What is it for an animal to be female, or male? An emerging consensus among philosophers of biology is that sex is grounded in some manner or another on anisogamy, that is, the ability to produce either large gametes (egg) or small gametes (sperm), though the exact nature of this grounding remains contentious. Here we argue for a new conception of this relation. In our view, one’s sex doesn’t depend on the kind of gamete one is capable of making, but (...) on the kind of gamete one is designed to make, where design is understood in terms of an evolutionary or ontogenetic selection process. Specifically, we argue that what it is to be, say, male, is to have a part or process that has the (proximal or distal) biological function of producing sperm. We outline and defend our view, and sketch some implications for scientific and social problems related to sex. (shrink)

Summary Background Self-binding directives instruct clinicians to overrule treatment refusal during future severe episodes of illness. These directives are promoted as having potential to increase autonomy for individuals with severe episodic mental illness. Although lived experience is central to their creation, service users’ views on self-binding directives have not been investigated substantially. This study aimed to explore whether reasons for endorsement, ambivalence, or rejection given by service users with bipolar disorder can address concerns regarding self-binding directives, decision-making capacity, and human (...) rights. Methods This study used qualitative data from an internet-based survey distributed to the mailing list of the UK charity Bipolar UK, which contained multiple closed and open questions on advance decision-making in bipolar disorder. Quantitative analysis of a closed question about self-binding directives had already demonstrated endorsement amongst a very high proportion of participants with bipolar disorder who completed the survey. We conducted thematic analysis of responses from those participants who answered a subsequent open question about reasons for their view. Research was co-produced within a multi-disciplinary team, with clinical, legal, and ethical expertise, and lived experience of bipolar disorder. Ideas and methodologies associated with all these areas of expertise were used in the analysis of these reasons and to gain insight into the thoughts of individuals with bipolar disorder about self-binding directives and associated issues. Findings Between Oct 23 and Dec 5, 2017, 932 individuals with a self-reported clinical diagnosis of bipolar disorder completed the internet survey, with 565 (154 men; 400 women; 11 transgender or other) providing free text answers to the open question. A large majority of respondents endorsed self-binding directives, nearly all describing a determinate shift to types of distorted thinking and decision-making when unwell as their key justification. Responses indicating ambivalence were dominated by logistical concerns about the drafting and implementation of self-binding directives, while those who rejected self-binding directives also cited logistical concerns, validity of their thinking when unwell, and potential contravention of human rights. Interpretation This study is, to our knowledge, the first large study of reasons why mental health service users might endorse or reject the use of self-binding directives. The findings provide empirical support for introducing self-binding directives into mental health advance decision-making practice and policy and may help to address enduring ethical concerns surrounding possible implementation of the directive while a person retains decision-making capacity. The opinions expressed here in responses given by multiple service users with bipolar disorder challenge a prominent view within international disability rights debates that involuntary treatment and recognition of impaired mental capacity constitute inherent human rights violations. Funding The Wellcome Trust . (shrink)

Este trabalho é uma breve análise do livro eletrônico ― tomado como meio de comunicação relevante para a educação e a cultura no futuro próximo ― centrada nos potenciais e desafios que ele apresenta em relação a acesso e autonomia. A análise visa apontar tendências gerais relativas às características das plataformas de leitura (dispositivos leitores e softwares), particularmente para leitores. Essas tendências são extrapoladas a partir de um pequeno número de exemplos ou casos já existentes. O trabalho avalia as restrições (...) à autonomia impostas pelo caráter proprietário das plataformas de leitura atuais, bem como seus efeitos sobre a mercantilização do livro, e esboça alternativas possíveis, ligadas a padrões abertos de arquivos, software livre e hardware livre. Conclui relacionando esse novo meio à chamada “era do acesso” (RIFKIN) ― evidenciada pela transição da propriedade à licença de uso dos livros ―, e avaliando as principais consequências possíveis (positivas e negativas) dessa transformação. (shrink)