Jada Wiggleton-Little

In December 2023, the U.S. Food and Drug Administration approved gene‐editing therapies as sickle cell disease treatments. Such approvals for gene‐editing not only mark radical scientific innovations for populations living with sickle cell disease (SCD) across the United States but also generate an expectation of a potential cure—the end or eradication of an illness and its effects. This essay, however, cautions against framing gene‐editing therapy as a “cure” for SCD. Our argument illustrates that, even if gene editing is proven to permanently normalize the hematologic function of the body, there are other painful aspects of SCD that gene editing is unable to transform. Scientific researchers and health care practitioners could benefit from further bioethical consideration of the effects of using curative language with regards to SCD. The curative framing can easily generate misunderstandings in patient‐provider communication and elicit unrealistic expectations. Raising awareness about the importance of how gene‐editing therapies for SCD are described and about the need to discuss their limitations can prevent further harm.

This essay introduces the special issue Contemporary Issues in Black Philosophy: Pluralism in Methodological Approaches and advances a metaphilosophical argument about method in Black philosophy. We distinguish the question of what makes philosophy Black from the question of what counts as philosophy, and argue that conflating these questions produces a misleading methodological monism. Attention to the difference between substance and method shows that methodological choice must be guided by the problems under investigation. We defend a disciplined pluralism according to which methods are justified by problem-fit rather than by allegiance to a single tradition. The essays in this collection are a demonstration, not a discussion, of methodological pluralism and its benefits to philosophy.

The stereotypical images of Black women as hypersexual, have long been used to silence Black women in pain via social authoring—the social translation of Black women's pain that generates a radically different meaning than what a typical pain expression is intended to convey. Aware of this social authoring, I argue that Black women maintain their voice by “doing” pain. I define “doing” pain as the deliberate adjustments to one's appearance or behavior by disenfranchised agents attempting to express pain within a medical context. Moreover, I argue that “doing” pain can be a form of insurgent agency in which the patient manipulates the rules of the “pain game” as a costly attempt to secure equitable pain care.

This project aims to identify and explain a phenomenon I call pain-related motivational deficit, which occurs when there is proper uptake of the epistemic contributions of a pain utterance, but defective uptake of the motivational contributions of a pain utterance. I argue that the normalization of fibroid pain in Black women, and of menstrual pain more broadly, causes a pain-related motivational deficit to be unfairly assigned to utterances about these pain experiences. I show that current ways of thinking about epistemic injustice cannot adequately explain these cases.

When one communicates that they are in pain, it is often assumed that the speaker is providing an assertion or report. Call this the cognitivist stance of pain utterances. Nevertheless, many sentential pain utterances seem to have both assertive and imperatival communicative content in virtue of expressing both the speaker's pain belief and the pain experience, respectively. I call this view hybrid expressivism about pain. In this paper, I take the imperativist idea of pain seriously and show that, via an expression relation, pain utterances inherit the imperative and motivational force of the pain. A hybrid expressivist stance better explains why pain utterances often have the perlocutionary effect of eliciting care from others, and it can provide a new understanding of what it means to silence one's pain.

The novel coronavirus of 2019 exposed, in an undeniable way, the severity of racial inequities in America’s healthcare system. As the urgency of the pandemic grew, administrators, clinicians, and ethicists became concerned with upholding the ethical principle of “most lives saved” by re-visiting crisis standards of care and triage protocols. Yet a colorblind, race-neutral approach to “most lives saved” is inherently inequitable because it reflects the normality and invisibility of ‘whiteness’ while simultaneously disregarding the burdens of ‘Blackness’. As written, the crisis standards of care (CSC) adopted by States are racist policies because they contribute to a history that treats Black Americans are inherently less than. This paper will unpack the idealized fairness and equity pursued by CSC, while also considering the use of modified Sequential Organ Failure Assessment (mSOFA) as a measure of objective equality in the context of a healthcare system that is built on systemic racism and the potential dangers this can have on Black Americans with COVID-19.

ABSTRACT:Autistic adults suffer from an alarmingly high and increasing unemployment rate. Many companies use pre-employment personality screening tests. These filters likely have disparate impacts on neurodivergent individuals, exacerbating this social problem. This situation gives rise to a bind. On the one hand, the tests disproportionately harm a vulnerable group in society. On the other, employers think that personality test scores are predictors of job performance and have a right to use personality traits in their decisions. It is difficult to say whether these negative disparate impacts are a case of wrongful discrimination. Nevertheless, we will show that pre-employment personality tests prey on several features of autism in an unfair way, and for this reason, we suggest the contours of some regulation that we deem necessary.