Defined as patients who ‘lack decision-making capacity and a surrogate decision-maker’, the unrepresented present a major quandary to clinicians and ethicists, especially in handling errors made in their care. A novel concern presented in the care of the unrepresented is how to address an error when there is seemingly no one to whom it can be disclosed. Given that the number of unrepresented Americans is expected to rise in the coming decades, and some fraction of them will experience a medical (...) error, creating protocols that answer this troubling question is of the utmost importance. This paper attempts to begin that conversation, first arguing that the precarious position of unrepresented patients, particularly in regards to errors made in their care, demands their recognition as a vulnerable patient population. Next, it asserts that the ethical obligation to disclose error still exists for the unrepresented because the moral status of error does not change with the presence or absence of surrogate decision-makers. Finally, this paper concludes that in outwardly acknowledging wrongdoing, a clinician or team leader can alleviate significant moral distress, satisfy the standards of a genuine apology, and validate the inherent and equivalent moral worth of the unrepresented patient. (shrink)

Abstract: We live in the age of apology, particularly the age of collective apology. Here, I focus specifically on collective state apologies. In these apologies, political leaders apologize on behalf of an entire collective to another collective, often a racial or ethnic minority. Cynicism and skepticism arise on whether these apologies are morally legitimate. Here, moral legitimacy entails that an apology deserves to be given the authority, seriousness, and consideration that interpersonal apologies usually demand. In this paper, I respond to (...) two groups that doubt the moral legitimacy of such apologies, namely political-realists and moral-individualists. Ultimately, I argue that collective state apologies can be morally legitimate. Political-realists are wrong to think that sincerity is necessary or sufficient for moral legitimacy. Moral-individualists overmoralize the role of the individual to the point of “hyperindividualism.” I end by proposing that at least democratically elected leaders have standing to apologize on behalf of their constituents. (shrink)

The paper explores the possibility of collectives forgiving and being forgiven. The first half of the paper articulates and amends Hannah Arendt’s account of forgiveness of and by individuals. The second half raises several objections to the possibility of extending this account to forgiveness of and by collectives. In reply, I argue that collectives can have emotions, be guilty, and meet other necessary conditions for forgiving or being forgiven. However, I explain why, even though collective forgiveness is possible, it may, (...) nonetheless, prove dissatisfying. (shrink)

The problem of dirty hands is, roughly speaking, concerned with situations in which an agent is faced with a choice between two evils so that, no matter what they do, they will have to violate something of important moral value. Theorists have been primarily concerned with dirty hands choices arising in politics because they are thought to be particularly frequent and pressing in this sphere. Much of the subsequent discussion in the literature has focused on the impact that such choices (...) have on a well-functioning democracy and how, if at all, we can ensure that a politician dirtying their hands does not undermine core democratic values and processes. A particular concern has been whether dirty-handed politicians ought to publicly reveal their actions after the fact and whether they should be held accountable through some form of punishment. The first aim of this paper is to point out that the focus on what is required in the wake of a dirty-handed decision, based on the need to protect the democratic system ought to be balanced with a genuine concern for reparative justice and what is owed to the victims of dirty hands. In the second part of this paper, I then examine the suitability of one common way in which perpetrators partly repair the damage they have done to victims, namely apologizing, in the dirty hands context. (shrink)

If I do you a good turn, you may respond with gratitude and express that gratitude by saying “Thank you.” Similarly, if I insult you, you may react with resentment which you express by shouting, “Screw you!” or something of the sort. Broadly put, when confronted with another’s morally significant conduct, we are inclined to respond with a reactive attitude and to express that reactive attitude in speech. A number of familiar speech acts have a call-and-response structure. Questions, demands and (...) hails are all call-types, and each seeks a defining response. Questions seek answers, demands seek compliance, and a hail, for example, “Hi Coleen” seeks a “Hi” in return. Many theorists claim that expressions of the reactive attitudes also have this structure. Yet, this insight raises a number of questions. There are, after all, many familiar call-types, not only questions, demands and hails, but also requests, invitations, recommendations and entreaties. Given this, it is natural to wonder whether the expressed reactive attitudes are a sui generis call-type or whether they can be properly assimilated to one of the better-known forms. Further, we might wonder about the response component. It is utterly familiar that the response suited to a demand is compliance, and that the response sought by a question is an answer, but what response do the expressed reactive attitudes seek? The answer to this question is not similarly ready to hand. In this paper, I provide a recognition-based theory of the call-and-response structure of the expressed reactive attitudes. On my account, both the positive and negative expressed reactive attitudes are modes of recognition that seek for their target to give expression to her recognition of having been appropriately recognized. In the negative case, the target does this by feeling and expressing guilt or remorse, and in the positive case, by feeling and expressing self-approbation. (shrink)

