Previously proposed strategies for tackling hermeneutical injustices take for granted the interests people have in certain things about them being intelligible to them and/or to others, and seek to enable them to satisfy these interests. Strategies of this sort I call interests-as-given strategies. I propose that some hermeneutical injustices can instead be tackled by doing away with certain of these interests, and so with the possibility of their unfair non-satisfaction. Strategies of this sort I call interests-in-question strategies. As a case (...) study in when such an interests-in-question strategy ought to be pursued, I look at how to tackle hermeneutical injustices arising in the context of gender-affirming healthcare as provided to adults by the National Health Service in the UK. I argue that considerations of trust, privacy, and respect all support pursuing such a strategy. One way to do so, I suggest, would be by replacing the existing gatekeeping model with an informed consent model for the provision of gender-affirming healthcare. Considerations of hermeneutical justice can hence be added to the already-impressive case for undertaking this shift. (shrink)

Gender-affirming healthcare interventions are medical or surgical interventions that aim to allow trans and non-binary people to better affirm their gender identity. It has been argued that rights to GAH must be grounded in either a right to be cured of or mitigate an illness—gender dysphoria—or in harm prevention, given the high rates of depression and suicide among trans and non-binary people. However, these grounds of a right to GAH conflict with the prevalent view among (...) theorists, institutions and activists that trans and non-binary people do not have a mental illness and that one can be trans and entitled to GAH without being depressed or suicidal. This paper challenges the orthodoxy that a right to GAH must be grounded in either of these ways and instead argues for a right to GAH grounded in a right to live and act with integrity. The standard view, which this paper explains, is that our rights to live and act with integrity ground a right to religious accommodation in many cases such as a right to not be denied social security due to one’s refusal to work a job on a holy day. This paper argues that if our rights to live and act with integrity can ground prima facie rights to religious accommodation, our rights to live and act with integrity ground prima facie rights to GAH. There are no data in this work. (shrink)

According to the ICD-11 and DSM-5, transgender people’s experienced gender is incongruent with their natal sex or gender and the purpose of gender affirming-healthcare (GAH) interventions is to reduce this incongruence. Vincent and Jane argue that this view is conceptually incoherent—the incoherence thesis—and propose that the ICD and DSM should be revised to understand transgender people as experiencing a merely felt incongruence between their gender and their natal sex or gender—the feelings revision. I (...) argue that (i) Vincent and Jane in fact give us no reason to believe the incoherence thesis and that (ii) we may want to resist the combination of the incoherence thesis and the feelings revision because this combination implies that all transgender people have feelings that are misplaced and are, in an importance sense, incorrect or mistaken. I then give a fit-based account of how trans people’s experienced gender can be incongruent with their natal sex or gender and how GAH can reduce this incongruence. (shrink)

In this article, I examine the moral dimensions of gender affirmation. I argue that the moral value of gender affirmation is rooted in what Iris Murdoch called loving attention. Loving attention is central to the moral value of gender affirmation because such affirmation is otherwise too fragile or insincere to have such value. Moral reasons to engage in acts that gender affirm derive from the commitment to give and express loving attention to trans people as a (...) way of challenging their marginalization. In the latter part of the paper, I will discuss how my arguments bear on recent arguments by Robin Dembroff and Daniel Wodak (2018) on the use of gender-neutral language. They argue that we have a duty not to use gender-specific pronouns for anyone. Their conclusion turns, in part, on a rejection of gender affirmation as a moral duty. The value of gender affirmation, rooted in our moral perception of trans people, should make us skeptical of this conclusion, in favor of a more nuanced and pluralistic approach to the ethics of gendering. (shrink)

Gender affirming hormone treatment is an important part of the care of trans adolescents which enables them to develop the secondary sexual characteristics congruent with their identified genders. There is an increasing amount of empirical evidence showing the benefits of gender affirming hormone treatment for psychological health and social well-being in this population. However, in several countries, access to gender affirming hormone treatment for trans adolescents has recently been severely restricted. While much of the (...) opposition to gender affirming hormone treatment for trans adolescents has in part been ideologically motivated, it also reflects a debate about whether there are harms that outweigh the benefits of the treatment. Accordingly, a systematic and comprehensive philosophical analysis of the ethics of gender affirming hormone treatment for trans adolescents is needed. Herein, I offer such an analysis that draws on the four principles of biomedical ethics by Tom Beauchamp and James Childress. Based on the considerations of beneficence, nonmaleficence, autonomy, and justice, I argue that the provision of access to gender affirming hormone treatment for consenting trans adolescents is ethically required and that the current restrictions to such treatment are ethically wrong. (shrink)

Recent increases in the rates of parental refusal of routine childhood vaccination have eroded many countries’ “herd immunity” to communicable diseases. Some parents who refuse routine childhood vaccines do so because they deny the mainstream medical consensus that vaccines are safe and effective. I argue that one reason these vaccine denialists disagree with vaccine proponents about the reasons in favor of vaccination is because they also disagree about the sorts of practices that are conducive to good reasoning about healthcare (...) choices. Vaccine denialists allocate epistemic authority more democratically than do mainstream medical professionals. They also sometimes make truth ascriptions for nonepistemic reasons, fail to recognize legitimate differences in expertiseand competence, and seek uncritical affirmation of their existing beliefs. By focusing on the different epistemic values and practices of vaccine denialists and mainstream medical professionals, I locate my discussion of vaccine denialism within broader debates about rationality. Furthermore, I argue that gender inequality and gendered conceptions of reason are important parts of the explanation of vaccine denialism. Accordingly, I draw upon feminist work—primarily feminist social epistemology—to help explain and evaluate this form of vaccine refusal. (shrink)

In this paper, I engage with a recent contextualist account of gender terms proposed by Díaz-León, E. 2016. “Woman as a Politically Significant Term: A Solution to the Puzzle.” Hypatia 31 : 245–58. Díaz-León’s main aim is to improve both on previous contextualist and non-contextualist views and solve a certain puzzle for feminists. Central to this task is putting forward a view that allows trans women who did not undergo gender-affirming medical procedures to use the gender (...) terms of their choice to self-identify. My goal is to investigate Díaz-León’s proposal, point out several shortcomings of the view and discuss possible replies on her part. (shrink)

Are words like ‘woman’ or ‘man’ sex terms that we use to talk about biological features of individuals? Are they gender terms that we use to talk about non-biological features e.g. social roles? Contextualists answer both questions affirmatively, arguing that these terms concern biological or non-biological features depending on context. I argue that a recent version of contextualism from Jennifer Saul that Esa Diaz-Leon develops doesn't exhibit the right kind of flexibility to capture our theoretical intuitions or moral and (...) political practices concerning our uses of these words. I then float the view that terms like 'woman' or 'man' are polysemous, arguing that it makes better sense of the significance of some forms of criticisms of mainstream gender ideology. (shrink)

This article examines the development of affirmative sexual consent in Canadian jurisprudence and legal theory and its adoption in Canadian law. Affirmative sexual consent requirements were explicitly proposed in Canadian legal literature in 1986, codified in the 1992 Criminal Code amendments, and recognized as an essential element of the common law and statutory definitions of sexual consent by the Supreme Court of Canada in a series of cases decided since 1994. Although sexual violence and non-enforcement of sexual assault laws are (...) worldwide phenomena, the international scholarly literature reflects limited awareness of these developments in Canadian law. This article remedies that gap in the literature. The Canadian experience with the definition of sexual consent as communicated “voluntary agreement” demonstrates the value of this conceptualization of consent; the definition provides a well-defined set of nondiscretionary reference points for legal analysis of the facts in sexual assault offenses. The effect is to facilitate effective enforcement of the sexual assault laws and affirm the right to sexual autonomy, sexual self-determination, and equality, consistent with fundamental principles of individual human rights. For all these reasons, familiarity with the Canadian experience may be useful to those engaged with the reform of rape and sexual assault laws in other jurisdictions. (shrink)

Some philosophers and segments of the public think age is relevant to healthcare priority-setting. One argument for this is based in equity: “Old” patients have had either more of a relevant good than “young” patients or enough of that good and so have weaker claims to treatment. This article first notes that some discussions of age-based priority that focus in this way on old and young patients exhibit an ambiguity between two claims: that patients classified as old should have (...) a low priority, and that patients classified as young should have high priority. The author next argues, drawing on a problem raised by Christine Overall, that equity cannot justify giving “old” patients low priority, since there is wide variety in the total lifetime experiences of older people, partly influenced by gender, race, class, and disability injustice. Finally, the author suggests that there might be a limited role for age-based prioritization in the context of infant and childhood death, since those who die in childhood are always and uncontroversially among the worst-off. (shrink)

RésuméEn réponse à l'article de D. C. Matthew, « Racial Integration and the Problem of Relational Devaluation », j'examine la politique de la beauté physique à l'intersection entre les catégories de race et de genre. J’évalue et je rejette l'affirmation de Matthew selon laquelle être perçu comme physiquement attrayant se traduit à coup sûr soit par un bon traitement, soit par une haute estime de soi. Je soutiens que, au contraire, le genre peut fonctionner comme un moyen de contrôle social, (...) dans lequel le désir du corps des femmes n'apporte aucun bon traitement ni n'améliore leur estime de soi. Ce problème peut persister au sein des communautés raciales intragroupes autoségréguées. (shrink)

