We respond to a Letter to the Editor regarding "Principlism and contemporary ethical considerations for providers of transgender health care." We address criticisms by Castle & Klein (2024) of blatant fatphobia related to the ethical elements concerning BMI restrictions for gender-affirming surgery. Our response corrects several mischaracterizations of the article and clarifies our position. My co-authors and I remain focused on advocating for patient-centered, ethically sound, evidence-based, and equitable healthcare policies.

Background: Transgender health care is a subject of much debate among clinicians, political commentators, and policy-makers. While the World Professional Association of Transgender Health (WPATH) Standards of Care (SOC) establish clinical standards, these standards contain implied ethics but lack explicit focused discussion of ethical considerations in providing care. An ethics chapter in the SOC would enhance clinical guidelines. Aims: We aim to provide a valuable guide for healthcare professionals, and anyone interested in the ethical aspects of clinical support for gender (...) diverse and transgender people of all ages. Recognizing that the WPATH is a global association, we address broad challenges. We offer a reflection on general ethical principles, providing conceptual tools for healthcare providers, patients, and families to navigate the specific challenges they might encounter in transgender health care, in line with WPATH’s worldwide mission and scope. Method: This article employs a descriptive analysis, and our framework of reference is the four principles of biomedical ethics: respect for autonomy, beneficence, nonmaleficence, and justice. Results: The article presents a discussion on the four ethical principles as applied to transgender health care. We address issues such as respect for patient autonomy in decision-making, the role of beneficence and nonmaleficence in clinical interventions, and the importance of justice in equitable treatment and access to care. Some of the ethical concerns we address in this article pertain to the current sociopolitical climate, where there has been increasing legal interference, internationally, for transgender and nonbinary people, particularly youth, seeking medical care. Discussion: We highlight the interplay between ethical principles and clinical practice, underscoring the need for ethical guidance in addressing the diverse challenges faced by healthcare providers and patients in transgender health care. We advocate for continuous refinement of ethical thinking to ensure that transgender health care is not only medically effective but also ethically sound. (shrink)

In the 70 years since Alan Turing’s ‘Computing Machinery and Intelligence’ appeared in Mind, there have been two widely-accepted interpretations of the Turing test: the canonical behaviourist interpretation and the rival inductive or epistemic interpretation. These readings are based on Turing’s Mind paper; few seem aware that Turing described two other versions of the imitation game. I have argued that both readings are inconsistent with Turing’s 1948 and 1952 statements about intelligence, and fail to explain the design of his game. (...) I argue instead for a response-dependence interpretation. This interpretation has implications for Turing’s view of free will: I argue that Turing’s writings suggest a new form of free will compatibilism, which I call response-dependence compatibilism. The philosophical implications of rethinking Turing’s test go yet further. It is assumed by numerous theorists that Turing anticipated the computational theory of mind. On the contrary, I argue, his remarks on intelligence and free will lead to a new objection to computationalism. (shrink)

Recent work in social robotics, which is aimed both at creating an artificial intelligence and providing a test-bed for psychological theories of human social development, involves building robots that can learn from ‘face-to-face’ interaction with human beings — as human infants do. The building-blocks of this interaction include the robot’s ‘expressive’ behaviours, for example, facial-expression and head-and-neck gesture. There is here an ideal opportunity to apply Wittgensteinian conceptual analysis to current theoretical and empirical work in the sciences. Wittgenstein’s philosophical psychology (...) is sympathetic to embodied and situated Artificial Intelligence (see Proudfoot, 2002, 2004b), and his discussion of facial-expression is remarkably modern. In this chapter, I explore his approach to facial-expression, using smiling as a representative example, and apply it to the canonical interactive face robot, Cynthia Breazeal’s Kismet (see e.g. Breazeal, 2009, 2002). I assess the claim that Kismet has expressive behaviours, with the aim of generating philosophical insights for AI. (shrink)

Turing used the expression “emotional” in three distinct ways: to state his philosophical theory of the concept of intelligence, to classify arguments for and against the possibility of machine intelligence, and to describe the education of a “child machine”. The remarks on emotion include several of the most important philosophical claims. This paper analyses these remarks and their significance for current research in Artificial Intelligence.

