When is it ethically permissible for clinicians to surgically intervene into the genitals of a legal minor? We distinguish between voluntary and nonvoluntary procedures and focus on nonvoluntary procedures, specifically in prepubescent minors (“children”). We do not address procedures in adolescence or adulthood. With respect to children categorized as female at birth who have no apparent differences of sex development (i.e., non-intersex or “endosex” females) there is a near-universal ethical consensus in the Global North. This consensus holds that clinicians may (...) not perform any nonvoluntary genital cutting or surgery, from “cosmetic” labiaplasty to medicalized ritual “pricking” of the vulva, insofar as the procedure is not strictly necessary to protect the child’s physical health. All other motivations, including possible psychosocial, cultural, subjective-aesthetic, or prophylactic benefits as judged by doctors or parents, are seen as categorically inappropriate grounds for a clinician to proceed with a nonvoluntary genital procedure in this population. We argue that the main ethical reasons capable of supporting this consensus turn not on empirically contestable benefit–risk calculations, but on a fundamental concern to respect the child’s privacy, bodily integrity, developing sexual boundaries, and (future) genital autonomy. We show that these ethical reasons are sound. However, as we argue, they do not only apply to endosex female children, but rather to all children regardless of sex characteristics, including those with intersex traits and endosex males. We conclude, therefore, that as a matter of justice, inclusivity, and gender equality in medical-ethical policy (we do not take a position as to criminal law), clinicians should not be permitted to perform any nonvoluntary genital cutting or surgery in prepubescent minors, irrespective of the latter’s sex traits or gender assignment, unless urgently necessary to protect their physical health. By contrast, we suggest that voluntary surgeries in older individuals might, under certain conditions, permissibly be performed for a wider range of reasons, including reasons of self-identity or psychosocial well-being, in keeping with the circumstances, values, and explicit needs and preferences of the persons so concerned. Note: Because our position is tied to clinicians’ widely accepted role-specific duties as medical practitioners within regulated healthcare systems, we do not consider genital procedures performed outside of a healthcare context (e.g., for religious reasons) or by persons other than licensed healthcare providers working in their professional capacity. (shrink)

What are the ethics of child genital cutting? In a recent issue of the journal, Duivenbode and Padela (2019) called for a renewed discussion of this question. Noting that modern health care systems...

Background Deep brain stimulation is approved for treating refractory obsessive-compulsive disorder in adults under the US Food and Drug Administration Humanitarian Device Exemption, and studies have shown its efficacy in reducing symptom severity and improving quality of life. While similar deep brain stimulation treatment is available for pediatric patients with dystonia, it is not yet available for pediatric patients with obsessive-compulsive disorder, although soon could be. The prospect of growing indications for pediatric deep brain stimulation raises several ethical concerns relating (...) to bodily integrity, the ability to offer informed assent, and the role pediatric patients play in the decision-making process. Objective The aim of this study is to solicit and assess the views of stakeholders (children, parents, clinicians) on pediatric assent, autonomy, and bodily integrity in the context of potential pediatric deep brain stimulation for obsessive-compulsive disorder. Methods Semi-structured interviews were conducted with pediatric obsessive-compulsive disorder patients ( n = 21), caregivers of pediatric obsessive-compulsive disorder patients aged 14–18 ( n = 19), and clinicians with experience treating refractory obsessive-compulsive disorder ( n = 25). Interviews were transcribed and coded in MAXQDA 2018 and 2020 software and processed for thematic content analysis to isolate and compare specific themes. Results A majority of respondents (74%, 48/65) across all three stakeholder groups voiced that the decision-making process should be collaborative and involve everyone (clinicians: 84% or 21/25, caregivers 71% or 15/21, and patients 63% or 12/19). We identified a split between respondents’ views on who should have the final say in the event of disagreement (38% or 25/65 favored the patient versus 35% or 23/65 favoring caregivers). A split between respondents also emerged concerning the maturity relevant for deep brain stimulation decision-making, with 45% (29/65) favoring developmental maturity (age/physiological development) and 45% (29/65) favoring decisional maturity (capacity to understand and weigh information). A majority of clinicians indicated that they would not move forward with deep brain stimulation without securing patient assent (80% or 20/25), with some stating the only exception is if patient quality of life was very poor and/or they lacked insight. Both caregivers and patients expressed a significant respect for the patient's right to bodily integrity, with 67% of caregivers (14/21) and 68% of patients (13/19) justifying patient involvement in decision-making specifically with reference to infringements of bodily integrity. Conclusion Our findings demonstrate that despite broad agreement across stakeholders that the decision-making process for pediatric deep brain stimulation for obsessive-compulsive disorder should be collaborative and somehow involve pediatric patients, there is disagreement about what this process entails and what factors determine patient involvement in the process. However, there is agreement that children have a right to bodily and brain integrity, which should only be infringed upon in rare circumstances. (shrink)

Children are treated differently to adults in liberal societies with respect to their right to bodily integrity. A commonly given justification for treating them differently is that they supposedly lack the sort of autonomy that is normally attributed to neurotypical adults. As such children fall through the cracks when it comes to protecting their bodily integrity: they are viewed as less than fully autonomous persons in philosophical, medical, and legal settings. With this editorial, we analyse current (...) treatments of the concept of the child's right to bodily integrity and how this relates to their (developing or future) autonomy on various conceptions. (shrink)

This paper explores the ambiguous notion of bodily integrity, focusing on male and female circumcision. In the empirical part of the study we describe and analyse the various meanings that are given to the notion of bodily integrity by people in their daily lives. In the philosophical part we distinguish (1) between a person-oriented and a body-oriented approach and (2) between four levels of interpretation, i.e. bodily integrity conceived of as a biological wholeness, an (...) experiential wholeness, an intact wholeness, and as an inviolable wholeness. We argue that bodily integrity is a prima facie principle in its own right, closely connected with, but still fundamentally different from, the principle of personal autonomy, that is, autonomy over the body. (shrink)

This paper examines two different ways of understanding the concept of bodily integrity and their political implications. In Drucilla Cornell's use of the concept, the body cannot be separated from the mind. Protecting bodily integrity means protecting possibilities of imagining the self as whole. Martha Nussbaum's theorizing is based on a liberal way of conceptualizing subjectivity, in which the mind and the body are separate, and bodily integrity is used to refer to physical inviolability.

