Kennedy Institute of Ethics Journal最新文献

{"title":"Editor's Note","authors":"Quill Kukla","doi":"10.1353/ken.2023.a917927","DOIUrl":"https://doi.org/10.1353/ken.2023.a917927","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 --> Editor’s Note <!-- /html_title --></li> <li> Quill Kukla, <em>Editor-in-Chief</em> </li> </ul> <p><strong>T</strong>his issue of the <em>Kennedy Institute of Ethics Journal</em> contains two essays and one dialogue, all of which concern ethical and epistemological issues that arise at the meeting point of our cognitive and mental lives and technology.</p> <p>In the first piece, two leading bioethicists with expertise in neurotechnology, James Giordano and Joseph J. Fins, discuss a wide range of complex problems surrounding people with disorders of consciousness that make their mental states opaque to observers. It is especially difficult to know how to respectfully care for and interact with such people, since we cannot directly communicate with them and our technological methods for discerning whether and how they are conscious are nascent and unreliable. People with these disorders challenge our norms for decision-making and patient care, including end of life care. It is easy for doctors, who may only sporadically have contact with people with these disorders, to be unaware of their consciousness altogether. Because caring for people with these sorts of consciousness disorders is typically technologically intense, such care also raises difficult questions concerning resource allocation. Giordano and Fins discuss these and a wide range of other issues in depth. Their discussion of how the tools of disability studies and disability rights advocacy can and should be applied when it comes to people with whom we cannot communicate is particularly powerful. As Fins points out, the important principle, “Nothing about us without us,” cannot be honored in the case of people whose voices and experiences we cannot discern; this slogan presupposes communicative abilities. Fins and Giordano challenge us to revisit our concepts of accessibility and inclusion in ways that might let them be adapted to the needs of people with consciousness disorders.</p> <p>Phoebe Friesen and Anna Swartz—in “The First Smart Pill: Digital Revolution or Last Gasp?”—offer a critical social history of Abilify MyCite, a version of the popular antipsychotic drug Abilify, which contains a small sensor that digitally tracks when patients take the medication, thereby enabling compliance information to be shared with health care professionals. Friesen and Swartz show in detail the ways in which the story <strong>[End Page ix]</strong> of this drug’s use and uptake were fundamentally shaped by marketing pressures and financial incentives. Even though we do not actually have good evidence that the drug provides benefits that normal Abilify does not provide, nor that it increases compliance, Abilify MyCite was marketed as a success story. Bioethicists who were paid consultants for Otsuka, the maker of the drug, offered shallow analyses that justified the drug’s existe","PeriodicalId":46167,"journal":{"name":"Kennedy Institute of Ethics Journal","volume":"1 1","pages":""},"PeriodicalIF":1.4,"publicationDate":"2024-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139551732","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":"Social Robots to Fend Off Loneliness?","authors":"Zohar Lederman, Nancy S. Jecker","doi":"10.1353/ken.2023.a917929","DOIUrl":"https://doi.org/10.1353/ken.2023.a917929","url":null,"abstract":"<p><p>Social robots are increasingly being deployed to address social isolation and loneliness, particularly among older adults. Clips on social media attest that individuals availing themselves of this option are pleased with their robot companions. Yet, some people find the use of social robots to meet fundamental human emotional needs disturbing. This article clarifies and critically evaluates this response. It sets forth a framework for loneliness, which characterizes one kind of loneliness as involving an affective experience of lacking <i>human</i> relations that provide certain social goods. Next, the article discusses social robots and critically reviews the literature on the ethics of using them in light of this loneliness characterization. Third, we present a normative argument connecting the philosophical critique of loneliness-as-absence with the design and deployment of social robots. Finally, we draw out the implications of our analysis for public health and for interrogating the aims of commercial companies who make social robots.