Importance Informed consent is essential to ethical, rigorous research and is important to recruitment and retention in cancer trials.Objective To examine cancer clinical trial (CCT) participants’ perceptions of informed consent processes and variations in perceptions by cancer type.Design and Setting and Participants Cross-sectional survey from mixed-methods study at National Cancer Institute–designated Northeast comprehensive cancer center. Open-ended and forced-choice items addressed: (1) enrollment and informed consent experiences and (2) decision-making processes, including risk-benefit assessment. Eligibility: CCT participant with gastro-intestinal or genitourinary, hematologic-lymphatic (...) malignancies, lung cancer, and breast or gynecological cancer (N = 334).Main Outcome Measures Percentages satisfied with consent process and information provided; and assessing participation’s perceptions of risks/benefits. Multivariable logistic or ordinal regression examined differences by cancer type.Results Most patient-participants felt well informed by the consent process (more than 90% overall and by cancer type) and. most (87.4%) reported that the consent form provided all the information they wanted, although nearly half (44.8%) reported that they read the form somewhat carefully or less. More than half (57.9%) said that talking to research staff (i.e., the consent process) had a greater impact on participation decisions than reading the consent form (2.1%). A third (31.1%) were very sure of joining in research studies before the informed consent process (almost half of lung cancer patients did—47.1%). Most patients personally assessed the risks and benefits before consenting. However, trust in physicians played an important role in the decision to enroll in CCT.Conclusions and Relevance Cancer patients rely less on written features of the informed consent process than on information obtained from the research staff and their own physicians. Research should focus on information and communication strategies that support informed consent from referring physicians, researchers, and others to improve patient risk-benefit assessment and decision-making. (shrink)

Lexical alignment, a communication phenomenon where conversational partners adapt their word choices to become more similar, plays an important role in the development of language and social communication skills. While this has been studied extensively in the conversations of preschool‐aged children and their parents in Western, Educated, Industrialized, Rich, and Democratic (WEIRD) communities, research in other pediatric populations is sparse. This study makes significant expansions on the existing literature by focusing on alignment in naturalistic conversations of school‐aged children from a (...) non‐WEIRD population across multiple conversational tasks and with different types of adult partners. Typically developing children aged 5 to 8 years (n = 45) engaged in four semi‐structured conversations that differed by task (problem‐solving vs. play‐based) and by partner (parent vs. university student), resulting in a corpus of 180 conversations. Lexical alignment scores were calculated and compared to sham conversations, representing alignment occurring at the level of chance. Both children and adults coordinated their conversational utterances by re‐using or aligning each other's word choices. This alignment behavior persisted across conversational tasks and partners, although the degree of alignment was moderated by the conversational context. These findings suggest that lexical alignment is a robust phenomenon in conversations between school‐age children and adults. Furthermore, this study extends lexical alignment findings to a non‐WEIRD culture, suggesting that alignment may be a coordination strategy employed by adults and children across diverse linguistic and cultural backgrounds. (shrink)

Building on their important findings in The Source of the River, the authors now probe even more deeply into minority underachievement at the college level. Taming the River examines the academic and social dynamics of different ethnic groups during the first two years of college. Focusing on racial differences in academic performance, the book identifies the causes of students' divergent grades and levels of personal satisfaction with their institutions. Using survey data collected from twenty-eight selective colleges and universities, Taming the (...) River considers all facets of student life, including who students date, what fields they major in, which sports they play, and how they perceive their own social and economic backgrounds. The book explores how black and Latino students experience pressures stemming from campus racial climate and "stereotype threat"--when students underperform because of anxieties tied to existing negative stereotypes. Describing the relationship between grade performance and stereotype threat, the book shows how this link is reinforced by institutional practices of affirmative action. The authors also indicate that when certain variables are controlled, minority students earn the same grades, express the same college satisfaction, and remain in school at the same rates as white students. A powerful look at how educational policies unfold in America's universities, Taming the River sheds light on the social and racial factors influencing student success. (shrink)

Sports are an excellent venue for demonstrating evolutionary principles to audiences not familiar with academic research. Team sports and sports fandom feature dynamics of in-group loyalty and intergroup competition, influenced by our evolved coalitional psychology. We predicted that reactions to expressions signaling mutual team/group allegiance would vary as a function of the territorial context. Reactions should become more prevalent, positive, and enthusiastic as one moves from the home territory to a contested area, and from a contested area to a rival’s (...) territory during active rival engagement. We also predicted that men would be more responsive than women based on sex differences in evolved coalitional psychology. The research team visited public places immediately prior to 2016–2017 collegiate football and basketball games. A male research confederate wore a sweatshirt displaying the logo of one of the competing university teams and vocalized the team’s most popular slogan when he saw a fan displaying similar logos. Observers followed 5 m behind, recording reactions and response positivity/enthusiasm. Reaction tone was most positive in the rival territory, least positive in the home territory, and intermediate in the periphery and contested territory. Rates of “no reaction” were lowest in the rival territory but were highest in the periphery. Men had higher reaction rates and more positive and enthusiastic reaction tones than women. Reactions generally followed predictions based on expected signal value. This project provides evidence that coalitional psychology influences dynamics related to university sports team rivalries and that context matters for expressions of alliance. (shrink)

Background: When adolescent boys experience close, secure relationships with their parents and peers, the implications are potentially far reaching, including lower levels of mental health problems in adolescence and young adulthood. Here we use rare prospective intergenerational data to extend our understanding of the impact of adolescent attachments on subsequent postpartum mental health problems in early fatherhood.Methods: At age 17–18 years, we used an abbreviated Inventory of Parent and Peer Attachment to assess trust, communication, and alienation reported by 270 male (...) participants in their relationships with mothers, fathers, and peers. More than a decade later, we assessed the adult males, now fathers, at 12 months postpartum for symptoms of depression, anxiety, and stress. Logistic regression was used to examine the extent to which attachment dimensions predicted paternal postpartum mental health, adjusting for potential confounding, and with assessment for interactions between parent and peer attachments.Results: Trust in mothers and peers, and good communication with fathers during adolescence, were associated with 5 to 7 percentage point reductions in postpartum mental health symptoms in early fatherhood. Weak evidence of parent-peer interactions suggested secure attachments with either parent or peer may compensate for an insecure attachment with the other.Conclusions: Our results suggest that fostering trust and communication in relationships that adolescent boys have with parents and peers may have substantial effects on rates of paternal postpartum mental health problems. The protective benefits may be preventative in intergenerational cycles of risk for mental health problems. (shrink)

The speed and scale of the COVID‐19 pandemic has highlighted the limits of current health systems and the potential promise of non‐establishment research such as “DIY” research. We consider one example of how DIY research is responding to the pandemic, discuss the challenges faced by DIY research more generally, and suggest that a “trust architecture” should be developed now to contribute to successful future DIY efforts.

