By applying classical and contemporary insights of the phenomenological tradition to key findings within the literature on stereotype threat, this paper considers the embodied effects of everyday exposure to racism and makes a contribution to the growing field of applied phenomenology. In what follows, the paper asks how a phenomenological perspective can both contribute to and enrich discussions of ST in psychology. In answering these questions, the paper uses evidence from social psychology as well as first personal testimonies from members (...) of marginalized groups to argue that subjectively experienced racial oppression is embodied and thus has effects on selfhood that are harmful. More specifically, it makes the case that what are most often considered to be temporary or context-based consequences of ST are in fact more wide reaching and harmful than assumed in that the harms that result from suffering ST become a part of one’s identity, and thus a background lens through which one experiences the world. (shrink)

For a variety of reasons, it's difficult to determine, with any accuracy, the number of trans and gender nonbinary folks living in the United States.1 Data are difficult to obtain since neither the U.S. Census Bureau nor the Centers for Disease Control and Prevention survey people's gender identity. But even if they did, responses would likely be unreliable. Many members of these two groups are hesitant to answer such questions for fear of their safety, resulting discrimination, or because they disagree (...) on the definition of what it means to be transgender. It's also difficult to obtain accurate numbers on these groups since most medical forms still rely on a two-sex system of... (shrink)

The past five years have seen a dramatic increase in scholars working to supplement or challenge accounts of structural injustice. Almost without exception, scholars in this area assume that the move from personal responsibility to political or public responsibility will represent a net gain in justice, at least in modern liberal regimes. In this essay, I challenge this assumption and introduce the concept of “structural hobbling” as a parallel cause of injustice, but one whose origins derive from neutral state activities (...) rather than from intentional bad faith or diffuse private action (as in structural injustice). Using health-care regulations as a lens, I offer two narratives of individuals navigating health-care regulations that demonstrate how seemingly neutral regulatory decisions create regressive hobbling effects. Structural hobbling challenges structural-injustice theorists to take more seriously the complex and often subtle ways in which apparently benevolent state activity can create downstream injustice, while adding complexity to existing narratives around public responsibility and what it demands. (shrink)

John Nolt offers a helpful, albeit rough quantitative analysis of the harmfulness of the average American's greenhouse gas emissions. By examining the lifetime contributions of the average American...

Discussions of harm are central in the climate ethics literature. Especially in the rapidly emerging body of work addressing the question of whether or not individuals are morally responsible for their greenhouse gas (GHG) emissions, whether or in what way individuals’ emissions are harmful is a hotly debated question. John Nolt’s recent paper, “How harmful are the average American’s greenhouse gas emissions?” illustrates the prevalence of this framing (Nolt 2011). Here I take a step back and ask what we mean (...) by the concept “harmful” when talking about climate change. I argue, as several respondents to Nolt have suggested (e.g., Attfield 2011, Odenbaugh 2011), that we should not be so quick to apply our standard .. (shrink)

This article draws attention to the ethical complexity researchers may be confronted with during fieldwork should an adult participant with intellectual disabilities disclose that harm or an illegal activity is occurring or has occurred in the past. The need to gain ethical approval and the positioning of people with intellectual disabilities as vulnerable within ethics review procedures can result in the adoption of paternalistic approaches as researchers are encouraged to break confidentiality to report concerns to other professionals. Whilst this may (...) fulfil a researcher’s duty to ensure no harm occurs to participants, if it takes place against the participant’s wishes it may also violate participant autonomy, reinforce unequal relations of power, and may unwittingly contribute to subsequent harm occurring. Whilst the article begins from our experience as two UK-based researchers working with people with intellectual disabilities, it draws on existing literature and guidelines to expose the ethical tensions which may be encountered. It is intended that the paper acts as a starting point for researchers wishing to reflect on their practice and ethical decision-making, whilst contributing to wider debates on the position of people with intellectual disabilities within society. (shrink)

In this article, we analyse the novel case of Phoenix, a non-binary adult requesting ongoing puberty suppression to permanently prevent the development of secondary sex characteristics, as a way of affirming their gender identity. We argue that the aim of OPS is consistent with the proper goals of medicine to promote well-being, and therefore could ethically be offered to non-binary adults in principle; there are additional equity-based reasons to offer OPS to non-binary adults as a group; and the ethical defensibility (...) of facilitating individual requests for OPS from non-binary adults also depends on other relevant considerations, including the balance of potential benefits over harms for that specific patient, and whether the patient’s request is substantially autonomous. Although the broadly principlist ethical approach we take can be used to analyse other cases of non-binary adults requesting OPS apart from the case we evaluate, we highlight that the outcome will necessarily depend on the individual’s context and values. However, such clinical provision of OPS should ideally be within the context of a properly designed research study with long-term follow-up and open publication of results. (shrink)