With dying increasingly becoming a medicalised experience in old age, we are witnessing a shift from concern over death itself to an interest in dying ‘well’. Fierce discussions about end-of-life decision making and the permissibility of medical intervention in dying, discursively structured around the notion of a ‘good’ death, are evidence of this shift. This article focuses on ‘autonomy’ and ‘dignity’ as key signifiers in these discussions. Rather than being fully fixed and stable, both signifiers are contingent and carry a (...) variety of meanings within different discursive projects. The article aims to distinguish the varieties of these signifiers by elaborating existing theoretical perspectives on autonomy and dignity, and also, starting from a perspective on mass media as sites of meaning production and contestation, to study the contingency of autonomy and dignity in Belgian newspaper coverage of four prominent euthanasia cases. By means of a discourse-theoretical textual analysis, this study exposes a dominant—yet contested—articulation of rational-personal autonomy and of dignity in external terms as something that can be obtained, retained or lost, rather than in terms of intrinsic human integrity. These logics of representation reflect a more general late modern dominance of liberal autonomy and of dignity as being closely connected to self-identity, but at the same time result in limited visibility of alternative ways of experiencing an autonomous and dignified death. (shrink)

A recent thematic issue of Clinical Ethics contains a number of papers on bodily integrity in paediatric populations. The papers assume that defining ‘bodily integrity’ is a simple matter, and that the main ethical and legal issue is to define when breaches of bodily integrity in pre-autonomous children can be justified. This paper will argue that defining bodily integrity raises specific problems in the paediatric context because the child has a body that (...) is continually developing. The problems will be illustrated by analysing one of the commonly used definitions in the literature, and by considering the developing brain as a body part. (shrink)

In this article, we present an analysis of bodily integrity in hand transplants from a phenomenological narrative perspective, while drawing on two contrasting case stories. We consider bodily integrity as the subjective bodily experience of wholeness which, instead of referring to actual bodily intactness, involves a positive identification with one’s physical body. Bodily mutilations, such as the loss of a hand, may severely affect one’s bodily integrity. A possible restoration of one’s (...) experience of wholeness requires a process of re-identification. Medical interventions, such as a hand transplant, may improve the possibility of a successful re-identification. However, since the experience of wholeness does not refer simply to physical intactness or impairment, the choice for medical intervention should not be based merely upon the degree of physical mutilation. It should also be based upon the degree to which a person fails in re-identifying with his or her mutilated body. We argue that a normalizing operation is only ethically justifiable if the intervention enables the person to be the body he or she has. (shrink)

My focus on vulnerability and bioethics – which acknowledges but goes beyond mainstream feminist ethics - will take a phenomenological perspective that understands the self as having no meaning or existence beyond its embodiment. As such we are always open, and therefore vulnerable, to the constant changes of embodied experience. The transformations in embodiment are both necessary for development and continuous over the life course, but it is only when something breaks the cycle of normative development that the intimation of (...) vulnerability and disorder arise. Corporeal disorder operates in a highly individual and differentiated way as it manifests, for example, in the experience of disability, pain, ageing and dying. These are not exceptional moments of vulnerability in a life otherwise secure and predictable, but they do clearly set out the limits of the western imaginary, and more particularly of modern western biomedicine and conventional healthcare. In offering a critique of the positivist enterprise of biomedicine, I want to suggest a different understanding of the embodiment that has radical implications for bioethics. (shrink)

This article addresses how bodily integrity has been mobilised in the context of genital cutting of male infants and the extent to which the concept is taken into account in legal decision-making in the United Kingdom. While bioethicists have debated whether interventions on children's bodies are more appropriately determined on the basis of hypothetical consent or in the child's best interest, it is clear that in law the relevant test is whether interventions are in the child's best interest. (...) As the issue of nonconsensual genital cutting of infants has become more contested, courts have been asked to adjudicate on the best interests of infants in situations where their caregivers disagree about procedures. Although this body of jurisprudence remains (surprisingly) small, in this article we argue that, while there are now discernible trends in such cases (e.g. deferring decision-making until the child has the requisite capacity to decide, engaging with certain human rights norms), too often judicial reasoning about a child's best interests remains largely empty of reasoned content, and in certain respects is regressing. Using the recent case of Re P to exemplify this logic, and drawing on our previous work advocating the value of embodied integrity, we argue that judges should adopt a more substantive framework of values in judging the child's corporeal and other interests in such cases. This would move best interests assessments beyond a mere formalistic exercise and lead to better reasoned legal judgements. (shrink)

