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Added by: Chris Blake-TurnerAbstract:
In this article, I argue that (1) transgender adolescents should have the legal right to access puberty-blocking treatment (PBT) without parental approval, and (2) the state has a role to play in publicizing information about gender dysphoria. Not only are transgender children harmed psychologically and physically via lack of access to PBT, but PBT is the established standard of care. Given that we generally think that parental authority should not go so far as to (1) severally and permanently harm a child and (2) prevent a child from access to standard physical care, then it follows that parental authority should not encompass denying gender-dysphoric children access to PBT. Moreover, transgender children without supportive parents cannot be helped without access to health care clinics and counseling to facilitate the transition. Hence there is an additional duty of the state to help facilitate sharing this information with vulnerable teens.Ashley, Florence. Gatekeeping Hormone Replacement Therapy for Transgender Patients is Dehumanising2019, The Journal of Medical Ethics. 45: 480-482.-
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Added by: Chris Blake-TurnerAbstract:
Although informed consent models for prescribing hormone replacement therapy are becoming increasingly prevalent, many physicians continue to require an assessment and referral letter from a mental health professional prior to prescription. Drawing on personal and communal experience, the author argues that assessment and referral requirements are dehumanising and unethical, foregrounding the ways in which these requirements evidence a mistrust of trans people, suppress the diversity of their experiences and sustain an unjustified double standard in contrast to other forms of clinical care. Physicians should abandon this unethical requirement in favour of an informed consent approach to transgender care.Comment (from this Blueprint): Ashley draws on their own experiences as a trans person, as well as that of the trans community more broadly, to argue against assessment and referral requirements for hormone-replacement therapy (HRT). Ashley argues instead for an informed consent model, on which providers of HRT are not gatekeepers of transness, but facilitators of thoughtful decision-making.
Peter, Elizabeth, Liaschenko, Joan. Moral Distress Reexamined: A Feminist Interpretation of Nurses’ Identities, Relationships, and Responsibilites2013, The Journal of Bioethical Inquiry. 10: 337–345.-
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Added by: Chris Blake-TurnerAbstract:
Moral distress has been written about extensively in nursing and other fields. Often, however, it has not been used with much theoretical depth. This paper focuses on theorizing moral distress using feminist ethics, particularly the work of Margaret Urban Walker and Hilde Lindemann. Incorporating empirical findings, we argue that moral distress is the response to constraints experienced by nurses to their moral identities, responsibilities, and relationships. We recommend that health professionals get assistance in accounting for and communicating their values and responsibilities in situations of moral distress. We also discuss the importance of nurses creating “counterstories” of their work as knowledgeable and trustworthy professionals to repair their damaged moral identities, and, finally, we recommend that efforts toward shifting the goal of health care away from the prolongation of life at all costs to the relief of suffering to diminish the moral distress that is a common response to aggressive care at end-of-life.Comment (from this Blueprint): Moral distress is, roughly, when a healthcare worker is institutionally constrained to act against their best moral judgement. A typical example is a nurse being prevented from giving care they deem morally required because they are hierarchically constrained by the orders of a physician. Moral distress has been much discussed in nursing ethics, but is almost entirely absent from broader bioethics syllabi and conversations. This paper examines moral distress through a lens of feminist care ethics. In doing so, it draws lessons that apply very broadly throughout professional ethics.
Stramondo, Joseph A.. Tragic Choices: Disability, Triage, and Equity Amidst a Global Pandemic2021, The Journal of Philosophy of Disability. 1: 201–210.-
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Added by: Chris Blake-TurnerAbstract:
In this paper, I make three arguments regarding Crisis Standards of Care developed during the COVID-19 pandemic. First, I argue against the consideration of third person quality of life judgments that deprioritize disabled or chronically ill people on a basis other than their survival, even if protocols use the language of health to justify maintaining the supposedly higher well-being of non-disabled people. Second, while it may be unavoidable that some disabled people are deprioritized by triage protocols that must consider the likelihood that someone will survive intensive treatment, Crisis Standards of Care should not consider the amount or duration of treatment someone may need to survive. Finally, I argue that, rather than parsing who should be denied treatment to maximize lives saved, professional bioethicists should have put our energy into reducing the need for such choices at all by resisting the systemic injustices that drive the need for triage.Comment (from this Blueprint): Stramondo critiques triage protocols that were put into place, or at least proposed, during the COVID-19 pandemic. Stramondo argues that protocols that prioritize quality of life involve ableist commitments. While chance-of-survival protocols might do better here, he argues that they are also vulnerable to creeping ableism. Stramondo’s paper is valuable not only for its perspective on triage protocols, but also for highlighting some crucial theoretical contributions by philosophers of disability and by bioethicists. Stramondo also argues not to cede too much ground to fatalism in thinking about triage protocols; bioethicists should also, and perhaps primarily, resist the framing of triage as inevitable, rather than a product of various privileged interests.
