In this article, I confront Jessica Flanigan’s recent attempt to show not merely that women have a right to commit prenatal injury, but also that women who act on this right are praiseworthy and should not be criticized for this injury. I show that Flanigan’s arguments do not work, and I establish presumptive grounds against any such right—namely, prenatal injury, by definition, involves intentional or negligent harm and, as such, may be subsumed under a wider class of (...) actions that are presumptively wrong. (shrink)

In this article, I confront Jessica Flanigan’s recent attempt to show not merely that women have a right to commit prenatal injury, but also that women who act on this right are praiseworthy and should not be criticized for this injury. I show that Flanigan’s arguments do not work, and I establish presumptive grounds against any such right—namely, prenatal injury, by definition, involves intentional or negligent harm and, as such, may be subsumed under a wider class of (...) actions that are presumptively wrong. (shrink)

As moral injury is a still-emerging concept within the area of military mental health, prevalence estimates for moral injury and its precursor, potentially morally injurious events (PMIEs), remain unknown for many of the world’s militaries. The present study sought to estimate the prevalence of PMIEs in the Canadian Armed Forces (CAF), using data collected from CAF personnel deployed to Afghanistan, via logistic regressions controlling for relevant sociodemographic, military, and deployment characteristics. Analyses revealed that over 65% of CAF members (...) reported exposure to at least one event that would be considered a PMIE. The most commonly PMIEs individuals reported included seeing ill or injured women and children they were unable to help (48.4%), being unable to distinguish between combatants and non-combatants (43.6%), and finding themselves in a threatening situation where they were unable to respond due to the rules of engagement under which they were required to operate (35.4%). These findings provide support for both the presence of exposure to PMIEs in CAF members and the need for formal longitudinal data collection regarding PMIE exposure and moral injury development. (shrink)

Despite a growing body of research on the sociology of time and, analogously, on the sociology of sport, to date there has been relatively little sports literature that takes time as the focus of the analysis. Given the centrality of time as a feature of most sports, this would seem a curious lacuna. The primary aims of this article are to contribute new perspectives on the subjective experience of sporting injury and to analyze some of the temporal dimensions of (...) sporting “injury time” and subsequent rehabilitation. The article is based on data derived from a 2-year autoethnographic research project on 2 middle/long-distance runners, and concludes with some indicative comments regarding the need for sports physiotherapists and other health-care practitioners to take into account the subjective temporal dimension of injury and rehabilitative processes. (shrink)

This article seeks to describe in general terms what has become the standard way of conceptualizing moral injury in the clinical psychological and psychiatric literature, which is the key source for applications of the concept in other domains. What we call “the standard model” draws on certain assumptions about beliefs, mental states, and emotions as well as an implicit theory of causation about how various forms of harm arise from certain experiences or “events” that violate persons’ moral beliefs and (...) systems. Our analysis makes these assumptions more explicit and subjects them to critical scrutiny. In so doing, we survey the current literature and identify basic features of how moral injuries are defined, how they are thought to occur, and the forms of treatment or repair that appear to be indicated. We caution that it matters how moral experience is characterized and argue that an alternative understanding of what is the moral in moral injury is important for overcoming critical challenges to the standard model. Moreover, recently evolving approaches to moral repair could be more consistent with an alternative model. Our concluding suggestion is that a more robust account of the nature of moral experience and its relations to self-identity and social experience more generally could advance understanding of the etiology of moral injury and promote rehabilitation. (shrink)

The specific objects are to know the source of income and employment status of the children at work, to investigate the types of injury that affect the working child of the child laborer and to explore the hazardous work places and abuse of the working children. The study conducted with the secondary data of Bangladesh Labor Force Survey (ILO), 2013. SPSS software were used for finding the result. It is found that the predominating income source of the working child (...) was service sector and child labor mostly were self-employed. 18.5% child were engaged with hazardous work, 2.3% working child had experienced various types of injuries and almost 8.5% had subjected to insult, physically or sexually abuse. Most of the child don’t like their work and working environment that have adverse physical and emotional effects on children’s health. Public and private sectors should maintain child labor rules and regulations, arrange awareness program for child safety. (shrink)

Guilt is a moral emotion that plays an important role in some understandings and manifestations of moral injury. In “Ulterior Motives and Moral Injury in War,” I note that soldiers returning from war are often assailed by profound feelings of guilt. Such soldiers might feel irrevocably diminished as persons, which is characteristic of a type of moral injury. I explore how the ulterior motives of the leaders who authorized the war might exacerbate the moral injury of (...) soldiers. According to the argument I develop, civilian and military leaders, by virtue of their practical authority over combatants serving in the military, confer upon those combatants a particular purpose. The ulterior motives that the leaders harbor constitutively determine the content of the purpose they confer. So long as a combatant remains under the practical authority of her leaders, there is nothing she can do to divest herself of the specific purpose conferred upon her. Even if the war and her conduct in it are just by hypothesis, her sense of integrity might demand more: that she helps kill only for scrupulous purposes. It might be impossible to reconcile the demands of integrity with the cynical purpose that her self-serving, career-minded, opportunistic leaders confer upon her. This failure to justify to herself the carnage she helps cause can exacerbate the severity of any psychological trauma she suffers. (shrink)

My aim is to argue that forgiveness may be conceived by analogy to healing. The analogy is not self-evident, but a number of subsidiary analogies will be seen to point in its direction, or so I will argue. In the course of the discussion we shall see how injustice (and wrong-doing) may be compared to physical injury (both change the state of the sufferer to the worse), and how the resentment caused by suffering injustice may be compared to the (...) physical pain caused by injury (both are aversive, action-motivating states). The analogies will be illustrated and supported by concrete examples, ultimately suggesting that, in an important sense, when we forgive, we actually heal. (shrink)

This chapter demonstrates the role that displacement can play in generating moral injury (MI) within refugee communities. To better understand the consequences of displacement, it considers how individuals’ identities and values are formed through their local communities. While there are many reasons that displacement ought to be understood as a potentially morally injurious experience (PMIE), particular attention is given to the negative effects of disorientation, which are associated with displacement. The chapter uncovers multiple facets of disorientation, such as despair, (...) confusion, and apathy. Understanding the morally injurious consequences of displacement marks an important first step toward better serving refugee communities, particularly those citizens of Ukraine who have been forced to flee their homes in the wake of Russian aggression. (shrink)

