Empathy as a Desideratum in Health Care – Normative Claim or Professional Competence?

This article investigates the possible functions of empathic interpersonal engagement in the context of medicine and health care. While empathy can be understood in different ways on a theoretical level – as an embodied process of resonance and synchronization, as an affective process of emotional sharing, as a cognitive process of understanding the other, or as a narrative process of externalizing and communicating personal experiences – it is often called for on a normative level as a desideratum in the competence of medical professionals. We address this issue by introducing different models of the relationality between doctors and patients, in order to clarify which dimensions of empathy are relevant in which model and raise the question whether empathy is more than a nice-to-have virtue on the side of the professionals.

The Status of Soft Law in Interpreting the Lithuanian Constitution

In this paper, I examine the status of soft law in the official interpretation of the Lithuanian Constitution. The “living constitution” doctrine dominates the Lithuanian constitutional scholarship. I question this dominance by providing insights on the essence and application potential of the alternative methodology – the doctrine of originalism. Based on originalistic approach, I doubt the normative claim made in Lithuanian constitutional scholarship that soft law could be considered as a mandatory source of interpretation of the Lithuanian Constitution.

Revisiting the legitimacy question of the Nigerian 1999 Constitution

This article revisits the legitimacy question as it touches the Nigerian 1999 Constitution, bringing to the discourse a review and application of pertinent theoretical perspectives on constitution making and constitutional legitimacy. This theoretical and pragmatic approach introduces a refreshing angle to the debate, revealing the paucity of any attempt to ascribe any legitimacy claim to a constitution with a doubtful normative claim and fraudulent attribution of its source and legitimacy to the people. The author finds the consent basis of constitutional legitimacy as most attractive to a divided state like Nigeria, and concludes by advocating the adoption of a blend of the principles of the constituent assembly and post sovereign constitution-making models for the production of a new people-driven and inclusive constitution to meet the needs of the Nigerian people.

P-352 Beyond individualisation: towards a more contextualised understanding of women’s social egg freezing experiences

Study question What are the moral perceptions and views of women considering social egg freezing? Summary answer Participants did not perceive egg freezing as a morally problematic solution to societal problems but addressed concerns about relationship formation and wanted more social efforts. What is known already Central to the social egg freezing debate is the individualisation argument which underlines the idea that it is morally problematic to use individual medical-technological solutions, such as egg freezing, to solve the societal challenges women face, for instance in the current labour market. It has been said that, instead of quick medical-technical solutions that target individual women’s bodies, we should focus on substantive changes that target the androcentric work culture. This theme relates to feminist concerns about unnecessary medicalisation geared towards women. Furthermore, there is a call for more empirical studies to back up this central normative claim. Study design, size, duration Seventeen participants were recruited by psychologists working in two Belgian centres for reproductive medicine which offer egg freezing for social reasons. In addition, four participants were recruited through via social networks. Interviews took place between February 2019 and November 2020 at a location of the participants’ preference or through online video connections. Participants/materials, setting, methods At the beginning of the interview, open questions were asked to invite the participants to speak about social egg freezing in their own words. In the second part of the interview, we used four cards with controversial statements based on a study of the bioethics literature, to encourage the participants to reflect about ethical concerns. In this part, we engaged in Socratic dialogue. For the analysis, thematic analysis was used combined with interdisciplinary collaborative auditing. Main results and the role of chance This is the first study providing empirical evidence about (potential) egg freezers’ moral reasoning about individualisation arguments. Most participants in our study could make sense of the individualisation argument but emphasised another societal challenge rather than the current labour market. They highlighted ‘the lack of a partner relationship’ as driving their motivation for this procedure. The shortage of eligible partners has been well defined in social science scholarship about social egg freezing but this element has rarely been articulated in the premises of individualisation arguments. This topic of relationships is challenging to analyse from a normative perspective because it was experienced as much more personal and intimate by the women in our study than for instance measures to realise more fair labour conditions, such as improved access to childcare. Some participants believed egg freezing resulted from individual problems and found the individualisation argument not applicable to their own situation. Furthermore, no participant found the individualisation argument legitimate to depict social freezing as morally problematic. Nonetheless, the participants showed a sense of sympathy with women who lack access to egg freezing and were in favour of societal solutions in several public domains. Limitations, reasons for caution Given that we report on a small-scale qualitative study of possible social egg freezers at two Belgian fertility clinics, and that our study foregrounds the voices of mostly white higher educated women who were able to afford this technology, our results cannot be generalised to all social egg freezers. Wider implications of the findings Our findings can contribute to a better understanding of previously identified normative arguments (e.g., individualisation and unnecessary medicalisation). There is a definite need to further analyse the complex interplay between respecting autonomous choices and evaluating contextual factors in this debate and other practices where similar individualisation arguments are used. Trial registration number Not applicable

P–352 Beyond individualisation: towards a more contextualised understanding of women’s social egg freezing experiences