Philosophical understanding of experimental scientific practice is impeded by disciplinary differences, notably that between philosophy and sociology of science. Severing the two limits the stock of philosophical case studies to narrowly circumscribed experimental episodes, centered on individual scientists or technologies. The complex relations between scientists and society that permeate experimental research are left unexamined. In consequence, experimental fields rich in social interactions have received only patchy attention from philosophers of science. This paper sketches a remedy for both the symptom and (...) its root cause. An empirical study of social interactions in an established field of biomedicine grounds a robust account of success in experimental practice. The core idea is the concept of collaboration, of participants working together on a common project toward a shared goal. The interactive social integument of experimental research is both examined and enacted in a study integrating socio-historical research and philosophical investigation. The two approaches are used in concert to explicate the concept of scientific objectivity. Their joint explication of this contested epistemic ideal demonstrates that philosophical and sociological approaches can work together toward a social epistemology of scientific practice. The explication is in three stages. First, a minimal framework for investigating collaborative activities is established. Social action is understood and evaluated in terms of the connection between shared goals that participants hope to accomplish together, and the coordinated means by which they try to do so. This connection is explicated as participation, a relation mediating between a group and its members, which includes minimal constraints of instrumental rationality. Second, this framework is fleshed out via empirical study of scientific practices. The focal case examines the intersection of immunology and stem cell research in mid-20th century biomedicine, tracing the key social interactions within and among laboratory groups, as the field of blood stem cell research emerged in the 1960s and advanced throughout the next four decades. The study yields a robust empirical result. Participants consistently recognize two aspects of scientific success: construction of improved models of blood cell development, and formation of new boundaries among scientific groups. In the third and final stage, this result is generalized to other experimental episodes and shown to fit with recent accounts of models in scientific practice. The generalized result approximates a familiar normative view of scientific knowledge. An epistemic ideal of scientific objectivity in practice is then derived from this robust general result, using the minimal constraints on rational participation. The derivation is analogous to specification of ends in moral philosophy; given the means taken and assuming some hope of success, what must the goal of scientific inquiry be like? The aim of science so conceived corresponds to a classic conception of scientific objectivity: knowledge independent of epistemic criteria specific to particular persons or groups. This result weaves together sociological and philosophical accounts of science, explicating the epistemic ideal of objectivity in relation to social aspects of scientific practice. This undercuts the entrenched dualism between normative, vs. descriptive approaches to scientific knowledge. Socio-historical study of science does not deflate, but vindicates, scientific objectivity. Philosophy and sociology are recast as collaborating participants in articulating social epistemology of science. (shrink)

Political and legal theories of animal rights tend to raise the issue of domesticated animals’ sexuality and reproduction as a matter of population management and therefore concentrate too narrowly on providing justification for fertility restrictions. In this article, I argue that the normative logic underpinning the historical evolution and conceptual development of the fundamental right to health in international law, in its paradigm shift from population control to health rights, is consistent with initiating a similar transition in the domesticated animal (...) case. Without the relevant legal rights protections in place, individual interests in having control over, and making decisions about, their sexuality and reproduction get subordinated to the imperative of achieving sustainable population goals, resulting in the violation of bodily integrity and self-determination. What is missing from the present discussion of domesticated animals’ sexuality and reproduction is a rights-based discourse. I seek to address this gap in the literature by drawing on the existing human rights law norms to develop a conception of sexual and reproductive rights for domesticated animals as a shared yet differentiated fundamental right to health. I show that the realization of this right for domesticated animals is conditional upon a set of freedoms and entitlements, such as the freedom of choice, association, and mobility, as well as access to a range of health facilities, goods, and services. The aim is to introduce a new way of thinking about domesticated animals’ sexuality and reproduction as a rights and agency issue not just a population and fertility control dilemma. (shrink)

In the current debate about the pros and cons of routine (nonreligious) neonatal circumcision (RNC), the emphasis is on medical justifications for the practice. Questions of human rights also are widely discussed. However, even if the alleged medical benefits of RNC were to outweigh the harms and risks, this is not a sufficient justification for RNC. The practice of RNC is questionable from a variety of viewpoints including not only the ideal of evidence-based medicine and human rights considerations, but also (...) the notion of respect for bodily integrity. (shrink)

Medically unnecessary penile circumcision (MUPC) performed on a non-consenting child has been the subject of increasing critical attention in recent years. This paper provides a behind-the-scenes narrative of the politics of ethical policymaking in the United Kingdom in this area including a discussion about some potential barriers to reform. After a brief overview of ethical guidance for medically unnecessary surgical procedures on children in general and on their genitalia in particular, the paper takes a closer look at three contemporary documents (...) released by UK medical bodies and highlights the unique ethical and safeguarding contradictions in this area. The outcomes of initiatives aimed at engaging constructively with the medical bodies and encouraging wider debate are then described, along with some of the main obstacles to engagement and counter-arguments employed. MUPC is subsequently discussed in a wider societal context, highlighting why serious safeguarding concerns have been raised about what many people believe to be a harmful, preventable practice hiding ‘in plain sight’. The paper ends by calling for UK MUPC guidance to be made consistent with the body of guidance that UK doctors are expected to follow. (shrink)

A shift from top-down, hierarchical decision-making toward collaborative, consensus-oriented decision-making is taking place across many settings, leading to meetings in which diverse participants seek to reach agreement on issues of significance. This article proposes a new approach to analyzing such meetings that integrates conversation analysis and issue framing. While CA and IF have both been applied to collaborative decision-making, each approach, on its own, suffers from significant limitations. Combined, they allow negotiation talk in meetings to be examined holistically, integrating a (...) consideration of both process and content. New relationships among interactional sequences and framing processes are revealed, leading to the discovery of patterns across the decision-making activity as a whole. These patterns, in turn, can be situated in the context of the institutions within which the negotiations take place. This novel integrative approach is illuminated through application to a 162-turn decision-making activity. (shrink)

The following interview explores neuroscientist Christof Koch's participation in the adversarial collaboration, testing the integrated information theory (IIT) of consciousness against the global neuronal workspace theory (GNW). The interview offers a current update on the adversarial project and then pivots to Koch's responses to three standing critiques of IIT, which include the inexactness of IIT's measures of the neural correlates of consciousness, the charge that IIT implies an unwieldy panpsychism, and the claim that IIT conflates its measures with consciousness.

