:Discussions about the ethical permissibility of pediatric cognitive enhancement frequently revolve around arguments about welfare, and often include an appeal to the child’s right to an open future. Both proponents and opponents of cognitive enhancement claim that their respective positions best serve the interests of the child by promoting an open future. This article argues that this right to an open future argument only captures some of the risks to the welfare of children, therefore requiring a broader ethical approach. Further, (...) it suggests that a thorough moral assessment of the ends pursued is needed before concluding on the moral permissibility of cognitive enhancement in children, which ultimately hinges on the effect on the overall welfare of the child, beyond an open future. (shrink)

The desire to self-improve is probably as old as humanity: most of us want to be smarter, more athletic, more beautiful, or more talented. However, in the light of an ever increasing array of possibilities to enhance our capacities, clarity about the purpose and goal of such efforts becomes crucial. This is especially true when decisions are made for children, who are exposed to their parents’ plans and desires for them under a notion of increasing wellbeing. In recent years, cognitive (...) enhancement has become a popular candidate for the promotion of wellbeing; welfarists even impose a moral duty on parents to cognitively enhance their children for the sake of their wellbeing. In this article, I aim to show that welfarists are mistaken in inferring such a moral obligation from the potential benefit of cognitive enhancement. In support of this, I offer three arguments: the vagueness of wellbeing as a theoretical concept means it becomes impossible to apply in practice; the link between cognition and wellbeing is far from unequivocal; and quantification issues with regard to cognition make a duty impossible to discharge. In conclusion, I reject the welfarist approach as a justification for a parental moral obligation to cognitively enhance children. (shrink)

While the substantiation of “best interests” has received much attention, the question of how “the child” is conceptualised to ensure any action taken or decision made is in the particular child’s best interests has been largely neglected. In this paper, I argue that the lack of robust understanding of who “the child” is means that we continue to make many generalisations and category-based assumptions in determining the child’s best interests. In addressing the challenge of doing right by the individual child, (...) I propose a three-step approach based on a theoretical model of the child that avoids presumptions about child-typical needs and insists on an assessment of the child’s individual characteristics, needs, qualities, and circumstances, making it the only conceptualisation fully meeting the child centrism criterion required by children’s rights as determined by the United Nations Convention on the Rights of the Child. (shrink)

A significant proportion of child protection cases involve care-experienced mothers, which reveals a continuous cycle of mothers who lose their children to social services after having been in state care themselves as children. While the importance of protecting children requires little explanation and forms the justificatory basis for child protection interventions, it is important to remember that care-experienced mothers were once children entrusted to the state’s care, and who arguably have been failed by the state in that their parenting opportunities (...) are significantly reduced. This paper aims to address this underexplored dilemma between protecting children and safeguarding mothering opportunities for care-experienced mothers. Appealing to the concept of solidarity, I argue that the state has an obligation to increase its compensatory efforts to secure the right of care-experienced women to not only become parents but to be able to be parents, with the aim of breaking the cycle of care experience. (shrink)

Despite the welfare of the child being afforded special legal and moral importance, it appears that the law is currently not objective in its application to children. There is an undeniable link between healthy child development and education, with the latter greatly impacting on mental health and general well-being. Drawing on the example of the differential treatment of gifted children in an educational context, I argue that the legal framework with regard to learning disabilities and cognitive impairments operates contrary to (...) the proclaimed goal of protecting and promoting the welfare of the child. This, I argue, constitutes unjustified discrimination, especially since there is a case to be made that highly cognitively able children could be considered disabled under a social model of disability. Whilst the group of affected children is small at present, developments in cognitive enhancement technologies mean that many more children might in the future be affected. Since the law currently fails gifted children, it will by analogy also likely fail cognitively enhanced children. (shrink)

This special issue aims to spotlight the individual, lived experiences of caregivers and those receiving care–areas often overshadowed by clinical and medicalized narratives within clinical ethics. Our aim is to enrich the discourse by incorporating stories and narratives of medical care and challenge existing clinical practices by emphasizing patient and practitioner experiences. Through a blend of clinical and academic insights, this issue provides phenomenological narratives, highlighting the importance of lived experiences in understanding and improving clinical caregiving practices. The contributions, ranging (...) from theoretical analyses to personal narratives, explore various aspects of caregiving. Each article contributes to a deeper understanding of the phenomenologies of care, advocating for a more inclusive, patient-centered approach in clinical ethics and practice. (shrink)

Machine learning algorithms may radically improve our ability to diagnose and treat disease. For moral, legal, and scientific reasons, it is essential that doctors and patients be able to understand and explain the predictions of these models. Scalable, customisable, and ethical solutions can be achieved by working together with relevant stakeholders, including patients, data scientists, and policy makers.

