In this commentary, I suggest expanding the deliberative aspects of critical care policy development in two ways. First, critical-care policy development should expand the scope of deliberation by leaving fewer issues up to expertise or private choice. For instance. it should allow deliberation about the relevance of age, disability, social position, and psychological well-being to allocation decisions. Second, it should broaden both the set of costs considered and the set of stakeholders represented in the deliberative process. (...) In particular, it should consider efforts to reduce the cost of end-of-life care and to redirect resources away from the provision of costly interventions, and should expand the set of individuals included in deliberation to include stakeholders outside the health-care system. (shrink)

While agreeing with the main conclusion of Dominic Wilkinson and colleagues (Wilkinson, Butcherine, and Savulescu 2019), namely, that there is no moral difference between treatment withholding and withdrawal as such, we wish to criticize their approach on the basis that it treats the widespread acceptance of withdrawal aversion (WA) as a cognitive bias. Wilkinson and colleagues understand WA as “a nonrational preference for withholding (WH) treatment over withdrawal (WD) of treatment” (22). They treat WA as a manifestation of loss aversion (...) and refer to Kahneman and colleagues (1991), which defined this effect as follows: “the disutility of giving up an object is greater that the utility associated with acquiring it” (194). In a previous work, Wilkinson and Savulescu understood nonequivalence between treatment withholding and withdrawal as a reflection of slightly different, although related, phenomena: status quo bias or omission bias (Wilkinson and Savulescu 2012, 130–131). In neither of these two papers do they describe precisely the relation between these well-known psychological effects and WA, nor do they explain why they treat these effects as examples of nonrational preferences, despite the fact that these issues have been the subject of wide-ranging discussions on the intersection of psychology, economy, and philosophy. (shrink)

The article analyses the necessary conditions an argument for popular punishment would need to meet, and argues that it faces the challenge of a dilemma of reasonableness: either popular views on punishment are unreasonable, in which case they should carry no weight, or they are reasonable, in which case the reasons that support them, not the views, should carry weight. It proceeds to present and critically discuss three potential solutions to the dilemma, arguing that only an argument for the beneficial (...) effects of coherence between popular views and penal policy is persuasive, but that it makes popular punishment less important than proponents claim, and offers a justification proponents will find it difficult to advance. (shrink)

This author’s reply addresses critiques by Daniel Engster, Kelly Gawel, and Andrea Westlund about my 2020 book, Freedom to Care: Liberalism, Dependency Care, and Culture. I begin with a statement of my commitment to liberalism. In section two, I defend the value of a distinction between conceptions of persons in the real world and in contract theory to track inequalities in care when indexed to legitimate needs. I argue, as well, that my variety of contract theory supplies (...) the normative content needed to reject the subordination of women of color. Acknowledging the enduring danger of expressive subordination, I emphasize my theory’s compatibility with the full social inclusion of people with disabilities. Section three then defends liberal dependency care’s compatibility with radical critique and transformative change by emphasizing the abstract nature of its core theoretical module. Finally, in section four, I reaffirm conceptual distinctions between autonomy skills, care skills, and a sense of justice by explicating their theoretical roles. In that section, I also embrace Westlund’s insight that theorists of justice need to have skills enabling responsiveness to other perspectives. To this new requirement for actual theorists of justice, I further add that we must attain capacities to engage critically with our society’s norms. Thus, the final section of this article supplements the justificatory module of liberal dependency care, building from the necessary conditions specified as two-level contract theory toward an account of necessary and sufficient conditions for this liberalism’s justificatory module. (shrink)

Healthcare systems across the globe are struggling with increasing costs and worsening outcomes. This presents those responsible for overseeing healthcare with a challenge. Increasingly, policymakers, politicians, clinical entrepreneurs and computer and data scientists argue that a key part of the solution will be ‘Artificial Intelligence’ (AI) – particularly Machine Learning (ML). This argument stems not from the belief that all healthcare needs will soon be taken care of by “robot doctors.” Instead, it is an argument that rests on the (...) classic counterfactual definition of AI as an umbrella term for a range of techniques that can be used to make machines complete tasks in a way that would be considered intelligent were they to be completed by a human. Automation of this nature could offer great opportunities for the improvement of healthcare services and ultimately patients’ health by significantly improving human clinical capabilities in diagnosis, drug discovery, epidemiology, personalised medicine, and operational efficiency. However, if these AI solutions are to be embedded in clinical practice, then at least three issues need to be considered: the technical possibilities and limitations; the ethical, regulatory and legal framework; and the governance framework. In this article, we report on the results of a systematic analysis designed to provide a clear overview of the second of these elements: the ethical, regulatory and legal framework. We find that ethical issues arise at six levels of abstraction (individual, interpersonal, group, institutional, sectoral, and societal) and can be categorised as epistemic, normative, or overarching. We conclude by stressing how important it is that the ethical challenges raised by implementing AI in healthcare settings are tackled proactively rather than reactively and map the key considerations for policymakers to each of the ethical concerns highlighted. (shrink)

In this paper I analyze a view that is increasingly spreading among philosophers and even physicians. Many of them believe that it is right to apply the principle of responsibility for illness in the allocation of health care. I attempt to show that this idea is unacceptable.