</p></p>","PeriodicalId":46167,"journal":{"name":"Kennedy Institute of Ethics Journal","volume":"28 1","pages":""},"PeriodicalIF":1.4,"publicationDate":"2024-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139551472","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.2024.a943426","DOIUrl":"https://doi.org/10.1353/ken.2024.a943426","url":null,"abstract":"","PeriodicalId":46167,"journal":{"name":"Kennedy Institute of Ethics Journal","volume":"34 1","pages":"vi-vii"},"PeriodicalIF":1.1,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142711485","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":"From Patients to Citizens-Narrative Solidarity in Healthcare.","authors":"Aleksandra Glos","doi":"10.1353/ken.2024.a943430","DOIUrl":"https://doi.org/10.1353/ken.2024.a943430","url":null,"abstract":"<p><p>This article analyzes the meaning of solidarity for bioethics and healthcare. Drawing on the anthropology of embodiment, it argues that solidarity arises upon relations of care for our vulnerable bodies and transforms it into our common democratic project. Its main focus is, therefore, not on distribution, which is the purpose of justice, but on the recognition and democratic inclusion of persons who-due to the vulnerable condition of their bodies-are still deprived of full participation in the public sphere. By reorienting caring relationships around the horizontal axis, solidarity obliges us to treat a person who is cared for not only as a passive recipient of healthcare goods, but as a fellow citizen and a partner in the process of care. It is argued that the model of narrative citizenship, by establishing discursive equality between a patient and a physician, can contribute to greater inclusion of vulnerable individuals into our societies.</p>","PeriodicalId":46167,"journal":{"name":"Kennedy Institute of Ethics Journal","volume":"34 1","pages":"61-98"},"PeriodicalIF":1.1,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142711491","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":"What Participatory Research and Methods Bring To Ethics: Insights From Pragmatism, Social Science, and Psychology.","authors":"Eric Racine","doi":"10.1353/ken.2024.a943431","DOIUrl":"https://doi.org/10.1353/ken.2024.a943431","url":null,"abstract":"<p><p>Ethics can be envisioned as a process where human beings move from a more passive stance in their moral lives to a more active one, in which the moral aspects of their lives become the basis of a project to best live one's life. Participatory research and methods would appear essential to ethics in this light, yet they remain rather marginally used in bioethics. In this article, I argue that participatory research methods are particularly compelling means of ethical enactments because of their ability-when carried out properly-to help promote self-actualization. Although I cannot review in detail the vast array of participatory research undertaken in management, education, communication, and so on, I pinpoint the advantages of this orientation to research, especially in light of a pragmatist and deliberative form of ethics that aims to help understand and enact human flourishing. These advantages include: (1) the co-understanding and co-reconstruction of problem situations and responses; (2) the importance attributed to meaning and intersubjectivity; (3) mutual learning (moral co-learning); (4) empowerment for effective eudemonistic change; and (5) opening the evaluation of outcomes to human flourishing. I also explain that these attributes of participatory research and methods do not preclude the use of non-participatory methods and approaches in ethics.</p>","PeriodicalId":46167,"journal":{"name":"Kennedy Institute of Ethics Journal","volume":"34 1","pages":"99-134"},"PeriodicalIF":1.1,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142710235","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":"Making Ends Meet: A Conceptual and Ethical Analysis of Efficiency.","authors":"Polly Mitchell, Alan Cribb, Vikki Entwistle, Sonya Crowe, Martin Utley","doi":"10.1353/ken.2024.a943428","DOIUrl":"https://doi.org/10.1353/ken.2024.a943428","url":null,"abstract":"<p><p>Efficiency is often overlooked as an ethical value and seen as ethically relevant chiefly when it conflicts with other values, such as equality. This article argues that efficiency is a rich and philosophically interesting concept deserving of independent normative examination. Drawing on a detailed healthcare case study, we argue that making assessments of efficiency involves value-laden, deliberative judgments about how to characterize the functioning of human systems. Personal and emotional resources and ends are crucial to system functioning but are often discounted in favor of a relatively narrow set of financial inputs and institutional or procedural outputs. Judgments about efficiency tend to advantage (or disadvantage) different parties, depending on the resources and ends considered. Different constructions of efficiency can therefore promote or neglect the perspectives and interests of differently placed actors. Models of efficiency do not merely embody contestable ethical standpoints but-put to use-can unwittingly reify and reproduce them.</p>","PeriodicalId":46167,"journal":{"name":"Kennedy Institute of Ethics Journal","volume":"34 1","pages":"1-26"},"PeriodicalIF":1.1,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142711493","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 Smallest Cut: The Ethics and (Surprising) Implications of <i>Hatafat Dam Brit</i> for the Ongoing Genital Cutting Debate.","authors":"Max Buckler","doi":"10.1353/ken.2024.a943429","DOIUrl":"https://doi.org/10.1353/ken.2024.a943429","url":null,"abstract":"<p><p>This essay applies an ethical analysis of the Jewish religious rite of hatafat dam brit to the ongoing debate on child genital cutting. Recent scholarship on the ethical and legal status of \"de minimis\" or \"symbolic\" involuntary genital cutting practices features disagreement over what, if anything, grounds their wrongfulness given that they are (relatively) physically superficial. Hatafat dam brit (\"the drawing of covenantal blood\") is even less physically intrusive than the most minor of the other practices commonly debated (e.g., \"ritual nicking\" of the vulva) yet still, as I will show, elicits moral concern-including from within the practicing religious community. As a type of genital cutting ritual that does not, in fact, modify the body, hatafat dam brit challenges those on both sides of the debate to clarify the basis for their moral objection or approval. I argue that debates about involuntary genital cutting of minors should focus on the ethics of these practices considered as (sexually) embodied interpersonal interactions, rather than as body modifications.