The genetic modification of pigs as a source of transplantable organs is one of several possible solutions to the chronic organ shortage. This paper describes existing ethical tensions in xenotransplantation (XTx) that argue against pursuing it. Recommendations for lifelong infectious disease surveillance and notification of close contacts of recipients are in tension with the rights of human research subjects. Parental/guardian consent for pediatric xenograft recipients is in tension with a child’s right to an open future. Individual consent to transplant is (...) in tension with public health threats that include zoonotic diseases. XTx amplifies concerns about justice in organ transplantation and could exacerbate existing inequities. The prevention of infectious disease in source animals is in tension with the best practices of animal care and animal welfare, requiring isolation, ethologically inappropriate housing, and invasive reproductive procedures that would severely impact the well-being of intelligent social creatures like pigs. (shrink)

Abstract:Human and animal research both operate within established standards. In the United States, criticism of the human research environment and recorded abuses of human research subjects served as the impetus for the establishment of the National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research, and the resulting Belmont Report. The Belmont Report established key ethical principles to which human research should adhere: respect for autonomy, obligations to beneficence and justice, and special protections for vulnerable individuals and (...) populations. While current guidelines appropriately aim to protect the individual interests of human participants in research, no similar, comprehensive, and principled effort has addressed the use of (nonhuman) animals in research. Although published policies regarding animal research provide relevant regulatory guidance, the lack of a fundamental effort to explore the ethical issues and principles that should guide decisions about the potential use of animals in research has led to unclear and disparate policies. Here, we explore how the ethical principles outlined in the Belmont Report could be applied consistently to animals. We describe how concepts such as respect for autonomy and obligations to beneficence and justice could be applied to animals, as well as how animals are entitled to special protections as a result of their vulnerability. (shrink)

Postmortem research on the brains of American tackle football players has revealed the presence of chronic traumatic encephalopathy (CTE), a degenerative brain disease caused by repeated head trauma. Repeated concussion is a risk factor for CTE, raising ethical concerns about the long-term effects of concussion on athletes at risk for football-related concussion. Of equal concern is that youth athletes are at increased risk for lasting neurocognitive and developmental deficits that can result in behavioral disturbances and diminished academic performance. In this (...) article, we consider evidence of the effects of concussion in youth athletes, and discuss ethical duties to youth athletes and how these duties might be satisfied, given the intrinsic risks of football. Finally, we evaluate potential strategies for reducing concussions in junior football, and recommend the optimal strategy for reducing brain injury to an acceptable level while still making available the benefits of football participation for youth athletes. (shrink)

Important advances in biomedical and behavioral research ethics have occurred over the past few decades, many of them centered on identifying and eliminating significant harms to human subjects of research. Comprehensive attention has not been paid to the totality of harms experienced by animal subjects, although scientific and moral progress require explicit appraisal of these harms. Science is a public good and the prioritizing within, conduct of, generation of, and application of research must soundly address questions about which research is (...) morally defensible and valuable enough to support through funding, publication, tenure, and promotion. Likewise, educational pathways of re-imagined science are critical. (shrink)

Several types of inferences are employed in the diagnosis and prognosis of patients with brain injuries and disorders of consciousness. These inferences introduce unavoidable uncertainty, and can be evaluated in light of inductive risk: the epistemic and nonepistemic risks of being wrong. This article considers several ethically significant inductive risks generated by and interacting with inferences about patients with disorders of consciousness, and argues for prescriptive measures to manage and mitigate inductive risk in the context of disorders of consciousness.

Disorders of Consciousness (DoCs) raise difficult and complex questions about the value of life for persons with impaired consciousness, the rights of persons unable to make medical decisions, and our social, medical, and ethical obligations to patients whose personhood has frequently been challenged and neglected. Recent neuroscientific discoveries have led to enhanced understanding of the heterogeneity of these disorders, and focused renewed attention on the medical and ethical problem of misdiagnosis. -/- This book examines the entanglement of epistemic and ethical (...) uncertainty in DoCs and other medical contexts, and how they interact to create both epistemic and ethical risks. Philosopher and bioethicist L. Syd M Johnson pulls together multiple threads in this work: the ontological mysteries of consciousness, medical uncertainty about unconsciousness, ableist bias, withdrawal of treatment in neurointensive care, and the rarely questioned view that consciousness is essential to personhood and moral status. Johnson challenges longstanding bioethical dogmas about DoC patients, and argues for an ethics of uncertainty for contexts where there is a need for decisive action in the presence of unavoidable uncertainty. The ethics of uncertainty refocuses ethical inquiry concerning persons with DoCs, placing less emphasis on their contested personhood, and more on inductive risk and uncertainty, on respect for autonomy, and especially on epistemic justice. With applications to various decisional contexts where uncertainty and ethical risk interact, this ethical approach enables surrogate decision makers facing fraught and risky choices to fulfill their obligations as moral and epistemic agents. (shrink)