"Descartes ou la philosophie française : le caractère fondateur qui a été reconnu de droit à Descartes au regard de toute la philosophie moderne a masqué l'importance toute particulière que les penseurs français lui ont toujours accordée, de fait, dans leur propre édification intellectuelle. Descartes fournit en France moins les idées que la trame qui a servi à les ordonner -- ce qui n'est le cas d'aucun philosophe ailleurs. Sartre, toute sa vie durant, fut tenu par le projet de construire (...) une morale. Par la suite, il ne s'est jamais lassé de conclure : « Et j'ai toujours échoué. » Conscient de cet échec où son projet de métaphysique l'a mené, il reconduit les motifs qu'il avait de l'écrire à son enfance : « Ma seule affaire était de me sauver. » Il avait cru être au monde ; il a vécu dans l'imaginaire. Il avait bâti tout une œuvre afin de s'y mettre tout entier. Or ce Moi immortalisé, celui auquel il aspirait, c'était secrètement Descartes, médiateur caché dans la pénombre mais qui lui avait tracé un chemin pour le rejoindre. Sartre ne l'a pas dit. Néanmoins il savait qu'il était en train de récrire les Méditations métaphysiques de Descartes. C'était son secret et le propre du secret est d'appartenir à ce qui relève en chacun non pas de l'inconscient mais de ce « fonds sombre qui refuse d'être dit » -- le vécu. Un tel secret, encore enveloppé et obscur à lui-même, explique également que Sartre ait pu se dire à la fois existentialiste et cartésien. D'un côté, l'existentialisme est le nom que l'adversaire avait donné à la doctrine. Il est la manière objective dont sa pensée s'est extériorisée dans l'histoire, il est la doctrine vue du dehors. De l'autre côté, le cartésianisme est la même doctrine mais telle qu'elle est comprise du dedans par Sartre. Il est la manière subjective dont Sartre a intériorisé sa doctrine dans l'histoire de la philosophie. Deux courants de pensée dont l'un, tout en surface, a recouvert malencontreusement l'autre qui était pourtant le seul qui fût profond."--Page 4 de la couverture. (shrink)

La question qu’on nomme aujourd’hui des « genres naturels » en métaphysique porte sur les « jointures » du monde : quelles classes de choses constituent le monde et existent réellement? Si nominalistes et réalistes s’opposent depuis longtemps sur la possibilité même de répondre à cette question, les sciences modernes proposent des découpages en genres naturels qui contrastent souvent avec l’image naturelle du monde. Cet article se concentre sur les genres naturels en biologie. Après avoir présenté le principe de réponse (...) offert par la biologie évolutive, à savoir la systématique cladistique, j’expose le paradoxe du poisson, puisque « poisson » n’y est pas un nom de classe objectif, et semble donc aussi peu réel que « légume ». Je montre ensuite comment ce paradoxe est abordé différemment par des conceptions réalistes ou pragmatistes des genres naturels, et, en distinguant plusieurs sortes de pragmatismes en fonction des pratiques sociales auxquelles ils réfèrent la vérité des énoncés, je défendrai un pragmatisme modéré quant aux genres naturels en biologie. (shrink)

