It is widely held that it is good to conceive of one's life narratively, but why this is the case has not been well established. I argue that conceiving of one's life narratively can contribute to one's flourishing by mediating to oneself a second-person experience of oneself, furnishing one with valuable second-personal productive distance from oneself and as a result self-understanding. Drawing on Eleonore Stump's theory that narratives re-present to their audiences the second-person experiences they depict, I argue that conceiving (...) of one's life narratively facilitates taking on the second-person experience that an audience would have in hearing one's life narrative, mediating how someone from a second-person perspective might perceive oneself and as a result yielding valuable self-understanding. I conclude with some practical implications. (shrink)

Stigmatization and sharming of healthcare workers in Japan during the coronavirus 2019 pandemic reveal uniquely Japanese features. Seken, usually translated as ‘social appearance or appearance in the eyes of others,’ is a deep undercurrent woven into the fabric of Japanese life. It has led to providers who become ill with the SARS-CoV-2 virus feeling ashamed, while concealing their conditions from coworkers and public health officials. It also has led to healthcare providers being perceived as polluted and their children being told (...) they were not welcome in schools. Although such experiences are not isolated to Japan and have appeared in other parts of the world, the cultural forces driving them in Japan are unique. Overcoming stigmatization and shaming of Japanese healthcare providers will require concerted efforts to understand cultural barriers and to view such practices as raising human rights issues affecting the safety and well-being of all. (shrink)

The paper begins by tracing the historical development of American medicine as practice, profession, and industry from the eighteenth century to the present. This historical outline emphasizes shifting conceptions of physicians and physician ethics. It lays the basis for showing, in the second section, how contemporary controversies about the physician’s role in managed care take root in medicine’s past. In the final two sections, I revisit both the historical analysis and its application to contemporary debates. I argue that historical narratives (...) can function as “master narratives” that suppress or leave out historical facts. I bring to the surface what is covered up by the master narrative approach, and show its relevance to contemporary ethical debates. I conclude by proposing that preserving the integrity of medicine will require modifying the master narratives we tell about physicians. The integrity of medicine also offers new perspectives for thinking about managed care and the broader topic of health care reform. (shrink)

Authenticity has been recognized as a central concept in the ethics of human enhancement. In the last decade, a plethora of novel distinctions, specifications, and definitions of authenticity have been added to the debate. This chapter takes a step back and maps the different accounts of authenticity to provide a nuanced taxonomy of authenticity and reveal the emerging underlying structures of this concept. I identify three kinds of conditions for authentic creation and change of the true self (coherence, endorsement, and (...) relations) as well as ways how the true self should be expressed (in one’s self-conception, self-presentation, and one’s body, emotions, and actions). Based on this analysis, I discuss the hopes and concerns human enhancement raises for authenticity. Enhancement technologies do not threaten or foster authenticity across the board but affect different dimensions of authenticity individually. Finally, I turn to the value of authenticity and argue that the debate on authenticity in the ethics of human enhancement would profit from a more extended discussion on the comparative value of the individual dimensions of authenticity. (shrink)

Narratives structure and inform how we understand our experiences and identity, especially in instances of suffering. Suffering in mental disorder (e.g. bipolar disorder) is often uniquely distressing as it impacts capacities central to our ability to make sense of ourselves and the world—and the role of narratives in explaining and addressing these effects is well-known. For many with a mental disorder, spiritual/religious narratives shape how they understand and experience it. For most, this is because they are spiritual and/or religious. For (...) others, spiritual/religious narratives still often influence secular approaches to mental disorder, more than approaches to other disabilities (e.g. intellectual, physical) or causes of suffering (e.g. physical disease). Such narratives are often harmful, especially insofar as they ‘over-spiritualize’ mental disorder; and undercut ‘spiritual meaning-making’. Here I address the impact of spiritual/religious narratives that helpfully avoid over-spiritualizing mental disorder while enabling spiritual meaning-making about it. First, I address the role of narratives in meaning-making more generally; then, I present results from my recent empirical study testing the impact of such narratives on participants’ meaning-making about their mental disorder. I conclude by addressing implications and potential worries. (shrink)

