Kennedy Institute of Ethics Journal最新文献

{"title":"Multivalent Environmental and Ecological Justice Reimagined.","authors":"Bridget Pratt","doi":"10.1353/ken.2025.a978177","DOIUrl":"https://doi.org/10.1353/ken.2025.a978177","url":null,"abstract":"<p><p>Climate change and worsening environmental degradation remain the greatest threat of our time. How to address the environmental crisis ethically and equitably is one of the most important questions facing the global community. Conceptions of environmental justice and ecological justice are key sources of guidance on this matter. Yet these conceptions are ill equipped to guide global action. They identify four core dimensions of environmental justice and ecological justice: distribution, recognition, inclusion, and well-being. In this paper, I argue that different ontological (e.g., holism) and experiential (e.g., colonization and coloniality) starting points in the Global South identify additional dimensions-harmony and power-and additional aspects of the recognition dimension that are largely missing from dominant multivalent concepts. I next offer three epistemic reasons why excluding the additional dimensions and aspects from our conception of environmental justice and ecological justice is problematic. I then apply relevant theory from the Global North and South to propose how the power, harmony, and recognition dimensions might be understood or reimagined. I demonstrate that a broadened environmental justice and ecological justice concept identifies certain issues voiced by people from the Global South as injustices, where current mainstream concepts do not. I conclude by considering important objections to the ideas proposed in the paper.</p>","PeriodicalId":46167,"journal":{"name":"Kennedy Institute of Ethics Journal","volume":"35 1","pages":"61-98"},"PeriodicalIF":2.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145805572","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":"Editor's Note, June 2025.","authors":"Quill R Kukla","doi":"10.1353/ken.2025.a987085","DOIUrl":"10.1353/ken.2025.a987085","url":null,"abstract":"","PeriodicalId":46167,"journal":{"name":"Kennedy Institute of Ethics Journal","volume":"35 2","pages":"ix-xii"},"PeriodicalIF":0.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147677576","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":"Remembering Pain Otherwise: Disability, Enclosed Surfacing, and Crip Memory.","authors":"Nic Cottone, Jessica Martínez-Cruz","doi":"10.1353/ken.2025.a994320","DOIUrl":"https://doi.org/10.1353/ken.2025.a994320","url":null,"abstract":"<p><p>By tracing the sticky history between pain and disability studies, this paper examines how chronic pain is either excluded from the debate or framed as a problem of the body itself. To address these resulting tensions, we articulate the phenomenology of enclosed surfacing to describe how chronic pain can make the body feel like a closed container-where pain circulates inwardly and feels unmediated-rather than shaped through relation and histories of meaning. We then develop crip memory as a method for attending to pain otherwise: as something carried, remembered, and transmitted across time, place, and relation. Through narrative, we show how memory, as both medium and practice, keeps pain in relation rather than enclosing it. We name crip accompaniment as a way of being carried and oriented by the reverberations of others' pained memories in ways that sustain survival and orient us toward collective disabled futurities.</p>","PeriodicalId":46167,"journal":{"name":"Kennedy Institute of Ethics Journal","volume":"35 3-4","pages":"233-262"},"PeriodicalIF":0.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148391961","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":"Introduction to the <i>Kennedy Institute of Ethics</i> Special Issue, \"Chronic Pain and Social Justice\".","authors":"Jada Wiggleton-Little, Daniel Buchman","doi":"10.1353/ken.2025.a994319","DOIUrl":"https://doi.org/10.1353/ken.2025.a994319","url":null,"abstract":"","PeriodicalId":46167,"journal":{"name":"Kennedy Institute of Ethics Journal","volume":"35 3-4","pages":"xi-xvi"},"PeriodicalIF":0.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148392001","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":"Editor's Note, March 2025.","authors":"","doi":"10.1353/ken.2025.a978174","DOIUrl":"10.1353/ken.2025.a978174","url":null,"abstract":"","PeriodicalId":46167,"journal":{"name":"Kennedy Institute of Ethics Journal","volume":"35 1","pages":"ix-xi"},"PeriodicalIF":0.