Braun explores the use of digital twin technology in medicine with a particular emphasis on the question of how such simulations can represent a person.1 In defining some first conditions for ethically justifiable forms of representation of digital twins, he argues that digital twins do not threaten an embodied person, as long as that person retains control over their simulated representation via dynamic consent, and ideally with the option to choose both form and usage of the simulation. His thoughtful elaboration (...) provides insight into the challenges inherent in interactions between a person and their digital twin, emphasising the modes of control required to respect personal modes of freedom. This individual-centric approach to the question of representation leaves out the important ethical consideration of ensuring that all, not merely some, can be represented. Braun describes dynamic consent as a necessary mode of control, arguing that where a person is unable to give consent, ‘such simulations threaten to become illegitimate representations. They would then shift the kind of interaction from representation to illegitimate forms of prediction or surveillance and thereby could lead to infringements to individual modes of freedom.’ Consequently, the implementation of digital twin technology in healthcare would seem to exclude the most vulnerable members of society from participation in and benefiting from medical innovation, …. (shrink)

This open access book presents an ethical approach to utilizing personal medical data. It features essays that combine academic argument with practical application of ethical principles. The contributors are experts in ethics and law. They address the challenges in the re-use of medical data of the deceased on a voluntary basis. This pioneering study looks at the many factors involved when individuals and organizations wish to share information for research, policy-making, and humanitarian purposes. -/- Today, it is easy to donate (...) blood or even organs, but it is virtually impossible to donate one’s own medical data. This is seen as ethically unacceptable. Yet, data donation can greatly benefit the welfare of our societies. This collection provides timely interdisciplinary research on biomedical big data. Topics include the ethics of data donation, the legal and regulatory challenges, and the current and future collaborations. -/- Readers will learn about the ethical and regulatory challenges associated with medical data donations. They will also better understand the special nature of using deceased data for research purposes with regard to ethical principles of autonomy, beneficence, and justice. In addition, the contributors identify the key governance issues of such a scheme. The essays also look at what we can learn in terms of best practice from existing medical data schemes. (shrink)

This article argues that personal medical data should be made available for scientific research, by enabling and encouraging individuals to donate their medical records once deceased, similar to the way in which they can already donate organs or bodies. This research is part of a project on posthumous medical data donation developed by the Digital Ethics Lab at the Oxford Internet Institute at the University of Oxford. Ten arguments are provided to support the need to foster posthumous medical data donation. (...) Two major risks are also identified—harm to others, and lack of control over the use of data—which could follow from unregulated donation of medical data. The argument that record-based medical research should proceed without the need to secure informed consent is rejected, and instead a voluntary and participatory approach to using personal medical data should be followed. The analysis concludes by stressing the need to develop an ethical code for data donation to minimise the risks, and offers five foundational principles for ethical medical data donation suggested as a draft code. (shrink)

Within the broad field of human enhancement, pediatric cognitive neuro-enhancement appears to arouse particular interest. The increasing importance of cognitive capacities in our contemporary and cultural context appears to be the main reason for the focus on cognition as the preferred trait of enhancement, while the choice of pharmacological means is based on factors of feasibility, accessibility, and cost. While the ethical issues arising in the adult context have already been extensively covered in the literature, pediatric neuro-enhancement brings with it (...) additional ethical challenges requiring further attention. Although there are numerous important ethical considerations, the focus of this chapter is on the pursuit of normalcy as the goal in pediatric neuro-enhancement. Parental attempts to shape children are not new, and the resources available for them to do so include widespread and mostly uncontroversial tools, such as education. The increasing use of psychotropic drugs, however, reveals the significant impact of the concept of normalcy, which has resulted in a trend to medicalize what used to be considered “normal” behavior. In this context, special challenges are posed by psychiatric disorders, where the familiar treatment-enhancement distinction continues to be relied upon to justify interventions in children. Drawing on the examples of attention deficit/hyperactivity disorder and autism spectrum disorder, it will be argued that children are already being enhanced within psychiatric practice and that this is incompatible with an understanding of disability under a mixed model. (shrink)

