In lieu of an abstract, here is a brief excerpt of the content:Editors' Introduction to the Special Issue on the Translational Work of BioethicsElizabeth Lanphier and Larry R. ChurchillRecent essays in Perspectives and Biology and Medicine, including "Can Clinical Ethics Survive Climate Change" by Andrew Jameton and Jessica Pierce and "Ethical Maxims for a Marginally Inhabitable Planet" by David Schenck and Larry R. Churchill, both appearing in the Autumn 2021 issue, inspired conversations between us, among our colleagues, and with (...) various contributors to this symposium. We asked of ourselves and each other: where can, should, or must bioethics as a field go to make what bioethicists know and publish about in the academic literature relevant to public policy decisions, health and technological innovation, and a general public? In other words, where do we, practically speaking, go with our bioethical insights and discoveries to make a tangible impact on issues like climate change—though that is only one of the various topics that the authors in this symposium tackle.This translational work of connecting scholarly innovation back to overt practical innovation is often peripheral to academic bioethics. It is not the work the academy typically recognizes in its credit system. Yet this translational work is becoming a critical, central duty of bioethics for the 21st century, while the kinds of work the academy most valorizes may be the least important at this time. In particular, the need for translational initiatives is increasingly evident as pandemics linger into a new normal, the long history and ongoing impacts of racism become even more evident at institutional levels, and the devastating health implications of global warming emerge. [End Page 515]Bioethicists function in privileged proximity to the deleterious effects of failed health and social policy, as well the interplay between seemingly personal health choices, such as those related to diet or lifestyle, and inequitable conditions that impact the options available to individuals and groups. We are increasingly distressed by what we see from this privileged window into health. The COVID-19 pandemic has made preexisting social and policy inequities impacting health impossible to ignore. At the same time, the patterns of carbon pollution portend health crises of unprecedent severity and magnitude in the near future—and will likely deepen inequities and disparities already occurring between those most contributing to, and those most harmed by, climate change.As a field, bioethics has, since its start, been at the intersection of theory and practice. But it is not sufficient for the field to reside passively at this crossroads. The field must be constantly innovating new byways and highways, new offshoots from existing pathways and connector roads between them, that build out both the theory and practice of bioethics in a mutually innovative relationship to each other. Bioethics does not make sense without attention to the real-world practices and the lived realities of health and care. The practical engagement is what deepens and enriches theory, in ways that are more responsive to the real world in which bioethicists toil. But it also is not enough to merely contribute to the body of bioethics scholarship. The translational bioethics we envision is also about using novel theories and concepts to actively shape practices and realities; it is a bioethics in which theory and practices mutually influence each other, each reaching out to generate and change the other.This collection of essays, drawn from a diverse number of scholars, offers several promising paths forward. The essays were written in the spring of 2022, two years into the COVID-19 pandemic, two years after the murder of George Floyd and international attention to the movement for Black lives, and for the most part in the weeks just prior to a set of US Supreme Court decisions with enormous impacts on health, including the June 24 Dobbs v. Jackson Women's Health Organization and the June 30 West Virginia v. EPA decisions.The authors are diverse in age, spheres of work, discipline, sex, race, and ethnicity. They expand our vision for what bioethics can and should be. While we have grouped the essays by subject matter, most of the pieces speak to the field as a whole and invite cross-fertilization. We hope readers will find new ideas, old ideas... (shrink)

Background Diversity in Institutional Review Board (IRB) membership is important for both intrinsic and instrumental reasons, including fairness, promoting trust, improving decision quality, and responding to systemic racism. Yet U.S. IRBs remain racially and ethnically homogeneous, even as gender diversity has improved. Little is known about IRB chairpersons’ perspectives on membership diversity and barriers to increasing it, as well as current institutional efforts to promote diversity, equity, and inclusion (DEI) within IRB membership.Methods We surveyed IRB chairpersons leading U.S. boards registered (...) with the Office for Human Research Protections. Here, we focus exclusively on responses from a subset of 388 chairpersons of IRBs at universities and academic medical centers (AMCs).Results Board chairs were predominantly white and evenly split between men and women. Only about half reported that their boards had at least one member who is Black or African American (51%), Asian (56%), or Hispanic (48%), with 85% of university/AMC boards comprised entirely (15%) or mostly (70%) of white members. Most IRB chairpersons (64%) reported satisfaction with the current diversity of their membership. Participants largely agreed that considering diversity in the selection of IRB members is important (91%), including to improve the quality of IRB deliberation (80%), with an emphasis on racial/ethnic (85%) and gender diversity (74%). Most participants (80%) reported some type of active DEI effort regarding board membership at their university/AMC and just over half (57%) expressed satisfaction with these efforts.Conclusions Our national survey found that although university/AMC IRB chairpersons report valuing diversity in board membership, it may be lacking in key areas. Going forward, it will be important to specify clear reasons for diversity in the IRB context, as well to establish targets for acceptable levels of board diversity and to match DEI efforts to those targets. (shrink)

Letters commenting on Hardwig, J "Is There a Duty to Die?" with a reply to those letters by the author.