Wiesler, Christine. Epistemic Oppression and Ableism in Bioethics2020, Hypatia. 35: 714–732.-
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Added by: Chris Blake-TurnerAbstract:
Disabled people face obstacles to participation in epistemic communities that would be beneficial for making sense of our experiences and are susceptible to epistemic oppression. Knowledge and skills grounded in disabled people's experiences are treated as unintelligible within an ableist hermeneutic, specifically, the dominant conception of disability as lack. My discussion will focus on a few types of epistemic oppression—willful hermeneutical ignorance, epistemic exploitation, and epistemic imperialism—as they manifest in some bioethicists’ claims about and interactions with disabled people. One of the problems with the epistemic phenomena with which I am concerned is that they direct our skepticism regarding claims and justifications in the wrong direction. When we ought to be asking dominantly situated epistemic agents to justify their knowledge claims, our attention is instead directed toward skepticism regarding the accounts of marginally situated agents who are actually in a better position to know. I conclude by discussing disabled knowers’ responses to epistemic oppression, including articulating the epistemic harm they have undergone as well as ways of creating resistant ways of knowing.Comment (from this Blueprint): Wieseler draws on resources developed by feminists and disability theorists to critique the practice of philosophical bioethics (bioethics done by philosophers). In particular, she argues that philosophical bioethics involves and perpetuates ableism. Among its many problems, this ableism is epistemically fraught. It interferes with disabled people’s ability to participate in various kinds of knowledge production. Wieseler uses a lot of technical terms—like epistemic exploitation, epistemic imperialism, and willful hermeneutical ignorance—but she explains everything clearly and the payoff is worthwhile. Wieseler uses these concepts to develop a powerful and thought-provoking critique of bioethical practice with respect to disability. The concepts are also useful in broader contexts, as we’ll see in section 3.
Shelby, Tommie. Justice, Work, and the Ghetto Poor2012, The Law and Ethics of Human Rights. 6 (1): 69-96-
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Added by: Deryn Mair ThomasAbstract:
In view of the explanatory significance of joblessness, some social scientists, policymakers, and commentators have advocated strong measures to ensure that the ghetto poor work, including mandating work as a condition of receiving welfare benefits. Indeed, across the ideological political spectrum, work is often seen as a moral or civic duty and as a necessary basis for personal dignity. And this normative stance is now instantiated in federal and state law, from the tax scheme to public benefits. This Article reflects critically on this new regime of work. I ask whether the normative principles to which its advocates typically appeal actually justify the regime. I conclude that the case for a pro tanto moral or civic duty to work is not as strong as many believe and that there are reasonable responses to joblessness that do not involve instituting a work regime. However, even if we grant that there is a duty to work, I maintain that the ghetto poor would not be wronging their fellow citizens were they to choose not to work and to rely on public funds for material support. In fact, I argue that many among the black urban poor have good reasons to refuse to work. Throughout, I emphasize what too few advocates of the new work regime do, namely, that whether work is an obligation depends crucially on whether background social conditions within the polity are just.Comment (from this Blueprint): This text is useful for several reasons. First, it introduces an argument examining a civic obligation to work; second, it discusses that obligation in relation to structural injustices regarding socio-economic and racial inequality. It can be used to discuss the intersection of these topics more generally, or to further discuss philosophical questions concerning who should have access to good work and why.
Greene, Amanda. Making a Living: The Human Right to Livelihood2019, In Jahel Queralt and Bas van der Vossen (eds.), Economic Liberties and Human Rights. Routledge.-
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Added by: Deryn Mair ThomasAbstract:
In this chapter I argue that we have a human right to livelihood. Although some economic rights have been defended under a human rights framework, such as freedom of occupation and the right to an adequate standard of living, the right to livelihood requires a separate defense. We have a livelihood when we are able to exercise some control over how we generate income and accumulate wealth. I argue that this control is good in itself, and that it leads to two further goods, social contribution esteem and a sense of self-provision. Beyond its being a right per se, having a livelihood also fulfills Joseph Raz’s conditions for being a constitutional right, insofar as it is a right that can be fairly and effectively protected through legal mechanisms, and for being a human right, insofar as it a right that can be suitably enforced through a system of international law.Comment (from this Blueprint): Greene's perspective, although not the same as Penner's, does share some important features, and as a result, she presents an argument for a right to livelihood which can help push students into another set of questions related to this weeks topic. These ask whether having agency over one's material resources and the manner of their acquisition is so important as to be essential, and consequently, whether that can be considered a right. One could also use this text to challenge the dominant rights narrative - perhaps a having a livelihood is essential, but not the sort of good that can be protected by rights. In that case, one could use the text to explore what other ways this important human capability might be protected, and by whom.