Adoption may be defined as ‘the legal process through which the state establishes a parental relationship, with all its attendant rights and duties, between a child and a (set of) parent(s) where there exists no previous procreative relationship’ . In adoptions from care, state intervention effectively converts an established, or nascent, adult– child relationship into ‘family’ in the legal sense. From the state’s perspective, adoption thus entails the transfer of parental responsibilities for a child in public care to a private (...) family unit, enabling the state to permanently delegate its duties towards a child to this new unit. This seemingly straightforward legal act raises deeper philosophical questions relating to such state ‘family creation’, particularly when the child’s perspective is taken. Such a child- centric approach normatively regards children as equal moral beings, who ought to be included in actions concerning them, regardless of their capacity to form and express an opinion. Accordingly, adoption from care can be described as a moral decision, aimed at doing what is in the child’s best interests. The purpose of this chapter is to explore a suspicion of a lack of child- centrism in adoption from care practice, and to illustrate how adopted children’s rights are inferior to those of their non- adopted peers. This will shed light on a practice currently lacking transparency and accountability and will increase our understanding of how we fail to treat children as equal moral individuals in decision- making that severely impacts children’s lives. (shrink)

Although the employment situation of disabled people has widely been identified as in need of improvement, progress in this area remains slow. While some progress has been made in including the physically or sensory disabled in the workplace, other types of disability have been largely neglected. This applies particularly to disabled workers in atypical employment, such as those whose workplace is the Digital Economy. In this article, we discuss the case of disabled app developers as a significant example of how (...) the current regulatory framework fails to be inclusive in its attempts to protect the rights of disabled Digital Economy workers. We identify two problems that are at the heart of this: first, a continuing failure to collect relevant and comprehensive data on disability, and second, a lack of accountability towards disabled workers in atypical employment. Consequently, we call for better data collection and argue for urgent policy changes to close the existing accountability gap. (shrink)

This article argues that personal medical data should be made available for scientific research, by enabling and encouraging individuals to donate their medical records once deceased, in a way similar to how they can already donate organs or bodies. This research is part of a project on posthumous medical data donation developed by the Digital Ethics Lab at the Oxford Internet Institute. Ten arguments are provided to support the need to foster posthumous medical data donation. Two major risks are also (...) identified—harm to others, and lack of control over the use of data—which could follow from unregulated donation of medical data. The argument that record-based medical research should proceed without the need to ask for informed consent is rejected, and it instead a voluntary and participatory approach to using personal medical data should be followed. The analysis concludes by stressing the need to develop an ethical code for data donation to minimise the risks providing five foundational principles for ethical medical data donation; and suggesting a draft for such a code. (shrink)

In today’s world, Artificial Intelligence plays a central role in many decision-making processes. However, its use can lead to structural and epistemic injustices—especially in the context of healt...

Focusing on episodes of student-generated and -sustained talk during document-based disciplinary history discussions, this study explored what teacher candidates prioritize and value about social studies discussions, and how these priorities align with their actions and goals as facilitators. Using a complex systems-based model, we investigated candidates’ goals as they planned for, facilitated, and reflected upon student sensemaking relative to three common orientations for social studies discussions: disciplinary history, participatory civics, and critical literacy. Findings revealed that candidates employed elements from all (...) three orientations, yet without clear alignment to any particular approach. This misalignment reflected tensions between candidates’ stated goals, beliefs about student engagement, and instructional decisions. We draw implications for teacher education to support candidates in developing coherent practices for discussion facilitation that align with their instructional visions and sociocultural contexts. (shrink)

The frequency and severity of natural disasters and extreme weather events are increasing, taking a dramatic economic and relational toll on the communities they strike. Given the critical role that entrepreneurship plays in a community’s viability, it is necessary to understand how small business owners respond to these events and move forward over time. This study explores the long-term dynamics and trajectory of individuals within the broader business community following a natural disaster, paying particular attention to the influence of social (...) identity. Results suggest that the community identity changes over the course of recovery and rebuilding, underscoring the need for a holistic approach so that intervening agencies can achieve the sustainable economic recovery desired. (shrink)

This paper considers the question of whether predictions of wrongdoing are relevant to our moral obligations. After giving an analysis of ‘won’t’ claims (i.e., claims that an agent won’t Φ), the question is separated into two different issues: firstly, whether predictions of wrongdoing affect our objective moral obligations, and secondly, whether self-prediction of wrongdoing can be legitimately used in moral deliberation. I argue for an affirmative answer to both questions, although there are conditions that must be met for self-prediction to (...) be appropriate in deliberation. The discussion illuminates an interesting and significant tension between agency and prediction. (shrink)

