Pre-Reflective Ethical Know-How

In recent years there has been growing attention paid to a kind of human action or activity which does not issue from a process of reflection and deliberation and which is described as, e.g., ‘engaged coping’, ‘unreflective action’, and ‘flow’. Hubert Dreyfus, one of its key proponents, has developed a phenomenology of expertise which he has applied to ethics in order to account for ‘everyday ongoing ethical coping’ or ‘ethical expertise’. This article addresses the shortcomings of this approach by examining the pre-reflective ethical know-how individuals first develop and on which all later forms of ethical expertise are dependent. In the first section an account is given of the ‘ethical second nature’ which every individual develops from childhood onwards and which forms the basis of pre-reflective ethical know-how. The acquisition of an ethical second nature early on opens up the very domain of ‘the ethical’ for us in the first place and is constitutive of our sensitivity to it. The second section turns to pre-reflective ethical know-how and whether it is conceptual in nature. Just as sensorimotor understanding forms the basis of our reflective perceptual concepts, pre-reflective ethical know-how is similarly proto-conceptual and is the source of our reflective ethical and moral concepts. Finally, the third section examines the process whereby ethical second nature and pre-reflective ethical know-how are actually acquired, namely, through immersion in an ‘ethical world’. This world consists of both the web of ethical meanings and significances which has evolved in a particular society or community as well as its members whose actions and interactions continually reproduce that web.     

‘Ought’ and Control

Ethical theorists often assume that the verb ‘ought’ means roughly ‘has an obligation’; however, this assumption is belied by the diversity of ‘flavours’ of ought-sentences in English. A natural response is that ‘ought’ is ambiguous. However, this response is incompatible with the standard treatment of ‘ought’ by theoretical semanticists, who classify ‘ought’ as a member of the family of modal verbs, which are treated uniformly as operators. To many ethical theorists, however, this popular treatment in linguistics seems to elide an important distinction between agential and non-agential ought-statements. The thought is that ‘ought’ must have at least two senses, one implicating agency and connected to obligations, and another covering other uses. In this paper, I pursue some resolution of this tension between semantic theory and ethical theory with respect to the meaning of ‘ought’. To this end, I consider what I believe to be the most linguistically sophisticated argument for the view that the word ‘ought’ is ambiguous between agential and non-agential senses. This argument, due to Mark Schroeder, is instructive but based on a false claim about the syntax of agential ought-sentences—or so I attempt to show by first situating Schroeder's argument in its proper linguistic background and then discussing some syntactic evidence that he fails to appreciate. Then, I use the failure of this argument to motivate some more general reflections on how the standard treatment of ‘ought’ by theoretical semanticists might be refined in the light of the distinction important to ethical theory between agential and non-agential ought-statements, but also on how ethical theory might benefit from more careful study of the dominant treatment of modals as operators in theoretical semantics.     

Irony,Embodiment, and the ‘critical Attitude’: Engaging Saba Mahmood's Critique of Secular Morality

At the intersection of feminism, postcolonial studies, and religious studies, this essay engages Saba Mahmood's critique of universalistic ethics and post-structural feminism. It contrasts Mahmood's ‘ethical embodiment’ with a concept of ‘ethical irony’, offering examples of the latter from literature (Brecht, Baudelaire) and cultural theory (Carolyn Steedman, Judith Butler, Michel Foucault). Its thesis is that ethical irony signifies modes of critical engagement that are not premised on notions of metaphysical subjectivity or abstract rules, but may nonetheless be cross-culturally translatable. One specific formulation of ethical irony considered concerns the figure of injurable bodies. At once material (bodily) and transcendental (unknown injuries from unknown sources, or the possibility of injury), injurable bodies the irreducibility of ethics to the purely abstract and the purely empirical. Finally, the defence of ethical irony speaks to the viability of upholding what Foucault called the ‘critical attitude’ as a cross-cultural norm.     

Three paradoxes of medical diagnosis

Sadegh-zadeh [23] has proposed a theory of the relativity of medical diagnosis in terms of the time at which a diagnosis is accepted, the patient to whom the diagnosis applies, the physician who renders the diagnosis, the medical knowledge used, the diagnostic method applied, and the set of patient observations. Use of classical formal logic as the ‘diagnostic method’ may result in three paradoxes: the paradoxes of consistency, completeness, and justifiable ignorance. These paradoxes may be resolved by the addition of two non-classical operators, the ‘certainty’ and ‘effort’ operators, akin to the non-classical operators of modal logic.     

