It is widely agreed that living kidney donation is permitted but living kidney sales are not. Call this the Received View. One way to support the Received View is to appeal to a particular understanding of the conditions under which living kidney transplantation is permissible. It is often claimed that donors must act altruistically, without the expectation of payment and for the sake of another. Call this the Altruism Requirement. On the conventional interpretation, the Altruism Requirement is a moral fact. (...) It states a legitimate constraint on permissible transplantation and is accepted on the basis of cogent argument. The present paper offers an alternative interpretation. I suggest the Altruism Requirement is a moral fiction—a kind of motivated falsehood. It is false that transplantation requires altruism. But the Requirement serves a purpose. Accepting it allows kidney donation but not kidney sale. It, in short, rationalizes the Received View. (shrink)

I shall argue, first, that potential kidney donors may be subject to harmful pressure to donate. This pressure may take almost any form; people have diverse interests, and anything that could set them back may qualify as pressure. Given features of the context—the high stakes, the involvement of family, and the social meaning of donation—such pressure may be especially harmful. This problem is less tractable than the more familiar worry that pressure may compromise consent. Screening may ensure donors validly consent, (...) but it provides no protection against harmful pressure. I shall argue, second, that the use of such pressure is the predictable consequence of the prohibition on kidney sales. Potential donors have something—a transplantable kidney—that is both valuable and scarce. Many of them, informed about donation, decide against it. Those in need of a transplant may seek to persuade the unwilling. Given the prohibition, the donation cannot be made more attractive in absolute terms by, say, the addition of money. However, it can be made more attractive in relative terms. If declining the option is made worse, then, by comparison, accepting it is made better. The application of harmful pressure has the desired effect. With so much at stake, and no good alternatives, its use is predictable. I conclude that potential donors' interests should figure more prominently in the discussion of transplant policy. Those who defend the prohibition have made virtually no attempt to account for its impact on that group. (shrink)

An increasingly common objection to kidney sales holds that the introduction of monetary incentives may undermine potential donors’ altruism, discourage donation, and possibly result in a net reduction in the supply of kidneys. To explain why incentives might be counterproductive in this way market opponents marshal evidence from behavioral economics. In particular, they claim that the context of kidney sales is ripe for motivational crowding. This reasoning, if sound, would have a profound influence on the debate over kidney sales. What’s (...) perhaps the principal reason to favor a market – the increase in supply it would bring – would be called into doubt. However, on inspection it becomes apparent that the evidence touted by market opponents not only lends no credence to their claims, but also provides some positive reason to doubt them. The near-ubiquitous references to motivational crowding in the literature on kidney sales are fundamentally misplaced. (shrink)

Erik Malmqvist defends the prohibition on kidney sales as a justifiable measure to protect individuals from harms they have not autonomously chosen. This appeal to ‘group soft paternalism’ requires that three conditions be met. It must be shown that some vendors will be harmed, that some will be subject to undue pressure to vend, and that we cannot feasibly distinguish between the autonomous and the non-autonomous. I argue that Malmqvist fails to demonstrate that any of these conditions are likely to (...) obtain. His argument involves two common errors. First, he, like many, proceeds on a mistaken understanding of how to assess harm. What matters is not the balance of costs and benefits of vending, but a comparison of potential vendors’ welfare across two possible courses of action. Second, Malmqvist's concerns about third-party pressure are predicated on an empirically unrealistic understanding of the operation of a regulated market. A widely underappreciated fact is that kidney sales will be relatively rare, and most who try to vend will be unable to. Because pressure on another to vend will not result in the desired outcome, few will exert it. (shrink)

Julian Koplin, drawing extensively on empirical data, has argued that vendors, even in well-regulated kidney markets, are likely to be significantly harmed. I contend that his reasoning to this conclusion is dangerously mistaken. I highlight two failures. First, Koplin is insufficiently attentive to the differences between existing markets and the regulated markets proposed by advocates. On the basis of this error, he wrongly concludes that many harms will persist even in a well-regulated system. Second, Koplin misunderstands the utilitarian assessment of (...) the market. He focuses on the costs and benefits of the transaction for the vendor. But, the relevant comparison is between an individual’s welfare across different courses of action, namely, vending and the nonvending alternative. Although Koplin’s empirically informed contribution is a welcome addition to this literature, the mistakes that pervade his interpretation of the data demand correction. (shrink)