The predominant account of the etiology of moral injuries among Veterans and military personnel in the clinical psychological and psychiatric literature construes morality as inherent in belief structures. This supports the conceptualization of moral injuries as intrapsychic phenomena resulting from exposure to high-stakes events in which fixed beliefs are contravened in ways that result in psychological harms, including maladaptive beliefs and distress. We identify several problems with this formulation and offer suggestions for modification, including greater focus on: 1) experiences rather (...) than events in identifying circumstances in which moral injuries occur, and 2) degradation of relevant relationships rather than conflicts with and among moral contents. These shifts in framing could have epidemiological salience, facilitating more robust case characterization and enabling a variety of approaches to reestablishing the moral conditions that support life affirmation. (shrink)

The high prevalence of brain injury incidents in adolescence and adulthood demands effective models for re-learning lost cognitive abilities. Impairment in brain injury survivors’ higher-level cognitive functions is common and a negative predictor for long-term outcome. We conducted two small-scale interventions (N = 12; 33.33% female) with persons with acquired brain injuries in two municipalities in Sweden. Age ranged from 17 to 65 years (M = 51.17, SD = 14.53). The interventions were dialogic, inquiry-based, and inspired by the (...) Philosophy for Children Programme, a participatory thinking skills approach with documented higher-order cognitive outcomes, such as developed argumentation skills, in other target groups. Philosophical dialogues were conducted once a week in the two groups, totalling 12 dialogues per group. Group argumentation development was measured through compared scores from structured observations of filmed dialogues early and late in the intervention. Large positive changes in mean scores from early to late in the intervention, together with constantly high facilitator quality, suggest argumentation development in the sample due to the intervention. (shrink)

It is well documented that people with moderate-to-severe traumatic brain injury (TBI) can undergo personality changes, including becoming more impulsive in terms of how they behave. Legal guidance and academic commentary support the view that impulsiveness can render someone decisionally incompetent as defined by English and Welsh law. However, impulsiveness is a trait found within the healthy population. Arguably, impulsiveness is also a trait that gives rise to behaviours that should normally be tolerated even when they cause harm to (...) the person enacting the behaviours. The purpose of this paper is to show why both of these considerations present as significant challenges to the law in England and Wales. (shrink)

This paper explicates a conception of injury as right-violation, which allows us to distinguish between setbacks to interests that should, and should not, be the concern of theories of justice. It begins by introducing a hybrid theory of rights, grounded in (a) the mobilisation of our moral equality to (b) protect our most important interests, and shows how violations of rights are the concern of justice, while setbacks where one of the twin grounds of rights is defeated are not. (...) It then looks more closely at the substantive moral components of injury, namely harm—damage to one’s interests—and wrong—disrespect for one’s moral equality. It argues that, on the hybrid conception of rights, harm and wrong are individually necessary and jointly sufficient components of injury, and the disvalue of neither is reducible to the other—in particular, it is a mistake to construe the disrespect identified by wrong as another damaged interest. Finally, it distinguishes between the public and private dimensions of harm and wrong, and makes some preliminary suggestions as to whether the remedy for these different dimensions should lie in criminal, distributive, or corrective justice. (shrink)

Should the government censor dangerous anti-vaccination propoganda? Should it restrict the praise of terrorist groups, or speech intended to promote discriminatory attitudes? In other words, should the government curb the advocacy of dangerous ideas and actions (i.e. 'harmful advocacy'), or should the government take a more permissive approach? Strong free speech supporters argue that citizens should be free to engage in and to hear harmful advocacy, arguing that restrictions are deeply objectionable at best, and, at worst, wholly impermissible. To support (...) their position, strong free speech supporters have offered a wide range of arguments and ideas. One of the most interesting arguments revolves around the idea that restrictions on harmful advocacy are deeply insulting to citizens. The worry, broadly understood, is that this kind of censorship is demeaning, treats citizens as though they are stupid, or as though they are children. As such, even when censorship is effective in preventing harms to citizens, it nonetheless comes at the significant political cost of failing to properly respect the citizenry at large. By contrast, so the thought goes, an alternative political scheme that prohibits censorship, or permits it only in exceptional cases, does a better job of respecting citizens as independent, rational, morally responsible agents. This alternative political system may, sometimes, be less effective at preventing speech harms. But it is a political system where citizens can stand tall and hold their heads high. In this paper, I consider and reject three versions of the worry that censorship is insulting. §1 explores the idea that censorship is insulting qua involving a negative appraisal of the citizens being interfered with. The key idea here is that censorship involves a lack of what Stephen Darwall terms ‘appraisal respect’, insofar as the government is suggesting that citizens cannot be trusted to manage their own beliefs and intentions. Drawing on the work of Thomas Nagel, §2 explores the idea that censorship diminishes the political status of citizens. Finally, §3 explores the suggestion that censorship is incompatible with a full appreciation of the thinking nature of citizens, and thus involves a lack of what Darwall would term ‘recognition respect’. The paper argues that censorship is not necessarily premised upon an insulting view of the citizenry. On the contrary, it argues that the best kind of censorship stems from a rich appreciation of the diverse range of capabilities, needs, vulnerabilities, and responsibilities of citizens, as well as the need for co-operation between citizens if societal flourishing is going to be achieved on a large scale. Granted, such a vision places an emphasis on the imperfections and liabilities of citizens – at least when compared to the rather solitary, highly intellectual creature one sometimes finds in the philosophical literature. Still, such a vision of citizens as imperfect falls well short of being genuinely insulting. To err is human. And there’s nothing insulting about being treated like a human. (shrink)