Scandalous subwomen and sublime superwomen: exploring portrayals of female suicide bombers’ agency

When the terms ‘women’ and ‘violence’ are used, it is usually in the context of women as victims and rarely as perpetrators of violence, and yet women do behave aggressively – for instance, as female suicide bombers. An ethical analysis of this role, however, has tended to be somewhat overlooked, partly because of the gender stereotypes at play, with little (or spurious) focus on the agency and autonomy of the women. This has resulted in an incomplete understanding of the unique ways in which societies treat female political aggressions, and the consequences of this for their agency. This paper seeks to redress these issues by evaluating two different societal portrayals of female suicide bombers; that of the ‘scandalous subwoman’ and the ‘sublime superwoman’. It argues that violent women's agency is often distorted to extremes beyond that of their male counterparts, and that it is imperative to avoid misrepresenting them either as agentless victims (‘subwomen’) or wholly agentic (‘superwomen’) since, even in times of political instability, they can rarely be dichotomised in this binary way.     

Drawing Limits: contemporary views on biotechnology

Biotechnology deals with the stuff of life; living things can be changed and barriers between species broken down. Through biotechnology human beings are ‘playing god’ in ways that have not been possible before. This article discusses some findings of the Biocult project, which investigated the views of 956 young people on risk and safety in relation to biotechnology [1]. The article focuses on the responses of young people aged 11 to 18 to the statement ‘human beings can use science and technology to do what they want’ set in the context of answers to other questions on specific applications. Despite the emphasis on individual freedom of choice found in surveys of personal morality, most young people spontaneously brought in notions of limits and barriers to human action in the field of biotechnology. The ways these limits are justified are of interest as they uncover ethical thinking which may or may not be religious or spiritual.     

Playing God and the Intrinsic Value of Life: Moral Problems for Synthetic Biology?

Most of the reports on synthetic biology include not only familiar topics like biosafety and biosecurity but also a chapter on ‘ethical concerns’; a variety of diffuse topics that are interrelated in some way or another. This article deals with these ‘ethical concerns’. In particular it addresses issues such as the intrinsic value of life and how to deal with ‘artificial life’, and the fear that synthetic biologists are tampering with nature or playing God. Its aim is to analyse what exactly is the nature of the concerns and what rationale may lie behind them. The analysis concludes that the above-mentioned worries do not give genuine cause for serious concern. In the best possible way they are interpreted as slippery slope arguments, yet arguments of this type need to be handled with care. It is argued that although we are urged to be especially vigilant we do not have sufficiently cogent reasons to assume that synthetic biology will cause such fundamental hazards as to warrant restricting or refraining from research in this field.     

Discourse,agency and the question of evil

Abstract

This paper addresses the question of evil from an ethical and discourse-analytical perspective, taking Joan Copjec’s commentary on Kant’s notion of ‘radical evil’ and its relation to human freedom as its point of departure. Specifically, Copjec’s argument, that for Kant (and, one may add, for Lacan) the subject is always “in excess of itself”, provides an important foil for, or corrective to what may seem to be the upshot of Foucault’s notion of discourse (its heuristic value notwithstanding). The latter entails that, insofar as the subject is ineluctably discursively constructed, its actions could be understood as being ‘determined’ by the discursive structure of (its) subjectivity. That is, the subject as agent may seem to lack volitional freedom in the sense that it is merely an instrument of a certain discourse by which it is ’spoken‘. However, Kant’s idea of ’radical evil‘, it is further argued, presupposes that the subject is free, in other words, that it always exceeds itself. In Foucault’ s terms, this would mean that the subject of discourse is able to adopt a counter-discursive position - something Foucault sometimes seems to make room for. What Kant calls ‘radical evil’ may be understood as something that occurs in the world through human agency, in the face of the possibility of an alternative course of action; that is, it is chosen - even if we only know this in retrospect through the phenomenon of guilt. i, in contrast, it is understood as being ‘diabolical’ in the sense of being unavoidably and irresistibly part and parcel of human ‘nature’, no one could condemn it in moral terms. This line of thinking is fleshed out, or given concrete significance by means of a discourse-analysis of documents pertaining to the so-called ‘ripper-rapist’ (criminal) case in Port Elizabeth, South Africa, in the mid-1990s.     

