Punishment as Moral Fortification

The proposal that the criminal justice system should focus on rehabilitation – rather than retribution, deterrence, or expressive denunciation – is among the least popular ideas in legal philosophy. Foremost among rehabilitation’s alleged weaknesses is that it views criminals as blameless patients to be treated, rather than culpable moral agents to be held accountable. This article offers a new interpretation of the rehabilitative approach that is immune to this objection and that furnishes the moral foundation that this approach has lacked. The view rests on the principle that moral agents owe it to one another to maintain the dependability of their moral capacities. Agents who culpably commit criminal wrongs, however, betray an unacceptable degree of moral unreliability. Punishment, on this theory, consists in the enforcement of the duties that offenders have to reduce their own likelihood of recidivism

Extreme Speech, Democratic Deliberation, and Social Media

Social media are now central sites of democratic discourse among citizens. But are some contributions to social media too extreme to be permitted? This entry considers the permissibility of suppressing extreme speech on social media, such as terrorist propaganda and racist hate speech. It begins by considering the argument that such restrictions on speech would wrong democratic citizens, violating their freedom of expression. It proceeds to investigate the moral responsibilities of social media companies to suppress extreme speech, and whether these ought to be enforced through the law. Finally, it explores an alternative mechanism for combatting extreme speech on social media—counter-speech—and evaluates its prospects

Terror, Hate and the Demands of Counter-Speech

It is a familiar mantra of American politics that the best response to dangerous speech that incites violence and spreads hate is 'more speech'. Yet the principle obscures at least three crucial questions. Who, in particular, is to undertake the counter-speech that the doctrine recommends? What, exactly, are they required to do? And why is it morally justified to demand that they do it? This article argues that if citizens are to rely on counter-speech to defuse the dangers of dangerous expression, it is not enough to cheerlead its abstract importance and then sit back and hope for the best. Someone needs to do the work, and do it well. The article defends the thesis that all citizens have a moral duty to engage in counter-speech against dangerous expression. Focusing on counter-speech against expression that implicitly or explicitly advocates wrongful criminal violence, it argues that these duties can be derived from a much more basic normative source: the samaritan obligation, held by all moral agents, to rescue others from risks of harm. The specification of these duties' content, however, depends upon interdisciplinary work that integrates normative theory with social scientific research on human communication

The labors of justice: democracy, respect, and judicial review

Why value democracy? One familiar answer is that democracy expresses respect for citizens, whereas non-democratic modes of governance insultingly express disrespect. Recent work has subjected this view to substantial criticism, raising serious doubts about its plausibility. This article contends that prevailing objections succeed only because they target implausible interpretations of this view, according to which the wrong of political exclusion consists in some insulting disregard for the interests of excluded agents. On the revised respect-based argument to be defended here, however, the insult of political exclusion implicates not the interests of excluded agents, but rather their duties. On this view, democracy is uniquely respectful because it recognizes that the work of achieving a just political order is work that morality assigns not simply to a select few, but to all. To shut moral agents out of the decision-making process is insulting because it flouts their status as the kinds of beings on whom duties of justice equally fall, and who therefore have a presumptively equal prerogative to be involved in seeing to it that justice is done. This interpretation of the respect-based argument is not susceptible to the objections advanced against other interpretations. It better accounts for the role of reasonable disagreement about justice in democratic theory. And it is superior at explaining why respect-based democrats should harbor a qualified skepticism toward judicial review: because the job of securing justice fundamentally belongs not to judges, but to everybody

Free Speech and Hate Speech

Should hate speech be banned? This article contends that the debate on this question must be disaggregated into discrete analytical stages, lest its participants continue to talk past one another. The first concerns the scope of the moral right to freedom of expression, and whether hate speech falls within the right's protective ambit. If it does, hate speech bans are necessarily unjust. If not, we turn to the second stage, which assesses whether speakers have moral duties to refrain from hate speech. The article canvasses several possible duties from which such a duty could be derived, including duties not to threaten, harass, offend, defame, or incite. If there is a duty to refrain from hate speech, it is yet a further question whether the duty should actually be enforced. This third stage depends on pragmatic concerns involving epistemic fallibility, the abuse of state power, and the benefits of counter-speech over coercion

Movement variability in stroke patients and controls performing two upper limb functional tasks: a new assessment methodology

Background: In the evaluation of upper limb impairment post stroke there remains a gap between detailed kinematic analyses with expensive motion capturing systems and common clinical assessment tests. In particular, although many clinical tests evaluate the performance of functional tasks, metrics to characterise upper limb kinematics are generally not applicable to such tasks and very limited in scope. This paper reports on a novel, user-friendly methodology that allows for the assessment of both signal magnitude and timing variability in upper limb movement trajectories during functional task performance. In order to demonstrate the technique, we report on a study in which the variability in timing and signal magnitude of data collected during the performance of two functional tasks is compared between a group of subjects with stroke and a group of individually matched control subjects. Methods: We employ dynamic time warping for curve registration to quantify two aspects of movement variability: 1) variability of the timing of the accelerometer signals' characteristics and 2) variability of the signals' magnitude. Six stroke patients and six matched controls performed several trials of a unilateral ('drinking') and a bilateral ('moving a plate') functional task on two different days, approximately 1 month apart. Group differences for the two variability metrics were investigated on both days. Results: For 'drinking from a glass' significant group differences were obtained on both days for the timing variability of the acceleration signals' characteristics (p = 0.002 and p = 0.008 for test and retest, respectively); all stroke patients showed increased signal timing variability as compared to their corresponding control subject. 'Moving a plate' provided less distinct group differences. Conclusion: This initial application establishes that movement variability metrics, as determined by our methodology, appear different in stroke patients as compared to matched controls during unilateral task performance ('drinking'). Use of a user-friendly, inexpensive accelerometer makes this methodology feasible for routine clinical evaluations. We are encouraged to perform larger studies to further investigate the metrics' usefulness when quantifying levels of impairment

Temporal trends and lesion sets for persistent atrial fibrillation ablation: a meta-analysis with trial sequential analysis and meta-regression

BACKGROUND: Ablation for persistent atrial fibrillation (PsAF) has been performed for over 20 years, although success rates have remained modest. Several adjunctive lesion sets have been studied but none have become standard of practice. We sought to describe how the efficacy of ablation for PsAF has evolved in this time period with a focus on the effect of adjunctive ablation strategies. METHODS: Databases were searched for prospective studies of PsAF ablation. We performed meta-regression and trial sequential analysis. RESULTS: A total of 99 studies (15 424 patients) were included. Ablation for PsAF achieved the primary outcome (freedom of atrial fibrillation/atrial tachycardia rate at 12 months follow-up) in 48.2% (5% CI, 44.0-52.3). Meta-regression showed freedom from atrial arrhythmia at 12 months has improved over time, while procedure time and fluoroscopy time have significantly reduced. Through the use of cumulative meta-analyses and trial sequential analysis, we show that some ablation strategies may initially seem promising, but after several randomized controlled trials may be found to be ineffective. Trial sequential analysis showed that complex fractionated atrial electrogram ablation is ineffective and further study of this treatment would be futile, while posterior wall isolation currently does not have sufficient evidence for routine use in PsAF ablation. CONCLUSIONS: Overall success rates from PsAF ablation and procedure/fluoroscopy times have improved over time. However, no adjunctive lesion set, in addition to pulmonary vein isolation, has been conclusively demonstrated to be beneficial. Through the use of trial sequential analysis, we highlight the importance of adequately powered randomized controlled trials, to avoid reaching premature conclusions, before widespread adoption of novel therapies