The core idea of social constructivism in mathematics is that mathematical entities are social constructs that exist in virtue of social practices, similar to more familiar social entities like institutions and money. Julian C. Cole has presented an institutional version of social constructivism about mathematics based on John Searle’s theory of the construction of the social reality. In this paper, I consider what merits social constructivism has and examine how well Cole’s institutional account meets the challenge of accounting for the (...) characteristic features of mathematics, especially objectivity and applicability. I propose that in general social constructivism shows promise as an ontology of mathematics, because the view can agree with mathematical practice and it offers a way of understanding how mathematical entities can be real without conflicting with a scientific picture of reality. However, I argue that Cole’s specific theory does not provide an adequate social constructivist account of mathematics. His institutional account fails to sufficiently explain the objectivity and applicability of mathematics, because the explanations are weakened and limited by the three-level theoretical model underlying Cole’s account of the construction of mathematical reality and by the use of the Searlean institutional framework. The shortcomings of Cole’s theory give reason to suspect that the Searlean framework is not an optimal way to defend the view that mathematical reality is socially constructed. (shrink)

This paper considers the question of whether predictions of wrongdoing are relevant to our moral obligations. After giving an analysis of 'won't' claims, the question is separated into two different issues: firstly, whether predictions of wrongdoing affect our objective moral obligations, and secondly, whether self-prediction of wrongdoing can be legitimately used in moral deliberation. I argue for an affirmative answer to both questions, although there are conditions that must be met for self-prediction to be appropriate in deliberation. The discussion illuminates (...) an interesting and significant tension between agency and prediction. (shrink)

Peer review is a widely accepted instrument for raising the quality of science. Peer review limits the enormous unstructured influx of information and the sheer amount of dubious data, which in its absence would plunge science into chaos. In particular, peer review offers the benefit of eliminating papers that suffer from poor craftsmanship or methodological shortcomings, especially in the experimental sciences. However, we believe that peer review is not always appropriate for the evaluation of controversial hypothetical science. We argue that (...) the process of peer review can be prone to bias towards ideas that affirm the prior convictions of reviewers and against innovation and radical new ideas. Innovative hypotheses are thus highly vulnerable to being “filtered out” or made to accord with conventional wisdom by the peer review process. Consequently, having introduced peer review, the Elsevier journal Medical Hypotheses may be unable to continue its tradition as a radical journal allowing discussion of improbable or unconventional ideas. Hence we conclude by asking the publisher to consider re-introducing the system of editorial review to Medical Hypotheses. (shrink)

I develop a theory of counterfactuals about relative computability, i.e. counterfactuals such as 'If the validity problem were algorithmically decidable, then the halting problem would also be algorithmically decidable,' which is true, and 'If the validity problem were algorithmically decidable, then arithmetical truth would also be algorithmically decidable,' which is false. These counterfactuals are counterpossibles, i.e. they have metaphysically impossible antecedents. They thus pose a challenge to the orthodoxy about counterfactuals, which would treat them as uniformly true. What’s more, I (...) argue that these counterpossibles don’t just appear in the periphery of relative computability theory but instead they play an ineliminable role in the development of the theory. Finally, I present and discuss a model theory for these counterfactuals that is a straightforward extension of the familiar comparative similarity models. (shrink)

In the last few years, justice has emerged as a matter of concern for the contemporary constitution of technoscience. Increasingly, both practicing scientists and engineers and scholars of science and technology cite justice as an organizing theme of their work. In this essay, I consider why “science and justice” might be arising now. I then ask after the opportunities, but also the dangers, of this formation. By way of example, I explore the openings and exclusions created by the recent conjugation (...) of science and justice in the field of personal genomics. Finally, I conclude with reflections on what other forms “science and justice” might take, and what might be gained or lost in fostering them. (shrink)

In this essay, I argue that to create a genomics that offers more gifts than weights, central attention must be paid to questions of justice. This will require expanding bioethical imaginations so that they grasp and can respond to questions of structural inequity. It will necessitate building novel coalitions and collaborations that turn the attention of bioethical governance away from narrow individual questions such as, “Do I consent?” and toward the broader collective question, is this just? What kind of lives (...) and collectivities are made possible? What rights and principles should govern them? The essay ends with one example of this novel coalition building arising from the Science and Justice Research Center at the University of California, Santa Cruz. It draws lessons from this effort to build new alliances that bridge the social sciences and natural sciences, arts and engineering, to create new kinds of training and thinking that create a genomics that more adequately responds to fundamental questions of justice. (shrink)

This article proposes reconsideration of laws prohibiting paid surrogacy in Australia in light of increasing transnational commercial surrogacy. The social science evidence base concerning domestic surrogacy in developed economies demonstrates that payment alone cannot be used to differentiate “good” surrogacy arrangements from “bad” ones. Compensated domestic surrogacy and the introduction of professional intermediaries and mechanisms such as advertising are proposed as a feasible harm-minimisation approach. I contend that Australia can learn from commercial surrogacy practices elsewhere, without replicating them.