This chapter explores the impact of “bureaucratic individualism” and profit-centered models on the medical profession, specifically examining Chronic Moral Injury (CH-MI). Drawing on Alasdair MacIntyre’s philosophy and Farr Curlin and Christopher Tollefsen’s critique of the Provider of Services Model (PSM) in healthcare, we argue that the erosion of practical reason—a key element for pursuing excellence in the profession—has dire consequences. Within the PSM, the focus on consumerism and radical patient autonomy hampers medical professionals’ ability to make value-informed judgments, contributing (...) to CH-MI and a crisis of purpose. The chapter calls for redefining healthcare models to prioritize human flourishing over corporate interests. (shrink)

This chapter conceptually analyzes the post-traumatic stress injuries called moral injury, moral fatigue or exhaustion, and broken spirit. It then identifies two puzzles. First, soldiers sometimes sustain moral injury even from doing right actions. Second, they experience moral exhaustion from making decisions even where the morally right choice is so obvious that it shouldn’t be stressful to make it; and even where rightness of decision is so murky that no decision could be morally faulted. The injuries result of (...) mistaken moral self-evaluation. Methods of preventing and treating these injuries are defended, including training in self-forgiveness, moral off-loading of actions and decisions to persons and devices less likely to feel inappropriate guilt, and the use of drugs to prevent such guilt. The foregoing has been about moral injury erroneously resulting from the non-violation of a correct moral code. But the chapter then introduces the concept of moral pseudo-injury—felt moral injury that has in reality resulted from violation of a false moral code, so that no one has really been morally injured. This can be used as a method in warfighting. And since the injuries it produces are illusory, this would be morally superior to physical violence. For it causes less injury to its victims, and should cause less guilt in those who must inflict it. Historical precedents are considered. Finally, our enemies often use moral pseudo-injury against us, in the form of terrorist violence against civilians. Terrorism causes comparatively few harms, yet we mistakenly see it as more morally horrific than conventional combat that causes much worse loss of life among armed forces members. Here we need the nuancing and clarifying power of philosophy to restore a sense of proportion, thence to prevent or therapize the moral pseudo-injury we may experience from these sorts of attacks. (This is a pre-penultimate version of the published version, available from OUP at the external link, which contains minor variances. The paper was earlier known as "PTSD Weaponized: A Theory of Moral Injury"; that now superseded version is archived under "past conferences" on the Center for Ethics and the Rule of Law website.). (shrink)

Until recently, the problem of traumatic brain injury in sports and the problem of performance enhancement via hormone replacement have not been seen as related issues. However, recent evidence suggests that these two problems may actually interact in complex and previously underappreciated ways. A body of recent research has shown that traumatic brain injuries, at all ranges of severity, have a negative effect upon pituitary function, which results in diminished levels of several endogenous hormones, such as growth hormone and (...) gonadotropin. This is a cause for concern for many popular sports that have high rates of concussion, a mild form of TBI. Emerging research suggests that hormone replacement therapy is an effective treatment for TBI-related hormone deficiency. However, many athletic organizations ban or severely limit the use of hormone replacing substances because many athletes seek to use them solely for the purposes of performance enhancement. Nevertheless, in the light of the research linking traumatic brain injury to hypopituitarism, this paper argues that athletic organizations’ policies and attitudes towards hormone replacement therapy should change. We defend two claims. First, because of the connection between TBI and pituitary function, it is likely many more athletes than previously acknowledged suffer from hormone deficiency and thus could benefit from hormone replacement therapy. Second, athletes’ hormone levels should be tested more rigorously and frequently with an emphasis on monitoring TBI and TBI-related issues, rather than simply monitoring policy violations. (shrink)

Background We investigated the personal philosophies of eight persons with a tetraplegic condition (four male, four female), all living in Sweden with a chronic spinal cord injury (SCI) and all reporting a good life. Our purpose was to discover if there is a philosophical mindset that may play a role in living a good life with a traumatic SCI. Methods Two rounds of in-depth qualitative interviews were performed by the same interviewer, a philosophical practitioner by training (de Miranda). The (...) second round systematically covered the following elements: bodily sense, sense of self, sense of belonging, sense of the possible, sense of purpose and philosophical sense. This six-step method developed by de Miranda is called SMILE_PH, an acronym for Sense-Making Interviews Looking at Elements of Philosophical Health. Results All the interviewees, as a consequence of their trauma, reported having gone through a reinvention of themselves which implied questioning the meaning and purpose of their life in particular and life in general. A philosophical rather than realistic sense of the possible was abstracted toward teleological growth. All interviewees developed a sense of purpose based on self-interested altruism and solidarity with disabled peers. Conclusions To reinvent a good life with SCI, in addition to physical training and willpower, one needs to consider philosophical questions about the self and life, what Kant called the cosmic interests of reason: What may I hope? What must I do? What can I know? Our results indicate that we should, in the future, explore what the philosophical health approach may bring to rehabilitation processes in the months or years that follow the trauma. (shrink)

Reid argues that Hume’s claim that justice is an artificial virtue is inconsistent with the fact that gratitude is a natural sentiment. This chapter shows that Reid’s argument succeeds only given a philosophy of mind and action that Hume rejects. Among other things, Reid assumes that one can conceive of one of a pair of contradictories only if one can conceive of the other—a claim that Hume denies. So, in the case of justice, the disagreement between Hume and Reid is, (...) at bottom, a disagreement over their respective conceptions of how the human mind works at its most fundamental level. (shrink)

Traumatic brain injury is the leading cause of death in children. Children with severe TBI are in need of neurointensive care where the goal is to prevent secondary brain injury by avoiding secondary insults. Monitoring of cerebral blood flow (CBF) and autoregulation in the injured brain is crucial. However, there are limited studies performed in children to investigate this. Current studies report on age dependent increase in CBF with narrow age range. Low initial CBF following TBI has been (...) correlated to poor outcome and may be more prevalent than hyperemia as previously suggested. Impaired cerebral pressure autoregulation is also detected and correlated with poor outcome but it remains to be elucidated if there is a causal relationship. Current studies are few and mainly based on small number of patients between the age of 0–18 years. Considering the changes of CBF and cerebral pressure autoregulation with increasing age, larger studies with more narrow age ranges and multimodality monitoring are required in order to generate data that can optimize the therapy and clinical management of children suffering TBI. (shrink)

