Quill R Kukla

In Games: Agency as Art, Thi Nguyen has given us a deep and compelling picture of agency as much more layered, volatile, environment-dependent and discontinuous than it appears in most philosophical accounts. Games ‘inscribe … forms of agency into artifactual vessels’.1 1 When we play a game, we take up a form of agency, including a set of motivations, values and goals, which has been artificially provided by the game. Our purpose in playing, in the kinds of gameplay that interest Nguyen, is to have the aesthetic experience of first-personally exercising the kind of agency sculpted by the game. As we move in and out of gameplay, we take up and drop values, motives, and goals that are provided to us by the game. Games can expand our autonomy and the richness of life by allowing us to practice different forms of agency, taking on different ends for the aesthetic experience of striving to meet them. While I am on board with these central moves of Nguyen’s book, in this essay I will argue that the situation is substantially messier than Nguyen portrays it as being. Game play, I will claim, is inextricably embedded and entangled in its larger social, material and cultural context. Conversely, I will argue, everyday life is routinely sculpted in ways Nguyen claims are distinctive of games.

Our autonomy can be compromised by limitations in our capacities, or by the power relationships within which we are embedded. If we insist that real consent requires full autonomy, then virtually no sex will turn out to be consensual. I argue that under conditions of compromised autonomy, consent must be socially and interpersonally scaffolded. To understand consent as an ethically crucial but nonideal concept, we need to think about how it is related to other requirements for ethical sex, such as the ability to exit a situation, trust, safety, broader social support, epistemic standing in the community, and more.

It is with great pleasure and a sense of urgency that we present this KIEJ double issue on ethical issues raised by the COVID-19 pandemic. The sheer range of ethical concerns raised by the pandemic, combined with the speed with which these problems emerged, is staggering and unprecedented in our generation. We have tried to give space to papers that raise immediately pressing ethical issues that have not received much discussion in popular media. Topics range from fundamental questions about how we set up our public health infrastructure, to ethical issues in scientific communication and the translation of science into policy, to the impact of the pandemic on people with intellectual disabilities, to the ethics of...

Traditional moral explorations of sexual violation are dyadic: they focus on the relationship between the perpetrator and the victim, considered in relative isolation. We argue that the moral texture of sexual violation and its fallout only shows up once we see acts of sexual violation as acts that occur within an ecosystem. An ecosystem is made up of dwellers and an environment embedded in a broad, thick, interdependent, and relatively stable web of norms, practices, environments, material and institutional structures. We argue that many of the important and interesting harms wrought by sexual violation can only be understood as ecological harms. To illustrate this, we focus on sexual violations that occur within a specific type of ecosystem, namely an academic department with a graduate program. We examine the possible damaging effects of sexual violation on the ecology of a department. We also consider what makes an ecosystem resilient and relatively able to self-repair, and how sexual violation within an ecosystem may weaken its self-repairing resources. We show that looking at sexual violation through this ecological lens lets us identify harms that are otherwise obscured or difficult to locate.

I explore the role that values and interests, especially ideological interests, play in managing and balancing epistemic risks in medicine. I will focus in particular on how diseases are identified and operationalized. Before we can do biomedical research on a condition, it needs to be identified as a medical condition, and it needs to be operationalized in a way that lets us identify sufferers, measure progress, and so forth. I will argue that each time we do this, we engage in epistemic risk balancing that inevitably draws upon values and interests, often including social and ideological values. My main interest here is in the conceptualization of infertility as a disease. Infertility is a rich test case for exploring the interplay between interests and epistemic risk management. There is no uncontested or standardized definition of infertility. The various definitions of it are internally ambiguous and tension-ridden, and in spectacular contradiction with one another. Many interest groups who are invested in framing infertility as a pressing problem deserving of social and medical redress are quick to insist that it is a legitimate ‘disease,’ but they cannot agree on which disease it is, what its symptoms or diagnostic markers are, or even what its basic ontology is. I suggest that there are political explanations for this epistemic mess. Indeed, I contend that there are good scientific and ethical reasons to reduce away the category of ‘infertility,’ especially understood as a scientific or medical category; I argue that we should excise the concept from our research and clinical practices.

Our lead article in this issue of the Kennedy Institute of Ethics Journal, Jonathan Kaplan’s “Self-Care as Self-Blame Redux: Stress as Personal and Political,” opens up an entirely new and clearly important topic for bioethicists: the concept and role of ‘self-care.’ Advice for ‘self-care’ is everywhere, and often this advice takes the form of a kind of moral imperative: we owe ourselves self-care and have a responsibility to care for ourselves. Meanwhile, typical suggested self-care practices focus on individual behaviors and purchases, rather than social interventions. Moreover, they very often require quite a bit of time, money, organization, and energy to complete. These include yoga classes, meditation, diet...

