Allies are extremely important to LGBT rights. Though we don’t often enumerate what tasks we expect allies to do, a fairly common conception is that allies “support the LGBT community.” In the first section I introduce three difficulties for this position that collectively suggest it is conceptually insufficient. I then develop a positive account by starting with whom allies are allied to instead of what allies are supposed to do. We might obviously say here that allies are allied to the (...) LGBT community, but I will argue that this community is better thought of as a loose coalition because there are often intersectional issues and conflicting interests that challenge any unified sense of community. I argue that people typically become allies because a friend or family member is experiencing some kind of specific harm; if that harm or discrimination is what causally explains why people become allies, then allies are required to do more than we commonly think. Although allies have a prima facie obligation to honor what members of a subcommunity identify as a harm, this obligation is defeasible if an ally believes fulfilling the obligation would be harmful. I conclude by looking at how we can understand what an ally is in terms of a larger discussion about moral obligations. If people already have these obligations, whatever they are, because morality requires it, then the status “ally” is redundant. I conclude by showing that certain social statuses can not only transform or reprioritize prior moral commitments, but can also introduce new kinds of responsibility that an agent did not have before. (shrink)

Autonomy in bioethics is coming under sustained criticism from a variety of perspectives. The criticisms, which target personal or individual autonomy, are largely justified. Moral conceptions of autonomy, such as Kant’s, on the other hand, cannot simply be applied in bioethical situations without moralizing care provision and recipience. The discussion concludes with a proposal for re-thinking autonomy by focusing on what different agents count as reasons for choosing one rather than another course of action, thus recognising their involvement in the (...) decision process. (shrink)

This article outlines and develops the concept of ‘ethics work’ in social work practice. It takes as its starting point a situated account of ethics as embedded in everyday practice: ‘everyday ethics’. This is contrasted with ‘textbook ethics’, which focuses on outlining general ethical principles, presenting ethical dilemmas and offering normative ethical frameworks (including decision-making models). ‘Ethics work’ is a more descriptive account of ethics that refers to the effort people put into seeing ethically salient aspects of situations, developing themselves (...) as good practitioners, working out the right course of action and justifying who they are and what they have done. After identifying seven features of ethics work, including work on framing, roles, emotion, identity, reason, relationships and performance, each element is illustrated with reference to two case examples from social work practice. It is argued that the concept of ethics work, with its focus on the practitioners as moral agents in context, is an important antidote to the rules-based managerialism of much contemporary practice. (shrink)

Feminist critiques of intention challenge some aspects of traditional just war reasoning, including the criteria of right intention and discrimination. I take note of these challenges and propose some directions just war reasoners might take in response. First, right intention can be evaluated more accurately by judging what actors in war actually do than by attempting to uncover inward dispositions. Assessing whether agents in war have taken due care to minimize foreseeable collateral damage, avoided intentional targeting of noncombatants, corrected previous (...) mistakes in their later actions, and taken responsibility to repair unintended damage they cause are examples of ways in which just war reasoners can evaluate intention by looking at actions. (shrink)

Background Clinical moral case deliberation consists of the systematic reflection on a concrete moral case␣by health care professionals. This paper presents the study of a 4-year moral deliberation project.Objectives The objectives of this paper are to: (a) describe the practice and the theoretical background of moral deliberation, (b) describe the moral deliberation project, (c) present the outcomes of␣the evaluation of the moral case deliberation sessions, and (d) present the implementation process.Methods The implementation process is both monitored and supported by an (...) interactive responsive evaluation design with: (a) in-depth interviews, (b) Maastricht evaluation questionnaires, (c) evaluation survey, and (d) ethnographic participant observation. In accordance with the theory of responsive evaluation, researchers acted both as evaluators and moderators (i.e. ethicists).Results Both qualitative and quantitative results showed that the moral case deliberations, the role of the ethics facilitator, and the train-the-facilitator program were regarded as useful and were evaluated as (very) positive. Health care professionals reported that they improved their moral competencies (i.e. knowledge, attitude and skills). However, the new trained facilitators lacked a clear organisational structure and felt overburdened with the implementation process. The paper ends with both practical and research suggestions for future moral deliberation projects. (shrink)

Moral distress has been written about extensively in nursing and other fields. Often, however, it has not been used with much theoretical depth. This paper focuses on theorizing moral distress using feminist ethics, particularly the work of Margaret Urban Walker and Hilde Lindemann. Incorporating empirical findings, we argue that moral distress is the response to constraints experienced by nurses to their moral identities, responsibilities, and relationships. We recommend that health professionals get assistance in accounting for and communicating their values and (...) responsibilities in situations of moral distress. We also discuss the importance of nurses creating “counterstories” of their work as knowledgeable and trustworthy professionals to repair their damaged moral identities, and, finally, we recommend that efforts toward shifting the goal of health care away from the prolongation of life at all costs to the relief of suffering to diminish the moral distress that is a common response to aggressive care at end-of-life. (shrink)

This paper draws on Claudia Card’s discussions of moral luck to consider the complicated moral life of people—described as pessimists—who accept the heavy knowledge of the predictability of the bad moral luck of oppression. The potential threat to ethics posed by this knowledge can be overcome by the pessimist whose resistance to oppression, even in the absence of hope, expresses a sense of still having a ‘‘claim’’ on flourishing despite its unattainability under oppression.

