Papers in Progress

Gendering Capacity: The Two-Sided Vulnerability of Survivors of Abuse

Georgina D. Campelia & Lauren S. Flicker

Abstract: Decisional capacity is, on its face, a genderless concept. However, gender norms are powerful and can impinge on how medical providers respond to women’s choices in the inpatient setting. A particularly complicated example is that of a patient requesting that an abusive partner serve as health care proxy. For healthcare providers, these choices pose a particular challenge to traditional principles of autonomy and beneficence. A conflict resides in the fact that survivors of abuse are vulnerable on two fronts. On the one hand, they are vulnerable to their abusive partners, who may not be “ethically appropriate” decision makers insofar as they consistently and characteristically act contrary to the best interests of the patient. On the other hand, survivors of abuse are vulnerable to the unwarranted revocation of decisional capacity, by a well-meaning clinical team who may conflate “accepting” abuse with lacking capacity. Patients with this social positioning can be particularly vulnerable to having their autonomous choices unnecessarily overridden for the sake of best interests or beneficence. In this paper, we reflect on one such clinical case and advocate for a response that balances these two vulnerabilities and hinges on the notion of relational autonomy.

Empathy's Web: The Virtue of Empathic Attunement

The moral relevance of empathy is highly contested. Some argue that it is of little or no moral worth because of its proneness to personal bias, stereotypes, and lack of connection to altruistic behavior. Others contend that particular definitions of empathy are morally relevant in virtue of empathy's causal role in caring or altruistic behavior. In light of this discussion, I develop an important distinction between empathic practice, which is morall neutral, and empathic attunement, which identifies empathic practices done excellently. Further, equipped with four conditions of empathic attunement, I argue that empathic attunement is a virtue. However, unlike other accounts of empathy's moral worth, I maintain that its worth lies not in its causal connections to caring and altruistic behavior. Rather, the virtue of empathic attunement lies in its unique way of respecting, caring for, and connecting with others. In this way, empathic attunement is a distinct and important character trait that demonstrates, and is crucial to, human flourishing.

Better, Faster, Stronger: A Culture of Stimulant Use and the Construction of Disability

This paper takes a new perspective on the role of clinicians in the culture of academic and professional stimulant usage, such as Adderall. While some argue that prescribing psychotropic medications when not medically indicated is morally acceptable, even morally recommended,  so as to accommodate concerns of individual and public health; here, it is contended that what should be of equal, if not greater, concern are the cultural norms that encourage and even mandate stimulant usage in academic environments. Clinicians ought to consider how their role in prescribing stimulants can help to create and perpetuate norms of escalated pace; namely, norms that require students and professionals to be better, faster, and stronger. The harm, it is argued, is found in the way these norms construct disability where there is none and exacerbate conditions that are already disabling.

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