In the United States, sex education is more than just an uncomfortable rite of passage, it's an amorphous curriculum that varies widely based on the politics, experience, resources, and biases of the people teaching it. Most often, it's a train wreck, overemphasizing or underemphasizing STIs, teen pregnancy, abstinence, and consent. In Touchy Subject, philosopher Lauren Bialystok and historian Lisa M. F. Andersen make the case for thoughtful sex education, explaining why it's worth fighting for and which kind most deserves (...) our fight, despite all the inconveniences and compromises along the way. They argue that democratic and humanistic aims can be used to provide the tools to reason about the content and form of sex education. In practice, this amounts to a curriculum that meets what are currently considered highly comprehensive standards, incorporates ethics and civics education, and substantially modifies some aspects of teacher training and school design; it also assigns different responsibilities to different actors inside and outside schools, and it responds to the salient features of young people's evolving worlds, including the inequities that put some students at much higher risk of sexual harm than others. Throughout their inquiry, the authors show the reader how sex education has progressed and how the very concept of "progress" remains contestable. (shrink)

Individuals engage in moral cleansing, a compensatory process to reaffirm one's moral identity, when one's moral self-concept is threatened. However, too much moral cleansing can license individuals to engage in future unethical acts. This study examined the effects of incentives and consequences of one's actions on cheating behavior and moral cleansing. Results found that incentives and consequences interacted such that unethical thoughts were especially threatening, resulting in more moral cleansing, when large incentives to cheat were present and cheating explicitly harmed (...) others. Implications are discussed in terms of ethics training, using incentives as motivators, and the depersonalized norms of science. (shrink)

This chapter examines medical privacy issues presented by surveillance capitalism outside the legally confidential clinical context. Working with family resemblance accounts of privacy, I argue that for-profit medical data commodification practices, including data collection, aggregation, predictive modeling, and sale, undermine informational and decisional medical privacy without sufficient justification. Although some privacy infringements may be justifiable with voluntary informed consent, for medical research or to prevent significant and likely harm to public health, for-profit data commodification practices do not usually serve the (...) public interest, and meaningful voluntary informed consent usually is not obtained. These privacy infringements expose people to a number of harms, including chilling effects, emotional distress, intrusive targeted advertising, manipulation, decisional interference, and in some cases, legal repercussions, particularly in the wake of the Dobbs decision. I conclude by calling for improved legal and technical privacy protections, transparent privacy policies, and the minimization of unnecessary medical data collection. (shrink)

The effects of the present COVID-19 crisis transcend national and social borders, requiring all of us to adapt to ever-changing, unprecedented circumstances. While in some respects these experiences are shared, the impact of the crisis has been disproportionately harmful for those who were already socially vulnerable: low-income people and workers who are precariously employed, people with disabilities and chronic health issues, unhoused people, people who depend on now-defunct public services, and, as will be the focus of this paper, incarcerated people.In (...) response to the pandemic, state, local, and federal governments have enacted policies that would be politically unthinkable in normal circumstances. The US... (shrink)

Microaggressions in Medicine demonstrates that the harms of microaggressions are anything but micro. Guided by diverse patient testimonies and case studies, the book focuses on harms experienced by patients who are marginalized on the basis of race, gender, sexual orientation, body size, and disability. It amplifies their voices, stories, and experiences, which have too often been excluded from mainstream bioethical, medical, and popular discussions. The novel account advanced in Microaggressions in Medicine illustrates that microaggressions in medicine are not (...) rare, but frequent in the healthcare experiences of marginalized patients. Our hope is that the book helps patients better understand and make sense of... Read More. (shrink)

To call attention to and motivate action on ethical issues in business or society, messengers often criticize groups for wrongdoing and ask these groups to change their behavior. When criticizing target groups, messengers frequently identify and express concern about harm caused to a victim group, and in the process address a target group by criticizing them for causing this harm and imploring them to change. However, we find that when messengers criticize a target group for causing harm to a victim (...) group in this way—expressing _singular concern_ for the victim group—members of the target group infer, often incorrectly, that the messenger views the target group as less moral and unworthy of concern. This inferred lack of moral concern reduces criticism acceptance and prompts backlash from the target group. To address this problem, we introduce _dual concern_ messaging—messages that simultaneously communicate that a target group causes harm to a victim group and express concern for the target group. A series of several experiments demonstrate that dual concern messages reduce inferences that a critical messenger lacks moral concern for the criticized target group, increase the persuasiveness of the criticism among members of the target group, and reduce backlash from consumers against a corporate messenger. When pursuing justice for victims of a target group, dual concern messages that communicate concern for the victim group _as well as_ the target group are more effective in fostering openness toward criticism, rather than defensiveness, in a target group, thus setting the stage for change. (shrink)