When people rely on the web to gather and distribute information, they can build a sense of trust in the websites with which they interact. Understanding the correlates of trust in most websites (general website trust) and trust in websites that one frequently visits (familiar website trust) is crucial for constructing better models of risk perception and online behavior. We conducted an online survey of active Internet users and examined the associations between the two types of web trust and several (...) independent factors: information technology competence, adverse online events, and general dispositions to be trusting or cautious of others. Using a series of nested ordered logistic regression models, we find positive associations between general trust, general caution, and the two types of web trust. The positive effect of information technology competence erases the effect of general caution for general website trust but not for familiar website trust, providing evidence that general trust and self-reported competence are stronger associates of general website trust than broad attitudes about prudence. Finally, the experience of an adverse online event has a strong, negative association with general website trust, but not with familiar website trust. We discuss several implications for online behavior and suggest website policies that can help users make informed decisions about interacting with potentially risky websites. (shrink)

If the world itself is metaphysically indeterminate in a specified respect, what follows? In this paper, we develop a theory of metaphysical indeterminacy answering this question.

Introduction: human rights in healthcare -- A right to treatment? the allocation of resouces in the National Health Service -- Ensuring quality healthcare: an issue of rights or duties? -- Autonomy and consent in medical treatment -- Treating incompetent patients: beneficence, welfare and rights -- Medical confidentiality and the right to privacy -- Property right in the body -- Medically assisted conception and a right to reproduce? -- Termination of pregnancy: a conflict of rights -- Pregnancy and freedom of choice (...) -- The right to life at the end of life -- The law and ethics of assisted dying: is there a right to die? (shrink)

Focuses on the encounters of feminist and queer theories, on the ways in which basic terms such as - sex, gender, and sexuality change meaning as they move from one body of theory to another. This book includes essays by Judith Butler, Evelynn Hammonds, Biddy Martin, Kim Michasiw, Carole-Anne Tyler, and Elizabeth Weed.

Money plays a powerful role in modern medicine, both in terms of how health services are organized and delivered and increasingly in how physicians understand themselves and their work. The phrase “the hegemony of money” is intended to capture that power.

It is commonplace to point out that Alfred Kinsey's taxonomic work on gall wasps provided a methodology for his studies of human sexual behavior. It is equally commonplace to point out that, when researching and presenting his sexual studies, Kinsey's professedly neutral scientific data were constrained by a social agenda. What I have done in this paper is to join these two claims and demonstrate, with particular reference to Kinsey's Sexual Behavior in the Human Male, how his zoology helped guide (...) Kinsey to a naturalistic ethics that, despite contrasts to, shared certain parallel logical failures with the traditional ethics of his critics. (shrink)

Wittgenstein's insistence in his later philosophy that explanation comes to an end in the explication of what it is to follow a rule provides a locus for the awakening of wonder, analogous to the mystical awe referred to in the "Tractatus". While Wittgenstein did not explore this analogy, it provides a point of entry into the examination of the relevance of his work to religious concerns. Every regular practice is built on capacities of reaction, uptake, and response which are the (...) endpoints of explanation, whose sheer givenness in their relation to our physical and social environment can bring on amazement. This wonder at the end of explanation has been explored -- from quite a different perspective -- by Stephen Gould, whose conclusions complement Wittgenstein's own. (shrink)

We will argue here that after more than 30 years of talk, theory, and clinical practice, we bioethicists still know far too little about what patients, subjects, and healthcare professionals are up to, morally. Bioethics is still near the beginning in grasping what it means to understand, much less to honor fully, the moral power and perspicacity of those bioethics is designed to serve. This is, of course, a serious charge, but one we will endeavor to show has merit. However, (...) we want to be clear from the start that we do not gainsay the important work that has been done in and through the influence of bioethics, both as a field of practical engagement and as a cultural movement, in improving how healthcare is delivered and how human subjects are treated. Thirty or 40 years—depending on how one marks the beginning point—is a very short time, and it is hard to imagine that wholesale changes, all of them in the right direction, could be the outcome for a field this young. Hence, we do not intend the title, “One Cheer for Bioethics,” as a wholesale indictment, but as an indication that there is a great deal of work yet to be done, and that following the currently dominant direction of the field is not likely to get us there. Our aim is to indicate just where future work should be focused, and to do so we will need to be critical of some of the preoccupations of the last three decades. a. (shrink)

