Essex University, in association with Johns Hopkins Center for Public Health and Human Rights, has brought out a timely report highlighting the increasing global criminalisation of the provision of healthcare.1 The report, with a foreword by Professor Dainius Puras, United Nations Special Rapporteur on the right to health, explores the pressures on medical impartiality arising in large part from both global and national responses to the threat of terrorism. Both international humanitarian law, human rights law and long-established principles of (...) medical ethics—as set out in various declarations of the World Medical Association—establish an absolute principle that all people, regardless of their beliefs, affiliation or status, have rights of access to appropriate healthcare. And this right extends to wounded and sick combatants, as well as civilians, during times of armed conflict. One of the challenges in this area is that in recent years, many conflicts have become ‘asymmetric’. Contemporary conflicts seldom involve opposing state armies. Instead, they increasingly involve irregular combatants, often labelled ‘terrorists’ or ‘insurgents’ by the states they are opposing. In response to these threats, many states have developed sometimes draconian legislation outlawing terrorist groups and those offering support. The danger, outlined in some detail in the report, is that the vital distinction between the impartial provision of medical care and the criminal offence of materially aiding terrorism is lost. In 2016, largely in response to the deliberate targeting of healthcare personnel and facilities in the conflicts disfiguring the greater Middle …. (shrink)

Re AA and Re P : the ‘forced caesarean’ caseOn 30 November 2013 The Telegraph reported that Essex County Council Social Services had obtained a High Court Order against a woman that allowed her to be forcibly sedated and her child removed by caesarean section and taken into care.1 The original story reported that the woman, an Italian national who had been in the UK on a short-term basis for work, had experienced ‘something of a panic attack’ and, after (...) calling the police, was compulsorily detained under the Mental Health Act 1983. Five weeks later, the report said, she was restrained, forcibly sedated and awoke hours later to find that, pursuant to a court order obtained by Essex County Council Social Services, her baby had been removed by caesarean section and taken into care by social workers.The story was subsequently reported in a number of other media outlets and prompted such widespread outrage that the presiding judge, Mr Justice Mostyn, took the unprecedented step of releasing both the judgement of the initial application to the Court of Protection and the verbatim transcript of proceedings. It became apparent that the facts of the case had been drastically misreported by the media and that coverage had conflated two very separate issues: the medical procedure of the caesarean section and the taking of the child into local authority care.The initial case heard in the Court of Protection on 23 August 2012, Re AA,2 was the result of an application made not by the local authority or social workers seeking to remove the child but by Mid-Essex National Health Service Trust seeking a declaration and an order, on the basis of medical evidence, that the patient lacked capacity and that it would be in her best interests to undergo a caesarean section. Mr Justice Mostyn found in …. (shrink)

This article considers two arguments that purport to show that inductive reasoning is unjustified: the argument adduced by Sextus Empiricus and the (better known and more formidable) argument given by Hume in the Treatise. While Sextus’ argument can quite easily be rebutted, a close examination of the premises of Hume’s argument shows that they are seemingly cogent. Because the sceptical claim is very unintuitive, the sceptical argument constitutes a paradox. And since attributions of justification are theoretical, and the claim that (...) they are never (or seldom) true isn’t preposterous, the correct response to the paradox may well be to admit that the sceptic has exposed our error in making them. (shrink)

Ruth Garrett Millikan presents a strikingly original account of how we get to grips with the world in thought. Her question is Kant's 'How is knowledge possible?', answered from a contemporary naturalist standpoint. We begin with an understanding of what the world is like prior to cognition, then develop a theory of cognition within that world.

Previous research has established that the success of strikes, and social movements more broadly, depends on their ability to garner support from the public. However, there is scant published research investigating the response of the public to strike action by healthcare workers. In this study, we address this gap through a study of public responses to UK nursing strikes in 2022–2023, using a data set drawn from Twitter of more than 2300 publicly available tweets. We focus on negative tweets, investigating (...) which societal discourses social media users draw on to oppose strike action by nurses. Using a combination of corpus‐based approaches and discourse analysis, we identified five categories of opposition: (i) discourse discrediting nurses; (ii) discourse discrediting strikes by nurses; (iii) discourse on the National Health System; (iv) discourse about the fairness of strikers' demands and (v) discourse about potential harmful impact. Our findings show how social media users operationalise wider societal discourses about the nursing profession (e.g., associations with care, gender, vocation and sacrifice) as well as recent crises such as the Covid‐19 pandemic to justify their opposition. The results also provide valuable insights into misconceptions about nursing, strike action and patient harm, which can inform strategies for public communication. (shrink)

