Investigating an actual case that occurred in a New York state hospital where an Orthodox Jewish patient’s legal proxy demands that the clinicians and hospital administrators should provide aggressive treatment with all available technological resources for the seemingly brain-dead patient with a medically futile condition. The authors argue that a health care policy or regulation should be developed to limit patient’s access to technology in critical care. Otherwise, we will be allowing society to issue a carte blanche to religious autonomy (...) by technology abuse. It is argued that religious autonomy should be restricted when its demand exhibits apparent logical absurdity and/or goes against the common survival of the entire population. (shrink)

Although they are continually compositionally reconstituted and reconfigured, organisms nonetheless persist as ontologically unified beings over time – but in virtue of what? A common answer is: in virtue of their continued possession of the capacity for morphological invariance which persists through, and in spite of, their mereological alteration. While we acknowledge that organisms‟ capacity for the “stability of form” – homeostasis - is an important aspect of their diachronic unity, we argue that this capacity is derived from, and grounded (...) in a more primitive one – namely, the homeodynamic capacity for the “specified variation of form”. In introducing a novel type of causal power – a „structural power‟ – we claim that it is the persistence of their dynamic potential to produce a specified series of structurally adaptive morphologies which grounds organisms‟ privileged status as metaphysically “one over many” over time. (shrink)

In this article, we address the relevance of J.S. Mill’s political philosophy for a framework of public health ethics. In contrast to some readings of Mill, we reject the view that in the formulation of public policies liberties of all kinds enjoy an equal presumption in their favor. We argue that Mill also rejects this view and discuss the distinction that Mill makes between three kinds of liberty interests: interests that are immune from state interference; interests that enjoy a presumption (...) in favor of liberty; and interests that enjoy no such presumption. We argue that what is of focal importance for Mill in protecting liberty is captured by the essential role that the value of self-determination plays in human well-being. Finally, we make the case for the plausibility of a more complex and nuanced Millian framework for public health ethics that would modify how the balancing of some liberty and public health interests should proceed by taking the thumb off the liberty end of the scale. Mill’s arguments and the legacy of liberalism support certain forms of state interference with marketplace liberties for the sake of public health objectives without any presumption in favor of liberty. (shrink)

In this paper I examine Grace A. de Laguna’s theory of universals in its historical context and in relation to contemporary debates in analytic metaphysics. I explain the central features of her theory, arguing that her theory should be classified as a form of immanent realism and as a powers ontology. I then show in what ways her theory affords a theory of modality in terms of potentialities and discuss some of its consequences along the way.

The purpose of this essay is to offer support for the substance view of persons, the philosophical anthropology defended by Patrick Lee in his essay. In order to accomplish this the author presents a brief definition of the substance view; argues that the substance view has more explanatory power in accounting for why we believe that human persons are intrinsically valuable even when they are not functioning as such, why human persons remain identical to themselves over time, and why (...) it follows from these points that the unborn are human persons; and responds to two arguments that attempt to establish the claim that the early human being is not a unified substance until at least fourteen days after conception. (shrink)

Pieterse, Jan Nederveen and Parekh, Bhikhu (eds.). The Decolonization of Imagination: Culture, Knowledge and Power. London: Zed Books, 1995. 265pp. $59.95 (cloth), $22.50 (paper).

By its alternative depiction of God's non-violent creative power at the start of the biblical canon, Gen 1 signals the Creator's original intent for shalom and blessing at the outset of human history, prior to the rise of human (or divine) violence. Gen 1 constitutes a normative framework by which we may judge all the violence that pervades the rest of the Bible.

BSTRACT Frantz Fanon’s works have been invaluable in the analysis of colonies and the colonized subject’s mentality therein, but an analysis of the colonial power itself has been largely left to the wayside. The aim of this paper is to explicate a key element of Fanon’s theoretical framework, the metropolis/periphery dichotomy, then, using the writings of Huey P. Newton and Stokely Carmichael, among others, show its reversal within the colonial power. I will analyze this reversal in three ways: (...) first, the reversal of the relationship between, and the roles of, the metropolis and periphery; second, the role of police and the differences between the colonial police and the police within the colonial power; and third, the modified role of prisons within the colonial power. (shrink)

This paper examines possible converging points between Heidegger and Foucault on being and language. Both are concerned with the temporal movement of a transient event which, whether "presencing" as a thing-present or erupting-forth out of conflicting forces as a discursive configuration, becomes preserved as a subsistent "thing"--as a mode of being for Heidegger, as a mode of knowledge in relation to techniques of power for Foucault. This is accompanied with the claim to persist throughout its coming-to-be, transformations, and disappearing--an (...) artificial preservation accomplished in relation to language which names "that-which-cannot-be-named". (shrink)

On Kratzer’s canonical account, modal expressions (like “might” and “must”) are represented semantically as quantifiers over possibilities. Such expressions are themselves neutral; they make a single contribution to determining the propositions expressed across a wide range of uses. What modulates the modality of the proposition expressed—as bouletic, epistemic, deontic, etc.—is context.2 This ain’t the canon for nothing. Its power lies in its ability to figure in a simple and highly unified explanation of a fairly wide range of language use. (...) Recently, though, the canon’s neat story has come under attack. The challenge cases involve the epistemic use of a modal sentence for which no single resolution of the contextual parameter appears capable of accommodating all our intuitions.3 According to these revisionaries, such cases show that the canonical story needs to be amended in some way that makes multiple bodies of information relevant to the assessment of such statements. Here I show that how the right canonical, flexibly contextualist account of modals can accommodate the full range of challenge cases. The key will be to extend Kratzer’s formal semantic account with an account of how context selects values for a modal’s.. (shrink)