The ‘Wrong Kind of Reason’ problem for buck-passing theories (theories which hold that the normative is explanatorily or conceptually prior to the evaluative) is to explain why the existence of pragmatic or strategic reasons for some response to an object does not suffice to ground evaluative claims about that object. The only workable reply seems to be to deny that there are reasons of the ‘wrong kind’ for responses, and to argue that these are really reasons for wanting, trying, or (...) intending to have that response. In support of this, it is pointed out that awareness of pragmatic or strategic considerations, unlike awareness of reasons of the ‘right kind’, are never sufficient by themselves to produce the responses for which they are reasons. I argue that this phenomenon cannot be used as a criterion for distinguishing reasons-for-a-response from reasons-for-wanting-to-have-a-response. I subsequently investigate the possibility of basing this distinction on a claim that the responses in question (e.g. admiration or desire) are themselves inherently normative; I conclude that this approach is also unsuccessful. Hence, the ‘direct response’ phenomenon cannot be used to rule out the possibility of pragmatic or strategic reasons for responses; and the rejection of such reasons therefore cannot be used to circumvent the Wrong Kind of Reason Problem. (shrink)

In this paper I explore the various meanings of embodiment from a patient’s perspective. Resorting to phenomenology of health and medicine, I take the idea of ‘lived experience’ as starting point. On the basis of an analysis of phenomenology’s call for bracketing the natural attitude and its reduction to the transcendental, I will explain, however, that in medical phenomenological literature ‘lived experience’ is commonly one-sidedly interpreted. In my paper, I clarify in what way the idea of ‘lived experience’ should be (...) revisited and, subsequently, what this reconsideration means for phenomenological research on embodiment in health and medicine. The insight that the body is a condition of possibility for world-disclosing yet, at the same time, itself conditioned by this world forces us to not only zoom in on the body’s subject-side, but also on its object-side. I argue that in order to render account for this double body ontology, phenomenology should include empirical sociological analyses as well. I thus argue in favor of the idea of a socio-phenomenology. Drawing on material from my own research project on embodied self-experiences after breast surgery, I show how this approach can be fruitful in interpreting the impact of disfigurements on a person’s embodied agency, or a person’s ‘I can’. (shrink)

I said at the beginning that some quantum leaps in our thinking would be required as we face up to the challenges and changes that health care delivery will and must undergo.It is not a matter of politics, it is a matter of pragmatism.It is a matter of reality and it's a matter of simply having to face up to what, may I say, has been glaringly obious for some time.I know that doctors come with a strong ethos in terms (...) of their commitment to their patient and that is as it should be, but governments are always going to be constrained by the amount of money that is available to spend in any one particular field of health service.Within the priorities that governments have, health versus education, versus welfare, versus debt, debates will continue to be had.One of the strengths of New Zealand's health services, with its contracting arrangements, is that it is able to respond flexibly to the priorities that the government sets for the health services it seeks to deliver to every person in New Zealand.I am very optimistic that over time this new model of funding of our New Zealand health services will see a fairer distribution of the health dollars available to meet the wide range of medical needs of New Zealanders.Health care delivery is changing rapidly around the world.If we are to keep up in the future we must be realistic now. The challenge is mine as Minister of Health. The challenge is yours as health professionals. The challenge is ours as a community. (shrink)

One famous debate in contemporary epistemology considers whether there is always one unique, epistemically rational way to respond to a given body of evidence. Generally speaking, answering “yes” to this question makes one a proponent of the Uniqueness thesis, while those who answer “no” are called “permissivists”. Another influential recent debate concerns whether non-truth-related factors can be the basis of epistemic justification, knowledge, or rational belief. Traditional theories answer “no”, and are therefore considered “purists”. However, more recently many theorists have (...) argued to the contrary, claiming that impurist factors, such as practical stakes, can sometimes encroach or even override truth-related considerations. This paper bridges the two debates by presenting and defending what I call “Impurist Permissivism”. I support Impurist Permissivism by showing how it can resist Roger White’s famous Argument from Arbitrariness (2005). (shrink)