Background There is ongoing debate regarding whether and under which circumstances secondary findings (SF) should be offered in the pediatric context. Although studies have examined patient perspectives on receiving SF, little research has been conducted examining the experiences of clinicians offering SF to parents of newborns receiving genomic sequencing for a recently diagnosed medical condition.Methods To address this, we conducted qualitative interviews exploring the views and experiences of 12 clinicians who offered SF to parents of infants who had diagnostic exome (...) sequencing (ES) to identify the cause of their hearing loss. Interviews explored clinicians’ accounts of parents’ choices and decision-making about receiving SF, their views on whether and when to offer SF, their experiences returning SF, and any ethical challenges they encountered. Interviews were audio-recorded, transcribed and analyzed using inductive content analysis.Results Clinicians reported parents who declined all SF often felt finding out about future conditions unrelated to their child’s hearing loss may be unhelpful, or even harmful, or were overwhelmed by their child’s diagnosis. Clinicians also reported that some parents chose SF because they felt obliged to, even if they did not want to receive them. They explained that while some parents experienced decision-making regarding SF as positive, for others, this process was challenging or distressing. While clinicians generally agreed SF should be offered, mainly to promote parental choice, most felt SF should be offered after disclosing diagnostic results, primarily to avoid overwhelming parents. Clinicians encountered several ethical challenges, including balancing parental autonomy with non-maleficence, wanting to report or not report certain SF, and questioning whether parents can make an autonomous choice regarding SF.Conclusions Our findings, which are novel as they relate to parents of young infants with a recent diagnosis of hearing loss, add new insights into clinicians’ and parents’ decision-making regarding SF in pediatrics. (shrink)

The complexity of chromium chemistry makes it an ideal example of how the Principle of Expediency, first articulated by sanitary pioneer Earle Phelps, can be used in a standard setting. Expediency, defined by Phelps as “the attempt to reduce the numerical measure of probable harm, or the logical measure of existing hazard, to the lowest level that is practicable and feasible within the limitations of financial resources and engineering skill”, can take on negative connotations unless subject to ethical guidance. In (...) this paper we argue that without ethical principles as a rubric for negotiating environmental regulations, communities run the risk of slipping from the Principle of Expediency as defined by Phelps to the alternative usage of expediency meaning that which does not reflect ethical consideration or concern beyond self-serving interest. Three ethical ideals—justice, mercy and humility—are suggested as values to be considered while resolving regulatory issues related to environmental protection. The Principle of Expediency serves as a working principle, but not as a rigid algorithm, for setting regulatory limits for environmental concentrations of waste products like chromium. (shrink)

This paper argues for analyzing the systematic invisibility of persons living with disabilities by temporalizing their oppression within a framework of “productive time,” which I posit as a normative sense of time by which cultural products and practices appear within capitalist economies. I argue that productive time is employed in cultural evaluations of actions that render persons with disabilities as “non-productive agents” who cannot partake in historical processes. My hope is that a theory of productive time will assist social justice (...) efforts in analyzing the oppression of particular minority groups by identifying and combating harmful social values. (shrink)

Predatory grooming is a form of abuse most familiar from high-profile cases of sexual misconduct, for example, the Nassar case at Michigan State. Predatory groomers target individuals in a systematic effort to lead them into relationships in which they are vulnerable to exploitation. This is an example of a broader form of epistemic misconduct that Leydon-Hardy describes as epistemic infringement, where this involves the contravention of social and epistemic norms in a way that undermines our epistemic agency. In this chapter, (...) Leydon-Hardy looks at the distinctive epistemic harm caused by epistemic infringement. She argues that this harm cannot be understood simply as the victim’s having a false belief, or even as her being alienated from her belief-forming mechanisms. A deeper understanding of the harm caused by infringement shows that it stems from damage to one’s epistemic agency, and indeed, to one’s personhood. (shrink)

This paper reviews the ethical literature on conflicts between health professionals and parents about medical decision-making for children. We present the results of a systematic review which addressed the question ‘when health professionals and parents disagree about the appropriate course of medical treatment for a child, under what circumstances is the health professional ethically justified in overriding the parents’ wishes?’ We identified nine different ethical frameworks that were put forward by their authors as applicable across various ages and clinical scenarios. (...) Each of these frameworks centred on a different key moral concept including harm, constrained parental autonomy, best interests, medically reasonable alternatives, responsible thinking and rationality. (shrink)

