The article addresses issues at the nexus of physician industrial action, moral agency, and responsibility. There are situations in which we find ourselves best placed to offer aid to those who may be in vulnerable positions, a behavior that is consistent with our everyday moral intuitions. In both our interpersonal relationships and social life, we make frequent judgments about whether to praise or blame someone for their actions when we determine that they should have acted to help a vulnerable person. (...) While the average person is unlikely to confront these kinds of situations often, those in the medical professions, physicians especially, may confront these and similar situations regularly. Therefore, when physicians withhold their services for whatever reason in support of industrial action, it raises issues of moral responsibility to patients who may be in a vulnerable position. Using theories of moral responsibility, vulnerability, and ethics, this paper explores the moral implications of physician industrial action. We explore issues of vulnerability of patients, as well as the moral responsibility and moral agency of doctors to patients. Determining when a person is vulnerable, and when an individual becomes a moral agent, worthy of praise or blame for an act or non-action, is at the core of the framework. Notwithstanding the right of physicians to act in their self-interest, we argue that vulnerability leads to moral obligations, that physicians are moral agents, and the imperatives of their obligations to patients clear, even if limited by certain conditions. We suggest that both doctors and governments have a collective responsibility to prevent harm to patients and present the theoretical and practical implications of the paper. (shrink)

Nossa seleção de verbetes parte do interesse de cada pesquisador e os dispomos de maneira histórico-cronológica e, ao mesmo tempo, temática. O verbete de Melissa Lane, “Filosofia Política Antiga” vai da abrangência da política entre os gregos até a república e o império, às portas da cristianização. A “Filosofia Política Medieval”, de John Kilcullen e Jonathan Robinson, é o tópico que mais demanda espaço na nossa seleção em virtude das disputas intrínsecas ao período, da recepção de Aristóteles pelo medievo e (...) da tensão entre poder Papal e Civil. No verbete “Liberalismo”, de Gerald Gaus, Shane Courtland e David Schmidtz, vemos as fontes fundantes da Filosofia Política da modernidade. As ideias de liberdade negativa e positiva se coadunam com a Ética Liberal e sua influência sobre a abrangência do valor fundamental da liberdade individual diante das políticas públicas. O texto de Ian Carter, “Liberdade Positiva e Liberdade Negativa”, expõe o paradoxo da liberdade em suas concepções valorativas e neutra, muito úteis para compreender os problemas políticos que enfrentamos hoje. Por fim, Bas Van Der Vossen no texto “Libertarianismo” trata das noções tensas entre Estado e indivíduos. A concepção de “liberdade de si”, genuinamente negativa, ganha destaque justificatório. Jackie Scully, no verbete Bioética Feminista, exemplifica o valor da influência dessas correntes no âmago de todos os contemporâneos. Sua escrita homenageia postumamente Anne Donchin com um apanhado histórico da luta de inserção de políticas feministas na pesquisa acadêmica global. No verbete “Democracia”, os professores brasileiros Gustavo Dalaqua e Alberto Ribeiro Barros acrescentaram tópicos importantes ao tema geral, respectivamente: “Construtivismo Representativo vs. Representação Descritiva” e “Democracia Contestatória de Philip Pettit”. O texto de Thomas Christiano perpassa os principais argumentos de justificação política contra e a favor da democracia ocidental, com foco central nas concepções de liberdade e igualdade. Os verbetes dispostos nessa seleção de textos são tendenciosos na medida que expressam o interesse genuíno de cada pesquisador com os assuntos relevantes em suas pesquisas. Em virtude disso, a escolha “adota um lado” em detrimento de outros – mais especificamente: de outro que poderia ser mais “progressista”. Por si só, o livro já nasce reclamando um segundo volume, que será providenciado. Colocamos de lado qualquer exigência de “imparcialidade”, algo que não existe na Filosofia, muito menos na Filosofia Política. Sobressai, nesse aspecto, o caráter reflexivo que o assunto exige e a importância do assunto, sem o qual não teríamos a modernas concepções de representatividade, as teorias da justiça ou mesmo as ciências sociais. Um outro volume, portanto, se faz imperativo, por conta da abrangência da própria SEP e do respeito a seu projeto inicial, genuinamente um plano plural. (shrink)