In this article, we engage with a theory of management advanced by MacIntyrean scholars of business ethics and organization studies to develop an account of “chronic moral injury” in the workplace. In contrast to what we call “acute moral injury,” which focuses on grave, traumatic events, chronic moral injury results from poor institutional form—when an individual desiring excellence must function within a vicious institution that impedes the acquisition of virtues and marginalizes practices. In other words, chronic moral (...) injury occurs when practitioners who pursue excellence in their practice work within corrupt or malformed organizations. To demonstrate this point, we recount the events associated with the rise and fall of the biotech company, Theranos. This case study advances an empirical contribution to MacIntyrean studies by demonstrating how chronic moral injury can happen under such conditions and what the negative consequences may entail for workers. (shrink)

Criminal offences and regulatory breaches in using social networking evidence in personal injury litigation Pages 2-7 Current Criminal Law ISSN 1758-8405 Volume 2 Issue 3 March 2010 Author SALLY RAMAGE WIPO 900614 UK TM 2401827 USA TM 3,440.910 Orchid ID 0000-0002-8854-4293 Sally Ramage, BA (Hons), MBA, LLM, MPhil, MCIJ, MCMI, DA., ASLS, BAWP. Publisher & Managing Editor, Criminal Lawyer series [1980-2022](ISSN 2049-8047); Current Criminal Law series [2008-2022] (ISSN 1758-8405) and Criminal Law News series [2008-2022] (ISSN 1758-8421). Sweet & Maxwell (...) (Thomson Reuters) (Licensed Annotator of UK Statutes) in Current Law Statutes Annotated, (2006, 2009, 2010 editions) (sole and separate S&M contracts) for 7 UK Criminal Justice Statutes: UK Safeguarding Vulnerable Persons Act 2006; UK International Development Act 2006; UK Fraud Act 2006; UK Policing and Crime Act 2009, UK Local Democracy Act 2009; UK Bribery Act 2010; and UK Crime and Security Act 2010. Trade Mark SALLY RAMAGE ® 2401827 (2005-2025) in the UK, WIPO Trade Mark SALLY RAMAGE® 900164; USA-(Trade Mark 3,440,910) (2008-2028). WARNING: The doing of an unauthorized act in relation to a copyright work may result in both a civil claim for damages and criminal prosecution. Essentially, Social Network information may not always be admissible in a court of law but may be the door to lead to other, non-contentious evidence. In fact, even illegally obtained evidence may sometimes be admissible evidence, though this is not absolute. Most of the information available on social networking sites will be ‘personal data’. The data controller is the network operator, without whose consent, collecting such information could be an offence, unless it was necessary for the purpose of preventing or detecting crime. (shrink)

Objectives: To explore individuals’ perception of the personal, family and societal educational needs following a spinal cord injury. Methods: Sixty-one patients who sustained a traumatic SCI between March 2015 and June 2016 referred to Brain and Spinal Cord Injury Research Center were included in a cross sectional study and completed an online survey containing open-and closed-ended questions, in Iran. Participants’ responses were analyzed i using a qualitative approach with a thematic analysis. Results: Following a thematic analysis of the (...) patient’s perceived educational needs, 3 themes and 14 subthemes were identified. The 3 themes included personal, family, and societal educational perceived needs. Within personal educational needs, there were 7 subthemes which included personal independence and transportation, financial independence, life skills modification, knowledge about SCI, prevention of SCI complications, relationships and sexual function, and psychological adjustments. Among family educational needs, the 3 subthemes were caregiver skills and communication, first aid and emergency skills, and emotional and psychological support. For societal educational needs, the 4 subthemes described were social integration, interpersonal communication skills, SCI awareness and injury prevention, sympathize while avoiding pity. Conclusion: According to our findings, people with SCI have various needs that need to be addressed. Educational support should be a part of a comprehensive rehabilitation program and geared towards addressing the patients’ personal and family needs, while educating the community about SCI in order to allow for reintegration into society. (shrink)

There is a long-standing debate in philosophy about whether it is morally permissible to harm one person in order to prevent a greater harm to others and, if not, what is the moral principle underlying the prohibition. Hypothetical moral dilemmas are used in order to probe moral intuitions. Philosophers use them to achieve a reflective equilibrium between intuitions and principles, psychologists to investigate moral decision-making processes. In the dilemmas, the harms that are traded off are almost always deaths. However, the (...) moral principles and psychological processes are supposed to be broader than this, encompassing harms other than death. Further, if the standard pattern of intuitions is preserved in the domain of economic harm, then that would open up the possibility of studying behavior in trolley problems using the tools of experimental economics. We report the results of two studies designed to test whether the standard patterns of intuitions are preserved when the domain and severity of harm are varied. Our findings show that the difference in moral intuitions between bystander and footbridge scenarios is replicated across different domains and levels of physical and non-physical harm, including economic harms. (shrink)

This paper discusses a dialectic whereby the law not only influenced medical thinking in late nineteenth-century Germany, but also underwent medicalization of its own initiative. At the end of the 1880s, social legislation was crucial in initiating the German discourse on traumatic nervous disorders. By employing doctors as medical experts in court, the law also created a new experiential realm for doctors, altering their behavior toward patients and shifting their focus from therapy to investigation. However, in the wake of their (...) experiences in court, doctors developed a dual etiology of traumatic symptoms, which included the law itself as a pathogenic element with the power to aggravate symptoms. Two medical views of law can be distinguished: some doctors claimed that it was the desire to receive the pensions offered under social legislation that induced workers to perpetuate and exaggerate their symptoms; others argued that since pension claims embroiled claimants in intimidating legal proceedings, the pathogenic effect of social legislation stemmed from fear rather than greed. (shrink)