It is the great honor of the Kennedy Institute of Ethics Journal to present this special issue celebrating the career and bioethical contributions of LeRoy Walters. Professor Walters is the former Director of the Kennedy Institute of Ethics, which he has been affiliated with since its inception in 1971 until his recent retirement from his position as Joseph P. Kennedy, Sr. Professor of Christian Ethics. Trained as a philosopher and a theologist, LeRoy Walters was also a lifelong political activist, fighting for social justice and protections for the vulnerable. He was also a visionary who played a substantial role in creating and building the field of bioethics, and in bridging the divide between academia and the...

This issue's lead article, Alison Reiheld's "Rightly or For Ill: The Ethics of Individual Memory," takes up a topic that is manifestly deserving of philosophical analysis, and routinely important in our private and public interactions, and yet as far as I know it has never before received systematic treatment: the ethics of memory. That is, Reiheld asks, when are we morally blameworthy or praiseworthy for remembering, forgetting, or encoding a memory in a specific way, and what are the ethical principles that should govern our practices of remembering and forgetting? As Reiheld points out, this set of questions only makes sense once we understand remembering and forgetting as constructive activities involving...

The goal of this paper is to give an account of the pragmatic and social function of slurs, taken as speech acts. I develop a theory of the distinctive illocutionary force and pragmatic structure of slurs. I argue that slurs help to produce subjects who occupy social identities carved out by pernicious ideologies, and that they do this whether or not anyone involved intends for the slur to work that way or has any particular feelings or conscious thoughts associated with using or being targeted by the slur. I offer an Althusser‐inspired account of what an ideology is, as well as of the mechanisms by which slurs can serve to cue and strengthen ideologies. A slur, I argue, is a kind of interpellation, which reduces its target to a generic identity and derogates and subordinates its target. I explore how slurs and ideologies work in tandem to constitute and fortify one another. I end by applying my account to see how well it fits and helps illuminate three quite different, especially complex slurs.

This quarter’s issue of the Kennedy Institute of Ethics Journal dives deeply into questions concerning who is the proper target of medical interventions, and under what circumstances. Mary Jean Walker and James Franklin’s article, “An Argument Against Drug Testing Welfare Recipients,” and Maggie Taylor’s “Too Close to the Knives: Children’s Rights, Parental Authority, and Best Interests in the Context of Elective Pediatric Surgeries” both ask hard questions about when medical interventions can be imposed without consent, purportedly in order to secure non-medical, social benefits for their recipients. Lauren Freeman and Saray Ayala López’s “Sex Categorization in Medical Contexts: A Cautionary Tale,” questions who...

I explore how we negotiate sexual encounters with one another in language and consider the pragmatic structure of such negotiations. I defend three theses: Discussions of consent have dominated the philosophical and legal discourse around sexual negotiation, and this has distorted our understanding of sexual agency and ethics. Of central importance to good-quality sexual negotiation are sexual invitations and gift offers, as well as speech designed to set up safe frameworks and exit conditions. Sexual communication that goes well does not just prevent harm; it enables forms of agency, pleasure, and fulfillment that would not otherwise be possible.

This issue of the Kennedy Institute of Ethics Journal contains a couple of papers that may be difficult to read for some: one concerning the sexual violation of young Black boys and one on the Guatemalans who were intentionally infected with sexually transmitted diseases and sexually abused in the hands of the United States government and other US-based institutions. I’m honored and proud to be publishing these papers in the journal; both dive headfirst into formidably painful topics of enormous social and ethical importance. However, readers should understand before reading these papers that they contain descriptions of sexual violation within relationships of gross power inequality...

I explore how gender can shape the pragmatics of speech. In some circumstances, when a woman deploys standard discursive conventions in order to produce a speech act with a specific performative force, her utterance can turn out, in virtue of its uptake, to have a quite different force—a less empowering force—than it would have if performed by a man. When members of a disadvantaged group face a systematic inability to produce a specific kind of speech act that they are entitled to perform—and in particular when their attempts result in their actually producing a different kind of speech act that further compromises their social position and agency—then they are victims of what I call discursive injustice. I examine three examples of discursive injustice. I contrast my account with Langton and Hornsby's account of illocutionary silencing. I argue that lack of complete control over the performative force of our speech acts is universal, and not a special marker of social disadvantage. However, women and other relatively disempowered speakers are sometimes subject to a distinctive distortion of the path from speaking to uptake, which undercuts their social agency in ways that track and enhance existing social disadvantages.

