Although informed consent models for prescribing hormone replacement therapy are becoming increasingly prevalent, many physicians continue to require an assessment and referral letter from a mental health professional prior to prescription. Drawing on personal and communal experience, the author argues that assessment and referral requirements are dehumanising and unethical, foregrounding the ways in which these requirements evidence a mistrust of trans people, suppress the diversity of their experiences and sustain an unjustified double standard in contrast to other forms of clinical (...) care. Physicians should abandon this unethical requirement in favour of an informed consent approach to transgender care. (shrink)

By attending to how people speak about their gender, we can find diverse answers to the question of what it is like to have a gender identity. To some, it is little more than having a body whereas others may report it as more attitudinal or dispositional—seemingly contradictory views. In this paper, I seek to reconcile these disparate answers by developing a theory of how individual gender identity comes about. In the simplest possible terms, I propose that gender identity is (...) how we make sense of our gender subjectivity, the totality of our gendered experiences of ourselves. Gender identity is constituted by gender subjectivity, but this constitutive relationship is underdetermined. While gender subjectivity may narrow the range of inhabitable gender identities, it is always compatible with more than one. To arrive at a gender identity, we arrange gender subjectivity like building materials. My theory helps us understand how different people offer seemingly incompatible accounts of their gender identity without questioning their authenticity or validity. They simply arrange similar building materials differently. (shrink)

Drawing on the principle of subsidiarity, this article develops a framework for allocating medical decision-making authority in the absence of capacity to consent and argues that decisional authority in paediatric transgender healthcare should generally lie in the patient. Regardless of patients’ capacity, there is usually nobody better positioned to make medical decisions that go to the heart of a patient’s identity than the patients themselves. Under the principle of subsidiarity, decisional authority should only be held by a higher level decision-maker, (...) such as parents or judges, if lower level decision-makers are incapable of satisfactorily addressing the issue even with support and the higher level decision-maker is better positioned to satisfactorily address the issue than all lower level decision-makers. Because gender uniquely pertains to personal identity and self-realisation, parents and judges are rarely better positioned to make complex medical decisions. Instead of taking away trans youth’s authority over their healthcare decisions, we should focus on supporting their ability to take the best possible decision for themselves. (shrink)

During the last two decades there has been an enormous development in treatment possibilities in the field of neonatology, particularly for (extremely) premature infants. Although there are cross-cultural differences in treatment strategy, an overview of the literature suggests that every country is confronted with moral dilemmas in this area. These concern decisions to initiate or withhold treatment directly at birth and, later on, decisions to withdraw treatment with the possible consequence that the child will die. Given that the neonate cannot (...) express his or her own will, who will decide? And on the basis of what information, values and norms? We explored some of these issues in daily practice by interviewing a small sample of health care practitioners in a Dutch university Neonatal Intensive Care Unit (NICU). It turned out that experiencing moral dilemmas is part of their daily functioning. Nurses underline the suffering of the newborn, whereas physicians stress uncertainty in treatment outcome. To make the best of it, nurses focus on their caring task, whereas physicians hope that future follow-up research will lead to more predictable outcomes. As for their own offspring, part of these professionals would hesitate to bring their own extremely premature newborn to a NICU. For the most oppressing dilemma reported – terminating an already initiated treatment – we propose the concept of ‘evidence shift’ to clarify the ambiguous position of uncertainty in decision making. (shrink)

As global warming continues to attract growing levels of attention, various stakeholders have put climate change on corporate agendas and expect firms to disclose relevant greenhouse gas information. In this paper, we investigate the consistency of the GHG information voluntarily disclosed by French listed firms through two different communication channels: corporate reports and the Carbon Disclosure Project. More precisely, we contrast the amounts of GHG emissions reported and the methodological explanations provided in each channel. Consistent with a stakeholder theory perspective, (...) we find that GHG amounts are significantly lower in the CR than in the CDP. We also find that firms increase the CR figures’ traceability when there is a discrepancy between disclosures in the two channels. We suggest that the aim of this greater traceability is to enhance information credibility across the different channels used. (shrink)

A well-established narrative in the history of science has it that the years around 1800 saw the end of a purely descriptive, classificatory and static natural history. The emergence of a temporal understanding of nature and the new developmental-history approach, it is thought, permitted the formation of modern biology. This paper questions that historical narrative by closely analysing the concepts of development, history and time set out in Karl Ernst von Baer’s study of the mammalian egg (1827). I show that (...) Baer’s research on embryogenesis aimed not simply to explain temporal changes, but to inscribe the formation of new individual organisms into a continuous, unending organic process. I confront Baer’s views with other explanations of embryogenesis arising in the 1820s and 1830s, especially those of Jean-Baptiste Dumas and Jean-Louis Prévost and of Theodor Schwann. By highlighting divergences between these scientists, especially as to their view of the role of gender differences in reproduction, I argue that biology evolved not from a homogeneous concept of developmental history but out of various, even opposing, views and research programmes. Thus, the birth of biology did not imply the end of all natural history’s thought models. (shrink)