Photo by Jonathan Ford on Unsplash ABSTRACT Since 2008, an average of twenty million people per year have been displaced by weather events. Climate migration creates a special setting for a duty to rescue. A duty to rescue is a moral rather than legal duty and imposes on a bystander to take an active role in preventing serious harm to someone else. This paper analyzes the idea of expanding a duty to rescue to climate migration. We address who should have (...) the duty and to whom the duty should extend. The paper discusses ways to define and apply the duty to rescue as well as its limitations, arguing that it may take the form of an ethical duty to prepare. INTRODUCTION Climate migration creates a special setting for a duty to rescue. A duty to rescue is a moral rather than legal duty and imposes on a bystander to take an active role in preventing serious harm to someone else. Examples of circumstances range from person-to-person intimate rescue to saving those in poverty, even in distant parts of the world.[1] Since 2008, an average of twenty million people per year have been displaced by weather events.[2] Circumstances like being thrust from homes under the threat of fire, mudslide, and flooding vary greatly from long-term changes like land becoming too arid for crops or temperatures increasing annually gradually pushing up the number of heat-related deaths, with the area slowly becoming uninhabitable. Imminence in fleeing affects resettling and need for rescue with important implications for how the duty to rescue might apply. This paper reevaluates the ethical framing of the duty to rescue and, while it is arguably a stretch, applies it to climate migration. Climate migration has become common and is expected to increase due to rises in sea level, increases in weather events that make areas uninhabitable, and changes to land that preclude farming or other necessary land uses. We argue that a duty to rescue may help highlight who has moral obligations to whom. Because the problem is so large in scope, we suggest a change in the ethical limits to humans' duty to rescue other humans who are in distress. We imagine an expansion or extension of the duty to rescue to meet some of the basic needs created by climate migration. Yet how it should expand, and how much depend on ethical framing and practical limitations. l. Expanding the Geographical Boundaries Two commonly recognized emergencies, Hurricane Katrina in the case of weather events and the current COVID-19 pandemic, provide a historical and current backdrop to evaluate ethical obligations as more disasters displace people. A significant reassessment of the ethical scope of an obligation to rescue in the case of weather events will be limited by the ability to render aid to those in distress in the case of a planet-wide weather catastrophe. The problems may overwhelm the ability to rescue or the reasonableness of attempting rescue. The extent of the moral obligation borne by humans to other humans in the case of a weather event has been largely defined by its locality and limited geographic influence. Whether we are imagining the scope of ethical obligation in the case of hurricane, flood, tornado, drought, or wildfire events, the perceived ethical obligation is significantly defined by the limited impact of these weather events on people outside the zone of the weather event's direct impact, yet close to that zone. A hurricane affecting New Orleans will not have immediate impact on the residents of California or even those on the northeast coast of the United States until a later time. Wildfires in the Pacific Northwest do not impair the ability of those in the rest of the country to come forward with assistance. But as climate migration crosses international borders, and climate events occur simultaneously in many regions, a more expansive duty to rescue may provide the ethical impulse to help those who live afar or migrate long distances. In this respect, the need for help in the event of widespread climate migration due to global warming is more like a pandemic than a weather event. Its broad impact area diminishes the capability of nearly the entire balance of the human population to help due to those populations' awareness that they will, in short order, have the same need for the same resources, from the same cause. Those living near current flood zones may find their historically safe havens are also a flood zone. Those previously best positioned to rescue may find themselves also needing to relocate. Thus, we may observe the need for new rescuers. ll. The Rule of Rescue The Rule of Rescue as defined by Al Jonsen describes the moral impetus or knee jerk reaction to save identifiable people facing death.[3] A duty to rescue has since been expanded beyond imminent death and beyond the near and identifiable. But there are limitations. For example, by most accounts, the ethical duty tends not to require extreme bodily risk or financial depletion. In comparing Good Samaritans to humanitarians, Scott M. James argues the duty to rescue arises from unique dependence, but the ethical obligation to help strangers through humanitarian aid is of a different nature.[4] The wrongness of failing to help is arguably more egregious when one is in a unique position to help. Like in the tragedy of the commons, where there is no unique positioning, when the global community is called upon to help, each individual in it may feel less obliged to do so. Climate migration falls in between—it requires helping strangers, yet it may move forward without anyone seeing themselves as uniquely positioned to help until those strangers become part of communities, at which time, there may be more moral justification to help a community member in need. Generally, arguments about Good Samaritans hinge on extraordinary acts, praiseworthy because they are acts of compassion, not obligation. Now all US states have Good Samaritan laws[5] which protect helpers from liability for help gone wrong or for a failure to succeed once engaged in an act of rescue. Extraordinary help as a moral good is thus somewhat encouraged through legal protection, but not imposed. Conversely, jobs like firefighting, search and rescue, and emergency medical care tend to oblige employees to take on risks that would be extraordinary if undertaken by the average bystander, yet they are rendered ordinary rescue as part of the job. Three states, Minnesota, Rhode Island, and Vermont have a broad duty to rescue, adding legal considerations to an otherwise moral conundrum. The laws do not require bystanders to take on risk for the sake of rescuing strangers.[6] The moral duty will require looking beyond law, but it is unclear how the moral duty to rescue should be distributed in the case of climate migration. A bare minimum would prevent taking advantage of newcomers, paying sub-minimum wage, and discriminating against them. Yet such a minimum is hardly rescue. lll. An Ethical Rather than Legal Duty The difficulty in defining the duty to rescue as a legal obligation is that it is difficult to determine the extent of risk a rescuer ought to be required to take. The nature of this ethical duty is also arguably tied to the experiences of both the rescuer and the rescued. There are subjective aspects like what someone perceives as a danger that make it difficult to write enforceable laws requiring rescue. It is one thing to expect a rescuer to step into several inches of relatively warm water to lift a person lying face down in a pond and enable them to breathe. It is something altogether different to expect that rescuer to dive into frigid water and attempt to extricate someone trapped in a submerged automobile. As the legal philosopher H.L.A. Hart observed, it is always easier to define application of the core intention of any rule, whether law or ethical norm. It is more difficult to create legal certainty about how the law applies to what he described as “penumbra circumstances”. In the case of a hurricane, it is easier to define what surplus resources are available in areas geographically remote from the impact of the storm and demand, as a moral obligation, that those nearby but outside the area provide assistance. It is more difficult to obligate people, organizations, or governments to supply a quantity of medication or some number of ventilators to an adjacent community when they expect to imminently need them for their own community. In the early stages of climate migration, the ethics of extreme weather event assistance, a common application of the duty to rescue, will be useful and appropriate. The rising sea levels first experienced by island nations in the South Pacific[7] will not render those living in other coastal communities, those with greater available “high ground”, unable to supply resources to those in need. But when sea level rise and climate change affect more communities simultaneously, albeit in varying degree, the task of defining what response is ethically obligatory becomes increasingly complicated. Pinpointing the obligations of those communities which are resource rich to those communities which are resource deprived, and of those partly affected to those more severely affected may become necessary. The limitations of the traditional duty to rescue could expand to meet the needs. lV. Contribution to the Problem Many argue that the duty to rescue may depend on any appropriate claim of those needing rescue. One issue is whether preferential claims among those who can identify the source of the harm should call for a greater duty or whether everyone in need should be approached as like candidates for rescue, shaping the duty as equal across those on the receiving end. As climate change does have human-made causes, there are strong arguments to impose a greater ethical duty on any entity that caused the climate-related problems leading to the mass exodus. While the global north is often implicated in pollution that causes migration, industries like energy, transportation, and agriculture are tied to climate change and associated with significant greenhouse gas emissions.[8] Practices like directing agriculture to less sustainable single crop growth generally made land less farmable. Yet it is difficult to place blame and identify specific causal relationships as most migration is due to many factors. A movement toward greater accountability can be reframed as a greater duty to rescue, a duty to engage in the extraordinary. The fossil fuel industry, for example, should have a larger obligation than the average person. Similarly, some may argue anyone unjustly enriching themselves while contributing to climate change or people who over-consume have an elevated duty to rescue.[9] Climate change lawsuits demonstrate an eagerness to hold governments and corporations accountable, despite difficulty proving causation. V. The Most Vulnerable One ethical dimension of climate migration that remains unexplored is how a duty to rescue applies to vulnerable populations who stand to be left behind or unable to migrate without assistance. Researchers from the Global North working across the Global South are increasingly observing the phenomenon of ethics dumping, where the research ethics of some countries are imposed on research subjects in other countries.[10] In that vein, rescuers should be careful not to impose unwelcome cultural standards or exploit people who are in the process of migrating. There is a gap in discussions reflecting voices that have been left out. The duty to rescue is incomplete without an attempt to understand the ethical experiences of those being rescued. The actual people affected by climate migration who are the least likely to have the means to migrate, or to do so without extreme hardship, should have a voice informing the global community including those in a position to carry out rescue. People who have the means and are young and healthy may easily make decisions to avoid the catastrophic consequences that climate migration brings. However, what about those who are left behind? For example, especially recognizing cultural differences, the homeless community, disabled community, refugees, the elderly community, and women[11] and children may suffer differently and call for more attention. In some parts of the world, human rights are severely constrained. An ethical duty to rescue, with many considerations and variables, may be more justified in the case of those most in need. As climate migration continues and increases significantly, it may be reasonable to ask the local and global community to focus on those least well positioned to migrate successfully. In this context, the use of phenomenology to understand the lived experiences of those migrating, sometimes termed “ethical experiences”, may help flesh out how a duty to rescue takes shape. The discussion of duty and obligation requires an articulation of the ethical experiences (how the local community in need of rescue views the proposed rescue). Then, the obligation to interpret the duty as ‘one shall not’ or ‘one must’ can be focused on the migrants’ needs rather than the rescuers’ feelings of obligation.