The increasing use of digital image recording devices, whether they are digital cameras or mobile phone cameras, has democratised clinical photography in the UK. However, when non-professional clinical photographers take photographs of patients the issues of consent and confidentiality are either ignored or given scant attention.Whatever the status of the clinician, the taking of clinical photographs must be practised within the context of a professional etiquette. Best practice recognises the need for informed consent and the constraints associated with confidentiality. Against (...) the background of the poverty of the current discourse of these issues, as presented during the Valentine GMC Fitness to Practice1 hearing, the paper considers the need for orthopraxy in the use of clinical photography. (shrink)

Drawing on Pennock’s theory of scientific virtues, we are developing an alternative curriculum for training scientists in the responsible conduct of research that emphasizes internal values rather than externally imposed rules. This approach focuses on the virtuous characteristics of scientists that lead to responsible and exemplary behavior. We have been pilot-testing one element of such a virtue-based approach to RCR training by conducting dialogue sessions, modeled upon the approach developed by Toolbox Dialogue Initiative, that focus on a specific virtue, e.g., (...) curiosity and objectivity. During these structured discussions, small groups of scientists explore the roles they think the focus virtue plays and should play in the practice of science. Preliminary results have shown that participants strongly prefer this virtue-based model over traditional methods of RCR training. While we cannot yet definitively say that participation in these RCR sessions contributes to responsible conduct, these pilot results are encouraging and warrant continued development of this virtue-based approach to RCR training. (shrink)

This article takes the failure to grasp fully the paradigmatic case of European security after the Cold War as an example of how International Relations (IR) would benefit from reformulating not only its empirical research questions but also several of its central conceptual building blocks with the aid of Bourdieusian sociology. The separation between theory and practice and the overemphasis on military power and state actors blind IR from seeing the power struggles that reshaped European security. Instead, a Bourdieusian reformulation (...) adds new types of agency, focuses on the social production of forms of power, and stresses the processual rather than the substantive character of social reality. (shrink)

The literature on the determination of death has often if not always assumed that the concept of human death should be defined in terms of the end of the human organism. I argue that this broadly biological conceptualization of human death cannot constitute a basis for agreement in a pluralistic society characterized by a variety of reasonable views on the nature of our existence as embodied beings. Rather, following Robert Veatch, I suggest that we must define death in moralized terms, (...) as the loss of an especially significant sort of moral standing. Departing from Veatch, however, I argue that we should not understand death in terms of the loss of all moral status whatsoever. Rather, I argue, what we should argue about, when we argue about death, is when and why people lose their rights-claims to the protection and promotion of their basic bodily functioning. (shrink)

In this paper I develop an account of member obligation: the obligations that fall on the members of an obligated collective in virtue of that collective obligation. I use this account to argue that unorganized collections of individuals can constitute obligated agents. I argue first that, to know when a collective obligation entails obligations on that collective’s members, we have to know not just what it would take for each member to do their part in satisfying the collective obligation, but (...) also what they should do if they cannot do their part because others will not do theirs. I go on to argue (contra recent proposals) that it is not good enough for members in this situation to reasonably believe that others will not do their part. Rather, for a member of an obligated collective to permissibly escape doing her part in a collective obligation, she must both reasonably doubt that others will do their part and stand ready to act in case others do as well. -/- This necessary condition for collective obligation points the way to plausible sufficient conditions – conditions that, I argue, allow unstructured collectives to bear obligations. For (a) if a collective’s members are individually obligated to be ready to do their part, in a given collective action, and (b) if that individual readiness makes it sufficiently likely that the collective will in fact act, then it is hard to see what could block an attribution of collective obligation. In particular, in that case there ought to be no additional objection that there is no existing, organized “agent” on which the obligation might fall. For agents are, simply, things that can act. To be able to act is just to be able to succeed by trying. Unstructured collectives try to do something, I argue, when each member acts on their willingness to do their part in that thing if others do theirs; sometimes they succeed, producing a collective action. Some unstructured collectives, therefore, can succeed by trying; therefore, they can act; therefore they are agents. (shrink)

What makes something a part of my body, for moral purposes? Is the body defined naturalistically: by biological relations, or psychological relations, or some combination of the two? This paper approaches this question by considering a borderline case: the status of prostheses. I argue that extant accounts of the body fail to capture prostheses as genuine body parts. Nor, however, do they provide plausible grounds for excluding prostheses, without excluding some paradigm organic parts in the process. I conclude by suggesting (...) that embodiment is moralized all the way down: to be a body part is to be the sort of thing that ought to be protected, in a certain way, by social practices. (shrink)