Hydrogen Fuel‐Cell Vehicles,Energy Policy,and the Ethics of Expertise

Relatively few thinkers have attempted to develop a systematic ‘ethics of expertise’ (EOE) that can guide scientists and other technical experts in providing information to the public. This paper argues that the prima facie duty to disseminate information in a manner that does not damage the self‐determination of decision makers could fruitfully serve as one of the core principles of an EOE. Moreover, this duty can be fleshed out in promising ways by drawing on the concept of informed consent, which guides medical clinicians in preserving the self‐determination of their patients. The paper applies the resulting ethical framework to recent policy discussions about hydrogen fuel‐cell (HFC) vehicles, both because they have received a good deal of research funding and because their merits have been hotly debated. It concludes that technical experts providing information about HFC vehicles should be especially cognizant of three issues: (1) important alternatives to hydrogen technology that need to be addressed, (2) major false beliefs that should be prevented or corrected, and (3) significant framing effects that could influence the recipients of information.     

Engagement and suffering in responsible caregiving: On overcoming maleficience in health care

The thesis of this article is that engagement and suffering are essential aspects of responsible caregiving. The sense of medical responsibility engendered by engaged caregiving is referred to herein as ‘clinical phronesis,’ i.e. practical wisdom in health care, or, simply, practical health care wisdom. The idea of clinical phronesis calls to mind a relational or communicative sense of medical responsibility which can best be understood as a kind of ‘virtue ethics,’ yet one that is informed by the exigencies of moral discourse and dialogue, as well as by the technical rigors of formal reasoning. The ideal of clinical phronesis is not (necessarily) contrary to the more common understandings of medical responsibility as either beneficence or patient autonomy — except, of course, when these notions are taken in their “disengaged” form (reflecting the malaise of “modern medicine”). Clinical phronesis, which gives rise to a deeper, broader, and richer, yet also to a more complex, sense than these other notions connote, holds the promise both of expanding, correcting, and perhaps completing what it currently means to be a fully responsible health care provider. In engaged caregiving, providers appropriately suffer with the patient, that is, they suffer the exigencies of the patient's affliction (though not his or her actual loss) by consenting to its inescapability. In disengaged caregiving — that ruse Katz has described as the ‘silent world of doctor and patient’ — provides may deny or refuse any ‘given’ connection with the patient, especially the inevitability of the patient's affliction and suffering (and, by parody of reasoning, the inevitability of their own. When, however, responsibility is construed qualitatively as an evaluative feature of medical rationality, rather than quantitatively as a form of ‘calculative reasoning’ only, responsibility can be viewed more broadly as not only a matter of science and will, but of language and communication as well — in particular, as the task of responsibly narrating and interpreting the patient's story of illness. In summary, the question is not whether phronesis can ‘save the life of medical ethics’ — only responsible humans can do that! Instead, the question should be whether phronesis, as an ethical requirement of health care delivery, can ‘prevent the death of medical ethics.’     

Facilitating Informed Consent: A Multicultural Perspective

Respect for the dignity and autonomy of patients has long been a fundamental principle of ethical decision making. As a practical matter, a primary way of maintaining this ethical standard is by obtaining an individual’s informed consent prior to intervening or collecting data. By giving individuals clear information about alternative treatments and potential risks and benefits, the practitioner tries to ensure that the patient can make an informed choice. However, there are cases in which those seeking informed consent have very different values and belief systems from those whose consent is being sought. In this article we explore such discrepancies using informed consent with Navajo clients as an example, illustrate potential challenges with case examples, and propose ways in which ethical dilemmas may be successfully navigated.     

Kierkegaard,Levinas and the Question of Escaping Metaphysics

While Kierkegaard and Levinas may well be thought of as religious or ethical thinkers, I should not like the reader to be misled by this into assuming that this article is primarily about religion or ethics. Rather, my main concern may more properly be described as metaphysical or epistemological, for I am interested in certain styles of thinking that underlie the religious/ethical themes dealt with here. Thus, this article aims to show that in relation to traditional metaphysical styles, and to each other, the thinking of Kierkegaard and Levinas is parallel and divergent in complex ways. Both share a mistrust of modernist metaphysics, which they aim to escape by pointing to the way in which conceptions of metaphysical totalities (or systems) are breached by a destabilising infinity already internal to them. This anticipates later postmodern styles of thinking which challenge modern metaphysics, its resentment against time, and its confidence in human power to represent all that is by means of closed systems of interpretation. To the extent that they offer philosophical alternatives that accommodate the temporal, both have had highly significant contributions to make to a postmodern style of thinking that has implications not limited to religion or ethics. A study of the philosophical strategies of these two thinkers, where they seem to succeed or fall short in relation to each other and to the traditional strategies of metaphysics, should go some way toward clarification of what I believe to be the most viable style of thinking for a postmodern world. As I see it, one is confronted with three options. The first, represented by Kierkegaard’s ‘infinite resignation,’ may be associated with a Derridean style of thinking. Kierkegaard himself abandons this in favour of a style of thinking for which faith and revelation stand as metaphors. Levinas, in contrast, offers an alternative whose leitmotif is ethical responsibility. I shall try to show in the end that the first of these, which best accommodates the ‘undecidability’ of a middle ground, is the most suitable for contemporary thinkers.     