In this paper I look at attempts to develop forms of consequentialism which do not have a feature considered problematic in Direct Consequentialist theories (that is, those consequentialist theories that apply the criterion of rightness directly in the evaluation of any set of options). The problematic feature in question (which I refer to as ‘evaluative conflict’) is the possibility that, for example, a right motive might lead an agent to perform a wrong act. Theories aiming to avoid this phenomenon must (...) argue that causal relationship entails motives and acts (for example) having the same moral status. I argue that attempts to ensure such ‘evaluative consistency’ are themselves deeply problematic, and that we must therefore accept evaluative conflict. (shrink)

It has long been acknowledged that one of the most original aspects of Ockham’s account of knowledge is his contention that bodies of scientific knowledge are aggregates but without much explanation as to why he holds this view. In this chapter, I argue that a plausible philosophical motivation lies in the inner structure of his mental ontology, namely, in the intellect’s habits, acts, and their objects, which are the true and necessary principles and conclusions of demonstrations. Ockham upholds what I (...) call a “Principle of Object-Act-Habit-Specification,” according to which kinds of habits and their acts are determined by the objects they grasp. This principle entails that if a body of scientific knowledge contains two or more sentences, it can only have aggregate unity. Furthermore, I look at the logical and determinate orders that gather together the sentences of various aggregate bodies of scientific knowledge. (shrink)

"As a doctor, I make every effort to strengthen the belief in immortality, especially with older patients when such questions come threateningly close. For, seen in correct psychological perspective, death is not an end but a goal, and life's inclination towards death begins as soon as the meridian is past."--C.G. Jung, commentary on The Secret of the Golden FlowerHere collected for the first time are Jung's views on death and immortality, his writings often coinciding with the death of the most (...) significant people in his life. The book shows many of the major themes running throughout the writings, including the relativity of space and time surrounding death, the link between transference and death, and the archetypes shared among the world's religions at the depths of the Self. The book includes selections from "On Resurrection," "The Soul and Death," "Concerning Rebirth," "Psychological Commentary on The Tibetan Book of the Dead" from the Collected Works, "Letter to Pastor Pfafflin" from Letters, and "On Life after Death.". (shrink)

This essay considers how the Zhuangzi 莊子 sheds light on a new direction to the contemporary discussion of desires. Harry Frankfurt proposes an account of personhood based on a hierarchy of desires. He defines a wanton as a being that does not have second-order volitions, the desires that a certain desire of action becomes her will. J. David Velleman proposes, in the context of the Zhuangzi, that when a Daoist sage performs her skills she can be regarded as a “higher” (...) wanton because her actions are spontaneous flows of skillful actions. In this essay, I propose along the line of Velleman a constructive interpretation of the Zhuangzian way to deal with desires from my reading of the Zhuangzi. I argue that there are two roles a Daoist sage can play: the observer and the performer. A Daoist sage can be an observer at a certain time and a performer at other times. Although a performer can be regarded as a higher wanton, it is inappropriate to regard an observer as a wanton. Also, I propose that observation is a means to transform desires—once the practitioner achieves high spirituality, one does not need to possess second-order volitions because one’s first-order desires are transformed such that they are in accordance with the Dao 道. (shrink)

Although scars never disappear completely, in time most people will basically get used to them. In this paper I explore what it means to habituate to scars against the background of the phenomenological concept of incorporation. In phenomenology the body as Leib or corps vécu functions as a transcendental condition for world disclosure. Because of this transcendental reasoning, phenomenology prioritizes a form of embodied subjectivity that is virtually dis-embodied. Endowing meaning to one’s world through getting engaged in actions and projects (...) is most successful indeed when one’s body is “absent,” “transparent,” or, at least, if it is not in the center of one’s attention. This taken-for-granted nature can be disturbed by discomfort, disability, and disfigurement. Incorporation, so I explain, aims at maintaining or restoring the body’s taken-for-grantedness. My analysis of the case of a woman who successfully habituated to her mastectomy scar demonstrates, however, that habituation to a perceptible scar can only be understood partly in terms of incorporation. Next to a decrease of explicit attention for the scar and the discomfort it produces, the scar should also stop being a sign that refers to something else than itself. This is only possible, I argue, by taking the body’s materiality seriously, rather than it being wiped out as a result of transcendental reasoning. (shrink)