Trans healthcare and thus trans people have been severely affected by the COVID-19 pandemic. Trans people’s healthcare situations have turned out to be so vulnerable in this crisis because they have been precarious to begin with. There are multiple ways in which trans healthcare has been affected: Surgeries and other procedures have been cancelled or postponed, and mental health services have been paused or moved online. This raises ethical questions around discrimination against trans people in the (...) class='Hi'>healthcare system. This article argues that cancelling trans surgeries and procedures in the COVID-19 crisis is made possible through an understanding of trans healthcare as non-essential. The article explores how trans healthcare in particular has been affected by the pandemic. (shrink)

Pressuring someone into having sex would seem to differ in significant ways from pressuring someone into investing in one’s business or buying an expensive bauble. In affirming this claim, I take issue with a recent essay by Sarah Conly (‘Seduction, Rape, and Coercion’, Ethics, October 2004), who thinks that pressuring into sex can be helpfully evaluated by analogy to these other instances of using pressure. Drawing upon work by Alan Wertheimer, the leading theorist of coercion, she argues that so (...) long as pressuring does not amount to coercing someone into having sex, her consent to sex answers the important ethical questions about it. In this essay, I argue that to understand the real significance of pressuring into sex, we need to appeal to background considerations, especially the male-dominant gender hierarchy, which renders sexual pressuring different from its non-sexual analogues. Treating pressure to have sex like any other sort of interpersonal pressure obscures the role such sexual pressure might play in supporting gender hierarchy, and fails to explain why pressure by men against women is more problematic than pressure by women against men. I suggest that men pressuring women to have sex differs from the reverse case because of at least two factors: (1) gendered social institutions which add to the pressures against women, and (2) the greater likelihood that men, not women, will use violence if denied, and the lesser ability of women compared to men to resist such violence without harm. (shrink)

This thesis under the title “Public Health Policy in Resource Allocation: the Role of Ubuntu Ethics in Redressing Resource Disparity between Public and Private Healthcare in South Africa” explores health care disparities pertaining to resource allocation between public and private sector. It is of relevance and importance in South Africa where 54% of the population live on less than US$3 per day. Although the government has instituted certain changes aimed at transforming the public health care system, the resource allocation (...) gap between the two persists and remains wide. The research gives special attention to the role that Ubuntu ethics can play in redressing the resource allocation disparities between public and private health care sectors in South Africa, pointing out the existing gap in financing, as well as human resource between public and private health care sectors, which leads to poor health outcomes in public sector. Therefore, the problem is the prevalent inequality of resource allocation between private and public health care sectors. The analysis of policy gaps, as well as evaluating the cause of disparities in the health system is the goal of this research. The study endeavours to redress the disparities within the context of Ubuntu ethical principles and proposes a change in public policy so as to enhance healthcare for the benefit of the people. The study is philosophical and ethical, so the methodology used is discursive in nature, majorly focusing on critically reviewing existing literature, that is, the philosophical resources on Ubuntu ethics and justice theories as well as a range of government resources inclusive of public health policy documents. Social determinants of health and their impact in a South African context are discussed with the implication that health is not merely freedom from disease and or incapacity, but rather being well mentally, physically and socially. The attainment of a healthy status goes beyond ability to access healthcare services, and incorporates social determinants including but not limited to conditions in which people have been born into, stay, establish career and grow old in. It also includes the arrangements put in place to deal with illness and determine health. Issues of revenue, literacy, communal safety networks, vocation and conditions under-which vocation is undertaken, lack of work and vocation insecurity, early stages of human development, gender, cultural group, dietary insecurity, housing communal exclusion and disability all come into the picture as factors that determine health. But there is also discussion of the socio-economic status as contributors to health inequity wherein alcohol abuse, sugar intake, and smoking are identified as behavioural factors that complicate public health. One outstanding feature of this research is that it establishes a link between Ubuntu and public health policy. The researcher establishes that Ubuntu ethics is appropriate for not only discussing public morality, but also for formulating public policy that is morally tenable for South Africa, especially for the public health sector. This thesis calls for an application of Ubuntu in a proper context in order to enhance societal well-being for the benefit of many, if not all. The research proposes the fundamental principle of Ubuntu ethics in which the good of the community is as important as the good of every member of the community. Since Ubuntu ethics does not merely seek to fulfil what benefits the majority, as would be the case in a utilitarian society, the researcher advocates for the building of consensus on the common good, which should be understood to imply not just what is good for everyone in the community, but also what is good for the continued well-being of the community as a single unit. In this regard, the research finds it important that deliberate effort be made to integrate Ubuntu ethics into policies, citing the example of the National Health Insurance (NHI). The good health of all the members of a community is an assurance of the well-being and continuity of the whole national community. The research concludes that public health policy should integrate Ubuntu ethical values such as community, sharing, care, solidarity, identity, harmony, respect, and dignity into policy documents and legislation. (shrink)

The connection between Chinese sexism and Confucianism has been a subject of study on the condition of Chinese women in the West since the rise of feminist consciousness in the 1970s. However Confucianism in feminist scholarship is inescapably construed as a misogynous ideology that is incapable of self-rectification in regards to the issue of gender parity. Hence, conceptually the eradication of Confucianism becomes the necessary condition for the liberation of Chinese women, and the adoption of Western ideology let it (...) be Marxist-socialism, Liberalism, or Existentialism is then a logical next step for Chinese women. Yet, such a dichotomization of the West as a superior moral subject and the East as a passive object victimized by their "sexist" tradition is nevertheless an oversimplification of the condition and the liberation of women in the developing world. In the end, it is essentially a neo-colonial discourse in a feminist disguise. This dissertation sets itself up to accomplish two tasks: first, it is to obtain a conceptual clarity of what constitutes Confucianism and its connection with dominant sexist, social practices; second, it is to go beyond a mere critique of Confucianism and feminism as an ally of Chinese patriarchal family structure and Western imperialism respectively, and to lay a foundation for a future construction of a gender theory based on Confucianism as a theoretical ground to explain the cultural construct of Chinese women and to conceive an alternative ethical ground for women's liberation. Eventually, the whole project can be seen as an act of self-affirmation of my ethnic identity as a Chinese and an act of reconciliation with my feminist identity in the modern world. (shrink)

Why has modern American conservatism committed itself to gender binaries? Examining why this new categorizing unsettles conservatives (and how they have reacted against teacher unions and transgender influencers), this paper turns to Nietzschean analysis. It finds that the unsettling of heteronormative gender norms resulted in a pivot by conservatism to perpetuate a new gender identity politics in which nonbinary and especially transgender people are scapegoated. Imagining a nihilistic interpretation of gender, conservatives have made “transgender” a signifier (...) of amorality and barbarism, envisioning themselves as warriors of normalcy. Conservative activists have named their frontier “radical gender ideology” while contesting the legitimacy of diagnosed gender dysphoria, revising its pathology, and alleging clinical gender transitioning is a financial ploy. As a result, bodies have become sites of contestation between doctors, trans activists, and groups that advocate against gender-affirming care. This paper traces the conservative movement from resentment to opposition on three fronts – pathology, pronouns, and restrooms. (shrink)

In the political discourse regarding gender identity, the concept of biological sex has been weaponised by gender critical commentators to oppose gender affirmation for trans people. Recently, these commentators have appealed to an essentialist model of sex based on anisogamy, or relative gamete size, to argue that one’s sex is an immutable characteristic. I argue that the gender critical argument is unsound. The diverse purposes of sex classification and the complex variability of people’s sexual characteristics show (...) that an essentialist model is untenable. I then consider how a more adequate theoretical framework from the philosophy of biology can accommodate this complexity and capture how sex is classified in relevant contexts. Further implications of the framework are explored which concern the vagueness, polysemy, and mutability of sex. These undercut the gender critical argument and show that the appeal to biological sex fails to undermine gender affirmation for trans people. (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)

Nowadays, healthcare and medical education is qualified by test scores and competitiveness. This article considers its quality in terms of improving the moral competence of future healthcare providers. Objectives. Examining the relevance of moral competence in medico-clinical decision-making despite the paradigm shift and discussing the up-to-date findings on healthcare students. Design and method. N=115 participants were surveyed with a standard Moral Competence Test to examine how their moral competence development was affected by the learning environment and further (...) important factors. Results. The sample allowed the identification of a regress in moral competence during students’ pre-clinical curriculum, and progress during their clinical curriculum. A gender-related bias, a segmentation effect, and a pronunciation effect were noticed. Explanations. Scholarly literature usually reports a linear decrease of medical students’ C-scores resulting from, e.g., competitive trends in education. We identified such trends in terms of gender-specific competitive tactics. Religious and ethical affiliations were discussed to explain the unexpected gender bias and the related segmentation and pronunciation effects. The findings can be regarded as predictive for similar developments in educational institutions regardless of cultural contexts as the sample examined in this article represents medical education in a country facing a transition from a non-competitive to competitive tertiary education model, and between presecular and monocultural to secular and pluralist social ethics. (shrink)