Erik Malmqvist defends the prohibition on kidney sales as a justifiable measure to protect individuals from harms they have not autonomously chosen. This appeal to ‘group soft paternalism’ requires that three conditions be met. It must be shown that some vendors will be harmed, that some will be subject to undue pressure to vend, and that we cannot feasibly distinguish between the autonomous and the non-autonomous. I argue that Malmqvist fails to demonstrate that any of these conditions are likely to (...) obtain. His argument involves two common errors. First, he, like many, proceeds on a mistaken understanding of how to assess harm. What matters is not the balance of costs and benefits of vending, but a comparison of potential vendors’ welfare across two possible courses of action. Second, Malmqvist's concerns about third-party pressure are predicated on an empirically unrealistic understanding of the operation of a regulated market. A widely underappreciated fact is that kidney sales will be relatively rare, and most who try to vend will be unable to. Because pressure on another to vend will not result in the desired outcome, few will exert it. (shrink)

Kidney failure is a major killer. Many lives could be saved through organ donation if people were less reluctant to part with their spare kidney. Should we incentive donation by paying people to do it?

Many are unwilling to donate their vital organs in death. To affirm this choice is to prefer the integrity of one's corpse over possibly saving and improving the lives of others. This position enjoys no sound defence. Refusing to donate amounts to a gratuitous moral failure.Export citation.

Here, I briefly respond to a recent paper by Julian Koplin, in which he criticises my earlier work in this journal. I show that Koplin has misunderstood the distinction I have made between pressure to vend and pressure with the option to vend. I also show that his pessimism about the market regulations I favour is unwarranted.

A dogma of contemporary normative theorizing holds that some reasons are distinctively moral while others are not. Call this view Reasons Pluralism. This essay looks at four approaches to vindicating the apparent distinction between moral and non-moral reasons. In the end, however, all are found wanting. Though not dispositive, the failure of these approaches supplies strong evidence that the dogma of Reasons Pluralism is ill-founded.

When it comes to the duty of beneficence, a formidable class of moderate positions holds that morally significant considerations emerge when one's actions are seen as part of a larger series. Agglomeration, according to these moderates, limits the demands of beneficence, thereby avoiding the extremely demanding view forcefully defended by Peter Singer. This idea has much appeal. What morality can demand of people is, it seems, appropriately modulated by how much they have already done or will do. Here we examine (...) a number of recent proposals that appeal to agglomeration. None of them, we argue, succeeds. (shrink)

Felix Pinkert has proposed a solution to the no-difference problem for AC. He argues that AC should be supplemented with a requirement that agents’ optimal acts be modally robust. We disagree.

Agent-relative consequentialism is thought attractive because it can secure agent-centred constraints while retaining consequentialism's compelling idea—the idea that it is always permissible to bring about the best available outcome. We argue, however, that the commitments of agent-relative consequentialism lead it to run afoul of a plausibility requirement on moral theories. A moral theory must not be such that, in any possible circumstance, were every agent to act impermissibly, each would have more reason to prefer the world thereby actualized over the (...) world that would have been actualized if every agent had instead acted permissibly. (shrink)

_Thinking Through Utilitarianism: A Guide to Contemporary Arguments_ offers something new among texts elucidating the ethical theory known as Utilitarianism. Intended primarily for students ready to dig deeper into moral philosophy, it examines, in a dialectical and reader-friendly manner, a set of normative principles and a set of evaluative principles leading to what is perhaps the most defensible version of Utilitarianism. With the aim of laying its weaknesses bare, each principle is serially introduced, challenged, and then defended. The result is (...) a battery of stress tests that shows with great clarity not only what is attractive about the theory, but also where its problems lie. It will fascinate any student ready for a serious investigation into what we ought to do and what is of value. (shrink)

Personal relationships matter. Traditional Consequentialism, given its exclusive focus on agent-neutral goodness, struggles to account for this fact. A recent variant of the theory—one incorporating agent-relativity—is thought to succeed where its traditional counterpart fails. Yet, to secure this advantage, the view must take on certain normative and evaluative commitments concerning personal relationships. As a result, the theory permits cases in which agents do as they ought, yet later ought to prefer that they had done otherwise. That a theory allows such (...) cases is a serious defect. We thus conclude that, in terms of how the theories handle personal relationships, agent-relative consequentialism fairs no better than its traditional counterpart. (shrink)

Recently, Cohen and Timmerman, 1–18, 2016) argue that actualism has control issues. The view should be rejected, they claim, as it recognizes a morally irrelevant distinction between counterfactuals over which agents exercise the same kind of control. Here we reply on behalf of actualism.