The traditional organizational boundaries between healthcare, social work, police and other non-profit organizations are fading and being replaced by new relational patterns among a variety of disciplines. Professionals work from their own history, role, values and relationships. It is often unclear who is responsible for what because this new network structure requires rules and procedures to be re-interpreted and re-negotiated. A new moral climate needs to be developed, particularly in the early stages of integrated services. Who should do what, with (...) whom and why? Departing from a relational and hermeneutic perspective, this article shows that professionals in integrated service networks embark upon a moral learning process when starting to work together for the client’s benefit. In this context, instrumental ways of thinking about responsibilities are actually counterproductive. Instead, professionals need to find out who they are in relation to other professionals, what core values they share and what responsibilities derive from these aspects. This article demonstrates moral learning by examining the case of an integrated social service network. The network’s development and implementation were supported by responsive evaluation, enriched by insights of care ethics and hermeneutic ethics. (shrink)

Implicit in feminist and other critiques of ideal theorizing is a particular view of what normative theory should be like. Although I agree with the rejection of ideal theorizing that oppression theorists (and other theorists of justice) have advocated, the proposed alternative of nonideal theorizing is also problematic. Nonideal theorizing permits one to address oppression by first describing (nonideal) oppressive conditions, and then prescribing the best action that is possible or feasible given the conditions. Borrowing an insight from the "moral (...) dilemmas debate"— namely that moral wrongdoing or failure can be unavoidable—I suggest that offering (only) action-guidance under non-ideal conditions obscures the presence and significance of unavoidable moral failure. An adequate normative theory should be able to issue a further, non-action-guiding evaluative chim, namely that the best that is possible under oppressive conditions is not good enough, and may constitute a moral failure. I find exclusively action-guiding nonideal theory to be both insufficiently nonidealizing (because it idealizes the moral agent by falsely characterizing the agent as always able to avoid moral wrongdoing) and meanwhile too strongly adapted to the nonideal (because normative expectations are lowered and detrimentally adapted to options that, while the best possible, are still unacceptable). (shrink)

: International instruments now defend a "right to the truth " for victims of political repression and violence and include truth telling about human rights violations as a kind of reparation as well as a form of redress. While truth telling about violations is obviously a condition of redress or repair for violations, it may not be clear how truth telling itself is a kind of reparations. By showing that concerted truth telling can satisfy four features of suitable reparations vehicles, (...) I defend the idea that politically implemented modes of truth telling to, for, and by those who are victims of gross violation and injustice may with good reason be counted as a kind of reparations. Understanding the doubly symbolic character of reparations, however, makes clearer why truth telling is unlikely to be sufficient reparation for serious wrongs and is likely to be sensitive to the larger context of reparative activity and its social, political, and historical background. (shrink)

Disputes about theory in bioethics almost invariablyrevolve around different understandings of morality or practicalreasoning; I here suggest that the field would do well to becomemore explicitly contentious about knowledge, and start the taskof putting together a clinical epistemology. By way of providingsome motivation for such a discussion, I consider two cases ofresistance to shifts in clinical practice that are, by and large,not ethically controversial, highlighting how differentconceptions of epistemic authority may contribute to clinicians'unwillingness to adopt these changes, and sketching out (...) someinitial suggestions for epistemic analysis of clinical practice. (shrink)

: Are social movements responsible for their unfinished agendas? Feminist successes in opening the professions to women paved the way for the emergence of the upper middle-class two-career household. These households sometimes hire domestic servants to accomplish their child care work. If, as I shall argue, this practice is unjust and furthers social inequality, then it poses a moral problem for any feminist commitment to social justice.

: Care theorists have made significant gains over the past twenty-five years in establishing caring as a viable moral and political concept. Nonetheless, the concept of caring remains underdeveloped as a basis for a moral and political philosophy, and there is no fully developed account of our moral obligation to care. This article advances thinking about caring by developing a definition of caring and a theory of obligation to care sufficient to ground a general moral and political philosophy.