Within the context of women’s studies, Thomas Aquinas is probably best known for his paraphrasing of Aristotle’s view, which describes woman as a “deformed man”. While the Philosopher indeed adopts the empirically dubious premise of woman’s value being intrinsically inferior to that of man, which he consistently implements throughout his many works, in Thomas’s case the issue of gender is not addressed as clearly and definitively. Above all, Aquinas does not call woman “something deformed”, but “only” occasional and misbegotten. (...) This is a reference to his ontological theory, in which woman is an occasional entity on the individual level, but a necessary one on the general level. He also distinguishes two relations of equality and affirms one of them to exist between woman and man. Although he accepts some of Aristotle’s beliefs (such as the impaired rationality of woman and her natural submission to man), he rejects other which show her as a being devoid of dignity. If one accepts the superiority of the spiritual sphere over the bodily one, it is ultimately possible to interpret Aquinas’s thought in a quasi-feminist way, as evidenced by the existence of Catholic Neo-Thomistic feminism, among others. Its achievements include recognising the divorce of marriages in which there is no friendship, abandoning Aristotelian biology in favour of modern scientific knowledge, and indicating the possibility of a feminist interpretation of the concept of natural law, which should include the welfare of women and minorities. (shrink)

This article adapts John Rawls’s writings, arguing that past injustice can change what we ought to publicly affirm as the standard of justice today. My approach differs from forward-looking approaches based on alleviating prospective disadvantage and backward-looking historical entitlement approaches. In different contexts, Rawls’s own concern for the ‘social bases of self-respect’ and equal citizenship may require public endorsement of different principles or specifications of the standard of justice. Rawls’s difference principle focuses on the least advantaged socioeconomic group. I argue (...) that a historicized difference principle considers the relative standing of racial, gender, and other historically stigmatized groups; provides their members assurance by weakening incentives to manipulate justice to another group’s advantage; and may result in policies resembling reparations, though justified by forward-looking considerations of self-respect and public assurance. I then examine how disrespectful justifications were historically used to forcibly include indigenous peoples as citizens. While Rawls thinks providing citizens one package of basic liberties signals respect, indigenous self-government could better support self-respect. I invoke Rawlsian international justice, which calls for mutual respect between peoples. Indigenous peoples’ status should reflect their past and persisting peoplehood, providing assurance by weakening incentives to unjustly transform international into domestic contexts. (shrink)

ABSTRACT This essay focuses on two underlying presumptions that impinge on the effort of UNESCO to engender universal agreement on a set of bioethical norms: the conception of universality that pervades much of the document, and its disregard of structural inequalities that significantly impact health. Drawing on other UN system documents and recent feminist bioethics scholarship, we argue that the formulation of universal principles should not rely solely on shared ethical values, as the draft document affirms, but also on differences (...) in ethical values that obtain across cultures. UNESCO's earlier work on gender mainstreaming illustrates the necessity of thinking from multiple perspectives in generating universal norms. The declaration asserts the ‘fundamental equality of all human beings in dignity and rights’1 and insists that ‘the highest attainable standard of health is one of the fundamental rights of every human being without distinction of race, religion, political belief, economic or social condition’2 yet it does not explicitly recognize disparities of power and wealth that deny equal dignity and rights to many. Without attention to structural (as opposed to merely accidental) inequities, UNESCO's invocation of rights is so abstract as to be incompatible with its avowed intention. (shrink)

Recent decades of women's rights advocacy have produced numerous regional and international agreements for protecting women's security, including a UN convention that affirms the state's responsibility to protect key gender-specific rights, with no exceptions on the basis of culture or religion. At the same time, however, the focus on universal women's rights has enabled influential feminists in the United States to view women's rights in opposition to culture, and most often in opposition to other people's cultures. Not surprisingly, then, (...) feminists across the global South have criticized the universal-women's-rights agenda. This article reviews representative critical responses to universal-women's-rights advocacy. The author argues that, taken collectively, these critical responses do not reject the possibility of cross-cultural feminist advocacy but they do suggest the need for feminists in the United States and Europe to focus less on transferring rights across the obstacles of culture and more on how they can revise and expand their own understanding of women's rights in response to the struggles of other women, many of whom view women's rights as organic to their own cultures and as connected to broader social struggles. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:This Universalism Which Is Not OneLinda M. G. Zerilli (bio)Ernesto Laclau. Emancipation(s). London: Verso, 1996.Judging from the recent spate of publications devoted to the question of the universal, it appears that, in the view of some critics, we are witnessing a reevaluation of its dismantling in twentieth-century thought. One of the many oddities about this “return of the universal” 1 is the idea that contemporary engagements with it are (...) more or less of a piece, and that they reflect a growing consensus that poststructuralist political theories are incapable of generating a viable alternative to the collective fragmentation that characterizes late modernity. 2 The putative return to the universal marks, on this view, both a homecoming to Enlightenment ideals—purified of their more poisonous elements, of course—and a reconciliation of sorts between those who refuted these ideals and those who sought to realize them. Now that “we” all know and agree that poststructuralism is critically valuable but politically bankrupt; now that we all know and agree that the “old universal” was indeed a “pseudo-universal,” so the homecoming narrative goes; we can get on with the project of constructing a “new universal.” 3 This authentic universal would really be inclusive of all people, regardless of race, class, gender, sexuality, ethnicity, nationality, and whatever else attaches to the “embarrassing etcetera” that, as Judith [End Page 3] Butler reminds us, inevitably accompanies such gestures of acknowledging human diversity.Before signing on to this felicitous agreement about “the necessity of universalism,” we may wish to know whether we have anything like a minimal agreement in language, that is, whether we who speak of this universal are even speaking about the same thing. Apart from the not insignificant problem of translating from a philosophical to a political idiom, the whole question of this agreement is virtually occluded by the rush to rescue politics from the virulent particularisms that admit no common ground or sense of collective belonging. Presented in terms of the familiar binary couple, the choice between universalism and particularism seems settled by merely pointing to global and domestic political realities. Universalism is the only alternative to social fragmentation, wild child of the collapse of communism, the rise of deadly nationalisms, and the multiculturalist romance with particularism. To invoke the name of the universal in any affirmative sense is already to sign on to the political diagnosis and its solution.One of the many virtues of Ernesto Laclau’s Emancipation(s) is that it offers both an alternative to the binarisms spawned by the “return” to the universal (for example, false universalism/true universalism) and a trenchant critique of the original binary couple itself (universalism/ particularism). Demonstrating the imbrication of the universal and the particular, Laclau shows why it is a matter not of choosing one over the other but of articulating, in a scrupulously political sense, the relation between the two. He thus explicitly rejects the notion that this relation is one of mutual exclusion, and shows that the tendency to see it as just that has led to the impasse of the contemporary debate, an impasse that is glossed over in some highly visible academic cases by proclaiming the necessary return to the universal. Although the language of universalism as spoken by Laclau searches for some common ground between particularists and universalists, it is more by way of articulating their mutual contamination, that is, how each is rendered impure by the irreducible presence of the other.The Problem of UniversalsLaclau situates his collection of essays in the context of the increasingly polarized debate over multiculturalism, a debate in which the classical universalism of the philosophical tradition has come under serious question. Reading his essays, one comes to see the deep dependence of the entire contemporary discussion on this tradition, even when its metaphysical assumptions are explicitly rejected (as, say, in the work of Seyla Benhabib) or insufficiently comprehended (as in most of the popularized political discourse). Laclau’s book can help us to see that the political question of universalism cannot be posed properly as long as it remains tethered to the classical philosophical “problem of universals.” At stake in sorting out the affinities and... (shrink)