The ongoing trauma of COVID-19 will no doubt mark entire generations in ways inherent in an unmanaged global pandemic. The question that I ask is why this ongoing trauma seems so particularly profound and so uniquely shattering, and whether there is anything that we could do now, while still in the midst of disaster, to begin the process of social and moral repair? I will begin by considering the trauma of isolation with unknown time-horizons, and argue that it not only (...) damages our experiences as social selves, but its languages of overwhelming grief rob us of hope of self-restoration. Second, I will examine some reasons for the “why us”-type of trauma experienced by so many in the Global North, and suggest that such laments are predicated on the misalignment among our socio-historical awareness, disaster-imagination, and our sense of ourselves as uniquely unfortunate. Finally, relying in part on Viktor Frankl’s notion of “tragic optimism,” I conclude by considering how we may begin to reconsider our traumas as not just endings of what is, but beginnings of what still might be —as repair without a master plan. (shrink)

This article provides a conceptual and normative framework through which we may understand the potentially ethically significant roles that information generated by neurotechnologies about our brains and minds may play in our construction of our identities. Neuroethics debates currently focus disproportionately on the ways that third parties may (ab)use these kinds of information. These debates occlude interests we may have in whether and how we ourselves encounter information about our own brains and minds. This gap is not yet adequately addressed (...) by most allusions in the literature to potential identity impacts. These lack the requisite conceptual or normative foundations to explain why we should be concerned about such effects or how they might be addressed. This article seeks to fill this gap by presenting a normative account of identity as constituted by embodied self-narratives. It proposes that information generated by neurotechnologies can play significant content-supplying and interpretive roles in our construction of our self-narratives. It argues, to the extent that these roles support and detract from the coherence and inhabitability of these narratives, access to information about our brains and minds engages non-trivial identity-related interests. These claims are illustrated using examples drawn from empirical literature reporting reactions to information generated by implantable predictive BCIs and psychiatric neuroimaging. The article concludes by highlighting ways in which information generated by neurotechnologies might be governed so as to protect information subjects’ interests in developing and inhabiting their own identities. (shrink)

Irony has a suspicious moral reputation, especially in popular media and internet culture. Jonathan Lear (2011) introduces a proposal which challenges this suspicion and identifies irony as a means to achieve human excellence. For Lear, irony is a disruptive uncanniness which arises from a gap between aspiration and actualisation in our practical identity. According to Lear, such a disruptive experience of ironic uncanniness reorients us toward excellence, because it passionately propels us to really live up to that practical identity. However, (...) Lear’s understanding of irony is idiosyncratic and his proposal overlooks that disruption often results from value incompatibility between different practical identities. The disruption which follows from value incompatibility does not inherently reorient us toward excellence. The point is exactly that achieving excellence in one practical identity is sometimes incompatible with excellence in the other. Pace Lear, I do not identify this disruptive experience as a central example of irony. Instead, I consider irony a virtuous coping strategy for such disruption, because it introduces the necessary distance from our moral imperfection to sustain practical deliberation and maintain good mental health. Such virtuous irony negotiates a golden mean between too little disruption (complete insensitivity toward one’s imperfection) and too much disruption (a complete breakdown of practical deliberation and mental health). I argue that ironic media in popular culture provide a rich source of such virtuous irony, which I demonstrate through analysis of satirical examples. (shrink)

Bioethics has increasingly become a standard part of medical school education and the training of healthcare professionals more generally. This is a promising development, as it has the potential to help future practitioners become more attentive to moral concerns and, perhaps, better moral reasoners. At the same time, there is growing recognition within bioethics that nonideal theory can play an important role in formulating normative recommendations. In this chapter we discuss what this shift toward nonideal theory means for ethical curricula (...) within healthcare education. In particular, we contend that more attention to the particularities of historical and social context needs to be incorporated into bioethics training. To make this argument, we focus on two examples: teaching units on race and medicine and those that focus on stigma and coercion in mental health. For both, we show how a pedagogical approach in which educators focus on social injustice could influence how practitioners engage in ethics in the clinic. This chapter, then, demonstrates what a commitment to nonideal theory can mean practically when it comes to bioethics education. (shrink)

This paper attempts to make more explicit the relationship between narrativity and feminist care ethics. The central concern is the way in which narrativity carries the semantic load that some accounts of feminist care ethics imply but leave hanging. In so doing, some feminist theorists of care-based ethics then undervalue the major contribution that narrativity provides to care ethics: it carries the semantic load that is essential to the best care. In this article, I defend the narrative as the central (...) medium though which we make sense of and communicate our lives and their attendant hopes and cares. More than just working with the narrative of the cared-for, caring is about investing in the narrative of the cared-for in order to meet the needs of this cared-for and how this narrative might turn out. I will further demonstrate how the attitude of caring or investing in a narrative would amount to what Gabriel Marcel has described as the attitude of disponibilité. (shrink)