As there is currently a neo-Aristotelian revival currently taking place within contemporary metaphysics and dispositions, or causal powers are now being routinely utilised in theories of causality and modality, more attention is beginning to be paid to a central Aristotelian concern: the metaphysics of substantial unity, and the doctrine of hylomorphism. In this paper, I distinguish two strands of hylomorphism present in the contemporary literature and argue that not only does each engender unique conceptual difficulties, but neither adequately captures the (...) metaphysics of Aristotelian hylomorphism. Thus both strands of contemporary hylomorphism, I argue, fundamentally misunderstand what substantial unity amounts to in the hylomorphic framework – namely, the metaphysical inseparability of matter and form. (shrink)

Moral perceptualism is the view that perceptual experience is attuned to pick up on moral features in our environment, just as it is attuned to pick up on mundane features of an environment like textures, shapes, colors, pitches, and timbres. One important family of views that incorporate moral perception are those of virtue theorists and sensibility theorists. On these views, one central ability of the virtuous agent is her sensitivity to morally relevant features of situations, where this sensitivity is often (...) spoken of in perceptual terms. However, sensibility theorists have often not been careful to specify how to understand their claims about moral sensibilities as perceptual. In this paper, we distinguish between what we call Attentional Moral Perception and Contentful Moral Perception. We argue that sensibility theorists should endorse Attentional Moral Perception, because it has very powerful empirical evidence in its favor, and it can play all of the explanatory roles that the sensibility theorist needs in her theory of moral sensibilities. (shrink)

As a philosopher of action, I might be expected to believe that the will is a good thing. Actually, I believe that the will is a great thing - awesome, in fact. But I'm not thereby committed to its being something good. When I say that the will is awesome, I mean literally that it is a proper object of awe, a response that restrains us from abusing the will and moves us rather to use it respectfully, in a way (...) that does it justice. To say that the will is a good thing, however, would imply that having a will is better than not having one, or that using it is better than not using it - neither of which I am prepared to assert as a general rule. Speaking metaphorically, I would say that the will is like a magic wand. In fairy tales, the character who looks upon a magic wand as an unalloyed good is destined to be sadder but wiser in the end. Being a magician isn't better than being an ordinary human, just different; and a magician must value his powers by respecting them and therefore using them appropriately, even sparingly, not by using them as much as possible. (shrink)

A -/- abortion and infanticide/ academic freedom/ academics/ action/ act-omission doctrine/ addiction and dependence/ adoption/ advertising/ affirmative action/ age of consent/ age of criminal responsibility/ age of majority/ agent/ aggression/ agriculture/ aid, foreign/ AIDS/ air/ akrasia/ allies/ altruism/ American Civil War (1861-1865)/ American exceptionalism/ American War of Independence (1775–1783)/ anarchic social order/ anarcho-capitalism/ anarchy/ animal rights/ animal welfare/ apartheid/ apathy/ appeasement/ apriorism/ aristocracy/ arms trade/ arms race/ artificial intelligence/ arts and sciences/ assassination/ asset stripping/ asylum seekers/ atomism, social/ Austrian School (...) of economics/ authoritarianism/ authority/ autonomy, intellectual/ axis/ -/- B -/- balance of trade/ balance of power (international)/ banking/ bankruptcy, insolvency, and limited liability/ barriers to entry/ begging/ belief/ betting/ big business/ bigotry/ biodiversity/ bioethics/ black market/ blackmail/ blasphemy/ booms and slumps/ borders, political/ boxing and dangerous sports/ boycott/ bribery/ British Broadcasting Corporation (BBC)/ BSE (Bovine Spongiform Encephalopathy)/ bureaucracy/ business cycles/ . (shrink)

J. L. Mackie distinguished himself in twentieth-century philosophy by presenting an important objection to the traditional free will explanation for why God would allow evil: If evil is due to the free choice of creatures, why wouldn’t an omnipotent God simply create free creatures who would choose better? Alvin Plantinga, in turn, distinguished himself with his critique of Mackie. Plantinga’s main point is that Mackie made a mistake in assuming that it is within the power of omnipotence fully to (...) create just any possible world. However, Mackie made a second questionable assumption which Plantinga does not critique, and which I aim to clarify in this article. Mackie assumes that a God, as construed by classical theistic belief, who could create either of two people—one of whom would freely choose right and the other of whom would freely choose wrong—must create the one who would freely choose right. This assumption motivates Plantinga’s own account of trans-world depravity, which suggests that every free creature God might have created would have sinned had God created them. I consider Plantinga’s suggestion highly improbable. More importantly, under Mackie’s assumption, if there is at least one possible creature who would choose rightly, then there is no possibility of God ever allowing any other creature to sin, which would seem to be incompatible with their having any free will. -/- This version of the paper does have the same pagination as the published version. Permission has been granted from the Editor of Philosophia Christi to upload this contribution according to Philosophy Documentation Center terms of use. Learn more about the Journal by going to wwwepsociety. org/philchristi. (shrink)