" Biosemantics " was the title of a paper on mental representation originally printed in The Journal of Philosophy in 1989. It contained a much abbreviated version of the work on mental representation in Language Thought and Other Biological Categories. There I had presented a naturalist theory of intentional signs generally, including linguistic representations, graphs, charts and diagrams, road sign symbols, animal communications, the "chemical signals" that regulate the function of glands, and so forth. But the term " biosemantics " (...) has usually been applied only to the theory of mental representation. Let me first characterize a more general class of theories called "teleological theories of mental content" of which biosemantics is an example. Then I will discuss the details that distinguish biosemantics from other naturalistic teleological theories. (shrink)

A list of groceries, Professor Anscombe once suggested, might be used as a shopping list, telling what to buy, or it might be used as an inventory list, telling what has been bought (Anscombe 1957). If used as a shopping list, the world is supposed to conform to the representation: if the list does not match what is in the grocery bag, it is what is in the bag that is at fault. But if used as an inventory list, the (...) representation is supposed to conform to the world: if the list does not match what is in the bag, it is the list that is at fault. The first kind of representation, where the world is supposed to conform to the list, can be called "directive"; it represents or directs what is to be done. The second, where the list is supposed to conform to the world, can be called "descriptive"; it represents or describes what is the case. I wish to propose that there exist representations that face both these ways at once. With apologies to Dr. Doolittle, I call them pushmi-pullyu representations or PPRs. (shrink)

Strike action in healthcare has been a common global phenomenon. As such action is designed to be disruptive, it creates substantial ethical tension, the most cited of which relates to patient harm, that is, a strike may not only disrupt an employer, but it could also have serious implications for the delivery of care. This article systematically reviewed the literature on strike action in healthcare with the aim of providing an overview of the major justifications for strike action, identifying relative (...) strengths and shortcomings of this literature and providing direction for future discussions, and theoretical and empirical research. Three major themes emerged related to (1) the relationship between healthcare workers, patients and society; (2) the consequences of strike action; and (3) the conduct of strike action. Those who argue against strike action generally cite the harms of such action, particularly as it relates to patients. Many also argue that healthcare workers, because of their skills and position in society, have a special obligation to their patients and society more generally. Those who see this action as not only permissible but also, in some cases, necessary have advanced several points in response, arguing that healthcare workers do not necessarily have any special obligation to their patients or society, and even if so, this obligation is not absolute. Overwhelmingly, when talking about the potential risks of strike action, authors have focused on patient welfare and the impact that a strike could have. Several directions for future work are identified, including greater explorations into how structural and systemic issues impact strike action, the need for greater consideration about the contextual factors that influence the risks and characteristics of strike action and finally the need to tie this literature to existing empirical evidence. (shrink)

In this article I will introduce and outline the concept of resistance as it relates to health and healthcare. Starting with a number of examples of action, I will then turn to the broader literature to discuss some conventional definitions and related concepts, outlining debates, controversies and limitations related to conceptualizing resistance. I conceptualize resistance broadly, as any act, performed by any individual (or collective) acting as or explicitly identifying as a healthcare professional, that is a response to power, most (...) often in opposition to contentious, harmful or unjust rules, practices, policies or structures. Practically this could account for any public action, marches, sit‐ins and civil disobedience, but also forms of ‘everyday resistance’, such as working slowly, feigning sickness, or even providing care for marginalized groups that would otherwise not have access. Such action could go unrecognized by those in power and perhaps more contentiously, those resisting needn’t even recognize their actions as resistance. I will then apply this conceptualization to explain action that has been undertaken by healthcare professionals, identifying its key features. I will briefly discuss future directions for inquiry that appear particularly pressing. These including ongoing conceptual development, identifying the functions of resistance in health and healthcare along with what makes it distinct from healthcare as usual and other forms of resistance and finally, the range of normative questions resistance raises. (shrink)