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

Architecture and Deconstruction Case of Peter Eisenman and Bernard Tschumi -/- Introduction Towards deconstruction in architecture Intensive relations between philosophical deconstruction and architecture, which were present in the late 1980s and early 1990s, belong to the past and therefore may be described from a greater than before distance. Within these relations three basic variations can be distinguished: the first one, in which philosophy of deconstruction deals with architectural terms but does not interfere with real architecture, the second one, in which (...) a collaboration between Jacques Derrida and a group of architects interested in his concepts is commenced, and the third one, in which completed or only designed objects or new concepts of deconstruction created by architects gain their supremacy over philosophy. The following book analyses these three possible ways, first of all with the reference to Peter Eisenman and Bernard Tschumi. -/- Peter Eisenman -/- Misreading… and Other Errors -/- The issue of relations between Peter Eisenman’s work and philosophy of deconstruction may be referred to his activity more than ten years preceding his direct collaboration with Jacques Derrida (in 1985) and organisation of the exhibition Deconstructivist Architecture at Museum of Modern Art in New York (in 1988). As soon as at the stage of designing the first houses (House I-III, 1967-1970), which almost entirely inscribed in formalistic aesthetics of Modernism, the architect analysed the problem of architecture dependence on its assumptions. All his later designs may be treated as consequence of this initial interest in relations between practice and theory, and at the same time as an introduction to manipulations later on led at the level of metaphysics of architecture. Beginning with the issue of presence, considered in comments to House VI (1972), the number of ideas having their analogies in philosophy of deconstruction increased. The text entitled The End of the Classical: The End of the Beginning, The End of the End (1984), in which Eisenman criticised questions of representation in architecture, its delusive strive for truth and comparably unattainable attempts at ultimate definition of elementary rules, should be acclaimed the breaking point. This attitude was extended by numerous strategies disturbing architecture rules defined at metaphysical level in an essay Moving Arrows, Eros, and Other Errors: an Architecture of Absence (1986). The issue of Eisenman’s passage from formalism to deconstruction has already been much discussed in the literature (Rosalind Krauss, Thomas Patin among others), still it should be mentioned that the threads similar to Derrida’s concept included in Eisenman’s writing reveal untranslatability of architecture and philosophy. -/- Choral Works or Separate tricks -/- In 1985-1986 a series of seven disputes between Jacques Derrida and Peter Eisenman took place. The pretext for them were designs concerning Parc de la Villette in Paris. The situation of many months of collaboration between a notable philosopher of the second half of the 20th c. and an architect that already had a huge theoretical oeuvre, ended up with a publication of a large volume entitled Chora L Works and it became at the same time a vast study area for historians of contemporary architecture and philosophers. Derrida’s contribution to concept works were his considerations over the idea of chôra, the properties related to this concept were about to be reflected in shapes of the park. Therefore, Chora L Works became an example of the abilities of contemporary art, both in its capability of translation from philosophical ideas to artistic forms and its resistance to tradition of representing in architecture some phenomena and values originating outside this discipline. In the final period of their collaboration both interlocutors started to polemicise with each other more decidedly, what became a separate part of their thought exchange. The exchange of letters between Derrida and Eisenman at the turn of 1989 ended up the period of their direct contacts, nevertheless, at this time precisely a large group of experts in issues of deconstruction joined the discussion and extended the revealed in the former dispute problems into more than ten years of further considerations and publications. Except for a long text by Jeffrey Kipnis, who had participated in the meetings of the philosopher and the architect, there appeared also comments of researchers of artistic theories (K. Michael Hays, Thomas Patin), philosophers (Andrew Benjamin), and even experts in Greek literature (Maria Theodorou or Ann Bergren). Following these debates a contemporary reflection on architecture has saturated with indeed numerous concepts originating in philosophy of deconstruction. -/- Architecture which imitates mute philosophy -/- The series of Jacques Derrida and Peter Eisenman meetings, which took place in the period of 1985-1987, induced many authors to make comments. Some of them (Jeffrey Kipnis, Ann Bergren, Maria Theodorou) developed the subject of chôra which was introduced to the discussion by Derrida. The problem that was about to be solved was the question of tying up the concept of chôra with architecture, including Eisenman’s architecture and the series of meetings within frames of Chora L Works project. Kipnis on this occasion paid attention to chôra and its character of anachronia which infects any being created within chôra. In other words any event has its counterpart (analogon) in another, earlier event. He demonstrated the similarity of structure of many events and statements from the times of Derrida and Eisenman’s meetings to the almost identical behaviour of figures in Plato’s dialogue Timaeus. The loss of beginning present in this phenomenon was appropriate to both features of chôra and the effects of typical analyses of philosophy of deconstruction. Bergren’s analyses focused on accentuating gender of chôra, which, according to this author, had been neglected hitherto in discussions. She collated chôra descriptions with characteristics of women in myths, early Greek epic and philosophy and she arrived at a conclusion that chôra has features of a single woman and a married one at the same time. And yet Theodorou’s studies showed that in the Homeric epics chôra is not treated as an idea but is related with single things and events. The other part of the comments (represented by Andrew Benjamin and K. Michael Hays’ utterances) concerns Eisenman’s attitude to tradition which was treated as a variety of iteration understood philosophically. Benjamin commenced his considerations at the point of closeness between a definition of tradition and a concept of chôra understood as perpetuation (placement). A problematic issue was for him Eisenman’s complex relation to tradition based on its contest and affirmation at the same time. Overcoming the simple subordination to tradition – according to Benjamin – was based on awareness of the role of repetition in culture not known before. Hays made an attempt to explain the pleasure and torment of repetition with the support of Sigmund Freud and Roland Barthes’ concepts. According to Hays repetitions are attempts of a single being to a certain primal state perceived as free of any tension. In a similar way Rosalind Krauss explained a motif of a grate present in Modernistic art and also exceptionally frequent in Eisenman’s work. -/- Annex Architecture is still writing Balzac novels. Peter Eisenman and literature -/- Architecture’s approach to writing, script or literature, present within Peter Eisenman’s work, is an exceptional phenomenon, furthermore a complex one. The article considers four possible relations. The first one relates to Eisenman’s characteristics as a person extremely gifted with the ability to wordplay, which very ‘play’ reveals skills to create architectural images. In the second approach the attention has been paid to Eisenman’s interests – in the first period of his oeuvre – in linguistic works by Noam Chomsky and his transformational-generative grammar. The third kind of relations applied to overcoming the need for autonomy of architecture (and of modernist aesthetics at the same time) and renew interests in questions of meaning in architecture. The fourth sort of relations occurred when Eisenman started to create reflections of historic or literary narrations in architecture – ‘stone stories’ and architectural fictions of their kind. -/- Bernard Tschumi -/- From perversion to deconstruction In Bernard Tschumi’s writings from the 1970s and 1980s we can find a transposition of important threads of post-structuralist ideas deriving from Georges Bataille, Roland Barthes and Jacques Derrida’s works. The analysis of the architect’s writings also shows roots in Phillippe Sollers, Michel Foucault and Denis Hollier’s works. The analysis of borrowed elements from the beginnings of Tschumi’s theoretical activity may be helpful in explaining the contents of his later writings motre inspired by philosophy of deconstruction. The set of his earliest views was inspired by Marxism, Neo Marxism and French Structuralism, mainly by the writings of Henri Levebre and Guy Debord. From the thought of Levebre Tschumi took interest for city as not only a question of urbanistics but also a political issue. From Debord’s concepts he borrowed a conviction about the role of situational violation for changes in the society structure. Some of these beliefs were preserved in his own concepts of architecture as an event. From this period derived also his will to change conservative elements of social structure not by means of political revolution but of theoretical and creative activity. Tschumi acknowledged that the effective way of the proceedings towards achieving his aims would be accepting the role of both a critical intellectualist and architecture expert who would not hide away his left-wing orientation. The speculations defined by the architect as ‘revolting analyses’ were about to characterise contradictions which tear the society apart, penetrate architecture and constitute the basis of culture. Spreading away of the conscience of false assumptions hidden away in various disciplines could have weakened cohesion of a conservative society and influence the will to change among the elites. This way the beginnings of political revolution were rooted in philosophy of architecture. In 1977 Tschumi published his text entitled The Pleasure of Architecture inspired by Roland Barthes’s The Pleasure of the Text, it also included some concepts derived from Georges Bataille and Jacques Derrida. First of all the author used Barthes’s concept which made an assumption that literary activity is pervaded by the spirit of resistance towards social rules, and Tschudi transferred this remark onto architecture. From the ideas of Bataille, acquainted via Holier’s work, he derived his belief that two concepts of space, a conceptual one (defined as Pyramid) and a sensual one (defined as Labirynth), not losing their distinct features, they join in the concept of experienced space which exceeds contradictions. The exceeding itself was defined as the basic rule of architecture and it was referred to situations in which architecture not only negates social needs, but also disavows its own tradition. Crossing the borders applies not only to political issues or permanent rules of the very discipline but also interfering with other fields (especially literature and film). The fact that architecture is associated with organising events turned Tschumi’s attention to questions of violence that result from upsetting architectural order of a given building by its users and the one hand, and on the other from forcing the users to specific acts imposed by this very order. The analysis of the concepts used by Tschumi in his early writings indicates that they are close to definitions that would occur in his reflection in the following years influenced by philosophy of deconstruction. -/- Approaching deconstruction Tschumi in his theories developed in the 1980s presumed that the current social world had undergone a deep process of decay, and the reaction against which ought to be based on ordering-up actions, and also preserving the main outline of disintegration of the whole and its elements in the state of conflict. The statements concerning the nature of the contemporary to Tschumi social relations were applied