Obtaining informed consent from patients prior to a medical or surgical procedure is a fundamental part of safe and ethical clinical practice. Currently, it is routine for a significant part of the consent process to be delegated to members of the clinical team not performing the procedure (eg, junior doctors). However, it is common for consent-taking delegates to lack sufficient time and clinical knowledge to adequately promote patient autonomy and informed decision-making. Such problems might be addressed in a number of (...) ways. One possible solution to this clinical dilemma is through the use of conversational artificial intelligence using large language models (LLMs). There is considerable interest in the potential benefits of such models in medicine. For delegated procedural consent, LLM could improve patients’ access to the relevant procedural information and therefore enhance informed decision-making.In this paper, we first outline a hypothetical example of delegation of consent to LLMs prior to surgery. We then discuss existing clinical guidelines for consent delegation and some of the ways in which current practice may fail to meet the ethical purposes of informed consent. We outline and discuss the ethical implications of delegating consent to LLMs in medicine concluding that at least in certain clinical situations, the benefits of LLMs potentially far outweigh those of current practices. (shrink)

Recently, Australia became the second jurisdiction worldwide to legalize the use of mitochondrial donation technology. The Mitochondrial Donation Law Reform (Maeve’s Law) Bill 2021 allows individuals with a family history of mitochondrial disease to access assisted reproductive techniques that prevent the inheritance of mitochondrial disease. Using inductive content analysis, we assessed submissions sent to the Senate Committee as part of a programme of scientific inquiry and public consultation that informed drafting of the Bill. These submissions discussed a range of bioethical (...) and legal considerations of central importance to the political debate. Significantly, submissions from those with a first-hand experience of mitochondrial disease, including clinicians and those with a family history of mitochondrial disease, were in strong support of this legislation. Those in support of the Bill commended the two-staged approach and rigorous licencing requirements as part of the Bill’s implementation strategy. Submissions which outlined arguments against the legislation either opposed the use of these techniques in general or opposed aspects of the implementation strategy in Australia. These findings offer a window into the ethical arguments and perspectives that matter most to those Australians who took part in the Senate inquiry into mitochondrial donation. The insights garnered from these submissions may be used to help refine policy and guidelines as the field progresses. (shrink)

When making substituted judgments for incapacitated patients, surrogates often struggle to guess what the patient would want if they had capacity. Surrogates may also agonize over having the (sole) responsibility of making such a determination. To address such concerns, a Patient Preference Predictor (PPP) has been proposed that would use an algorithm to infer the treatment preferences of individual patients from population-level data about the known preferences of people with similar demographic characteristics. However, critics have suggested that even if such (...) a PPP were more accurate, on average, than human surrogates in identifying patient preferences, the proposed algorithm would nevertheless fail to respect the patient’s (former) autonomy since it draws on the ‘wrong’ kind of data: namely, data that are not specific to the individual patient and which therefore may not reflect their actual values, or their reasons for having the preferences they do. Taking such criticisms on board, we here propose a new approach: the Personalized Patient Preference Predictor (P4). The P4 is based on recent advances in machine learning, which allow technologies including large language models to be more cheaply and efficiently ‘fine-tuned’ on person-specific data. The P4, unlike the PPP, would be able to infer an individual patient’s preferences from material (e.g., prior treatment decisions) that is in fact specific to them. Thus, we argue, in addition to being potentially more accurate at the individual level than the previously proposed PPP, the predictions of a P4 would also more directly reflect each patient’s own reasons and values. In this article, we review recent discoveries in artificial intelligence research that suggest a P4 is technically feasible, and argue that, if it is developed and appropriately deployed, it should assuage some of the main autonomy-based concerns of critics of the original PPP. We then consider various objections to our proposal and offer some tentative replies. (shrink)

In today’s evolving understanding of gender, questions arise about the future of the feminist movement. Using Simone de Beauvoir’s The Second Sex, Hugh Ryan's “Who's Afraid of Social Contagion,” and Ben Kesslen’s “How the Idea of a 'Transgender Contagion' Went Viral—and Caused Untold Harm,” this paper explores the concept of the Other to analyze social contagion and gender-based oppression. It argues that while feminism must adapt, its future lies in embracing the experiences of all classified as the Other. Through de (...) Beauvoir's work, historical definitions of gender, and social constructivism, this paper proposes a new idea for the future of feminism. (shrink)

This book explores Kant's views on the concept of God and on the attempt to demonstrate God's existence as a means of understanding Kant's work as a whole and of achieving a proper appreciation of the contents of Kant's moral faith.