This edited volume represents a unique addition to the available literature on animal ethics, animal studies, and neuroethics. Its goal is to expand discussions on animal ethics and neuroethics by weaving together different threads: philosophy of mind and animal minds, neuroscientific study of animal minds, and animal ethics. Neuroethical questions concerning animals’ moral status, animal minds and consciousness, animal pain, and the adequacy of animal models for neuropsychiatric disease have long been topics of debate in philosophy and ethics, and more (...) recently also in neuroscientific research. The book presents a transdisciplinary blend of voices, underscoring different perspectives on the broad questions of how neuroscience can contribute to our understanding of nonhuman minds, and on debates over the moral status of nonhuman animals. All chapters were written by outstanding scholars in philosophy, neuroscience, animal behavior, biology, neuroethics, and bioethics, and cover a range of issues and species/taxa. Given its scope, the book will appeal to scientists and students interested in the debate on animal ethics, while also offering an important resource for future researchers. Chapter 13 of this book is available open access under a CC BY 4.0 license at link.springer.com. (shrink)

Since its inception in 1968, the concept of whole-brain death has been contentious, and four decades on, controversy concerning the validity and coherence of whole-brain death continues unabated. Although whole-brain death is legally recognized and medically entrenched in the United States and elsewhere, there is reasonable disagreement among physicians, philosophers, and the public concerning whether brain death is really equivalent to death as it has been traditionally understood. A handful of states have acknowledged this plurality of viewpoints and enacted “conscience (...) clauses” that require “reasonable accommodation” of religious and moral objections to the determination of death by neurological criteria. This paper argues for the universal adoption of “reasonable accommodation” policies using the New Jersey statute as a model, in light of both the ongoing controversy and the recent case of Jahi McMath, a child whose family raised religious objections to a declaration of brain death. Public policies that accommodate reasonable, divergent viewpoints concerning death provide a practical and compassionate way to resolve those conflicts that are the most urgent, painful, and difficult to reconcile. (shrink)

The right to die has for decades been recognised for persons in a vegetative state, but there remains controversy about ending life-sustaining medical treatment for persons in the minimally conscious state. The controversy is rooted in assumptions about the moral significance of consciousness, and the value of life for patients who are conscious and not terminally ill. This paper evaluates these assumptions in light of evidence that generates concerns about quality of life in the MCS. It is argued that surrogates (...) should be permitted to make decisions to withdraw life-sustaining medical treatment from patients in the MCS. (shrink)

Volume 20, Issue 6, June 2020, Page 33-35.

We have arrived at an inflection point, a moment in history when the sentience, conscious- ness, intelligence, agency, and even the moral agency of many nonhuman animals can no longer be questioned without ignoring centuries of accumulated scientific knowledge. Nowhere is this more true than in our understanding of nonhuman primates (NHPs). A neu- roethics committed to probing the ethical implications of brain research must be able to respond to and anticipate the challenges ahead as brain projects globally prepare to (...) increase the use of NHPs in research. This requires adopting a less anthropocentric focus that includes nonhuman animals within its scope. But the Neuroethics Roadmap represents a missed opportunity to critically examine the future direction of research with NHPs in an ethically-responsive neuroscience. (shrink)

As usually understood, the Dead Donor Rule (DDR) for organ donation requires either that (1) the donor is already dead (which legally occurs when death is determined by neurological criteria), and/or that (2) organ procurement does not cause the donor’s death.