by him to the world of architecture, this led him to coming up with designing strategies that took into consideration the destabilised character of conditions in which works of architecture were created. New ways of conduct invented by Tschumi drew their inspiration from literature and research on literature, psychoanalysis, structural linguistics, structuralism and post structuralism, and eventually also deconstruction philosophy. The proposed methods were opposed by their author both to functionalism continuity trends and postmodern architecture. Tschumi’s proposals contradicted any forms of conservatism or traditionalism in political sphere as well as in reference to tendencies in architecture. They were not simple contradictions of social or architectural rules, they intrude them from the inside, weaken or escalate the already existing incongruities, they move the boundaries between the areas. Revolutionary illusions about the possibility of radical changes were replaced with strategies which completed, tainted or test former rules in the series of formal games of permutation and combination. Quite different from avant-garde formalism Tschumi’s games were not about maintaining the autonomy of a given area, but on the contrary – polluting it with other areas’ influences. Tschumi enjoyed demonstrating illusions of architecture concerning simple relations between form and function, or between form and meaning. Making use of Freud, Lacan and Foucault’s research he introduced a category of “madness” into architecture allowing an observation that the recognised norms are nothing but merely ones of many possible principles of behaviour, and their recognised status resulted from unjustified hindering innovativeness which is crucial for architecture. To reborn architecture’s capability of changing Tschumi also made use of Barthes’s discoveries concerning rules of narration and works by writers who applied in their writing knowledge on linguistics. Making a work’s author unclear by various mechanical transformations of its elements was however apparent only, and formal rigours imposed on the process of designing liberated possibilities difficult to obtain in more traditional creative action. Another mode of acting introduced by Tschumi was combining his work of elements deriving from outside architecture; joining space records with notation of motion and events accompanying architectural objects among others. These architectural and extra-architectural elements were not unified, on the contrary their heterogenous and conflictual character was stressed. This is how shock, anxiety and instability, typical for live in great metropolises, infiltrated architecture. Taking some ideas of deconstruction philosophy as a pattern Tschumi also took into critical consideration in his essays traditional in architecture oppositions between form and figuration, or theory and practice. By combining various inspirations he eventually worked out an idea of architectural event, which he understood as a series of actions contesting its own field, redefining its sources, principles and elements. An event, understood in this way, was not so much producing works as rather creating conditions of their production and at the same time designing the society different from a hierarchic one. -/- Park of deconstruction Among numerous philosophical strategies of deconstruction most frequently used was questioning the practice of strong opposition of two reasons. In many cases Bernard Tschumi’s writings just consider functioning of the conflict juxtaposition of the ideas of structure and ornament or theory and practice in history of architecture. Violation of traditional relations between terms of this kind, both old and modern, raised Jacques Derrida’s objections, when he was induced for the first time to co-operate with architects’ milieu. During this long lasting thought exchange the philosopher eventually acknowledged Bernard Tschumi’s arguments for reasoning the encroachment of architecture’s fundamental rules. Deconstruction applied in architecture was not a simple transposition or analogy of practices that had been applied by philosophy of deconstruction. We may even say that considering architectural terms became an important formula of deconstruction. Architecture understood in philosophical way became something beyond the practice and theory of its own discipline, a sort of metaphysics of both philosophy and architecture. The deliberate encroachment of simplicity of dividing architecture into theory and practice, for the first time became a clear aim for Tschumi in his drawings and texts entitled The Manhattan Transcripts. The contents of this series of works was a record of characteristic features of this New York district in such a way that not only objects were the subject of the record but also relations between objects, people and events. The record was about to take into consideration a conflict character of elements of this representation and at the same time to avoid applying to them the rule of mimetism. The record became a form of reflection over the very record by an increased control over the ways of representation. Architecture which was considered in the The Manhattan Transcripts was not directed to fulfill the needs of inhabitation or production, it was rather related with hitherto usually marginalised liminal situations: building ostentatiously big monuments, religious cult, war etc. Architecture operating in these relations focused also the attention on the included in it continuous tendency to overpass its own restrictions, the role of violence as its not recognised factor, or the meaning of excess and shock in its operation. Architecture moving from reason towards madness became even more visible in the design of Parisian Parc de la Villette, whose pavilions were defined as folies (in French it means both small park buildings and follies). The park was supposed to be on the one hand a reflection of traditional society disintegration while on the other it questioned basic rules of producing a work of architecture. The traditional rules of designing, based on ordering up, were replaced with the strategies of dysfunction and dissociation. In Tschumi’s opinion methods of this kind may be equivalent of what Derrida named différance. Instead of aiming at mergence, any diversity, plays or variations were strengthen. Tschumi’s texts, in which he explained his attitude, were completed by Derrida’s extent statement entitled Point de folie – Maintenant l’architecture. Derrida’s article is the most significant of all his statements on architecture as a form of thinking and activity. According to the philosopher, architecture should divide space (in French defined as espacement), what enables both thinking and action – it arranges the space of an event. Tschumi’s buildings, defined as folies, in an essential way destabilise any created order, and at the same time they refresh it. Derrida’s statement suggests that architecture may become both metaphor of an order merging a language or a society but also of inner forces which deconstruct and reconstruct it. Therefore architecture is at the same time a construction, a deconstruction and a reconstruction. Parc de la Villette stands out in this system with its attempt to step beyond the scheme of an easy repetition and its heading for chances of achieving more radical otherness. -/- Conclusion Destruction as construction. Paradoxes of deconstruction in architecture -/- Scepticism about persistence and common importance of fundamental values of human culture evinced in philosophers and writers’ works as early as in Greek antiquity, nevertheless it was not expressed so strongly as in the second half of the 20th century. Especially in Heidegger’s work Being and Time (although originated in 1927, still influential in all later philosophy) the following states were characterised: the state of losing the ground (Abgrund), of being out of sight (Unheimlichkeit) and of being out of dwelling (Un-zuhause-sein) – as the basis of self-confidence of conscious being there (Dasein). The entire criticism of philosophy of home and dwelling draws the inspiration from this early writing of the German philosopher, it combines crisis of basic terms of metaphysics with social conditions which are dictated by living in large metropolis. The crisis of both metaphysical foundation and home appears to be similar to the situation of weakening the relations between a man and his dwelling in extensively expanding cities. Whereas philosophy, as well as many disciplines of social sciences, have diagnosed for a long time the destabilisation of fundamental ideas of Western culture and crucial changes in the ways of dwelling, architecture itself occurred to be “the last fortress of metaphysics” (J. Derrida). Among contemporary architects, Peter Eisenman and Bernard Tschumi were the ones who engaged most decidedly in the issues of critical analysis of architecture foundation and its social role. Both the architects noticed new formulas of contemporary social and individual existence, tremendously different from the entire history, and at the same time they affirmed lack of adequacy of architecture concepts to new situations. Both Eisenman and Tschumi used to describe the existing architecture as a tool for consolidation of highly integrated and hierarchised societies, and also as a discipline extremely uncoincidental with the current character of social life based on ideas of freedom and diversity. The means to transform architecture and make a factor of further social changes out of it, was a concept that accentuated revealing the inner contradictions of this discipline, and considering them in designing strategies. Eisenman’s activity, in regard of what has just been noticed, was focused on questioning the basic rules of traditionally comprehended architecture, especially the rule of purpose. The American architect noticed that the concept of architecture as fulfilment the need of location, hides away the fact that the location has to be constantly reconsidered, and hence it is overtaken by change (dislocation). Therefore new concept of architecture propounded architectural activity to translocate the concept of location – more than before – but also to change its status perpetually. Such comprehended architecture should claim, as its main purpose, the constant revision of this purpose and create itself anew permanently. Even Eisenman’s earliest designs of houses nos. I-IV broke with such values as the sense of safety, closeness and familiarity, and just on the contrary they accentuated senses of strangeness, homelessness and loss of confidence. The contradictions within architecture noticed by Tschumi referred to combination of intellectual and sensual values in architecture, when their non-appropriation was defeated by an additional condition, namely the way of experience based on pleasure of excess, marked by insanity. The features of folly were especially visible in his designs of gardens, where the order of planning was mixed with sensual experience introduced by particular elements (both the ones created by nature, and the buildings defined as folies). Parc de la Villette designed by the French architect in Paris put in question not only the common understanding of purpose in architecture but also the ideas of order and integrity, as its plan was based on the combination of independent layers with records of grids of points, various lines and planes. The architecture that collides inadequate elements with each other was supposed to be a kind of an event with no beginning and no end. The architecture treated as an event became a form of a space weakened articulation that maintains its diversity and lack of accordance of the elements building it up. The analyses of Eisenman and Tschumi’s theoretical writings indicate how much the aims of architecture have actually changed; instead of supporting social persistence, the architecture is rather intensifying contradictions, and instead of providing people with the sense of safety, it sublimes danger. From simple acts of defamiliarisation, increasing the distance to itself and enhancing the role of theory, through discomfort, anxiety, not feeling someone at home, weirdness, excess, shock and violence, architecture reached the edge of stability and uncertainty, only to make an attempt at penetrating what is impossible and unutterable, and recording what cannot become the subject of any records. -/- . (shrink)