This paper explores the issue whether feminism needs a metaphysical grounding, and if so, what form that might take to effectively take account of and support the socio-political demands of feminism; addressing these demands I further propose will also contribute to the resolution of other social concerns. Social constructionism is regularly invoked by feminists and other political activists who argue that social injustices are justified and sustained through hidden structures which oppress some while privileging others. Some feminists (Haslanger and Sveinsdóttir, (...) Feminist metaphysics. In E. N. Zalta (Ed.), Stanford encyclopedia of philosophy. Stanford: Stanford University, 2011) argue that the constructs appealed to in social constructivism are real but not metaphysically fundamental because they are contingent. And this is exactly the crux of the problem—is it possible to sustain an engaged feminist socio-political critique for which contingency is central (i.e., that things could be otherwise) and at the same time retain some kind of metaphysical grounding. Without metaphysical grounding it has been argued, the feminist project may be rendered nonsubstantive (Sider, Substantivity in feminist metaphysics. Philosophical Studies, 174(2017), 2467–2478, 2017). There has been much debate around this issue and Sider (as an exemplar of the points under contention) nuances the claims expressed in his earlier writings (Sider, Writing the book of the world. Oxford: Clarendon Press, 2011) and later presents a more qualified account (Sider, Substantivity in feminist metaphysics. Philosophical Studies, 174(2017), 2467–2478, 2017). Nonetheless, I propose the critiques and defences offered by the various parties continue to depend on certain erroneous assumptions and frameworks that are challengeable. I argue that fundamentality as presented in many of these current accounts, which are underpinned by the explicit or implicit ontologies of monism and dualism and argued for in purely rationalist terms which conceive of subjects as primarily reason-responding agents, reveal basic irresolvable problems. I propose that addressing these concerns will be possible through an enactivist account which, following phenomenology, advances an ontology of interdependence and reconceives the subject as first and foremost an organism immersed in a meaningful world as opposed to a primarily reason-responding agent. Enactivism is thus, I will argue, able to legitimize feminist socio-political critiques by offering a non-reductive grounding in which not only are contingency and fundamentality reconciled, but in which fundamentality is in fact defined by radical contingency. My paper proceeds in dialogue with feminists generally addressing this ‘metaphysical turn’ in feminism and specifically with Sally Haslanger and Mari Mikkola. (shrink)

Progressive family policy regimes typically aim to promote and protect women’s opportunities to participate in the workforce. These policies offer significant benefits to affluent, two-parent households. A disproportionate number of low-income and impoverished families, however, are headed by single mothers. How responsive are such policies to the objectives of these mothers and the needs of their children? This chapter argues that one-size-fits-all family policy regimes often fail the most vulnerable household and contribute to intergenerational poverty in two ways: by denying (...) at-risk children adequate parenting, and by undermining their mothers’ legitimate interest in nurturing and caring for their own children. The capabilities of these mothers and the well-being of their children are better served by policies which recognise maternal caregiving as a productive and valuable occupation meriting equal respect and social support. (shrink)

From the standpoint of disability advocacy, further exploration of the concept of well-being stands to be availing. The notion that “welfarism” about disability, which Julian Savulescu and Guy Kahane debuted, qualifies as helpful is encouraged by their claim that welfarism shares important commitments with that advocacy. As becomes clear when they apply their welfarist frame to procreative decisions, endorsing welfarism would, in fact, sharply undermine it. Savulescu and Kahane's Principle of Procreative Beneficence—which reflects transhumanism, or advocacy of radical bioenhancement—morally requires (...) parents to choose the child who will, in all probability, have “the best life.” Assuming the emergence of potent biotechnologies, procreative decision-making would be highly standardized, for prospective parents would be morally obliged to maximize select capacities, including intelligence, self-control, and hedonic set-point, in their children. Welfarism, applied to reproduction, is staunchly objectivist about what course is incumbent on decision-makers, giving no credence to first-personal values, aspirations, and experiences. Though this dismissal of individual perspectives applies to everyone, its implications for disability advocacy are especially severe. With that advocacy in view, greater attention to “well-being” should, therefore, be severed from the welfarism of Savulescu and Kahane. (shrink)