Technological developments involving robotics and artificial intelligence devices are being employed evermore in elderly care and the healthcare sector more generally, raising ethical issues and practical questions warranting closer considerations of what we mean by “care” and, subsequently, how to design such software coherently with the chosen definition. This paper starts by critically examining the existing approaches to the ethical design of care robots provided by Aimee van Wynsberghe, who relies on the work on the ethics of (...) care by Joan Tronto. In doing so, it suggests an alternative to their non-principled approach, an alternative suited to tackling some of the issues raised by Tronto and van Wynsberghe, while allowing for the inclusion of two orientative principles. Our proposal centres on the principles of autonomy and vulnerability, whose joint adoption we deem able to constitute an original revision of a bottom-up approach in care ethics. Conclusively, the ethical framework introduced here integrates more traditional approaches in care ethics in view of enhancing the debate regarding the ethical design of care robots under a new lens. (shrink)

I develop the foundation for cosmopolitan care, an underexplored variety of moral cosmopolitanism. I begin by offering a characterization of contemporary cosmopolitanism from the justice tradition. Rather than discussing the political, economic or cultural aspects of cosmopolitanism, I instead address its moral dimensions. I then employ a feminist philosophical perspective to provide a critical evaluation of the moral foundations of cosmopolitan justice, with an eye toward demonstrating the need for an alternative account of moral cosmopolitanism as cosmopolitan (...) class='Hi'>care. After providing an explanation of how care ethics in connection with Kantian ethics generates a duty to care, I consider one main feature of cosmopolitan care, namely the theory of obligation it endorses. In developing this account, I place special emphasis on the practical ramifications of the theory by using it to analyze gender violence in conflict zones. (shrink)

This is a critical discussion of the accuracy-first approach to epistemic norms. If you think of accuracy (gradational or categorical) as the fundamental epistemic good and think of epistemic goods as things that call for promotion, you might think that we should use broadly consequentialist reasoning to determine which norms govern partial and full belief. After presenting consequentialist arguments for probabilism and the normative Lockean view, I shall argue that the consequentialist framework isn't nearly as promising as it might (...) first appear. (shrink)

This paper attempts to show how Adorno’s thought can illuminate our reflections on the future of work. It does so by situating Adorno’s conception of genuine activity in relation to his negativist critical epistemology and his subtle account of the distinction between true and false needs. What emerges is an understanding of work that can guide our aspirations for the future of work, and one we illustrate via discussions of creative work and care work. These are types of (...) work which cater to persistent human needs, albeit ones that are distorted under present social conditions. Adorno’s thought helps us to understand why this is the case. (shrink)

Migrant women are often stereotyped. Some scholars associate the feminization of migration with domestic work and criticize the “care drain” as a new form of imperialism that the First World imposes on the Third World. However, migrant women employed as domestic workers in Northern America and Europe represent only 2% of migrant women worldwide and cannot be seen as characterizing the “feminization of migration”. Why are migrant domestic workers overestimated? This paper explores two possible sources of bias. The first (...) is sampling: conclusions about “care drain” are often generalized from small samples of domestic workers. The second stems from the affect heuristic: imagining children left behind by migrant mothers provokes strong feelings of injustice which trump other considerations. The paper argues that neither source of bias is unavoidable and finds evidence of gender stereotypes in the “care drain” construal. (shrink)

In this article, we explicate evidence-based nursing (EBN), critically appraise its framework and respond to nurses’ concern that EBN sidelines the caring elements of nursing practice. We use resources from care ethics, especially Vrinda Dalmiya’s work that considers care as crucial for both epistemology and ethics, to show how EBN is compatible with, and indeed can be enhanced by, the caring aspects of nursing practice. We demonstrate that caring can act as a bridge between ‘external’ evidence and the (...) other pillars of the EBN framework: clinical expertise; patient preferences and values. Drawing on an influential EBN handbook, section 1 presents the aims and features of EBN, including the normative principle that EBN should take place within a ‘context of caring’. We aim to understand this context and whether it can be neatly detached from the EBN framework, as the handbook seems to suggest. In section 2, we highlight the grounds for resistance to EBN from the nursing community, before mounting the argument that nursing practices can be understood fruitfully through feminist care ethics and/or virtue ethics lenses. In section 3, we deepen that analysis using Dalmiya’s concepts of care-knowing and care as a hybrid ethico-epistemic virtue, which are ideally suited to the complex practices of nursing. In section 4, we bring this rich understanding of care into conversation with EBN, showing that its framework cannot be adequately theorised without paying proper attention to care. Caring can be neither an innocuous background assumption of nor an afterthought to the EBN framework. (shrink)

Chenyang Li argues, in an article originally published in Hypatia, that the ethics of care and Confucian ethics constitute similar approaches to ethics. The present paper takes issue with this claim. It is more accurate to view Confucian ethics as a kind of virtue ethics, rather than as a kind of care ethics. In the process of criticizing Li's claim, the distinctiveness of care ethics is defended, against attempts to assimilate it to virtue ethics.

This essay critically examines a suggestion proposed by some Confucianists that Confucianism and Care Ethics share striking similarities and that feminism in Confucian societies might take “a new form of Confucianism.” Aspects of Confucianism and Care Ethics that allegedly converge are examined, including the emphasis on human relationships, and it is argued that while these two perspectives share certain surface similarities, moral injunctions entailed by their respective ideals of ren and caring are not merely distinctive but in fact (...) incompatible. (shrink)

This paper argues that societal duties of health promotion are underwritten (at least in large part) by a principle of beneficence. Further, this principle generates duties of justice that correlate with rights, not merely “imperfect” duties of charity or generosity. To support this argument, I draw on a useful distinction from bioethics and on a somewhat neglected approach to social obligation from political philosophy. The distinction is that between general and specific beneficence; and the approach from political philosophy has at (...) times been called equality of concern. After clarifying the distinction and setting out the basis of the equality of concern view, I argue that the result is a justice-based principle of “specific” beneficence that should be reflected in a society’s health policy. I then draw on this account to criticize, refine, and extend some prominent health care policy proposals from the bioethics literature. (shrink)