L’étude de l’empire a connu récemment un regain d’intérêt, même si (et peut-être parce que) sa définition pose problème. Elle permet en effet d’étudier plusieurs aspects du pouvoir symbolique : les formes d’administration, les modes d’appropriation d’un territoire, les intensités de la souveraineté, les marquages spatiaux de la domination, etc. L’empire de Charles Quint représente de ce point de vue un modèle heuristique, dans la mesure où l’empereur s’est rapidement trouvé confronté au gouvernement de territoires éloignés, de statuts différents, mais (...) rassemblés dans l’aspiration universelle de l’empire chrétien. (shrink)

L’étude de l’empire a connu récemment un regain d’intérêt, même si (et peut-être parce que) sa définition pose problème. Elle permet en effet d’étudier plusieurs aspects du pouvoir symbolique : les formes d’administration, les modes d’appropriation d’un territoire, les intensités de la souveraineté, les marquages spatiaux de la domination, etc. L’empire de Charles Quint représente de ce point de vue un modèle heuristique, dans la mesure où l’empereur s’est rapidement trouvé confronté au gouvernement de territoires éloignés, de statuts différents, mais (...) rassemblés dans l’aspiration universelle de l’empire chrétien. (shrink)

Feminism is going to ruin your life--in the best way possible--because society screams numerous messages every moment about how women must look, act, and speak in order to earn their right to be seen and heard. The only thing any human needs to do in order to earn their right to exist, however, is to exist. Break free of the insidious narratives that hold you back from being your most authentic self.

A recent paper by Teresa Baron and Geoffrey Dierckxsens argues that puberty blockers and hormone therapy should be disallowed before adulthood on prudential and consent-related grounds. This response contends that their argument fails because it is predicated on unsupported premises and misinterpretations of the available evidence. There is no evidence that a large proportion of pubertal and postpubertal youths later discontinue medical transition. Meaningful assent is a viable and commonly accepted alternative to meaningful consent in paediatric bioethics. And finally, the (...) primary purpose of transition-related interventions is to actualise youths’ gendered self-image, not treat an underlying mental illness. (shrink)

La mayoría de la gente o no conoce a Adrienne von Speyr o piensa en ella como en una extraña figura mística que trabajó con el teólogo Hans Urs von Balthasar. Sin embargo, pocos la conocen como médica de Basilea entre los años 30 y 50 del siglo XX. Ejerció su profesión con una pasión inspirada por su fe, integrando constantemente ciencia y espiritualidad. El objetivo de este artículo es presentar esta faceta poco estudiada de la vida de Adrienne von (...) Speyr, y el modo en que su actividad médica modeló su lectura de las Escrituras, en particular del capítulo 11 del evangelio de Juan. También y sobre todo destaca la originalidad de su contribución a la ética médica de su época. (shrink)

Florence Chiew interviews Maurizio Meloni on his new book, Impressionable Biologies: From the Archaeology of Plasticity to the Sociology of Epigenetics. The conversation reflects on a number of key themes and arguments in Meloni’s work, such as the use of the term ‘impressionability’ to explore longstanding ideas of the permeable body in constant flux in response to cosmological changes. This notion of the body-porous is one whose history Meloni traces back to ancient traditions and systems of medicine, such as (...) humoralism. In this important book, Meloni makes a compelling argument for questioning the current emphasis on the novelty of biological plasticity as an exclusively contemporary phenomenon, and urges us to take a longer genealogical perspective to appreciate how histories of corporeal plasticity have always been part of deeply gendered, racialized and classed discourses in which social hierarchies have been made through physiological distinctions. (shrink)

In conversation with Hortense Gallois’ recent essay on the importance of bioethicists participating in public discourse, I suggest that speaking up is as fraught as it is important. Focusing on the anti-trans movement’s misuse of expertise, I highlight the fine line between correcting misinformation and inadvertently causing harm through ill-timed speech. Drawing on the work of Eva Feder Kittay, I suggest that knowing when to speak up and when to stay silent starts with understanding the communities we speak about and (...) the consequences that our words can have on them. (shrink)