The dynamic of religious expression employs symbolic language, actions, and art. These symbols are symbols of transcendence because it is transcendence which is the unique referent that sets apart symbols which give rise to religious understanding from symbols which do not. The main objective of this book is to demonstrate that in Louis Dupre's work all religious expression, insofar as it has a transcendent reference, is intrinsically symbolic. Religious language is never purely objective nor purely subjective, but a dialectical relation (...) with a transcendent dimension. True to the teachings of Dupre, this book uncovers that without a transcendent referent, religious symbols lose their religious significance. This is the plight of the (late-post)modern condition which resulted from the fracturing of nature into its cosmic, human and transcendent components. To regain a sense of transcendence the believer is forced to make an inward turn akin to the mystical practice of past ages. This does not recover a sense of transcendence for culture but can do so for the believer's personal spiritual life. (shrink)

Communication, when defined as an act intended to affect the psychological state of another individual, demands the use of inference. Either the signaler, the recipient, or both must make leaps of understanding which surpass the semantic information available and draw from pragmatic clues to fully imbue and interpret meaning. While research into human communication and the evolution of language has long been comfortable with mentalistic interpretations of communicative exchanges, including rich attributions of mental state, research into animal communication has balked (...) at theoretical models which describe mentalized cognitive mechanisms. We submit a new theoretical perspective on animal communication: the model of inferential communication. For use when existing proximate models of animal communication are not sufficient to fully explain the complex, flexible, and intentional communication documented in certain species, specifically non-human primates, we present our model as a bridge between shallower, less cognitive descriptions of communicative behavior and the perhaps otherwise inaccessible mentalistic interpretations of communication found in theoretical considerations of human language. Inferential communication is a framework that builds on existing evidence of referentiality, intentionality, and social inference in primates. It allows that they might be capable of applying social inferences to a communicative setting, which could explain some of the cognitive processes that enable the complexity and flexibility of primate communication systems. While historical models of animal communication focus on the means-ends process of behavior and apparent cognitive outcomes, inferential communication invites consideration of the mentalistic processes that must underlie those outcomes. We propose a mentalized approach to questions, investigations, and interpretations of non-human primate communication. We include an overview of both ultimate and proximate models of animal communication, which contextualize the role and utility of our inferential communication model, and provide a detailed breakdown of the possible levels of cognitive complexity which could be investigated using this framework. Finally, we present some possible applications of inferential communication in the field of non-human primate communication and highlight the role it could play in advancing progress toward an increasingly precise understanding of the cognitive capabilities of our closest living relatives. (shrink)

An utterer may convey a message to her intended audience by means of an explicit statement; or by a non‐conventionally mediated one‐off signal from which the audience is able to work out the intended message; or by conversational implicature. I investigate whether the last two are equivalent to explicit testifying, as communicative act and epistemic source. I find that there are important differences between explicit statement and insinuation; only with the first does the utterer assume full responsibility for the truth (...) of what she communicates to her audience. (shrink)

It is often assumed that adaptation — a temporary change in sensitivity to a perceptual dimension following exposure to that dimension — is a litmus test for what is and is not a “primary visual attribute”. Thus, papers purporting to find evidence of number adaptation motivate a claim of great philosophical significance: That number is something that can be seen in much the way that canonical visual features, like color, contrast, size, and speed, can. Fifteen years after its reported discovery, (...) number adaptation’s existence seems to be nearly undisputed, with dozens of papers documenting support for the phenomenon. The aim of this paper is to offer a counterweight — to critically assess the evidence for and against number adaptation. After surveying the many reasons for thinking that number adaptation exists, we introduce several lesser-known reasons to be skeptical. We then advance an alternative account — the old news hypothesis — which can accommodate previously published findings while explaining various (otherwise unexplained) anomalies in the existing literature. Next, we describe the results of eight pre-registered experiments which pit our novel old news hypothesis against the received number adaptation hypothesis. Collectively, the results of these experiments undermine the number adaptation hypothesis on several fronts, whilst consistently supporting the old news hypothesis. More broadly our work raises questions about the status of adaptation itself as a means of discerning what is and is not a visual attribute. (shrink)

Contemporary literature criticises a necessary link between empathy and actions that demonstrate genuine moral worth. If there is such a necessary link, many argue, it must come in the developmental stages of our moral capacities, rather than being found in the mental states that make up our motivating reasons. This paper goes against that trend, arguing that critics have not considered how wide-ranging the mental states are that make up a person’s reasons. In particular, it argues that empathy can play (...) a role in moral motivation when it is to some extent unconscious or it occurs far prior to the moral action itself. (shrink)