_The Routledge Handbook of Neuroethics_ offers the reader an informed view of how the brain sciences are being used to approach, understand, and reinvigorate traditional philosophical questions, as well as how those questions, with the grounding influence of neuroscience, are being revisited beyond clinical and research domains. It also examines how contemporary neuroscience research might ultimately impact our understanding of relationships, flourishing, and human nature. The _Handbook_ features easy-to-follow chapters that appear here for the first time in print and—written by (...) 61 key scholars and fresh voices—represent the wide range of viewpoints in neuroethics. The volume spotlights new technologies and historical articulations of key problems, issues, and concepts, and includes cross-referencing between chapters to highlight the complex interactions of concepts and ideas within neuroethics. These features enhance the _Handbook_’s utility by providing readers with a contextual map for different approaches to issues, and a guide to further avenues of interest. (shrink)

The Emerging Issues Task Force (Kellmeyer et al. 2019) identifies several important trends and concerns that neuroethics will encounter and grapple with in the com- ing decades. Among these are ethical issues related to the creation of new nonhuman entities, such as artificial intelligence systems, and human origin entities like brain organoids. The task force briefly mentions animal minds and animal rights, to which neuroethics to date has paid scant attention (Buller et al. 2014). As neuroscientific knowledge and knowledge from (...) other fields, including, to name a few, comparative psychology, primatology, ethology, biology, genetics, and medical sociology, accu- mulate, ethical concerns about the use of nonhuman ani- mals in research, agriculture, entertainment, and elsewhere will grow more visible and more urgent. Turning neuroethical attention toward nonhuman ani- mals also promises to illuminate issues related to specific human populations that are within the purview of a more expansive, forward-looking neuroethics. (shrink)

Two problems are considered here. One relates to who has moral status, and the other relates to who has moral responsibility. The criteria for mattering morally have long been disputed, and many humans and nonhuman animals have been considered “marginal cases,” on the contested edges of moral considerability and concern. The marginalization of humans and other species is frequently the pretext for denying their rights, including the rights to health care, to reproductive freedom, and to bodily autonomy. There is broad (...) agreement across cultural and philosophical traditions about the capacities and responsibilities of moral agents. I propose an inclusive and expansive way of thinking about moral status, situating it not in the characteristics or capacities of individuals, but in the responsibilities and obligations of moral agents. Moral agents, under this view, are not privileged or entitled to special treatment but rather have responsibilities. I approach this by considering some African communitarian conceptions of moral status and moral agency. I propose that moral agency can also be more expansive and include not just individual moral agents but collective entities that have some of the traits of moral agents: power, freedom, and the capacity to recognize and act on the demands of morality and acknowledge and respect the rights of others. Expanding who and what is a moral agent correspondingly extends moral responsibility for respecting rights and fostering the conditions for the health and well-being of humans and animals onto the collective entities who uniquely have the capacity to attend to global-scale health threats such as pandemics and human-caused climate change. (shrink)

_The Routledge Handbook of Neuroethics_ offers the reader an informed view of how the brain sciences are being used to approach, understand, and reinvigorate traditional philosophical questions, as well as how those questions, with the grounding influence of neuroscience, are being revisited beyond clinical and research domains. It also examines how contemporary neuroscience research might ultimately impact our understanding of relationships, flourishing, and human nature. The _Handbook_ features easy-to-follow chapters that appear here for the first time in print and—written by (...) 61 key scholars and fresh voices—represent the wide range of viewpoints in neuroethics. The volume spotlights new technologies and historical articulations of key problems, issues, and concepts, and includes cross-referencing between chapters to highlight the complex interactions of concepts and ideas within neuroethics. These features enhance the _Handbook_’s utility by providing readers with a contextual map for different approaches to issues, and a guide to further avenues of interest. (shrink)

There is ongoing ethical and legal debate about withdrawing life sup- port for patients with disorders of consciousness (DOCs). Frequently fu- eling the debate are implicit assumptions about the value of life in a state of impaired consciousness, and persistent uncertainty about the quality of life (QoL) of these persons. Yet there are no validated methods for assessing QoL in this population, and a significant obstacle to doing so is their inability to communicate. Recent neuroscientific discoveries might circumvent that problem (...) and help shed light on QoL in DOCs. There is an ethical imperative to prioritize QoL research in this patient population, to provide evidence to inform treatment, research, and end of life decisions. A minimalist and pragmatic model of QoL is proposed, targeting positive and negative affect as domains for which there is po- tential to reach across the communication gap, and restore to these voiceless persons some measure of control. (shrink)