Voluntades anticipadas: desafíos éticos en el cuidado del paciente Diretivas antecipadas de vontade: desafios éticos no cuidado do paciente Advance healthcare directives are intended for the individual to personally express their will and preferences about healthcare and treatment ahead of time. This literature review aims to describe the concept and structure of advance directives and the ethical aspects involved in patient care. Using the keywords “Advance Healthcare Directive” AND “Ethical Implication” and its Spanish equivalents, five databases were accessed: ProQuest, Philosophy, (...) PubMed, Web of Science and Scielo. Publications were narrowed down to the 2010-2018 period. Thirty-one articles were obtained and read critically. Results of this review were grouped into the following categories: concept, structure, clinical situations in which advance directives apply, strengths and limitations, as well as the ethical aspects involved. End of life-related experiences in which a person loses their ability to make decisions and cannot express their wishes, so it is impossible to know their will, are more common nowadays. Most health workers are not appropriately trained in the preparation and application of advance directives, which becomes an opportunity to research and delve deeper into the subject. Advance directives are a tool that gives health workers reliable information on a patient’s values and wishes, so it is vital to train them to provide respectful quality care. Para citar este artículo / To reference this article / Para citar este artigo Forero J, Vargas I, Bernales M. Voluntades anticipadas: desafíos éticos en el cuidado del paciente. Pers Bioet. 2019;23:224-244. DOI: https://doi.org/10.5294/pebi.2019.23.2.5 Recibido: 26/01/2019 Aceptado: 22/08/2019. (shrink)

In this paper, I explore the meaning of bodily integrity in disfiguring breast cancer. Bodily integrity is a normative principle precisely because it does not simply refer to actual physical or functional intactness. It rather indicates what should be regarded and respected as inviolable in vulnerable and damageable bodies. I will argue that this normative inviolability or wholeness can be based upon a person's embodied experience of wholeness. This phenomenological stance differs from the liberal view that identifies respect for integrity (...) with respect for autonomy (resulting in an invalidation of bodily integrity's proper normative meaning), as well as from the view that bodily integrity is based upon ideologies of wholeness (which runs the risk of being disadvantageous to women). I propose that bodily integrity involves a process of identification between the experience of one's body as “Leib” and the experience of one's body as “Körper.” If identification fails or is not possible, one's integrity is threatened. This idea of bodily integrity can support breast cancer patients and survivors in making decisions about possible corrective interventions. To implement this idea in oncology care, empirical-phenomenological research needs to establish how breast cancer patients express their embodied self-experiences. (shrink)

This article contributes to a more nuanced and contextual approach to women’s decision-making concerning their stored IVF (in vitro fertilisation) embryos through attempting to craft a space for the expression of the complex, and contradictory, emotions attached to these decisions, unhooked from any notion of abstract moral status inhering in the embryo itself. Women struggle to express the confounding nature of the relationship to the stored IVF embryo as something of-the-body but not within the body, neither self nor other, person (...) nor thing. In order to try to address this sense of the ineffable, I draw in this article upon a series of images by German-born American artist, Kiki Smith. The article explores three major themes, each alongside one of Smith’s artworks connecting to an experience of discomfort or confounding unease. (shrink)

In light of the summer 2020 protests and their subsequent backlash, questions about the prospective timeline for achieving a racially just society have taken on renewed significance. This article investigates Du Bois’s writings between 1920 and 1940 as a lens through which to examine the temporality of social change. I argue that Du Bois’s turn to the role of white unreason explains the dual temporality of his political vision and the dual strategies that ensue. According to Du Bois, white supremacy (...) is upheld not only by ignorance, but also by white unreason, reproduced through generations of institutional conditioning. Du Bois therefore turns to propaganda for transforming white unreason, thereby making a racially just society possible. But because the transformation of white unreason through propaganda is a slow process, Du Bois argues that Black Americans must ensure their survival through voluntary self-segregation. By presenting us with a framework of social change, Du Bois models how advocates of racial justice might navigate defeat without devolving into defeatism. (shrink)

The experience of musical surprise is explained by psychologists in terms of the thwarting of prior musical expectations. The assumption that surprise is always caused by expectations is widespread not just in psychology at large, but also in philosophy. I argue here that this assumption is ill-founded. Many musical surprises, as well as many non-musical instances of perceptual surprise, can be explained by the falsification of assessments of the present, rendering the appeal to expectations unnecessary. I elaborate the positive view (...) before considering objections, and offering replies. (shrink)

Women intimately interact with various medical technologies and prosthetic artifacts in the context of breast cancer. While extensive work has been done on the agency of technological artifacts and how they affect users’ perceptions and experiences, the agency of users is largely taken for granted hitherto. In this article, we explore the agency of four women who engage with breast cancer technologies and artifacts by analyzing their narrative accounts of such engagements. This empirical discussion is framed within the tradition of (...) science and technology studies, philosophy of technological mediation and phenomenology of embodied agency as ‘I can/not’. This approach leads to the conclusions that women’s technologically mediated agencies range from being restricted to extended, take place on different bodily levels, within complex temporal structures, and are determined by certain socio-cultural contexts. Furthermore, it reveals that such agency shaping does not imply a one-way conditioning relationship between technologies and users, but rather involves a reciprocal relationship in which both subject and object are co-constituted. We therefore suggest that the ‘material turn’ in philosophy of technology also needs to take into account technologically mediated, material human beings in order to gain a better understanding of human existence. (shrink)