A key takeaway from the recent volume Theistic Evolution: A Scientific, Philosophical, and Theological Critique is that no version of theistic evolution that adheres largely to consensus views in biology is a plausible option for orthodox Christians. In this paper we argue that this is false: contrary to the arguments in the volume, evolutionary theory, properly understood, is perfectly compatible with traditional Christian commitments. In addition, we argue that the lines between Intelligent Design and theistic evolution are not as sharp (...) as most scholars have assumed, such that many who self-identify as Intelligent Design adherents would also qualify as theistic evolutionists. (shrink)

Many philosophers judge that typical agent-causal accounts of freedom improperly sacrifice the possibility of rational explanation of the action for the sake of securing control, while others judge that the reverse shortcoming plagues typical event causal accounts. (Of course, many philosophers make both these judgments.) After briefly rehearsing the reasons for these verdicts on the two traditional strategies, we undertake an extended examination of Randolph Clarke's recent attempt to meet the challenge by proposing an original, "integrated agent-causal" account of human (...) free action. We argue that Clarke's account fails. In a final section, we sketch a more promising route to integration. (shrink)

Face perception, perhaps the most highly developed visual skill in humans, is mediated by a distributed neural system in humans that is comprised of multiple, bilateral regions. We propose a model for the organization of this system that emphasizes a distinction between the representation of invariant and changeable aspects of faces. The representation of invariant aspects of faces underlies the recognition of individuals, whereas the representation of changeable aspects of faces, such as eye gaze, expression, and lip movement, underlies the (...) perception of information that facilitates social communication. The model is also hierarchical insofar as it is divided into a core system and an extended system. The core system is comprised of occipitotemporal regions in extrastriate visual cortex that mediate the visual analysis of faces. In the core system, the representation of invariant aspects is mediated more by the face-responsive region in the fusiform gyrus, whereas the representation of changeable aspects is mediated more by the face-responsive region in the superior temporal sulcus. The extended system is comprised of regions from neural systems for other cognitive functions that can be recruited to act in concert with the regions in the core system to extract meaning from faces. (shrink)

This set of seven experiments examines reasoning about the inheritance and acquisition of physical properties in preschoolers, undergraduates, and biology experts. Participants (N = 390) received adoption vignettes in which a baby animal was born to one parent but raised by a biologically unrelated parent, and they judged whether the offspring would have the same property as the birth or rearing parent. For each vignette, the animal parents had contrasting values on a physical property dimension (e.g., the birth parent had (...) a short tail; the rearing parent had a long tail). Depending on the condition, the distinct properties had distinct functions (“function-predictive”) were associated with distinct habitats (“habitat-predictive”), or had no implications (“non-predictive”). Undergraduates' bias to view properties as inherited from the birth parent was reduced in the function- and habitat-predictive conditions. This result indicates a purpose-based view of inheritance, whereby animals can acquire properties that serve a purpose in their environment. This stance was not found in experts or preschoolers. We discuss the results in terms of how undergraduates' purpose-based inheritance reasoning develops and relates to larger-scale misconceptions about Darwinian evolutionary processes, and implications for biology education. (shrink)

Grosz gives a critical overview of Lacan's work from a feminist perspective. Discussing previous attempts to give a feminist reading of his work, she argues for women's autonomy based on an indifference to the Lacanian phallus.

Throughout the 1990s, Jaegwon Kim developed a line of argument that what purport to be nonreductive forms of physicalism are ultimately untenable, since they cannot accommodate the causal efficacy of mental states. We argue that, while the argument needs some tweaking, its basic thrust is sound. In what follows, we lay out our preferred version of the argument and highlight its essential dependence on a causal-powers metaphysic, a dependence that Kim does not acknowledge in his official presentations of the argument. (...) We then discuss two recent physicalist strategies for preserving the causal efficacy of the mental in the face of this sort of challenge, strategies that (ostensibly) endorse a causal powers metaphysics of properties while offering distinctive accounts of the physical realization of mental properties. We argue that neither picture can be satisfactorily worked out, and that seeing why they fail strongly suggests that nonreductive physicalism and a causal powers metaphysic are not compatible, as our original argument contends. Since we also believe that robust realism concerning mental causation should not be abandoned, we take the argument of this paper to strongly motivate an account on which the mental is unrealized by and ontologically emergent from the physical. In a final section, we sketch what an ontologically emergentist account of the mental might look like. (shrink)