This collection of essays serves both as an introduction to Ruth Millikan’s much-discussed volume Language, Thought, and Other Biological Categories and as an extension and application of Millikan’s central themes, especially in the philosophy of psychology. The title essay discusses meaning rationalism and argues that rationality is not in the head, indeed, that there is no legitimate interpretation under which logical possibility and necessity are known a priori. In other essays, Millikan clarifies her views on the nature of mental (...) representation, explores whether human thought is a product of natural selection, examines the nature of behavior as studied by the behavioral sciences, and discusses the issues of individualism in psychology, psychological explanation, indexicality in thought, what knowledge is, and the realism/antirealism debate. Table of Contents Preface Acknowledgments Introduction 1 In Defense of Proper Functions 2 Propensities, Exaptations, and the Brain 3 Thoughts without Laws 4 Biosemantics 5 On Mentalese Orthography, Part 1 6 Compare and Contrast Dretske, Fodor, and Millikan on Teleosemantics 7 What Is Behavior? A Philosophical Essay on Ethology and Individualism in Psychology, Part 1 8 The Green Grass Growing All Around: A Philosophical Essay on Ethology and Individualism in Psychology, Part 2 9 Explanation in Biopsychology 10 Metaphysical Antirealism? 11 Truth Rules, Hoverflies, and the Kripke-Wittgenstein Paradox 12 Naturalist Reflections on Knowledge 13 The Myth of the Essential Indexical 14 White Queen Psychology; or, The Last Myth of the Given References Index. (shrink)

How the various things that are said to have meaning—purpose, natural signs, linguistic signs, perceptions, and thoughts—are related to one another.

Resistance involves a range of actions such as disobedience, insubordination, misbehaviour, agitation, advocacy, subversion, and opposition. Action that occurs both publicly, privately, and day-to-day in the delivery of care, in discourse and knowledge. In this article I will demonstrate how resistance plays an important role in shaping health and well-being, for better and worse. To show how it can be largely productive and protective, I will argue that resistance intersects with health in at least two ways. First, it acts as (...) an important counterbalance to power; undermining harmful policies, disobeying unfair instructions, challenging rights abuses, confronting those who would otherwise turn a blind eye and even holding ourselves to account when simply accepting the status quo. Second, and beyond being oppositional, resistance is a constructive, productive force, that is fundamental to imagining alternatives; new and better futures and perhaps most fundamentally resistance is cause for hope that we are not resigned to the status quo. While there are numerous examples of how resistance has been employed in service of health and well-being, resistance is not always rational or productive, it can also harm health. I will briefly explore this point. Finally, I will offer some reflections on the intersections of power and health and why this makes resistance both distinct and important when it comes to how it shapes health and well-being. (shrink)

I defend the historical definition of "function" originally given in my Language, Thought and Other Biological Categories (1984a). The definition was not offered in the spirit of conceptual analysis but is more akin to a theoretical definition of "function". A major theme is that nonhistorical analyses of "function" fail to deal adequately with items that are not capable of performing their functions.

In this article, we illuminate the affective phenomenon of loneliness by exploring the question of how it relates to love and other forms of friendship. We reflect in particular on the question of how different forms of loneliness are relevant to human existence. Distinguishing three forms of loneliness, we first introduce two border cases of loneliness: unfelt loneliness in which one’s individuality is denied and one therefore cannot feel lonely; and existential loneliness in which the possibility of intimacy and existential (...) communication are denied and one therefore cannot but feel lonely. We then turn to loneliness that occurs within intimate friendships—even the most intimate ones. In our analysis, we pay attention especially to the role of communication. In order to do so, we repeatedly turn to poetic expressions of loneliness. We argue that loneliness cannot reflect only the absence or partial failure of communication but also the inherent limits of communication. These limits in turn point back to the nature of human existence and love itself. (shrink)

Academic misconduct is a threat to the validity and reliability of online examinations, and media reports suggest that misconduct spiked dramatically in higher education during the emergency shift to online exams caused by the COVID-19 pandemic. This study reviewed survey research to determine how common it is for university students to admit cheating in online exams, and how and why they do it. We also assessed whether these self-reports of cheating increased during the COVID-19 pandemic, along with an evaluation of (...) the quality of the research evidence which addressed these questions. 25 samples were identified from 19 Studies, including 4672 participants, going back to 2012. Online exam cheating was self-reported by a substantial minority (44.7%) of students in total. Pre-COVID this was 29.9%, but during COVID cheating jumped to 54.7%, although these samples were more heterogenous. Individual cheating was more common than group cheating, and the most common reason students reported for cheating was simply that there was an opportunity to do so. Remote proctoring appeared to reduce the occurrence of cheating, although data were limited. However there were a number of methodological features which reduce confidence in the accuracy of all these findings. Most samples were collected using designs which makes it likely that online exam cheating is under-reported, for example using convenience sampling, a modest sample size and insufficient information to calculate response rate. No studies considered whether samples were representative of their population. Future approaches to online exams should consider how the basic validity of examinations can be maintained, considering the substantial numbers of students who appear to be willing to admit engaging in misconduct. Future research on academic misconduct would benefit from using large representative samples, guaranteeing participants anonymity. (shrink)