We generally accept that medicine’s conceptual and ethical foundations are grounded in recognition of personhood. With patients in vegetative state, however, we’ve understood that the ethical implications of phenomenal consciousness are distinct from those of personhood. This suggests a need to reconsider medicine’s foundations. What is the role for recognition of consciousness (rather than personhood) in grounding the moral value of medicine and the specific demands of clinical ethics? I suggest that, according to holism, the moral value of medicine is (...) secured when conscious states are recognized in everyday medical science. Moreover, consciousness fully motivates traditional principles of clinical ethics if we understand respect for autonomy as respect for the dominion of an experiencer in the private, inescapable realm of bodily experience. When medicine’s foundations are grounded in recognition of consciousness, we understand how patients fully command respect even when they lack capacity to exercise their bodily dominion through decision-making. (shrink)

Biomedical diagnostic science is a great deal less successful than we've been willing to acknowledge in bioethics, and this fact has far-reaching ethical implications. In this article I consider the surprising prevalence of medically unexplained symptoms, and the term's ambiguous meaning. Then I frame central questions that remain answered in this context with respect to informed consent, autonomy, and truth-telling. Finally, I show that while considerable attention in this area is given to making sure not to provide biological care to (...) patients without a need, comparatively little is given to the competing, ethically central task of making sure never to obstruct access to biological care for those with diagnostically confusing biological conditions. I suggest this problem arises from confusion about the philosophical value of vagueness when it comes to the line between biological and psychosocial needs. (shrink)

What position on dualism does medicine require? Our understanding of that ques- tion has been dictated by holism, as defined by the biopsychosocial model, since the late twentieth century. Unfortunately, holism was characterized at the start with con- fused definitions of ‘dualism’ and ‘reductionism’, and that problem has led to a deep, unrecognized conceptual split in the medical professions. Some insist that holism is a nonreductionist approach that aligns with some form of dualism, while others insist it’s a reductionist view (...) that sets out to eradicate dualism. It’s important to consider each version. Nonreductive holism is philosophically consistent and clinically unprob- lematic. Reductive holism, however, is conceptually incoherent—yet it is the basis for the common idea that the boundary between medical and mental health disorders must be vague. When we trace that idea through to its implementation in medical practice, we find evidence that it compromises the safety of patient care in the large portion of cases where clinicians grapple with diagnosis at the boundary between psychiatry and medicine. Having established that medicine must embrace some form of nonreduc- tionism, I argue that Chalmers’ naturalistic dualism is a stronger prima facie candidate than the nonreductive alternatives. Regardless of which form of nonreductionism we prefer, some philosophical corrections are needed to give medicine a safe and coherent foundation. (shrink)

This study emphasizes the importance of enhancing food safety and hygiene practices among sidewalk vendors to safeguard public health in Balayan Public Market. Employing a mixed-methods approach, with both quantitative and qualitative components, a diverse sample of 55 consumers, 5 sidewalk vendors, and 5 market administrators was selected using a combination of purposive and random sampling techniques under non-probability sampling. Microbial investigations were conducted during both the initial sampling and testing phase (A) and subsequent sampling and testing phase (B) on (...) popular street food items at Lipa Quality Control Inc., including chicken nuggets, chicken nugget sauce (sweet and vinegar), Isaw, Isaw sauce, Proben, Proben sauce, Calamares, Calamares Vinegar Sauce, Kwek- Kwek, and Kwek-Kwek sauce. The findings reveal that “Isaw and Chicken Nuggets Sauce (Sweet)” had a result of “Too Numerous To Count (TNTC),” indicating an extraordinarily high bacteria count. This underscores the imperative need to raise awareness and provide targeted guidance to sidewalk vendors regarding essential food handling, storage, and sanitation practices. Therefore, a sanitary action plan is developed to promote community engagement, educational initiatives, and regulatory support, enhancing food safety practices among sidewalk vendors and ensuring a safer and healthier food environment. (shrink)

As national and state health care policy -making becomes contentious and complex, there is a need for a forum to debate and explore public concerns and values in health care, give voice to local citizens, to facilitate consensus among various stakeholders, and provide feedback and direction to health care institutions and policy makers. This paper explores the role that regional health care ethics committees can play and provides two contrasting examples of Networks involved in facilitation of public input into and (...) the development of health care policies and adoption of state-wide practices. (shrink)

The Repugnant Conclusion served an important purpose in catalyzing and inspiring the pioneering stage of population ethics research. We believe, however, that the Repugnant Conclusion now receives too much focus. Avoiding the Repugnant Conclusion should no longer be the central goal driving population ethics research, despite its importance to the fundamental accomplishments of the existing literature.