In a context of imperfect risk protection, households may protect against the impact of a health shock by employing various financial and non-financial coping mechanisms, such as foregoing or reducing needed medical care, labor substitution, consumption reduction, borrowing money, dissaving, and selling assets. However, leveraging certain coping mechanisms may reduce future productivity, potentially trapping households in chronic or persistent poverty. Resources and risk are not necessarily shared equitably within a household; the ability and willingness of the household to leverage coping (...) mechanisms, or the choice of coping mechanism may depend on the social protection policy context, household socioeconomic status, and type of intrahousehold risk sharing. Vietnam has been making policy changes aimed towards achieving Universal Health Coverage for the past several decades, culminating in a 2015 change mandating universal insurance coverage. This can potentially influence both providers in making decisions around service delivery and households around financing care. This research aims to contribute to the literature exploring the relationships among direct and indirect health care costs, potentially maladaptive coping mechanisms, and household living standards, within the particular health financing and social protection environment in Vietnam. (shrink)

Based upon a collaborative autoethnographic research project, this article explores from a sociological perspective the emotional dimension of the injured sporting body. It takes as its analytic focus the journey, rehabilitative, emotional and narrative, of two middle-aged, non-élite, middle/long-distance runners who encountered serious, long-term knee injuries. The paper examines in particular the interactional and narrative elements of the rehabilitative journey, focussing on dimensions of the emotion management, emotion work, and emotional intersubjectivity of the researcher/author and her training partner as they (...) struggled to contend with the liminality of the injured athletic role, and to maintain positive identities in the face of serious threat to their running selves. (shrink)

Illness and injury are often accompanied by experiences of bodily objectification. Medical treatments intended to restore the structure or function of the body may amplify these experiences of objectification by recasting the patient’s body as a biomedical object—something to be examined, measured, and manipulated. In this article, we contribute to the phenomenology of embodiment in illness and medicine by reexamining the results of a qualitative study of the experiences of nurses and patients isolated in an intensive care unit during (...) the first wave of COVID-19. Drawing upon the phenomenological concept of embodiment—as developed in the work of Edmund Husserl, Maurice Merleau-Ponty, Jean-Paul Sartre, and Emmanuel Levinas—we reconsider how bodily objectification manifests in complex clinical encounters. We show that, in these settings, objectification is not simply the unilateral act of a clinician objectifying a patient. Rather, both clinicians and patients reported a variety of objectifying experiences influenced by their interactions, the immediate context of the intensive care milieu, and the broader atmosphere of a global pandemic. In light of these findings, we argue that bodily objectification in illness and medicine can often be more complicated than typically presented in the phenomenological literature. (shrink)

Some patients, following brain injury, do not outwardly respond to spoken commands, yet show patterns of brain activity that indicate responsiveness. This is “cognitive-motor dissociation” (CMD). Recent research has used machine learning to diagnose CMD from electroencephalogram (EEG) recordings. These techniques have high false discovery rates, raising a serious problem of inductive risk. It is no solution to communicate the false discovery rates directly to the patient’s family, because this information may confuse, alarm and mislead. Instead, we need a (...) procedure for generating case-specific probabilistic assessments that can be communicated clearly. This article constructs a possible procedure with three key elements: (1) a shift from categorical “responding or not” assessments to degrees of evidence; (2) the use of patient-centred priors to convert degrees of evidence to probabilistic assessments; and (3) the use of standardized probability yardsticks to convey those assessments as clearly as possible. (shrink)

Male genital problems and injuries may occur quite simply because of the scrotum and penis are not protected like other organs. Genital problems and injuries normally happen through: recreational activities (like Football, Hooky, biking, basketball), work- related tasks (like contact to irritating chemicals), downhill drop, and sexual activity. A genital injury frequently causes harsh pain that typically disappear fast without causing enduring harm. Home handling is generally all that is required for trivial problems or injuries. Pain, inflammation, staining, or (...) rashes that are coexist with other symptoms might be a source for concern. Genital problems in men is one of the most common problems which requires fast intervention. In this paper we present an expert system that help men diagnose their genital problems and give them the proper treatment. SL5 Object expert system language was used to design and implement this expert system. (shrink)

Male genital problems and injuries may occur quite simply because of the scrotum and penis are not protected like other organs. Genital problems and injuries normally happen through: recreational activities (like Football, Hooky, biking, basketball), workrelated tasks (like contact to irritating chemicals), downhill drop, and sexual activity. A genital injury frequently causes harsh pain that typically disappear fast without causing enduring harm. Home handling is generally all that is required for trivial problems or injuries. Pain, inflammation, staining, or rashes (...) that are coexist with other symptoms might be a source for concern. Genital problems in men is one of the most common problems which requires fast intervention. In this paper we present an expert system that help men diagnose their genital problems and give them the proper treatment. SL5 Object expert system language was used to design and implement this expert system. (shrink)

After severe brain injury, one of the key challenges for medical doctors is to determine the patient’s prognosis. Who will do well? Who will not do well? Physicians need to know this, and families need to do this too, to address choices regarding the continuation of life supporting therapies. However, current prognostication methods are insufficient to provide a reliable prognosis. -/- Functional Magnetic Resonance Imaging (MRI) holds considerable promise for improving the accuracy of prognosis in acute brain injury (...) patients. Nonetheless, research on functional MRI in the intensive care unit context is ethically challenging. These studies raise several ethical issues that have not been addressed so far. In this article, Prof. Charles Weijer and his co-workers provide a framework for researchers and ethics committees to design and review these studies in an ethically sound way. (shrink)

Objective: Eye injuries are one of the leading causes of disabling ocular morbidity. The objective of this bibliometric study was to evaluate the top 100 cited articles on ocular trauma published between 1975 and 2018 via multidimensional citation analysis. Methods: We analyzed the top 100 cited articles among 3,768 ocular trauma articles published between 1975 and 2018; these articles were obtained from the databases in Web of Science and PubMed based on their citation rates per article, publication years, countries of (...) origin, institutions or organizations, the most common subjects, funding status, article types, and levels of evidence. The data obtained were analyzed with the SPSS® 20.0 software package program. Results: In the top 100 cited articles on ocular trauma, the total number of authors was 420 and the average authorship was 4.20±2.23 (range: 1–14). In our study, 70 of the top 100 cited articles were published in journals with an impact factor (IF) of ≥2.00 (range: 2.016–8.806), and Q index or quartile score of these journals was mostly Q1. Although the most preferred journal was Ophthalmology according to the total number of citations and articles (n=2,183 and n=23, respectively), Eye was the most preferred journal according to the mean number of citations per article. Besides, the three most common topics among the top 100 cited articles were mechanical eyeball injury (40 articles), epidemiology of ocular trauma (19 articles), and traumatic eye infection (17 articles). The average level of evidence was found to be 3.14±0.66 (range: 1–4), and the mean number of citations per article was the highest level at 2. Moreover, we also found that the most commonly preferred article type by authors was clinical research (92 articles), and most of them were in the B level of evidence group (70 articles). Conclusion: Analysis of the top 100 most cited articles on ocular trauma as an update study can provide us scientific contributions and vital current data in clinical implementations. (shrink)