[12] A revised theory of the duty to rescue taking into account the asymmetrical experiences of communities involved could ensure that the needs of people whose living situations, gender, ethnicity, age, or race impact their ability to even begin the migration process are considered. In this discussion, the rescuing is directed toward communities /collectives of persons migrating, whether at once or across a period of time. Often, the climate migrant may not be in a state to articulate the nature of this event when it happens, given its subjective proximity. Yet, when communities are given the space and opportunity to articulate their shared values, the ethical action of rescue derives its meaningfulness from the community rather than the rescuers. In other words, allowing climate migrants to explain their feelings can add complexity to what some see as a binary receiver-giver (of rescue) dynamic. This is necessary because the concept of vulnerable populations is fraught with problematic assumptions. There have been various definitions and criteria to determine what would constitute vulnerable populations.[13] For example, the United Nations Framework Convention on Climate Change[14] identifies and assesses vulnerable populations. These criteria may be helpful. However, they do not provide the full picture. Rather than identifying categorical criteria of vulnerable populations, engaging with people who are experiencing climate migration and listening to their current experiences and concerns helps determine need. Knowing what people need may prevent the kneejerk reaction to label people who are quite resilient yet have appropriate needs “vulnerable”. Proceeding with caution is important because the duty to rescue has hierarchical underpinnings of "us" and "them." Often when people swoop in to save, there are good and bad consequences of the intervention. We should proceed with caution because often the helper misses the actual needs of those in need. The only way to combat this would be to make sure that people are empowered to inform those agencies that are able to help. In addition to more practical approaches, large scale oral histories could allow those who have migrated already to share their experiences. It would be important to capture the lived experiences of people who are already experiencing the consequences of climate migration or of other migration like that due to political or economic extreme events. These experiences could shape our analysis of whether people in fact wish for rescue. If so, further conversations can determine best actions as well as give important insight into what resources might be necessary to empower people now and in the future. Vl. A Duty to Rescue as a Duty to Prepare If we view Good Samaritans as going above and beyond, then a duty to rescue, something ethically compelled, must bring rescue out of the framework of charity and place it in the context of humanity and obligations. Such a view would also support expanding the geographical reach of the otherwise more proximate duty. The duty may be stronger and take shape in a more workable way if it applies to preparing places expecting to see an influx of people due to climate migration and to helping those most in need. The duty may arise out of expectations of what type of community the place welcoming those migrating due to climate should be—does it want to offer good housing, schooling, and medical care as well as economic opportunity to new people? And if so, at what cost, or with which risks? If the newcomers are viewed as community members rather than strangers, a model of acceptance may lead to better preparation. Some considerations like whether the actions will reasonably help the persons in need of rescue[15] will shape the application of a duty to rescue in the context of climate migration. Similarly, ensuring that people have the chance to articulate their values may help communities support the newcomers. New relationships should not be defined as migrant and rescuer. Voluntariness in participation and not forcing any action deemed rescue would help ensure the human rights of those migrating. In the United States, President Biden issued an executive order addressing impending climate migration steeped in a duty to prepare by making plans for resettlement and to address the impact of climate migration.[16] Vll. At What Risk? As we investigate the ethical obligations to meet even basic needs, we must also ask what level of risk is ethically compelled. There is an extraordinary need to integrate newcomers successfully, but it is difficult to stretch an ethical duty to rescue to require all the prerequisites for successful climate migration. Even defining success would create deep ethical arguments. As observed in almost all migrations, extraordinary charitable acts may be the key to success, while an ethical duty to rescue must try to require the important government and community-based basics and ensuring respect for human rights. That is, the migrating people should be rescued from circumstances that contradict basic human rights. Rather than comparing communities to bystanders, mere places where people will arrive and need to hash out how to find housing, jobs, education, and opportunity, a duty of preparation may be the key to rescue those disenfranchised by migration. There are cultural, personal, physical, psycho-social, and geopolitical issues surrounding how to best help those needing to permanently relocate. Ethics arguments will certainly range from “do nothing”, which may fail people, to “do everything”, which could waste taxpayer money in futile over-preparation while failing to actually help. Communities must avoid planning exclusively for one scenario only to have it not take place. Striking the balance, a duty to rescue as it could apply to climate migration should set goals of societal integration, and providing the basics like education, housing, food, health care, and job opportunity, the precursors to flourishing. Recommending the extraordinary, morally preferred but perhaps not compulsory, when charitable actors are participating, or when wrongdoers are compensating, may be more workable than seeing the duty to rescue as compelling people or local governments to take on significant financial and personal risk for newcomers. While humanitarian ethics supports helping everyone, it is likely that people who resettle in advance of a need to flee will find themselves with more choices and opportunities. Help is warranted for those with more dire needs. Preparing for them may do just that. Vlll. Rescue Prior to Migration and Rescue in the Process of Resettlement The duty to enable the migration in the first-place hints to the inadequacy of a duty to prepare. The traditional duty to rescue perhaps steps in if rescue looks like those geographically just out of harm's way rescuing those in danger. That resembles the traditional moral requirement, or duty to rescue according to the Rule of Rescue. Humanitarian aid typically provided by many institutions makes sense and is in place, although financial support for additional humanitarian aid is always needed. Despite having moved to purportedly more capable communities, migrant communities may be able to develop more egalitarian orders of living. Rather than continually being identified as having been rescued, it is important to make sure people keep or make social ties during and after migration. Immigrants often face social isolation.[17] Small shifts in gestural language also have the potential to welcome people and show they are valued. For instance, some migrants may not like questions like “Where are you from?” and “What brings you here?” as they emphasize differences over fitting in. CONCLUSION The ethical duty to rescue should be expanded to better match those in need of relocation with a welcome environment and the resources needed to achieve success and fully integrate socially and culturally. Expanding a dialogue that includes the voices of people who have recently migrated whether due to violence, poverty, or climate, could properly frame the extent of the duty. If we are to apply the duty of rescue to climate migration, rescuers should avoid labeling people vulnerable, dependent, or needy, although there is reason to focus on those whose needs are the most dire. A soft duty to rescue people during the course of climate migration can come in the form of preparation. People will need help finding housing, education, access to food, and employment. Ultimately, to help them help themselves may be the best goal. While the obligations should be borne differently by people, whether due to a special responsibility, or a special relationship that creates a clearer duty, the global community must prepare for its role in rescuing those displaced by climate events. By helping those displaced at the start of the climate migration process according to a more commonly held notion of the duty to rescue, and by preparing to incorporate newcomers successfully according to an expanded duty to rescue, effectively a duty to prepare, countries that take on climate refugees may find themselves rewarded by the cultural diversity and workplace talents that people bring. A duty to those at a distance is a reasonable expansion of the duty to rescue. But what one ought to do in the global community varies somewhat from the traditional Rule of Rescue. - [1] Singer, P. (1972). Famine, Affluence, and Morality. Philosophy and Public Affairs, 1(3): 229-43. [2] Irfan, U. (2022, March 16). Why We Still Don’t Yet Know How Bad Climate Migration Will Get. Vox. https://www.vox.com/2022/3/16/22960468/ipcc-climate-change-migration-migrant-refugee, citing the International Panel on Climate Change (IPCC) (2022). Sixth Assessment Report, Climate Change 2022, Impacts, Adaptation, and Vulnerability. https://www.ipcc.ch/report/ar6/wg2/ [3] McKie, J., Richardson, J. (2003) The Rule of Rescue. Social Science & Medicine, 56(12): 2407-2419. https://doi.org/10.1016/S0277-9536(02)00244-7. [4] James, S.M. (2007). Good Samaritans, Good Humanitarians. Journal of Applied Philosophy, 24(3):238-254. [5] Overview of Good Samaritan laws. https://worldpopulationreview.com/state-rankings/good-samaritan-law-states [6] Fifield, J. (2017, Sept. 19). Why It’s Hard to Punish ‘Bad Samaritans’. Stateline Blog, Pew Charitable Trusts, https://www.pewtrusts.org/en/research-and-analysis/blogs/stateline/2017/09/19/why-its-hard-to-punish -bad-samaritans [7] Cassella, C. (2019). There’s a Climate Threat Facing Pacific Islands That’s More Dire Than Losing Land, Science Alert, https://www.sciencealert.com/pacific-islanders-are-in-a-climate-crisis-as-rising-sea-levels-threaten -water; Hassan, H. R., and Cliff, V. (2019). For Small Island Nations, Climate Change is not a Threat. It’s Already Here, World Economic Forum, https://www.weforum.org/agenda/2019/09/island-nations-maldives-climate-change/ [8] For example, Lyons, K. (2019). Australia Coal use is Existential threat to Pacific Islanders, The Guardian. https://www.theguardian.com/world/2019/aug/12/australia-coal-use-is-existential-threat-to-pacific-is lands-says-fiji-pm [9] Cripps, E. (2013). Climate Change and the Moral Agent: Individual Duties in an Interdependent World. Oxford: Oxford University Press. [10] Schroeder, D., Chatfield, K., Singh, M., Chennells, R., and Herissone-Kelly, P.. Ethics Dumping and the Need for a Global Code of Conduct. In Cham. (Ed.)(2019). Equitable Research Partnerships. SpringerBriefs in Research and Innovation Governance. Springer. 2019. https://doi.org/10.1007/978-3-030-15745-6_1 [11] Giudice L.C., Llamas-Clark E.F., DeNicola N., Pandipati, S., Zlatnik, M.G., Decena, D.C.D., Woodruff, T.J., Conry, J.A. (2021). Climate Change, Women’s Health, and the Role of Obstetricians and Gynecologists in Leadership, International J Gynecol Obstet, 155(3), 345-356. 10.1002/ijgo.13958 [12] See Ferrarello, S. and Zapien, N. (2020). Ethical Experience: A Phenomenology, Bloomsbury. (for understanding phenomenological determinants of ethical action). [13] McLeman, R.A., Hunter, L.M., (2010). Migration in the context of vulnerability and adaptation to climate change: insights from analogues. Wiley Interdiscip Rev Clim Change, 1(3): 450-461. [14] Least Developed Countries Expert Group. (2018). Considerations Regarding Vulnerable Groups, Communities and Ecosystems in the Context of the National Adaptation Plans: United Nations Framework Convention on Climate Change. [15] Jecker, N.S. 2013. "The Problem with Rescue Medicine." J Med Philos, 38(1):64-81. [16] White House Report. (February 9, 2021), Executive Order (E.O.) 14013, “Rebuilding and Enhancing Programs to Resettle Refugees and Planning for the Impact of Climate Change on Migration.” (calls on the National Security Advisor to prepare a report on climate change and its impact on migration. “This report marks the first time the U.S. Government is officially reporting on the link between climate change and migration.” https://www.whitehouse.gov/briefing-room/presidential-actions/2021/01/27/executive-order-on-tackling -the-climate-crisis-at-home-and-abroad/ [17] Torres, J.M., Casey, J.A. (2017) The centrality of social ties to climate migration and mental health. BMC Public Health, 17: 600. https://doi.org/10.1186/s12889-017-4508-0. (shrink)