Disconnecting a patient from artificial life support, on their request, is often if not always a matter of letting them die, not killing them—and sometimes, permissibly doing so. Stopping a patient’s heart on request, by contrast, is a kind of killing, and rarely if ever a permissible one. The difference seems to be that procedures of the first kind remove an unwanted external support for bodily functioning, rather than intervening in the body itself. What should we say, however, about cases (...) at the boundary—procedures involving items that seem bodily in some respects, but not others? When, for instance, does deactivating an implanted device like a pacemaker count as killing, and when as letting die? Contra existing proposals, I argue that the boundaries of the body for this purpose are not drawn at the boundaries of the self, or (if this is different) the human organism. Nor should we determine when we are killing and when we are letting die by deferring to existing practices for distinguishing ongoing from completed treatment. Rather, I argue that whether something (organic or inorganic) counts as body part for purposes of this distinction depends on the results of a normative analysis of the particular character of our rights in it—particularly, whether and in what way these rights ought to be alienable. I conclude by arguing that there are likely good reasons to recognize distinctively “bodily” rights and restrictions in at least some implantable devices. (shrink)

This paper argues that disabled people can be healthy. I argue, first, following the well-known ‘social model of disability’, that we should prefer a usage of ‘disabled’ which does not imply any kind of impairment that is essentially inconsistent with health. This is because one can be disabled only because limited by false social perception of impairment and one can be, if impaired, disabled not because of the impairment but rather only because of the social response to it. Second, I (...) argue that it is often wrong to use the term ‘healthy’ in a way that makes health inconsistent with any degree whatsoever of health-relevant bodily dysfunction. Whether someone is ‘healthy’ properly-so-called depends on standards of health presupposed in conversational context. Sometimes, I argue, these standards are or ought to be lax enough to allow some people with some health deficits still to count as ‘healthy’ per se. Taking inspiration from David Lewis and Mary Kate Mcgowan, I go on to argue that denying that someone is ‘healthy’ in a context typically succeeds in shifting going presuppositions to require standards strict enough to make that denial acceptable. And this, I conclude by arguing, often constitutes an abuse of conversational power. (shrink)

This article asks whether personal ventilators should be redistributed to maximize lives saved in emergency condition, like the COVID-19 pandemic. It begins by examining extant claims that items like ventilators are literally parts of their user’s bodies. Arguments in favor of incorporation for ventilators fail to show that they meet valid sufficient conditions to be body parts, but arguments against incorporation also fail to show that they fail to meet clearly valid necessary conditions. Further progress on this issue awaits clarification (...) of difficult normative, conceptual, and metaphysical questions about the possible boundaries of a person’s body. Rather than relying solely on incorporation arguments, we propose an argument against reallocation from widely accepted anti-discrimination principles. Possession of a personal ventilator is an obvious marker of disability identity; thus, reallocating ventilators from those that already possess them discriminates on the basis of a stigmatized trait – a paradigm case of presumptively wrongful discrimination. This discrimination claim, taken together with uncertainty about the bodily status of ventilators, yields a strong presumption against personal ventilator reallocation. (shrink)

Technological measures meant to change sexual orientation are, we have argued elsewhere, deeply alarming, even and indeed especially if they are safe and effective. Here we point out that this in part because they produce a distinctive kind of ‘clinical collective action problem’, a sort of dilemma for individual clinicians and researchers: a treatment which evidently relieves the suffering of particular patients, but in the process contributes to a practice that substantially worsens the conditions that produce this suffering in the (...) first place. We argue that the role obligations of clinicians to relieve the suffering of their patients put them in a poor position to solve this problem, though they can take measures to avoid complicity in the harms that would result from widespread use of individually safe and effective reorientation biotechnology. But in the end the medical community as a whole still seems obligated to provide these measures, if they become technologically feasible. Medical researchers are in a better position to prevent the harms that would result if reorientation techniques were safe, effective and widely available. We argue that the harms attendant on the development of safe and effective re-orientation techniques give researchers reason to avoid ‘applied‘ research aimed at developing these techniques, and to be careful in the conduct of basic orientation research which might be applied in this way. (shrink)