Neurovascular coupling (NVC), the transient regional hyperemia following the evoked neuronal responses, is the basis of blood oxygenation level-dependent techniques and is generally adopted across physiological conditions, including the intrinsic resting state. However, the possibility of neurovascular dissociations across physiological alterations is indicated in the literature. To examine the NVC stability across sleep–wake states, we used electroencephalography (EEG) as the index of neural activity and functional magnetic resonance imaging (fMRI) as the measure of cerebrovascular response. Eight healthy adults were recruited (...) for simultaneous EEG-fMRI recordings in nocturnal sleep. We compared the cross-modality (EEG vs. fMRI) consistency of functional indices (spectral amplitude and functional connectivity) among five states of wakefulness and sleep (state effect). We also segregated the brain into three main partitions (anterior, middle and posterior) for spatial assessments (regional effect). Significant state effects were found on δ, α and fMRI indices and regional effects on the α and fMRI indices. However, the cross-state EEG changes in spectral amplitude and functional connectivity did not consistently match the changes in the fMRI indices across sleep–wake states. In spectral amplitude, the δ band peaked at the N3 stage for all brain regions, while the fMRI fluctuation amplitude peaked at the N2 stage in the central and posterior regions. In regional connectivity, the inter-hemispheric connectivity of the δ band peaked at the N3 stage for all regions, but the bilateral fMRI connectivity showed the state changes in the anterior and central regions. The cross-modality inconsistencies across sleep–wake states provided preliminary evidence that the neurovascular relationship may not change in a linear consistency during NREM sleep. Thus, caution shall be exercised when applying the NVC presumption to investigating sleep/wake transitions, even among healthy young adults. (shrink)

Until recently, philosophers debating the rationality of time-biases have supposed that people exhibit a first-person hedonic bias toward the future, but that their non-hedonic and third-person preferences are time-neutral. Recent empirical work, however, suggests that our preferences are more nuanced. First, there is evidence that our third-person preferences exhibit time-neutrality only when the individual with respect to whom we have preferences—the preference target—is a random stranger about whom we know nothing; given access to some information about the preference target, third-person (...) preferences mirror first-person preferences. As a result, the simulation hypothesis has been proposed, according to which third-person preferences will mirror first-person preferences when we can simulate the mental states of the preference target. Second, there is evidence that we prefer negative hedonic events to be in our past (we are first-person negatively hedonically future-biased) only when we view future events as fixed and in no way under our control. By contrast, when we perceive it to be within our power to mitigate the badness of future events, we are first-person negatively hedonically past-biased. This is the mitigation hypothesis. We distinguish two versions of the mitigation hypothesis, the squirrelling version and the heuristic version. We ran a study which tested the simulation hypothesis, and which aimed to determine whether the squirrelling or the heuristic version of the mitigation hypothesis enjoys more empirical support. We found support for the heuristic version of the hypothesis, but no support for the squirrelling version. (shrink)

In this paper I argue for an association between impurity and explanatory power in contemporary mathematics. This proposal is defended against the ancient and influential idea that purity and explanation go hand-in-hand (Aristotle, Bolzano) and recent suggestions that purity/impurity ascriptions and explanatory power are more or less distinct (Section 1). This is done by analyzing a central and deep result of additive number theory, Szemerédi’s theorem, and various of its proofs (Section 2). In particular, I focus upon the (...) radically impure (ergodic) proof due to Furstenberg (Section 3). Furstenberg’s ergodic proof is striking because it utilizes intuitively foreign and infinitary resources to prove a finitary combinatorial result and does so in a perspicuous fashion. I claim that Furstenberg’s proof is explanatory in light of its clear expression of a crucial structural result, which provides the “reason why” Szemerédi’s theorem is true. This is, however, rather surprising: how can such intuitively different conceptual resources “get a grip on” the theorem to be proved? I account for this phenomenon by articulating a new construal of the content of a mathematical statement, which I call structural content (Section 4). I argue that the availability of structural content saves intuitive epistemic distinctions made in mathematical practice and simultaneously explicates the intervention of surprising and explanatorily rich conceptual resources. Structural content also disarms general arguments for thinking that impurity and explanatory power might come apart. Finally, I sketch a proposal that, once structural content is in hand, impure resources lead to explanatory proofs via suitably understood varieties of simplification and unification (Section 5). (shrink)

The harmonious free play of the imagination and understanding is at the heart of Kant’s account of beauty in the Critique of the Power of Judgement, but interpreters have long struggled to determine what Kant means when he claims the faculties are in a state of free play. In this article, I develop an interpretation of the free play of the faculties in terms of the freedom of attention. By appealing to the different way that we attend to objects (...) in aesthetic experience, we can explain how the faculties are free, even when the subject already possesses a concept of the object and is bound to the determinate form of the object in perception. (shrink)

In this paper, I examine the role of attention in Kant’s aesthetic theory in the Critique of the Power of Judgment. While broadly Kantian aestheticians have defended the claim that there is a distinct way that we attend to objects in aesthetic experience, Kant himself is not usually acknowledged as offering an account of aesthetic attention. On the basis of Kant’s more general account of attention in other texts and his remarks on attention in the Critique of the (...) class='Hi'>Power of Judgment, I reconstruct Kant’s account of aesthetic attention. On this account, aesthetic attention is simultaneously directed at the form of an object and at the judging subject’s own mental states as she attends to the object. In the experience of beauty, we specifically attend to the harmonious relation between the faculties of imagination and understanding. (shrink)