Patients with serious illnesses or injuries may decide to quit their medical treatment if they think paying the fees will put their families into destitution. Without treatment, it is likely that fatal outcomes will soon follow. We call this phenomenon “near-suicide”. This study attempted to explore this phenomenon by examining how the seriousness of the patient’s illness or injury and the subjective evaluation of the patient’s and family’s financial situation after paying treatment fees affect the final decision on the (...) treatment process. Bayesian Mindsponge Framework (BMF) analytics were employed to analyze a dataset of 1042 Vietnamese patients. We found that the more serious the illnesses or injuries of patients were, the more likely they were to choose to quit treatment if they perceived that paying the treatment fees heavily affected their families’ financial status. Particularly, only one in four patients with the most serious health issues who thought that continuing the treatment would push themselves and their families into destitution would decide to continue the treatment. Considering the information-filtering mechanism using subjective cost–benefit judgments, these patients likely chose the financial well-being and future of their family members over their individual suffering and inevitable death. Our study also demonstrates that mindsponge-based reasoning and BMF analytics can be effective in designing and processing health data for studying extreme psychosocial phenomena. Moreover, we suggest that policymakers implement and adjust their policies (e.g., health insurance) following scientific evidence to mitigate patients’ likelihood of making “near-suicide” decisions and improve social equality in the healthcare system. (shrink)

Many of our most important goals require months or even years of effort to achieve, and some never get achieved at all. As social psychologists have lately emphasized, success in pursuing such goals requires the capacity for perseverance, or "grit." Philosophers have had little to say about grit, however, insofar as it differs from more familiar notions of willpower or continence. This leaves us ill-equipped to assess the social and moral implications of promoting grit. We propose that grit has an (...) important epistemic component, in that failures of perseverance are often caused by a significant loss of confidence that one will succeed if one continues to try. Correspondingly, successful exercises of grit often involve a kind of epistemic resilience in the face of failure, injury, rejection, and other setbacks that constitute genuine evidence that success is not forthcoming. Given this, we discuss whether and to what extent displays of grit can be epistemically as well as practically rational. We conclude that they can be (although many are not), and that the rationality of grit will depend partly on features of the context the agent normally finds herself in. In particular, grit-friendly norms of deliberation might be irrational to use in contexts of severe material scarcity or oppression. (shrink)

सम्पादक – श्रमण सुव्रतसागर मुनि; English rendering - Vijay K. Jain -/- 'सत्यार्थ-बोध' सृष्टा आचार्य विशुद्धसागर एक ओर तार्किक मनीषी हैं तो दूसरी ओर शास्त्रज्ञ दार्शनिक। जगत् के इस लक्ष्य-विहीन, अर्थहीन वातावरण में 'सत्यार्थ-बोध' मानवमात्र के लिए परमौषधि है जो अपूर्व-अपूर्व आनन्द की प्रदाता है तथा इष्ट की परमसिद्धि का कारण है। 'सत्यार्थ-बोध' अत्यंत सरल-सुबोध है, वाक्य-वाक्य में नीतियाँ गुंथित हैं। आचार्य विशुद्धसागर के सर्वोदयी, प्राञ्जल, सर्वहितकर एवं सुखकर वचन अतीव शान्तता का रसास्वादन कराने वाले हैं तथा हमारे परिणामों को (...) निर्मल बनाने वाले हैं। -/- English Rendering – Vijay K. Jain; -/- Ācārya Viśuddhasāgara’s ‘Satyārtha-bodha’ – ‘Know The Truth’ – through its thirty-one chapters, instructs us on what attributes we need to adopt or renounce in order to attain the supreme state of perfection and bliss, in life present and beyond. The instructions provided in the book constitute the true 'dharma' – the own-nature of substances – applicable universally to mankind. (shrink)

This paper clarifies Merleau-Ponty’s original account of “higher-order” cognition as fundamentally embodied and enacted. Merleau-Ponty’s philosophy inspired theories that deemphasize overlaps between conceptual knowledge and motor intentionality or, on the contrary, focus exclusively on abstract thought. In contrast, this paper explores the link between Merleau-Ponty’s account of motor intentionality and his interpretations of our capacity to understand and interact productively with cultural symbolic systems. I develop my interpretation based on Merleau-Ponty’s analysis of two neuropathological modifications of motor intentionality, the case (...) of the brain-injured war veteran Schneider, and a neurological disorder known as Gerstmann’s syndrome. Building on my analysis of Schneider’s sensorimotor compensatory performances in relation to his limitations in the domains of algebra, geometry, and language usage, I demonstrate a strong continuity between the sense of embodiment and enaction at all these levels. Based on Merleau-Ponty’s interpretations, I argue that “higher-order” cognition is impaired in Schneider insofar as his injury limits his sensorimotor capacity to dynamically produce comparatively more complex differentiations of any given phenomenal structure. I then show how Merleau-Ponty develops and specifies his interpretation of Schneider’s intellectual difficulties in relation to the ambiguous role of the body, and in particular the hand, in Gerstmann’s syndrome. I explain how Merleau-Ponty defends the idea that sensorimotor and quasi-representational cognition are mutually irreducible, while maintaining that symbol-based cognition is a fundamentally enactive and embodied process. (shrink)