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145805430","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":"The Double-Blind Randomized Controlled Trial as the Gold Standard in Psychedelic Research: Neither Feasible Nor Desirable.","authors":"Daniel Villiger","doi":"10.1353/ken.2025.a978176","DOIUrl":"https://doi.org/10.1353/ken.2025.a978176","url":null,"abstract":"<p><p>Double-blind, randomized, controlled trials (DB-RCT), if designed and conducted well, are widely considered the gold standard in medical research for purposes of establishing causal efficacy. Their logic is compelling: by balancing out all confounding variables through the research design, DB-RCTs are thought to reveal whether a proposed treatment-by virtue of its characteristic constituents-causes therapeutic effects. Many studies on psychedelic-assisted therapy (PAT) follow this ostensible gold standard and use a DB-RCT design. But several authors have already noted that conducting psychedelic DB-RCTs is particularly challenging: due to the psychoactive effects of psychedelics, participant awareness of condition assignment is likely; this awareness may then interact with response expectancy and experimenter behavior, introducing systematic bias into the trial. For this reason, these authors have suggested ways to rescue DB-RCTs for PAT. This paper takes a different direction. It argues that we should abandon the DB-RCT design as the assumed gold standard in PAT research, because its logic is largely undermined by the intervention(s) in question, and the design in its standard form neglects potentially important aspects of PAT (i.e., extrapharmacological factors and their interaction(s) with the psychedelic). Abandoning DB-RCT opens the door to a more holistic study of PAT, in which DB-RCTs are still useful for certain ends but are considered to produce results that are not per se superior but complementary to those of other research designs.</p>","PeriodicalId":46167,"journal":{"name":"Kennedy Institute of Ethics Journal","volume":"35 1","pages":"27-60"},"PeriodicalIF":2.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145805694","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":"Relational Autonomy in Nonideal Medical Decision-Making.","authors":"Laura Specker Sullivan","doi":"10.1353/ken.2025.a987087","DOIUrl":"10.1353/ken.2025.a987087","url":null,"abstract":"<p><p>Autonomy is a core concept for medical decision-making in the United States. Yet as issues of social justice have been increasingly appreciated by American bioethicists, so has the difficulty of reconciling autonomy with unjust contexts. Bioethicists have turned to the feminist concept of relational autonomy to address these issues, but there is disagreement over its implementation. This paper aims to clarify the relationship between unjust circumstances and respect for autonomy by analyzing the utility of relational autonomy for medical decision-making in nonideal social contexts.</p>","PeriodicalId":46167,"journal":{"name":"Kennedy Institute of Ethics Journal","volume":"35 2","pages":"127-161"},"PeriodicalIF":0.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147677609","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":"Suck It Up and Stay on the Grind: Ethical Considerations Surrounding Trust, Chronic Pain, and the American Workplace.","authors":"Amny M Shuraydi","doi":"10.1353/ken.2025.a994325","DOIUrl":"https://doi.org/10.1353/ken.2025.a994325","url":null,"abstract":"<p><p>The United States has long been scrutinized for its lack of accessible social services, including access to quality health care and employee leave accommodations. Studies show that over 24 percent of US adults suffer from chronic pain, with 9 percent of adults indicating that their pain hinders their life or work activities almost daily. As employer-based coverage remains the most common method for obtaining health insurance, many of these people must continue working in order to maintain their access to affordable medical care. Additionally, a lack of standardized medical leave policies creates an environment where workers may face feelings of ambivalence as they struggle to find a balance between needing their jobs for the benefits while also not receiving enough benefits or support for their needs. This reality can be counterproductive to healing and recovery, mental health, and overall well-being, as well as productivity. The state of these US structural systems and their operations under capitalism also create situations that are ripe for distrust, skepticism, and increased potential for further disparities. This article discusses chronic pain and trust in the context of the US workplace and health care systems, contextualizing historical and modern factors that may impact the decision-making processes among those experiencing chronic pain. Understanding this framing may create opportunities for health care workers, employers, and policymakers to reimagine their approaches toward providing support or achieving employee/patient buy-in.</p>","PeriodicalId":46167,"journal":{"name":"Kennedy Institute of Ethics Journal","volume":"35 3-4","pages":"379-405"},"PeriodicalIF":0.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148391984","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":"Editor's Note","authors":"Quill R. Kukla","doi":"10.1353/ken.2023.a931049","DOIUrl":"https://doi.org/10.1353/ken.2023.a931049","url":null,"abstract":"&lt;span&gt;&lt;span&gt;In lieu of&lt;/span&gt; an abstract, here is a brief excerpt of the content:&lt;/span&gt;\u0000&lt;p&gt; &lt;ul&gt; &lt;li&gt;&lt;!-- html_title --&gt; Editor's Note &lt;!