Sport-related neurotrauma annually affects millions of athletes worldwide. The return-to-play protocol (RTP) is the dominant strategy adopted by sports leagues and organizations to manage one type of sport-related neurotrauma: concussions. RTPs establish guidelines for when athletes with concussions are to be removed from competition or practice, and when they can return. RTPs are intended to be neuroprotective, and to protect athletes from some of the harms of sport-related concussions, but there is athlete resistance to and noncompliance with RTPs. This prompts (...) consideration of whether RTPs, as employed in adult, professional sports, are paternalistic, and if they are, whether they are objectionably so. If RTPs are uniquely effective at protecting current or future athlete autonomy, they might be justified by paternalism. I conclude that RTPs are paternalistic in their effects, but are not adequately justified, and thus they are objectionable. (shrink)

Concussion and Mild Traumatic Brain Injury affect millions of people worldwide. mTBI has been called the “signature injury” of the recent conflicts in Iraq and Afghanistan, affecting thousands of active duty service men and women, and veterans. Sport-related concussion represents a significant public health problem, with elite and professional athletes, and millions of youth and amateur athletes worldwide suffering concussions annually. These brain injuries have received scant attention from neuroethicists, and the focus of this special issue is on defining the (...) ethical considerations and developing and elucidating the neuroethical contributions to the discussion about concussion and mTBI. (shrink)

The phenomenon whereby severely disabled persons self-report a higher than expected level of subjective well-being is called the “disability paradox.” One explanation for the paradox among brain injury survivors is “response shift,” an adjustment of one’s values, expectations, and perspective in the aftermath of a life-altering, disabling injury. The high level of subjective well-being appears paradoxical when viewed from the perspective of the non-disabled, who presume that those with severe disabilities experience a quality of life so poor that it might (...) make their lives not worth living. This presumption has profound consequences, for it may inform end-of-life choices made in advance directives, or influence decisions made by surrogates on behalf of persons who are unable to direct their own medical treatment. -/- Peterson et al propose a cautious, well-considered plan to use fMRI-based brain-computer interfaces to assess the decision making capacity of covertly aware, behaviorally non-responsive individuals who retain high levels of preserved cognition. Their plan, if it succeeds, could eventually restore autonomy and empower some severely disabled persons, allowing them to participate in clinical decision making. Peterson et al discuss possible in-principle objections to their proposal, among them the “argument from psychological health,” and the “changing sets of values” objection. These objections both presume that deviations from a pre-injury norm could indicate diminished decision making capacity. This presumption threatens the autonomy of the patient who is capable of making decisions, but whose post-injury decisions appear to diverge from pre-injury preferences or values. In light of the potential for response shift, and the disability paradox, it should not be inferred that changes in values or preferences are unreflective of the true current preferences of a brain-injured person, nor are they conclusive evidence of diminished capacity. Presuming diminished capacity on the basis of unexpected or unconventional preferences has, in the past, been used to disempower patients whose autonomy and capacity would not have been doubted had they made choices that accorded with the expectations or values of others. We must be cautious, and vigilant, to prevent similarly diminishing the autonomy of covertly aware, behaviorally non-responsive individuals on the basis of empirically and ethically questionable inferences about their decision making capacity. (shrink)

Concussion is a common, serious injury in youth ice hockey, affecting up to 25% of players per season by one estimate. • Bodychecking is a major cause of injury and concussion in hockey, yet some Canadian provinces allow players as young as nine years to engage in bodychecking. • Reducing rates of concussion requires eliminating bodychecking for all except elite hockey players aged 16 years and older, as per the recommendations of the Canadian Academy of Sports and Exercise Medicine.