Intersectionality has utilized various feminist theories that continue subculture of violence thinking about Black men and boys. While intersectional feminists often claim that intersectionality leads to a clearer social analysis of power and hierarchies throughout society and within groups, the categories and claims of intersectionality fail to distinguish themselves from previously racist theories that sought to explain race, class, and gender, based on subcultural values. This article is the first to interrogate the theories used to construct the gendered categories (...) and the assumptions behind Black male positionality under intersectional analyses. Contrary to its promises for more liberated Black identities, intersectionality merely replicates the pseudo-science of racist criminology and presents decades old theories as cutting-edge gender analyses. In short, while intersectionality has allowed Black women to create nuanced experiences and epistemological accounts of Black womanhood, the very same theory has confined Black male experience to the perpetration of violence and defined Black manhood as lesser—merely the exemplification of white masculinity’s pathological excess. (shrink)

Under the traditional system of peer-reviewed publication, the degree of prestige conferred to authors by successful publication is tied to the degree of the intellectual rigor of its peer review process: ambitious scientists do well professionally by doing well epistemically. As a result, we should expect journal editors, in their dual role as epistemic evaluators and prestige-allocators, to have the power to motivate improved author behavior through the tightening of publication requirements. Contrary to this expectation, I will argue that (...) the publication bias literature in academic medicine demonstrates that editor interventions have had limited effectiveness in improving the health of the publication and trial registration record, suggesting that much stronger interventions are needed. (shrink)

According to the character condition, a person is morally responsible for an action A only if a character trait of hers non-accidentally motivates her performing A. But that condition is untenable according to the out of character objection because people can be morally responsible for acting out of character. We reassess this common objection. Of the seven accounts of acting out of character that we outline, only one is even a prima facie counterexample to the character condition. And it is (...) not obvious that people act out of character in that sense. We argue that whether the out of character objection succeeds ultimately depends on the unnoticed methodological commitment that cases that may not resemble human life provide good data for theorizing about moral responsibility. But even if such cases provide good data, the forcefulness of the objection is at least deflated given that its persuasive power is supposed to come from clear real-life cases. (shrink)

Commonsense reasoning about the physical world, as exemplified by "Iron sinks in water" or "If a ball is dropped it gains speed," will be indispensable in future programs. We argue that to make such predictions (namely, envisioning), programs should use abstract entities (such as the gravitational field), principles (such as the principle of superposition), and laws (such as the conservation of energy) of physics for representation and reasoning. These arguments are in accord with a recent study in physics instruction where (...) expert problem solving is related to the construction of physical representations that contain fictitious, imagined entities such as forces and momenta (Larkin 1983). We give several examples showing the power of physical representations. (shrink)

The Zwolinski 2013 "libertarianism and liberty" essays on libertarianism_org are argued to have the following problems: taking libertarianism to be a "commitment" to the view that "liberty is the highest political value" ; examining and rejecting the maximization of liberty without a libertarian theory of liberty; accepting a persuasive sense of "coercion" ; misunderstandingliberty in the work place; conflating, to varying degrees, freedom of action and freedom from aggression and justice/rights/morals; focusing on logically possible clashes instead of practically possible congruence (...) among utility, liberty, and justice – in particular, that "rule (preference-)utilitarianism" fits "rule libertarianism" ; failing to distinguish liberty from license (and power) concerning slavery, and so-called "civil and democratic liberties" (and everything else); the idea that any coherent reference to a quantity of liberty requires precise cardinality; failing to see that the quantity of liberty has an inherently qualitative aspect; misunderstanding property as about limiting freedom; mistaking clashing Hobbesian freedom for non-clashing Lockean liberty; adopting G. A. Cohen's confusion about freedom as the libertarian conception of freedom; assuming the – illogical – epistemology of justification" ; not realizing that both allowing and prohibiting pollution "aggresses" and so "aggressions" need to be minimized; the failure of all six of its reasons for rejecting the non-aggression principle. (shrink)

Cartesian arguments for global skepticism about the external world start from the premise that we cannot know that we are not in a Cartesian scenario such as an evil-demon scenario, and infer that because most of our empirical beliefs are false in such a scenario, these beliefs do not constitute knowledge. Veridicalist responses to global skepticism respond that arguments fail because in Cartesian scenarios, many or most of our empirical beliefs are true. Some veridicalist responses have been motivated using verificationism, (...) externalism, and coherentism. I argue that a more powerful veridicalist response to global skepticism can be motivated by structuralism, on which physical entities are understood as those that play a certain structural role. I develop the structuralist response and address objections. (shrink)

ABSTRACT Lewtas [2017] recently articulated an argument claiming that emergent conscious causal powers are impossible. In developing his argument, Lewtas makes several assumptions about emergence, phenomenal consciousness, categorical properties, and causation. We argue that there are plausible alternatives to these assumptions. Thus, the proponent of emergent conscious causal powers can escape Lewtas’s challenge.