A familiar objection to mental state theories of well-being proceeds as follows: Describe a good life. Contrast it with one identical in mental respects, but lacking a connection to reality. Then observe that mental state theories of well-being implausibly hold both lives in equal esteem. Conclude that such views are false. Here we argue this objection fails. There are two ways reality may be thought to matter for well-being. We want to contribute to reality, and we want our experience of (...) the world to be veridical. Yet, if one accepts that reality matters in either of these ways, one must posit differences in well-being where no such differences exist. (shrink)

Luke Semrau argues that the documented harms of existing organ markets do not undermine the case for establishing regulated systems of paid kidney donation. He offers two arguments in support of this conclusion. First, Semrau argues that the harms of kidney selling are straightforwardly amenable to regulatory solution. Second, Semrau argues that even in existing black markets, sellers would likely have experienced greater harm if the option of selling a kidney were not available. This commentary challenges (...) both of Semrau’s claims. I argue that there is no reason to believe that kidney sellers benefit from the current black market trade in organs, and highlight a number of potential issues regarding the effectiveness and feasibility of Semrau’s proposed market regulations. (shrink)

The unity of consciousness has so far been studied only as a relation holding among the many experiences of a single subject. I investigate whether this relation could hold between the experiences of distinct subjects, considering three major arguments against the possibility of such ‘between-subjects unity’. The first argument, based on the popular idea that unity implies subsumption by a composite experience, can be deflected by allowing for limited forms of ‘experience-sharing’, in which the same token experience belongs to more (...) than one subject. The second argument, based on the phenomenological claim that unified experiences have interdependent phenomenal characters, I show to rest on an equivocation. Finally, the third argument accuses between-subjects unity of being unimaginable, or more broadly a formal possibility corresponding to nothing we can make sense of. I argue that the familiar experience of perceptual co-presentation gives us an adequate phenomenological grasp on what between-subjects unity might be like. (shrink)

Recent research on the evolution of religion has focused on whether religion is an unselected by-product of evolutionary processes or if it is instead an adaptation by natural selection. Adaptive hypotheses for religion include direct fitness benefits from improved health and indirect fitness benefits mediated by costly signals and/or cultural group selection. Herein, I propose that religious denominations achieve indirect fitness gains for members through the use of ecologically arbitrary beliefs, rituals, and moral rules that function as recognition markers of (...) cultural inheritance analogous to kin and species recognition of genetic inheritance in biology. This recognition signal hypotheses could act in concert with either costly signaling or cultural group selection to produce evolutionarily altruistic behaviors within denominations. Using a cultural phylogenetic analysis, I show that a large set of religious behaviors among extant Christian denominations supports the prediction of the recognition signal hypothesis that characters change more frequently near historical schisms. By incorporating demographic data into the model, I show that more-distinctive denominations, as measured through dissimilar characteristics, appear to be protected from intrusion by nonmembers in mixed-denomination households, and that they may be experiencing greater biological growth of their populations even in the present day. (shrink)

Lisa Tessman (2016: 164) recounts the case of a Jewish mother, running from Nazis, who faced a terrible choice. She could (a) drown her infant, or (b) accept the virtual certainty that her baby’s cries would doom the refugee group she was fleeing with. Given those options, (b) is worse. If the whole group is discovered, many will die, including the infant. Still, preemptively drowning a baby—indeed one’s own baby—is a terrible act. To make sense of cases like this, Tessman (...) turns to the concept of moral failure: an act that violates an important moral value such that the loss cannot be fully redeemed by gains elsewhere. I will argue that criminal justice needs a moral framework like Tessman’s. It needs to make sense of the fact that some options are genuinely better than others, without letting honorifics like ‘justice’ obscure the equally important fact the best available option might be terrible. More specifically, I will argue that when punishment involves prison, as it often does, it is a moral failure. It can be justified only in the sense that preemptively drowning an infant can be justified: like the fleeing mother, society might on some terrible occasions find itself with no better alternative. (shrink)

I address a question in moral metaphysics: How are conflicts between moral obligations possible? I begin by explaining why we cannot give a satisfactory answer to this question simply by positing that such conflicts are conflicts between rules, principles, or reasons. I then develop and defend the “Dispositional Account,” which posits that conflicts between moral obligations are conflicts between the manifestations of obligating dispositions (obligating powers, capacities, etc.), just as conflicts between physical forces are conflicts between the manifestations of (certain) (...) causal dispositions (causal powers, capacities, etc.). This account combines the so-called “moral forces” interpretation of prima facie obligations with a dispositional moral metaphysic according to which the metaphysical grounds of moral obligations are not rules or laws, but rather real, irreducibly dispositional properties (or powers) of moral agents and patients. My principal aims are to offer a theoretically attractive and suitably metaphysical account of conflicts of obligation, and to show that the dispositional moral metaphysic that grounds the Dispositional Account can explain and accommodate plausible normative views that rule- and law-based alternatives cannot, as well as to answer objections that have been pressed against other accounts of moral conflict (especially Ross’s) that appeal to moral dispositions or forces. (shrink)