At Euripides' Heraclidae 630, an anonymous character arrives onstage to report the arrival of Hyllus' army, and returns at 928 accompanying the defeated Eurystheus. He is generally identified by editors as a therapōn, following the dramatis personae of the hypothesis. Mastronarde briefly challenges this assumption, stating that ‘he is a soldier, not a servant’. There are, however, four reasons to identify the character as neither a soldier nor a therapōn, but as Hyllus' herald. Although none of these reasons is conclusive (...) on its own, the cumulative weight of the evidence is compelling. This identification contributes to the structural coherence and thematic development of the play, and gains special significance from the play's interest in the representation of absent characters. (shrink)

Although it has been recognized that employees regularly engage in non-green behaviors, little research has been conducted to explain how these behaviors may be avoided. Using data from a three-wave study, this study tested a moderated-mediation model in which trust in the immediate manager was expected to increase the indirect effect of supervisory support for the environment on non-green behaviors through employee environmental commitment. While the findings showed, as predicted, that exchange relationships with the immediate manager reduce the tendency of (...) employees to engage in non-green behaviors, the indirect effect of supervisory support on non-green behaviors through employee environmental commitment was moderated at a low level of trust in the manager, contrary to predictions. Though unexpected, this result seems less surprising when discussed in the light of negotiated exchange, suggesting that employee efforts to avoid non-green behaviors need to be seen as the result of a deal between managers and subordinates. The findings of this study contribute to the emerging literature on social exchange in an environmental context and have implications for organizations seeking to achieve environmental sustainability. (shrink)

"An impressively reasoned and startlingly unorthodox treatise on religion." - Belles Lettres Florence Nightingale (1820-1920) is famous as the heroine of the Crimean War and later as a campaigner for health care founded on a clean environment and good nursing. Though best known for her pioneering demonstration that disease rather than wounds killed most soldiers, she was also heavily allied to social reform movements and to feminist protest against the enforced idleness of middle-class women. This original edition provides bold (...) new insights into Nightingale's beliefs and a new picture of the relationship between feminism and religion. Suggestions for Thought to the Searchers after Truth Among the Artisans of England (1860), which contains the novel Cassandra , is a central text in 19th-century history of feminist thought and is published here for the first time. Nightingale argues that work was the means by which every individual sought self-fulfillment and served God. She wrote influentially about the group most Victorians declared to be above work: unmarried, middle-class women. (shrink)

Scholars have noted persistent high rates of agricultural health and safety incidents and the need to develop more effective interventions. Participatory research provides an avenue to broaden the prevailing research paradigms and approaches by allowing those most impacted to illuminate and work to solve those aspects of their lives. One such approach is photovoice, an emancipatory visual narrative approach. Yet, despite its broad appeal, photovoice can be hard to implement. In this article, we leverage our experience using photovoice for a (...) farm children safety project to describe and reflect on the ethical and methodological aspects broadly relevant to agricultural health and safety topics. We first contextualize the tensions of navigating between photovoice, the research ethics committees (RECs) regulatory frameworks, and competing views on visual representations in agriculture. We then discuss the sources of risks to participants and researchers, how we addressed these risks, and how these risks unfolded during the research phase of the photovoice activity. We conclude with three lessons we (re)learned: the importance of collaborating with RECs, the need to increase preparation to limit psychological risks to participants and researchers, and avenues to augment the emancipatory power of photovoice in a virtual environment. (shrink)

Although critiques of humanism are not new, the currency of posthumanist discourse on the nonhuman – the animal, the environment, or the object – suggests rising concerns about humanity’s place in the ecological order. This article interrogates Cary Wolfe's posthumanist framework as he approaches the questions of activism and agency in the context of animal ethics and disability politics. By drawing attention to the contradictions in his own commitments to rethinking human exceptionalism, I examine how Wolfe's appeal for a more (...) compassionate account of ethics vis-à-vis the notion of ‘trans-species empathy’ can be more gainfully addressed through the work of feminist and quantum physicist Karen Barad. This essay contends that by preserving the difference between the human and the nonhuman as something that is given rather than interrogated, the assumption of ‘the human’ as a self-contained identity is left unchanged and unchallenged. (shrink)