Breast cancer treatment is being transformed by artificial intelligence (AI). Nevertheless, most scientists, engineers, and physicians aren't ready to contribute to the healthcare AI revolution. In this paper, we discuss our experiences teaching a new American student undergraduate course that seeks to train the next generation for cross-cultural design thinking, which we believe is critical for AI to realize its full potential in breast cancer treatment. The main tasks of this course are preparing, performing and translating interviews with healthcare (...) professionals from both Portugal and the USA. Since the course is offered in Portugal as a short-term faculty-led study abroad program, students can explore the effect of culture on healthcare delivery and the design of healthcare technologies. The learning tests demonstrated student growth for breast cancer treatment in many areas important for the development of AI. In respect to understanding breast cancer care, most students had undervalued the effect of cancer and its treatment on the quality of life of women before taking this course and most were unaware of the importance of multidisciplinary care teams. Regarding AI in medical, students became more mindful of data privacy issues and the need to consider the effect of AI on healthcare professionals. (shrink)

This book introduces readers to the many arguments and controversies concerning abortion. While it argues for ethical and legal positions on the issues, it focuses on how to think about the issues, not just what to think about them. It is an ideal resource to improve your understanding of what people think, why they think that and whether their (and your) arguments are good or bad, and why. It's ideal for classroom use, discussion groups, organizational learning, and personal reading. -/- (...) From the Preface -/- To many people, abortion is an issue for which discussions and debates are frustrating and fruitless: it seems like no progress will ever be made towards any understanding, much less resolution or even compromise. -/- Judgments like these, however, are premature because some basic techniques from critical thinking, such as carefully defining words and testing definitions, stating the full structure of arguments so each step of the reasoning can be examined, and comparing the strengths and weaknesses of different explanations can help us make progress towards these goals. -/- When emotions run high, we sometimes need to step back and use a passion for calm, cool, critical thinking. This helps us better understand the positions and arguments of people who see things differently from us, as well as our own positions and arguments. And we can use critical thinking skills help to try to figure out which positions are best, in terms of being supported by good arguments: after all, we might have much to learn from other people, sometimes that our own views should change, for the better. -/- Here we use basic critical thinking skills to argue that abortion is typically not morally wrong. We begin with less morally-controversial claims: adults, children and babies are wrong to kill and wrong to kill, fundamentally, because they, we, are conscious, aware and have feelings. We argue that since early fetuses entirely lack these characteristics, they are not inherently wrong to kill and so most abortions are not morally wrong, since most abortions are done early in pregnancy, before consciousness and feeling develop in the fetus. -/- Furthermore, since the right to life is not the right to someone else’s body, fetuses might not have the right to the pregnant woman’s body—which she has the right to—and so she has the right to not allow the fetus use of her body. This further justifies abortion, at least, until technology allows for the removal of fetuses to other wombs. Since morally permissible actions should be legal, abortions should be legal: it is an injustice to criminalizing actions that are not wrong. -/- In the course of arguing for these claims, we: 1. discuss how to best define abortion; 2. dismiss many common “question-begging” arguments that merely assume their conclusions, instead of giving genuine reasons for them; 3. refute some often-heard “everyday arguments” about abortion, on all sides; explain why the most influential philosophical arguments against abortion are unsuccessful; 4. provide some positive arguments that at least early abortions are not wrong; 5. briefly discuss the ethics and legality of later abortions, and more. -/- This essay is not a “how to win an argument” piece or a tract or any kind of apologetics. It is not designed to help anyone “win” debates: everybody “wins” on this issue when we calmly and respectfully engage arguments with care, charity, honesty and humility. This book is merely a reasoned, systematic introduction to the issues that we hope models these skills and virtues. Its discussion should not be taken as absolute “proof” of anything: much more needs to be understood and carefully discussed—always. (shrink)

The metaphor of “care drain” has been created as a womanly parallel to the “brain drain” idea. Just as “brain drain” suggests that the skilled migrants are an economic loss for the sending country, “care drain” describes the migrant women hired as care workers as a loss of care for their children left behind. This paper criticizes the construction of migrant women as “care drain” for three reasons: 1) it is built on sexist stereotypes, 2) (...) it misrepresents and devalues care work, and 3) it misses the opportunity for a theoretical change about how skills in migration contexts can be understood. (shrink)

Death can be bad for an individual who has died, according to the “deprivation approach,” by depriving that individual of goods. One worry for this account of death’s badness is the Lucretian symmetry argument: since we do not regret having been born later than we could have been born, and since posthumous nonexistence is the mirror image of prenatal nonexistence, we should not regret dying earlier than we could have died. Anthony Brueckner and John Martin Fischer have developed a response (...) to the Lucretian challenge by arguing that it is rational to have asymmetric attitudes toward posthumous and prenatal nonexistence. Recently, Jens Johansson has criticized the Brueckner/Fischer position, claiming that it is irrelevant whether it is actually rational to care about future pleasures but not past pleasures. What matters, according to Johansson, is whether it would be rational for us to care about past pleasures had we come into existence earlier. In this paper, I add to the conversation between Johansson and Brueckner/Fischer by suggesting a way to defend the latter side’s position in a way that has not yet been suggested. I do this by considering a suggestion of Johansson’s for interpreting the Brueckner/Fischer position and by arguing that Johansson’s worry for the position I consider is actually incoherent. (shrink)