We expand on Della Croce’s ambition to interpret “epistemic injustice” as a specification of non-maleficence in the use of the influential four-principle framework. This is an alluring line of thought for conceptual, moral, and heuristic reasons. Although it is commendable, Della Croce’s attempt remains tentative. So does our critique of it. Yet, we take on the challenge to critically address two interrelated points. First, we broaden the analysis to include deliberations about hermeneutical injustice. We argue that, if due consideration of (...) epistemic injustice is to require more than negative ethical obligations in medicine, dimensions of hermeneutical injustice should be explored as an avenue to arrive at such positive duties. Second, and relatedly, we argue that this may encompass moral responsibilities beyond the individual level, that is: positive obligations to take action on a structural level. Building on Dotson’s concept of “contributory injustice” and Scheman’s concept of “perceptual autonomy,” we suggest that the virtues of testimonial and hermeneutical justice may provide additional content not only to negative prohibitions of action (i.e. non-maleficence) but also to positive requirements of action, like respecting patient autonomy. (shrink)

In both popular and scholarly discussions, sexual consent is gaining traction as the central moral consideration in how people should treat one another in sexual encounters. However, while the concept of consent has been indispensable to oppose many forms of sexual violence, consent-based sexual ethics struggle to account for the phenomenological complexity of sexual intimacy and the social and structural pressures that often surround sexual communication and behavior. Feminist structural critique and social research on the prevalence of violation even within (...) consensual sex suggest that consent is insufficient to ground responsibility; a more fundamental orientation toward the value of sexual agency provides a better foundation for sexual ethics. Using feminist critical theory, phenomenology, and black feminist thought, this dissertation develops a socially situated and relational notion of sexual agency and diagnoses how such agency is neglected in prevailing discussions of consent in moral philosophy and legal theory. I argue that the ethical question of responsibility to another in a sexual encounter—apart from juridical considerations—should be reframed around the value of each person’s socially situated practices of agency. Preceding and extending beyond the obligation to gain valid consent for an action, responsibility demands adapting one’s intentions and behaviors in response to the wider range of another’s communicative expressions of agency. However, communicative expressions can be ambiguous or overdetermined by social context and cultural norms; they often offer only provisional traces of agency. To address this inherent uncertainty in intimacy, I propose drawing on insights from Emmanuel Levinas about the dynamic, open-ended nature of relationality, responsibility, and communication. Responsibility toward another does not depend on securing certainty about their “yes” or “no,” but requires responding continuously under conditions of uncertainty and ambiguity, adapting behaviors and intentions to make room for another’s agency despite its opacity. (shrink)

This thesis defends utilitarianism: the view that as far as morality goes, one ought to choose the option which will result in the most overall well-being. Utilitarianism is widely rejected by philosophers today, largely because of a number of influential objections. In this thesis I deal with three of them. Each is found in Bernard Williams’s ‘A Critique of Utilitarianism’ (1973). The first is the Integrity Objection, an intervention that has been influential whilst being subject to a wide variety of (...) interpretations. In Chapter Two I give my interpretation of Williams’s Integrity objection; in Chapter Three I discuss one common response to it, and in Chapters Four and Five I give my own defence of utilitarianism against it. In Chapter Six I discuss a second objection: the problem of pre-emption. This problem is also found in Williams, but has received greater attention through the work of other authors in recent years. It suggests that utilitarianism is unable to deal with some of the modern world’s most pressing moral problems, and raises an internal tension between the twin utilitarian aims of making a difference and achieving the best outcomes. In Chapter Seven I discuss a third objection: that utilitarianism is insufficiently egalitarian. I find this claim to be unwarranted, in light of recent social science and philosophy. My responses to Williams’s objections draw upon resources from the socialist tradition – in particular, that tradition’s emphasis on the importance of social connections between individuals. Socialists have often been hostile to utilitarianism, in part for socialist-inflected versions of Williams’s objections. Thus, in responding to these objections I aim to demonstrate that socialist thought contains the means to defuse not only mainstream philosophy’s rejection of utilitarianism but also its own, and thus to re-open the possibilities for a productive engagement between the two traditions. (shrink)

At no time in recent decades has more attention been paid to ethical issues in pregnancy. Particularly riveting—and alarming, to many—was the passage of Senate Bill 8, a Texas law banning abortion...