In some views, philosophy’s glory days in bioethics are over. While philosophers were especially important in the early days of the field, so the argument goes, the majority of the work in bioethics today involves the “simple” application of existing philosophical principles or concepts, as well as empirical work in bioethics. Here, we address this view head on and ask: What is the role of philosophy in bioethics today? This paper has three specific aims: (1) to respond to skeptics and (...) make the case that philosophy and philosophers still have a very important and meaningful role to play in contemporary bioethics, (2) to discuss some of the current challenges to the meaningful integration of philosophy and bioethics, and (3) to make suggestions for what needs to happen in order for the two fields to stay richly connected. We outline how bioethics center directors, funders, and philosopher bioethicists can help. (shrink)

Farm to school is a popular approach to food systems education in K-12 schools across the United States. FTS programs are highly heterogeneous, but generally include serving locally grown fruits and vegetables in school nutrition programs, planting and maintaining school gardens, and engaging students in garden and food-based learning across the school curriculum. While FTS has been promoted as a “win–win–win” for children, farmers, and communities, it has also been critiqued for reinscribing neoliberal trends that exacerbate social inequalities. Through a (...) year-long, ethnographic study of FTS within one public middle school in the Southeast US, this paper contributes to these debates. Drawing upon theoretical frameworks of materiality and affective labor, we investigate how engagement with FTS activities can transform the social practice of everyday life in school for students, staff, and teachers. We find that FTS can reframe success in collaborative terms, engage the school around collective responsibility, and foster relationships across socioeconomic and racial difference. Although there is continued need to expand policies to ensure equitable funding for FTS, our research demonstrates that the hands-on work and collective subjectivities produced through FTS can mitigate the harms of neoliberalism and be a force for positive social change within a school. (shrink)

This paper argues for Serious Distributive Egalitarianism – the view that some material inequalities are seriously objectionable as such; not merely, say, because such inequalities tend to generate inequalities in status. Social justice requires equality, I argue, because basic social institutions produce important goods and are produced in turn by the relevantly equal contributions of all those that comply with them. E.g., basic social institutions make it much easier to produce cooperatively than it would be in their absence; therefore, these (...) institutions produce, among other things, opportunities to participate in particular productive enterprises. But basic social institutions are themselves produced, in large part, by the compliance of those subject to them; these subjects, therefore, contribute to the production of the goods that basic institutions produce. This gives (at least) every compliant subject of basic social institutions a claim on these goods. And, I argue that, though some do contribute more to the maintenance of basic institutions than others, those who contribute more are too responsible for the fact that others contribute less to point to the consequences of this difference as a reason they should get greater returns. I conclude that all subjects of basic social institutions have equally forceful and forcefully equal claims on the goods these institutions produce; claims that render inequalities in the Distribution of these goods Seriously objectionable as such. (shrink)

A person’s body can, it seems, survive well after losing the capacity to support Lockean personhood. If our rights in our bodies are, basically, rights in our selves or persons, this seems to imply that we do not after all have a right to direct the disposition of our living remains via advance directive. Govind Persad argues that our rights over our bodies persist after the loss of our personhood; we have a right to insist that our bodies die after (...) we are gone for much the same reason that we have a right to decide whether or not to donate organs, after our death. Persad’s conclusion may be right; however, his arguments regarding body rights are insufficient. Persad’s suggestion that our rights in our bodies come from a history of acting and sensing through them cannot, quite, be right, since we act and sense through tools, as well. Nor should we accept Persad’s arguments, from intuitions in cases involving posthumous pregnancy, that our posthumous body rights are powerful enough to allow choices that will result in the death of beings that need our living remains to survive. Problems with these intuitions point to a more general concern for this sort of case-based intuitionistic method: it presupposes that what body rights we have is a matter of ‘natural right’, accessible to all, rather than a function of how social institutions do or should resolve conflicts about the proper way of defining our authority over our bodies. (shrink)

Cet ouvrage est une réédition numérique d’un livre paru au XXe siècle, désormais indisponible dans son format d’origine.

The social model of disability claims that disadvantage from disability is primarily a result of the social response to bodily difference. Social modellers typically draw two normative conclusions: first, that society has a responsibility to address disability disadvantage as a matter of justice, not charity; second, that the appropriate way of addressing this disadvantage is to change social institutions themselves, to better fit for bodily difference, rather than to normalize bodies to fit existing institutions. This paper offers a qualified defense (...) of both inferences. Social institutions have reasons of justice to fix disability disadvantage, because the choice of institutions that contingently favor those whose bodies are statistically typical incurs responsibilities to compensate those who disfavored, in that choice. Among other things, this responsibility implies that societies should not simultaneously materially disadvantage disabled people, and also withhold symbolic resources, by demanding a presumption in favor of personal transformation – thereby, undermining the social conditions for disability pride. (shrink)