A pressing issue in neuroscience is the high rate of misdiagnosis of disorders of consciousness. As new research on patients with disorders of consciousness has revealed surprising and previously unknown cognitive capacities, the need to develop better and more reliable methods of diagnosing these disorders becomes more urgent. So too the need to expand our ethical and social frameworks for thinking about these patients, to accommodate new concerns that will accompany new revelations. A recent study on trace conditioning and learning (...) in vegetative and minimally conscious patients shows promise as a potential diagnostic and prognostic tool, both for differentiating between states of diminished consciousness, and for predicting patient outcomes, but it also generates fresh concerns about quality of life in patients previously thought to be completely unaware. Optimism about progress in diagnosing and treating disorders of consciousness must be tempered by the understanding that not all progress will necessarily be good for all patients. The prognosis for most patients remains bleak, and we must remain vigilant to acute questions and concerns about welfare and quality of life. (shrink)

In December 2013, the Nonhuman Rights Project (NhRP) filed a petition for a common law writ of habeas corpus in the New York State Supreme Court on behalf of Tommy, a chimpanzee living alone in a cage in a shed in rural New York (Barlow, 2017). Under animal welfare laws, Tommy’s owners, the Laverys, were doing nothing illegal by keeping him in those conditions. Nonetheless, the NhRP argued that given the cognitive, social, and emotional capacities of chimpanzees, Tommy’s confinement constituted (...) a profound wrong that demanded remedy by the courts. Soon thereafter, the NhRP filed habeas corpus petitions on behalf of Kiko, another chimpanzee housed alone in Niagara Falls, and Hercules and Leo, two chimpanzees held in research facilities at Stony Brook University. Thus began the legal struggle to move these chimpanzees from captivity to a sanctuary, an effort that has led the NhRP to argue in multiple courts before multiple judges. The central point of contention has been whether Tommy, Kiko, Hercules, and Leo have legal rights. To date, no judge has been willing to issue a writ of habeas corpus on their behalf. Such a ruling would mean that these chimpanzees have rights that confinement might violate. Instead, the judges have argued that chimpanzees cannot be bearers of legal rights because they are not, and cannot be persons. In this book we argue that chimpanzees are persons because they are autonomous. (shrink)

The minimally conscious state presents unique ethical, legal, and decision-making challenges because of the combination of diminished awareness, phenomenal experience, and diminished or absent comm...

The American Journal of Bioethics, Volume 11, Issue 10, Page 9-10, October 2011.

Currently, there are many advocacy interventions aimed at reducing animal consumption. We report results from a lab (N = 267) and a field experiment (N = 208) exploring whether, and to what extent, some of those educational interventions are effective at shifting attitudes and behavior related to animal consumption. In the lab experiment, participants were randomly assigned to read a philosophical ethics paper, watch an animal advocacy video, read an advocacy pamphlet, or watch a control video. In the field experiment, (...) we measured the impact of college classes with animal ethics content versus college classes without animal ethics content. Using a pretest, post-test matched control group design, humane educational interventions generally made people more knowledgeable about animals used as food and reduced justifications and speciesist attitudes supporting animal consumption. None of the interventions in either experiment had a direct, measurable impact on self-reported animal consumption. These results suggest that while some educational interventions can change beliefs and attitudes about animal consumption, those same interventions have small impacts on animal consumption. (shrink)

We submit this brief in support of the Nonhuman Rights Project’s efforts to secure habeas corpus relief for the elephant named Happy. We reject arbitrary distinctions that deny adequate protections to other animals who share with protected humans relevantly similar vulnerabilities to harms and relevantly similar interests in avoiding such harms. We strongly urge this Court, in keeping with the best philosophical standards of rational judgment and ethical standards of justice, to recognize that, as a nonhuman person, Happy should be (...) released from her current confinement and transferred to an appropriate elephant sanctuary, pursuant to habeas corpus. (shrink)

In this brief, we argue that there is a diversity of ways in which humans (Homo sapiens) are ‘persons’ and there are no non-arbitrary conceptions of ‘personhood’ that can include all humans and exclude all nonhuman animals. To do so we describe and assess the four most prominent conceptions of ‘personhood’ that can be found in the rulings concerning Kiko and Tommy, with particular focus on the most recent decision, Nonhuman Rights Project, Inc v Lavery.

We submit this brief in support of the Nonhuman Rights Project’s efforts to secure habeas corpus relief for the elephant named Happy. The Supreme Court, Bronx County, declined to grant habeas corpus relief and order Happy’s transfer to an elephant sanctuary, relying, in part, on previous decisions that denied habeas relief for the NhRP’s chimpanzee clients, Kiko and Tommy. Those decisions use incompatible conceptions of ‘person’ which, when properly understood, are either philosophically inadequate or, in fact, compatible with Happy’s personhood.