Herzog, Lisa. Reclaiming the System: Moral Responsibility, Divided Labour, and the Role of Organizations in Society2018, Oxford University Press-
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Added by: Deryn Mair ThomasPublisher’s Note:
The world of wage labour seems to have become a soulless machine, an engine of social and environmental destruction. Employees seem to be nothing but ‘cogs’ in this system—but is this true? Located at the intersection of political theory, moral philosophy, and business ethics, this book questions the picture of the world of work as a ‘system’. Hierarchical organizations, both in the public and in the private sphere, have specific features of their own. This does not mean, however, that they cannot leave room for moral responsibility, and maybe even human flourishing. Drawing on detailed empirical case studies, Lisa Herzog analyses the nature of organizations from a normative perspective: their rule-bound character, the ways in which they deal with divided knowledge, and organizational cultures and their relation to morality. She asks how individual agency and organizational structures would have to mesh to avoid common moral pitfalls. She develops the notion of ‘transformational agency’, which refers to a critical, creative way of engaging with one’s organizational role while remaining committed to basic moral norms. The last part zooms out to the political and institutional changes that would be required to re-embed organizations into a just society. Whether we submit to ‘the system’ or try to reclaim it, Herzog argues, is a question of eminent political importance in our globalized world.Comment (from this Blueprint): This text, an introduction to a longer work on organisational ethics, proposes and discusses novel arguments about the nature of organisations, and organisational spaces, as moral entities. By challenging long held common sense assumptions that corporate organisations are 'amoral' or outside the scope of human morality, Herzog offers an alternate view. It is therefore useful as a way to examine and discuss alternate visions of organisational structure and the role that human beings play as moral agents within those structures.
Galgut, Elisa. A Critique of the Cultural Defense of Animal Cruelty2019, Journal of Animal Ethics 9 (2):184-
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Added by: Simon Fokt, Contributed by: AnonymousAbstract:
I argue that cultural practices that harm animals are not morally defensible: Tradition cannot justify cruelty. My conclusion applies to all such practices, including ones that are long-standing, firmly entrenched, or held sacred by their practitioners. Following Mary Midgley, I argue that cultural practices are open to moral scrutiny, even from outsiders. Because animals have moral status, they may not be harmed without good reason. I argue that the importance of religious or cultural rituals to adherents does not count as a sufficiently good reason to harm or kill animals, since rituals are inherently symbolic, and cultures are able to adapt and change, making adherence to cruel traditions unnecessary.Comment: This paper can be used in a class on animal ethics / rights. It argues that rituals involving harm or cruelty to animals are not justifiable. The paper can be used in a discussion on animal rights issues and multi-culturalism.
Galgut, Elisa. Raising the Bar in the Justification of Animal Research2015, Journal of Animal Ethics 5 (1):5-19-
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Added by: Simon Fokt, Contributed by: AnonymousAbstract:
Animal ethics committees (AECs) appeal to utilitarian principles in their justification of animal experiments. Although AECs do not grant rights to animals, they do accept that animals have moral standing and should not be unnecessarily harmed. Although many appeal to utilitarian arguments in the justification of animal experiments, I argue that AECs routinely fall short of the requirements needed for such justification in a variety of ways. I argue that taking the moral status of animals seriously—even if this falls short of granting rights to animals—should lead to a thorough revision or complete elimination of many of the current practices in animal experimentation.Comment: This paper can be used in a course on animal research ethics.
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Priest, Maura. Transgender Children and the Right to Transition: Medical Ethics When Parents Mean Well but Cause Harm
2019, The American Journal of Bioethics. 19 (2): 45-59.
Comment (from this Blueprint): Priest argues that the state should provide puberty-blocking treatment (PBT) for trans youth, even if their parents are not supportive. Priest’s argument is important partly because it avoids the issue of whether adolescents and children can give properly informed consent. This is a point that some of Priest’s critics seem to have missed (see, for example, Laidlaw et al. 2019. “The Right to Best Care for Children Does Not Include the Right to Medical Transition”, and Harris et al. 2019. “Decision Making and the Long-Term Impact of Puberty Blockade in Transgender Children”). Priest’s conclusion is founded instead on a principle of harm avoidance.