In Parmenides, the young Socrates defends several candidate forms against Parmenides, who makes five objections: the objection of forms of common things, the question of the part vs. the whole, the third man argument, infinite regress, and the greatest difficulty problem. I define forms in terms of Leibniz’s Principle of the Identity of Indiscernibles (PII) in an attempt to overcome Parmenides’ opposition. I show that the main force in Parmenides’ objections consists of absurdities that emerge in relations between forms and (...) particulars: absurdities that are avoided if the form and its instantiation in the particular are identical. (shrink)

The meaning of κερτομω and its congeners in Homer has been the subject of debate in this journal. Jones has argued that ‘to κερτομω someone is to speak in such a way as to provoke a powerful emotional reaction’, whether of anger or fear, and thus means ‘“to utter stinging words at [someone]”, “pierce to the heart”, “cut to the quick”, rather than merely “provoke” This definition seems to work well enough for some cases, but certainly not for all, and (...) especially not for the passage from which the whole controversy began: Iliad 24.649, where Achilles speaks to Priam ༐πικερτομέωυ. As Richardson says in his Iliad commentary, ‘there is no sign that Akhilleus’ speech has this direct effect [i.e. arouses fear] on Priam’. Jones's article was responding to an earlier one by J. T. Hooker, who attempted to ascertain the sense of Achilles’ ༐πικερτομέυ by surveying the usage of kertom- words throughout Homeric epic. He concluded that the basic meaning is ‘to taunt’ or, more abstractly, it ‘indicates the provocation of another person into behaving in a certain way, whether that is the behaviour desired by the speaker… or is not desired by the speaker’. The problem was that this definition did not seem to fit the very line from which his inquiry began, the words of Achilles to Priam. Hooker then hypothesized that the verse betrayed signs of an ‘imperfect adaptation’ of a different version of the poem in which Achilles taunted a defeated enemy or perhaps preserved his grudge against Agamemnon to its end. This explanation is unpersuasive. (shrink)

A phenomenal concept is a concept that one possesses only if one has the relevant experience. In this essay, I argue that phenomenal concept theorists, namely, those who believe that we acquire phenomenal concepts through being acquainted with the relevant experience, can never succeed in determining which species of non-human animals are phenomenally conscious because they prohibit any a priori correlation between phenomenal and non-phenomenal concepts. I make my argument by first discussing several ways in which a phenomenal concept theorist (...) may explain which animal species are conscious, namely, with neuro-identity theory, behaviorism, and functionalism, and the problem that these approaches entail. I then illustrate how the alternative approaches of scientific inference to the best explanation, analogical inference, similarity inference, and inference by prototype face the same problem. (shrink)

This article explores the metaphorical models English speakers employ in their understanding of transgenderism. Transgender is the term ascribed to those who have begun or completed a change in their sex characteristics from male to female or female to male. Using both qualitative and quantitative measures, I examine an archive of narrative data and a transition-specific corpus to show how spoken and written narrative support a spatially based representation of gender identity and transition. Two robust models are revealed in the (...) data, each carrying a set of suppositions consequential to how speakers understand their lived experience. I show how metaphor-evoking trigger lexemes relate to each model and can be used jointly to demonstrate conceptual salience. This investigation should be seen as part of an ever-growing body of research directed at revealing the unconscious assumptions, which organize speakers’ comprehension of complex topics with political relevance (cf. Charteris-Black, 2004; Lakoff, 2002,.. (shrink)

Enmarcada en el área Docencia y referida específicamente a nuevas fórmulas docentes, esta reflexión profundiza en la metodología Didáctica del m2 (P.I. 269.529), que propone su propio marco teórico y referentes y que se presenta como un aporte a la formación de formadores, así como una posibilidad de educación en el aula. Entrega oportunidades para la expresión y creación en espacios de restricción, resignificando la escuela, los patios y las propias salas de clases, promoviendo experiencias significativas de conocimiento y soluciones. (...) Relevando así procesos artísticos de experiencia-acción en educación, así como también la aplicación de nuevas metodologías posibles de transferir. (shrink)