In her latest book, The End of Progress, Amy Allen embarks on an ambitious and much-needed project: to decolonize contemporary Frankfurt School Critical Theory. As with all of her books, this is an exceptionally well-written and well-argued book. Allen strives to avoid making assertions without backing them up via close and careful textual reading of the thinkers she engages in her book. In this article, I will state why this book makes a central contribution to contemporary critical theory (...) (in the broader sense), after which I pose a few questions. These questions are not meant to prove that there are any serious problems with her argumentation. Instead, they are meant in the spirit of dialogue and allow her to elaborate her work for her audience. (shrink)

This summary of Freedom to Care begins with the core claims and conceptualizations upon which the theory of liberal dependency care rests. It then summarizes the book’s chapters. The first five chapters (Part I) delineate its theoretical foundations, which include the two-level contract theory approach to distributive justice for caregiving arrangements. In Part II of the book, chapters six through nine, I formulate liberal proposals for justice-enhancing social change before identifying cross-cultural metrics of justice for the internal evaluation (...) of caregiving arrangements. (shrink)

Moral (or ethical) sensitivity is widely viewed as a foundational learning goal in engineering ethics education. We have argued in this paper is that this view of moral sensitivity cannot be readily transported from the nursing context to the engineering context on the basis of a care-analogy. The particularized care characteristic of the nursing context is decisively different from the generalized and universalized forms of care characteristic of the engineering context. Through a focus on care and (...) maintenance, the engineering student’s moral sensitivity can be refined, opening up a perceptual awakening and affectivity towards the complex nature of the engineer’s Other. This awakening is in part promoted through an understanding of the ideology of neutrality as a moment in the history engineering. Becoming aware of this ideology as an ideology can then be seen as an activity of dividing loyalties that allows for a reflexive and critical view of the biases and presuppositions inherited within the world of engineering. This process of deepening the engineering student’s moral sensitivity is perhaps as much a process of the student becoming aware of her professional world, how it shapes her understanding of herself, and what it means to be a good engineer. (shrink)

Beyond reasonable doubt, the influence of Western culture and civilizations has enervated traditional African family systems, and their functions as providers of social welfare. Hitherto, traditional African family and clan by extension served as the plausible medium by which Africans proffered solutions to those social, economic and other existential problems found within their communities. However, measuring and evaluating the successes of the various social welfare programs organized by the family and clan was a difficult task to achieve. It seems the (...) services rendered merely controlled the social problems but did not improve the standard of living of the victims. This paper seeks to critically analyse the traditional African family system and its role as a provider of social welfare and argues that it can complement the Western models towards holistic social integration. Thus this work adopts the theory of change as a tool for understanding how Western models of social welfare should be integrated with traditional African approaches to care for the ‘weak’ in the society. Advocating for a paradigm shift from the modern models of providing social welfare to the traditional African family and clan model is consequent upon the claim that the latter is more embracing in approach. (shrink)

Nicole Hassoun’s sufficientarian theory is based on a particular conception of caring, which she calls ‘care, simpliciter’. However, ‘care, simpliciter’ is not described in any detail. This essay tries to offer a critical revision of Hassoun’s concept of care in a way that would put the MGL theory on its strongest footing. To that end, I will contrast her view with a taxonomy of care that supplements the accounts of care provided by Stephen Darwall (...) and Lori Gruen. I then put forward a form of empathy that is best suited to the MGL theory, which fits the description of ‘care, simpliciter’. **Unpublished manuscript: feel free to cite.**. (shrink)

Liberal theories of justice have been rightly criticized for two things by care theorists. First, they have failed to deal with private care relations’ inherent (inter)dependency, asymmetry and particularity. Second, they have been shown unable properly to address the asymmetry and dependency constitutive of care workers’ and care-receivers’ systemic conditions. I apply Kant’s theory of right to show that current care theories unfortunately reproduce similar problems because they also argue on the assumption that good (...) class='Hi'>care requires only virtuous private individuals. Giving up this assumption enables us to solve the problems regarding both private care relations and systemic injustice. (shrink)

The relationship between feminist theory and traditionally feminine activities like mothering and caring is complex, especially because of the current diversity of feminist scholarship. There are many different kinds of feminist theory, and each approaches the issue of women's oppression from its own angle. The statement, "feminist ethics is about mothering and caring," can be critically evaluated by outlining specific feminist approaches to ethics and showing what role mothering and caring play in each particular view. In this paper, feminine and (...) feminist perspectives are delineated, and the four classic feminist approaches (liberal, Marxist, radical, and socialist) are summarized. I argue that to some extent all of the examples of feminist ethics are "about" mothering and caring. In some cases this is because the particular view describes mothering and caring as features of the roots of women's oppression, or as a positive force in changing the prevailing social order to do away with oppression. I include a discussion of an additional role mothering might play in the socialist feminist framework. (shrink)