While strike action has been common since the industrial revolution, it often invokes a passionate and polarising response, from the strikers themselves, from employers, governments and the general public. Support or lack thereof from health workers and the general public is an important consideration in the justification of strike action. This systematic review sought to examine the impact of strike action on patient and clinician attitudes, specifically to explore (1) patient and health worker support for strike action and (2) the (...) predictors for supporting strike action and the reasons given for engaging in strike action. A systematic scoping review was employed to identify all relevant literature, followed by a textual narrative synthesis. A total of 34 studies met inclusion criteria. Support for strike action was largely context‐dependent. A range of factors impact support for strike action; broader cultural and structural factors, such as unionisation and general acceptance of strike action; systemic factors, such as the nature of the healthcare system, including infrastructure and work conditions; the strike itself and a range of individual factors, the most notable of which was being a student or in an early career stage. There were also some surprising results, for example, during doctors strike, nurses were provided with the opportunity to expand their role, which led to greater professional autonomy and job satisfaction. (shrink)

Ruth Millikan is well known for having developed a strikingly original way for philosophers to seek understanding of mind and language, which she sees as biological phenomena. She now draws together a series of groundbreaking essays which set out her approach to language. Guiding the work of most linguists and philosophers of language today is the assumption that language is governed by prescriptive normative rules. Millikan offers a fundamentally different way of viewing the partial regularities that language displays, comparing (...) them to biological norms that emerge from natural selection. This yields novel and quite radical consequences for our understanding of the nature of public linguistic meaning, the process of language understanding, how children learn language, and the semantics/pragmatics distinction. (shrink)

Charles Taylor is one of the most influential and prolific philosophers in the English-speaking world today. The breadth of his writings is unique, ranging from reflections on artificial intelligence to analyses of contemporary multicultural societies. This thought-provoking introduction to Taylor's work outlines his ideas in a coherent and accessible way without reducing their richness and depth. His contribution to many of the enduring debates within Western philosophy is examined and the arguments of his critics assessed. Taylor's reflections on the topics (...) of moral theory, selfhood, political theory and epistemology form the core chapters within the book. Ruth Abbey engages with the secondary literature on Taylor's work and suggests that some criticisms by contemporaries have been based on misinterpretations and suggests ways in which a better understanding of Taylor's work leads to different criticisms of it. The book serves as an ideal companion to Taylor's ideas for students of philosophy and political theory, and will be welcomed by the non-specialist looking for an authoritative guide to Taylor's large and challenging body of work. (shrink)

A leading scholar in the psychology of thinking and reasoning argues that the counterfactual imagination—the creation of "if only" alternatives to ...

Australian immigration detention has been called state sanctioned abuse and a crime against humanity. The Australian healthcare community has been closely involved with these policies, calling for their reform and working within detention centres to provide healthcare. As well as having a devastating impact on health, immigration detention changes the scope and nature of healthcare, with its delivery described as a Sisyphean task. In this article I will explore the guidance that is available to clinicians who work within detention centres (...) and argue that codes, guidelines and positions statements provide little help in relation to ethical decision making. First I will outline guidance that can be found in codes of ethics and position statements, focusing on particularly relevant principles, such as advocacy, clinical independence and the clinicians’ relationship to human rights. I will then highlight the disparity between this guidance and the delivery of healthcare within detention by drawing on the testimony of clinicians who formerly worked in these environments. While this disparity should be cause for alarm and at a minimum call into question how codes and positions statements are being used, there are more fundamental reasons why codes and position statements fail to provide guidance in these circumstances. I will outline a more general criticism of codes of ethics and use this to suggest a way forward, including looking beyond codes and position statements to guide action within Australian immigration detention. (shrink)

Australian immigration detention has been called state sanctioned abuse, cruel and degrading and likened to torture. Clinicians have long worked both within the system providing healthcare and outside of it advocating for broader social and political change. It has now been over 25 years and little, if anything, has changed. The government has continued to consolidate power to enforce these policies and has continued to attempt to silence dissent. It was in this context that a boycott was raised as a (...) possible course of action. Despite discussions among the healthcare community about the merits of such action, a number of questions have been overlooked. In this article, I will examine whether a boycott is both ethical and feasible. Taking into account the costs and benefits of current engagement and the potential impact of a boycott, more specifically the potential it has to further harm those detained, I conclude that under current circumstance a boycott cannot be justified. This however does not mean that a boycott should be dismissed completely or that the status quo should be accepted. I discuss potential ways forward for those seeking change. (shrink)

This encyclopedia entry provides an overview of the field of public health ethics. It focuses on what distinguishes public health ethics from other nearby subfields—especially biomedical ethics. It also frames the problems of public health ethics in terms of the concepts of justice and political legitimacy.