The first part of this paper presents a dilemma for arationalism about propaganda. Arationalists hold that propaganda is constitutively reliant on bypassing audience-side rationality. According to the twin pillars of arationalism, then, propaganda is distinguished by the arationalism of audience-side uptake, and criticizable for its circumvention of audience-side rationality. Here, I argue that if the twin pillars of arationalism hold, then arationalists must either deny that bald-faced propaganda is propaganda or deny that bald-faced propaganda is objectionable qua propaganda. Against arationalism, (...) I argue that propagandizing is apt to epistemically infringe on an audience. Propagandizing constitutively involves the systematic contravention of the norms typifying the relationship between communicator and audience, with the characteristic effect of eroding the audience's epistemic agency. The epistemic harm of propaganda is that it has the power to alienate its audience from itself both epistemically and politically by illegitimately constraining what is epistemically possible for its audience. (shrink)

Transparency and openness are frequently praised as vital institutional strategies to foster public trust in science. The expectation is that transparent and open science will be more trusted, either because publics will have access to information about what scientists do or because scientists will behave better under the watchful gaze of others. In this contribution, we challenge this widespread assumption by searching for the downsides of transparency in relation to public trust in science. The question we ask is: could transparency (...) also have unintended negative effects on public trust? First, we consider _theoretical_ treatments of transparency that challenge its status as an absolute value. This analysis highlights the benefits of seclusion and secrecy and the perils of excessive transparency. Next, we turn to the _practice_ of transparency, as enacted via open-science strategies. Open Science is a framework defined by a commitment to openness, sharing and collaboration; effectively, it offers a set of actionable strategies for scientists to be transparent. We examine risks associated with both specific open-science strategies and an Open Science normativity. This allows us to explicate three concrete pathways via which the enactment of transparency could inadvertently harm public trust in science. These pathways indicate that transparency (as enacted via open-science strategies) could fuel 1) well-placed distrust, 2) misplaced trust or 3) misplaced distrust. Eventually, we conclude that the architecture of Open Science needs a conditional and contextual operationalisation of transparency which results in new responsibilities for the scientific community. (shrink)

The precautionary principle states, roughly, that it is better to take precautionary measures now than to deal with serious harms to the environment or human health later on. This paper builds on the work of Neil A. Manson in order to show that the precautionary principle, in all of its forms, is fraught with vagueness and ambiguity. We examine the version of the precautionary principle that was formulated at the Wingspread Conference sponsored by the Science and Environmental Health Network (...) in 1998. That version fails to indicate who must bear the cost of precaution; what constitutes a threat of harm; how much precaution is too much; and what should be done when environmental concerns and concern for human health pull in different directions. Whether this vagueness is a strength or weakness of the principle depends on what purpose(s) the precautionary principle is supposed to serve. (shrink)

I identify a further harm of agential testimonial injustice and explore its implications for epistemically reparative work. The central idea is that within the criminal legal system, the socio-epistemic norms apt to elicit false confessions are widely and deeply held to be predictive of good epistemic outcomes. Thus, many practitioners are poorly epistemically positioned in respect of their culpability/complicity in gross epistemic misconduct. This is significant for some victims of agential testimonial injustice. For false confessors, for instance, there is a (...) further epistemic injury in that those most responsible—and with the greatest power to restore their standing—are among the furthest from the light of truth. This bears on the pursuit of epistemic reparations. Ensconced within epistemically hostile contexts, we might worry that epistemic reparations are out of reach. However, where perpetrators have a perfect duty of epistemic repair, non-perpetrators have imperfect epistemic obligations. Whenever possible, we can and should bear witness. Discharging our imperfect duties may not be ideally restorative. Nevertheless, the reparative value in this work may extend to both victims and perpetrators. It could be that by bearing witness nonculpable agents stand to promote the conditions in which perpetrators begin to reckon with their proper epistemic obligations. If so, then in epistemically hostile contexts, imperfect epistemic duties are all the more compelling. (shrink)

Precaution is usually associated with the intuition that it is better to be safe than sorry, and/or that it is sometimes necessary to act in advance of scientific certainty to prevent harmful outcomes. At this point, we cannot entirely prevent climate change, but we can affect how harmful such change is. Adaptation may therefore be understood as a precautionary measure against the damage due to climate change. 'The' precautionary principle alone is too vague to shape adaptation policy, but a limited (...) catastrophic precautionary principle may productively guide adaptation policy makers. I argue in this paper that an explicit commitment to a precautionary approach based on the catastrophic precautionary principle could and should be made to strengthen the adaptation policies introduced at the United Nations Framework Convention on Climate Change (UNFCCC). (shrink)