-- /html_title --&gt;&lt;/li&gt; &lt;li&gt; Quill R. Kukla &lt;/li&gt; &lt;/ul&gt; &lt;p&gt;This issue of the &lt;em&gt;Kennedy Institute of Ethics Journal&lt;/em&gt; offers three articles that encourage readers to think in different ways about how we use and share medical facts and information. Communication and information-sharing in medicine are never value-neutral processes, and there is never an objective answer to what information should be shared or how. What information we have access to, what information we take as relevant, and how we share that information are always vexed issues. This is because medical information is inherently socially charged, value-laden, and uncertain, and sharing it is bound up with norms of privacy, principles of relevance and empirical reasoning, and the complexities of health communication. All three essays in this issue, in taking up these issues, work at the intersection of ethics and social epistemology.&lt;/p&gt; &lt;p&gt;In \"The Goals of Medicine: Debate and Disagreements Around Contraceptive Side Effects,\" Ilvie Prince argues that our framing of the benefits, risks, and side effects of hormonal contraception is shaped by a specific understanding of the purpose and nature of medicine. This framing, she argues, ends up harming people who can become pregnant. While it is common to point out that contraceptive and reproductive health care are distorted by sexism, Prince argues that there are yet deeper distortions at work in our understanding of contraceptive side effects. When the primary goal of medicine is understood as the prevention of disease and dysfunction, narrowly construed, this obscures our ability to properly weigh and articulate the harms of both pregnancy and contraception. Since women are disproportionately the ones who bear the burdens and risks of both reproduction and contraception, this obfuscation has sexist results, as it disproportionately harms women. Prince also argues that once we understand the goals of medicine more broadly, we cannot avoid the uncomfortable fact that doctors must address social harms and benefits—and not just narrowly biological ones—despite the risk that this kind of intervention can serve politically nefarious ends. Prince's rich piece draws on her deep understanding of bioethics, as well as the history and science of reproductive medicine. &lt;strong&gt;[End Page vii]&lt;/strong&gt;&lt;/p&gt; &lt;p&gt;Benjamin Chin-Yee's tightly argued paper—\"Generalizations in Clinical Trials: Do Generics Help or Harm?\"—digs into the details of the language of health communication and its epistemic and ethical perils. He points out that generalizations in biomedical science (statements about what is generally true) often take the form of &lt;em&gt;generics&lt;/em&gt;. Generics are general statements that contain implicit generalizations, but don't actually use quantificational language, such as \"Drug A cures condition C\" or \"Peop","PeriodicalId":46167,"journal":{"name":"Kennedy Institute of Ethics Journal","volume":"7 1","pages":""},"PeriodicalIF":1.4,"publicationDate":"2024-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141510820","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":"Contributors","authors":"","doi":"10.1353/ken.2023.a931053","DOIUrl":"https://doi.org/10.1353/ken.2023.a931053","url":null,"abstract":"<span><span>In lieu of</span> an abstract, here is a brief excerpt of the content:</span>\u0000<p> <ul> <li><!-- html_title --> Contributors <!-- /html_title --></li> </ul> <p>Michiel De Proost is a postdoctoral researcher at the Department of Philosophy and Moral Sciences at Ghent University and is affiliated with the Bioethics Institute Ghent and the METAMEDICA consortium.</p> <p>Benjamin Chin-Yee is a hematologist in the Division of Hematology, Western University, Canada, and a doctoral student in the Department of History and Philosophy of Science at the University of Cambridge. His research interests span philosophy of medicine, values in science, and the ethics of scientific and clinical communication.</p> <p>Ilvie Prince is a doctoral candidate at Leibniz University Hannover. Her work focuses on the complex relationship between ethics and epistemology in medicine, with a particular interest in medical practices that challenge established concepts and methods.</p> <p>Megan A. Dean is an assistant professor in the Philosophy Department at Michigan State University and the North American coordinator of Culinary Mind: Center for Philosophy of Food. She works in feminist bioethics with a focus on the ethics of eating.</p> <p>Jonathan Ichikawa is a professor and department head in philosophy at the University of British Columbia. His research interests center around epistemology, feminist philosophy, ethics, and the philosophy of language, especially the points at which those philosophical subfields interact with one another.</p> Copyright © 2024 Johns Hopkins University Press ... </p>","PeriodicalId":46167,"journal":{"name":"Kennedy Institute of Ethics Journal","volume":"13 1","pages":""},"PeriodicalIF":1.4,"publicationDate":"2024-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141510819","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}