Ellie Anderson

As the field of clinical ethics consultation sets standards and moves forward with the Quality Attestation process, questions should be raised about what ethical issues really do arise in practice. There is limited data on the type and number of ethics consultations conducted across different settings. At Loyola University Medical Center, we conducted a retrospective review of our ethics consultations from 2008 through 2013. One hundred fifty-six cases met the eligibility criteria. We analyzed demographic data on these patients and conducted a content analysis of the ethics consultation write-ups coding both the frequency of ethical issues and most significant, or key, ethical issue per case. Patients for whom ethics consultation was requested were typically male, white, between 50 and 69 years old, of non-Hispanic origin, and of Roman Catholic faith. Nearly half were in the intensive care unit and 44.2 % died in the hospital. The most frequent broad ethical categories were decision-making, goals of care/treatment, and end-of-life. More specifically, capacity, patient’s wishes/autonomy, and surrogate decision maker were the most frequent particular ethical issues. The most common key ethical issues were withdrawing/withholding treatment, patient wishes/autonomy, and capacity. Our findings provide additional data to inform the training of clinical ethics consultants regarding the ethical issues that arise in practice. A wider research agenda should be formed to collect and compare data across institutions to improve education and training in our field.

Rather than as a giving of permission to someone to transgress one’s bodily boundaries, I argue for defining sexual consent as feeling-with one’s sexual partner. Dominant approaches to consent within feminist philosophy have failed to capture the intercorporeal character of erotic consciousness by treating it as a form of giving permission, as is evident in the debate between attitudinal and performative theories of consent. Building on the phenomenology of Maurice Merleau-Ponty, Ann Cahill, Linda Martín Alcoff, and others, I argue that taking consent to be an intercorporeal and dynamic coexistence of desiring bodies opens up new ways of thinking about the role of consent in sexual ethics. I suggest that phenomenology’s theories of embodied consciousness, operative intentionality, and the direct perception of others provide a better groundwork for conceptualizing the role of ambiguity and subtle power dynamics in sexual encounters than attitudinal or performative accounts of consent. I also defend my view against Jonathan Jenkins Ichikawa’s argument for doing away with the concept of consent in sexual ethics due to consent's stubborn and infelicitous presupposition of permission-giving.

In recent years, feminist scholarship on emotional labor has proliferated. I identify a related but distinct form of care labor, hermeneutic labor. Hermeneutic labor is the burdensome activity of: understanding and coherently expressing one’s own feelings, desires, intentions, and movitations; discerning those of others; and inventing solutions for relational issues arising from interpersonal tensions. I argue that hermeneutic labor disproportionately falls on women’s shoulders in heteropatriachal societies, especially in intimate relationships between women and men. I also suggest that some of the gendered burdens of emotional labor that feminist scholars point out would better be described as hermeneutic labor. Drawing on feminist philosophy as well as findings from social psychology and sociology, I argue that the exploitation of women’s hermeneutic labor is a pervasive element of what Sandra Bartky calls the ‘micropolitics’ of intimate relationships. The widespread expectation that women are relationship maintenance experts, as well as the prevalence of a gendered demand-withdraw pattern of communication, leads an exploitative situation to appear natural or even desirable, even as it leads to women’s dissatisfaction. This situation may be considered misogynistic in Kate Manne’s sense, where misogyny is a property of social environments rather than a worldview.

Discussions of sexual ethics often focus on the wrong of treating another as a mere object instead of as a person worthy of respect. On this view, the task of sexual ethics becomes putting the other’s subjectivity above their status as erotic object so as to avoid the harms of objectification. Ward and Anderson argue that such a view disregards the crucial, moral role that erotic objecthood plays in sexual encounters. Important moral features of intimacy are disclosed through the experience of being an erotic object for another, as well as in perceiving another as an erotic object. Drawing on phenomenology, especially the insights of Simone de Beauvoir, Ward and Anderson argue that erotic encounters are shaped by the human condition of ambiguity, where being an object for others is intertwined with bodily agency. Because sexual agency is complex in this way, theories of sexual ethics and responsibility must widen their focus beyond transparent communication and authoritative expressions of will.