Curbside ethics consultations occur when an ethics consultant provides guidance to a party who seeks assistance over ethical concerns in a case, without the consultant involving other stakeholders, conducting his or her own comprehensive review of the case, or writing a chart note. Some have argued that curbside consultation is problematic because the consultant, in focusing on a single narrative offered by the party seeking advice, necessarily fails to account for the full range of moral perspectives. Their concern is that (...) any guidance offered by the ethics consultant will privilege and empower one party’s viewpoint over—and to the exclusion of—other stakeholders. This could lead to serious harms, such as the ethicist being reduced to a means to an end for a clinician seeking to achieve his or her own preferred outcome, the ethicist denying the broader array of stakeholders input in the process, or the ethicist providing wrongheaded or biased advice, posing dangers to the ethical quality of decision-making. Although these concerns are important and must be addressed, we suggest that they are manageable. This paper proposes using conflict coaching, a practice developed within the discipline of conflict management, to mitigate the risks posed by curbside consultation, and thereby create new spaces for moral discourse in the care of patients. Thinking of curbside consultations as an opportunity for clinical ethics conflict coaching can more fully integrate ethics committee members into the daily ethics of patient care and reduce the frequency of ethically harmful outcomes. (shrink)

Despite their benevolent intent, health-care delivery organizations often cause harm. While some harms are unavoidable in the course of doing business— and are perhaps morally justified—other harms constitute organizational wrongs, which are never justifiable. When a health-care delivery organization acts wrongly, the organizational wrong imbues individual employees with a responsibility to mitigate those wrongs. This article explores the question of individual responsibility in relationship to organizational wrongs and proposes strategies that complicit individuals can adopt to mitigate organizational wrongs.

ObjectiveMedical-Legal Partnerships (MLPs) integrate attorneys into health care settings to provide free legal care for low-income families. Our objective was to explore MLP client experiences of a neonatal MLP integrated into a neonatal intensive care unit and fetal care program.Study DesignWe used a qualitative descriptive inquiry methodological approach to conduct interviews with clients of the neonatal MLP clients. Interviews were conducted via telephone, recorded, and transcribed. We conducted a reflexive thematic analysis of the data.ResultsSixteen neonatal MLP clients completed qualitative interviews. (...) We found that MLPs may facilitate supportive, holistic, and interdisciplinary care that mitigates parental distress and addresses structural barriers to family stability. The program would be improved with more transparency, capacity, and visibility.ConclusionMedical-Legal Partnerships offer an innovative strategy to address social determinants with legal implications that impact the health and well-being of neonatal intensive care unit and fetal care therapy patients and families. (shrink)

Ethical issues arise in the world’s first population-level treatment of severe lead poisoning caused by small-scale mining for gold in rural Nigeria. Emergency medical intervention and environmental cleanup have reduced the mortality in children younger than 5 years from lead poisoning from over 40 to 2.5 per cent leaving little evidence of the harms caused by lead poisoning. In the absence of obvious sequelae, family adherence to long-term intensive therapy to remove accumulated lead reservoirs in children wanes and some (...) community miners challenge safer mining interventions to prevent recontamination of the environment with lead. This letter raises questions regarding community versus individual rights in public health interventions and patient autonomy. (shrink)

From aggressive billing practices to neglectful or discriminatory care, news stories about the misconduct of healthcare organizations abound. Yet there has been limited ethical scrutiny of hospitals and other healthcare organizations in the bioethics literature. In this paper, we explore what philosophy and organizational theory can offer in terms of concepts for articulating the obligations of healthcare organizations, specifically hospitals. We highlight how the concepts of institutional agency and responsibility, administrative harms and burdens, and communicative blame provide theoretical resources (...) that can help bioethics get closer to a more robust organizational ethics. We advance two claims: first, these concepts help us make sense of how hospitals or healthcare organizations—not just individuals and the broader systems they operate within—can be morally responsible or blameworthy. Second, critical reflection on these concepts as they apply to several historical examples suggest some prima facie obligations of organizations that provide patient care. (shrink)

A proposed state administrative rule would have required medical ethicists to approve certain aspects of gender-affirming care. The authors argue the proposed rule lacked appropriate justification compared to other instances of state-mandated ethics oversight and would undermine trust, raise practical challenges, and send harmful messages to society, patients, and providers.