In modern hospitals in developed countries, deaths are determined usually after a prearranged schedule of resuscitative efforts. By default, death is diagnosed and determined after “full code” or after the failure of intensive resuscitation. In end-of-life contexts, however, various degrees of less-than-full resuscitation and sometimes no resuscitation are allowed after the consent and shared decision-making of the patient and/or surrogates. The determination of brain death is a unique exception in these contexts because such an end-of-life care plan is usually (...) not offered until after brain death is declared. This essay analyzes and critiques three arguments for denying the family and/or surrogate a chance to consent to or forego the diagnostic protocol of brain death and choose an alternative end-of-life plan. First, opponents of consent for the determination of brain death argue that presenting it as a selectable end-of-life plan undermines the integrity of death determination. The second argument is that it is inconsistent to allow foregoing the determination of brain death when the determination of circulatory death is non-negotiable. The third argument is that allowing the patient/surrogate to forego the determination of brain death would jeopardize the fair and appropriate utilization of intensive care resources and potentially reduce organ donor pools. After closer conceptual examinations of these three arguments, this essay concludes that these arguments are conceptually and morally problematic. It defends an alternative patient-centered end-of-life care plan based on consent and shared decision-making. (shrink)

We reply to critics of the World Health Organisation's Report "Making Fair Choices on the Path to Universal Health Coverage". We clarify and defend the report's key moral commitments. We also explain its role in guiding policy in the face of both financial and political constraints on making fair choices.

This paper offers a critical examination of Fischer and Ravizza's attempt in Responsibility and Control to give a comprehensive account of the kind of control that grounds moral responsibility (RC, 14). The kind of control required for moral responsibility, they argue, is not some form of regulative control that involves alternate possibilities. What is required is guidance control, which is compatible with causal determinism (RC, 34). Guidance control has 'two separate dimensions' that Fischer and Ravizza aim to articulate and (...) defend. The first of these is that the mechanism that actually issues in the relevant conduct must be moderately reasons-responsive. The second is that the mechanism concerned must be the agent's own. The arguments that Fischer and Ravizza provide in defence of this overall position are carefully articu- lated and imaginatively defended. It is impossible not to admire this book. It will receive and deserves to receive a considerable amount of attention and discussion from all those who have an interest in the free will problem. I am confident that this work will prove to be of lasting influence and importance. My own discussion shows that I am not persuaded by the particular arguments that Fischer and Ravizza have given to support the two basic components of guidance control. How- ever, if my own experience is anything to judge by, readers will find this book challenging, stimulating, and highly rewarding. It sets a high standard by which to evaluate and assess other work and theories in the field. (shrink)

Background: Critically ill patients often require complex clinical care by highly trained staff within a specialized intensive care unit (ICU) with advanced equipment. There are currently limited data on the costs of critical care in low-and middle-income countries (LMICs). This study aims to investigate the direct-medical costs of key infectious disease (tetanus, sepsis, and dengue) patients admitted to ICU in a hospital in Ho Chi Minh City (HCMC), Vietnam, and explores how the costs and cost drivers (...) can vary between the different diseases. -/- Methods: We calculated the direct medical costs for patients requiring critical care for tetanus, dengue and sepsis. Costing data (stratified into different cost categories) were extracted from the bills of patients hospitalized to the adult ICU with a dengue, sepsis and tetanus diagnosis that were enrolled in three studies conducted at the Hospital for Tropical Diseases in HCMC from January 2017 to December 2019. The costs were considered from the health sector perspective. The total sample size in this study was 342 patients. -/- Results: ICU care was associated with significant direct medical costs. For patients that did not require mechanical ventilation, the median total ICU cost per patient varied between US$64.40 and US$675 for the different diseases. The costs were higher for patients that required mechanical ventilation, with the median total ICU cost per patient for the different diseases varying between US$2,590 and US$4,250. The main cost drivers varied according to disease and associated severity. -/- Conclusion: This study demonstrates the notable cost of ICU care in Vietnam and in similar LMIC settings. Future studies are needed to further evaluate the costs and economic burden incurred by ICU patients. The data also highlight the importance of evaluating novel critical care interventions that could reduce the costs of ICU care. (shrink)

This paper offers a critical examination of Fischer and Ravizza's attempt in Responsibility and Control to give a comprehensive account of the kind of control that grounds moral responsibility (RC, 14). The kind of control required for moral responsibility, they argue, is not some form of regulative control that involves alternate possibilities. What is required is guidance control, which is compatible with causal determinism (RC, 34). Guidance control has 'two separate dimensions' that Fischer and Ravizza aim to articulate and (...) defend. The first of these is that the mechanism that actually issues in the relevant conduct must be moderately reasons-responsive. The second is that the mechanism concerned must be the agent's own. The arguments that Fischer and Ravizza provide in defence of this overall position are carefully articu- lated and imaginatively defended. It is impossible not to admire this book. It will receive and deserves to receive a considerable amount of attention and discussion from all those who have an interest in the free will problem. I am confident that this work will prove to be of lasting influence and importance. My own discussion shows that I am not persuaded by the particular arguments that Fischer and Ravizza have given to support the two basic components of guidance control. How- ever, if my own experience is anything to judge by, readers will find this book challenging, stimulating, and highly rewarding. It sets a high standard by which to evaluate and assess other work and theories in the field. (shrink)

This article draws upon the work of Timothy Morton and Slavoj Žižek in order to critically examine how mountain bike trail builders orientated themselves within nature relations. Beginning with a discussion of the key ontological differences between Morton’s object-oriented ontology and Žižek’s blend of Hegelian-Lacanianism, we explore how Morton’s dark ecology and Žižek’s account of the radical contingency of nature, can offer parallel paths to achieving an ecological awareness that neither idealises nor mythologises nature, but instead, acknowledges its strange and (...) contingent form. Empirically, we support this theoretical approach in interviews with twenty mountain bike trail builders. These interviews depicted an approach to trail building that was ambivalently formed in/with the contingency of nature. In doing so, the trail builders acted with a sense of temporal awareness that accepted the radical openness of nature, presenting a ‘symbolic framework’ that was amiable to nature’s ambivalent, strange and contingent form. In conclusion, we argue that we should not lose sight of the ambivalences and strange surprises that emanate from our collective and unpredictable attempts to symbolize nature and that such knowledge can coincide with Morton’s ‘dark ecology’ – an ecological awareness that remains radically open to our ecological existence. (shrink)