</p>","PeriodicalId":46167,"journal":{"name":"Kennedy Institute of Ethics Journal","volume":"34 1","pages":"27-59"},"PeriodicalIF":1.1,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142711494","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":"","doi":"10.1353/ken.2024.a943427","DOIUrl":"https://doi.org/10.1353/ken.2024.a943427","url":null,"abstract":"","PeriodicalId":46167,"journal":{"name":"Kennedy Institute of Ethics Journal","volume":"34 1","pages":"ix-xi"},"PeriodicalIF":1.1,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142711488","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":"Contributor","authors":"","doi":"10.1353/ken.2023.a904078","DOIUrl":"https://doi.org/10.1353/ken.2023.a904078","url":null,"abstract":"ABSTRACT:COVID-19 elicited a rapid emergence of new mutual aid networks in the US, but the practices of these networks are understudied. Using qualitative methods, we explored the empirical ethics guiding US-based mutual aid networks' activities, and assessed the alignment between principles and practices as networks mobilized to meet community needs during 2020–21. We conducted in-depth interviews with 15 mutual aid group organizers and supplemented these with secondary source materials on mutual aid activities and participant observation of mutual aid organizing efforts. We analyzed participants' practices in relation to key mutual aid principles as defined in the literature: 1) solidarity not charity; 2) non-hierarchical organizational structures; 3) equity in decision-making; and 4) political engagement. Our data also yielded a fifth principle, \"mutuality,\" essential to networks' approaches but distinct from anarchist conceptions of mutualism. While mutual aid networks were heavily invested in these ethical principles, they struggled to achieve them in practice. These findings underscore the importance of mutual aid praxis as an intersection between ethical principles and practices, and the challenges that contemporary, and often new, mutual aid networks responding to COVID-19 face in developing praxis during a period of prolonged crisis. We develop a theory-of-change model that illuminates both the opportunities and the potential pitfalls of mutual aid work in the context of structural inequities, and shows how communities can achieve justice-oriented mutual aid praxis in current and future crises.","PeriodicalId":46167,"journal":{"name":"Kennedy Institute of Ethics Journal","volume":"35 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135046176","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":"Mutual Aid Praxis Aligns Principles and Practice in Grassroots COVID-19 Responses Across the US.","authors":"Nora Kenworthy, Emily Hops, Amy Hagopian","doi":"10.1353/ken.2023.a904080","DOIUrl":"10.1353/ken.2023.a904080","url":null,"abstract":"<p><p>COVID-19 elicited a rapid emergence of new mutual aid networks in the US, but the practices of these networks are understudied. Using qualitative methods, we explored the empirical ethics guiding US-based mutual aid networks' activities, and assessed the alignment between principles and practices as networks mobilized to meet community needs during 2020-21. We conducted in-depth interviews with 15 mutual aid group organizers and supplemented these with secondary source materials on mutual aid activities and participant observation of mutual aid organizing efforts. We analyzed participants' practices in relation to key mutual aid principles as defined in the literature: 1) solidarity not charity; 2) non-hierarchical organizational structures; 3) equity in decision-making; and 4) political engagement. Our data also yielded a fifth principle, \"mutuality,\" essential to networks' approaches but distinct from anarchist conceptions of mutualism. While mutual aid networks were heavily invested in these ethical principles, they struggled to achieve them in practice. These findings underscore the importance of <i>mutual aid praxis</i> as an intersection between ethical principles and practices, and the challenges that contemporary, and often new, mutual aid networks responding to COVID-19 face in developing praxis during a period of prolonged crisis. We develop a theory-of-change model that illuminates both the opportunities and the potential pitfalls of mutual aid work in the context of structural inequities, and shows how communities can achieve justice-oriented mutual aid praxis in current and future crises.</p>","PeriodicalId":46167,"journal":{"name":"Kennedy Institute of Ethics Journal","volume":"33 1","pages":"115-144"},"PeriodicalIF":1.1,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10927022/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44574988","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}