{"title":"Coming to America: Bioethical Training at the Kennedy Institute of Ethics and the Establishment of Medical Ethics in Germany.","authors":"Mathias Schütz, Felix Sommer","doi":"10.1353/ken.2025.a987090","DOIUrl":"10.1353/ken.2025.a987090","url":null,"abstract":"<p><p>Between 1987 and 1995, the Kennedy Institute of Ethics held a number of training courses specifically addressing German physicians and scholars engaged in the establishment of medical ethics in West Germany. These courses were linked to the annual Intensive Bioethics Course the institute had been organizing since 1975. During the 1980s, the perspective of bioethical training began to shift toward an international audience. Through the fundraising skills and organizational efforts of Hans-Martin Sass, a German philosopher and senior research scholar at the institute, the focus eventually shifted toward the situation in Germany, where interest in bioethics was emerging but infrastructure and knowledge were lacking. Based on extensive archival research in the US and Germany, this paper retraces the history of German participation in the Kennedy Institute's bioethical training courses and analyzes the impact this experience had on the institute's outlook as well as on the development of German medical ethics.</p>","PeriodicalId":46167,"journal":{"name":"Kennedy Institute of Ethics Journal","volume":"35 2","pages":"205-232"},"PeriodicalIF":0.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147677651","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"A Reply to Bernstein, Jayaram, and Hutler's \"Assessing the Liberty-Based Case Against Pandemic Lockdowns\".","authors":"Eric Winsberg","doi":"10.1353/ken.2025.a987089","DOIUrl":"https://doi.org/10.1353/ken.2025.a987089","url":null,"abstract":"","PeriodicalId":46167,"journal":{"name":"Kennedy Institute of Ethics Journal","volume":"35 2","pages":"197-204"},"PeriodicalIF":2.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147677634","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Beyond Words: A Philosophical Analysis of the Linguistic Refractoriness of Chronic Pain.","authors":"Veronica Campos, Daniel De Luca-Noronha","doi":"10.1353/ken.2025.a994323","DOIUrl":"https://doi.org/10.1353/ken.2025.a994323","url":null,"abstract":"<p><p>Chronic pain challenges health care due to its subjective, complex nature and resistance to verbal expression. Patients try to explain what their pain feels like but fail to produce a report that is both faithful and communicatively effective. Traditional assessment tools for expressing and quantifying pain, like the McGill Pain Questionnaire, also have limitations, rendering diagnosis and treatment more difficult. This paper explores the communicative limitations of verbal language in expressing chronic pain, drawing on philosophy, cognitive science, medical humanities, and pain studies. We analyze three complementary hypotheses: (1) the pain's prelinguistic and private nature (PPN), which sees pain as inherently inexpressible; (2) the limitations of language and metaphor (LLM), which highlights how metaphor both enables and distorts expression; and (3) the disruption of narrative and temporal coherence (DNTC), which suggests chronic pain fractures the temporal and narrative structures needed for self-expression. Together, these frameworks reveal the epistemic fragility of verbal pain reports. The paper advocates for developing multimodal, nonlinguistic communication strategies to better capture the affective, temporal, and existential dimensions of chronic pain.</p>","PeriodicalId":46167,"journal":{"name":"Kennedy Institute of Ethics Journal","volume":"35 3-4","pages":"315-343"},"PeriodicalIF":0.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148391855","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Travis N Rieder, Vivian Altiery De Jesus, Yoram Unguru
{"title":"On the Dangers of Cancer Exceptionalism in Pain Medicine.","authors":"Travis N Rieder, Vivian Altiery De Jesus, Yoram Unguru","doi":"10.1353/ken.2025.a994326","DOIUrl":"https://doi.org/10.1353/ken.2025.a994326","url":null,"abstract":"","PeriodicalId":46167,"journal":{"name":"Kennedy Institute of Ethics Journal","volume":"35 3-4","pages":"407-425"},"PeriodicalIF":0.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148391992","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Claudia R Sotomayor, Christopher J Spevak, Margaret M Mahon
{"title":"The Silent Struggle: A Woman's Journey Through Pain.","authors":"Claudia R Sotomayor, Christopher J Spevak, Margaret M Mahon","doi":"10.1353/ken.2025.a994321","DOIUrl":"10.1353/ken.2025.a994321","url":null,"abstract":"<p><p>This paper seeks to deepen the understanding of the complex issues surrounding this patient by exploring the intersections of her experiences. Specifically, it focuses on three aspects of Maria's pain: her identity as a woman, her pregnancy status, and her role as a new mother. This paper employs the concept of intersectionality through a patient's narrative to examine the compounded barriers to healthcare faced by many women. Our aim is to demonstrate the practical application of intersectionality in clinical practice, offering a pragmatic tool for clinicians to understand how intersecting identities influence patient care. The case study illustrates that health experiences, especially pain, are not solely biological issues for women. Instead, pain is profoundly influenced by factors such as gender, race, class, immigration status, culture, and age. These elements interact to shape how pain is experienced, expressed, and understood in clinical settings. Our goal is to highlight the structural and interpersonal barriers that impact access to quality care for vulnerable groups and to foster reflection on how intersecting identities affect clinical outcomes.</p>","PeriodicalId":46167,"journal":{"name":"Kennedy Institute of Ethics Journal","volume":"35 3-4","pages":"263-286"},"PeriodicalIF":0.