Robert Veatch’s The Foundations of Justice: Why the Retarded and the Rest of Us Have Claims to Equality delves into deep questions of justice through the case of a child with disabilities. I describe what is basically right about this vision, as well as what is problematic from the standpoint of contemporary disability bioethics. From there, I dive into the notion of vulnerability that is at play in his work. He describes disability as necessarily a condition of weakness, lesser-than existence, (...) and neediness. When disability is viewed in this way as an inherently vulnerable state of being, the essential sociopolitical dimensions of disability receive inadequate attention, which, in turn, makes it impossible to identify injustices correctly. I connect these points to concrete challenges faced by disability communities during the COVID-19 pandemic, which have raised profound questions about the just use of scarce critical care resources. Any case drawn from the pandemic is a very different kind of case than that of the child in Veatch’s book, but a commonality is the question of who should get what limited resources when needs and urgency vary. (shrink)

By drawing on Jean-Luc Nancy’s philosophy of ontological relationality, this article explores what it means to be a ‘we’ in breast cancer. What are the characteristics—the extent and diversity—of couples’ relationally lived experiences of bodily changes in breast cancer? Through analyzing duo interviews with diagnosed women and their partners, four ways of sharing an embodied life are identified. (1) While ‘being different together’, partners have different, albeit connected kinds of experiences of breast cancer. (2) While ‘being there for you’, partners (...) take care of each other in mutually dependent ways. (3) While ‘being reconnected to you’, partners (re-)relate to each other through intimacy and sexuality. (4) While ‘being like you’, partners synchronize their embodied daily lives to one another, sometimes up to the point that the self cannot be distinguished from the other anymore. These ways reveal that being a ‘we’ involves complex affective, bodily encounters in which the many fault lines that both separate partners into individual selves and join them together as a unity are continuously reshaped and negotiated. Being a ‘we’ may be understood as something we have to do. Therefore, in being true to the legacy of Nancy, we argue at the end of this article for a sensible praxis of sharing a life and body, particularly in breast cancer. (shrink)

ABSTRACTThis essay elaborates how an imbalanced reciprocity between inhabitants of places of relative safety and places of greater precarity results from pursuing security on the basis of a reactive fear of vulnerability. It analyzes a range of features that shape the complex forms that vulnerability takes with a particular focus on how the constitution of places as rhetorically and corporeally secure or not renders different groups of people secure and/or subject to heightened exposure to harm. This analysis suggests that vulnerability (...) is better conceived as a process than a quality, mediating between conceptions of vulnerability as a universal condition and as a highly specific empirical condition. Finally, by departing from the negative, reactive view of vulnerability that animates the supposition of the boundedness of selves and places, an alternative conception of security that neither equates it with invulnerability nor opposes it to vulnerability can be developed. (shrink)

In this article I seek a more complete understanding of evil action. To this end, in the first half of the article I assess the conceptual strengths and weaknesses of the most compelling theories of evil action found in the contemporary philosophical literature. I conclude that the theories that fall under the category I call ‘‘Nuanced Harm Accounts’’ successfully identify the necessary and sufficient conditions of the concept. However, necessary and sufficient conditions are not coextensive with significant features, and Nuanced (...) Harm Accounts are incomplete even if they are correct. In order to supplement them, in the second half of the article I examine the normative relation that obtains between perpetrators and victims of evil and find them to be parties to a relation of asymmetrical power in which the vulnerability of the weaker party is exploited by the stronger party for its advantage, pleasure, or otherwise to achieve its aims. Moreover, the parties in the relation reciprocally enable each other’s role relative to one another. The strength of the more powerful party emerges out of the states of vulnerability of the victims, and the victims are vulnerable relative to the power(s) of the perpetrator. (shrink)