This article reviews the debate on ‘intersectionality’ as the dominant approach in gender studies, with an emphasis on the politics of representation. The debate on intersectionality officially began in the late 1980s, though the approach can be traced back to the institutionalization of women's studies in the 1970s and the feminist movement of the 1960s. Black and lesbian feminists have long advocated hyphenated identities to be the backbone of feminist thought. But in recent years, intersectionality has sustained criticism from (...) numerous angles within gender studies, ranging from feminist philosophy to applied political research. This article will use the theorization of ‘interference’ as a searchlight to produce an overview of this interdisciplinary debate, culminating in our affirmative answer to the question: should we move from intersectionality to interference? Our answer is based on onto-epistemological reflections, i.e., reflections in which being and knowing are always already entangled. -/- . (shrink)

The argument of this dissertation is that despite the intellectual gendered burden of the problem of disembodiment I define, it can be employed from within the limitations of a gendered account in feminist philosophy of the continental-realist type. I formulate the problem of disembodiment as rooted in the notion of the boundless (apeiron) associated with femininity. Both boundlessness and disembodiment are subject to radicalization in Plato (chōra) and Plotinus (to hen). Read as a dyad, they culminate in a tendency towards (...) gendered disembodiment, mediated by Plato’s soul-body dualism. The dissertation seeks to compare the gendered dimension of disembodiment in the work of Plato and Plotinus and that of the non- philosophers François Laruelle and Katerina Kolozova. “Part I. The Problem of Boundlessness: Radicalizing Disembodiment” is divided in three chapters, which present an intellectual history of the problem of boundlessness as femininity. I survey the problem of boundlessness as drafting relations between elements and principles and femininity in Greek mythology (Chapter 1), Plato’s cosmology (Chapter 2), and Plotinus’ metaphysics (Chapter 3). I argue that the relation between death and the female was ambivalent by the time of the Anaximandrean apeiron and that it became a subject of radicalization via Plato’s chōra and Plotinus’ One, mediated by the notion of the Indefinite Dyad and the doctrine of divided matter. The problem of boundlessness was subject to conceptual radicalization that led to hierarchical metaphysics and deepened the division between body and soul via the association of femininity, reproductivity and matter. “Part II. The Problem of Disembodiment: Revising Boundlessness” is divided in two chapters focusing on the contemporary relevance and importance of the problem of disembodiment as a way of revising boundlessness. I present and explain the legacy of the Platonic chōra and the Plotinian One and what they as a dyad entail for contemporary continental philosophy. I offer (Chapter 4) a trajectory for a continental feminist philosophy interpretation of disembodiment by combining continental feminist philosophy, non- philosophy and new realism. With the aid of Laruelle’s non-philosophy, I explain how and why chōra and the One can be used for/from continental feminist philosophy, followed by a presentation of how chōra and the One are revised in continental philosophy from non- philosophical and new realist perspectives. I then develop (Chapter 5) a continental feminist philosophical interpretation of and approach to the problem of disembodiment from a realist perspective by problematizing continental and feminist philosophical anti-realism. The approach presented is itself an argument in defence of a feminist engagement with disembodiment and the dissertation’s contribution: a non-philosophical contribution to the problem of disembodiment via a continental feminist-realist philosophical approach. The approach is offered through the intersection of continental feminist realism and non- philosophy, and partially new realism. My conclusion is that an affirmative project and consideration of disembodiment for continental feminist philosophy is possible via a non- philosophical and new realist reconsideration of the One. (shrink)

Abstract: Heart attacks, or myocardial infarctions, are a leading cause of mortality worldwide. Early prediction and accurate analysis of potential risk factors play a crucial role in preventing heart attacks and improving patient outcomes. In this study, we conduct a comprehensive review of datasets related to heart attack analysis and prediction. We begin by examining the various types of datasets available for heart attack research, encompassing clinical, demographic, and physiological data. These datasets originate from diverse sources, including hospitals, research institutions, (...) and public health agencies. Our analysis aims to identify common features, data quality, and potential biases in these datasets. Next, we explore the predictive modeling techniques employed in heart attack prediction. Machine learning algorithms, such as decision trees, support vector machines, and deep neural networks, have gained prominence in predicting heart attacks. We discuss the strengths and limitations of these methods and highlight recent advancements in predictive modeling. Furthermore, we delve into the critical risk factors associated with heart attacks. Factors such as age, gender, hypertension, diabetes, and cholesterol levels are examined for their significance in predicting cardiac events. We also investigate the role of lifestyle factors, including smoking, diet, and physical activity, in heart attack risk assessment. Additionally, this review addresses the importance of data preprocessing and feature engineering in improving prediction accuracy. Feature selection methods, missing data handling, and data scaling techniques are discussed to enhance the robustness of heart attack prediction models. In conclusion, this comprehensive dataset review provides valuable insights into the state of heart attack analysis and prediction. It serves as a resource for researchers and healthcare professionals seeking to better understand the datasets available for heart attack research and the methods employed for accurate prediction. Ultimately, our efforts in dataset analysis and predictive modeling contribute to the advancement of preventive cardiology and the reduction of heart attack-related morbidity and mortality. (shrink)

This study thoroughly investigates the financial behaviors of financially independent, young, single professionals aged 24 to 35 in Balayan, Batangas, amidst a period of global inflation. Focusing on five industries—education, finance, government, healthcare, and retail—the research employs a mixed-methods approach. Quantitative analysis, involving 75 respondents through a 4-point Likert scale survey, is complemented by qualitative insights from in-depth interviews with 5 participants from each industry. The findings from numerical values revealed that demographics did not impact working professionals' saving habits (...) and buying behaviors during the global inflation surge. This suggests that despite differences in age, gender, industry, employment status, and monthly income or salary, all professionals prioritized robust, strong savings and reduced spending to ensure financial stability. The research underscores the significance for professionals in various industries to prioritize specific aspects of personal financial management during the prevailing global inflation surge. The study suggests that, irrespective of industry, working professionals should prioritize specific aspects of personal financial management during the global inflation surge. (shrink)

In this chapter, I propose that conceptions of justice in bioethics must be feminist, meaning they must be able to capture how the domains of health, healthcare and medicine exacerbate the subordination of those perceived to be women and girls and how injustice impacts their health. After providing context in the first section, I identify three problems with conceptions of justice in the bioethics literature that interfere with their potential to be feminist. They tend to adopt the ahistoricism and (...) distributivism characteristic of theories of justice that have been dominant in political philosophy, and they often rely on gendered conceptions of health that result in troubling comparisons of men and women’s health. My argument is primarily “negative”: it is a critique of generalist conceptions of justice in bioethics. However, in the final section I present characteristics of what a feminist conception of justice needs to look like and indicate how feminist bioethicists are using such a conception in assessing issues of injustice in bioethics. I emphasize the centrality of actual structural injustices, relational egalitarianism, and the assessment of values in conceptions of health and the health sciences. (shrink)

In January 1995, at the age of 22, Annabel Chong (whose real name is Grace Quek), a former pornographic actress/director set a world record (which has since been topped) for having the most number of sex acts, 251 with about 70 men, over a period of about ten hours, for a film called the World’s Biggest Gangbang. Chong claims in subsequent interviews that more than anything else, she did it to challenge the stereotypical notion that female sexuality is passive—that women (...) like to be “seduced, kissed and cuddled, and [are] basically biologically monogamous”. She quips that “if a guy did 251 women in one day . . . everyone would think he’s a real stud”; But if a girl does the same “she’s considered a terrible slut.” This paper is my attempt to investigate what Annabel Chong’s dissent means for feminism: Is Annabel Chong the quintessential feminist, defying an oppressive system, asserting her individuality, redefining the parameters of a gender-determined sexuality? Or is she a victim of her own misguided ideals, objectifying herself in the belief that this affirms her subjectivity, submitting herself to domination to reclaim control, eventually propagating the same oppressive system she professes to end? I want to approach this inquiry using Foucault’s framework of power-discourse-sexuality for two reasons: First, I believe that Foucault’s genealogy of sexuality successfully exploits how sexuality as a discursive construct is used as a technique of control; Second, I believe that Foucault provides us a way of understanding how an individual responds to various systems of control, as well as a framework that explains the many power relations that determine an individual’s mode of existence. However, since in effect, I would be presenting a Foucauldian analysis of the gendered experience of a feminist subject, I find it necessary to first overcome what I consider as theoretical barriers, alluding to the ongoing debate concerning the usefulness of Foucault’s framework for feminists. To address this issue, I will present a brief survey of the criticisms directed to the inadequacy of Foucault’s theory of the subject posed by some notable feminists, as well as the proposed resolutions to them. This also establishes the framework on which I ground my inquiry. My contention is that to some extent these criticisms have already been resolved, and that it is now possible to present an analysis of the gendered experience of the feminist subject using a Foucauldian framework. (shrink)