This study is focused on unsustainable agri-food systems, especially intensive livestock farming and its resulting environmental harms. Specifically we focus on the development of technologies that seek to mitigate these environmental harms. These technologies are generally developed as incremental innovations in response to government regulation. Critics of these technological solutions allege that these developments legitimate unsustainable food production systems and are incapable of supporting agri-food systems transformation. At the same time, technology developers and other actors seek to present (...) these technologies as the legitimate solution to agri-environmental harms. Our study seeks to explore the perceptions and constructions of legitimacy for technologies that are developed to reduce ammonia emissions in intensive livestock farming in Flanders (Belgium). We use a qualitative case study, employing semi-structured interviews and workshops, with technology developers of ammonia-emission reducing technologies and stakeholders in the intensive livestock farming industry in Flanders. What our study shows is that technologies developed to reduce emissions are dependent on regulative legitimacy. The normative and cognitive legitimacy of these technologies is lacking, both due to ties to the intensive livestock industry and due to uncertainty over the performance of these technologies. With the delegitimation of intensive livestock farming, the legitimacy of these technologies is also under threat. In response, technology developers are looking to (re-)construct this legitimacy through knowledge claims over the performance of their technologies. We show several ways for other actors to deal with this, centred on either re-legitimising technologies to maintain the status quo, or to contest these knowledge claims and use them to disrupt path dependencies. (shrink)

Aims and hypothesesIn an environment of absolute silence, researchers have found many of their participants to perceive phantom sounds. With this between-subject experiment, we aimed to elaborate on these research findings, and specifically investigated whether–in line with the fear-avoidance model of tinnitus perception and reactivity–fear or level of perceived threat influences the incidence and perceptual qualities of phantom sound percepts in an anechoic room. We investigated the potential role of individual differences in anxiety, negative affect, noise sensitivity and subclinical hearing (...) loss. We hypothesized that participants who experience a higher level of threat would direct their attention more to the auditory system, leading to the perception of tinnitus-like sounds, which would otherwise be subaudible, and that under conditions of increased threat, narrowing of attention would lead to perceptual distortions.MethodsIn total, N = 78 normal-hearing volunteers participated in this study. In general, the study sample consisted of young, mostly female, university students. Their hearing was evaluated using gold-standard pure tone audiometry and a speech-in-noise self-test, which is a sensitive screening test to identify subclinical hearing loss. Prior to a four-minute stay in an anechoic room, we randomized participants block design-wise in a threat and no-threat condition. Participants in the threat condition were deceived about their hearing and were led to believe that staying in the room would potentially harm their hearing temporarily. Participants were asked whether they perceived sounds during their stay in the room and rated the perceptual qualities of sound percepts. They were also asked to fill-out standardized questionnaires measuring anxiety, affect and noise sensitivity. The internal consistency of the questionnaires used was verified in our study sample and ranged between α = 0.61 and α = 0.90.ResultsIn line with incidence rates reported in the literature, 74% of our participants reported having heard tinnitus-like sounds in the anechoic room. Speech-in-noise identification ability was comparable for both groups of participants. The experimental manipulation of threat was proven to be effective, as indicated by significantly higher scores on a Threat Manipulation Checklist among participants in the threat condition as compared to those in the no-threat condition. Nevertheless, participants in the threat condition were as likely to report tinnitus percepts as participants in the no-threat condition, and tinnitus percepts were not rated as being louder or more unpleasant as a function of level of threat. For participants who did experience tinnitus percepts, a higher level of threat was associated with a higher degree of experienced unpleasantness. These associations were absent in those who did not experience tinnitus. Higher negative affect was only slightly associated with higher ratings of tinnitus unpleasantness.ConclusionWhereas our threat manipulation was successful in elevating the level of fear, it did not contribute to a higher percentage of participants perceiving tinnitus-like sounds in the threat condition. However, higher levels of perceived threat were related to a higher degree of perceived tinnitus unpleasantness. The findings of our study are drawn from a rather homogenous participant pool in terms of age, gender, and educational background, challenging conclusions that are applicable for the general population. Participants generally obtained normophoric scores on independent variables of interest: they were low anxious, low noise-sensitive, and there was little evidence for the presence of subclinical hearing loss. Possibly, there was insufficient variation in scores to find effects. (shrink)