Shaming behavior on social media has been the cause of concern in recent public discourse. Supporters of online shaming argue that it is an important tool in helping to make social media and online communities safer and more welcoming to traditionally marginalized groups. Objections to shaming often sound like high-minded calls for civility, but I argue that shaming behavior poses serious risks. Here I identify moral and political risks of online shaming. In particular, shaming threatens to undermine our commitment to (...) the co-deliberative practices of morality. As a result, online shaming can undermine the very goals it is supposed to accomplish. (shrink)

Ethics is enabling of agency, but also normative and conventional. At the moment a gendered ethics, or the gendering of ethics, is a helpful approach because it is concerned with issues to do with people often peripheral to and excluded from power. At the moment it can work to keep ethics responsive, but how do we halt the drift into the normative, both as prescriptive and as ideological? A feminist ethics maintains the responsive and undermines prescriptive categories, and is committed (...) to involving disempowered voices in the conversation. The article is particularly concerned with the articulation of the situated, and raises questions about attending to, learning how to listen to and learning how to speak, so that many people from different places can get involved in ethics. Otherwise ethics isn’t ethical. (shrink)

In this article, I aim to contribute to the remedy of the current under-theorization of discourse on food ethics and politics from the perspective of the Islamic food tradition by proposing a formulation of an Islamic conception of food justice that extends the religious discourse on food beyond that of dietary laws. The conception of Islamic food justice that I propose makes explicit the connections between the religious, ethical, and political discourses on food. First, I argue that the similarity between (...) the central question of the secular approach to food ethics and that of the modern interpretation of the religious approach to food is best understood as a consequence of the shared assumption of the modern concept of subjectivity. Second, I argue that problematizing the concept of subjectivity that underlies both the secular and the religious approaches to food ethics is key to challenging the boundaries of the current disciplinary-bound discourses as it would allow for a reformulation of the central question beyond that of individual identity and extend the religious discourse on food to the realm on politics. (shrink)

Feminist socially constitutive conceptions of autonomy make the presence of idealized social conditions necessary for autonomy. I argue that such conceptions cannot, when applied under nonideal conditions, play two key feminist theoretical roles for autonomy: the roles of anti-oppressive character ideal and paternalism-limiting concept. Instead, they prescribe action that reinforces oppression. Treated as character ideals, socially constitutive conceptions of autonomy ask agents living under nonideal ones to engage in self-harm or self-subordination. Moreover, conceptions of autonomy that make idealized social conditions (...) a requirement of autonomy yield the conclusion that oppressed agents are appropriate objects of paternalism. (shrink)

Nurses and other medical practitioners often experience moral distress: they feel an anguished sense of responsibility for what they take to be their own moral failures, even when those failures were unavoidable. However, in such cases other people do not tend to think it is right to hold them responsible. This is an interesting mismatch of reactions. It might seem that the mismatch should be remedied by assuring the practitioner that they are not responsible, but I argue that this denies (...) something important that the phenomenon of moral distress tells us. In fact, both the practitioners’ tendencies to hold themselves responsible and other people’s reluctance to hold the practitioners responsible get something right. The practitioners may be right that they are responsible in the sense of having failed to meet a binding moral requirement, even when the requirement was impossible to meet. This makes moral distress a fitting response because it correctly represents their own action as a wrongdoing. However, others may meanwhile be right that the practitioners are not responsible in the sense of being culpable and blameworthy. To blame others, or oneself, for certain failures, including those that are unavoidable, would be unfair. My claim depends on distinguishing between the fittingness and the fairness of holding someone (including oneself) responsible for moral failure. Having drawn the distinction, I suggest that moral distress should be addressed in a way that both recognizes it as a fitting response and avoids the unfairness of blame. (shrink)

I argue for the merits of studying historical moral revolutions to inform moral and political philosophy. Such a research program is not merely of empirical, historical interest but has normative implications. To explain why, I situate the proposal in the tradition of naturalized epistemology. As Alison M. Jaggar and other scholars have argued, a naturalistic approach is characteristic of much feminist philosophy. Accordingly, I argue that the study of moral revolutions would be especially fruitful for feminist moral and political philosophers.

O artigo tem como objetivo inicial apresentar, a partir de um panorama geral, alguns elementos centrais da concepção de moral no pensamento de Simone de Beauvoir, bem como suas articulações com outros conceitos pertinentes. A partir disso, pretende-se considerar determinadas apropriações e críticas de teóricas feministas recentes, buscando avaliar as possíveis contribuições do pensamento de Beauvoir à filosofia moral de viés feminista.