What is Genetic Information,and why is it Significant? A Contextual,Contrastive, Approach

abstract Is genetic information of special ethical significance? Does it require special regulation? There is considerable contemporary debate about this question (the ‘genetic exceptionalism’ debate). ‘Genetic information’ is an ambiguous term and, as an aid to avoiding conflation in the genetic exceptionalism debate, a detailed account is given of just how and why ‘genetic information’ is ambiguous. Whilst ambiguity is a ubiquitous problem of communication, it is suggested that ‘genetic information’ is ambiguous in a particular way, one that gives rise to the problem of ‘significance creep’ (i.e., where claims about the significance of certain kinds of genetic information in one context influence our thinking about the significance of other kinds of genetic information in other contexts). A contextual and contrastive methodology is proposed: evaluating the significance of genetic information requires us to be sensitive to the polysemy of ‘genetic information’ across contexts and then examine the contrast in significance (if any) of genetic, as opposed to nongenetic, information within contexts. This, in turn, suggests that a proper solution to the regulatory question requires us to pay more attention to how and why information, and its acquisition, possession and use, come to be of ethical significance.     

Contextualizing Nanotechnology Education: Fostering a Hybrid Imagination in Aalborg,Denmark

In the context of worldwide economic and environmental crisis it is increasingly important that nanotechnology, genomics, media engineering and other fields of ‘technoscience’ with immense societal relevance are taught in ways that promote social responsibility and that educational activities are organized so that science and engineering students will be able to integrate the ‘contextual knowledge’ they learn into their professional, technical–scientific identities and forms of competence. Since the 1970s, teaching programmes in science, technology and society for science and engineering have faded away at many universities and have been replaced by courses in economic and commercial aspects, or entrepreneurship and/or ethical and philosophical issues. By recounting our recent efforts in contextualizing nanotechnology education at Aalborg University in Denmark, we consider a socio-cultural approach to contextual learning, one that is meant to contribute to a greater sense of social responsibility on the part of scientists and engineers. It is our contention that the social, political and environmental challenges facing science and engineering in the world today require the fostering of what we have come to call a ‘hybrid imagination’, mixing scientific–technical skills with a sense of social responsibility or global citizenship, if science and engineering are to help solve social problems rather than create new ones. Three exemplary cases of student project work are discussed: one on raspberry solar cells, which connected nanotechnology to the global warming debate, and two in which surveys on the public understanding of nanotechnology were combined with a scientific–technical project.     

The Ethics of Big Data: Current and Foreseeable Issues in Biomedical Contexts

The capacity to collect and analyse data is growing exponentially. Referred to as ‘Big Data’, this scientific, social and technological trend has helped create destabilising amounts of information, which can challenge accepted social and ethical norms. Big Data remains a fuzzy idea, emerging across social, scientific, and business contexts sometimes seemingly related only by the gigantic size of the datasets being considered. As is often the case with the cutting edge of scientific and technological progress, understanding of the ethical implications of Big Data lags behind. In order to bridge such a gap, this article systematically and comprehensively analyses academic literature concerning the ethical implications of Big Data, providing a watershed for future ethical investigations and regulations. Particular attention is paid to biomedical Big Data due to the inherent sensitivity of medical information. By means of a meta-analysis of the literature, a thematic narrative is provided to guide ethicists, data scientists, regulators and other stakeholders through what is already known or hypothesised about the ethical risks of this emerging and innovative phenomenon. Five key areas of concern are identified: (1) informed consent, (2) privacy (including anonymisation and data protection), (3) ownership, (4) epistemology and objectivity, and (5) ‘Big Data Divides’ created between those who have or lack the necessary resources to analyse increasingly large datasets. Critical gaps in the treatment of these themes are identified with suggestions for future research. Six additional areas of concern are then suggested which, although related have not yet attracted extensive debate in the existing literature. It is argued that they will require much closer scrutiny in the immediate future: (6) the dangers of ignoring group-level ethical harms; (7) the importance of epistemology in assessing the ethics of Big Data; (8) the changing nature of fiduciary relationships that become increasingly data saturated; (9) the need to distinguish between ‘academic’ and ‘commercial’ Big Data practices in terms of potential harm to data subjects; (10) future problems with ownership of intellectual property generated from analysis of aggregated datasets; and (11) the difficulty of providing meaningful access rights to individual data subjects that lack necessary resources. Considered together, these eleven themes provide a thorough critical framework to guide ethical assessment and governance of emerging Big Data practices.     

