A very clear and powerfully argued defence of a most important and surprisingly neglected view."--Derek Parfit, All Souls College, Oxford. "If Dr. Olson is right, we are living animals and what goes on in our minds is wholly irrelevant to questions about our persistence through time....[Should] transform philosophical thinking about personal identity."--Peter van Inwagen, University of Notre Dame.

In our age of ecological disaster, this book joins the growing philosophical literature on vegetable life to ask how our present debates about biopower and animal studies change if we take plants as a linchpin for thinking about biopolitics. Logically enough, the book uses animal studies as a way into the subject, but it does so in unexpected ways. Upending critical approaches of biopolitical regimes, it argues that it is plants rather than animals that are the forgotten and abjected forms (...) of life under humanist biopower. Indeed, biopolitical theory has consistently sidestepped the issue of vegetable life, and more recently, has been outright hostile to it. Provocatively, Jeffrey T. Nealon wonders whether animal studies, which has taken the "inventor" of biopower himself to task for speciesism, has not misread Foucault, thereby managing to extend humanist biopower rather than to curb its reach. Nealon is interested in how and why this is the case. Plant Theory turns to several other thinkers of the high theory generation in an effort to imagine new futures for the ongoing biopolitical debate. (shrink)

In conventional identity politics subjective differences are understood negatively, as gaps to be overcome, as lacks of sameness, as evidence of failed or incomplete unity. In _Alterity Politics _Jeffrey T. Nealon argues instead for a concrete and ethical understanding of community, one that requires response, action, and performance instead of passive resentment and unproductive mourning for a whole that cannot be attained. While discussing the work of others who have refused to thematize difference in terms of the possibility or impossibility (...) of sameness—Levinas, Butler, Derrida, Foucault, Deleuze, Guattari, Zizek, Jameson, Heidegger, Bakhtin—Nealon argues that ethics is constituted as inexorable affirmative response to different identities, not through an inability to understand or totalize the other. _Alterity Politics_ combines this theoretical itinerary with crucial discussions of specific and diverse sites of literary and cultural production—the work of William S. Burroughs, Amiri Baraka, Andy Warhol, Ishmael Reed, Rush Limbaugh, and Vincent Van Gogh—along with analyses of the social formation of subjects as found in identity politics, and in multicultural and whiteness studies. In the process, Nealon takes on a wide variety of issues including white male anger, the ethical questions raised by drug addiction, the nature of literary meaning, and the concept of “becoming-black.” In seeking to build an ethical structure around poststructuralist discourse and to revitalize the applied use of theoretical concepts to notions of performative identity, _Alterity Politics_ marks a decisive intervention in literary theory, cultural studies, twentieth-century philosophy, and performance studies. (shrink)

Health disparities are primarily driven by structural inequality including systemic racism. Medical educators, led by the AAMC, have tended to minimize these core drivers of health disparities. Ins...

Incapacitated adult patients are commonly divided into two groups for purposes of decision making; those with a surrogate and those without. Respectively, these groups are often referred to as represented and unrepresented, and the relative ethics of decision making between them raises two particular issues. The first issue involves the differential application of the best interests standard between groups. Second is the prevailing notion that representedness and unrepresentedness are categorical phenomena, though it is more aptly understood as a multidimensional and (...) continuous variable based on relational moral authority. This paper examines the nature of representedness as it relates to ethical norms of surrogate decision making. (shrink)

Volume 20, Issue 7, July 2020, Page 112-114.

With narrow exception, physicians’ treatment of incapacitated patients requires the consent of health surrogates. Although the decision-making authority of surrogates is appropriately broad, their moral authority is not without limits. Discerning these bounds is particularly germane to ethically complex treatments and has important implications for the welfare of patients, for the professional integrity of clinicians, and, in fact, for the welfare of surrogates. Palliative sedation is one such complex treatment; as such, it provides a valuable model for analyzing the scope (...) of surrogates’ moral authority. Guidelines for palliative sedation that present it as a “last-resort” treatment for severe and intractable suffering yet require surrogate consent in order to offer it are ethically untenable, precisely because the moral limits of surrogate authority have not been considered. (shrink)