An explorative contribution to the ongoing discussion of thought experiments. While endorsing the majority view that skepticism about thought experiments is not well justified, in what follows we attempt to show that there is a kind of “bodiliness” missing from current accounts of thought experiments. That is, we suggest a phenomenological addition to the literature. First, we contextualize our claim that the importance of the body in thought experiments has been widely underestimated. Then we discuss David Gooding's work, which contains (...) the only explicit recognition of the importance of the body to understanding thought experiments. Finally, we introduce a phenomenological perspective of the body, which will give us the opportunity to sketch the power and promise of a phenomenological approach to thought experiments. (shrink)

The evidence-based medicine (EBM) movement is touted as a new paradigm in medical education and practice, a description that carries with it an enthusiasm for science that has not been seen since logical positivism flourished (circa 1920–1950). At the same time, the term ‘‘evidence-based medicine’’ has a ring of obviousness to it, as few physicians, one suspects, would claim that they do not attempt to base their clinical decision-making on available evidence. However, the apparent obviousness of EBM can and should (...) be challenged on the grounds of how ‘evidence’ has been problematised in the philosophy of science. EBM enthusiasm, it follows, ought to be tempered. The post-positivist, feminist, and phenomenological philosophies of science that are examined in this paper contest the seemingly unproblematic nature of evidence that underlies EBM by emphasizing different features of the social nature of science. The appeal to the authority of evidence that characterizes evidence-based practices does not increase objectivity but rather obscures the subjective elements that inescapably enter all forms of human inquiry. The seeming common sense of EBM only occurs because of its assumed removal from the social context of medical practice. In the current age where the institutional power of medicine is suspect, a model that represents biomedicine as politically disinterested or merely scientific should give pause. (shrink)

The famous Cartesian Nicolas Malebranche (1638-1715) espoused the occasionalist doctrine that ‘there is only one true cause because there is only one true God; that the nature or power of each thing is nothing but the will of God; that all natural causes are not true causes but only occasional causes’ (LO, 448, original italics). One of Malebranche’s well-known arguments for occasionalism, known as, the ‘no necessary connection’ argument (or, NNC ) stems from the principle that ‘a true cause… (...) is one such that the mind perceives a necessary connection between it and its effect’ (LO, 450). The outline of this paper is as follows. I explicitly layout NNC and articulate some of its prima facie strengths (§1). I then critically discuss, what I take to be, the two main arguments against NNC of the Lee-Pyle interpretation (§2). The main conclusion from (§2) is that Malebranche did not abandon NNC in his later works given textual evidence from the Dialogues, contrary to the Lee-Pyle interpretation. In (§3) I discuss in what ways Suárez, Leibniz, Régis and Spinoza all accepted the main premise of NNC. Then, I rebut Steven Nadler’s influential and unchallenged criticism that Malebranche conflated causal and logical necessity, and provide a more accurate interpretation of Malebranche that only commits him to a partial reduction of causal to logical necessity (§4). (shrink)

Online shaming is a subject of import for social philosophy in the Internet age, and not simply because shaming seems generally bad. I argue that social philosophers are well-placed to address the imaginal relationships we entertain when we engage in social media; activity in cyberspace results in more relationships than one previously had, entailing new and more responsibilities, and our relational behaviors admit of ethical assessment. I consider the stresses of social media, including the indefinite expansion of our relationships and (...) responsibilities, and the gap between the experiences of those shamed and the shamers’ appreciation of the magnitude of what they do when they shame; I connect these to the literature suggesting that some intuitions fail to guide our ethics. I conclude that we each have more power than we believe we do or than we think carefully about exerting in our online imaginal relations. Whether we are the shamers or the shamed, we are unable to control the extent to which intangible words in cyberspace take the form of imaginal relationships that burden or brighten our self-perceptions. (shrink)

As the quality movement in health care now enters its fourth decade, the language of quality is ubiquitous. Practitioners, organizations, and government agencies alike vociferously testify their commitments to quality and accept numerous forms of governance aimed at improving quality of care. Remarkably, the powerful phrase ‘‘quality of care’’ is rarely defined in the health care literature. Instead it operates as an accepted and assumed goal worth pursuing. The status of evidence-based medicine, for instance, hinges on its ability to improve (...) quality of care, and efforts are made by both proponents and detractors to unpack the contents and outcomes of evidence-based practice while the contents of ‘‘quality of care’’ are presumed to be understood. Because the goals of medicine are far from obvious, this paper investigates the neglected term, ‘‘quality of care,’’ in an effort to understand what it is that health care practices are so uncritically assumed to be striving for. Finding lack of consensus on the terminology in the quality literature, I propose that the term operates rhetorically by way of persuasive appeal (and lack of descriptive meaning). Unsatisfied that ‘‘quality of care’’ operates as a mere buzzword in morally contentious debates over resource allocation and duties of care, I implore health care communities to go beyond mere commitments to quality and, instead, to focus attention on the difficult task of specifying what counts as quality care within an economically constrained health care system. (shrink)