The right to bodily integrity (RBI) may seem inapt for inclusion in this volume, which is supposed to address new human rights, for as A. M. Viens notes, the RBI is a long-standing fixture in the philosophical and legal discussion of rights. However, Viens does, I think, make a good case for the right’s inclusion here. Not only does he note the increasing recognition of a new right to genital integrity derived from the more general RBI, he (...) also argues for a new conceptualisation of the RBI itself: he argues that we ought to decompose the RBI into several constituent rights, delineated according to the different values from which they derive – rights to bodily autonomy, bodily dignity, bodily ownership, well-being, and so on. (shrink)

This research focuses on how research ethics committee and integrity board members discuss and decide on solutions to case scenarios that involve a dimension of research ethics or integrity in collaborative settings. The cases involved issues around authorship, conflict of interest, disregard of good scientific practice and ethics review, and research with vulnerable populations (children and neonates). The cases were set in a university, a hospital, or a research institute. In the research, we used a deductive qualitative approach (...) with thematic analysis. Twenty-seven research ethics committee and research integrity board members from 16 European countries and one country outside Europe participated. Participants represented natural and life sciences, social sciences, and humanities. They worked on cases involving ethical/integrity issues in six different constellations. Results show that experts apply key elements of ethical decision making, namely identification of ethical issues, stakeholders, guidelines, solutions, and own positionality, in dealing collaboratively with ethics/ integrity problems, and the nature of the application depends on the complexity of the case. Understanding how individuals knowledgeable in research ethics and integrity, in this case, individuals serving on research ethics committees and integrity boards, approach ethical/ moral issues can help to identify strategies that may be useful in the development of research ethics and integrity training for junior researchers who may benefit from learning professional strategies. (shrink)

Eating disorders can be viewed as “embodied acts” that help to cope with internal and external demands that are perceived as overwhelming. The maintenance of EDs affects the entire identity of the person; the lack of a defined; or valid sense of self is expressed in terms of both physical body and personal identity. According to attachment theory, primary relationships characterized by insecurity, traumatic experiences, poor mirroring, and emotional attunement lead to the development of dysfunctional regulatory strategies. Although the literature (...) shows an association between attachment style or states of mind, trauma, behavioral strategies, and various EDs, the debate is still ongoing and the results are still conflicting. Therefore, we believe it is important to examine and treat EDs by understanding which narrative trajectory intercepts distress in relation to narrative and embodied self-concept. Drawing on clinical observation and a narrative review of the literature, we focus on the construction and organization of bodily and narrative identity. Because bodily representations are the primary tools for generating meaning, organizing experience, and shaping social identity from the earliest stages of life, we focus on the role that bodily interactions and sensorimotor and proprioceptive patterns have played in the development of EDs. We consider the role that lack of attunement, insecure attachment, and relational trauma play in mentalizing, affecting self-representation and emotion regulation strategies. The paper also considers a semantic mode of trauma in EDs that involves a top-down pathway through beliefs and narratives about oneself based on lack of amiability, on devaluation, and on humiliation memories. Finally, we would like to highlight the proposal of an integrated model with multiple access model to psychotherapy that takes into account the complexity of ED patients in whom aspects related to dysregulation, body image disintegration, and post-traumatic symptoms are associated with a suffering sense of self and a retraumatizing narrative. (shrink)

The mapping of therapeutic collaboration throughout counseling deepens our understanding of how the helping relationship fosters client change. To better understand the process of career construction counseling, we analyzed the therapeutic collaboration on six successful face-to-face cases. The participants were six Portuguese adults, five women and one man, real clients of a career counseling service, and four psychologists, three female and one male trained in the career intervention model. The participants completed demographic questions and measures of career certainty, (...) vocational identity, career indecision, and psychological functioning. The Therapeutic Collaboration Coding System was used to track collaboration throughout all interactive episodes. The clinical significance of the intervention was calculated by analyzing pre-post-test statistical differences for each case, with the Reliable Change Index and Z score. The findings evidenced a pattern of therapeutic collaboration evolution for good outcome cases. Based on this pattern, we propose a model of process-outcome evolution for the three phases of CCC. (shrink)

According to the decomposition thesis, perceptual experiences resolve without remainder into their different modality-specific components. Contrary to this view, I argue that certain cases of multisensory integration give rise to experiences representing features of a novel type. Through the coordinated use of bodily awareness—understood here as encompassing both proprioception and kinaesthesis—and the exteroceptive sensory modalities, one becomes perceptually responsive to spatial features whose instances couldn’t be represented by any of the contributing modalities functioning in isolation. I develop an argument (...) for this conclusion focusing on two cases: 3D shape perception in haptic touch and experiencing an object’s egocentric location in crossmodally accessible, environmental space. (shrink)

But it would be neither fair nor truthful to present to those perhaps less familiar with the EU and the 60 year old project of European integration, a picture which is only partial. The highly successful project of European integration, the EU, faces today (like it did 10, 20, 30 years ago) big challenges. Yet Brussels is, often, a very useful tool to face them is.

This research aimed to identify patterns, intellectual structure, contributions, social interactions, gaps, and future research directions in the field of academic integrity (AI). A bibliometric analysis was conducted with 1406 publications covering the period 1966–2023. The results indicate that there has been significant growth in AI literature over the last decade. The most influential publications focused on academic integrity violations such as cheating, plagiarism, and academic misconduct. The largest contribution to the field has come from journals that publish (...) specifically on ethics and academic integrity. Studies in the historical origins of the field have focused on students’ cheating behavior. The thematic structure of the field has focused on academic integrity and its violations, cheating, academic dishonesty, academic integrity in the context of online education, research ethics, and research on the detection of academic violations. The trending topics in the field are academic dishonesty, especially plagiarism and cheating, and online education. The UK, USA, Canada, and Australia have been the most collaborative and productive. More research is needed to address the AI field in the context of new developments. (shrink)

Many states recognize a legal right to bodily integrity, understood as a right against significant, nonconsensual interference with one’s body. Recently, some have called for the recognition of an analogous legal right to mental integrity: a right against significant, nonconsensual interference with one’s mind. In this chapter, we describe and distinguish three different rationales for recognizing such a right. The first appeals to case-based intuitions to establish a distinctive duty not to interfere with others’ minds; the second (...) holds that, if we accept a legal right to bodily integrity, then we must, on pain of philosophical inconsistency, accept a case for an analogous right over the mind; and the third holds that recent technological developments create a need for a legal right to mental integrity. (shrink)