This paper focuses on the reasons for, and consequences of, expanding our notions of human embodiment to virtual worlds. Increasingly, it is within virtual environments that we seek to extend, and enhance, who we are. Yet, philosophical worries persist about what sorts of selves count as moral agents, and the extent to which self-enhancements affect personal identity and agency. This paper critiques and expands the discourse on embodiment and personal identity by locating it within the virtual environments of Second Life, (...) challenging the prevailing limitations of what counts as identity-constituting embodiment. I argue that more inclusive notions of embodiment make possible a deeper understanding of its moral and epistemic force that constitutes and locates our identities in a universe of shared moral understandings. Thus, by including enhanced virtual embodiments alongside the non-virtual, not only do we expand our ideas of what it might mean to be embodied, but we also deepen our moral vocabularies of the self. (shrink)

The dissertation attempts to answer the question of how to theorize resistance from within the philosophy of social science. To answer this question we must consider more than just the philosophy of social science; we also must look to political and moral philosophy. Resistance to the social norms of one’s community is possible to theorize from within the philosophy of social science once we develop a sufficiently nuanced account of social and moral communities, according to which membership in a community (...) is not defined by sharing judgments, conceptual frameworks, or comprehensive worldviews, but by sharing terms of discourse so that discussion about judgments, conceptual frameworks, and comprehensive worldviews is possible. Understanding the structure of one’s moral community is not the same as to endorsing that structure. This suggests that contestation is already present within communities about what ‘we’ do, up to and including who ‘we’—as a ‘community’—are. Challenging communitarian understandings of what makes a community a community, I argue that communities are best understood as forming around common concerns or perceptions of problems. This contestation plays a major role in determining the identities of communities, and these identities are constantly shifting. (shrink)

How ethics in human services is a political activity, shaping social relationships, is explored through the examination of two opposing discourses, a principle-based and a situated/relational narrative. Factors such as neo-liberalism, managerialism, and the risk-aversive society give a context for the reasons that the principle-based discourse has been the predominant influence, and what interests are served by this trope taking center stage. A delineation and critique of both perspectives are provided, including an explanation of the epistemological underpinnings of these discourses. (...) The piece ends with what needs to be done to strengthen ethics. (shrink)

There is a consensus that the effects of medical brain drain, especially in the Sub-Saharan African countries, ought to be perceived as more than a simple misfortune. Temporary restrictions on the emigration of health workers from the region is one of the already existing policy measures to tackle the issue—while such a restrictive measure brings about the need for quite a justificatory work. A recent normative contribution to the debate by Gillian Brock provides a fruitful starting point. In the first (...) step of her defence of emigration restrictions, Brock provides three reasons why skilled workers themselves would hold responsibilities to assist with respect to vital needs of their compatriots. These are fair reciprocity, duty to support vital institutions, and attending to the unintended harmful consequences of one’s actions. While the first two are explained and also largely discussed in the literature, the third requires an explication on how and on which basis skilled workers would have a responsibility as such. In this article, I offer a vulnerability approach with its dependency aspect that may account for why the health workers in underserved contexts would have a responsibility to attend to the unintended side effects of their actions that may lead to a vital risk of harm for the population. I discuss HIV/AIDS care in Zimbabwe as a case in point in order to show that local health workers may have responsibilities to assist the population who are vulnerable to their mobility. (shrink)

In The Beautiful Risk of Education, Gert Biesta displays his gift for engaging generously with the thought of others to illuminate what makes education educational, that is, the value in maintaining the complexity and risk involved in a dialogic approach to education. As Biesta puts it, “[education] is therefore, again, a dialogical process. This makes the educational way the slow way, the difficult way, the frustrating way, and so we might say, the weak way” . Such a view of education (...) promises no “results”, in fact the outcomes of education can never be guaranteed. Embracing the risk inherent in this weak notion of education entails welcoming the risk involved in teaching. In this review, we focus on Biesta’s attention to the meaning of teaching and his call for a kind of teacher education that learns from and develops virtuosity. We find Biesta’s use of the term “virtuosity”—rather than the more typical usage for the exercise of wisdom found in educational theory, “virtue”—prod .. (shrink)

Despite the amount of attention that activists, educators, psychologists, and the media place on bullying and bullying prevention, there has been no sustained philosophical reflection on bullying, nor has there been a feminist analysis of the growing literature on bullying. This essay seeks to satisfy those two needs. The first section is a broad introduction to the literature on bullying. I define bullying and distinguish it from teasing, sassing, roughhousing, and other more benign interactions. I also outline two common solutions (...) to bullying: zero-tolerance policies and “ecological” interventions. The second section uses feminist ethics of care to analyze the effectiveness of each approach. I argue that ecological approaches to bullying are preferable to zero-tolerance policies because they operate on a relational model of the self and identity-formation. I elaborate a notion of affirmation as the mechanism that stabilizes and solidifies our sense of self across time. I then use affirmation to analyze three things: why people bully one another, the specific harm inflicted by bullying, and why ecological approaches are more effective in reducing bullying. The third section uses my account of affirmation to critique the scientism and troublingly gendered assumptions that underlie much of the work on bullying. (shrink)