We live in an age of evidence-based healthcare, where the concept of evidence has been avidly and often uncritically embraced as a symbol of legitimacy, truth, and justice. By letting the evidence dictate healthcare decision making from the bedside to the policy level, the normative claims that inform decision making appear to be negotiated fairly—without subjectivity, prejudice, or bias. Thus, the term ‘‘evidence-based’’ is typically read in the health sciences as the empirically adequate standard of reasonable practice and a means (...) for increasing certainty. Supporters believe that evidence-based medicine (EBM) can introduce rational order to the deliberative processes of healthcare decision making. It is perhaps puzzling, then, to come across critical perspectives (typically arising from the humanities and the more theory-driven social sciences) raising concerns about a seeming technogovernance being introduced by this deferral to the evidence where power interests can be obfuscated by way of technical resolve. The critics holding this minority view argue that technological solutions to problems of knowledge and practice cannot replace medicine’s normative content. Against EBM’s democratic leanings toward transparency and accountability, medical criteria alone cannot decide valueladen ethically charged decisions. This paper attempts to explain and evaluate this important debate in the philosophy of medicine, focusing specifically on the dispute over 'evidence-based women's health'. (shrink)

In this paper I examine the ethics of benefit-sharing agreements between victims and beneficiaries of injustice in the context of trans-national bodily giving, selling, and sharing. Some obligations are the same no matter who the parties to a transaction are. Prohibitions on threats, fraud and harm apply universally and their application to transactions in unjust contexts is not disputed. I identify three sources of obligations that are affected by unjust background conditions. First, power disparities may illegitimately influence transactions in (...) unintentional ways. Second, better-off individuals have duties to ameliorate injustices. These are not specifically duties to those with whom they interact, though often it is easier and more effective to help those with whom one already interacts. Third, the power differentials created by injustice make exploitative transactions more likely. I summarize a transactional account of exploitation and argue that avoiding exploitation is usually easiest to achieve by ensuring that the more powerful party does not obtain an unfair share of the benefits from the transaction. The beneficiaries of a transaction do not have to be only those individuals directly involved in it. Indeed, in many cases it is thought that exploitation may be avoided by providing benefits to third parties. Working out when this is the case requires working out when a contribution or burden on another’s behalf can count towards the avoidance of exploitation. I argue that it counts as such in two main cases: when the people in question are already involved in relationships of reciprocation, and when the individual making the contribution identifies with the interests of the other people. (shrink)

The Council of Europe’s 2008 White Paper on Intercultural Dialogue: ‘living together as equals in dignity’ points to the need for shared values upon which intercultural dialogue might rest. In order, however, to overcome the monologic separateness that threatens community, we must educate ourselves to recognize the dialogism of our humanity and to engage in deep encounters with others with a mature skepticism of all dogmatisms, including our own. In order to aid us in reaching the necessary insight, the author (...) calls upon Bakhtin’s ideas of the dialogism of every utterance and of the unity and heteroglossia of language, Gadamer’s hermeneutical experience that shakes us loose from what we think we know, and Levinas’s description of that transcendent ideal of a dialogue beyond reciprocity. These perspectives break open our certainty that tribalism and individualism are fundamental, placing them instead as secondary phenomena that, though powerful, pronounce neither the initial nor the final word on our life together. (shrink)

To improve oneself and grow professionally, career development has been found to be crucial, as it serves as a roadmap for the professional growth of employees. However, a barrier, known as the glass ceiling, hinders the progress of employees, especially those in the LGBTQIA+ community. This study explores the impact of the glass ceiling on the career development of selected LGBTQIA+ individuals, shedding light on the barriers faced by this community in the workplace. The researchers used a qualitative multiple-case study (...) and selected ten (10) LGBTQIA+ participants from large enterprises via the judgmental sampling technique. Through thematic analysis, psychological impact, workplace discomfort, lack of recognition, and career progress challenges emerged as the impacts of the glass ceiling on the participants. Strategies for overcoming glass ceiling barriers, such as resilience, self-reflection, and community support, are identified. Thus, the study found that glass ceilings are really evident in the context of businesses. With this, the proposed advocacy plan in the study suggests interventions like workplace inclusion training, mentorship networks, and seminars on employee rights. Furthermore, it emphasizes the call for ongoing research and advocacy efforts to dismantle barriers and cultivate workplaces that not only embrace diversity but also provide equitable opportunities for career growth. (shrink)

For children, the collateral damage of the COVID-19 pandemic response has been considerable. In this paper, we use the framework of evidence-based medicine to argue that child abuse is another negative side effect of COVID-19 lockdowns. While it was certain that school closures would have profound social and economic costs, it remains uncertain whether they have any effect on COVID-19 transmission. There is emerging evidence that lockdowns significantly worsened child abuse on a global scale. Low-income and middle-income countries are particularly (...) vulnerable to increases in child abuse. The best available external evidence from systematic research during the pandemic demonstrates an increase in the risk of child maltreatment, an increase in child maltreatment hospitalisations and a concerning decrease in official child maltreatment referrals. The paradoxical phenomenon of increased hospitalisations and decreased reports is unlikely to be explained by a genuine decrease in child abuse. We conclude that lockdowns have an unacceptably high risk of negative side effects for children, as evidenced by child abuse, the true extent of which appears to be masked by lockdown-related disruptions to schools and other surveillance systems. The desire for a sense of security may be a tempting bias towards emphasising the resilience of children, but it is ethically problematic to push children towards abuse in the name of public health. It is our view that the collateral damage of prolonged school closures for society’s most vulnerable members is a powerful ethical consideration against any pandemic response which involves their use. (shrink)