This masterful work on Kant's Religion within the Boundaries of Mere Reason explores Kant's treatment of the Idea of God, his views concerning evil, and the moral grounds for faith in God. Kant and Religion works to deepen our understanding of religion's place and meaning within the history of human culture, touching on Kant's philosophical stance regarding theoretical, moral, political, and religious matters. Wood's breadth of knowledge of Kant's corpus, philosophical sharpness, and depth of reflection sheds light not only on (...) Kant, but also on the fate of religion and its relation to philosophy in the modern world. (shrink)

Seamus heaney says that the best lyrics unite “reader and poet and poem in an experience of enlargement, of getting beyond the confines of the first person singular, of widening the lens of receptivity until it reaches and is reached by the world beyond the self.”1 In “Crossing Brooklyn Ferry,”2 the ferry crossing acts as a catalyst for meditations about the self, the interaction between self and other, their common experience of the physical world across time, and how to forge (...) bonds that overcome the intense separateness of each individual. From these meditations arise an apprehension of time that blends past, present, and future; philosophical speculations about individual human identity during corporeal.. (shrink)

This article explores chemical skin bleaching practices in urban Ghana to demonstrate the ways that particular racialized understandings of meaning are deployed in a contemporary postcolonial African society. I argue that the processes of racialization indexed by skin bleaching in Ghana must be contextualized within global racial formations; specifically, they can only be understood by examining the interlinked local and global ideologies and practices of race. In elaborating this argument, the essay also engages with contemporary African diaspora theorization that tends (...) to foreground diasporic identity and experience at the expense of contemporary continental processes. By bringing a postcolonial African society into a dialogue about race, processes of racialization, and the interlinked transnational construction of black identities, this essay offers one way out of the ambivalent relationship that I believe diaspora theorization has with Africa. (shrink)

This article argues that Judith Butler’s neglect of biopolitics in her reading of Michel Foucault’s work on sexuality leads her to propose a genealogy of gender ontology rather than conduct a genealogy of gender itself. Sex was not an effect of a cultural system for Foucault, but an apparatus of biopower that emerged in the eighteenth century for the administration of life. Butler, however, is interested in uncovering how something we call or identify as gender manifests itself in different times (...) and contexts, rather than asking what relations of power made necessary the emergence of gender as a discourse. After examining the theoretical configurations underpinning Butler’s engagement with Foucault’s Herculine Barbin, I suggest a more biopolitically informed reading of how the material body becomes captured by the discourses of sexuality and sex. Finally, the article sets out preliminary questions with which a more strictly Foucauldian genealogy of gender might be conducted. (shrink)

In this original work of cultural criticism, Allen S. Weiss explores the meaning of radio to the modern imagination.

The latest volume in the Cambridge Histories of Philosophy series, The Cambridge History of Philosophy in the Nineteenth Century brings together twenty-nine leading experts in the field and covers the years 1790-1870. Their twenty-seven chapters provide a comprehensive survey of the period, organizing the material topically. After a brief editor's introduction, it begins with three chapters surveying the background of nineteenth century philosophy: followed by two on logic and mathematics, two on nature and natural science, five on mind and language, (...) including psychology, the human sciences and aesthetics, four on ethics, three on religion, seven on society, including chapters on the French Revolution, the decline of natural right, political economy, and social discontent, and three on history, dealing with historical method, speculative theories of history and the history of philosophy. The essays are framed by an editor's introduction and a bibliography. (shrink)

This article demonstrates how class and racial dynamics generate different styles of activism among women's movement organizations. Based on a comparative study of two feminist organizations—one composed of lower-class women of color and another of upper-class white women—it charts the formation of divergent types of gender politics. First, it explores how differences in the class and racial backgrounds of the memberships create distinct organizational needs; second, how these divergent political interests motivate contrasting organizational ideologies, activities, and structures; and finally how (...) they motivate different approaches to the wider women's movement. At the conclusion, implications are drawn for cross-class/race alliances among grassroots women's organizations. (shrink)

Within barely a year, two school shootings shook Finland. The school shootings shocked Finnish society, forcing media, academics and experts, police and politicians alike to search for reasons behind the violent incidents. Focusing their analysis on the two main Finnish newspapers, Helsingin Sanomat and Hufvudstadsbladet, authoritative sources of information for Finland’s two language communities, the authors maintain that the Finnish case contributes to research on school shootings by evidencing the intimate linkages between the state, gender and violence. The authors argue (...) that violence is to be understood through different discourses about the Finnish state. In particular, they discern three discourses about the state that produce gendered discourses of violence: the welfare state, the realist state and the neoliberal state. The authors conclude that these discourses produce different notions of rational and irrational violence thereby providing different legitimizations for male-embodied/masculine violence. (shrink)

The idea of transgender identity is less perceived as a mental illness but as a sexual health condition in many parts of the Western world, while it is seen as an anomaly in most parts of Africa. Transgender identity is a gender expression that differs from the naturally assigned sex. The widely accepted reason behind transgender is unsatisfactory feelings toward assigned sex by the individual. This work sets out to explore transgender identity and family life in Africa. Several works have (...) explored the concept but with less emphasis on family life as it relates to the African setting. Furthermore, this work sets out to demonstrate some implications of transgender identity in an ideal African family. In this work, we shall argue that once transgender identity is normalized in Africa, it will be a threat to family life. The arguments to be used are historical, analytical, descriptive as well as evaluative. (shrink)