We argue for the addition of trauma informed awareness, training, and skill in clinical ethics consultation by proposing a novel framework for Trauma Informed Ethics Consultation (TIEC). This approach expands on the American Society for Bioethics and Humanities (ASBH) framework for, and key insights from feminist approaches to, ethics consultation, and the literature on trauma informed care (TIC). TIEC keeps ethics consultation in line with the provision of TIC in other clinical settings. Most crucially, TIEC (like TIC) is systematically sensitive (...) to culture, history, difference, power, social exclusion, oppression, and marginalization. By engaging a neonatal intensive care ethics consult example, we define our TIEC approach and illustrate its application. Through TIEC we argue it is the role of ethics consultants to not only hold open moral spaces, but to furnish them in morally habitable ways for all stakeholders involved in the ethics consultation process, including patients, surrogates, and practitioners. (shrink)

"The fixed person for fixed duties, who in older societies was such a godsend, in the future ill be a public danger." Twenty years ago, a single legal metaphor accurately captured the role that American society accorded to physicians. The physician was "c- tain of the ship." Physicians were in charge of the clinic, the Operating room, and the health care team, responsible - and held accountabl- for all that happened within the scope of their supervision. This grant of responsibility (...) carried with it a corresponding grant of authority; like the ship's captain, the physician was answerable to no one regarding the practice of his art. However compelling the metaphor, few would disagree that the mandate accorded to the medical profession by society is changing. As a result of pressures from a number of diverse directions - including technological advances, the development of new health professionals, changes in health care financing and delivery, the recent emphasis on consumer choice and patients' rights - what our society expects phy- cians to do and to be is different now. The purpose of this volume is to examine and evaluate the conceptual foundations and the moral imp- cations of that difference. Each of the twelve essays of this volume assesses the current and future validity of the "captain of the ship" metaphor from a different perspective. The essays are grouped into four sections. In Section I, Russell Maulitz explores the physician's role historically. (shrink)

In this project I am concerned with the extent to which conceptual engineering happens in domains outside of philosophy, and if so, what that might look like. Specifically, I’ll argue that...

This book is devoted to applied ethics. We focus on six popular and controversial topics: abortion, the environment, animals, poverty, punishment, and disability. We cover three chapters per topic, and each chapter is devoted to a famous or influential argument on the topic. After we present an influential argument, we then consider objections to the argument, and replies to the objections. The book is impartial, and set up in order to equip the reader to make up her own mind about (...) the controversial topics covered. (shrink)

When health care providers make decisions to use resources, their devotion to the patient at hand must be mediated by a framework that puts individual autonomy and social equity into focus simultaneously. The concept of citizenship yields such a framework.

Conferralism is the view that social properties are neither intrinsic to the things that have them nor possessed simply by virtue of their causal or spatiotemporal relations to other things, but are somehow bestowed (intentionally or not, explicitly or not) upon them by persons who have both the capacity and the standing to bestow them. We argue that conferralism faces a dilemma: either it is viciously circular, or it is limited in scope in a way that undercuts its motivation.

The practice of relational leadership is essential for dealing with the increasingly urgent and complex social, economic and environmental issues that characterize sustainability. Despite growing attention to both relational leadership and leadership for sustainability, an ethical understanding of both is limited. This is problematic as both sustainability and relational leadership are rife with moral implications. This paper conceptually explores how the moral theory of ‘ethics of care’ can help to illuminate the ethical dimensions of relational leadership for sustainability. In doing (...) so, the implications of ethics of care more broadly for the practice of relational leadership development are elaborated. From a caring perspective, a ‘relational stance’ or logic of effectiveness can be fostered through engaging in a reflective process of moral education through conversation. In starting this dialogue, we can begin to build capacity for relational leadership for sustainability and, thus, support the development of individual well-being and organizational and societal flourishing. (shrink)

The concept of vulnerability is widely used in bioethics, particularly in research ethics and public health ethics. The traditional approach construes vulnerability as inherent in individuals or the groups to which they belong and views vulnerability as requiring special protections. Florencia Luna and other bioethicists continue to challenge traditional ways of conceptualizing and applying the term. Luna began proposing a layered approach to this concept and recently extended this proposal to offer two new concepts to analyze the concept of vulnerability, (...) namely understanding external conditions that trigger vulnerability and layers of vulnerability with cascading effects. Luna's conception of vulnerability is useful, which we demonstrate by applying her layered view and the new analyses in multiple contexts. We begin by outlining Luna's view and we use vignettes from healthcare involving transgender patients, the care of patients in psychiatric contexts, and research involving prisoners to illustrate how each part of Luna's concept elucidates important moral issues. (shrink)