This investigation explores the methodological implications of choosing an unusual example for phenomenological description (here, a bodily awareness practice allowing spontaneous bodily shifts to occur at the leading edge of the living present); for example, the matters themselves are not pregiven, but must first be brought into view. Only after preliminary clarifications not only of the practice concerned, but also of the very notions of the “body” and of “protentionality” is it possible to provide both static and genetic (...) descriptions of the phenomena in question, leading to concluding meditations on the differences between an “integrating” consciousness engaged in a project of knowing and an “improvisational” consciousness open to radical transformation. In the end, however, the Urzeitigung in which what is protended is simply “more time” holds good as the invariant governing the deep structure of both of these styles of consciousness. (shrink)

Emerging evidence is now challenging the view that patients diagnosed with schizophrenia experience a selective deficit in their sense of agency. Additional disturbances seem to exist in their sense of body ownership. However, the factors underlying this disturbance in body ownership remain elusive. Knowledge of these factors, and increased understanding of how body ownership is related to other abnormalities seen in schizophrenia, could ultimately advance development of new treatments. Research on body ownership in schizophrenia has mainly been investigated with the (...) rubber hand illusion (RHI). Schizophrenia patients show higher susceptibility to the RHI, which may be explained by a stronger reliance on multisensory information over weaker stored body representations. This review shows that a coherent sense of body ownership arises from the integration of both bottom-up sensory processes and higher order, top-down bodily- and perceptual representations. Multisensory integration, temporal binding, anticipation, intention and efferent signals all partly modulate the complex experience of body ownership. Specifically, we propose that patients with schizophrenia have weaker stored body representations, and rely to a greater extent on external stimuli, such as visual information, due to imprecise or highly variable internal predictions on the consequences of action. Moreover, the reduced sense of agency in schizophrenia may additionally contribute to the disturbed sense of body ownership, as evidence from healthy participants suggests that agency and body ownership are interrelated. Vice versa, a reduced sense of body ownership may also contribute to a reduced sense of agency. Future studies should explicitly target the precise relation between the two in schizophrenia. (shrink)

Debates about bodily ownership and psychological ownership have typically proceeded independently of each other. This paper explores the relation between them, with particular reference to how each is illuminated by psychopathology. I propose a general framework for studying ownership that is applicable both to bodily ownership and psychological ownership. The framework proposes studying ownership by starting with explicit judgments of ownership and then exploring the bases for those judgments. Section 3 discusses John Campbell’s account of ψ-ownership in the (...) light of that general framework, emphasizing in particular his fractionation of ψ-ownership into two dissociable components. Section 4 briefly presents an account of φ-ownership that I have developed in more detail elsewhere. Section 5 explores the suggestion, originating with Alexandre Billon, that there needs to be an integrated account of φ-ownership and ψ-ownership because depersonalization disorders typically involve breakdowns of both φ-ownership and ψ-ownership. The argument from depersonalization is not compelling, but Section 6 proposes a different way of reaching the same conclusion. Section 7 shows how reflecting on agency and practical reasoning offers a common thread between the models of φ-ownership and ψ-ownership discussed earlier in the paper. (shrink)

Although we usually identify our abilities to reason, to adapt to situations, and to solve problems with the mind, recent research has shown that we should not, in fact, detach these abilities from the body. This work provides an integrative framework for understanding how these abilities are affected by visceral reactions. Schulkin presents provocative neuroscientific research demonstrating that thought is not on one side and bodily sensibility on the other; from a biological point of view, they are integrated. Schulkin (...) further argues that this integration has important implications for judgements about art and music, moral sensibilities, attraction and revulsion, and our perpetual inclination to explain ourselves and our surroundings. (shrink)

This paper is concerned with representational explanations of how one experiences and acts with one’s body as an integrated whole. On the standard view, accounts of bodily experience and action must posit a corresponding representational structure: a representation of the body as an integrated whole. The aim of this paper is to show why we should instead favour the minimal view: given the nature of the body, and representation of its parts, accounts of the structure of bodily experience (...) and action need not appeal to a representation of the body as an integrated whole. The argument proceeds by distinguishing two kinds of explanatory roles for representations: standing-in for absent targets and structuring ambiguous sensory information concerning a target. Representations of body-parts are suited to fulfil both kinds of explanatory role, whereas a representation of the body as an integrated whole is only suited to fulfil the latter, as a means of coordinating representations of body-parts. It is then argued that the structure of the body can itself serve as a means of coordinating body-part representations, rendering representation of the body as an integrated whole explanatorily superfluous. (shrink)

Criminal offenders are sometimes required, by the institutions of criminal justice, to undergo medical interventions intended to promote rehabilitation. Ethical debate regarding this practice has largely proceeded on the assumption that medical interventions may only permissibly be administered to criminal offenders with their consent. In this article I challenge this assumption by suggesting that committing a crime might render one morally liable to certain forms of medical intervention. I then consider whether it is possible to respond persuasively to this challenge (...) by invoking the right to bodily integrity. I argue that it is not. (shrink)

Relation algebras were invented by Tarski and his collaborators in the middle of the 20th century. The concept of integrality arose naturally early in the history of the subject, as did various constructions of finite integral relation algebras. Later the concept of finite-dimensionality was introduced for classifying nonrepresentable relation algebras. This concept is closely connected to the number of variables used in proofs in first-order logic. Some results on these topics are presented in chronological order.