Philosophers have highlighted a dilemma for the criminal law. Unjust, racist policies in the United States have produced conditions in which the dispossessed are more likely to commit crime. This complicity undermines the standing of the state to blame their offenses. Nevertheless, the state has reason to punish those crimes in order to deter future offenses. Tommie Shelby proposes a way out of this dilemma. He separates the state’s right to condemn from its right to punish. I raise doubts about (...) Shelby’s proposed resolution. So long as punishment is widely and reasonably understood to condemn crime, Shelby’s proposal does not resolve the dilemma. Moreover, there is reason to think the blaming aspect of punishment plays a role in the justification of its hard treatment. I conclude by considering some other ways out of the dilemma, focusing especially on how the United States might take responsibility for its complicity. (shrink)

The Oxford Handbook of Philosophy and Race provides up-to-date explanation and analyses by leading scholars of contemporary issues in African American philosophy and philosophy of race. These original essays encompass the major topics and approaches in this emerging philosophical subfield that supports demographic inclusion and diversity while at the same time strengthening the conceptual arsenal of social and political philosophy. Over the course of the volume's ten topic-based sections, ideas about race held by Locke, Hume, Kant, Hegel, and Nietzsche are (...) supplemented by suppressed thought from the African diaspora, early twentieth-century African American perspectives and Native-, Asian-, and Latin-, American views. The contributors bring philosophical analysis to bear on the status of racial divisions as categories of humanity in the biological sciences, as well as within contemporary criticism and conceptual analysis. Essays present the special applications of American philosophy and continental philosophy to ideas of race as methodological alternatives to more analytic approaches. As a collection of analyses and assessments of 'race' in the real world, the volume pays trenchant and relevant attention to historical and contemporary racism and what it means to say that 'race' and racial identities are socially constructed. The essays analyze contemporary social issues including the importance of racial difference and identity in education, public health, medicine, IQ and other standardized tests, and sports. Additionally, the essays consider the societal limitations and structures provided by public policy and law. As a critical theory, the volume compares the study of race to feminism. Historical and contemporary, academic and popular, racisms pertaining to male and female gender receive special consideration throughout the volume. While this comprehensive collection may have the effect of a textbook, each of the original essays is a fresh and authentic development of important present thought. (shrink)

Particular conceptions of reconciliation vary across a number of dimensions. As section 1 explains, the kind of relationship at issue in a specific context affects the type of improvement in relations that might be necessary in order to qualify as reconciliation. Reconciliation is widely taken to be a scalar concept. Section 2 discusses the spectrum of intensity along which kinds of improvement in relationships fall, and indicates why, in particular contexts, theorists often disagree about the point along this spectrum that (...) is morally or politically most significant. Section 3 provides an overview of the processes commonly cited as contributing to reconciliation. These processes are often controversial; those praised by some commentators as appropriate and constructive responses to past conflict are dismissed by others as undermining the moral or political conditions for just and peaceful relations. Section 4 concentrates on the relationship between reconciliation and justice. While some see these values as compatible and mutually supporting, others argue that, especially in the immediate wake of conflict, parties must often choose between reconciliation and justice. (shrink)

While the mechanisms of apology, forgiveness and reconciliation receive considerable scru-tiny, little attention has been afforded the non-apology. This counterfeit, confected typically by false substi-tution or mis-direction, adds moral insult to moral wrong. The paper elucidates the normative structural relationship among apologiser, the apologetic disposition, and the apology and defends the view of the non-apology as the pretended willingness to recalibrate the moral positional relationship among apologiser, wronged, and wrong without actually doing so.