Ambiguity in the Western Mind, edited with an Introduction by Craig J. N. de Paulo, Senior Editor, et al. New York: Peter Lang Publishers, 2005. Details: Preface by Joseph Margolis and distinguished contributors include John D. Caputo, Camille Paglia, Jaroslav Pelikan, Roland Teske, S.J. et al.

A revival of the dialogue between phenomenology and psychiatry currently takes place in the best international journals of psychiatry. In this article, we analyse this revival and the role given to phenomenology in this context. Although this dialogue seems at first sight interesting, we show that it is problematic. It leads indeed to use phenomenology in a special way, transforming it into a discipline dealing with empirical facts, so that what is called “phenomenology” has finally nothing to do with phenomenology. (...) This so-called phenomenology tallies however with what we have always called semiology. We try to explain the reasons why phenomenology is misused in that way. In our view, this transformation of phenomenology into an empirical and objectifying discipline is explained by the role attributed to phenomenology by contemporary authors, which is to solve the problems raised by the Diagnostic and Statistical Manual of Mental Disorders. (shrink)

Information can be public among a group. Whether or not information is public matters, for example, for accounts of interdependent rational choice, of communication, and of joint intention. A standard analysis of public information identifies it with (some variant of) common belief. The latter notion is stipulatively defined as an infinite conjunction: for p to be commonly believed is for it to believed by all members of a group, for all members to believe that all members believe it, and so (...) forth. This analysis is often presupposed without much argument in philosophy. Theoretical entrenchment or intuitions about cases might give some traction on the question, but give little insight about why the identification holds, if it does. The strategy of this paper is to characterize a practical-normative role for information being public, and show that the only things that play that role are (variants of) common belief as stipulatively characterized. In more detail: a functional role for “taking a proposition for granted” in non-isolated decision making is characterized. I then present some minimal conditions under which such an attitude is correctly held. The key assumption links this attitude to beliefs about what is public. From minimal a priori principles, we can argue that a proposition being public among a group entails common commitment to believe among that group. Later sections explore partial converses to this result, the factivity of publicity and publicity from the perspective of outsiders to the group, and objections to the aprioricity of the result deriving from a posteriori existential presuppositions. (shrink)