The ‘best interests’ decision making standard is used in clinical care to make necessary health decisions for non-capacitated individuals for whom neither explicit nor inferred wishes are known. It has been also widely acknowledged as a basis for enrolling some non-capacitated adults into clinical research such as emergency, critical care, and dementia research. However, the best interests standard requires that choices provide the highest net benefit of available options, and clinical research rarely meets this criterion. In the context of modern (...) norms of bioethics, the best interests standard rarely supports surrogate consent for research and should not be accepted as a routine provision. (shrink)

Current guidelines treat palliative sedation to unconsciousness as an effective medical treatment for terminally ill patients who need relief from severe symptoms, yet also restrict its use in ways that are extraordinary for medical treatments. A closer look at the kinds of cases in which palliative sedation is used suggests a way of adjusting the guidelines to resolve this seeming contradiction.

Since the path-breaking work of Karl Deutsch on security communities and Ernst Haas on European integration, it has been clear that international institutions may create senses of community and belonging beyond the nation state. Put differently, they can socialize. Yet the mechanisms underlying such dynamics have been unclear. This volume explores these mechanisms of international community building, from a resolutely eclectic stand point. Rationalism is thus the social theory of choice for some contributors, while others are more comfortable with social (...) constructivism. This problem-driven perspective and the theoretical bridge building it are the cutting edge in international relations theory. By providing more fined-grained arguments on precisely how international institutions matter, such an approach sheds crucial light on the complex relationship between states and institutions, between rational choice and social constructivism, and, in our case, between Europe and the nation state. (shrink)

Binding theory (e.g., Chomsky, 1981) has played a central role in both syntactic theory and models of language processing. Its constraints are designed to predict that the referential domains of pronouns and reflexives are nonoverlapping, that is, are complementary; these constraints are also thought to play a role in online reference resolution. The predictions of binding theory and its role in sentence processing were tested in four experiments that monitored participants' eye movements as they followed spoken instructions to have a (...) doll touch a picture belonging to another doll. The instructions used pronouns and reflexives embedded in picture noun phrases (PNPs) containing possessor phrases (e.g., Pick up Ken. Have Ken touch Harry's picture of himself). Although the interpretations assigned to pronouns were generally consistent with binding theory, reflexives were frequently assigned interpretations that violated binding theory. In addition, the timing and pattern of eye movements were inconsistent with models of language processing that assume that binding theory acts as an early filter to restrict the referential domain. The interpretations assigned to reflexives in PNPs with possessors suggest that they are binding‐theory‐exempt logophors, a conclusion that unifies the treatment of reflexives in PNPs. (shrink)

Although ethics is increasingly integrated in the curriculum of U.S. medical schools, it remains not well integrated with system issues, and social and structural contexts of illness. Moreover, ethical analysis is not often taught as a clinical skill. To address these issues, an outcomes driven course in Social Sciences, Humanities, Ethics and Professionalism (SHEP) was created. Within the course, a web-based concept mapping device, SHEP Case Analysis Tool (SCAT), was created which schematizes the structure and flow of clinical cases from (...) diagnosis to treatment options, to shared decision making to outcome, and includes key stakeholders, influences, and structural features of the health system. In the course, each student analyzes a case in which they were directly involved using SCAT and presents their analysis to faculty and peers. This exercise 1) reinforces knowledge-based portions of the course pedagogy, 2) supports meta-cognition and critical thinking through concept mapping, 3) applies multidimensional analysis to identify ethical, social, and system issues that impact patient-care. 4) develops problem solving skills, 5) counters the hidden curriculum/support professional identity formation, and 6) develops skills in reflective discourse. This paper outlines the development and use of this concept mapping case analysis tool in an undergraduate medical education curriculum. (shrink)

“The Ethics of Life: Plant and Animal” argues that when it comes to thinking about ethics and forms of life in the current biopolitical era, plants offer a key site for ethical inquiry precisely because the vegetable kingdom is not, to deploy a standard that has served as a linchpin for animal rights discourse, “like us” in any obvious way. Given that anthropomorphism is the primary driver of the ecological disaster that is the Anthropocene, there are good reasons not to (...) confine our ethical thinking to life forms we “care about” primarily because they are either straightforwardly “us” or somehow “like us.”. (shrink)