Knowledge of human uses of animals is an important, but understudied, aspect of how humans treat animals. We developed a measure of one kind of knowledge of human uses of animals – knowledge of factory farming. Studies 1 (N = 270) and 2 (N = 270) tested an initial battery of objective, true or false statements about factory farming using Item Response Theory. Studies 3 (N = 241) and 4 (N = 278) provided evidence that responses to a 10-item Knowledge (...) of Factory Farming Scale predicted a reduction in consumption of animal products (rs = −.17- −.27) and approval of political actions aimed at factory farming (rs = .2 – .24). Path models from Studies 3 and 4 suggested that different kinds of knowledge uniquely predicted different outcomes. The Knowledge of Factory Farming scale was a unique predictor of approval of political actions concerning factory farmed animals but not animal consumption. Knowledge of Animals Used as Food predicted animal consumption but not political actions concerning farmed animals. These results highlight that different kinds of knowledge can be relevant for different animal related outcomes. (shrink)

In this chapter we consider the theories of embodied cognition and extended mind with respect to the human ability to engage in numerical cognition. Such an enquiry requires first distinguishing between our innate number sense and the sort of numerical reasoning that is unique to humans. We provide anthropological and linguistic research to defend the thesis that places the body at the center of our development of numerical reasoning. We then draw on archaeological research to suggest a rough date for (...) when ancient humans first were able to represent numerical information beyond the body and in enduring material artifacts. We conclude by briefly describing how these capacities for embodied and extended numerical cognition shaped our world. (shrink)

Moving effortlessly between symbolist poetry and Barbie dolls, artificial intelligence and Kleist, Kant, and Winnicott, Barbara Johnson not only clarifies ...

How can a God of love also be a God of wrath? There's a lot of confusion today about God's character. It is all too easy to rely on cheap caricatures rather than rich truth. From the Cosmic Cop to the Benevolent Grandfather, Syd Brestel debunks the common misconceptions about God and shows you a picture of a God who is complex, just, severe, kind, and more worthy of our love than we ever knew. God in His Own Image explores (...) the tension between what Paul called in Romans "the kindness and severity of God." Without giving cheap answers or quick solutions, Brestel will have you not only tolerating God's wrath, but celebrating it along with God's kindness. If you've ever wondered what to do with God's judgements, are trying to explain God's wrath to others, or are exploring who God really is, God in His Own Image was written for you. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Negotiating Maternal IdentityAdrienne Rich’s Legacy for Inquiry into the Political-Philosophical Dimensions of Pregnancy and ChildbirthCandace JohnsonGiving birth has been described as the crossing of an imaginary threshold, which separates an independent maternal self from some sort of dual or subordinate existence. The metaphor of a border has also been employed to demonstrate this transformation, which may be liberating, oppressive, or some complex combination thereof (Weir 2006; Martinez 2004). What (...) happens, in psychic and sociopolitical terms, in the journey across this border? Can a woman, as an independent, autonomous being, preserve her identity, her selfhood as a mother? Is the transition to motherhood an expression of culture or nature? The answers to these questions are infinitely complex, yet are at the core of philosophical, political, and personal explorations of the maternal. Central to these explorations are academic critiques and personal responses to the biomedical mediation of the transition to motherhood. For some women, medical intervention in pregnancy and childbirth is inherently oppressive, whereas for other women such intervention is a marker of privilege. In a groundbreaking volume published in 1998, Margaret Lock and Patricia Kaufert argue that women respond to different biomedical interventions in pragmatic ways, which reflect their lived experiences. They claim that “it is more appropriate to understand women’s responses in medical settings as reflecting their daily experiences as part of a domestic group, a community, or a society” (19). [End Page 65]I would like to advance this analysis by suggesting that women respond to biomedical intervention in pregnancy and childbirth in ways that reflect not simply their practical needs and realities, but important details about inequality and identity. Women’s relative degrees of power and agency in society are expressed through their preferences for care during pregnancy and childbirth. In addition, and in connection with the (structural) dynamics of inequality, these preferences reflect the complexities of shifting, negotiated, maternal identities. In order to consider the ways in which women negotiate maternal identity through their preferences concerning care during pregnancy and childbirth, I will examine the contributions of Adrienne Rich, which effectively serve as the foundation for this and countless other areas of women’s and gender studies. In Of Woman Born, Rich dedicates two full chapters to childbirth, and explains in these chapters that the institution of childbirth has come to dominate and eclipse women’s experiences. Moreover, the patriarchal circumscription of childbirth is reinforced by the isolation of childbirth (and motherhood) from other life events. Rich demonstrates these problems through the metaphor of “giving birth to oneself ” (29), which has (at least) two distinct meanings: self actualization and self replacement.My investigation into these meanings will include an examination of Rich’s philosophical treatment of pregnancy and childbirth and an assessment of the sociopolitical implications of both conceptions of “giving birth to oneself.” I will then subject these conceptions to empirical testing, as Rich insists. Such empirical testing is crucial because the social and political dimensions of the institutions of childbirth and motherhood are complex and differ from one context to the next. Rich explains that[t]o hold power over others means that the powerful is permitted a kind of short-cut through the complexity of human personality. He does not have to enter intuitively into the souls of the powerless, or to hear what they are saying in their many languages, including the language of silence. Colonialism exists by virtue of this short-cut—how else could so few live among so many and understand so little?(65)This essay will avoid a similar shortcut often taken by theorists, which builds philosophical arguments without empirical support. The empirical cases to be considered in the context of philosophical debate include Canada, Honduras, and Cuba, and details of each case will be drawn from extensive interview data from a larger empirical study.1 In the Canadian context, resistance to the constraining effects of motherhood as institution is reduced to resistance to medical regulation of pregnancy and childbirth. The benefit indicated by this resistance is that women have found ways to expand their range of options and reinterpret the birthing event, thereby integrating it into other realms [End Page 66... (shrink)