I analyse the meaning of a popular idiom among consciousness researchers, in which an individual's consciousness is described as a 'field'. I consider some of the contexts where this idea appears, in particular discussions of attention and the unity of consciousness. In neither case, I argue, do authors provide the resources to cash out all the implications of field-talk: in particular, they do not give sense to the idea of conscious elements being arrayed along multiple dimensions. I suggest ways to (...) extend and generalize the attentional construal of 'field-talk' to provide a genuine multiplicity of dimensions, through the notions of attentional proximity and causal proximity: the degree to which two experiential elements are disposed to bring one another into attention when attended, or to interact in other distinctively mental ways. I conclude that if consciousness is a field, it is one organized by attentional and/or causal proximity. (shrink)

This edited collection had its origins in a two-day conference held at the Tate Britain, organised collaboratively by research staff and students at Middlesex University and the London Consortium in order to celebrate the 250th Anniversary of the publication of Edmund Burke's famous book on the sublime. The conference was funded by Middlesex University, the London Consortium and the Tate Britain's AHRC-funded "Sublime Object: Nature, Art and Language" research project. The conference set out to critically examine the legacy of the (...) sublime in contemporary art, culture and society and to assess the value and the dangers of this concept as it is articulated in current thought and practice. The book selected from and expanded on the papers delivered at the conference in order to pursue this goal further. It was broken into themed sections (each of which had an introduction), each exploring an different issue around contemporary uses of the sublime. The sections were: 1. Nature, Ecology and the Sublime; 2. The Sublime After Kant; 3. Capitalism, Terror, Art and the Sublime; 4. Baroque and Beyond: Art, Sex and the Sublime; 5. The Cinematic Sublime. The volume reflects the interdisiplinarity of the concept of the sublime today, and includes essays whose appraoches come from aesthetics and ethics, ecological and political thought, psychoanalysis, feminism, film studies, literary studies, art history and popular culture. It includes papers by internationally renowned authors from the UK, America and Europe alongside the new voices of younger academics. The contributors were: Jane Bennett (Johns Hopkins University), Mark Bould (University of the West of England), Eu Jin Chua (London Consortium), Gudrun Filipska (Middlesex University), Cornelia Klinger (Institute for Human Sciences, Vienna / University of Tübingen, Germany), Esther Leslie (Birkbeck), William McDonald (Middlesex Univeristy), Laura Mulvey (Birkbeck), Claire Pajaczkowska (Royal College of Art), Griselda Pollock (University of Leeds), Gene Ray (Geneva University of Art and Design), Bettina Reiber (Central St. Martins), Jan Rosiek (University of Copenhagen), Sherryl Vint (Brock University, Canada), and Luke White (Middlesex University). (shrink)

Chalmers (2002) argues against physicalism in part using the premise that no truth about consciousness can be deduced a priori from any set of purely structural truths. Chalmers (2012) elaborates a detailed definition of what it is for a truth to be structural, which turns out to include spatiotemporal truths. But Chalmers (2012) then proposes to define spatiotemporal terms by reference to their role in causing spatial and temporal experiences. Stoljar (2015) and Ebbers (Ms) argue that this definition of spatiotemporal (...) terms allows for the trivial falsification of Chalmers (2002)’s premise about structure and consciousness. I show that this result can be avoided by tweaking the relevant premise, and moreover that this tweak is well-motivated and not ad hoc. (shrink)

Is it impossible to imaginatively simulate what it’s like to be someone with a different gender experience – to understand them empathically? Or is it simply difficult, a challenge requiring effort and dedication? I first distinguish three different sorts of obstacle to empathic understanding that are sometimes discussed: Missing Ingredient problems, Awkward Combination Problems, and Inappropriate Background Problems. I then argue that, although all three should be taken seriously, there is no clear reason to think that any of them are (...) both genuinely intractable and also significant impediments to the kind of empathic understanding we might want. To that extent, the challenge to interpersonal understanding here may be more a matter of skill and work than a hard boundary. (shrink)

The best arguments against gun control invoke moral rights—it might be good if there were fewer guns in circulation, but there is a moral right to own firearms. Rather than emphasizing the potential benefits of gun control, this paper meets the best arguments on their home turf. I argue that there simply is no moral right to keep guns on one’s person or in one’s residence. In fact, our moral rights support the mutual disarmament of citizens and police.