The public image of nursing is important because it can facilitate or create barriers to achieving an adequate supply of nursing human resources. This study sought to gain a better understanding of nursing’s professional image within the Republic of Georgia. The Nursing Human Resources Systems model was used to guide the study’s exploratory, qualitative approach. Data collection occurred over a 2‐week period in the Republic of Georgia, and thirty‐three participants formed the final study sample. Participants included healthcare professionals, key informants (...) from nonprofit and research institutions, and patients. Data analysis occurred using directed content analysis techniques, and three themes emerged: (a) gender dimension; (b) the nursing service recipient experience; and (c) historical legacies. Themes revealed the complexities of nursing’s image in the country. Findings from this study serve as baseline data for understanding nursing’s image in the Republic of Georgia which could assist with improving pre‐entry nursing production issues. (shrink)

Controlled human infection studies (CHIs) involve the intentional infection of human subjects for a scientific aim. Though some past challenge trials have involved serious ethical abuses, in the last few decades, CHIs have had a strong track record of safety. Despite increased attention to the ethics of CHIs during the COVID‐19 pandemic, CHIs remain controversial, and there has been no in‐depth treatment of CHIs through the lens of virtue ethics. In this article, we argue that virtue theory can be helpful (...) for addressing CHIs that present a constellation of controversial, unresolved, and/or under‐regulated ethical issues. We begin with some brief background on virtue ethics. We then substantiate our claim that some CHIs raise a constellation of ethical issues that are unresolved in the ethics literature and/or lack adequate regulatory guidance by demonstrating that CHIs can present indeterminate social value, risks to third parties, limitations on the right to withdraw from research, and questions about the upper limit of allowable risk. We argue that the presence of a virtuous investigator, with virtues such as prudence, compassion, and integrity, is especially important when these unresolved research ethics issues arise, which is the case for certain types of controlled human infection studies. We use the historical example of Walter Reed and the Yellow Fever Commission to illustrate this claim, and we also highlight some contemporary examples. We end by sketching some practical implications of our view, such as ensuring that investigators with experience running CHIs are involved in novel CHI models. (shrink)

Preparations for large-scale disasters have tended to focus on triage schema, stockpiling of materials, and other logistical concerns. Less attention has been given to the myriad of distressing and almost unthinkable ethically charged dilemmas that will emerge at the bedside during a catastrophe, and how they may be best managed. Yet, it is these bedside issues that may limit or thwart the effectiveness of disaster planning, and, therefore, they ought to be carefully considered.

This retrospective of the last quarter century of clinical ethics offers an examination of some of the areas in which it should focus, and refocus, attention in the next.

Proportionality, as it pertains to palliative sedation, is the notion that sedation should be induced at the lowest degree effective for symptom control, so that the patient’s consciousness may be preserved. The pursuit of proportionality in palliative sedation is a widely accepted imperative advocated in position statements and guidelines on this treatment. The priority assigned to the pursuit of proportionality, and the extent to which it is relevant for patients who qualify for palliative sedation, have been overstated.

Robert Hopkins _Picture, Image, and Experience_ Cambridge: Cambridge University Press, 1998 ISBN 0521-58259-8 (hbk) 205 pp.

Just as noncapacitated decision making will forever be a feature of clinical medicine, so will the quest for effective advance care planning and serviceable documentation of these preferences. “Re-...

A commentary on “Must We Be Courageous?,” by Ann Hamric, John Arras, and Margaret Mohrmann, and on “Patient-Satisfaction Surveys on a Scale of 0 to 10: Improving Health Care, or Leading It Astray?,” by Alexandra Junewicz and Stuart J. Youngner, bothin the May-June 2015 issue.

(2010). Insult to Injury: Ethical Confusion in American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. The American Journal of Bioethics: Vol. 10, No. 1, pp. 68-70.

During a catastrophe that disables the health system, ethically charged situations will undoubtedly emerge that will challenge patients, relatives, clinicians, and others involved in health delivery. This second of two special sections of The Journal of Clinical Ethics includes discussions of the implications of a system collapse on particularly vulnerable member of society, children, pregnant women, and those who are socio-economically, culturally, and linguistically disempowered. Additionally, it offers insights into the processes used by committees to plan for catastrophic care.