In this critical notice of Clifford Williams’ Religion and the meaning of life, I focus on his argumentation in favour of the moderate supernaturalist position that, while a meaningful life would be possible in a purely physical world, a much greater meaning would be possible only in a world with God and an eternal afterlife spent close to God. I begin by expounding and evaluating Williams’ views of the physical sources of meaning, providing reason to doubt both that he (...) has captured all the central ones and that he has provided the right explanation of why we ought to care about them. Then I address Williams’ account of why God would greatly enhance the meaning of our lives, arguing that, if God could do so, then God could by the same token reduce their meaning as well, such that it is unclear that a world with God would offer a net gain in meaning. Finally, I take up Williams’ position that an eternal afterlife with God would greatly enhance the meaning of our lives, contending that, if it would do so, then it would to such an enormous degree as to make it hard to capture the intuition that a meaningful life would be possible in a purely physical world. (shrink)

This is a slightly more polished version of a presentation I wrote for the Author-Meets-Critics session on Colin's book at the Eastern APA session on Jan 4, 2017, in Baltimore. I’ve decided to post this commentary online pretty much as is -- I am afraid I don't have time to prepare a version suitable for publication. I hope the reader will find it helpful. At any rate, please treat this piece as a rough draft originally intended to be delivered to (...) a live audience. Although my commentary is mostly critical, I admire Colin's book for its originality, breadth, and depth. It stimulated my thought like no other books in recent years. (shrink)

The significance of critical phenomenology for psychiatric praxis has yet to be expounded. In this paper, I argue that the adoption of a critical phenomenological stance can remedy localised instances of hermeneutical injustice, which may arise in the encounter between clinicians and patients with psychosis. In this context, what is communicated is often deemed to lack meaning or to be difficult to understand. While a degree of un-shareability is inherent to subjective life, I argue that issues of unintelligibility (...) can be addressed by shifting from individualistic conceptions of understanding to an interactionist view. This takes into account the contextual, historical and relational background within which meaning is co-constituted. I conclude by providing a corrective for hermeneutical injustice, which entails a specific attentiveness towards the person’s subjectivity, a careful sensitivity to contingent meaning-generating structures, and a degree of hermeneutical flexibility as an attitude of openness towards alternative horizons of possibility. (shrink)

The outbreak of SARS-CoV-2 has exposed a shared condition of vulnerability on a global scale. How can we use vulnerability as an effective paradigm in order to foster collective political initiatives? This essay claims that the idea of care is key to understand the vulnerability framework as being both an epistemic and a political resource to address ethical issues. The first half of the essay recollects several arguments in Adriana Cavarero’s and Judith Butler’s most recent works, insofar as both (...) theorists have insisted on the notion of vulnerability in order to interpret contemporary political mobilizations. The second part of the essay retraces a constellation of practices of care in the works of several Black and decolonial feminist thinkers situated in different socio-political contexts. Whereas for Christina Sharpe and Saidiya Hartman the focus is on the matter of Blackness and Black lives in their constitutive vulnerability, both Cristina Rivera Garza’s and Sayak Valencia’s works remarkably insist on the specific socio-political context of today’s Mexico. These authors urge the readers to adopt a critical posture when encountering official narratives, also because in their texts they exhibit their own vulnerability. For them, writing, their writing is an ethical demand to imagine alternatives and to foster new entanglements between bodies persisting on the margins, at the limits of the norms that regulate legibility. (shrink)

The chapter is the final one in the volume of collected papers aiming to discuss the sharing economy in Europe. The idea of the book emerged within the research network created by the COST Action CA16121 ‘From Sharing to Caring: Examining Socio-Technical Aspects of the Collaborative Economy.’ The authors of the chapter sum up theoretical and empirical materials as well as country-specific cases provided in the book. The article critically assesses the current status of the sharing economy in European countries (...) by highlighting major controversial issues related to deregulation, market disruption, or social inequality. The authors conclude that, considering the comprehensive and up-to-date materials collected and analysed in the book, it may become an outstanding source of knowledge and a practical tool in the process of expansion of the sharing economy in Europe and beyond. (shrink)

In this interview, Estelle Ferrarese elaborates on her account of vulnerability and care to highlight its political and social, as opposed to its ethical, dimensions. Drawing on, amongst others, Adorno, Tronto, Castell, and Laugier, she argues that vulnerability and care should not be understood ontologically, as an antropological exposure of the body, but rather socially, as the normative expectations and material conditions under which care work takes place. Situating her approach in anglophone and francophone discussions on vulnerability (...) and precarity, she discusses her approach to normative expectations and how it informs her account of vulnerability of living at the mercy of someone else's agency, as well as the politicization of vulnerability. She also discusses the political implications of her account of vulnerability and care with regard to a range of contemporary issues, such as the Men's Right Movement, the posthuman turn and the Antropocene, and mutual aid and the neoliberalization of the welfare state. (shrink)