Healthcare strikes have been a remarkably common and varied phenomenon. Strikes have taken a number of forms, lasting from days to months, involving a range of different staff and impacting a range of healthcare systems, structured and resourced vastly differently. While there has been much debate about strike action, this appears to have done little to resolve the often polarising debate that surrounds such action. Building on the existing normative literature and a recent synthesis of the empirical literature, this paper (...) will present a deliberative framework to assess the justifiability of strike action. I will first review the empirical literature that explores the impact of strike action, on patient outcomes and healthcare delivery. I will then discuss the debates that have occurred in this area, including an existing deliberative framework proposed by Selemogo (2014). I will argue that this framework is overly restrictive in that it could lead us to find otherwise justified strike action, unjust. I will then propose a framework that remedies these shortcomings. The framework outlines two broad conditions that should be met if strike action is to be justified. It then goes on to outline two deliberative, interrelated questions that should be used to assess whether strike action meets these conditions. For the purposes of this framework, healthcare strike action is justified when 1) it makes demands or raises grievances about some form of injustice, unfairness or threat to health and when 2) the risks in striking are proportionate to its demands or grievances. These two conditions should be considered in light of two further questions, namely, the 3) social and political context of the strike and 4) the characteristics of the strike. I will offer some further reflections on the application of this framework and its shortcomings. (shrink)

Robert Alexy develops his influential theory of legal reasoning exploring the nature of legal argumentation and its relation to practical reasoning. In doing so he sheds light on fundamental questions of law and rationality, which are as crucial to practising lawyers and law students as they are to scholars of legal theory.

This book provides a clear, simple account of techniques involved in assisted reproduction and embryo research. It thoughtfully and provocatively explores controversies raised by developments in reproductive technology since the first IVF baby in 1978, such as 'saviour siblings', designer babies, reproductive cloning and embryo research.

This Element offers the first detailed study of Catharine Trotter Cockburn's philosophy and covers her contributions to philosophical debates in epistemology, metaphysics, moral philosophy, and philosophy of religion. It examines not only Cockburn's view that sensation and reflection are the sources of knowledge, but also how she draws attention to the limitations of human understanding and how she approaches metaphysical debates through this lens. In the area of moral philosophy, this Element argues that it is helpful to take seriously Cockburn's (...) distinction between questions concerning the metaphysical foundation of morality and questions concerning the practice of morality. Moreover, this Element examines Cockburn's religious views and considers her understanding of the relation between morality and religion and her religious views concerning the resurrection and the afterlife. (shrink)

In this article, I provide a philosophical analysis of the nature and role of perceived identity threats in the genesis and maintenance of fanaticism. First, I offer a preliminary definition of fanaticism as the social identity-defining devotion to a sacred value that demands universal recognition and is complemented by a hostile antagonism toward people who dissent from one’s group’s values. The fanatic’s hostility toward dissent thereby takes the threefold form of outgroup hostility, ingroup hostility, and self-hostility. Second, I provide a (...) detailed analysis of the fears of fanaticism, arguing that each of the three aforementioned forms of hostile antagonism corresponds to one form of fear or anxiety: the fanatic’s fear of the outgroup, renegade members of the ingroup, and problematic aspects of themselves. In each of these three forms of fear, the fanatic experiences both their sacred values and their individual and social identity as being threatened. Finally, I turn to a fourth form of fear or anxiety connected to fanaticism, namely the fanatic’s anxiety of and flight from the existential condition of uncertainty itself, which, at least in some cases, ground the fanatic’s fearfulness. (shrink)

Australian immigration detention has received persistent criticism since its introduction almost 25 years ago. With the recent introduction of offshore processing, these criticisms have intensified. Riots, violence, self-harm, abuse and devastating mental health outcomes are all now well documented, along with a number of deaths. Clinicians have played a central role working in these environments, faced with the overarching issue of delivering healthcare while facilitating an abusive and harmful system. Since the re-introduction of offshore processing a number of authors have (...) begun to discuss the possibility of a boycott. While taking such action may lead to change, further discussion is needed, not only in relation to the impact of a boycott, but whether it is possible for clinicians to engage with this system in more productive, ethical ways. This article utilises a framework proposed by Lepora and Goodin that provides a structured approach to examine complicity and seeks to explore how clinicians have engaged with Australian immigration detention and ultimately whether they should continue to do so. (shrink)

