Quill R Kukla

Three years ago, as my fortieth birthday disappeared into the far distance in my rearview mirror, driven by a combination of vanity and fear of my own mortality and decrepitude, I committed to getting in shape.I’ve always been fairly active: I have always walked a lot, commuted by bike when that was plausible, avoided driving whenever possible, and just generally been high energy. But a childhood full of failure at team sports and a lack of innate gifts in the coordination department scared me off for decades from formal physical activity. Indeed, I was convinced that I hated working out—that I would always hate it, no matter what, and that it would always take a tremendous and ongoing act of sheer will power to do...

This issue of the Kennedy Institute of Ethics Journal continues two conversations that have been developing in this journal over the last few years, and introduces a new and timely one. Kevin Elliot and Paul Mushak’s paper, “Structured Development and Promotion of a Research Field: Hormesis in Biology, Toxicology, and Environmental Regulatory Science,” continues an ongoing debate in this journal over the role of values in shaping scientific methodology and communication, and how this role should be managed at the level of policy. We inaugurated this discussion in our June 2012 special issue on Science, Expertise, and Democracy, and have followed up with multiple articles on science and values. David..

When Sandra Harding called for an epistemology of science whose systematic attention to the gendered Status of epistemic agents renders it ‘less partial and distorted’ than ‘traditional’ epistemologies, some commentators recoiled in horror. Propelled by ‘a mad form of the genetic fallacy’ they said, she descends ‘the slide to an arational account of science.’ On a less melodramatic reading, feminist epistemologies such as Harding's advocate not irrationalism, but senses of rationality more expanded than those which they associate with ‘traditional’ epistemology.

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.

In lieu of an abstract, here is a brief excerpt of the content:Editorial NoteRebecca Kukla, PhD, Editor in ChiefThis spring is an exciting time at the Kennedy Institute of Ethics Journal. We are rolling out our new series of online reviews of books in bioethics, practical ethics, and the ethical, social, and legal dimensions of science and medicine. These in-depth reviews will be written by leading figures in the discipline, and will be published in online issue supplements, with pre-publication versions available on our website or by e-mail subscription. We are very enthusiastic about this new initiative and hope that our reviews will become crucial tools and sources of inspiration for everyone interested in the field of bioethics, broadly construed. We hope that you will make use of and enjoy this new source of ethical conversation and information.Our spring issue represents our current attempt here at the journal to broaden the discipline’s conception of what counts as a bioethical issue.In our lead article, David DeGrazia brings the currently emotional debates over gun control policy within the purview of bioethics. Violence and policies concerning violent weapons are crucial health issues, and yet bioethicists have done little to bring their tools and insights to this domain. DeGrazia’s paper thus breaks new ground. He defends a moderate gun control policy, and argues that from the point of view of public health, it is morally inexcusable not to tighten gun regulations in the United States, regardless of which moral framework we employ.Our second two papers—“Resolving the Conflict: Some Clarifications of Vulnerability in Health Care” (by Anglea Martin, Nicholas Tavaglione, and Samia Hurst) and “Beneficence, Justice, and Health Care” (by J. Paul Kelleher)—both take rich philosophical concepts that usually find their home within research ethics and resituate them within the domain of patient care. Martin and her co-authors give a close analysis of the notion of vulnerability. They seek meaningful ways of identifying specific, morally pressing vulnerabilities among patients, given that all patients are to some extent vulnerable. Kelleher creatively revisits the much-discussed notion [End Page vii] of beneficence, arguing that duties of beneficence are sometimes grounded in justice-based duties. This pushes against the tradition of thinking of justice as a consideration that comes into play only at the population level.The final paper, Howard Brody’s “Chauncey Leake and the Development of Bioethics in America,” brings a new methodological approach to the journal. This is a historical paper examining the intellectual and social role that Leake played in the development of the discipline of bioethics. Leake’s advocacy for the integration of philosophy and medical expertise in bioethics became a hallmark of the field; yet Leake himself is mostly forgotten. Brody examines both his contribution and the reasons for his relative invisibility. This kind of intellectual history enriches and grounds ethical analysis in crucial ways, but it is too rarely integrated into bioethical conversations. [End Page viii]Rebecca Kukla, Editor in ChiefKennedy Institute of Ethics JournalCopyright © 2014 The Johns Hopkins University Press...