In the global fight against the rapid spread of COVID-19, a variety of unprecedented preventive measures have been implemented across the globe, as well as in Vietnam. How Vietnamese people respond to threats to their health and life remains unclear. For this reason, the current study aims to examine Vietnamese people’s protective behavior and its factors. Based on 1,798 online survey respondents’ data collected on the last three days of the nationwide social distancing campaign in mid-April, it is found that (...) gender, knowledge of COVID-19 and preventive measures, and attitudes towards the COVID-19 prevention policies are the three main factors of participants’ protective behaviors. We also find that males are less likely than females to adopt precautionary measures. People who are knowledgeable about COVID-19 may have inappropriate practices towards it. Further research is needed to examine other determinants of protective behaviors to provide more useful information for authorities, public health policy-makers, and healthcare workers to deliver the best practices to control COVID-19 in our country. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:MatteringPheng Cheah (bio)Judith Butler. Bodies That Matter: On the Discursive Limits of “Sex.” New York: Routledge, 1993.Elizabeth Grosz. Volatile Bodies: Toward a Corporeal Feminism. Bloomington: Indiana UP, 1994.Any cursory survey of contemporary cultural-political theory and criticism will indicate that the related concepts of “nature” and “the given” are not highly valued terms. The reason for this disdain and even moral disapprobation of naturalistic accounts of human existence is supposed (...) to be self-evident: simply put, in a post-Newtonian age, nature refers to the totality of objects governed by immutable causal laws. If human existence was merely natural or given, then we would never be able to alter the conditions that bring about human oppression. Antinaturalism in contemporary theory, however, betrays a deep fear in its repetitive tirades against the natural. For if it is so obviously precritical to treat human existence as given, then why does antinaturalism need to be articulated again and again? This obsessive pushing away of nature may well constitute an acknowledgement-in-disavowal that humans may be natural creatures after all. Furthermore, as a theoretical position, antinaturalism itself is produced by the polemical energy that strives to keep nature at bay, in quarantine from the sphere of human life. Consequently, antinaturalism works with a conventional philosophical definition of nature which it may do well to question. We may therefore be justified in claiming that, far from being tired superstitions that savvy discourse analysts and cultural constructionists can leave behind, the concepts of “nature” and “the given” are, in fact, neuralgic points, the contested sites around which any theory of political transformation is organized.In its conventional usage, nature is opposed to a whole host of other terms: history, culture, law, production, and so forth. The slipperiness of nature, however, is seen in the fact that the relation between nature and its others defies characterization as a simple relation of exteriority between two ontologically distinct terms. For instance, the relation of nature to history can be posed not only in terms of the modification of nature by historical agency but also from within the realm of historical agency insofar as the constraints of structure or construction on transformative rational agency seem to replicate the limitations or weightiness of nature. Feminism is an exemplary site for rehearsing this fundamental questioning of the distinction between nature and its others because it must refute biologistic and naturalistic justifications for the oppression of women even as it must affirm women’s bodily specificity as the minimal consensual stuff which grounds feminist practice. As Zillah Eisenstein astutely observes in spite of her own intellectual allegiances, “if the body is already engendered in this way, how can we claim our bodies without reproducing the inequities of the gender-system?... [S]o we become involved in explicating patriarchal relations without knowing where patriarchy begins and ends in the definition of a woman’s or a mother’s body. What aspect of the body constitutes a woman’s potential capacities, and what part articulates her oppression?” [73, 75]. [End Page 108] Philosophically speaking, the giving of body or matter—what I propose to call “mattering”—may be the process where history and nature become uncannily indistinguishable in a manner that is both enabling and disabling for political transformation, its condition of (im)possibility.Thus far, the productive unease in feminist theory occasioned by the body as the ambivalent ground of both oppression and emancipatory transformation has resulted in debates over the sex/gender distinction and the question of essentialism/antiessentialism. 1 Discussion has, however, primarily centered on the strategic deployment of the body as a political resource. Two recent books—Judith Butler’s Bodies That Matter and Elizabeth Grosz’s Volatile Bodies—stand out because they promise to raise discussion to a level where political issues concerning the body can be reevaluated through a rigorous rethinking of the relation between nature and its others: culture, history, and society. The authors of these books share the distinctive aim of articulating a feminist theory that is centered on a philosophical exploration of the status of the body. Both Grosz and Butler are trained in Continental philosophy, where the secondary status of... (shrink)

Ambient assisted living technologies are increasingly presented and sold as essential smart additions to daily life and home environments that will radically transform the healthcare and wellness markets of the future. An ethical approach and a thorough understanding of all ethics in surveillance/monitoring architectures are therefore pressing. AAL poses many ethical challenges raising questions that will affect immediate acceptance and long-term usage. Furthermore, ethical issues emerge from social inequalities and their potential exacerbation by AAL, accentuating the existing access gap (...) between high-income countries and low and middle-income countries. Legal aspects mainly refer to the adherence to existing legal frameworks and cover issues related to product safety, data protection, cybersecurity, intellectual property, and access to data by public, private, and government bodies. Successful privacy-friendly AAL applications are needed, as the pressure to bring Internet of Things devices and ones equipped with artificial intelligence quickly to market cannot overlook the fact that the environments in which AAL will operate are mostly private. The social issues focus on the impact of AAL technologies before and after their adoption. Future AAL technologies need to consider all aspects of equality such as gender, race, age and social disadvantages and avoid increasing loneliness and isolation among, e.g. older and frail people. Finally, the current power asymmetries between the target and general populations should not be underestimated nor should the discrepant needs and motivations of the target group and those developing and deploying AAL systems. Whilst AAL technologies provide promising solutions for the health and social care challenges, they are not exempt from ethical, legal and social issues. A set of ELSI guidelines is needed to integrate these factors at the research and development stage. (shrink)

There are many grounds to object to tokenism, but that doesn’t mean we should always avoid being the token woman, argues Anca Gheaus.

The ontological determination of the movement in its quality of way of Being incessantly moves the critic affirmed to denial it through come to be which affirms new critics, unity of continuities and discontinuities with the previous critic. Therefore, it is important to unveil the material determinations in which are rooted the conception of Being dissociated from Non-being consolidated in insurmountable distinction between Being and Entity in its quality of expression of ideas in an inverted reality, falsely apprehended. Ideally reproduced (...) reality that, nevertheless, allows alternatives corresponding to the realization of aims targeted to satisfy historically determined necessities. The confrontations in the production and reproduction of purposes to guide social relations cross-dress debility of determined and impotent movement to impose determinations to the full virtuosity of immobility that moves the transitory. The difference between Being e Entity conforms in a formal logic deprived from/of contradiction to affirm the development of knowledge in what, in truth, hindered and limit it to remain, reducing the movement to stationary, to what moves to what moves without moving, to what isolate the knowledge of reality, to what detaches idea and material, to what conserves and incarcerates and not to what transform and set free. The treatment conceived as a movement from radical critic brings together the ontological primacy to underpin the root of the constitution of social existence to establish the ontological determinations of the existence to consciousness is stated in Marx – being reaffirmed in Lukács – by affirming that categories are forms of Being, determinations from/of existence. The category of totality, as a result of it, constitute expression of form of Being from reality in movement and synthesis from multiples and mutual determinations of negated diversities in an unitarity which affirm them. Therefore, the dialectical reflexive movement refuses as an ineliminable condition to the movement which affirms to mould identity with unitarity between identity and non-identity or don’t conceive relation of identity with dialectic, with the existence of reality to express a contradiction and incessant transmutation between Being and Non-being. The totality by transmuting itself while remain totality albeit not identical to the previous moment embraces a category to synthesize the unity of diversity. This diversity moved and moving from/by unity contemplates the relation of identity ratio (nowadays totality) between the identity (continuity with the preceding totality) and the non-identity (discontinuity with the preceding totality). To ignore the identity of identity with a non-identity conforms the impotence of category to constitute an expression of existence for not affording the contradiction immanent to the existence of reality moving from transport incessant of Being to come to be which puts itself from Non-being to Being. In short, concomitantly the being is transposed to Non-being to a Being come to be transpose from Non-being to a Being whilst ontological determination is constituted and constitutive of movement. The realization of critic conditioned the self-critic that ontologically determines the denial of self-preservation because it constitutes roots in social conditions that limit the intended transformation through critic. The critique of science as an ideological and material condition of reproduction and realization of capital is not effective with the auto-conservation of Geography for conforming the necessity of conservation of science to be rooted in the conception of distinction idealized by superiority that would affirm the permanence and nullity of transcending the limitations to denial the inhumanity of alienation concomitantly affirm the conditions to recognition of necessities and possibilities oriented to an emancipatory purposes. The progressive compressing of expenditure of time on production and productivity of results in various fields of scientific knowledge – which do not realize strictly in the extent of knowledge or it would be equivalent to affirm the fallacy of isolation and to deny the material and historical determinations that constitutes the quality of form of Being -, expressed in the quality of objective necessity and possibility concomitantly to fragment the form and content of the orientation of aims for investigation and for apprehension of reality. The convergence of the movements above-mentioned conforms the constitution of consensus positivity of complexifying of knowledge, delimitating the conceiving of reality and the supposed objective determinations a priori that constraint the conscious apprehension of necessities and of purposes that manifestate in the immediacy by the quality of developing individual and humankind potentialities of social being. Therefore, the conception of suprahistorical and insuppressible ontological determination depriving from social intentionalities in naturalize the impute of greater speed and complexity with lesser time and size of fragmented reality to be known, strengthening the conditions of inversion of reality. Reversed reality deforms the conscious apprehension of corresponding reduce the humanity of individual and gender social sphere of Being for alienating the necessities and goals of theory and practice, consciously aimed to the development of conditions for impoverishment humanity cross-dress in fallaciously things provided by humanity. Things that would had identity with men humanization obfuscating the unifying the developing of thing in the developing of men in the quality of thing, to conceive the most primary theoretical and practical necessity for the purpose of development of thing as an irrevocable necessity from human activity. The confrontation in the sphere of ideas constitutes itself while conceiving the real and, in this direction, the domination of necessities and purposes of material (re)production of society requires the domination of the categories of space and time as forms of Being of substance in motion. The detachment between Being and Entity conceives the indetermination of the dominant conception of reality that determines the conditions for the reproduction of life and the come to be of individuals and humankind. (shrink)