The plight of women who kill their abuser was a key driver in abolishing provocation and introducing loss of control. However, it is increasingly documented that the partial defence to murder continues to aid violent men, while failing to assist abused women. Applying Nedelsky’s concept of relational autonomy, analysis of 117 appeal cases provides valuable insight into why reform aims have not been realised. Drawing upon intimate partner and familial abuse cases we explore how, in contrast to Nedelsky’s mobilisation, judicial (...) interpretation allows relationality to be ‘weaponised’ in ways which undermine statutory reform, perpetuating gendered injustice. To conclude, we argue that Nedelsky’s relational approach necessitates the implementation of an ethical interpretative framework which acknowledges the gendered harms of the past. We introduce the notion of ‘recuperated relationality’ to highlight the need to reclaim relationality so that it can be ethically mobilised to foster a more progressive interpretation to gendered violence. (shrink)

In Microaggressions in Medicine (2024), Lauren Freeman and Heather Stewart raise many philosophical issues undermining, and practical advice for improving, the practice of medicine. Here I offer some thoughts specifically on chapter 4, "Epistemic Microaggressions."Epistemic microaggressions "pertain to our status as knowers" and are "defined as intentional or unintentional verbal or gestural slights made by healthcare professionals that dismiss, ignore, or otherwise fail to recognize knowledge claims made by patients" (Freeman and Stewart 2024, 98). Note that intention is irrelevant; (...) only the impact of how the harm befalls the patient is the focus here. Could there be extenuating circumstances for any particular... Read More. (shrink)

Lauren Freeman and Heather Stewart (2024) have written a richly researched and argued, while also highly engaging and accessible, book with Microaggressions in Medicine. They argue for why microaggressions are best understood on a harm-based account and situate this view within timely examples from a range of healthcare experiences. In their view, focusing on the harms produced by microaggressions shifts the locus of concern from the agent committing a microaggression to the agent receiving it, and it enables an (...) attribution of a microaggression regardless of an agent's intent or even awareness.Freeman and Stewart leave the reader with an expanded understanding of what microaggressions are and how they function.... Read More. (shrink)

Why do we labour so hard to sustain relationships that are fundamentally harmful to our wellbeing? That is the question which lies at the heart of Maja Borg’s poetic and alternatively distributed documentary film, Future My Love. The detrimental bonds on which the film focuses are those that maintain our connection to an economic system that has thrown us into an acute state of crisis and the stillborn emotions that keep us hopefully attached to a romantic partnership that we have (...) already outgrown; this elision imbricates and implicates the personal in the political. Through a prism of painful and, at times, unbearable emotion, and by blurring the boundaries between the public and the private, the real and the fictional, this film urges us to imagine ourselves into a future in which it might be possible to live otherwise; but this requires us to abandon the future we have already imagined and, as the film evinces through archival imagery from the 1950s or golden age of capitalism, imaged ourselves into. By drawing on the work of Lauren Berlant and Sara Ahmed on the cultural politics of emotion, Judith Butler’s work on the act of mourning, and the writing of Eva Illouz, Luce Irigaray and Alain Badiou on love in the age of late capitalism, this article contends that Future My Love pleads with us to abandon, in Ahmed’s words, ‘happiness for life’, to forsake an ideology that is invested in a highly specific notion of what it means to flourish and to thrive, to mourn and name our losses, and to think about the future creatively and without cynicism. (shrink)

I commend Lauren Freeman and Heather Stewart for acknowledging that the final chapter of Microaggressions and Medicine (2024), chapter 7, which provides practical guide for healthcare workers to avoid committing microaggressions, is a work in progress. The authors primarily focus on "strategies that can be implemented on the interpersonal and environmental levels because this is where we can all immediately make the most impact to reduce microaggressions and their harmful consequences" (189). Presumably, readers of Microaggression and Medicine will by (...) and large be healthcare workers: physicians, nurses, and allied health professionals working in direct patient care settings, and presumably these individuals pick up... Read More. (shrink)

In the last two decades few topics in philosophy of science have received as much attention as mechanistic explanation. A significant motivation for these accounts is that scientists frequently use the term “mechanism” in their explanations of biological phenomena. While scientists appeal to a variety of causal concepts in their explanations, many philosophers argue or assume that all of these concepts are well understood with the single notion of mechanism. This reveals a significant problem with mainstream mechanistic accounts– although philosophers (...) use the term “mechanism” interchangeably with other causal concepts, this is not something that scientists always do. This paper analyses two causal concepts in biology–the notions of “mechanism” and “pathway”–and how they figure in biological explanation. I argue that these concepts have unique features, that they are associated with distinct strategies of causal investigation, and that they figure in importantly different types of explanation. (shrink)

