My aim in this paper is to move toward a relational moral theory of harm through examination of a common yet underexplored form of child maltreatment: childhood psychological abuse. I draw on relational theory to consider agential, intrapersonal, and interpersonal ways in which relational harms develop and evolve both in intimate relationships and in conditions of oppression. I set forth three distinctive yet interconnected forms of relational harm that childhood psychological abuse causes: harm to the relational agency of individuals, harm (...) to the relationships individuals hold with themselves, especially with regard to how they respect, know, and trust themselves, and harm to interpersonal relationships of both a direct and indirect nature in present and future timeframes. I close by noting that while relationships can be the site of human brutality that destroys the relational self, paradoxically and promisingly, they also can be a primary means of the relational reconstitution of the self. Ultimately, relational analyses of the harms of childhood psychological abuse reveal several key elements of a relational theory of harm and demonstrate the significance of relational harms for moral philosophy. (shrink)

This article defends an account of collective hope that arises through solidarity in the pursuit of justice. I begin by reviewing recent literature on the nature of hope. I then explore the relationship between hope and solidarity to demonstrate the ways in which solidarity can give rise to hope. I suggest that the hope born of solidarity is collective when it is shared by at least some others, when it is caused or strengthened by activity in a collective action setting, (...) and when the reciprocal hopeful expressions of individual group members result in an emotional atmosphere of hope that extends across the group. In the context of social movements, collective hope emerges alongside the collective intentions and actions of the solidarity group; namely, in the pursuit of a form of social justice that inspires the movement. I then suggest that the object of collective hope born of solidarity is the guiding ideal of justice and reflect on what it might mean to hope well for justice. (shrink)

One branch of bioethics assumes that mainly agents of the state are responsible for public health. Following Susan Sherwin’s relational ethics, we suggest moving away from a “state-centered” approach toward a more thoroughly relational approach. Indeed, certain agents must be reconstituted in and through shifting relations with others, complicating discussions of responsibility for public health. Drawing on two case studies—the health politics and activism of the Black Panther Party and the work of the Common Ground Collective in post-Katrina New Orleans—we (...) argue for the need to attend more carefully to the limitations of states and state-driven public health programs. (shrink)

In the scenario of growing polarization of promises and dangers that surround artificial intelligence (AI), how to introduce responsible AI and robotics in healthcare? In this paper, we develop an ethical–political approach to introduce democratic mechanisms to technological development, what we call “Caring in the In-Between”. Focusing on the multiple possibilities for action that emerge in the realm of uncertainty, we propose an ethical and responsible framework focused on care actions in between fears and hopes. Using the theoretical perspective of (...) Science and Technology Studies and empirical research, “Caring in the In-Between” is based on three movements: the first is a change of focus from the world of promises and dangers to the world of uncertainties; the second is a conceptual shift from assuming a relationship with robotics based on a Human–Robot Interaction to another focused on the network in which the robot is embedded (the “Robot Embedded in a Network”); and the last is an ethical shift from a general normative framework to a discussion on the context of use. Based on these suggestions, “Caring in the In-Between” implies institutional challenges, as well as new practices in healthcare systems. It is articulated around three simultaneous processes, each of them related to practical actions in the “in-between” dimensions considered: monitoring relations and caring processes, through public engagement and institutional changes; including concerns and priorities of stakeholders, with the organization of participatory processes and alternative forms of representation; and making fears and hopes commensurable, through the choice of progressive and reversible actions. (shrink)

Health is created and lived by people within the settings of their everyday life; where they learn, work, play and love. Health is created by caring for oneself and others, by being able to take decisions and have control over one's life circumstances, and by ensuring that the society one lives in creates conditions that allow the attainment of health by all its members.To begin, I largely agree with Doan and Harbin's argument in "Public Health and Precarity," and by extension (...) I largely agree with Sherwin's relational approach to public health. Since this is a commentary on Doan and Harbin's piece, I will keep this relatively short work focused on their paper, rather than... (shrink)

The COVID-19 pandemic is not the first pandemic that many of us have faced in our lives. The HIV/AIDS pandemic continues to affect women, racialized people, and LGBTQ2S+ people around the world today, and there are significantly fewer resources to address, and less political will and news coverage of, this other pandemic.1 Although many see COVID-19 as an unprecedented public health crisis that is challenging our societies and our relationships with each other in unique ways, I argue that we actually (...) have a lot to learn from our responses to HIV/AIDS and that feminist bioethicists can help us understand how the present situation is actually an extension of several underlying medical and social issues and... (shrink)

In this paper I use a feminist relational approach to critically examine contemporary mainstream assumptions in the field of development concerning the relationship between poverty and prosperity....