In the trust-health relationship, how trusting other people in society may promote good health is a topic often examined. However, the other direction of influence – how health may affect trust – has not been well explored. In order to investigate this possible effect, we employed Bayesian Mindsponge Framework (BMF) analytics to go deeper into the information processing mechanisms underlying the expressions of trust. Conducting Bayesian analysis on a dataset of 1237 residents from Cali, Colombia, we found that general health (...) status is positively associated with generalized trust, but recent experiences of illnesses/injuries have a negative moderating effect. Personalized trust is largely unchanged across different general health conditions, but the trust level becomes higher with recent experiences of illnesses/injuries. Psychophysiological mechanisms of increasing information filtering intensity toward unfamiliar sources during a vulnerable state of health is a plausible explanation of found patterns in generalized trust. Because established personal relationships are reinforced information channels, personalized trust is not affected as much. Rather, the results suggest that people may rely even more on loved ones when they are in bad health conditions. This exploratory study shows that the trust-health relationship can be examined from a different angle that may provide new insights. (shrink)

It is widely held that our beliefs can be epistemically faultless despite being morally flawed. Theories of moral encroachment challenge this, holding that moral considerations bear on the epistemic status of our attitudes. According to attitude-based theories of moral encroachment, morality encroaches upon the epistemic standing of our attitudes on the grounds that we can morally injure others with our epistemic practices. In this paper, I aim to show that current attitude-based theories have asymmetric mechanisms: moral features only make it (...) harder for attitudes to secure epistemic merits. I argue that, if attitudes can incur moral injury, failure to form attitudes can too. To make sense of this, I contend, attitude-based accounts require symmetric mechanisms, allowing that moral considerations make it both harder and easier for attitudes to attain epistemic merits. I maintain that, once we recognize this, attitude-based encroachment views must soon concede that they sometimes demand we believe against the evidence. (shrink)

How ought we to evaluate and respond to expressions of anger and resentment? Can philosophical analysis of resentment as the emotional expression of a moral claim help us to distinguish which resentments ought to be taken seriously? Philosophers have tended to focus on what I call ‘reasonable’ resentments, presenting a technical, narrow account that limits resentment to the expression of recognizable moral claims. In the following paper, I defend three claims about the ethics and politics of resentment. First, if we (...) care about socially just processes of reconciliation, we have good reason to pay attention to the logic of resentments. Second, the account philosophers offer of resentment – its distinctive features, aims, rationality, and gratification – will affect the conclusions we draw about which actual resentments to take seriously, which aspects of resentful claims need addressing, and what it means to address and repair them. In contesting definitions of resentment, I argue, we do more than simply perform housekeeping in philosophical taxonomies of emotion. Restricting our understanding to essentially ‘moral’ cases may cause us to lose sight of expressly political resentments. Instead, I argue, a plausible account of resentment must acknowledge that we resent violations and threats that are not necessarily self-pertaining, may not be expressible as individual, discrete injuries, and cannot always be construed as moral threats. Second, given the dependence of moral judgments on a broader horizon of moral possibility, philosophical standards of ‘reasonable’ or ‘appropriate’ resentment cannot avoid being politically charged. Thus, the widely accepted account of ‘reasonable’ resentment cannot make philosophical sense of the most interesting and perplexing cases. Ironically, a theoretical measure designed to revalue emotional expressions of moral protest may result in the exclusion and silencing of those with the most reasons to protest. (shrink)

The present article is a primary introduction to the semi-structured interviewing method SMILE_PH, an acronym for Sense-Making Interviews Looking at Elements of Philosophical Health. Beyond grounding this new methodology theoretically (a work that is started here but will in the future necessitate several developments), the main motivation here is pragmatic: to provide the recent philosophical health movement with a testable method and show that philosophically-oriented interviews are possible in a manner that can be reproduced, compared, tested and used systematically with (...) a population that has received no training in philosophy. The SMILE_PH approach was conceived by the author during an ethically approved pilot study focused on the philosophy of life of persons living with spinal cord injury (SCI), with the intention of rectifying the epistemic obstacles generated by rationalist, Socratic or unstructured ways of in-depth interviewing. The six-step structure of the method is also inspired by hundreds of individual dialogue sessions with philosophical counselees, led by the author between 2018 and 2022: the SMILE_PH method progressively gathers phenomenological data about 1 – our bodily sense, 2 – our sense of self, 3 – our sense of belonging, 4 – our sense of the possible, 5 – our sense of purpose and 6 – our philosophical sense. (shrink)

This chapter attends to somaesthetic expressions occurring irrespective of knowledge of the movement, using Mandalay’s Water Festival and Cairo’s Arab Spring as case studies. These celebrations and protests feature bodies creatively gravitating around urban structures and according to emotional, cultural concerns, all of this together defining city spaces for a time. Bodies also become venues for artistic refashioning, for example, through creative conversion of injuries into celebratory badges of dissent. Geared almost therapeutically towards life-improvement—albeit sometimes implicitly—these celebrations and protests also (...) have meliorative aspects that mark the somaesthetic movement. Moreover, they have a shared, public character stressed by Shusterman, but arguably lost on many because of his interest in self-focused meditation and the popular appeal of such exercises among those interested in body practices. (shrink)

Dysmenorrhea, or menstrual pain, is regularly suffered by 45 to 95% of menstruating women. Despite its prevalence, and despite the philosophical importance of pain as a general phenomenon, dysmenorrhea has been all but completely overlooked in contemporary analytic philosophy of mind. This paper aims at rectifying this situation. We single out three properties of what is often considered the paradigmatic case of painful experience, what we call injury-centered pains, and argue that dysmenorrhea does not have any of them, and (...) hence that it does not neatly conform to the injury-centered model of pain. This calls into question the centrality of the injury-centered model, and suggests novel research avenues within theoretical debates on affectivity. (shrink)

Resentment, as it is currently understood in the philosophical literature, is individual. That is, it is anger about a moral injury done to oneself. But in some cases, resentment responds to systemic harms and injustices rather than direct moral injuries. The purpose of this paper is to move beyond individualistic conceptions of resentment to develop an account of collective resentment that better captures the character and effects of the emotion in these cases. I use the example of indigenous and (...) settler Canadians’ reciprocal resentments in response to the Indian Residential Schools and continuing political disagreements as an example of a context in which understanding collective resentment is important. (shrink)