This article describes the results of qualitative research into the moral issues faced by social work professionals working in projects targeted at teenage mothers. The research is part of the tradition of empirical and practice-driven ethics. The main questions were: How does morality become visible in the social services for teenage mothers and how do social workers deal with the moral dimension of their work? (How) can education, training and peer review offer space for moral reflection? Interviews and group meetings (...) ('focus groups') were held to answer these questions. Nineteen professionals (front-line professionals as well as professionals in executive roles) participated in the research. The findings describe the moral issues and the moral actions of professionals and the organizational context respectively. The results reveal that the everyday practice of social work professionals can raise complex issues inherent to their work and that there is often no explicit reflection on the moral dimension of these issues. The authors argue that there needs to be greater focus on the complexity of moral issues and elaborate on three dimensions of this complexity. (shrink)

Neglect of the moral promise of disorientation is a persistent gap in even the most sophisticated philosophies of embodiment. In this article, I begin to correct this neglect by expanding our sense of the range and nature of disoriented experience and proposing new visions of disorientation as benefiting moral agency. Disorientations are experienced through complex interactions of corporeal, affective, and cognitive processes, and are characterized by feelings of shock, surprise, unease, and discomfort; felt disorientations almost always make us unsure of (...) how to go on. I argue that experiences of disorientation can strengthen the moral agency of individuals. I begin by clarifying experiences of felt ease and orientation. I then characterize disoriented embodiment by investigating select experiences that often involve or accompany disorientation, focusing throughout on how disorientation prompts changes in motivation and action. I conclude by charting how disoriented embodiments can help individuals become better moral agents overall, in part by challenging norms that restrict embodiment and undermining dualistic conceptions of the self. (shrink)

In this paper the authors argue that the exploration of the nature of needs and rights should begin with the actually existing organization of care and of justice in society. The authors raise two key concerns with this organization: 1) the invisibility of care to some, and 2) the inaccessibility of rights to others. Recent work by care scholars has called attention to the ways the current organization of care work perpetuates the myth of self-sufficiency for some, while reducing others (...) to mere dependents. Law and Society scholars have demonstrated the problems of uneven access to legal remedies within the current organization of the legal system. Addressing these concerns simultaneously reveals both the problems of the current organization of needs and rights as well as illuminating alternative possibilities. The authors argue, first, that a justice perspective, based on rights is inadequate because its presumed universality is belied by the reality of the inaccessibility of rights to many. Second, the authors argue that a care perspective, currently formulated upon the assumption that only some people have needs, is also flawed because its presumed particularity distorts the human experience and subsequent policies. Instead, the authors need to conceive of care in a public way that permits both rights and needs to be understood as applicable to all. The authors propose some initial thoughts about how to create such a public concept of care. (shrink)

How do we know which institutions provide good care? Some scholars argue that the best way to think about care institutions is to model them upon the family or the market. This paper argues, on the contrary, that when we make explicit some background conditions of good family care, we can apply what we know to better institutionalized caring. After considering elements of bad and good care, from an institutional perspective, the paper argues that good care in an institutional context (...) has three central foci: the purpose of care, a recognition of power relations, and the need for pluralistic, particular tailoring of care to meet individuals? needs. These elements further require political space within institutions to address such concerns. (shrink)

If business requires ethical solutions that are viable in the liminal landscape between concepts and corporate office, then business ethics and corporate social responsibility should offer tools that can survive the trek, that flourish in this well-traveled, but often unarticulated, environment. Indeed, feminist ethics produces, accesses, and engages such tools. However, work in BE and CSR consistently conflates feminist ethics and feminine ethics and care ethics. I offer clarification and invoke the analytic power of three feminist ethicists 'in action' whose (...) investigations into the "grey zones" of harms; identity and representational conventions; and "asymmetrical reciprocity" harmonize with business ethics' requirements. (shrink)

Contemporary critical approaches to bioethics increasingly present themselves as “relational,” though the meaning of relationality and its implications for bioethics seem to be many and varying. I argue that this confusion is due to a multiplicity of relational approaches originating from distinct theoretical lineages. In this article, I identify four key differences among commonly referenced relational approaches: the scope and nature of relationships considered, the extent of the determining influence on individual selfhood, and the integrity of individual selfhood. Importantly, these (...) four differences carry consequences for the usage of relational approaches within academic and clinical bioethics. I show that these differences attach to multiple objects of critique within mainstream bioethics and imply distinct metaethical commitments. Although I issue a cautionary note about combining relational approaches from distinct lineages, I close by suggesting that many such approaches may have their use, drawing on Susan Sherwin's sense of bioethical theories as lenses. (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 describes the approach of empirical ethics, a form of ethics that integrates non-positivist ethnographic empirical research and philosophy. Empirical ethics as it is discussed here builds on the ‘empirical turn’ in epistemology. It radicalizes the relational approach that care ethics introduced to think about care between people by drawing in relations between people and technologies as things people relate to. Empirical ethics studies care practices by analysing their intra-normativity, or the ways of living together the actors within these (...) practices strive for or bring about as good practices. Different from care ethics, what care is and if it is good is not defined beforehand. A care practice may be contested by comparing it to alternative practices with different notions of good care. By contrasting practices as different ways of living together that are normatively oriented, suggestions for the best possible care may be argued for. Whether these suggestions will actually be put to practice is, however, again a relational question; new actors need to re-localize suggestions, to make them work in new practices and fit them in with local intra-normativities with their particular routines, material infrastructures, know-how and strivings. (shrink)