In the time of Coronavirus, it is perhaps as good a time as any to comment on the use and abuse of metaphors. One of the worst instances of metaphor abuse-especially given the recent epidemiological crisis-is Lynne Tirrell's notion of toxic speech. In the foregoing reply piece, I analyze Tirrell's metaphor and reveal how it blinds us to the liberating power of public speech. Lynne Tirrell argues that some speech is, borrowing from field of Epidemiology, toxic in the sense (...) that it harms vulnerable listeners. In this response piece, I summarize the main points of Tirrell's toxic speech argument, map the underlying conceptual metaphor and pose three objections. (shrink)

Increasing life expectancy may explain why more elderly candidates appear to be running for office. This raises general questions regarding the specific risks of old age and frailty in demanding political positions. Therefore, I tried to give important contemporary examples of elderly leaders, study the mean age of leading political figures over the last 3 decades and present historical examples of heads of state with age-associated brain diseases and cognitive deficits. I reviewed the literature on mental illness and politics and (...) analyzed the ages of international political leaders in 1990, 2000, 2010 and 2020. Summary: There are several impressive contemporary examples of elderly politicians. The mean age of political leaders has not increased significantly in most parts of the world over the last 3 decades with the exception of the Gulf States and sub-Saharan Africa. Health problems of heads of state in earlier centuries had not been primarily age associated. After 1900, dementia but also mild cognitive and mild behavioral impairment became important issues in politically critical situations, for example international peace negotiations, the rise of Nazi Germany, the breakup of communism, the Arab Spring and others. This paper collects anecdotal evidence of cognitive frailty in ageing politicians; it is not an in-depth analysis of political history. Observations confirm that a very long time in power may obviously increase the risk of age-associated problems; dynamic revolutionary or entrepreneurial idols may be misled to rely on their irreplaceable charisma for too long. However, caution must be exercised against ageism on one side versus silent acquiescence towards leaders with failing mental powers on the other, who may become victims of obscure parties and their decompensating personality disorders. Current news nurture the impression that large and important states are governed by elderly people, and oc- casional reports indicate that there is a number of lesser known countries ruled by rather seasoned leaders. (shrink)

[1] From December 1994 to August 1996, Russia was engaged in the Chechen War, a Vietnam-style quagmire that exemplified, on the one hand, the end of Russia as a great military and imperial power, and, on the other hand, "one of the greatest epics of colonial resistance in the past century.'' No analysis can hope to understand the totality of forces that lend to the stability (or instability) of nations with large minority populations unless it first examines the conditions (...) that led to the Russian defeat in Chechnya. At the center of that problem lies an interesting issue. What aspects of the Russian state, Russian society, and the Russian psyche in the 1990s played a part in the Russian defeat, and what aspects of Chechen history, society, and culture played a part in the Chechen victory? Lieven uses the Chechen War as a keyhole into the wider debate concerning the nature and course of Russian nationalism. (shrink)

Extremism is a perennial problem in our civilisation. It has constantly impeded our progress by leading to unnecessary wars, conflicts, enmity and hatred. Understanding the middle way between these two extremes helps us to clarify what extremism is and how it arises. Such an understanding can be made part of the education system so that children are taught from an early age to detect extremist tendencies in their own thinking and to control them for their own good and the good (...) of society. This paper extends the views expressed in my book, The Promise of Dualism (Almostic Publications) and other papers on the subject of extremism. It is focused on the following table which shows how the middle way stands between the extremes of too much power and too much belief. After the introduction, the rest of this paper explicates this table’s contents in considerable detail – line by line and word by word – in explanatory notes. (shrink)

Heralded as the “Father of the Constitution,” James Madison was, besides one of the most influential architects of the U.S. Constitution, a man of letters, a politician, a scientist and a diplomat who left an enduring legacy for American philosophical thought. As a tireless advocate for the ratification of the Constitution, Madison advanced his most groundbreaking ideas in his jointly authoring The Federalist Papers with John Jay and Andrew Hamilton. Indeed, two of his most enduring ideas—the large republic thesis and (...) the argument for government separation-of-powers/checks-and-balances—are contained in there. In his life’s work, Madison fused together the three dominant philosophies in post-revolutionary, antebellum America: Lockean liberalism, classical republicanism and Christian Protestantism. (shrink)

Dispositional properties are often referred to as ‘causal powers’, but what does dispositional causation amount to? Any viable theory must account for two fundamental aspects of the metaphysics of causation – the causal complexity and context sensitivity of causal interactions. The theory of mutual manifestations attempts to do so by locating the complexity and context sensitivity within the nature of dispositions themselves. But is this theory an acceptable first step towards a viable theory of dispositional causation? This paper argues that (...) the reconceptualization that the theory entails comes at too high a price, and is an unnecessary step in the wrong direction: these two central aspects concerning the metaphysics of causation can and should be accounted for in a dispositional account of causation without it. (shrink)