Australian immigration detention has been called state sanctioned abuse and a crime against humanity. The Australian healthcare community has been closely involved with these policies, calling for their reform and working within detention centres to provide healthcare. As well as having a devastating impact on health, immigration detention changes the scope and nature of healthcare, with its delivery described as a Sisyphean task. In this article I will explore the guidance that is available to clinicians who work within detention centres (...) and argue that codes, guidelines and positions statements provide little help in relation to ethical decision making. First I will outline guidance that can be found in codes of ethics and position statements, focusing on particularly relevant principles, such as advocacy, clinical independence and the clinicians’ relationship to human rights. I will then highlight the disparity between this guidance and the delivery of healthcare within detention by drawing on the testimony of clinicians who formerly worked in these environments. While this disparity should be cause for alarm and at a minimum call into question how codes and positions statements are being used, there are more fundamental reasons why codes and position statements fail to provide guidance in these circumstances. I will outline a more general criticism of codes of ethics and use this to suggest a way forward, including looking beyond codes and position statements to guide action within Australian immigration detention. (shrink)

Although Australia has comparatively few individuals seeking asylum, it has had a mandatory detention policy in place since 1992. This policy has been maintained by successive governments despite the overwhelmingly negative impact mandatory detention has on mental health. For mental health professionals working in this environment, a number of moral, ethical, and human rights issues are raised. These issues are discussed here, with a focus on dual loyalty conflicts and drawing on personal experience, the bioethics and human rights literature, and (...) recent parliamentary inquiries. For those who continue to work in this environment, future directions are also discussed. (shrink)

Resistance is a concept understudied in the context of health and healthcare. This is in part because visible forms of social protest are sometimes understood as incongruent with professional identity, leading healthcare workers to separate their visible actions from their working life. Resistance takes many forms, however, and focusing exclusively on the visible means more subtle forms of everyday resistance are likely to be missed. The overarching aim of this study was to explore how resistance was enacted within the workplace (...) amongst a sample of twelve healthcare workers, based in the United Kingdom; exploring the forms that such action took and how this intersected with health and healthcare. In depth-interviews were conducted and results were analysed utilizing Lilja’s framework ( 2022 ). Our findings suggest that resistance took a number of forms, from more direct confrontational acts, to those which sought to avoid power or which sought to create alternative or prefigurative practices or norms. These findings speak to the complexities, ambiguities, and contradictions of resistance, as carried out by healthcare workers in the workplace. While many acts had clear political motives, with issues like climate change in mind for example, participants also described how the act of providing care itself could be an act of resistance. While saying something about our participants, this also said something about the healthcare systems in which they worked. These findings also raise a range of normative issues. Perhaps needless to say, there appears to be substantial scope to expand and interrogate our findings and apply the idea of resistance to health and healthcare. (shrink)

Offers an analysis of three strongly contrasting primitive civilizations, showing how behavior is influenced by custom and tradition.

In this paper, I will argue that a number of well-known health interventions or initiatives could be considered anarchist, or at the very least are consistent with anarchist thinking and principles. In doing this I have two aims: First, anarchism is a misunderstood term—by way of example, I hope to first sketch out what anarchist solutions in health and healthcare could look like; second, I hope to show how anarchist thought could stand as a means to improve the health of (...) many, remedying health inequalities acting as a buffer for the many harms that threaten health and well-being. On this second point, I will argue that there are a number of theoretical and instrumental reasons why greater engagement with anarchism and anarchist thinking is needed, along with how this could contribute to health and in addressing broader injustices that create and perpetuate poor health. (shrink)

In this interview, Ruth Groff discusses how she came to be a realist, her role as a community organizer, her relationship to critical realism, and various issues arising from her published work over the years. Discussion ranges across the nature of positivism and its legacy, the concept of falsehood, realism about causal powers, mind-independent reality, the history of philosophy, and the underlying interest in ideology-critique that runs through her thinking.

Exploitation locates what it is we recognize as bad when we judge a situation to be exploitative. Ideal for courses in social and political philosophy, public policy, or political science.