The ability to solve problems is a prerequisite in preparing mathematics preservice teachers. This study assessed preservice teachers’ problem-solving difficulties and performance, particularly in worded problems on number sense, measurement, geometry, algebra, and probability. Also, academic profile differences in the preservice teacher’s problem-solving performance and common errors were determined. A descriptive-comparative research design was employed with 158 random respondents. Data were gathered face-to-face during the first semester of the school year 2022-2023, and data were analyzed with the aid of jamovi (...) software, ensuring ethical measures. Overall findings revealed that the preservice teachers experienced average difficulty in solving problems. The low performance of the preservice teachers on the given problems was also demonstrated. Further analysis revealed a significant difference between the preservice teachers’ problem-solving performance based on their subject preference and program. Moreover, the error analysis revealed that the preservice teachers incurred comprehension errors in misrepresentation, misinterpretation, and miscalculation. These results will serve as a measure for policymakers and curriculum developers of the teacher education institution concerned to make relevant enhancements to the math courses offered in the elementary and secondary education programs. (shrink)

How can we improve business ethics education for the twenty first century? This study evaluates the effectiveness of a visual case exercise in the form of a 3D immersive game given to undergraduate students at two UK Universities as part of a mandatory business ethics module. We propose that due to evolving learning styles, the immersive nature of interactive games lends itself as a vehicle to make the learning of ethics more ‘concrete’ and ‘personal’ and therefore more engaging. To achieve (...) this, we designed and built an immersive 3D simulation game in the style of a visual case. The effectiveness of the game was evaluated using a mixed methods approach measuring recognised and adapted constructs from the technology acceptance model. Results demonstrate that students found the game beneficial to their learning of ethics with the development of knowledge and skills applicable to the real world and that they engaged with the process due to game elements. Findings demonstrate the potential for the development of simulated games to teach ethics at all levels and modes of delivery and the contribution of this type of visual case model as a pedagogic method. (shrink)

Kampus Merdeka was part of the Merdeka Belajar policy released by the Indonesian Ministry of Education, Culture, Research, and Technology (Kemendikbudristek) at the end of January 2020. This study focuses on a university program that gave students opportunities to develop skills in accordance with their talents and interests by entering the workforce right away as training for future careers. Until the middle of September 2022, 12 programs had launched. To provide a reliable reference, a comprehensive analysis of the Merdeka Curriculum (...) program was carried out in this work. We took a qualitative approach, conducting observations and interviews with fellow actors as well as a thorough analysis of pertinent databases on the related subjects. We found that active student participation and support from the university are the keys to the success of Kampus Merdeka. Furthermore, serious commitment is needed from all parties to gain a company’s trust. This study is important to gain deep insights into the Kampus Merdeka policy so that the needs of Kurikulum Merdeka can be met effectively. (shrink)

Individual attributes, such as educational background, may influence the degree of health consideration in food consumption. The local social norms may affect the same consideration in the collective level. Represented by education level and the custom rules adherence in food choosing behavior, this study aimed to examine how knowledge influences health consideration in food consumption and how the local social norms moderate this association in a multicultural enriched society. By utilizing the Bayesian Mindsponge Framework (BMF) as a conceptual framework, this (...) study analyzed a dataset of 710 urban residents in Indonesia. There was a negative association between education level and health consideration in food consumption in which the custom rules adherence in food choosing behavior moderated against this negative association. For those with a low level of custom-based food consumption, their health consideration is lower as they have higher education level. However, the opposite trend which is a more intuitive positive association was found in those who consume more custom-based food. Socio-cultural factors have a complex impact on food choosing behavior among Indonesian urban residents. Therefore, governmental policies in the health promotion campaign of healthy-nutritious food should incorporate socio-cultural aspects with a deeper understanding of the human mind’s information processing. (shrink)

Research within the H2020 PROGRESSIVE project has identified good practices in user co-production strategies and methodologies. Early findings from research in the PROGRESSIVE project were shared with relevant stakeholders outside the consortium for consultation and review. The outcomes of that initial investigation highlighted the need to focus on the objectives, processes, and methods used in user and older people co-production. This guide adapts these insights and makes them relevant specifically for standardisation in ICT for active and healthy ageing. This guide (...) was approved by representatives of the PROGRESSIVE project on 22 February 2018. The consortium has requested comments from interested stakeholders in an enquiry from 1 March to 30 April 2018. The PROGRESSIVE guide was approved on 5 June 2018. (shrink)

Book review of "The Evil Within: Why we need Moral Philosophy", by Diane Jeske.