In THE GENEALOGY OF MORALITY Nietzsche assess the value of the value judgments of morality from the perspective of human flourishing. His positive descriptions of the “higher men” he hopes for and the negative descriptions of the decadent humans he thinks morality unfortunately supports both point to a particular substantive conception of what such flourishing comes to. The Genealogy, however, presents us with a puzzle: why does Nietzsche’s own evaluative standard not receive a genealogical critique? The answer to this puzzle, (...) I argue, lies in recognizing the centrality of the notion of “life”, and its connection to power, in Nietzsche’s overall account. Leiter has argued that his “Millian Model” provides the most charitable reconstruction of appeals to a privileged evaluative standard of power; this model ascribes an inference from a strong doctrine of the will to power according to which only power can be desired. I propose a “Benthamite Model” that ascribes an inference from the inescapability of a tendency towards power, a tendency that is essential to life. I argue that this model avoids the objections Leiter directs at the Millian Model. (shrink)

The dispute between realists about color and anti-realists is actually a dispute about the nature of color properties. The disputants do not disagree over what material objects are like. Rather, they disagree over whether any of the uncontroversial facts about material objects--their powers to cause visual experiences, their dispositions to reflect incident light, their atomic makeup, and so on--amount to their having colors. The disagreement is thus about which properties colors are and, in particular, whether colors are any of the (...) properties in a particular set that is acknowledged on both sides to exhaust the properties of material objects. In a previous paper we discussed at length one attempt to identify colors with particular properties of material objects--namely, with their dispositions to cause visual experiences. Here we shall discuss a different and perhaps more influential version of realism, which says that the colors of material objects are microphysical properties of their surfaces. We shall call this theory physicalism about color (physicalism, for short). In order to evaluate this theory, however, we shall first have to clarify some methodological issues. Our hope is that we can bring some further clarity to the question of color realism, whether or not we succeed in our critique of the physicalists' answer. (shrink)

Though the realm of biology has long been under the philosophical rule of the mechanistic magisterium, recent years have seen a surprisingly steady rise in the usurping prowess of process ontology. According to its proponents, theoretical advances in the contemporary science of evo-devo have afforded that ontology a particularly powerful claim to the throne: in that increasingly empirically confirmed discipline, emergently autonomous, higher-order entities are the reigning explanantia. If we are to accept the election of evo-devo as our best conceptualisation (...) of the biological realm with metaphysical rigour, must we depose our mechanistic ontology for failing to properly “carve at the joints” of organisms? In this paper, I challenge the legitimacy of that claim: not only can the theoretical benefits offered by a process ontology be had without it, they cannot be sufficiently grounded without the metaphysical underpinning of the very mechanisms which processes purport to replace. The biological realm, I argue, remains one best understood as under the governance of mechanistic principles. (shrink)

In general, epistemic internalists hold that an individual’s justification for a belief is exhausted by her reflectively accessible reasons for thinking that the contents of her beliefs are true. Applying this to the epistemology of testimony, a hearer’s justification for beliefs acquired through testimony is exhausted by her reflectively accessible reasons to think that the contents of the speaker’s testimony is true. A consequence of internalism is that subjects that are alike with respect to their reflectively accessible reasons are alike (...) with respect to what they have justification to believe. Testimony should be thought no different: hearers that are alike with respect to reflectively accessible reasons to think that a speaker’s testimony is true are alike with respect to their justification for beliefs based upon that testimony. But it has been recently argued that this view faces powerful counterexamples. So the central question is this: assuming that a hearer can acquire justification to believe a proposition through the testimony of a speaker, can epistemic internalism provide the resources to explain how such justification is possible? My aim in this paper is to address these counterexamples, and in so doing, defend epistemic internalist accounts of testimony. (shrink)

Clark and Chalmers (1998) defend the hypothesis of an ‘Extended Mind’, maintaining that beliefs and other paradigmatic mental states can be implemented outside the central nervous system or body. Aspects of the problem of ‘language acquisition’ are considered in the light of the extended mind hypothesis. Rather than ‘language’ as typically understood, the object of study is something called ‘utterance-activity’, a term of art intended to refer to the full range of kinetic and prosodic features of the on-line behaviour of (...) interacting humans. It is argued that utterance activity is plausibly regarded as jointly controlled by the embodied activity of interacting people, and that it contributes to the control of their behaviour. By means of specific examples it is suggested that this complex joint control facilitates easier learning of at least some features of language. This in turn suggests a striking form of the extended mind, in which infants’ cognitive powers are augmented by those of the people with whom they interact. (shrink)

In 2005, Charles Mills published “‘Ideal Theory’ as Ideology” in Hypatia: a withering critique of much of contemporary political philosophy and ethics. For Mills such work in philosophy failed to attend to the realities of social life and politics, and in remaining silent on actual issues of domination and oppression served an ideological role in supporting the interests of white bourgeois men. Around the time that Charles Mills launched his broadside against ideal theory, trans theorists had been fighting their own (...) battle against the abstraction of theory from the realities of trans lives and oppression. Vivian Namaste (2000) and Jay Prosser (1998) argued that contemporary gender theory failed to justice to the actuality of trans life, retreating instead to understanding trans life through literary archetypes and idealized radical figures. In this chapter I’ll compare Mills’ critique of ideal theory with the transfeminist critique of 1990s gender theory, arguing that they share much in common. Centrally, both critiques share an underlying commitment to theory needing to be grounded in the actuality of oppression and power relations. This common thread, I suggest, must continue to guide transfeminist thought and action: contra Marquis Bey (2022) transfeminist thought and praxis must continue to be about trans lives, about the oppression of trans women, and about ways of actually achieving liberation from our current dire position. (shrink)