Healthcare organisations are hierarchical; almost all are organised around the ranking of individuals by authority or status, whether this be based on profession, expertise, gender or ethnicity. Hierarchy is important for several reasons; it shapes the delivery of care, what is prioritised and who receives care. It also has an impact on healthcare workers and how they work and communicate together in organisations. The purpose of this scoping review is to explore the qualitative evidence related to hierarchy in healthcare organisations (...) defined broadly, to address gaps in macro‐level healthcare organisational research, specifically focusing on the (1) impact of hierarchy for healthcare workers and (2) how hierarchy is negotiated, sustained and challenged in healthcare organisations. After a search and screening, 32 papers were included in this review. The findings of this review detail the wide‐reaching impacts that hierarchy has on healthcare delivery and health workers. The majority of studies spoke to hierarchy's impact on speaking up, that is, how it shaped communication between staff with differential status: not only what was said, but how it had an impact on what was acceptable to say, by whom and at what time. Hierarchy was also noted to have substantial personal costs, impacting on the well‐being of those in less powerful positions. These findings also provide insight into the complex ways in which hierarchy was negotiated, challenged and reproduced. Studies not only detailed the way in which hierarchy was navigated day to day but also spoke to the reasons as to why hierarchy is often entrenched and difficult to shift. A number of studies spoke to the impact that hierarchy had in sustaining gender and ethnic inequalities, maintaining historically discriminatory practices. Importantly, hierarchy should not be reduced to differences between or within the professions in localised contexts but should be considered at a broad organisational level. (shrink)

BackgroundNon-violent resistance which has involved healthcare workers has been instrumental in securing a number of health-related gains and a force in opposing threats to health. Despite this, we...

Civility is a nice idea. While we find common ground with the aspirations of a civility-based professional culture in healthcare and acknowledge the potential impacts of incivility on staff and patients, we should be careful in dismissing it entirely, as McCullough et al 1 do. As we will argue below, appeals to civility, when understood alongside power, could serve to stifle and mask legitimate dissent, limiting genuine criticism and progress. Crucially, we contend that incivility itself may serve instrumental and communicative (...) purposes that draw attention to injustice or inequity. Our aim is not to defend every act of incivility but to caution calls for its prevention. By focusing on intentional acts of incivility and by emphasising the political, we hope to show that ‘being polite is not the same as being a good citizen’2 and the absence of tension is not the same as the presence of justice (King, 1963).3 We go on to discuss the implications of this approach to addressing ‘uncivil’ behaviour, arguing that incivility is a by-product of institutions that dismiss genuine grievances and maintain inequitable conditions. When we …. (shrink)

By whatever general principles and mechanisms animal behavior is governed, human behavior control rides piggyback on top of the same or very similar mechanisms. We have reflexes. We can be conditioned. The movements that make up our smaller actions are mostly caught up in perception-action cycles following perceived Gibsonian affordances. Still, without doubt there are levels of behavior control that are peculiar to humans. Following Aristotle, tradition has it that what is added in humans is rationality ("rational soul"). Rationality, however, (...) can be and has been characterized in many different ways. I am going to speculate about two different kinds of cognitive capacities that we humans seem to have, each of which is at least akin to rationality as Aristotle described it. The first I believe we share with many other animals, the second perhaps with none. Since this session of the conference on rational animals has been designated a "brainstorming" session, I will take philosopher's license, presenting no more than the softest sort of intuitive evidence for these ideas. (shrink)

In _Feminist Interpretations of John Rawls_, Ruth Abbey collects eight essays responding to the work of John Rawls from a feminist perspective. An impressive introduction by the editor provides a chronological overview of English-language feminist engagements with Rawls from his Theory of Justice onwards. She surveys the range of issues canvassed by feminist readers of Rawls, as well as critics’ wide disagreement about the value of Rawls’s corpus for feminist purposes. The eight essays that follow testify to the continuing (...) ambivalence among feminist readers of Rawls. From the perspectives of political theory and moral, social, and political philosophy, the essayists address particular aspects of Rawls’s work and apply it to a variety of worldly practices relating to gender inequality and the family, to the construction of disability, to justice in everyday relationships, and to human rights on an international level. The overall effect is to give a sense of the broad spectrum of possible feminist critical responses to Rawls, ranging from rejection to adoption. Aside from the editor, the contributors are Amy R. Baehr, Eileen Hunt Botting, Elizabeth Brake, Clare Chambers, Nancy J. Hirschmann, Anthony Simon Laden, Janice Richardson, and Lisa H. Schwartzman. (shrink)

Self-harm within immigration detention centres has been a widely documented phenomenon, occurring at far higher rates than the wider community. Evidence suggests that factors such as the conditions of detention and uncertainty about refugee status are among the most prominent precipitators of self-harm. While important in explaining self-harm, this is not the entire story. In this paper, we argue for a more overtly political interpretation of detainee self-harm as resistance and assess the ethical implications of this view, drawing on interviews (...) with detainees from Australia’s offshore system. Self-harm by detainees is not only a medical ‘condition’ arising in response to oppression but a form of political action to lessen or contest it. We first establish how self-harm could be conceptualised as resistance. We then discuss its political purpose, noting it serves at least three functions: intrinsic, instrumental and disruptive or coercive. Viewing detainee self-harm as political resistance is a supplement to (rather than a substitute for) a medical approach. However, conceptualising self-harm this way has several advantages, namely, moving away from the idea that such behaviour is ‘maladaptive’, recognising detainees as political agents, combatting government claims of ‘manipulation’ and ‘blackmail’ and clarifying the duties of healthcare workers who work in detention. (shrink)

