterparts. This article argues that the unequal position of women academics is unethical, irrespective of whether one takes a consequentialist or deontological ethical position. By drawing on a range of international studies, the article explores the reasons for this inequity, suggesting that the ?cult of individual responsibility?, the positioning of women academics as ?other? and the impact of having a family are significant factors. Having identified the reasons why university (...) women experience the system differently, the article then reflects on how the ethical university can move towards bringing about greater equity between male and female colleagues. (shrink)

The work of Michel Foucault, the French philosopher who was interested in power relationships, has resonated with many nurses who seek a radically analytical view of nursing practice. The purpose of this article is to explore ‘ethics’ through a Foucauldian lens, in a conceptual and methodological sense. The intention is to provide a useful framework that will help researchers critically to explore aspects of nursing practice that relate to the construction of the self, morality and identity, be that nurse or (...) patient related. The fundamentals of the research method of genealogy and the methods of ethics are reviewed. Using an example taken from the sexual health practice area, advice is given on how to structure data collection, incorporate interview data, avoid discourse determinism and measure resistance. (shrink)

What role should the expertise of the autistic communities play in shaping the category of autism compared to the role played by science? This question led to a debate about the quantitative importance of science compared to first-person perspectives for the understanding of autism. I see this debate as lying on a false dichotomy between science and activism, according to which only scientific inquiry would reveal the empirical nature of autism, while the discourse of autistic communities would construct a socio-cultural (...) conception of autism. I consider the problems associated with such a dichotomy and show that first-person perspectives should be considered a necessary step in the scientific investigation of autism. (shrink)

Introduction: The humanities enrich and transform the practice of medicine. What remains to be seen, however, is how best to integrate humanities into the medical curriculum to optimize both educational and patient-related outcomes. The present study considers the structure of an innovative student-driven humanities curriculum and seeks to understand its strengths and limitations, as well as make recommendations for improvement. Methods: The Penn State College of Medicine, University Park Regional Campus uses an inquiry-based approach to education, whereby students are responsible (...) for creating learning objectives in four core pillars of exploration: Foundational Science, Clinical Science, Health Systems Science, and Health Humanities. This study explores student-derived humanities learning objectives (HLO) across four years of the curriculum. Results: 420 HLOs met criteria for analysis and were coded as instrumental (developing direct clinical skill), non-instrumental (non-skill based), or both. Of these, 125 (30%) were instrumental, 239 (57%) were non-instrumental, and 56 (13%) were coded as both. Most instrumental HLO centered around communication skills. Non-instrumental HLO most commonly focused on bearing witness and critiquing a particular experience within a social and/or political context. Conclusions: Findings from this study contribute to the development of a humanities curriculum in a student-directed learning program. Non-instrumental HLO lacked a theoretical framework to guide student’s investigations to a deeper level of analysis. Student-directed learning offers many strengths, but can be enhanced through external direction from humanities trained faculty, particularly given that many medical students have a limited humanities background. (shrink)

“Ambivalence” is the key word in much of this book; “comic” [is the book’s] most obscure and I think absolutely without use value. I don’t know what B[urke] means by “comic,” as a matter of fact. I wonder if he does, and could define it briefly. Readers of Kenneth Burke are well aware of the importance of comedy and its associated cluster of concepts in his work: comic, comic frame, comic attitude, comic corrective. This cluster of terms figures prominently in (...) his 1937 book Attitudes Toward History, most notably in two key passages that scholars turn to time and again. In the first, from the “Poetic Categories” section of the book, Burke explains how different genres serve as guides for how to act in the... (shrink)