Stories told about violence, trauma, and loss inform knowledge of post-conflict societies. Stories have a context which is part of the story-teller’s life narrative. Reasons for silences are varied. This article affirms the importance of telling and listening to stories and notes the significance of silences within transitional justice’s narratives. It does this in three ways. First, it outlines a critical narrative theory of transitional justice which confirms the importance of narrative agency in telling or withholding stories. Relatedly, it affirms (...) the importance of story-telling as a way to explain differentiated gender requirements within transitional justice processes. Second, it examines gendered differences in the ways that women are silenced by shame, choose silence to retain self-respect, use silence as a strategy of survival, or an agential act. Third, it argues that compassionate listening requires gender-sensitive responses that recognize the narrator’s sense of self and needs. (shrink)

One of the challenges of modern healthcare ethics practice is the navigation of boundaries. Practicing healthcare ethicists in the performance of their role must navigate meanings, choices, decisions and actions embedded in complex cultural and social relationships amongst diverse individuals. In light of the evolving state of modern healthcare ethics practice and the recent move toward professionalization via certification, understanding boundary navigation in healthcare ethics practice is critical. Because healthcare ethics is endowed with many boundaries which often delineate concerns about (...) professional expertise and authority, epistemological reflection on the relationship between theory and practice points toward the social context as relevant to the conceptualization of boundaries. The skills of social scientists may prove helpful to provide data and insights into the conceptualization and navigation of clinical ethics qua profession. Empirical ethics research, which combines empirical description (usually social scientific) with normative-ethical analysis and reflection, is a way forward as we engage and reflect upon issues which have implications for practice standards and professionalization of the role. This requires cooperative engagement of the descriptive and normative disciplines to explore our understandings of boundaries in healthcare ethics practice. This will contribute to the ongoing reflection not only as we envision the professional role but to ensure that it is enacted in practice. (shrink)

This essay focuses on the value of self-doubt in moral inquiry and in moral education. Using John Patrick Shanley’s play, Doubt: A parable, as illustration, it shows how self-doubt initiates and extends moral inquiry, highlights one’s epistemic fallibility and connects the inquirer to the virtue of humility. The essay draws on the work of Charles Sanders Peirce, Hullett, Nussbaum, Thayer-Bacon and Elbow to support the idea that the question ‘Am I wrong?’ is important for moral inquiry and for moral education.

Medicine is incorporating genetic services into all avenues of health‐care, ranging from the rarest to the most common diseases. Cognitive theories of decision‐making still dominate professionals’ understanding of patient decision‐making about how to use genetic information and whether to have testing. I discovered a conceptual model of decision‐making while carrying out a phenomenological‐hermeneutic descriptive study of a convenience sample of 12 couples who were interviewed while deciding whether to undergo prenatal genetic testing.Thirty‐two interviews were conducted with 12 men and 12 (...) women separately. Interviews were transcribed verbatim and all data were analyzed using three levels of coding that were sorted into 30 categories and then abstracted into three emergent meta‐themes that described men's and women's attempts to make sense and find meaning in how to best use prenatal genetic technology. Their descriptions of how they thought about, communicated, and coped with their decision were so detailed it was possible to discern nine different types of thinking they engaged in while deciding to accept or decline testing.They believed that decision‐making is a process of working through your own personal style of thinking. This might include only one or any combination of the following types of thinking: analytical, ethical, moral, reflective, practical, hypothetical, judgmental, scary, and second sight, as described in detail by these 12 couples. (shrink)

In this paper I engage interdisciplinary conversation on inaction as the dominant response to climate change, and develop an analysis of the specific phenomenon of complacency through a critical-feminist lens. I suggest that Chris Cuomo's discussion of the “insufficiency” problem and Susan Sherwin's call for a “public ethics” jointly point toward particularly promising harm-reduction strategies. I draw upon and extend their work by arguing that extant philosophical accounts of complacency are inadequate to the task of sorting out what it means (...) to be complacent on climate change. I offer a sketch for an alternative account, which I take to be a start in the direction of mapping out a diverse array of “motivational vices” that need to be named, grappled with, and remedied. (shrink)