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148391935","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"\"We Don't Want You Here\": A Critical Examination of Staring, Disability, and the Inaccessible Environment.","authors":"Natalie Hardy","doi":"10.1353/ken.2025.a978175","DOIUrl":"https://doi.org/10.1353/ken.2025.a978175","url":null,"abstract":"<p><p>Disability scholars generally categorize staring as a stigmatizing action that has negative psychosocial impacts on disabled people. Yet, interestingly, staring is also oftentimes understood as natural, understandable, and is even encouraged in different contexts. In this paper, I first articulate the diverse ways staring is experienced and conceptualized by drawing from general sociological, queer, and disability theories, and I demonstrate that staring itself is a value-neutral action. I argue that staring is experienced particularly negatively by disabled communities because (1) staring that occurs within inaccessible environments reinforces societal sentiments that disabled individuals are unwanted and unvalued, and (2) disabled individuals often lack control over whether and how they are stared at; thus, when staring occurs in a physically inaccessible context, staring perpetuates a loss of control over social experiences. I conclude by articulating how participatory planning as an alternative approach to inclusive design can attenuate the harmful impacts staring has on disabled individuals.</p>","PeriodicalId":46167,"journal":{"name":"Kennedy Institute of Ethics Journal","volume":"35 1","pages":"1-26"},"PeriodicalIF":2.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145805365","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"When \"Good-Enough\" Treatment Is Not Good Enough: Epistemic Injustice, Pain-Related Motivational Deficit, and Epistemic Deflection in the Treatment of Gynecological Pain.","authors":"Peter J Katz, Ferheen Abbasi","doi":"10.1353/ken.2025.a994322","DOIUrl":"https://doi.org/10.1353/ken.2025.a994322","url":null,"abstract":"<p><p>While treatments exist for gynecological conditions such as endometriosis, these treatments often fail to treat the root disease or disorder and entail severe side effects. This paper joins recent calls to challenge the normalization of menstruator's pain. We argue that the side effects of hormonal treatment for gynecological pain conditions have been problematically coded as expected and therefore \"good enough.\" Drawing on the work of Miranda Fricker and Jada Wiggleton-Little, we argue that hormonal treatment's normalization harms menstruators as knowers of their own bodies and experiences, and also reflects a subset of a broader lack of uptake that reinterprets and deflects the salience of menstruators' pain utterances. Because of the simultaneous invisibility and expectedness of menstruators' pain, treatments for gynecological pain conditions are considered \"good enough\" when they return women's bodies to silence.</p>","PeriodicalId":46167,"journal":{"name":"Kennedy Institute of Ethics Journal","volume":"35 3-4","pages":"287-313"},"PeriodicalIF":0.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148391933","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Ambiguous Invitations: Nonmaleficence, Uncertainty Attitudes and Public Health Policy.","authors":"Stephen John","doi":"10.1353/ken.2025.a987086","DOIUrl":"https://doi.org/10.1353/ken.2025.a987086","url":null,"abstract":"","PeriodicalId":46167,"journal":{"name":"Kennedy Institute of Ethics Journal","volume":"35 2","pages":"99-126"},"PeriodicalIF":2.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147677648","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"<i>Morbus Mediterraneus</i>: A Cultural Alibi for an Unequal Pain Burden.","authors":"Sara C da Piedade Gomes","doi":"10.1353/ken.2025.a994324","DOIUrl":"https://doi.org/10.1353/ken.2025.a994324","url":null,"abstract":"<p><p>According to a widespread trope in German medical literature, patients from the Mediterranean basin are hypersensitive to pain, exaggerating its severity to win familial sympathy and avoid responsibilities; moreover, they are alleged to be disproportionately susceptible to somatoform conditions and chronic pain. Underwritten by a philosophical anthropology positioning culture as a structuring cause of nearly all aspects of cognition, culture is made the first-order explanation for pain inequities, relegating structural factors to a background of minor causes. The institutionalization of these stereotypes prepares the ground for systematic testimonial injustice. To redress these injustices, one must dislodge the received view of culture and its clinical significance. I argue, conceptually and empirically, that clinical and experimental pain disparities have political and material, rather than cultural, causes. I offer an alternative understanding of culture that does not obfuscate the structural causes of pain inequities and is supportive of epistemic humility and equity-oriented care.</p>","PeriodicalId":46167,"journal":{"name":"Kennedy Institute of Ethics Journal","volume":"35 3-4","pages":"345-377"},"PeriodicalIF":0.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148391756","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Assessing the Liberty-Based Case Against Pandemic Lockdowns.","authors":"Justin Bernstein, Athmeya Jayaram, Brian Hutler","doi":"10.1353/ken.2025.a987088","DOIUrl":"10.1353/ken.2025.a987088","url":null,"abstract":"<p><p>Respecting individual liberty is a foundational principle of both liberal democratic theory and public health ethics. It is not always clear, however, what role liberty should play in evaluating restrictive public health policies such as those implemented by governments during the COVID-19 pandemic. During the pandemic, a number of scholars argued that an appeal to individual liberty provides a strong argument against restrictive policies such as stay-at-home orders, school and business closures, and gathering restrictions-which we will collectively refer to as \"lockdowns.\" This paper argues that while individual liberty is an important consideration, it does not, on its own, provide a strong argument against pandemic lockdowns. To show as much, we survey some of the most promising and prominent liberty-based arguments against lockdowns. We argue that such arguments either fail or are incomplete. Before concluding, we draw on this discussion to suggest a different liberty-based frame for evaluating pandemic policies. This approach would focus more on what functions liberties are meant to fulfill and whether lockdowns can be designed to preserve those functions-even if they restrict liberty.</p>","PeriodicalId":46167,"journal":{"name":"Kennedy Institute of Ethics Journal","volume":"35 2","pages":"163-196"},"PeriodicalIF":0.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147677619","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}