This article responds to Tim Hsiao's "The Moral Case for Gun Ownership".

A new formulation of the Fine-Tuning Argument (FTA) for the existence of God is offered, which avoids a number of commonly raised objections. I argue that we can and should focus on the fundamental constants and initial conditions of the universe, and show how physics itself provides the probabilities that are needed by the argument. I explain how this formulation avoids a number of common objections, specifically the possibility of deeper physical laws, the multiverse, normalisability, whether God would fine-tune at (...) all, whether the universe is too fine-tuned, and whether the likelihood of God creating a life-permitting universe is inscrutable. (shrink)

Studies of animal culture have not normally included a consideration of cetaceans. However, with several long-term field studies now maturing, this situation should change. Animal culture is generally studied by either investigating transmission mechanisms experimentally, or observing patterns of behavioural variation in wild populations that cannot be explained by either genetic or environmental factors. Taking this second, ethnographic, approach, there is good evidence for cultural transmission in several cetacean species. However, only the bottlenose dolphin (Tursiops) has been shown experimentally to (...) possess sophisticated social learning abilities, including vocal and motor imitation; other species have not been studied. There is observational evidence for imitation and teaching in killer whales. For cetaceans and other large, wide-ranging animals, excessive reliance on experimental data for evidence of culture is not productive; we favour the ethnographic approach. The complex and stable vocal and behavioural cultures of sympatric groups of killer whales (Orcinus orca) appear to have no parallel outside humans, and represent an independent evolution of cultural faculties. The wide movements of cetaceans, the greater variability of the marine environment over large temporal scales relative to that on land, and the stable matrilineal social groups of some species are potentially important factors in the evolution of cetacean culture. There have been suggestions of gene-culture coevolution in cetaceans, and culture may be implicated in some unusual behavioural and life-history traits of whales and dolphins. We hope to stimulate discussion and research on culture in these animals. (shrink)

The conceptions of jealousy used by philosophical writers are various, and, this paper suggests, largely inadequate. In particular, the difference between jealousy and envy has not yet been plausibly specified. This paper surveys some past analyses of this distinction and addresses problems with them, before proposing its own positive account of jealousy, developed from an idea of Leila Tov-Ruach(a.k.a. A. O. Rorty). Three conditions for being jealous are proposed and it is shownhow each of them helps to tell the emotion (...) apart from some distinct species of envy.It is acknowledged that the referents of the two terms are, to some extent, overlapping,but shown how this overlap is justified by the psychologies of the respective emotions. (shrink)

Edited by Thomas A. Shannon, this series provides anthologies of critical essays and reflections by leading ethicists in four pivotal areas: reproductive technologies, genetic technologies, death and dying, and health care policy. The goal of this series is twofold: first, to provide a set of readers on thematic topics for introductory or survey courses in bioethics or for courses with a particular theme or time limitation. Second, each of the readers in this series is designed to help students focus more (...) thoroughly and effectively on specific topics that flesh out the ethical issues at the core of bioethics. The series is also highly accessible to general readers interested in bioethics. (shrink)

In this paper we discuss how Causal Decision Theory should be modified to handle a class of problematic cases involving deterministic laws. Causal Decision Theory, as it stands, is problematically biased against your endorsing deterministic propositions (for example it tells you to deny Newtonian physics, regardless of how confident you are of its truth). Our response is that this is not a problem for Causal Decision Theory per se, but arises because of the standard method for assessing the truth of (...) certain counterfactuals. The truth of deterministic laws is `modally fragile' on the standard semantics for counterfactuals: if determinism is true and you were to do otherwise, the laws would be different. We provide two ways of avoiding this problem: 1) supplement the standard semantics for counterfactuals with impossible worlds, or 2) introduce rigid designators into the description of problematic decision situations. We argue that both of these approaches are well-motivated and can be readily incorporated into Lewisian Causal Decision Theory. (shrink)