Slurring language has had a lot of recent interest, but the focus has been almost exclusively on racial slurs. Gendered pejoratives, on the other hand—terms like “slut,” “bitch,” or “sissy”—do not fit into existing accounts of slurring terms, as these accounts require the existence of neutral correlates, which, I argue, these gendered pejoratives lack. Rather than showing that these terms are not slurs, I argue that this challenges the assumption that slurs must have neutral correlates, and so that a new (...) approach to thinking about the meaning of slurring terms is required. (shrink)

In this paper, I identify a form of epistemic insensitivity that occurs when someone fails to make proper use of the epistemic tools at their disposal in order to bring their beliefs in line with epistemically relevant evidence that is available to them. I call this kind of insensitivity agential insensitivity because it stems from the epistemic behavior of an individual agent. Agential insensitivity can manifest as a failure to either attend to relevant and available evidence, or appropriately interpret evidence (...) that is attended to. The concept of agential insensitivity allows us to conceptualize the kind of not-knowing involved in forms of ignorance that are cultivated and maintained by individual agents, especially when this ignorance is enabled or encouraged by social structures. I use the skepticism about racial disparities in policing practices that is displayed by many white Americans as a lens for exploring this connection. Understanding agential insensitivity thus provides insight into both social and epistemic phenomena. (shrink)

Kaplan and Craver claim that all explanations in neuroscience appeal to mechanisms. They extend this view to the use of mathematical models in neuroscience and propose a constraint such models must meet in order to be explanatory. I analyze a mathematical model used to provide explanations in dynamical systems neuroscience and indicate how this explanation cannot be accommodated by the mechanist framework. I argue that this explanation is well characterized by Batterman’s account of minimal model explanations and that it demonstrates (...) how relationships between explanatory models in neuroscience and the systems they represent is more complex than has been appreciated. (shrink)

Damon Tweedy is a psychiatrist, lawyer, and writer. He's also Black. While in his first year as a medical student at Duke University, one of his professors approached him in the classroom and asked why the light bulb in the room hadn't been changed, as requested. Tweedy realized that his professor assumed he was a maintenance worker, not a student. Tweedy never took up this incident with the professor, nor did the professor ever apologize. Tweedy recounts that his best "revenge" (...) would be to excel in the class, which he ultimately did. At the end of the semester, upon learning that Tweedy received the second highest grade of over one hundred students, this professor invited him to work as a research assistant in his... (shrink)

Causal selection has to do with the distinction we make between background conditions and “the” true cause or causes of some outcome of interest. A longstanding consensus in philosophy views causal selection as lacking any objective rationale and as guided, instead, by arbitrary, pragmatic, and non-scientific considerations. I argue against this position in the context of causal selection for disease traits. In this domain, causes are selected on the basis of the type of causal control they exhibit over a disease (...) of interest. My analysis clarifies the principled rationale that guides this selection and how it involves both pragmatic and objective considerations, which have been overlooked in the extant literature. (shrink)

When in 2001 Earth Liberation Front activists drove metal spikes into hundreds of trees in Gifford Pinchot National Forest, they were protesting the sale of a section of the old-growth forest to a timber company. But ELF's communiqu on the action went beyond the radical group's customary brief. Drawing connections between the harms facing the myriad animals who make their home in the trees and the struggles for social justice among ordinary human beings resisting exclusion and marginalization, the dispatch (...) declared, "all oppression is linked, just as we are all linked," and decried the "patriarchal nightmare" in the form of "techno-industrial global capitalism." In Total Liberation, David Naguib Pellow takes up this claim and makes sense of the often tense and violent relationships among humans, ecosystems, and nonhuman animal species, expanding our understanding of inequality and activists' uncompromising efforts to oppose it. Grounded in interviews with more than one hundred activists, on-the-spot fieldwork, and analyses of thousands of pages of documents, websites, journals, and zines, Total Liberation reveals the ways in which radical environmental and animal rights movements challenge inequity through a vision they call "total liberation." In its encounters with such infamous activists as scott crow, Tre Arrow, Lauren Regan, Rod Coronado, and Gina Lynn, the book offers a close-up, insider's view of one of the most important--and feared--social movements of our day. At the same time, it shows how and why the U.S. justice system plays to that fear, applying to these movements measures generally reserved for "jihadists"--with disturbing implications for civil liberties and constitutional freedom. How do the adherents of "total liberation" fight oppression and seek justice for humans, nonhumans, and ecosystems alike? And how is this pursuit shaped by the politics of anarchism and anticapitalism? In his answers, Pellow provides crucial in-depth insight into the origins and social significance of the earth and animal liberation movements and their increasingly common and compelling critique of inequality as a threat to life and a dream of a future characterized by social and ecological justice for all. (shrink)