The article examines the following interpretive hypothesis: from the formulation of the concept of “precariousness” in Precarious Life (2004), Judith Butler's thought undergoes a inflection towards a ethical-political foundation normatively understood and previously rejected by the author as evidenced in her debate with Nancy Fraser and Seyla Benhabib in the 1990s. It is therefore a matter of questioning the impact of this theoretical mutation on the notions of universal and subject that are embedded in the argumentative lines of the author’s (...) texts, thus establishing “precariousness” and “co-dependence” as ethical-political conditions that should guide political guidelines aimed at making life possible and viable. The article is divided into three moments: 1) the universal denied in form and content; 2) The universal affirmed in its form, but denied in its content; 3) the universal materially and formally affirmed. It will also address the different notions of subject that emerge from each of these three understandings of universal. (shrink)

Objective Our study sought to (1) describe the practices and preferences of Colombian adolescents in accessing sexual and reproductive health services: accompanied versus alone; (2) compare actual practices with stated preferences; and (3) determine age and gender differences regarding the practice and these stated preferences. -/- Methods 812 participants aged 11–24 years old answered a survey in two Profamilia clinics in the cities of Medellin and Cali in Colombia. A cross-sectional analysis was performed to compare participants’ answers based on (...) the variables of gender and age. -/- Results A quarter of participants visited the clinic alone (25.4%). Females were more likely to go alone in comparison to males (26.3% vs 14.1%; p = 0.031), and older participants went alone more often than younger participants (p < 0.001). Most participants – 72.7% (95 %CI: 69.3–75.9) – expressed a preference in being accompanied to the clinic, and more than 90% had their preferences met. The preferences of older participants were, however, less likely to be met than those of younger participants (p < 0.001), notably, because they predominantly wanted to be accompanied. -/- Conclusion Contemporary public health and bioethics literature advocates in favor of developing health services that better meet the preferences of adolescents. The present research highlights an apparent blind spot related to the role that others (e.g., parents, friends, partners) can or should play in accompanying adolescent patients when they access sexual and reproductive health services. Respecting adolescents’ preferences, and hence their autonomy, is not simply a matter of ensuring freedom from constraints (e.g., their right and ability to go alone). Rather, it should also consider the liberty to choose whether to be accompanied when accessing SHRS and by whom. (shrink)

After stating "I am gay" Navy Lieutenant Paul G. Thomasson was honorably discharged from the military. In Thomasson v. Perry (1996), the United States Court of Appeals for the Fourth District affirmed Thomasson's discharge. Thomasson is now considered the leading case evaluating the U.S. military's "don't ask, don't tell" policy. In this paper, I show that the court's analysis of the Department of Defense policy rests of two unarticulated and undefended assumptions about sexuality. The first is that an act of (...) sex is essentially defined in terms of the sexual orientation of the persons engaging in that act. The second is that whether or not a person is an open homosexual determines the essential nature of the homosexual acts of others. I conclude that both assumptions are untenable, therefore the "don't ask, don't tell" policy is indefensible. (shrink)

In their paper titled “Gender and philosophical intuition,” Buckwalter and Stich argue that the intuitions of women and men differ significantly on various types of philosophical questions. Furthermore, men's intuitions, so the authors claim, are more in line with traditionally accepted solutions of classical problems. This inherent bias, so the argument goes, is one of the factors that leads more men than women to pursue degrees and careers in philosophy. These findings have received a considerable amount of attention and (...) the paper is to appear in the second edition of Experimental Philosophy edited by Knobe and Nichols , which itself is an influential outlet. Given the exposure of these results, we attempted to replicate three of the classes of questions that Buckwalter and Stich review in their paper and for which they report significant differences. We failed to replicate the results using several different sources for data collection (one being identical to the original procedures.. (shrink)

My paper addresses a topic--the implications of Rawls's justice as fairness for affirmative action--that has received remarkably little attention from Rawls's major interpreters. The only extended treatments of it that are in print are over a quarter-century old, and they bear scarcely any relationship to Rawls's own nonideal theorizing. Following Christine Korsgaard's lead, I work through the implications of Rawls's nonideal theory and show what it entails for affirmative action: viz. that under nonideal conditions, aggressive forms of formal equality of (...) opportunity (e.g., sensitivity training, outreach efforts, external monitoring and enforcement) and compensating support (e.g., special fellowship programs, childcare facilities, mentoring, co-op opportunities, etc.) can be justified, but that "hard" and even "soft" quotas are difficult to defend under any conditions. I conclude the paper by exploring the implications of these surprising results for contemporary liberalism more broadly and for constitutional law and public policy. (shrink)

Philosophical theories of gender are typically understood as theories of what it is to be a woman, a man, a nonbinary person, and so on. In this paper, I argue that this is a mistake. There’s good reason to suppose that our best philosophical theory of gender might not directly match up to or give the extensions of ordinary gender categories like ‘woman’.

Philosophical arguments regarding academic freedom can sometimes appear removed from the real conflicts playing out in contemporary universities. This paper focusses on a set of issues at the front line of these conflicts, namely, questions regarding sex, gender and gender identity. We document the ways in which the work of academics has been affected by political activism around these questions and, drawing on our respective disciplinary expertise as a sociologist and a philosopher, elucidate the costs of curtailing discussion (...) on fundamental demographic and conceptual categories. We discuss some philosophical work that addresses the conceptual distinction between academic freedom and free speech and explore how these notions are intertwined in significant ways in universities. Our discussion elucidates and emphasises the educational costs of curtailing academic freedom. (shrink)

Deep learning may transform health care, but model development has largely been dependent on availability of advanced technical expertise. The aim of this study is to develop a deep learning model to predict the gender from retinal fundus images. The proposed model was based on the Xception pre-trained model. The proposed model was trained on 20,000 retinal fundus images from Kaggle depository. The dataset was preprocessed them split into three datasets (training, validation, Testing). After training and cross-validating the proposed (...) model, it was evaluated using the testing dataset. The result of testing, the area under receiver operating characteristic curve (AUROC) of the model was 0.99, precision, recall, f1-score and accuracy were 99%, precision, recall, f1-score and accuracy were 96.83%, 96.83%, 96.82% and 96.83% respectively.. Clinicians are presently unaware of dissimilar retinal feature variants between females and males, stressing the importance of model explain ability for the prediction of gender from retinal fundus images. The proposed deep learning may enable clinician-driven automated discovery of novel visions and disease biomarkers. (shrink)

Adaptation and stress are two main concepts useful for better understanding the phases of illness and health-related human behavior. The two faces of adaptation, adaptation as a process and adaptation as a product, have raised the question of how long the adaptation process will take in cancer trajectories. The care setting transition from clinical-based into home-based cancer care has stressed the role of family caregivers (FCG) in cancer management. This study examines how types of demanded healthcare information affect the (...) FCG’s role in catalyzing the adaptation of female cancer patients. The mindsponge theory was used in conceptual development and results interpretation. Bayesian Mindsponge Framework (BMF) analytics was used for statistical analysis on a dataset of 48 spouses (husbands) and 12 other family members in five congested communities of Surabaya, Indonesia. Results showed that among the six types of demanded healthcare information, FCGs with a higher tendency to demand cancer-specific information are more likely to need support in catalyzing the adaptation of female cancer patients. Meanwhile, FCGs with a higher demand for information on alternative therapies are less likely to need support in catalyzing cancer adaptation. Other types of healthcare information have ambiguous effects on the need for support in cancer adaptation assistance. This study reveals that the demanded cancer-specific information, e.g., cancer’s prognosis or likely outcome, must be prioritized to assist FCG’s role in catalyzing adaptation among female cancer patients. Cancer prognosis and outcomes reflect the future of cancer care results. (shrink)

Ill persons suffer from a variety of epistemically-inflected harms and wrongs. Many of these are interpretable as specific forms of what we dub pathocentric epistemic injustices, these being ones that target and track ill persons. We sketch the general forms of pathocentric testimonial and hermeneutical injustice, each of which are pervasive within the experiences of ill persons during their encounters in healthcare contexts and the social world. What’s epistemically unjust might not be only agents, communities and institutions, but the (...) theoretical conceptions of health that structure our responses to illness. Thus, we suggest that although such pathocentric epistemic injustices have a variety of interpersonal and structural causes, they are also sustained by a deeper naturalistic conception of the nature of illness. (shrink)