Kennedy Institute of Ethics Journal最新文献

One recent body of work has concerned medicalization and how it can create epistemic injustice. It focuses on medicalization as a hermeneutical process that shapes the conceptual framework(s) we use to refer to some conditions/experiences. In parallel, some scholars with lived experience of madness have started to explore the epistemic harms suffered by the Mad community. Building on this, I argue that the process of medicalization in psychiatry affects the Mad community in a specific way that has been overlooked in the literature on medicalization and epistemic injustice. That is, medicalization can create what is called "contributory injustice." This form of injustice occurs when marginalized communities have been able to create alternative hermeneutical resources, but these resources are dismissed or discredited by the dominant group. I argue that the emerging field of Mad Studies is a victim of this type of injustice when Mad experiences are unilaterally medicalized.

Robert Veatch argues that physician oaths should not be valued as substantive moral commitments, transformational rituals, or symbolic acts. Further, he insists that oath recitation in medical schools is immoral. I respond to Veatch's criticisms and argue that, with alterations to their content and practice, oaths can have value for articulating moral commitments and building a sense of moral community within the profession. I break down Veatch's multitude of objections to oaths over his career, and I suggest how medical schools can avoid the pitfalls identified by Veatch. A promising and innovative path forward is to integrate a commitment to diversity, equity, and inclusion-though with an understanding that a few lines in an oath are far from sufficient for institutional culture, faculty accountability, or students' education.

This paper offers a novel argument for the claim that "environmental" explanations of obesity meant to help address racial health disparities may actually reinforce racism. While some contend that these explanations reinforce racist and sizeist interracial dynamics, we argue that environmental explanations can bolster intraracial hierarchies of whiteness that reinforce white supremacy. Deployments of environmental accounts in contexts like the U.S. invoke and intertwine two damaging dichotomies: the "good fatty/bad fatty" and the "good white person/bad white person." This supports a cultural system that oppresses people of color and enables thin, white proponents to position themselves as "good white people" against those who deploy racist, moralizing accounts of obesity, and against fat white people, who are implicitly framed as morally inferior. This analysis furthers our understanding of racist and sizeist discourse about fatness and the insidious ways that attempts to address racism can reinforce it.

Guidelines and regulations for medical research recognize that the experiences of humans and animals both matter morally. They thus set a presumption against harming research subjects, whether humans or animals, and mandate that the harms subjects experience should be the minimal necessary for achieving the scientific aims of the study. Beyond this, guidelines and regulations place upper limits on the extent to which human, but not animal, subjects may be harmed. They also mandate that human, but not animal, subjects should be compensated for the harms they experience. In this article, I argue that this common approach to regulating medical research is mistaken. In particular, there are upper limits on the extent to which animals may ethically be harmed in order to collect data to benefit others, and there are moral reasons to compensate them for the harms they experience. I conclude that guidelines and regulations for research with animals should be revised accordingly.

Although researchers generally take great care to ensure that human subjects do not suffer very serious harms from their involvement in research, the situation is different for nonhuman animal subjects. Significant progress has been made in reducing unnecessary animal suffering in research, yet researchers still inflict severe pain and distress on tens of thousands of animals every year for scientific purposes. Some bioethicists, scientists, and animal welfare advocates argue for placing an upper limit on the suffering researchers may impose on animal subjects, with rare exceptions for research that promises critical social benefits. In this article, I argue against such an upper limit on harm on the grounds that researchers often can compensate animal subjects for their suffering, even severe and long-lasting suffering. If animal subjects receive adequate compensation for the harms they suffer, then there is no general limit on how much suffering researchers may impose on them for scientific purposes.