82 research outputs found

    Timeliness, relevance, freedom:on Steve Buckler’s reading of Hannah Arendt

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    Part of a symposium on Steve Buckler, Hannah Arendt and political theory: challenging the tradition (Edinburgh University Press, 2011).  This short appreciation of Buckler’s book highlights the two guiding features of Arendt’s method that he brings to the fore. First, its concern with timeliness: are there specific feature of contemporary affairs that political theory must take account of, and if so how? Second, how can political theory abstract from specific political constellations while still remaining relevant to actual political questions? It concludes with a brief note on how Arendt's approach contrasts with other ways of approaching political philosophy

    Taking Responsibility for Negligence and Non-Negligence

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    Negligence reminds us that we often do and cause things unawares, occasionally with grave results. Given the lack of foresight and intention, some authors argue that people should not be judged culpable for negligence. This paper offers a contrasting view. It argues that gaining control (over our agency, over a risky world) is itself a fundamental responsibility, with both collective and individual elements. The paper underlines both sides, focussing on how they relate as we ascribe responsibility or culpability. Following the introduction, Section 2 (“Culpability and Control: The Negligence Sceptics”) argues that conscious awareness is neither necessary nor sufficient for control. Control is not a property of deliberate choice, so much as a practical achievement. Section 3 (“Non-negligence as a Shared Task”) stresses the collective aspects of non-negligence: creating knowledge about risks, structuring environments to guard against them, and developing standards of care. Failings in the collective task, rather than lack of individual control, mean it can often be unfair to pin culpability on a single individual. Section 4 (“Culpability for Negligence Revisited”) suggests that a basic duty of a responsible person is to acknowledge the ways in which we may do more or less than we mean to, often in ways that create risks. It then sketches an approach to culpability as part of a collective exercise: as we take responsibility for standards of care, and for our own and others’ agency

    Explaining epistemic injustice in medicine:Tightrope walking, double binds, paths of least resistance and the invisibility of power positions to those who occupy them

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    Person-centered healthcare requires providers to appreciate the knowledge and perspectives of patients. Effective and appropriate care depends on such knowledge. Medical institutions can only function well when they acknowledge patients’ own experiences. Yet a range of evidence shows that professionals and organisations often ignore patients’ own knowledge about their condition and treatment. This article aims to explain why this epistemic injustice occurs and persists. (Epistemic: to do with knowledge. Justice, because professionals and organisations do wrong when they bypass or deny patients’ own knowledge.) The explanation focuses on problems of power and accountability. Illness is a disempowering experience, partly for bodily and psychological reasons, partly because the ill person depends on others for help, partly because professionals and organisations are specially empowered in order that they may help. Occupying a lesser power position, patients often walk a tightrope between conflicting demands and may be caught in double binds: situations where every possibility for action risks bad outcomes. By contrast, professionals need not notice their greater power position and how this opens up paths of least resistance, whereby it is easy to ignore or belittle patients’ knowledge. When it is hard for patients to voice their “complaints” (the details of their illness, their sense of being badly treated), accountability falters. Healthcare providers may see themselves as expert and responsible, even as they fail many persons they are meant to help

    The IDEFICS intervention:what can we learn for public policy?

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    Introduction: As considered in the rest of this volume, the effects of the IDEFICS intervention on obesity rates were not encouraging. This paper considers how far findings from the IDEFICS study and similar intervention studies are relevant to the policy process and political decision-making. Methods: The paper offers theoretical and policy-level arguments concerning the evaluation of evidence and its implications for policymaking. The paper is divided into three parts. The first considers problems in the nature and applicability of evidence gained from school- and community-level obesity interventions. The second part considers whether such interventions present a model that policy-makers could implement. The third part considers how we should think about policy measures given the limited evidence we can obtain and the many different goals that public policy must take account of. Results: The paper argues that (1) there are clear reasons why we are not obtaining good evidence for effective school- and community-level interventions; (2) public policy is not in a good position to mandate larger-scale, long-term versions of these interventions; and (3) there are serious problems in obtaining ‘evidence’ for most public policy options, but this should not deter us from pursuing options that tackle systemic problems and have a good likelihood of delivering benefits on several dimensions. Conclusions: Research on school- and community-level obesity interventions has not produced much evidence that is directly relevant to policymaking. Instead, it shows how difficult it is to affect obesity rates without changing wider social and economic factors. Public policy should focus on these

    Parents‘ evaluation of the IDEFICS intervention:an analysis focussing on socio-economic factors, child’s weight status and intervention exposure

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    Introduction: From April 2008 to August 2010 the Identification and prevention of Dietary- and lifestyle-induced health EFfects In Children and infantS (IDEFICS) intervention aimed to encourage healthier diets, higher physical activity levels and lower stress levels among European children and their families. While the intervention was intended to improve children’s health, we also wished to assess whether there were unwelcome aspects or negative side-effects. Therefore all parents of children who participated in the IDEFICS intervention were asked for their views on different aspects of the intervention. Methods: A total of 10,016 parents of children who participated in the IDEFICS survey and who were involved in the intervention were invited to complete a questionnaire on positive and negative impacts of the intervention. Responses to each of the statements were coded on a four point Likert-type scale. Demographic data were collected as part of the baseline (T0) and first follow-up (T1) surveys; intervention exposure data was also collected in the T1 follow-up survey. Anthropometric data was collected in the same surveys, and child’s weight status was assessed according to Cole and Lobstein. After initial review of the univariate statistics multi-level logistic regression was conducted to analyse the influence of socio-economic factors, child’s weight status and intervention exposure on parental responses. Results: In total 4,997 responses were received. Approval rates were high, and few parents reported negative effects. Parents who reported higher levels of exposure to the intervention were more likely to approve of it and were also no more likely to notice negative aspects. Less-educated and lower income parents were more likely to report that the intervention would make a lasting positive difference, but also more likely to report that the intervention had had negative effects. Parents of overweight and obese children were more likely to report negative effects – above all, that ‘the intervention had made their child feel as if he/she was “fat” or “overweight.”’ Conclusion: While the results represent a broad endorsement of the IDEFICS intervention, they also suggest the importance of vigilance concerning the psychological effects of obesity interventions on overweight and obese children