People with gut issues are often constrained in the foods they are able to eat. The choices they are able to make about food, however, are shaped not merely by specific medical and dietary needs but also by social, relational, and environmental factors such as the presence of trusted and supportive others who take their needs seriously. Drawing on work in disability theory and relational autonomy, as well as interviews undertaken in summer 2019, the paper explores the ways that choices (...) are enabled or undermined, and argues that these should be taken into account in work on the ethics and politics of food. (shrink)

An anthropocentric scope for clinical medical ethics (CME) has largely separated this area of bioethics from environmental concerns. In this article, we first identify and reconcile the ethical issues imposed on CME by climate change including the dispersion of related causes and effects, the transdisciplinary and transhuman nature of climate change, and the historic divorce of CME from the environment. We then establish how several moral theories undergirding modern CME, such as virtue ethics, feminist ethics, and several theories of justice, (...) promote both a flourishing of human medical practice and the environment. We conclude by defining an expanded the scope of CME as inclusive of not only patients, families, physicians, and other health professionals but other humans, non-humans, and their shared environment. We then apply this scope and theory to a widely used framework for applying CME, the Four Topics model, to construct a climate conscious approach to CME. (shrink)

This article draws on the insight that people and communities have fundamental relationships with place. People are defined and shaped by place; and place is, in turn, defined and shaped by communi...

In this paper, I consider how trust affects the decisions of men who have sex with men (MSM) around using pre-exposure prophylaxis (PrEP) as HIV prevention in their sexual and romantic relationships, and how the use of PrEP affects their relationships with healthcare providers. MSM have to trust their sexual and romantic partners as well as their healthcare providers for PrEP to be successful as a relatively new HIV prevention strategy. This trust includes both interpersonal trust and institutional trust and (...) it is complicated by different kinds of relationship dynamics and the history of prejudice against MSM in healthcare institutions. (shrink)

There is much to learn from and admire in Danielle Wenner's "Nondomination and the Limits of Relational Autonomy." The core claim Wenner advances is that the very concerns that have motivated feminist relational autonomy theorists would be better pursued by foregoing their concern with autonomy and pursuing instead the political aim of promoting a neorepublican conception of freedom as nondomination. While leaving open the possibility that "autonomy speak may remain valuable in some contexts", Wenner nevertheless claims that "for the purposes (...) of understanding and combating relations of oppression and subjection, freedom as nondomination provides a more useful conceptual apparatus than the ideal of... (shrink)

Access to public healthcare services for Belgium’s undocumented migrants is regulated through a parallel, administrative procedure within the legal framework of Urgent Medical Aid. This imposes several constraints on their access to healthcare services. Drawing on empirical-ethical methodologies, we show how this procedure impacts on the relationship between patients with undocumented status and healthcare workers. We use the concept of relational autonomy to show how the imposed legal constraints reduce the formal treatment options available to healthcare workers, but simultaneously lead (...) to informal care practices, and how the latter increase the discretionary power of the healthcare workers. We argue that in this context, provision becomes unpredictable and arbitrary, with undocumented migrants tending to value strong personal relations with one particular, trusted healthcare worker. Although this leads to increased dependence, it also increases patients’ options and autonomy by providing access to wider professional networks attached to that healthcare worker. (shrink)

COVID-19 has turned many ethical principles and presuppositions upside down. More precisely, the principle of respect for autonomy has been shown to be ill suited to face the ethical challenges posed by the current health crisis. Individual wishes and choices have been subordinated to public interests. Patients have received trial therapies under extraordinary procedures of informed consent. The principle of respect for autonomy, at least in its mainstream interpretation, has been particularly questioned during this pandemic. Further reflection on the nature (...) and value of autonomy is urgently needed. Relational autonomy has been proposed as an alternative account of autonomy that can more adequately respond to contemporary ethical issues in general and to a pandemic such as the one we are currently facing in particular. As relational autonomy is an emerging notion in current bioethics, it requires further consideration and development to be properly operationalized. This paper aims to show how six different philosophical branches––namely, philosophy of nature, philosophical anthropology, existential phenomenology, discourse ethics, hermeneutics, and cultural anthropology––have incorporated the category of relation throughout the twentieth century. We first delve into primary philosophical sources and then apply their insights to the specific field of medical ethics. Learning from the historical developments of other philosophical fields may provide illumination that will enable bioethics to experience a successful “relational turn”, which has been partially initiated in contemporary bioethics but not yet achieved. (shrink)