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:Studying Human Behavior: How Scientists Investigate Aggression and Sexuality by Helen LonginoRebecca KuklaReview: Helen Longino, Studying Human Behavior: How Scientists Investigate Aggression and Sexuality, University of Chicago Press, 2013In Studying Human Behavior: How Scientists Investigate Aggression and Sexuality, Helen Longino meticulously examines a wide variety of research programs devoted to studying human behavior, specifically aggression and sexual orientation. She teases apart the methodologies of the various approaches, examining their epistemic structure, the assumptions they must hold fixed, the research questions they enable and those they necessarily occlude, their underlying ontologies, the interests that motivate them, the ideological investments they help buttress, and the practical and political uses they serve. By the end of the book she has made clear that the so-called ‘nature-nurture’ debates invoke a hopelessly simplistic and distorting dualism when it comes to any interesting question about the etiology of a behavior. This is a readable, informative, rigorous, and elegantly organized new work from a leading scholar who has had a major hand in turning the interplay among science, ethics, and social interests into a topic of rigorous philosophical study.In the first part of the book, Longino devotes a chapter or substantial section to each major methodological approach to studying aggression and sexual orientation, including (using her labels): quantitative behavioral genetics, social-environmental approaches, molecular behavioral genetics, neurobiological approaches, and several ‘integrative’ approaches (such as developmental systems theory) that focus on the interactions and dynamics between causal factors over time rather than trying to isolate one causal contribution. She also briefly discusses human ecology, which takes the unit of study to be the behavior of a population, studied in its material environment, rather than the behavior of an individual.Longino shows elegantly how each of these research programs is equipped to reveal certain specific kinds of truths about behavior, while making other important dimensions of the phenomena invisible. Many of her examples are technical and detailed, but I can recap a few relatively simple and powerful examples: (1) Behavioral researchers have no shared understanding of what an ‘environment’ is or which features of it we need [End Page E-97] to measure. Whatever operationalization of ‘environment’ is used within a study or set of studies, this operationalization is not itself scientifically validated, but merely presupposed (33). Thus how much of a behavior shows up in a study as due to the ‘environment’ depends on just what we measure. On the behavioral genetic approach this will include everything other than genes, but on, say, the neurobiological approach this will be everything other than neural structure. But these are quite different senses of ‘environment’ with different scopes, and there’s no good reason to think they are easily commensurable. (2) ‘GxExN’ researchers use techniques to study the etiology of behavior that were developed expressly for studying disorders (112). This work thus presupposes that we can understand whatever behavior is under study on the disorder model, and will yield no well-formed results to the extent that this model does not fit. But it is at best non-obvious that a disorder model is unproblematic when it comes to aggression or—especially!—sexual orientation. (3) Most of the research programs Longino covers treat the behaving individual as the unit of analysis and study, as opposed to, for example, human ecologists’ focus on whole populations. But as she demonstrates, this affects what kinds of causes we can study, because patterns at the population level may not be detectable using the kinds of measures that can be manipulated at the individual level. Furthermore, some kinds of behaviors may require more than one participant to exist at all; for instance, the very same thing that counts as an aggressive act within one interaction may be a peaceful act in another (175).Longino does a lovely job of showing what sorts of social interests are served and buttressed by which kinds of research. For example, social-environmental approaches will, in virtue of their methodology, focus on social factors that are manipulable, and this makes them particularly amenable to generating suggestions for social interventions. Such research thus better serves the ends of those who are looking to implement...

We can understand objectivity, in the broadest sense of the term, as epistemic accountability to the real. Since at least the 1986 publication of Sandra Harding’s The Science Question in Feminism, so-called standpoint epistemologists have sought to build an understanding of such objectivity that does not essentially anchor it to a dislocated, ‘view from nowhere’ stance on the part of the judging subject. Instead, these theorists have argued that a proper understanding of objectivity must recognize that different agential standpoints offer different access to objective truths, with some standpoints holding better epistemic potential than others. As Harding puts it, standpoint epistemology calls for “a critical evaluation of which social situations tend to generate the most objective knowledge claims” so as to identify those standpoints that “produce empirically more accurate descriptions and theoretically richer explanations” (1991, 142, 149). Which standpoints enable the most objectivity with respect to a particular inquiry is, for the standpoint theorists, always an empirical at least as much as a conceptual question; it requires attention to the actual, material relationship between knowers, knowledge practices, and objects known. Standpoint epistemology was developed primarily by self-identiªed feminist epistemologists. Virtually all developments of standpoint episte-.

How can we conceptualize and promote agential choices in a complicated social world—one in which institutional, cultural, and marketing pressures convey values and norms that may not be in the best interest of individual patients? In this issue of the Kennedy Institute of Ethics Journal, Eric Racine and his colleagues explore this difficult question in the context of “preclinical” Alzheimer’s disease and complementary and alternative medicines. This is an especially murky and vexed context in which to think about patient agency, for at least two reasons. First...

This season’s issue includes two articles on a quickly expanding topic in bioethics: the ethics of enhancement. There are many kinds of enhancement both actual and imagined: we can enhance people’s physical, aesthetic, cognitive, or moral capacities, for instance; individuals might choose particular enhancements, parents might choose them for their future children, or states might institute them at the widespread population level; the enhancements might be technologically complex or take the form of low-tech education and training; they might be permanent genetic features or swappable technological prosthetics; and so forth. Many discussions of the ethics of enhancement are concerned..

This work seeks to take seriously the common philosophical claim that individual subjects are constituted by their social world. A detailed understanding this claim requires an analysis of what is involved in being a subject, of the nature of 'the social', and of the possible constitutive relationships between these. I begin with a critical history of the idea that subjects are norm-followers, and that social groups constitute individuals by demanding their conformity to norms. I trace this 'conformity theory' through the thought of Rousseau, Hegel, Mead, and Althusser, to its manifestation in contemporary continental and Anglo-American philosophy. I criticize this theory for being unable to sufficiently accommodate creativity and social resistance. I go on to develop an account of subjects as not only norm-followers but also sense-makers, who have identities in virtue of their engagement in narrative dramas. Such subjects are socially constituted in at least two ways: through their 'dialogical' interactions with particular others , and through their position in a public culture which determines what counts as a meaningful possibility for action. This understanding of subjectivity allows me to develop a new account of the nature of social groups--such as groups based on gender, class and nationality--which provides an alternative to the conformity theory. Social groups contribute to individual identities not only by imposing norms, but also by providing sense-making resources, in the form of literary and artistic traditions as well as the actual lives and dramas of members. My account allows us to understand creativity and social resistance as enabled by subjects' membership in social groups, and it reveals how the internal diversity of a group can strengthen rather than compromise its role in individual identities. I end with a discussion of the political implications of my work