In this paper, we argue that there are reasons to believe that an implicit bias for normalcy influences what are considered medically necessary treatments in psychiatry. First, we outline two prima facie reasons to suspect that this is the case. A bias for ‘the normal’ is already documented in disability studies; it is reasonable to suspect that it affects psychiatry too, since psychiatric patients, like disabled people, are often perceived as ‘weird’ by others. Secondly, psychiatry's explicitly endorsed values of well-being (...) and function are hard to measure directly, which is why we see simpler box-ticking conceptions of recovery used in large research studies. This need not be problematic, but might lead to researchers and clinicians focusing too much on treatments that promote easy-to-measure proxies for recovery, instead of what actually matters to psychiatric patients themselves. Next, we provide examples of treatments and treatment decisions within two areas – self-injury and psychosis – which are hard to explain unless we assume that an implicit and harmful normalcy bias is at work. We conclude with some suggestions for clinicians and future research. (shrink)

Analyses of factual causation face perennial problems, including preemption, overdetermination, and omissions. Arguably, the thorniest, are cases of omissive overdetermination, involving two independent omissions, each sufficient for the harm, and neither, independently, making a difference. A famous example is Saunders, where pedestrian was hit by a driver of a rental car who never pressed on the (unbeknownst to the driver) defective (and, negligently, never inspected) brakes. Causal intuitions in such cases are messy, reflected in disagreement about which omission mattered. What (...) these analyses mistakenly take for granted, is that at issue is the 'efficacy' of each omission. I argue, on the contrary, the puzzle of omissive overdetermination favors taking the act/omission distinction seriously. Factual causation, properly understood precludes omissions (i.e. omissions are not causal). Of course, the law also attaches liability to omissions, but this works differently from liability for real causes (e.g. omissions have a duty requirement, they also respond differentially to difference-making considerations). The manner in which liability attaches for omissions differs from that of straightforward causal liability, and is entirely dependent on the underlying causal structure. Attention to that structure (e.g. that the driver's hitting the pedestrian with his car is what actually caused the injury) sheds light on which omissions matter (e.g. driver's failure to press on the brakes) and why (because that failure removes a defense the driver would have to liability for the accident he caused). Other cases, where the parties' connection is entirely omissive (e.g. two physicians fail to detect independently lethal conditions), come out differently (tracking moralized elements). The analysis offered makes better sense of both why omissive determination cases are puzzling and how to resolve them. (shrink)

This paper suggests that time travelling scenarios commonly depicted in science fiction introduce problems and dangers for the time traveller. If time travel takes time, then time travellers risk collision with past objects, relocation to distant parts of the universe, and time travel-specific injuries. I propose several models of time travel that avoid the dangers and risks of time travel taking time, and that introduce new questions about the relationship between time travel and spatial location.

Warfare is becoming increasingly automated, from automatic missile defense systems to micro-UAVs (WASPs) that can maneuver through urban environments with ease, and each advance brings with it ethical questions in need of resolving. Proponents of lethal autonomous weapons systems (LAWS) provide varied arguments in their favor; robots are capable of better identifying combatants and civilians, thus reducing "collateral damage"; robots need not protect themselves and so can incur more risks to protect innocents or gather more information before using deadly force; (...) robots can assess situations more quickly and do so without emotion, reducing the likelihood of fatal mistakes due to human error; and sending robots to war protects our own soldiers from harm. However, these arguments only point in favor of autonomous weapons systems, failing to demonstrate why such systems need be made *lethal*. In this paper I argue that if one grants all of the proponents' points in favor of LAWS, then, contrary to what might be expected, this leads to the conclusion that it would be both immoral and illegal to deploy *lethal* autonomous weapons, because the many features that speak in favor of them also undermine the need for them to be programmed to take lives. In particular, I argue that such systems, if lethal, would violate the moral and legal principle of necessity, which forbids the use of weapons that impose superfluous injury or unnecessary harm. I conclude by highlighting that the argument is not against autonomous weapons per se, but only against *lethal* autonomous weapons. (shrink)

Several recent lines of inquiry have pointed to the amygdala as a potential lesion site in autism. Because one function of the amygdala may be to produce autonomic arousal at the sight of a significant face, we compared the responses of autistic children to their mothers’ face and to a plain paper cup. Unlike normals, the autistic children as a whole did not show a larger response to the person than to the cup. We also monitored sympathetic activity in autistic (...) children as they engaged in a wide range of everyday behaviours. The children tended to use self-stimulation activities in order to calm hyper-responsive activity of the sympathetic (`fight or flight’) branch of the autonomic nervous system. A small percentage of our autistic subjects had hyporesponsive sympathetic activity, with essentially no electrodermal responses except to self-injurious behaviour. We sketch a hypothesis about autism according to which autistic children use overt behaviour in order to control a malfunctioning autonomic nervous system and suggest that they have learned to avoid using certain processing areas in the temporal lobes. (shrink)

In this paper I criticise Axel Honneth's reactualization of reification as a concept in critical theory in his 2005 Tanner Lectures and argue that he ultimately fails on his own terms. His account is based on two premises: (1) reification is to be taken literally rather than metaphorically, and (2) it is not conceived of as a moral injury but as a social pathology. Honneth concludes that reification is ?forgetfulness of recognition?, more specifically, of antecedent recognition, an emphatic and (...) engaged relationship with oneself, others and the world, which precedes any more concrete relationship both genetically and categorially. I argue against this conception of reification on two grounds. (1) The two premises of Honneth's account cannot be squared with one another. It is not possible to literally take a person as a thing without this being a recognisable moral injury, and, therefore, I suggest that there are no cases of literal reification. (2) Honneth's account is essentially ahistorical, because it is based on an anthropological model of recognition that tacitly equates reification with autism. In conclusion, I suggest that any successful account of reification must (i) take reification metaphorically and (ii) offer a social-historical account of the origin(s) of reification. (shrink)