How can we distinguish between quasi-realist expressivism and normative realism? The most promising answer to this question is the “explanation” explanation proposed by Dreier (2004), Simpson (2018), and others: the two views might agree in their claims about truth and objectivity, or even in their attributions of semantic content to normative sentences, but they disagree about how to explain normative meaning. Realists explain meaning by invoking normative facts and properties, or representational relations between normative language and the world, the thought (...) goes, while expressivists appeal instead to desire-like mental states in their explanations of meaning. However, I argue that, if we adopt a deflationary approach to representation and other related notions, there need be no such explanatory divide between expressivism and anything recognizable as a plausible notion of normative realism. Any alleged explanatory criterion for realism will either be incompatible with deflationism, or it will fail to capture some standard versions of normative realism. I conclude that, in a deflationary framework, expressivism is compatible with genuine realism. (shrink)

We all could have had better lives, yet often do not wish that our lives had gone differently, especially when we contemplate alternatives that vastly diverge from our actual life course. What, if anything, accounts for such conservative retrospective attitudes? I argue that the right answer involves the significance of our personal attachments and our biographical identity. I also examine other options, such as the absence of self-to-self connections across possible worlds and a general conservatism about value.

The commons is a concept increasingly used with the promise of creating new collective wealth. In the aftermath of the economic and financial crises, finance and money have been criticized and redesigned to serve the collective interest. In this article, we analyze three types of complementary currency systems: community currencies, inter-enterprise currencies, and cryptocurrencies. We investigate whether these systems can be considered as commons. To address this question, we use two main theoretical frameworks that are usually separate: the “new commons” (...) in organization studies and the “common good” in business ethics. Our findings show that these monetary systems and organizations may be considered as commons under the “common good” framework since they promote the common interest by creating new communities. Nevertheless, according to the “new commons” framework, only systems relying on collective action and self-management can be said to form commons. This allows us to suggest two new categories of commons: the “social commons,” which fit into both the “new commons” and the “common good” frameworks, and the “commercial commons,” which fit the “common good” but not the “new commons” framework. This research advances a new conceptualization of the commons and of the ethical implications of CCs. (shrink)

Ned Block argues that the higher-order (HO) approach to explaining consciousness is ‘defunct’ because a prominent objection (the ‘misrepresentation objection’) exposes the view as ‘incoherent’. What’s more, a response to this objection that I’ve offered elsewhere (Weisberg 2010) fails because it ‘amounts to abusing the notion of what-it’s-like-ness’ (xxx).1 In this response, I wish to plead guilty as charged. Indeed, I will continue herein to abuse Block’s notion of what-it’s-like-ness. After doing so, I will argue that the HO approach accounts (...) for the sense of what-it’s-like-ness that matters in a theory of consciousness. I will also argue that the only incoherence present in the HO theory is that generated by embracing Block’s controversial notion of what-it’s-like-ness, something no theorist of any stripe ought to do. Block is famous for (among other things) having introduced the notion of ‘phenomenal consciousness’ into contemporary philosophy of mind (Block 1995). This term is widely employed in the philosophical literature and it even appears in the empirical literature. But wide-speared usage has brought about divergent interpretations of the term. We can distinguish a ‘moderate’ and a ‘zealous’ reading of ‘phenomenal consciousness’. On the moderate reading, ‘phenomenal consciousness’ just means ‘experience’. Many people have embraced this sense of the term and use it to roughly pick out conscious experience involving sensory quality (states like conscious visual experiences or conscious pains, for example).2 On the zealous reading, however, phenomenal consciousness is held to be ‘distinct from any cognitive, intentional, or functional property’ (Block 1995: 234). That is, any explanation of phenomenal consciousness in exclusively cognitive, intentional, or functional terms will fail to capture, without remainder, what is really distinctive about phenomenal consciousness. Block, of course, is fully clear about embracing the zealous reading; indeed, his initial introduction of the notion is in those terms. The same ambiguity occurs with the much-used (and abused) idea of ‘what-it’s-like-ness’.. (shrink)

It is often claimed that there is an explanatory divide between an expressivist account of normative discourse and a realist conception of normativity: more precisely, that expressivism and realism offer conflicting explanations of (i) the metaphysical structure of the normative realm, (ii) the connection between normative judgment and motivation, (iii) our normative beliefs and any convergence thereof, or (iv) the content of normative thoughts and claims. In this paper I argue that there need be no such explanatory conflict. Given a (...) minimalist approach to the relevant metaphysical and semantic notions, expressivism is compatible with any explanation that would be acceptable as a general criterion for realism. (shrink)

Suppose that there are objective normative facts and our beliefs about such facts are by-and-large true. How did this come to happen? This is the reliability challenge to normative realism. As has been recently noted, the challenge also applies to expressivist “quasi-realism”. I argue that expressivism is useful in the face of this challenge, in a way that has not been yet properly articulated. In dealing with epistemological issues, quasi-realists typically invoke the desire-like nature of normative judgments. However, this is (...) not enough to prevent the reliability challenge from arising, given that quasi-realists also hold that normative judgments are truth-apt beliefs. To defuse this challenge, we need to isolate a deeper sense in which normative thought is not representational. I propose that we rely on the negative functional thesis of expressivism: normative thought does not have the function of tracking normative facts, or any other kind of facts. This thesis supports an argument to the effect that it is misguided to expect an explanation of our access to normative facts akin to the explanations available in regions of thought that have a tracking function. We should be content with explanations of our reliability that take for granted certain connections between our psychology and the normative truths. (shrink)

The following scenario seems possible: a community uses concepts that play the same role in guiding actions and shaping social life as our normative concepts, and yet refer to something else. As Eklund argues, this apparent possibility poses a problem for any normative realist who aspires to vindicate the thought that reality itself favors our ways of valuing and acting. How can realists make good on this idea, given that anything they might say in support of the privileged status of (...) our normative concepts can be mirrored by the imagined community? E.g., the realist might claim that using our concepts is what we ought to do if we are to describe normative facts correctly, but members of the other community can claim the same about their concepts, using their own concept of ought. A promising approach to this challenge is to try to rule out the possibility of alternative normative concepts, by arguing that any concepts that have the same normative role must share a reference as well. In this paper I argue that normative quasi-naturalism, a view that combines expressivism about normative discourse with a naturalist metaphysics of normativity, supports referential normativity and solves the problem of alternative normative concepts. (shrink)