Ghostwriting scandals are pervasive in industry-funded biomedical research, and most responses to them have presumed that they represent a sharp transgression of the norms of scientific authorship. I argue that in fact, ghostwriting represents a continuous extension of current socially accepted authorship practices. I claim that the radically collaborative, decentralized, interdisciplinary research that forms the gold standard in medicine is in an important sense unauthored, and that this poses a serious problem in applied social epistemology. It is no easy matter to find procedural or architectural solutions that can secure epistemic trust and accountability for collaborative publishing in biomedicine.

The Routledge Companion to Bioethics is a comprehensive reference guide to a wide range of contemporary concerns in bioethics. The volume orients the reader in a changing landscape shaped by globalization, health disparities, and rapidly advancing technologies. Bioethics has begun a turn toward a systematic concern with social justice, population health, and public policy. While also covering more traditional topics, this volume fully captures this recent shift and foreshadows the resulting developments in bioethics. It highlights emerging issues such as climate change, transgender, and medical tourism, and re-examines enduring topics, such as autonomy, end-of-life care, and resource allocation.

Wilfrid Sellars's iconic exposé of the ‘myth of the given’ taught us that experience must present the world to us as normatively laden, in the sense that the contents of experience must license inferences, rule out and justify various beliefs, and rationalize actions. Somehow our beliefs must be governed by the objects as they present themselves to us. Often this requirement is cashed out using language that attributes agent-like properties to objects: we are described as ‘accountable to’ objects, while objects ‘hold us’ to standards, and so forth. But such language is either deeply anti-naturalistic or trades on a set of metaphors in need of a literal translation. We offer an explanation of how the material features of the world, as received in experience, can rationally constrain our beliefs and practices—one that makes no recourse to this imagery. In particular, we examine the structure of ostensive practices (that is, practices of directing one another's attention to objects and features of the world) and the distinctive role they play in making us jointly beholden to how things actually are

This paper discusses a crisis of accountability that arises when scientific collaborations are massively epistemically distributed. We argue that social models of epistemic collaboration, which are social analogs to what Patrick Suppes called a “model of the experiment,” must play a role in creating accountability in these contexts. We also argue that these social models must accommodate the fact that the various agents in a collaborative project often have ineliminable, messy, and conflicting interests and values; any story about accountability in a massively distributed collaboration must therefore involve models of such interests and values and their methodological and epistemic effects

Bioethicists have, of course, always been concerned with death: we have asked when should we allow it to happen without trying to stave it off any longer; whether is it ever acceptable for doctors to hasten or cause it; how can we make death a dignified and relatively humane experience for the dying and for their loved ones; and how we can and cannot treat human remains. We discussed all of these classic ethical issues even when death itself seemed to be a fairly straightforward, all-or-nothing concept: life and death were natural, biological states, and people were either alive, with a beating heart and a working brain, or they were dead, and everything in them had stopped. But over the last several...

It gives me great pleasure to introduce the December 2013 issue of the Kennedy Institute of Ethics Journal—our ninety-second!—and to introduce myself as the new Editor-in-Chief of the journal. For almost a quarter of a century, from its special vantage point in Washington, D.C., and at Georgetown University’s Joseph and Rose Kennedy Institute of Ethics, the KIEJ has served as a leading source for practically engaged, policy-relevant philosophical work in bioethics, broadly construed. Under the expert stewardship of Robert Veatch and Carol Spicer, the journal built a top-quality research legacy. It is with pride and anticipation that I take the helm.While I am committed to honoring and building on our past, I am ..

Moral perception, as the term is used in moral theory, is the perception of normatively contoured objects and states of affairs, where that perception enables us to engage in practical reason and judgment concerning these particulars. The idea that our capacity for moral perception is a crucial component of our capacity for moral reasoning and agency finds its most explicit origin in Aristotle, for whom virtue begins with the quality of perception. The focus on moral perception within moral theory has made a comeback in the last few decades, especially in the hands of self-proclaimed neo-Aristotelians such as John McDowell, Martha Nussbaum, and Nancy Sherman. For these writers, our perceptual capacities are not static, and the laborious honing of our perceptual skills is a crucial moral task. On this picture, as Nancy Sherman puts it, “How to see becomes as much a matter of inquiry as what to do.”Moral particularists—including but not restricted to the neo-Aristotelians—have emphasized the centrality of moral perception to moral agency and judgment, as a corrective to moral theories that treat deliberation in terms of universal principles as the privileged keystone of moral agency.