Philosophical and empirical research on bodily awareness has mostly focused so far on bodily disorders – such as anorexia nervosa, somatoparaphrenia, or xenomelia (body integrity dysphoria) – and bodily illusions induced in an experimental setting – such as the rubber hand illusion, or the thermal grid illusion. Studying these conditions can be illuminating to investigate a broad range of issues about the nature, function, and etiology of bodily experience. However, a number of psychoactive compounds can (...) also induce a remarkably wide variety of bodily effects that have received little attention despite their relevance to these issues. Some of these effects are similar to those associated with bodily disorders or experimental bodily illusions, while others appear to be unique. The purpose of this chapter is to provide an overview of these lesser known bodily effects of psychoactive compounds, and outline some ways in which they can bear on recent debates regarding bodily awareness and bodily ownership. (shrink)

Cognitive integration is a contribution to the embodied, embedded, and extended cognition movement in philosophy and cognitive science and the extended synthesis movement in evolutionary biology— particularly cultural evolution and niche construction. It is a framework for understanding and studying cognition and the mind that draws on several sources: empirical research in embodied cognition, arguments for extended cognition, distributed cognition, niche construction and cultural inheritance, developmental psychology, social learning, and cognitive neuroscience. Its uniqueness rests in its ability to account for (...) a range of cognitive phenomena diachronically across both ontogenetic and phylogenetic time scales as well as synchronically on faster time scales incorporating real- time online bodily interactions with the local environment. Furthermore, it does so by going beyond straightforwardly causal and dynamical descriptions of the phenomena in question to include normative social practices that govern and coordinate the brain- body- environment interactions that form the core of the cognitive integration (CI) framework. The three main pillars of the CI framework are interaction, cognitive practices, and the transformation of cognitive abilities. In this chapter I will outline the framework in terms of its core commitments, provide motivations for these core commitments, and discuss core examples of CI at work. I shall also respond to several recent criticisms of the CI framework. (shrink)

The present paper proposes an integrative account of social forms of practical irrationality and corresponding disruptions of individual and group-level emotion regulation. I will especially focus on disruptions in emotion regulation by means of collaborative agential and doxastic akrasia. I begin by distinguishing mutual, communal and collaborative forms of akrasia. Such a taxonomy seems all the more needed as, rather surprisingly, in the face of huge philosophical interest in analysing the possibility, structure and mechanisms of individual practical irrationality, with very (...) little exception, there are no comparable accounts of social and collaborative cases. However, I believe that, if it is true that individual akrasia is, in the long run, harmful for those who entertain it, this is even more so in social contexts. I will illustrate this point by drawing on various small group settings, and explore a number of socio-psychological mechanisms underlying collaborative irrationality, in particular groupthink. Specifically, I suggest that in collaborative cases there is what I call a spiralling of practical irrationality at play. I will argue that this is typically correlated and indeed partly due to biases in individual members' affect control and eventually the group's with whom the members identify. (shrink)

The increasing concern about ethics and integrity in research communities has brought attention to how students and junior academics can be trained on this regard. Moreover, it is known that ethical behaviour and integrity not only involve individual but also group norms and considerations. Thus, through action research and participant observation, this research investigates the learning processes through which 64 students collaboratively develop research ethics and integrity competencies. The aim was to understand how bachelor, master and PhD (...) students approach ethical dilemma cases through a collaborative process. The data consisted of recorded group work on ethics cases, student group reports, and post-training questionnaires. Later, the analyses considered groups as the unit of analysis. These data were analysed through content analysis utilizing the SOLO taxonomy to identify levels of understanding and assess evolvement of ethical sensitivity during a case-based training session. The results show that all groups reached the level of understanding where the groups demonstrated that concepts had been understood appropriately, but occasionally struggled to make connections between them. Students perceived working collaboratively as beneficial. The results help teachers of research ethics and integrity to make pedagogically justified choices in their teaching. Drawing on the results of this study, we propose a tool for the formative assessment of student learning of research ethics and integrity. (shrink)

Body dysmorphic disorder (BDD) poses a significant challenge to an individual’s mental well-being. The obsessive preoccupation with perceived defects in one’s appearance affects individuals’ daily functioning and can result in serious risks, including suicidal ideation and self-surgery. While treatments such as cognitive behavioural therapy and serotonin reuptake inhibitors can provide relief, they do not achieve complete remission. It has been suggested that therapy should not only interrupt the harmful behaviour, but should also address their sense of self, and that after (...) addressing their internalised values, individuals with BDD will be able to incorporate their perceived defect in a manner similar to how individuals with real deformities often do. Phenomenology of psychopathology analyses subjectivity in cases of pathology, and analyses of BDD show that the perceived defect has become a locus of shame. This implies that individuals with BDD have permanently incorporated the gaze of the Other and constantly experience their body as a body-for-others. This paper further explores the sense of self in individuals with BDD through Jenny Slatman’s interpretation of bodily integrity: bodily integrity as a never-ending process of identification. By comparing the experiences of individuals with BDD to those with real deformities and to those who have undergone cosmetic surgery, I will show that re-identification does not occur in individuals with BDD. This suggests that their bodily integrity is fundamentally disturbed and that addressing their internalised values alone will probably not be sufficient for the disorder to go into remission. (shrink)

Background Home care nurses are central in providing holistic and compassionate care to patients in home-based palliative care. Ethical caring competency is essential for home care to sustain nurses’ integrity in the face of moral adversity. Interprofessional collaboration is vital for ensuring ethical decision-making and providing patient-centered care in home-based palliative care settings. Aim This study explored the predictive roles of interprofessional collaboration and moral resilience on ethical caring competency among home care nurses in home-based palliative care. (...) Methods A cross-sectional survey of 400 nurses was conducted from October to December 2023, utilizing standardized scales to measure interprofessional collaboration, moral resilience, and ethical caring competency. A convenience sample of 400 home care nurses was also included in this study. Correlation and linear regression analysis were used to clarify the associative and predictive findings. Ethical Considerations Ethical approval from the ethics committee, institutional permission, and informed consent from the participants were obtained for data collection. Results Correlation analysis showed significant positive correlations between the ethical caring competency, interprofessional collaboration, and moral resilience constructs, with coefficients ranging from 0.482 to 0.967. Linear regression revealed that management of collaborative systems and total moral resilience significantly predict ethical caring competency, explaining 14.6% and 36.6% of its variance, respectively. Other variables, such as the effects of collaboration and communication, did not significantly influence ethical caring competency. Conclusion The study highlights the significant impact of interprofessional collaboration, particularly the management of collaborative systems and moral resilience, on enhancing ethical caring competency among nurses. Implications Enhancing interprofessional collaboration and moral resilience through targeted strategies in nursing practice and education can significantly improve ethical caring competencies. These efforts are essential for delivering high-quality, patient-centered care and for fostering a healthcare environment that respects the ethical principles guiding nursing practice. (shrink)