Normative naturalism holds that normative properties are identical with, or reducible to, natural properties. Various challenges to naturalism focus on whether it can make good on the idea that normative concepts can be used in systematically different ways and yet have the same reference in all contexts of use. In response to such challenges, some naturalists have proposed that questions about the reference of normative terms should be understood, at least in part, as normative questions that can be settled through (...) normative inquiry. In this paper I have two goals. First, I argue that these naturalist proposals do not yet allow for radical disagreement on normative matters, or at least do not explain how such disagreement is possible. Secondly, I argue that, in order to account for radical disagreement, naturalists should not only treat normative reference as a normative issue but also adopt a non-representationalist account of normative concepts, on which such concepts are individuated through their practical role. I illustrate this point by showing how a view that combines naturalism and expressivism about normative discourse can vindicate the elasticity of normative concepts, their referential stability, and the objectivity of normative truths. (shrink)

Over the last decade, personalized medicine has become a buzz word, which covers a broad spectrum of meanings and generates many different opinions. The purpose of this article is to achieve a better understanding of the reasons why personalized medicine gives rise to such conflicting opinions. We show that a major issue of personalized medicine is the gap existing between its claims and its reality. We then present and analyze different possible reasons for this gap. We propose an hypothesis inspired (...) by the Windelband’s distinction between nomothetic and idiographic methodology. We argue that the fuzzy situation of personalized medicine results from a mix between idiographic claims and nomothetic methodological procedures. Hence we suggest that the current quandary about personalized medicine cannot be solved without getting involved in a discussion about the complex epistemological and methodological status of medicine. To conclude, we show that the Gadamer’s view of medicine as a dialogical process can be fruitfully used and reveals that personalization is not a theoretical task, but a practical one, which takes place within the clinical encounter. (shrink)

It has been argued that there is something morally objectionable about moral realism: for instance, according to realism, we are justified in believing that genocide is wrong only if a certain moral fact obtains, but it is objectionable to hold our moral commitments hostage to metaphysics in this way. In this paper, I argue that no version of this moral argument against realism is likely to succeed. More precisely, minimal realism―the kind of realism on which realist theses are understood as (...) internal to moral discourse―is immune to this challenge, contrary to what some proponents of the moral argument have suggested, while robust non-naturalist realists might have good answers to all versions of the argument as well, at least if they adopt a certain stance on how to form metaphysical beliefs in the moral domain. (shrink)

Cet article se donne pour objectif de réfléchir à ce que la crise mondiale du Covid-19 a révélé de nos manières d’habiter les lieux où nous vivons, et parmi celles-ci, la pratique de la danse. La démarche adoptée ici est celle d’un dialogue entre trois courants philosophiques spécifiques : la phénoménologie, le pragmatisme et l’écoféminisme, au sujet de leur conception de l’expérience somatique, à la fois vécue, complexe et ordinaire. Nous cherchons ici les lignes communes à ces trois mouvements philosophiques, (...) dans le but d’esquisser une compréhensions nouvelle du corps, et par extension, une nouvelle approche de la danse par temps de crise pandémique. (shrink)

Cet article se donne pour objectif de réfléchir à ce que la crise mondiale du Covid-19 a révélé de nos manières d’habiter les lieux où nous vivons, et parmi celles-ci, la pratique de la danse. La démarche adoptée ici est celle d’un dialogue entre trois courants philosophiques spécifiques : la phénoménologie, le pragmatisme et l’écoféminisme, au sujet de leur conception de l’expérience somatique, à la fois vécue, complexe et ordinaire. Nous cherchons ici les lignes communes à ces trois mouvements philosophiques, (...) dans le but d’esquisser une compréhensions nouvelle du corps, et par extension, une nouvelle approche de la danse par temps de crise pandémique. (shrink)

La question de la religion - de son essence, de sa fonction, de son origine - a été centrale dans la sociologie et l'anthropologie classiques. Pour la tirer des impasses et de la stagnation où elle est reléguée de nos jours, Camille Tarot propose ici un bilan critique des œuvres des meilleurs comparatistes, à travers leurs théories si contradictoires de la religion. Huit auteurs principaux sont soumis à examen : Emile Durkheim, Marcel Mauss, Mircéa Eliade, Georges Dumézil, Claude Lévi-Strauss, (...) René Girard, Pierre Bourdieu et Marcel Gauchet. L'important en la matière est d'abord d'esquiver les faux irénismes comme les querelles stériles ou haineuses, pour confronter les doctrines en profondeur et systématiquement. Ensuite, de déceler l'impensé et les refoulements que produit chaque cadre théorique, pour proposer le modèle ou l'idéal-type de la religion qui paraît le mieux fondé. Au fil de cet examen, il apparaît que l'essence du fait religieux est à rechercher à l'intersection du symbolique et du sacré, à comprendre à partir des fondations d'Emile Durkheim et de Marcel Mauss, complétées par les apports de René Girard. La possible fécondité du modèle qui se dégage ainsi s'atteste par sa capacité à relire les sources et à renouveler en profondeur les vieux problèmes des fonctions de la religion, qui n'avaient guère avancé depuis Emile Durkheim. (shrink)

How can we rationally make peace with our past moral failings, while committing to avoid similar mistakes in the future? Is it because we cannot do anything about the past, while the future is still open? Or is it that regret for our past mistakes is psychologically harmful, and we need to forgive ourselves in order to be able to move on? Or is it because moral mistakes enable our moral growth? I argue that these and other answers do not (...) properly resolve the problem of temporal asymmetry in our attitudes toward moral imperfection, and I defend an alternative response, centered on our personal attachments and our biographical identity. (shrink)

The past 10 years have seen considerable developments in the use of narrative in medicine, primarily through the emergence of the so-called narrative medicine. In this article, I question narrative medicine’s self-understanding and contend that one of the most prominent issues is its lack of a clear epistemological framework. Drawing from Gadamer’s work on hermeneutics, I first show that narrative medicine is deeply linked with the hermeneutical field of knowledge. Then I try to identify which claims can be legitimately expected (...) from narrative medicine, and which ones cannot be. I scrutinize in particular whether narrative medicine can legitimately grasp the patient’s lived experience of his or her illness. In the last section of this article, I begin to explore the potential usefulness of this epistemological clarification. This analysis allows for a further understanding of what is really at stake with narrative medicine, and thus to identify when it may be convenient, and when it may not. Furthermore, this clarification opens up promising new possibilities of dialogue with critics of the field. I conclude that narrative medicine finds its proper place as a possible tool available to mediate dialogue, which is at the heart of the clinical encounter in medical practice. (shrink)