The simple model maintains that morally relevant factors combine in a simple, additive way, like weights on a scale. Although intuitive and familiar, this model entails that certain plausible views about particular cases and how morally relevant factors combine and interact therein are false. Shelly Kagan suggests that we could accommodate the relevant views and interactions by rejecting either of two assumptions the simple model makes: that the moral status of an act is determined by the sum of the contributions (...) made by each of the factors relevant thereto (additivity); and that neither the “weight” nor the “valence” of a factor’s contribution can be affected by other factors (atomism). But is there an atomistic option, a way of accommodating the relevant views and interactions by rejecting additivity rather than atomism? I argue that developing an atomistic option requires offering a conception of contribution that renders coherent the particular claims that must be true if there is, indeed, such an option. And I consider whether Rossian pluralism—the locus classicus for the idea of a contributory right-making factor—offers the resources necessary to offer such a conception, and whether it could accommodate the relevant views and interactions other than by rejecting atomism. (shrink)

This book explores a neglected philosophical question: How do groups of interacting minds relate to singular minds? Could several of us, by organizing ourselves the right way, constitute a single conscious mind that contains our minds as parts? And could each of us have been, all along, a group of mental parts in close cooperation? Scientific progress seems to be slowly revealing that all the different physical objects around us are, at root, just a matter of the right parts put (...) together in the right ways: How far could the same be true of minds? This book argues that we are too used to seeing the mind as an indivisible unity and that understanding our place in nature requires being willing to see minds as composite systems, simultaneously one conscious whole and many conscious parts. In thinking through the implications of such a shift of perspective, the book relates the question of mental combination to a range of different theories of the mind (in particular panpsychism, functionalism, and Neo-Lockeanism about personal identity) and identifies, clarifies, and addresses a wide array of philosophical objections (concerning personal identity, the unity of consciousness, the privacy of experience, and other issues) that have been raised against the idea of composite minds. The result is an account of the metaphysics of composition and consciousness that can illuminate many different debates in philosophy of mind, concerning split brains, collective intentionality, and the combination problem, among others. (shrink)

Volume 20, Issue 4, May 2020, Page 25-27.

Two options are ‘incommensurate’ when neither is better than the other, but they are not equally good. Typically, we will say that one option is better in some ways, and the other in others, but neither is better ‘all things considered’. It is tempting to think that incommensurability is vagueness—that it is (perhaps) indeterminate which is better—but this ‘vagueness view’ of incommensurability has not proven popular. I set out the vagueness view and its implications in more detail, and argue that (...) it can explain most of the puzzling features of incommensurability. This argument proceeds without appeal to John Broome’s ‘collapsing principle’. (shrink)

John Broome has argued that value incommensurability is vagueness, by appeal to a controversial about comparative indeterminacy. I offer a new counterexample to the collapsing principle. That principle allows us to derive an outright contradiction from the claim that some object is a borderline case of some predicate. But if there are no borderline cases, then the principle is empty. The collapsing principle is either false or empty.

I argue that there are non-trivial objective chances (that is, objective chances other than 0 and 1) even in deterministic worlds. The argument is straightforward. I observe that there are probabilistic special scientific laws even in deterministic worlds. These laws project non-trivial probabilities for the events that they concern. And these probabilities play the chance role and so should be regarded as chances as opposed, for example, to epistemic probabilities or credences. The supposition of non-trivial deterministic chances might seem to (...) land us in contradiction. The fundamental laws of deterministic worlds project trivial probabilities for the very same events that are assigned non-trivial probabilities by the special scientific laws. I argue that any appearance of tension is dissolved by recognition of the level-relativity of chances. There is therefore no obstacle to accepting non-trivial chance-role-playing deterministic probabilities as genuine chances. (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)

Community gardens are of increasing interest to scholars, policymakers, and community organizations but there has been little systematic study of community garden management at a broad scale. This study complements case study research by revealing shared experiences of community garden management across different contexts. In partnership with the American Community Gardening Association, we developed an online questionnaire. Results from 445 community garden organizations across the US and Canada reveal common themes as well as differences that are particularly significant across different (...) organizational sizes. The findings suggest that organizers see multiple benefits, and respondents confirmed recent expansion of gardening efforts. Analysis then focuses on challenges, which are closely related to garden management. We address garden losses as well as challenges to routine operation. Key challenges included funding, participation, land, and materials. We developed a typology based on organization size, to reveal distinctions between small organizations , medium-sized organizations , large organizations and very large organizations . These categories shed light on different needs for funding, land, material, and participation. Together, this analysis suggests that community gardens can be linked through the work it takes to sustain them rather than specific causes or outcomes. Community gardens can be better integrated into local food systems through analysis of how people involved with this work navigate these shared processes. (shrink)