"A Progress of Sentiments is a pleasure to read in every way. The book itself is attractively printed and produced. (It includes, for example, some well reproduced and unusual portraits of Hume, a useful chronology of Hume's life, and a carefully organized and comprehensive index.) Baier writes in a lively, smooth, and clear manner. She entirely avoids jargon and needless technicalities. The commentary and discussion is full of insight and interesting observations on the details of Hume's philosophy. The general interpretation (...) that is argued for presents the substance of the Treatise in a rather new light. Baier's theses and claims concerning Hume's thought are effectively defended and well supported. This is a study which can be recommended both to students who are coining to Hume's work with little background knowledge, and also to the established Hume scholar who is thoroughly familiar with the territory that Baier is covering. Anyone who reads this book with the care that it deserves will learn a great deal from it.". (shrink)

The idea that healthcare should become more person-centred is extremely influential. By using recent English policy developments as a case study, this article aims to critically analyse an important element of person-centred care, namely, the belief that to treat patients as persons is to think that care should be ‘co-produced’ by formal healthcare providers and patients together with unpaid carers and voluntary organizations. I draw on insights from political philosophy to highlight overlooked tensions between co-production and values like (...) equality and liberty. Regarding equality, I argue that co-production compounds both problems of gender inequality in the distribution of care labour and the challenges associated with securing equal access to care. Turning to liberty, I identify important commonalities between co-production and republicanism in political philosophy, given their shared insistence on common citizens’ civic virtue. Then, I use against co-production some liberal arguments against republicanism, to highlight a problem of over-demandingness. In bringing my argument to a close, however, I wish to caution against hastily rejecting co-production as a policy programme. (shrink)

Arguably the foundational text of Western political theory, Aristotle's Politics has become one of the most widely and carefully studied works in ethical and political philosophy. This volume of essays offers fresh interpretations of Aristotle's key work and opens new paths for students and scholars to explore. The contributors embrace a variety of methodological approaches that range across the disciplines of classics, political science, philosophy, and ancient history. Their essays illuminate perennial questions such as the relationship between individual and community, (...) the nature of democratic deliberation, and how to improve political institutions. Offering groundbreaking studies that both set Aristotle within the context of his own time and draw on contemporary discussion of his writings, this collection will provide researchers with an understanding of many of the major scholarly debates surrounding this key text. (shrink)

Rigorous evaluations of the effects of vertical public health enterprises on the health systems of low-income countries usefully identify the public health and ethical costs of those initiatives. They reveal that such narrowly focused public health ventures undermine the efforts of those countries to establish and maintain adequately resourced and well-developed national health systems, including comprehensive primary care programs. This paper argues that the scope of assessments of vertical public health ventures should be broadened to include gender as an (...) additional axis of analysis. When members of socio-economically marginalized populations are sick with conditions that are not covered by fragmented and inadequate public health programs or disease-specific vertical public health schemes, their untreated illnesses add to the gendered familial caregiving responsibilities of the female members of their households. Those women and girls have to perform their ‘normal’ familial care work, work outside the home for pay, and take care of the unwell family members for whom the household cannot afford treatment. Given that women and girls from low-income households already shoulder a disproportionate amount of care work for their families, their health and life prospects are further affected by the amplification of their caregiving responsibilities. This paper argues that analyses of the impact of vertical public health initiatives should also track this gendered consequence of those enterprises because it is a crucial public health and ethical matter. (shrink)

Objective: This main aim of the study is to explore COVID-19 pandemic problems from the perspective of public health-clinical care ethics through online mediareports in Turkey. Method: This research was designed as a descriptive and qualitative study that assesses COVID-19 through online media reports on critics between the periods of March 11, 2020 and April 2 2020 as a quantitative as number of reports and qualitative study, across Turkey. Reports were from Turkish Medical Association websites which included newspaper reports. (...) Study data were presented as statistically and qualitative data case and headlines. No ethical or ofTicial permission was sought as the study was conducted through open access internet news sites. Results: This online reports analysis retrieved about 6723 articles about the COVID-19. According to study data, information about COVID-19 were themed as follows: general deTiciencies in taking action and isolation, lack of isolation, passengers and transport vehicles not quarantined ; insufTicient diagnostic tests, decision to test after healthcare professionals become infected, lack of equipment, lack of evaluation outbreak countries [Table 2]. Conclusion and Suggestions: COVID-19 is a pandemic and is a global public health problem that concerns every individual and needs to be handled carefully. This requires a multi-faceted preparation and education. In this context, healthcare professionals should be well trained in this aspect and have all the necessary equipment throughout the process. Additionally, it should work systematically with the cooperation of all health organizations, the Ministry of Health, local governments and of course the media, in order to inform society, fairly distribute the resources and to implement the safety measures effectively. BrieTly, lack of transparency, insufTicient information, limited resources, lack of public health protection measures such as partial quarantine decision, partial implementation of the scientiTic board's re c ommenda ti on s fo r e c on omi c rea s on s, and contradiction of the explanations are revealed as serious ethical problems. (shrink)

A critical examination of the dispute about the existence and significance of "plasticity genes.".