Le problème historique majeur posé par l’étude de la prostitution à Rome est celui de l’existence de prostitué(e)s libres dans une société esclavagiste. Puisque des corps serviles, ou affranchis, masculins et féminins étaient disponibles en grand nombre, aussi bien dans les demeures des hommes libres que dans les maisons de prostitution, comment se fait-il que des femmes nées libres aient renoncé à leurs privilèges et statut de matrones? Comment se fait-il aussi que la société ait institutionnalisé ce renoncement en prévoyant (...) d’enregistrer officiellement ces prostituées d’origine libre? L’explication proposée ici est que les prostitué(e)s libres assument une fonction symbolique qui est d’être l’autre du soldat comme l’acteur est l’autre de l’orateur. Ces « parias » de la société romaine, toujours « efféminés » servent à marquer les marges de l’humanité civilisée dans la continuité, à définir les hommes, libres et adultes et donc « masculins » par ce qu’ils ne sont pas mais ce qu’ils pourraient par malheur, devenir des « effeminés » ou leur équivalent, des prostituées libres. (shrink)

In the shadow of various business scandals and societal crises, scholars and practitioners have developed a growing interest in authentic leadership. This approach to leadership assumes that leaders may access and leverage their “true selves” and “core values” and that the combination of these two elements forms the basis from which they act resolutely, lead ethically, and benefit others. Drawing on Heidegger’s work, we argue that a concern for authenticity can indeed instigate a leadership ethic, albeit one that acknowledges the (...) unfounded openness of existence and its inherent relationality. On this basis, we propose an ethics-as-practice approach in which leaders respond to the situation at hand by being “attuned to attunement,” which cultivates an openness to otherness and a responsibility to others. (shrink)

Fondée en 1928 par Magnus Hirschfeld, la Ligue Mondiale pour la Réforme Sexuelle entendait rassembler médecins et « profanes » dans le but de diffuser dans l’opinion publique les acquis de la nouvelle « science sexuelle » et d’influencer les gouvernements dans un sens progressiste, sur des questions aussi variées que le contrôle des naissances, le mariage et le divorce, l’homosexualité, la prostitution ou l’eugénisme. Très vite pourtant, elle fut déchirée entre des tendances contradictoires, et dans l’incapacité de mener à (...) bien ses objectifs, alors que la crise des années trente rendait son combat pour une nouvelle morale sexuelle rationnelle et humaniste de plus en plus utopique et que son pouvoir d’action se trouvait limité à la tenue de Congrès et à la dénonciation des lois injustes. (shrink)

Volume 19, Issue 6, June 2019, Page W3-W4.

In a previous article, I argued that assessment requirements for transgender hormone replacement therapy are unethical and dehumanising. A recent response published by the Journal of Medical Ethics criticises this proposal. In this reply, I advance that their response misunderstood core parts of my argument and fails to provide independent support for assessment requirements. Though transition-related care may have similarities with cosmetic surgeries, this does not suffice to establish a need for assessments, and nor do the high rates of depression (...) and anxiety justify assessments, especially given the protective role HRT plays towards mental well-being. (shrink)

Quel type d'expérience faisons-nous quand " nous regardons un film "? Bien que cette formule consacrée ne prenne pas en compte la complexité du voir/entendre spectatoriel, elle souligne néanmoins une forme d'équivocité à propos de ce qu'on " regarde ", comme de ce qui est ainsi mis en jeu. Le présent essai s'efforce de rendre compte des différentes modalités d'appréhension d'un film par le spectateur. L'auteure a choisi de travailler au plus près de la texture filmique en analysant de courts (...) extraits de films. (shrink)

Le livre édité par Tommaso Raso et Héliana Mello est une contribution fondamentale à la recherche sur les corpus oraux. Il rassemble les contributions majeures données lors d’un colloque international au Brésil, à Belo Horizonte, en février et mars 2012, organisé par le « Gruppo di Studio sulla Comunicazione Parlata », qui est un groupe de recherche de la Société de Linguistique Italienne. Les langues appréhendées sont diverses : l’anglais, trois langues romanes (portugais brésilien, français...

The “dynamic developmental” theory of attention-deficit/hyperactivity disorder (ADHD) has come full circle from Wender's (1971) reinforcement hypothesis. By specifying the principle of time constraints on reinforcement and extinction, the present theory allows for empirical validation. However, the theory implies, but does not discuss, implications for the neurophysiology of comorbidity in ADHD. The authors' attribution of comorbid oppositional behavior to parental and societal reinforcement leaves out biological factors.

Numerous mediators are involved in both the control and the transmission of nociceptive messages, and several lines of research have been developed in the management of pain. Complete enkephalin- degrading enzyme inhibitors, which produce naloxone-reversible analgesia in all tests where morphine has been found to be active, remains the most promising way. CCK compounds, especially the CCKB antagonists also may be interesting drugs. Indeed, they are able to strongly potentiate the antinociceptive effects of the opioids. [dickenson, wiesenfeld-hallin et al.].