Since 2008, in Flanders, we organize immersion sessions in a simulated context with the aim of stimulating student nurses and health professionals to learn virtuous caring. In this contribution, we first outline the purpose of this experiential learning: the cultivation of moral character. We come to the core of what we mean by moral character for care. We refer to Joan Tronto and Stan van Hooft to claim that caring is central to all aspects of nursing practice and is the (...) basis of its moral quality. We also stipulate that caring involves the integration of action with emotions, motivations, and knowledge. Second, we briefly explain how the immersion sessions in the care ethics lab take place and, in particular, reflect on what it yields in terms of experiences for the participants who take on the role of simulant patients in this experiential learning process. We focus on the significant role contrast experiences play in these experiences. Especially the negative contrast experiences do not wear off easily; care professionals remember even long after the immersion session and continue to carry them with them as a “corporeal built-in alarm.” Third, we discuss the role of contrast experiences in cultivating moral character for care. In particular, we explore the role of the body in the kind of knowing it cultivates and, by extension, its role in cultivating virtuous caring. By referring to specific philosophical ideas of Gabriël Marcel, Hans Jonas and Emmanuel Levinas, we try to understand how contrast experiences bring about an integration of virtuous action into knowledge, motivation, and emotion. We conclude that we need more space for contrast experiences in cultivating moral character. More attention should be paid to the role of the body in this learning process. (shrink)

Hoping to expand upon public philosophy endeavors within higher education, the following captures the story behind the course Dialogue, Integration, and Action. The course has yielded a number of innovative pedagogical tools and engagement strategies likely to be of value to philosophy instructors seeking to explore a more participatory, experiential educational approach. As a transdisciplinary, community-engaged philosophy class, it engages students in the theories and practices of deliberative democracy and activism, encouraging the development of dialogic skills for their personal, professional, (...) and civic lives. By documenting the community-instructor-student collaborative design of the university course; the feminist pragmatist philosophic commitments underlying its design; the community-led and student-facilitated dialogue and the subsequent public report, as well as the impact of this work on the students, the community partner, and the instructor, the article highlights the benefits and the challenges of undergraduate philosophic engagement that emerges from and responds to place-based needs. (shrink)

This research investigates how two different types of nongovernmental organization (NGO)–business collaboration for green innovation impact consumers’ purchase intentions. The authors carried out three studies, whose findings show that consumers prefer collaborations in which NGOs are integrated into the product development process (NGO co-development) over those that involve corporate giving to NGOs (sales-contingent donations). They show that green credibility works as a mediator, which explains why these two types of collaboration influence consumers’ purchase intentions differently. They also identify (...) aspirational talk about a company’s future ambitions as an important boundary condition. These findings are important for literature on corporate social responsibility (CSR) communication, co-development, and co-branding and contribute to the discussion of the role of business in society. (shrink)

Collaborative remembering is essential to enabling teams to build shared understanding of projects and their progress. This article presents an analysis of collaborative remembering sequences in a corpus of interactions collected in a workplace where a team of designers developed a video television commercial. On the basis of coding and analysing linguistic and bodily behaviors in 158 such sequences, extracted from over 45 hours of video recordings, recurrent patterns of collaborative remembering processes were identified, relating to the interplay of (...) work roles. This article shows that collaborative remembering in the design studio is structured by behavioural, interactive and social factors. (shrink)

Pregnant women and persons engaging in homosexual practices compose two groups that have been and still are amongst those most severely subjected to coercive restrictions regarding their own bodies. From an historical point of view, it is a recent and rare phenomenon that a woman’s right to abortion and a person’s right to engage in homosexual interactions are recognized. Although most Western liberal states currently do recognize these rights, they are under continuous assault from various political and religious movements. Moreover, (...) though liberal theories of justice typically defend women’s rights to abortion and people’s rights to homosexual activity, these theories often struggle to capture the fundamental ground for these rights. For example, it appears hard for the liberal to say why and when only the woman and not the embryo/fetus has rights and why the right to certain sexual practices is not on par with rights to other preferences. Contemporary liberal theories of justice, therefore, have a hard time identifying what distinguishes questions of abortion and sexual activities from other questions of right and thereby also have difficulty capturing the gravity of the wrongdoing involved in coercively restricting homosexual interactions and abortion as such. I argue that Kant’s theory of justice succeeds on both counts, because it can locate the fundamental ground for these rights in an understanding of the bodily integrity of the person. Just states will neither permit nor outlaw all abortions or sexual interactions, but rather will require all such laws to be reconcilable with the protection of each person’s right to freedom. (shrink)

Inter-organizational models are both a well-documented phenomena and a well-established domain in management and business ethics. Those models rest on collaborative capabilities. However, mainstream theories and practices aimed at developing these capabilities are based on a narrow set of assumptions and ethical principles about human nature and relationships, which constrain the very development of capabilities sought by them. This article presents an Aristotelic–Thomistic approach to collaborative entrepreneurship within and across communities of firms operating in complementary markets. Adopting a scholarship of (...) integration approach and evaluating the six studies of communities of organizations, we contribute an inter-organizational network model based on the assumptions about human motives and choice offered by Aristotle. We argue that the sustainability of inter-organizational communities depends on how rich is the set of assumptions about human nature upon which they are based. In order to develop and sustain collaborative capabilities in inter-organizational communities, a set of assumptions that takes both self-regarding and others’-regarding preferences as ends is required to avoid any kind of instrumentalization of collaboration, which is an end in itself. Implications for theory and practice are discussed. (shrink)

In this issue, Elizabeth Shaw and Gulzaar Barn offer a number of replies to my arguments in ‘Criminal Rehabilitation Through Medical Intervention: Moral Liability and the Right to Bodily Integrity’, Journal of Ethics. In this article I respond to some of their criticisms.