Background In the UK, the solidaristic character of the NHS makes it one of the most trusted public institutions. In recent years, the introduction of data-driven technologies in healthcare has opened up the space for collaborations with private digital companies seeking access to patient data. However, these collaborations appear to challenge the public’s trust in the. Main text In this paper we explore how the opening of the healthcare sector to private digital companies challenges the existing social contract and the (...) NHS’s solidaristic character, and impacts on public trust. We start by critically discussing different examples of partnerships between the NHS and private companies that collect and use data. We then analyse the relationship between trust and solidarity, and investigate how this relationship changes in the context of digital companies entering the healthcare system. Finally, we show ways for the NHS to maintain public trust by putting in place a solidarity grounded partnership model with companies seeking to access patient data. Such a model would need to serve collective interests through, for example, securing preferential access to goods and services, providing health benefits, and monitoring data access. Conclusion A solidarity grounded partnership model will help establish a social contract or licence that responds to the public’s expectations and to principles of a solidaristic healthcare system. (shrink)

Corruption poisons corporations in America and around the world, and has devastating consequences for the entire social fabric. In this article, we focus on organizational corruption, described as the abuse of authority for personal benefit, and draw on Weber’s three ideal-types of legitimate authority to develop a theoretical model to better understand the antecedents of different types of organizational corruption. Specifically, we examine the types of business misconduct that organizational leaders are likely to engage in, contingent on their legitimate authority, (...) motives, and justifications. We conclude by suggesting managerial implications of our theoretical model and propose directions for future research. (shrink)

Ruth Boeker offers a new perspective on Locke’s account of persons and personal identity by considering it within the context of his broader philosophical project and the philosophical debates of his day. Her interpretation emphasizes the importance of the moral and religious dimensions of his view. By taking seriously Locke’s general approach to questions of identity, Boeker shows that we should consider his account of personhood separately from his account of personal identity over time. On this basis, she argues (...) that Locke endorses a moral account of personhood, according to which persons are subjects of accountability, and that his particular thinking about moral accountability explains why he regards sameness of consciousness as necessary for personal identity over time. In contrast to some Neo-Lockean views about personal identity, Boeker argues that Locke’s account of personal identity is not psychological per se, but rather his underlying moral, religious, metaphysical, and epistemic background beliefs are relevant for understanding why he argues for a consciousness-based account of personal identity. Taking his underlying background beliefs into consideration not only sheds light on why many of his early critics do not adopt Locke’s view, but also shows why his view cannot be as easily dismissed as some of his critics assume. -/- . (shrink)

: This article considers what contribution the work of John Rawls can make to questions about animal ethics. It argues that there are more normative resources in A Theory of Justice for a concern with animal welfare than some of Rawls's critics acknowledge. However, the move from A Theory of Justice to Political Liberalism sees a depletion of normative resources in Rawlsian thought for addressing animal ethics. The article concludes by endorsing the implication of A Theory of Justice that we (...) look for ways other than rights discourse to respect and protect the well-being of animals. (shrink)

What kind of affective phenomenon is religious zeal and how does it relate to other affective phenomena, such as moral anger, hatred, and love? In this paper, I argue that religious zeal can be both, and be presented and interpreted as both, a love-like passion and an anger-like emotion. As a passion, religious zeal consists of the loving devotion to a transcendent religious object or idea such as God. It is a relatively enduring attachment that is constitutive of who the (...) zealot is, and it expresses itself in a distinctive set of mental and behavioral dispositions. Most importantly, it motivates uncompromising actions and involves intense, hot, and deep emotions. As an anger-like emotion, religious zeal is an occurrent affective state of mind that is intentionally directed towards a specific object, characteristically a person or group of persons. It condemns the violation of a religious norm that is taken to be of absolute validity and general applicability. It motivates an action aiming at vengeance and retaliation, and it involves intense and hot feelings of hostility towards its object. I argue that rather than reducing the complex phenomenon of religious zeal to one of these two manifestations, we should reflect upon the question of how the two distinct conceptualizations relate to each other. (shrink)