John Searle has proposed one of the most influential contemporary accounts of social ontology. According to Searle, institutional facts are created by the collective assignment of a specific kind of function —status-function— to pre-existing objects. Thus, a piece of paper counts as money in a certain context because people collectively recognize it as money, and impose a status upon it, which in turn enables that piece of paper to deliver certain functions (means of payment, etc.). The first part of this (...) essay presents Searle’s theory of social ontology and summarizes his views on money. The second part centers on criticisms of his views and compares his theory with its main competitors, including the theories of Tuomela, Guala and Hindriks, and Smit, Buekens and Duplessis. The conclusion attempts to see what may remain of Searle’s theory after careful examination. (shrink)

In The Republic of the Living, Miguel Vatter argues that, at the end of the 1970s, Michel Foucault did not convert to but criticized neoliberalism from a republican point of view. Neoliberal governmentality allegedly represses the capacity of human collectives to democratically govern themselves. The potential for republican self- government would then constitute the basis for an affirmative variant of biopolitics. I argue that this creative reformulation of Foucault’s oeuvre does not work as an interpretation of Foucault nor as a (...) valid critique of neoliberalism. Using the influ- ence of Georges Canguilhem on Foucault, I propose to locate the potential for affirmative biopolitics not in the collective capacity for self-government, but in the fragility of living beings in their interaction with their milieu. Because life is con- stitutively dependent on infrastructural conditions to flourish, we need a biopolitics that establishes institutions which support the sustenance of life. (shrink)

The spread of liberal individualism to the family is often portrayed as deeply inimical to the welfare of children and young people. In this view, the family is the bastion of the private and the antithesis of the contractual, rights-oriented model that underpins public life. This chapter examines that proposition critically.

Aldo Leopold’s A Sand County Almanac emphasizes values of receptivity and perceptivity that appear to be mutually reinforcing, critical to an ecological conscience, and cultivatable through concrete and embodied experience. His priorities bear striking similarities to elements of the ethics of care elaborated by feminist philosophers, especially Nel Noddings, who notably recommended receptivity, direct and personal experience, and even shared Leopold’s attentiveness to joy and play as sources of moral motivation. These commonalities are so fundamental that ecofeminists can (...) and should see Leopold as a philosophical ally. The three ecofeminist scholars who have devoted the most concerted attention to Leopold’s work argue that his Land Ethic is not, and does not provide a basis for, an ecofeminist ethic. I dispute the main criticisms of these scholars, and conclude that ecofeminists should attend more often to Leopold’s work, which extends possibilities for excellent praxis. (shrink)

This chapter advances a twofold analytical strategy. Firstly, an extrapolation of the legal method, i.e. the application of general rules to particular cases, into a general tool for both description and problem solving. Secondly, through the integration of the legal method with a phenomenological approach for the study of social worlds. This provides the basis for an integrated approach potentially deployable in relation to all social phenomena at the micro, meso and macro levels. This makes it an alternative to the (...) methodology of the social sciences, i.e. economics, political economy, political science and sociology. The social sciences have become characterized by hyper formalistic and opaque modelling and simplistic assumptions resulting in a structural incapacity of scholarly innovation with the consequence that they are incapable of answering ‘big questions’ and lacks the ability to reflect critically upon the basic structure of society and core assumptions about the composition of the social world. (shrink)

As the title of the article suggests, “The Burqa Ban”: Legal Precursors for Denmark, American Experiences and Experiments, and Philosophical and Critical Examinations, the authors embark on a factually investigative as well as a reflective response. More precisely, they use The 2018 Danish “Burqa Ban”: Joining a European Trend and Sending a National Message (published as a concurrent but separate article in this issue of INTERNATIONAL STUDIES JOURNAL) as a platform for further analysis and discussion of different perspectives. These (...) include case-law at the international level while focusing attention on recent rulings and judicial reasoning by the ECtHR and the ECJ; critical thought-experiments in religion, morality, human rights, and the democratic public space; a contextualized account of burqa-wearing interventions by federal and state governments and, moreover, various courts in the United States; and philosophical commentary and, in some instances, criticism of the Danish and/or European (French, etc.) approach. The different contributions have different aims. The section on case-law at the international level reports on those central judgments that, in effect, helped to pave the path for the Kingdom of Denmark’s burqa ban. Concerning the concurring judges at the ECtHR, the opinions served to uphold a preexisting ban and to grant a wide margin of appreciation to the national authorities, thereby limiting the Court’s own review. -/- As regards to the ECJ, the legality of company rules that contain a policy of neutrality for the workplace was examined, with a similar outcome. The authors who discuss religion, morality, human rights and the democratic public space are endeavoring to, respectively, appeal to ethics as a testing stone for law and to both challenge and address several forms of “expressivist worry” in connection with face veils. In doing so, the authors ask a number of thought-provoking questions that hopefully will inspire public policymakers to careful analysis. While the section that is devoted to American perspectives highlights a comprehensive survey of political and legal responses to, in particular, full-face veils like the burqa, the relevant author also incorporates public perceptions and, in the course of examining these, draws a parallel to “the fate” of the hoodie. The constitutionality of burqa-wearing in America, so it also appears, is partially an open question, but differentiating between religious, political, or personal reasons is a de jure premise. Given that the Danish legislators who drafted law L 219 to ban burqa-wearing in public places rely on a reference to political Islam, they relegate religious and personal reasons to the private domain, thereby also adopting secularism as a premise. This is explored in the last author response of the article, more precisely, in an account of the underlying materialism that, in turn, is applied to Muslim women. If policymakers and legislators engaged in Thinking Things Through exercises, they could, as a minimum, avoid law-making strategies that are not in the spirit of the theory they themselves invoke, albeit tacitly. While the aim of, as it were, arresting culturally self-contradicting legislators is unique for the section in question, all the authors who contribute to the joint research project have one end-goal in common, namely to inform about important perspectives while at the same time opening up for parameters for (more) fruitful, constructive and (if need be) critical debate in the future. With this in mind, four recommendations are presented by the research director for the project. Legally, politically, socially and culturally, conflict-resolution should not translate the relationship between rulers and the ruled into a separation ideology, an instance of controllers versus the controlled. All things being equal, that is the objective limit for a democratic society. (shrink)