Jean-Paul Sartre’s theory of “the look” has generally been understood as an argument for the impossibility of mutual recognition between consciousnesses. Being-looked-at reveals me as an object for the other, but I can never grasp this object that I am. I argue here that the chapter “The Look” in Being and Nothingness has been widely misunderstood, causing many to dismiss Sartre’s view unfairly. Like Hegel’s account of recognition, Sartre’s “look” is meant as a theory of successful mutual recognition that proves the existence of others. Yet Sartre claims that such an account is plausible only if recognition is affective, not cognitive. Situating Sartre’s account of the look within his technical understanding of affect’s distinctness from cognition not only enables a better understanding of Sartre’s view, but also reveals a compelling alternative to the understanding of self-other relations in contemporary affect theory.

ABSTRACT The ethics of reciprocity offered by Simone de Beauvoir is founded upon an irreducible epistemic gap between self and other. This gap is often overlooked by commentators, who have tended to imply that the ethics of reciprocity requires recognition of oneself in the other. I claim that Beauvoir's ethics forecloses such recognition of oneself in the other and reveals that it is at once illusory and dangerous. Recognition in this sense is based upon a false notion of self and constitutes a violation of the alterity of the other. I argue that Beauvoir stages this dangerous form of recognition in her novel She Came to Stay, while her claims about reciprocity in The Second Sex provide an image of a different, more positive recognition capable of respecting alterity. Finally, I claim that the epistemic gap characteristic of reciprocity also holds with respect to one's self-relation.

Phenomenologists have long viewed love as a central form of inter-subjective engagement. I show here that it is also of concern to phenomenological ethics. After establishing the relation of phenomenology to ethics, I show that both classical and existential phenomenology view love as an act of valuing the loved one. I argue that a second act of valuing is latent in phenomenology: valuing the relationship. These values are evident in the phenomenological distinction between true love, which generates a “perspective in difference,” and false love, which seeks union with the beloved manifesting in devotion and/or jealousy. Because culturally dominant heteronormative scripts incline individuals toward false love, lovers should create their own pacts for ethical relationships. I consider consensually non-monogamous relationships as an example.

While Simone de Beauvoir’s theory of alterity has been the topic of much discussion within Beauvoir scholarship, feminist theory, and social and political philosophy, it has not commonly been a reference point for those working within ethics. However, Beauvoir develops a novel view that those concerned with the ethical import of respect for others should consider seriously, especially those working within the Levinasian tradition. I claim that Beauvoir distinguishes between two forms of otherness: namely, existential alterity and sociopolitical alterity. While sociopolitical alterity is a contingent and surmountable form of otherness that results from oppression of individuals and groups, existential alterity is a necessary feature of the human condition that discloses the foreignness of the other as a freedom. Out of this view of existential alterity, I argue, Beauvoir develops an ethic of asymmetrical reciprocity. In contrast with Levinas, who dismisses reciprocity as a symmetrical or reversible model of relation that minimizes difference, Beauvoir promulgates a view of reciprocity that does not fall into the problems that Levinas diagnoses. Moreover, asymmetrical reciprocity more successfully figures the ethical relation to the other than the absolute asymmetry one finds in Levinas, which becomes evident through revisiting Levinas’s account of eros and contrasting it with that of Beauvoir.

Eros is often considered to be a desire or inclination for what is irreducibly other to the self. This view is particularly prominent among philosophers who reject a “fusion” model of erotic love in favor of one that foregrounds the difference between lovers. Drawing from this “difference” model, I argue in this essay that autoeroticism is a genuine form of Eros, even when Eros is understood to involve irreducible alterity. I claim that the autoerotic act is not adequately captured by traditional views of masturbation, where it is seen as distinct from the erotic encounter with another being. Instead, I employ Derrida and Irigaray to argue that the autoerotic act is auto-hetero-erotic, which depends on a view of the self as self-othering and heterogeneous.