Exclusive moral concern for human beings is often thought to be the ideological source of many contemporary environmental problems. So the development of a non-anthropocentric theory of intrinsic moral value, according to which at least some parts of the non-human world are morally considerable for their own sake, is often thought to be a defining characteristic of a satisfying environmental ethic. This chapter unpacks three distinct forms of anthropocentrism, outlines three versions of ethical nonanthropocentrism, and sketches some of the debate (...) between anthropocentrists and nonanthropocentrists before concluding that a virtue-theoretic approach to human natural goodness exemplifies one form of anthropocentrism that may continue to play a vital role in developing an environmental ethic suitable to the Anthropocene. (shrink)

Today humanity faces radical global climate change, mass species extinctions, and unprecedented transformations to both terrestrial and aquatic ecosystems across the globe. Environmental ethics is an academic subfield of philosophy concerned with normative and evaluative propositions about the world of nature and, perhaps more generally, the moral fabric of relations between human beings and the world we occupy. This Handbook contains 45 newly commissioned essays written by leading experts and emerging voices and represent some of the best and most contemporary (...) thinking in environmental ethics. The chapters range over a broad variety of issues, concepts, and perspectives that are both central to and characteristic of the field, thus providing an authoritative but accessible account of the history, analysis, and prospect of ideas that are essential to contemporary environmental ethics. (shrink)

Heathen Soul Lore Foundations presents a living spiritual landscape, rooted in ancient Germanic languages and understanding, offered for modern Heathens to explore and use in their own spiritual practice. This book also presents an approach for identifying and exploring ancient concepts of 'what a soul is' that may be of interest to followers of other branches of historically based modern Paganism, and to scholars of comparative religion. Linguistic analysis, literature, folklore, comparative religion, anthropology, esoteric and philosophical approaches are used to (...) analyze old Germanic-language words relating to 'the soul'. The following souls, identified through this process, are thoroughly reviewed: Ferah, Ahma, Ghost, Hama, Aldr, Mod, Hugr, Sefa, and Saiwalo. Both scholarly and inspirational perspectives are taken, intended to stimulate both intellectual and imaginative exploration of these soul-concepts and the world-view which opens out from them. This deluxe edition provides full-color illustrations on premium quality paper in a linen-wrap hardcover book. The illustrations are chosen to stimulate engagement of the imagination in comprehending these abstract entities and their metaphysical contexts. // Review by Diana L. Paxson, author of "Essential Asatru: Walking the Path of Norse Paganism": "Since she first sent me the article on "Heathen Full-Souls" for Idunna: A Journal of Northern Tradition in 2006, I have been fascinated by Winifred Hodge Rose's development of the concept of the souls as an interactive system. I am delighted to see the full presentation of so many years of patient research and contemplation becoming available at last. In Winifred's hands, philology becomes a spiritual adventure, as words from the old Germanic languages reveal new insights into who we are and our place in the spiritual universe." // Review by John Michael Greer, author of "A World Full of Gods": "Winifred Rose has done an excellent job of gathering and synthesizing material about Heathen soul lore from a wide range of disparate sources. The resulting book is a scholarly, thorough resource that belongs on the bookshelf of every Heathen, and everyone interested in the subject.". (shrink)

In this book, Newell makes the case for unified theories by setting forth a candidate.

A project featuring scholars in nursing ethics was planned in 2005. The goal was to document the contributions of some 24 selected American nurse ethicists to bioethics, and to discuss and explore the future trajectory of that work through a two-day working seminar. This article outlines the beginnings of bioethics in the USA and the specific contribution of nurse scholars to the debate, the preparation for the seminar, the results of the project, and the possible application of such a model (...) for teaching and archiving in the future. Documentation of the work carried out at the seminar resulted in the publication of a book. Short biographies of the participants at the seminar are included in Appendix 1. (shrink)

Although thousands of articles and books appear annually in the field of nursing ethics, the sheer volume of scholarly publications points to the need to provide assessment and focus, and that is what this book offers. Nursing and Healthcare Ethics documents the work of nurse scholars in ethics, and goes well beyond a mere documentation of what has transpired and a list of what can be done in the future. It creatively looks back to assess previous accomplishments and forward to (...) find new directions and strengthen future scholarly contributions in nursing ethics. Critical thinking activities, organized by the book s themes (such as vulnerability, care and caring, diversity and disparity, and pain and suffering) are examples of applying these scholarly insights into practice. This book is intended not only for undergraduate and graduate students in academic settings, but also for those in professional development programs. (shrink)