    Consent and confidentiality in the light of recent demands for data sharing

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    Many attempts have been made to formalize ethical requirements for research. Among the most prominent mechanisms are informed consent requirements and data protection regimes. These mechanisms, however, sometimes appear as obstacles to research. In this opinion paper, we critically discuss conventional approaches to research ethics that emphasize consent and data protection. Several recent debates have highlighted other important ethical issues and underlined the need for greater openness in order to uphold the integrity of health-related research. Some of these measures, such as the sharing of individual-level data, pose problems for standard understandings of consent and privacy. Here, we argue that these interpretations tend to be overdemanding: They do not really protect research subjects and they hinder the research process. Accordingly, we suggest another way of framing these requirements. Individual consent must be situated alongside the wider distribution of knowledge created when the actions, commitments, and procedures of researchers and their institutions are opened to scrutiny. And instead of simply emphasizing privacy or data protection, we should understand confidentiality as a principle that facilitates the sharing of information while upholding important safeguards. Consent and confidentiality belong to a broader set of safeguards and procedures to uphold the integrity of the research process

    Differential outcome of the IDEFICS intervention in overweight versus non-overweight children:did we achieve ‘primary’ or ‘secondary’ prevention?

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    Background: The aim of this study was to explore whether the IDEFICS intervention had a differential effect on 11,041 children’s weight trajectories depending on their baseline body mass index status. Methods: Two subgroups of children are considered in the present analysis: those who were overweight or obese prior to the intervention and those who were neither overweight nor obese. Results: Among children in all eight countries who did not have prevalent overweight or obesity (OWOB) at baseline, 2 years later, there was no significant difference between intervention and control groups in risk of having developed OWOB. However, we observed a strong regional heterogeneity, which could be attributed to the presence of one distinctly outlying country, Belgium, where the intervention group had increased risk for becoming overweight. In contrast, among the sample of children with prevalent OWOB at baseline, we observed a significantly greater probability of normalized weight status after 2 years. In other words, a protective effect against persistent OWOB was observed in children in intervention regions compared with controls, which corresponded to an adjusted odds ratio of 0.76 (95% confidence interval: 0.58, 0.98). Discussion: This analysis thus provided evidence of a differential effect of the IDEFICS intervention, in which children with overweight may have benefited without having been specifically targeted. However, no overall primary preventive effect could be observed in children without initial overweight or obesity

    The Social Creation of Morality and Complicity in Collective Harms:A Kantian Account

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    This article considers the charge that citizens of developed societies are complicit in large‐scale harms, using climate destabilisation as its central example. It contends that we have yet to create a lived morality – a fabric of practices and institutions – that is adequate to our situation. As a result, we participate in systematic injustice, despite all good efforts and intentions. To make this case, the article draws on recent discussions of Kant's ethics and politics. Section 2 considers Tamar Schapiro's account of how otherwise decent actions can be corrupted by others’ betrayals, and hence fall into complicity. Section 3 turns to discussions by Christine Korsgaard and Lucy Allais, which highlight how people can be left without innocent choices if shared frameworks of interaction do not instantiate core ideals. Section 4 brings these ideas together in order to make sense of the charge of complicity in grave collective harms, and addresses some worries that the idea of unavoidable complicity may raise

    Regulation Enables:Corporate Agency and Practices of Responsibility

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    Both advocates of corporate regulation and its opponents tend to depict regulation as restrictive—a policy option that limits freedom in the name of welfare or other social goods. Against this framing, I suggest we can understand regulation in enabling terms. If well designed and properly enforced, regulation enables companies to operate in ways that are acceptable to society as a whole. This paper argues for this enabling character by considering some wider questions about responsibility and the sharing of responsibility. Agents who are less able or willing to act well are obviously more likely to face criticism, mistrust, and adverse responses. It will be more difficult to hold those agents responsible, especially so when there are many who fail in their responsibilities or where there are wide-reaching disagreements about those responsibilities. Regulatory standards, like other norms and ways of defining responsibilities, address these problems: by restricting, they also enable social cooperation. Like other forms of holding responsible, ways of enforcing those standards against recalcitrant agents, or encouraging conformity to them, may also seem restrictive. Again, however, these practices play an important role in enabling responsible agency. This is partly because they can bolster readiness to act well in agents who experience or witness such responses. It is also because they free other agents to exercise initiative and commitment in defining their individual responsibilities in line with higher standards

    Verantwortung, RationalitÀt und Urteil

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    This chapter examines the philosophical grounds for linking responsibility with capacities to reason and to judge in the light of moral considerations. It discusses five different accounts that connect responsibility and rationality, the work of: Susan Wolf, R Jay Wallace, the jointly authored work of John Martin Fischer and Mark Ravizza, Angela M Smith, and Pamela Hieronymi. Through these authors’ contributions, the chapter argues that the notion of rational ability is central to understanding and justifying practices of responsibility. Although there has been clear progress in debates about this connection, however, understanding the notion of rational or moral ability still poses profound challenges. One reason for this is suggested: such abilities may have constitutive connections with practices of holding responsible and of taking responsibility – connections that have yet to be fully explored in the literature
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