This article compares case studies to better understand how third grade teachers, serving low-income (including Title I) schools, adapted their instruction in the midst of a global pandemic to better support their students’ learning about locally-relevant civic issues. Civic perspective-taking components were embedded in the unit design with the aim of building deliberative, inclusive classrooms. The team designed lessons drawing from theories of culturally sustaining pedagogy. Using semi-structured interview data, we examined teachers’ reported thinking and perceptions about students’ needs and (...) their own struggles to deliver purposeful, equitable instruction. Findings indicate that as teachers collaboratively designed the lessons they discussed how to balance relevance and sensitivity in relation to content that mirrored students lived realities. This study advances our understanding of what challenges teachers overcome to integrate culturally-sustaining practices in their social studies instruction. (shrink)

A long history of extractive industries and activities have shaped the societies of northern Mozambique, and the Cabo Delgado province in particular. For centuries, the growing international demand on local resources had a great impact on the northern micro-societies. The demand for cheap labour and natural resources, ranging from ivory and cotton, to timber, rubies, land, gas and more, involved thousands of local actors in its extraction, reproducing systems of local power. The persistence of poverty, inequality and conflicts, as well (...) as simmering and sometimes grand-scale violence, fits into a long-term trend of extractivism. Through a historical approach and field observations, we focus on the political economy of extracting natural resources. We point out the persisting basic patterns of extractivism that accompanied Mozambique's integration into global markets, and continued or even deepened, in the post-independence period. These activities are oriented towards foreign markets. They are instigated by foreign investment, but invariably carried out in collaboration with a chain of national gatekeepers. In a clientelist system, local elites resort to their proximity to the state to reproduce their power, often at the expense of state expropriation. Weak state institutions have the functional effect of reproducing the elites, also serving the interests of extractivist capital. It is, however, a system with many and profound contradictions, producing conflict and violence, which also recurrently put those interests at risk. (shrink)

To enhance patient care in the inevitable conditions of complexity that exist in contemporary healthcare, collaboration among healthcare professions is critical. While each profession necessarily has its own primary focus and perspective on the nature of human healthcare needs, these alone are insufficient for meeting the complex needs of patients (and potential patients). Persons are inevitably contextual entities, inseparable from their environments, and are subject to institutional and social barriers that can detract from good care or from accessing healthcare. (...) These are some of the reasons behind current movements to develop competency frameworks that can enhance cross‐disciplinary communication and collaboration. No single profession can claim the big picture. Effective teamwork is essential and requires members of diverse professions to understand the nature of each other's knowledge, skills, roles, perspectives, and perceived responsibilities so that they are optimally utilized on behalf of patients and their families. Interdisciplinary approaches to care permit different aspects of a person's needs to be addressed seamlessly and facilitate the removal of obstacles by engaging the range of resources exemplified by the different professions. Additionally, collaborative efforts are needed to influence policy changes on behalf of individual and social good and to address root causes of poor health especially as these impact society's most vulnerable. Here, we explore both the benefits and the risks of an uncritical acceptance of competency frameworks as a way to enhance interdisciplinary communication. We highlight the importance of anchoring proposed competency domains in the reason for being of a given profession and exemplify one way this has been accomplished for advanced practice nursing. Additionally, we argue that having this mooring, permits integration of the various competencies that both enhances professional moral agency and facilitates interdisciplinary collaboration to further the mutual goals of the healthcare professions on behalf of quality patient care. (shrink)

Multiple theories of problem-solving hypothesize that there are distinct qualitative phases exhibited during effective problem-solving. However, limited research has attempted to identify when transitions between phases occur. We integrate theory on collaborative problem-solving with dynamical systems theory suggesting that when a system is undergoing a phase transition it should exhibit a peak in entropy and that entropy levels should also relate to team performance. Communications from 40 teams that collaborated on a complex problem were coded for occurrence of problem-solving processes. (...) We applied a sliding window entropy technique to each team's communications and specified criteria for identifying data points that qualify as peaks and determining which peaks were robust. We used multilevel modeling, and provide a qualitative example, to evaluate whether phases exhibit distinct distributions of communication processes. We also tested whether there was a relationship between entropy values at transition points and CPS performance. We found that a proportion of entropy peaks was robust and that the relative occurrence of communication codes varied significantly across phases. Peaks in entropy thus corresponded to qualitative shifts in teams’ CPS communications, providing empirical evidence that teams exhibit phase transitions during CPS. Also, lower average levels of entropy at the phase transition points predicted better CPS performance. We specify future directions to improve understanding of phase transitions during CPS, and collaborative cognition, more broadly. (shrink)

Dance, Music and Dramaturgy: collaboration plan and dramaturgical apparatus – The unfolding of the concept of dramaturgy and the problematics of contemporary choreography are, today, a vast and diverse field of research, bearing numerous disclosures that lead to their reciprocal implication. Apart from that, dance and music share significant complementary ties allowing for the consideration of a common compositional inquiry. Reflecting on the compositional processes of dance and music, this article cross-examines the collaboration between choreographers and composers, integrating (...) the incidence of dramaturgy in the strategies of choreographic and musical composition. (shrink)