Efforts to combat the COVID-19 crisis brought mountains of legislation and guidance to coerce or encourage people to stay at home and reduce the spread of the virus. During peak lockdown in the United Kingdom regulations defined when people could or could not leave their homes. Meanwhile guidance on social distancing advised people to stay within ‘households’. This paper explores the legislation under lockdowns in the UK from March to October 2020 and the implications for women’s gendered caring roles. The (...) regulations and guidance assumed that households were separate units and ignored the interdependencies which exist between households and between individuals and wider society. The continuing focus in the lockdown regulations has been on households as autonomous, safe, adequate and secure. This overlooks the interdependency of human life, gendered aspects of caring and the inequalities of housing and living conditions, highlighted by feminist scholarship. (shrink)

Since its outbreak, the COVID-19 pandemic has generated discourses and practices that directly refer to the semantic universe usually connected to disability and illness. Words such as ‘pre-existing conditions’, ‘risk groups’, ‘accessibility’, and ‘vulnerability’ have become everyday elements of official and informal communications across the globe. In this article, I explore the contradictions that arise from such uses through the lens of crip studies. In the first part, I observe how the idea of vulnerability became mainstream, moving from being usually (...) attached to disability and illness to being depicted as a universal condition. Such a shift serves the double purpose of reinstating the predominance of able-bodiedness as the preferable normalcy and invisibilising the particular conditions of disabled and chronically ill people in the pandemic. In the second part, I discuss the perverse use of the expressions ‘risk group’ and ‘underlying conditions’ as biopolitical tools to reinforce already existing forms of oppression. The third part comprises a reflection on accessibility and the sudden advent of working-from-home. Finally, I reflect on confinement and interdependence as key concepts to draft a politics of transformation that moves from disability and chronic illness to include all experiences of intersectional oppression. As other markers of oppression, illness and disability can determine the possibilities of survival through the crisis, not only because they are linked to bodily fragility but also because of the systemic violence they are immersed in. The knowledge produced from a place of vulnerability can hence show interesting elements to better understand the challenges of this pandemic through an intersectional perspective. (shrink)

In this paper I present a critical analysis of the English law relating to the safeguarding of vulnerable adults, in particular how the law impacts on the sexual lives of adult women with mental disabilities. I consider the discourses of vulnerability that surround the different legal regimes and whether the emerging theoretical vulnerability literature can assist in developing more nuanced legal responses. I argue that the inherent jurisdiction and Care Act 2014 provide an opportunity to move away from the focus (...) on inherent features of vulnerability such as mental disability towards a more nuanced, situational and embodied account of what it means to safeguard ‘vulnerable adults’. This has the potential to be developed in England through the new legal framework of the Care Act and can be achieved through targeting interventions against the situational causes of vulnerability, for example the perpetrators of sexual violence. (shrink)

This article aims to contribute to literature on the conceptualisation of ‘vulnerability’ and its use by neo-liberal welfare regimes to demean, stigmatize and responsibilize welfare recipients. Several conceptions of ‘vulnerability’ will be explored and utilised in the context of welfare reforms that purport to regulate social security recipients as highly risky ‘vulnerable’ subjects. However, as this article will make clear, ‘vulnerability’ is a somewhat slippery concept and one susceptible to abuse by powerful interests intent on increasing coercive surveillance, discipline and (...) disentitlement for those designated as ‘vulnerable’. Legislation enacted ostensibly to address the ‘vulnerability’ of welfare recipients can foster intensive regulation and it must be asked who benefits most from such arrangements and the rhetoric that supports them. (shrink)