Most people accept that if they can save someone from death at very little cost to themselves, they must do so; call this the ‘duty of easy rescue.’ At least for many such people, an instance of this duty is to allow their vital organs to be used for transplantation. Accordingly, ‘opt-out’ organ procurement policies, based on a powerfully motivated responsibility to render costless or very low-cost lifesaving aid, would seem presumptively permissible. Counterarguments abound. Here I consider, in particular, objections (...) that assign a moral distinctiveness to the physical boundaries of our bodies and that concern autonomy and trust. These objections are singled out as they seem particularly pertinent to the stress I place on a distinctive benefit of the particular policy I defend. An opt-out system, resting not on the authority of ‘presumed consent’ but on the recognition of a duty to one another, has the prospect of prompting people to understand more richly the ways in which they are both physically embodied and communally embedded. (shrink)

Moral theory is an important guide to bioethical decision-making, but it can confuse and mislead those who offer ethical advice to clinicians and researchers, delaying decisions that must be made in a timely fashion. In this paper I examine the ways moral theory can lead bioethicists astray. Absent a sensitivity to the empirical realities of ethical problems, moral theory 1) contributes to the disappearance of the persons caught in an ethical quandary, 2) focuses on the puzzle-solving rather than examining the (...) conditions that generate moral problems, and 3) universalizes ethical dilemmas, overlooking local processes for resolving moral questions. Taken together, empirically informed moral theory and theoretically informed empirical research can help bioethicists transcend the is/ought problem in ethical work. (shrink)

Empirical research in bioethics has developed rapidly over the past decade, but has largely eschewed the use of technology-driven methodologies. We propose “design bioethics” as an area of conjoined theoretical and methodological innovation in the field, working across bioethics, health sciences and human-centred technological design. We demonstrate the potential of digital tools, particularly purpose-built digital games, to align with theoretical frameworks in bioethics for empirical research, integrating context, narrative and embodiment in moral decision-making. Purpose-built digital tools can engender situated engagement (...) with bioethical questions; can achieve such engagement at scale; and can access groups traditionally under-represented in bioethics research and theory. If developed and used with appropriate rigor, tools motivated by “design bioethics” could offer unique insights into new and familiar normative and empirical issues in the field. (shrink)

This study develops conceptual means in philosophy of agency to better and more systematically address intentional omissions of agents, including those that are about resisting the action not done. I argue that even though philosophy of agency has largely concentrated on the actions of agents, when applying philosophy of action to the social sciences, a full-blown theoretical account of what agents do not do and a non-normative conceptual language of the phenomena in question is needed. Chapter 2 aims to find (...) out what kind of things intentional omissions are. I argue that although intentional omissions are part of our intentional behavior, they are not actions in the sense that the standard account of action assumes. Instead, because intentional omissions are homogenous, continuous, unbounded, indefinite and directly uncountable, they should be thought of as activities instead of performances. This view links the ontology of intentional omissions to the ontology of processes instead of to that of events, and I argue that this kind of ontology accounts for the fluid nature of the agency of alive agents not only instigating but controlling and sustaining their intentional omissions as well. Chapter 3 aims to find out on what conditions is an omission intentional. The aim is to find a naturalized explanation of them that would make it possible to combine psychological perspectives with philosophical ones so that intentional omissions could be treated as something that exist in the world, not just in our philosophical intuitions. I argue that intentional omissions necessarily require the agent’s procedural metacognition concerning the action not done. Based on this metacognition view, a non-normative conceptual typology of not doings is presented. Chapter 4 aims to find out on what conditions is an intentional omissions resistance toward something. The necessary elements of resistance are clarified and I argue that resistant intentional omissions in which the agent does not perform an action out of resistance toward something are a normal part of our everyday agency. The implications of the findings are considered for theories of action, especially when it comes to the belief-desire model that may not be able to fully account for resistant intentional omissions. Chapter 5 aims to find out what conceptual means do we have for talking about not doing something as a form of resistance. I argue that in the social sciences, bioethics and military ethics to not do something out of resistance is taken as something that exists, and as something that has causes and effects. However, concepts such as civil disobedience, conscientious refusing, exit and everyday resistance do not account for the ordinariness of this kind of not doings. Thus, I argue that such concepts are not able to fully cover resistant inaction and philosophy of intentional omissions can be of use not just in the social sciences. Finally, Chapter 6 considers the implications of these findings. The main implication of this study is that our view of social and ethical agency would need to better include intentional not doings, not just the sum of the intentional actions of agents. Another major implication is that agents themselves should be heard when analyzing their intentional omissions in society, because intentional omissions are phenomena that can easily be mixed with the passivities of agents from the perspective of an outside observer. (shrink)