Patterned after Strunk and White's classic The Elements of Style , this handy reference concisely summarizes the substantial existing research on the delicate balance of professional ethics. Johnson and Ridley reduce the wealth of published material on the topic to the seventy-five most important and pithy truths for supervisors in all fields. These explore questions of integrity, loyalty, justice, respect, and delivering one's best in the business environment. Succinct and comprehensive, this is a must-have for any professional or business (...) leader striving to create an ethical workplace. (shrink)

Using path-breaking discoveries of cognitive science, Mark Johnson argues that humans are fundamentally imaginative moral animals, challenging the view that morality is simply a system of universal laws dictated by reason. According to the Western moral tradition, we make ethical decisions by applying universal laws to concrete situations. But Johnson shows how research in cognitive science undermines this view and reveals that imagination has an essential role in ethical deliberation. Expanding his innovative studies of human reason in Metaphors (...) We Live By and The Body in the Mind, Johnson provides the tools for more practical, realistic, and constructive moral reflection. (shrink)

Is it ethical to treat a death row inmate only to stabilize him or her for eventual execution? What happens when a military provider receives highly sensitive intelligence from a client? How can clinicians refuse costly gifts from clients without damaging the therapeutic relationship? Should a therapist disclose a client's suicidal intent to the authorities? In Ethical Conundrums, Quandaries and Predicaments in Mental Health Practice, these and other real-life scenarios constitute a comprehensive and definitive ethics casebook for mental health professionals. (...) Inspired by the many difficult situations they themselves have faced, an eminent group of accomplished mental health clinicians provide first-hand accounts of ethical problems that defy boilerplate solutions. Each chapter begins with a compelling and ethically complex case followed by an illustrative yet succinct analysis of the key ethical issues present and a personal reflection on the case itself, along with the process of ethical reasoning used to arrive at a final decision. Every case concludes with key recommendations for promoting ethical practice within an often challenging work setting. Highlighting the human aspect of ethics in mental health practice through the use of mesmerizing narratives while also provoking the reader to reflect upon what is the "right" thing to do, Ethical Conundrums, Quandaries and Predicaments in Mental Health Practice offers trainees and seasoned professionals alike invaluable informative models for dealing with ethical dilemmas, as well as the inspiration to confront seemingly insurmountable clinical problems. (shrink)