The Porn Factor. Pornography and child sexual abuse es un libro que ha surgido fruto de la experiencia de la autora de darse cuenta de que después de 38 años de matrimonio con su esposo, durante 13 años él había abusado de menores de edad. La respuesta está en que los perpetradores son manipuladores tan altamente calificados, que pueden engañar incluso a la pareja con quien viven y convencer al menor que mantener el secreto en la oscuridad es críticamente importante (...) para ambos. Los perpetradores son usualmente adictos a la pornografía y esto es lo que busca la autora de este libro: que entendamos que nuestra sociedad se está “pornificando”, que vivimos en una “cultura pornificada” y que esta droga (la pornografía), es tan adictiva como la cocaína y está siendo uno de los principales factores causantes del abuso sexual de niños, niñas y adolescentes. (shrink)

As a response to Diane Vaughan’s controversial work on the NASA Challenger Disaster, this article opposes the conclusion that NASA’s decision to launch the space shuttle was an inevitable outcome of techno-bureaucratic culture and risky technology. Instead, the argument developed in this article is that NASA did not prioritize safety, both in their selection of shuttle-parts and their decision to launch under sub-optimal weather conditions. This article further suggests that the “mistake” language employed by Vaughan and others is inappropriate (...) insofar as it obscures the responsibility of individuals within the organization and trivializes the loss of life and severity of the disaster. Contra to the conclusions of Vaughan’s casework, this article reveals various ethical transgressions on the side of NASA and its affiliates; from its decision to use poorly designed O-rings, to withholding crucial engineering assessments from the shuttle-crew, this article points out that NASA did not succumb to a pre-destined fate, but, rather, created its own. (shrink)

An interruption. Rethinking the first three chapters of this book, I have come to suspect that, not unlike Iris Murdoch and Emmanuel Levinas, the way I imagine ‘ethics’ floats on an idea that any ethical substantive position or ethical theory is always shaped through our existential condition and our embodied encounter with others. To Murdoch, existence is the disposition for our responses to the ways in which we perceive reality, and yet, although these responses are always part of who we (...) are, they are not always part of what we do, and so, we set ourselves ethical tasks when we desire to act ethically. As scholar Bridget Clarke argues, “to attend to something [for Murdoch] is to approach it with a just and loving eye, and therewith to perceive it in its unbounded particularity and complexity, and so, as it truly is.” Or as I argue, to attend to the other ‘justly and lovingly’, Murdoch would instruct, is not merely to accurately collect details about the other and then arrive at an approximation of its being, but also to apprehend the other as ‘distinctly singular’ and ‘distinctly foreign’ from oneself–which at once forgoes any assimilation of the other into oneself, incidentally. The recognition of the other as ‘one who embodies human otherness and dignity’ becomes the condition for and coherent way of imagining and accessing moral reality. Moreover, for Diane Davis, this “being-for-the-other names a pre-originary obligation to respond to the other [and] it is in this response that both the self and the other emerge as existents” whose ethical projects are each challenged by the markedly different and infinitely other being. This obligation, Levinas might also say, is an ‘authority’ that is experienced like the effect of the other upon me, so that I am subsequently motivated to enact ethical task-making. I am not, therefore, “pulling everything other into the same, the known, the comprehended,” nor am I looking to any normative theories as authoritative templates from which I act ethically. And so, unlike Husserl, I am not “joining the philosophical tradition in its fundamental disrespect for all things other,” but instead, by dispositioning myself between these theories in responsible Levinasian fashion, I will be tracking them in response to their confronting me, and not as normative theories that are applicable to real and lived experiences. (shrink)

Since at least 2008 linguists and philosophers of language have started paying more serious attention to issues concerning the meaning or use of racial epithets and slurs. In an influential article published in The Journal of Philosophy, for instance, Christopher Hom (2008) offered a semantic account of racial epithets called Combinatorial Externalism (CE) that advanced a novel argument for the exclusion of certain epithets from freedom of speech protection under the First Amendment (p. 435). Also in more recent work, “The (...) Expressive Meaning of Racial Epithets: Towards A Non-Unitary Account of Expressive Meaning,” Diane Blakemore (2013) offered an alternative pragmatic account of racial epithets rooted in Dan Sperber and Deirdre Wilson’s (1986) relevance theory. Adam Croom (2008) has also discussed epithets before in prior work, through a consideration of a paradigmatic racial epithet directed towards Native Americans, but then moved on in subsequent work to focus on developing a more nuanced account of paradigmatic slurring terms instead (Croom 2010; Croom 2011; Croom 2012; Croom 2013; Croom 2014a; Croom 2014b; Croom under review). So the purpose of this article is to return to and extend the previous account of racial epithets provided by Croom (2008) through a consideration of another paradigmatic racial epithet, but this time one directed towards Asian Americans instead of Native Americans. Here I also offer a novel suggestion for how to differentiate between epithets and slurs, offering new insight into how epithets and slurs are both similar and different. A sample list of over 100 other racial epithets that can be accounted for by the kind of analysis presented here is provided in Croom (2008, p. 44-45). (shrink)

Review of: Kant and the Faculty of Feeling, edited by Kelly Sorensen and Diane Williamson. Cambridge University Press, 2018.