The authors examine the nursing practice of disposing unaltered controlled substances into public water systems as an issue for nurses concerned with the environmental harm it can cause. A summary of the history of controlled substance management reveals inconsistencies in the interpretation of current regulations that have led to disposal policies that vary by institution, according to a benchmarking survey of regional hospitals. Much attention has been given to the phenomenon of conscientious objection in the context of patient care that (...) conflicts with a nurse’s moral integrity. Nurses who are compelled to dispose narcotics down drains may also face this struggle. The authors submit that this disposal method is based on a type of double effect logic where preventing diversion is viewed as a good effect of flushing unused controlled substances that outweighs any harm it may cause, though there is little evidence to support this conclusion. Consequently, the topic deserves further study so that nurse managers and administrators can support and offer alternatives to nurses who object to flushing drugs down the drain. (shrink)

My objective here is to give an account of self-deprecating humor—examining what works, what doesn't, and why—and to reflect on the significance of the audience response. More specifically, I will be focusing not only on the purpose or intention behind self-deprecating jokes, but considering how their consequences might render them successful or unsuccessful. For example, under what circumstances does self-deprecation tend to put listeners at ease, and when is this type of humor more likely to put people off? I will (...) also consider the ways in which self-deprecating jokes are similar to gallows humor, and the extent to which context counts. The target or "butt" of these jokes, in cases of self-deprecation as well as gallows humor, will be explored; as will whether or not the audience bears some responsibility or has a role to play in the ultimate success or failure of a joke. For instance, is the audience role a completely receptive and passive one? Is the joker/jokee relationship one which confers no responsibility on the listener whatsoever? Or, do listeners have an obligation to respond with appreciative laughter to mere attempts at humor, especially the self-deprecating sort, by accepting such levity in the spirit in which it is intended? Does this mean that being a good sport—responding generously or appreciatively when a well-intentioned joke fails to land—would be a habit worth cultivating? If so and courtesy laughter or a playful appreciation of self-deprecating humor is something that can be cultivated, what specifically would that entail? In sum, although I cannot fully or definitively answer each and every one of these questions, I do hope to provide some provisional responses. To better situate the nature of self-deprecation, I will not only provide a brief description of the gallows genre, I will also explore two traditional theories of humor. Those that are particularly relevant, to both gallows and self-deprecating humor are Freud's relief theory and the incongruity view. In addition, I will identify what I believe to be the three essential ingredients of successful self-deprecation and, finally, will conclude with the argument that audiences or listeners do have an important role to play. And, moreover, that generous, appreciative laughter can and should be cultivated—even though this is something that will largely depend on one's personal history and habits, dispositional character and cultural background. (shrink)

The essential qualities of human nature, including faith, trust, repentance, forgiveness, compassion, and mercy, are discussed in this collection of writings by some of the world's great sages, both ancient and contemporary. The advice of prophets Abraham, Moses, and Muhammad, the wisdom of Confucius and Buddha, and the prudence of saints, scholars, and even cyclists provide expert guidance for those looking to improve their spiritual well-being.

Historiography realized that the Middle Ages were not the “dark ages” of the European civilization. On the contrary, the period generated a series of ideas and phenomena that are associated with the modern period. At the beginning, the first chiefs of states started by establishing connections with the church authority (through the rituals of crowning, anointing, or through the magic powers attributed to the king’s touch). Gradually, and due to the contribution of some important thinkers (such as Thoma d’Aquino, Dante (...) or Marsilio di Padova), the fundaments of the rational concept of the state organization were settled, in the transition period of the XIIIth- XIVth centuries. The author discusses these ideas (of the natural rights, of the conciliar doctrine) underlining their importance in the formation of the modern paradigm. (shrink)

C. Mureseanu presents in an essayistic approach the history of tolerance as a concept. Its very domain may be described as regarding the relations among human beings. The concept has been dealt with different approaches as the philosophical, moral and political one. The article focuses especially on the religious tolerance, and also on the opposition of the pair of terms: tolerance vs. intolerance.

In this paper, I support a hybrid view regarding the metaphysics of worlds. I endorse Lewisian Modal Realism for possible worlds (LMR). My aim is to come up with a hybrid account of impossible worlds that provides all the plenitude of impossibilities for all fine-grained intentional contents. I raise several challenges for such a plenitudinous hybrid theory. My version of hybrid modal realism builds impossible worlds as set-theoretic constructions out of genuine individuals and sets of them, that is, as set-theoretic (...) constructions from parts and sets of parts of genuine Lewisian worlds. _Structured worlds_ are defined as sets of tuples: structured entities built out of Lewisian ‘raw material’. These structured worlds are ersatz worlds, some of which are impossible. I claim that propositions must be sets of worlds rather than members of sets. Once the construction is in place, I evaluate the proposal and show that my hybrid account is able to supply a plenitude of impossibilities and thus giving the resources to make all the hyperintensional distinctions we are looking for, whilst remaining Lewisian-conservative. (shrink)

BackgroundOver the past decade, the exponential growth of the literature devoted to personalized medicine has been paralleled by an ever louder chorus of epistemic and ethical criticisms. Their differences notwithstanding, both advocates and critics share an outdated philosophical understanding of the concept of personhood and hence tend to assume too simplistic an understanding of personalization in health care.MethodsIn this article, we question this philosophical understanding of personhood and personalization, as these concepts shape the field of personalized medicine. We establish a (...) dialogue with phenomenology and hermeneutics (especially with E. Husserl, M. Merleau-Ponty and P. Ricoeur) in order to achieve a more sophisticated understanding of the meaning of these concepts We particularly focus on the relationship between personal subjectivity and objective data.ResultsWe first explore the gap between the ideal of personalized healthcare and the reality of today’s personalized medicine. We show that the nearly exclusive focus of personalized medicine on the objective part of personhood leads to a flawed ethical debate that needs to be reframed. Second, we seek to contribute to this reframing by drawing on the phenomenological-hermeneutical movement in philosophy. Third, we show that these admittedly theoretical analyses open up new conceptual possibilities to tackle the very practical ethical challenges that personalized medicine faces.ConclusionFinally, we propose a reversal: if personalization is a continuous process by which the person reappropriates all manner of objective data, giving them meaning and thereby shaping his or her own way of being human, then personalized medicine, rather than being personalized itself, can facilitate personalization of those it serves through the data it provides. (shrink)