Democratic pluralism and majority rule

Abstract

I argue that Metz’s undertaking, in seeking a ‘comprehensive basic norm’ to underpin African ethics, is similar to Hans Kelsen’s postulation of the Grundnorm in his Pure Theory of Law. But African ethics does not need to be underpinned by an approach such as Kelsen’s. In my view, Metz’s preference for seeking to develop a Grundnorm rests upon a failure to attend carefully to the distinctness of African ethical thinking from Western ethical thinking. This failure is manifest in a spurious distinction (on which Metz relies) between ‘moral anthropology’ / ‘cultural studies’ and ‘normative theory’. It is also manifest in Metz’s failure to attend carefully to the work of Wiredu and Bujo, both of whom present systematic, critical analyses of African ethical thinking while implicitly rejecting the quest for a Grund norm as being unAfrican.     

What Do Happiness Studies Study?

What do, or should, happiness studies study? Everything to which we refer with the word ‘‘happiness’’ is worth some study. But the study of subjective states covers only part of the ground covered by the word ‘‘happiness’’ and by no means all the ground central to understanding happiness. On the central use of ‘‘happiness,’’ to be happy is to be glad or satisfied or content, which suggests subjectivity, with having a good measure of what is important in life, which suggests objectivity. We find the same suggestion of both subjectivity and objectivity in the list of what enhances the quality of life. There are strong arguments in favour both of the subjectivity of what enhances life and of its objectivity. I argue that neither is right, that the story is more complicated. The conclusion of the story is that there is a list of several non-reducible features that contribute to the quality of a characteristic human life, and that anything that contributes to the quality of any human life will be one or other of these features. But there is a problem. When we speak of the quality of a human life, there may be no one thing we have in mind. Perhaps some of us are not disagreeing with one another over the nature of a ‘‘happy’’ life but speaking of different things.     

Hacking on the Looping Effects of Psychiatric Classifications: What Is an Interactive and Indifferent Kind?

This paper examines Ian Hacking’s analysis of the looping effects of psychiatric classifications, focusing on his recent account of interactive and indifferent kinds. After explicating Hacking’s distinction between ‘interactive kinds’ (human kinds) and ‘indifferent kinds’ (natural kinds), I argue that Hacking cannot claim that there are ‘interactive and indifferent kinds,’ given the way that he introduces the interactive‐indifferent distinction. Hacking is also ambiguous on whether his notion of interactive and indifferent kinds is supposed to offer an account of classifications or objects of classification. I argue that these conceptual difficulties show that Hacking’s account of interactive and indifferent kinds cannot be based on—and should be clearly separated from—his distinction between interactive kinds and indifferent kinds. In clarifying Hacking’s account, I argue that interactive and indifferent kinds should be regarded as objects of classification (i.e., kinds of people) that can be identified with reference to a law‐like biological regularity and are aware of how they are classified. Schizophrenia and depression are discussed as examples. I subsequently offer reasons for resisting Hacking’s claim that the objects of classification in the human sciences—as a result of looping effects—are ‘moving targets’.     

Curious bedfellows: Psychoanalytic understanding and old age psychiatry

SUMMARY

The author outlines an approach to assessment, or as she prefers to call it, psychoanalytic consultation, in the Health Service. This involves giving the patient an experience of the analytic process, which they can then assess in a way, while the assessor gains information about a number of categories that can be thought of hierarchically, which inform the advice given the patient and the referrer about management and treatment. The safety of the patient is paramount, as psychoanalytic psychotherapy is a powerful and disruptive treatment. However it is argued that, on the whole, ‘suitability for psychotherapy’ should be on the basis of exclusion rather than involving the patient passing a sort of ‘suitability test’. The latter may enable public psychotherapy services to deny the incompleteness of what they are able to offer.