Study question What are the moral perceptions and views of women considering social egg freezing? Summary answer Participants did not perceive egg freezing as a morally problematic solution to societal problems but addressed concerns about relationship formation and wanted more social efforts. What is known already Central to the social egg freezing debate is the individualisation argument which underlines the idea that it is morally problematic to use individual medical-technological solutions, such as egg freezing, to solve the societal challenges women face, for instance in the current labour market. It has been said that, instead of quick medical-technical solutions that target individual women’s bodies, we should focus on substantive changes that target the androcentric work culture. This theme relates to feminist concerns about unnecessary medicalisation geared towards women. Furthermore, there is a call for more empirical studies to back up this central normative claim. Study design, size, duration Seventeen participants were recruited by psychologists working in two Belgian centres for reproductive medicine which offer egg freezing for social reasons. In addition, four participants were recruited through via social networks. Interviews took place between February 2019 and November 2020 at a location of the participants’ preference or through online video connections. Participants/materials, setting, methods At the beginning of the interview, open questions were asked to invite the participants to speak about social egg freezing in their own words. In the second part of the interview, we used four cards with controversial statements based on a study of the bioethics literature, to encourage the participants to reflect about ethical concerns. In this part, we engaged in Socratic dialogue. For the analysis, thematic analysis was used combined with interdisciplinary collaborative auditing. Main results and the role of chance This is the first study providing empirical evidence about (potential) egg freezers’ moral reasoning about individualisation arguments. Most participants in our study could make sense of the individualisation argument but emphasised another societal challenge rather than the current labour market. They highlighted ‘the lack of a partner relationship’ as driving their motivation for this procedure. The shortage of eligible partners has been well defined in social science scholarship about social egg freezing but this element has rarely been articulated in the premises of individualisation arguments. This topic of relationships is challenging to analyse from a normative perspective because it was experienced as much more personal and intimate by the women in our study than for instance measures to realise more fair labour conditions, such as improved access to childcare. Some participants believed egg freezing resulted from individual problems and found the individualisation argument not applicable to their own situation. Furthermore, no participant found the individualisation argument legitimate to depict social freezing as morally problematic. Nonetheless, the participants showed a sense of sympathy with women who lack access to egg freezing and were in favour of societal solutions in several public domains. Limitations, reasons for caution Given that we report on a small-scale qualitative study of possible social egg freezers at two Belgian fertility clinics, and that our study foregrounds the voices of mostly white higher educated women who were able to afford this technology, our results cannot be generalised to all social egg freezers. Wider implications of the findings: Our findings can contribute to a better understanding of previously identified normative arguments (e.g., individualisation and unnecessary medicalisation). There is a definite need to further analyse the complex interplay between respecting autonomous choices and evaluating contextual factors in this debate and other practices where similar individualisation arguments are used. Trial registration number Not applicable

Social Identity and Dental Modification at the Postclassic Maya Urban Centre of Mayapan

Dental modification represents one interesting aspect of corporeal adornment in human history that directly reflects personal social identity. Tooth filing choices distinguished certain individuals at the urban, Maya political capital of Mayapan from 1150 to 1450 ad, along with cranial modification, nose and ear piercings, tattoos and body paint. Here we examine how filing teeth, considered a beautification practice for women at Spanish Contact in the sixteenth century, is distributed across a skeletal sample of males, females, elites and commoners in this city. We evaluate the normative claim of the Colonial period and determine that while predominantly females filed their teeth, most women chose not to. Sculptural art further reveals that male personages associated with the city's feathered serpent priesthood exhibited filed teeth, and we explore the symbolic meaning of filed tooth shape. Assessing the practice in terms of associated archaeological contexts, chronology and bone chemistry reveals that it did not correlate with social class, dietary differences, or birthplace. Residents of Mayapan, a densely inhabited, multi-ethnic city of 20,000, engaged with multiple material expressions of belonging to intersecting imagined communities that crosscut competing influences of polity, city, hometown and family scale identity. Tooth filing reflects identities at the individual or family scale.

Negotiating the Descriptive–Normative Frontier of Complexity Research in the Anthropocene

This mini-review article offers a commentary on a singular analytical problem faced by legal scholars who use complexity theory and methods in legal research on climate change and the “Anthropocene”. It positions such research as a subset of complexity scholarship in law, which is generally faced with the methodological and analytical challenge of negotiating and reconciling empirical description with normative prescription. It argues that this challenge is particularly acute for legal scholars writing on climate change and the Anthropocene. Using examples from scholars writing about “Earth systems law,” it demonstrates how a heavy reliance on complexity-based empirical data as a source material for normative claim-making can distract scholars from important but difficult questions about normative legitimacy and how legal change happens at multiple levels. The special epistemological challenges posed by climate change and the Anthropocene should demand that scholars writing in this domain be especially mindful and explicit on how they link complexity descriptions to the normative claims they make, both for the sake of scientific credibility as well as for the legitimacy and viability of their propositions.

Against robot taxes: scrutinizing the moral reasons for the preservation of work

A recent political proposal to address the challenge of technological unemployment suggests that the state should impose a tax on labor-replacing technologies. The idea is to preserve jobs by disincentivizing automation. In this article, I critically assess the proposal from an ethical perspective. I show that, with respect to conceptions of distributive justice, it is unclear that precluding consumers’ potential real-income gains from automation can be justified. But foremost, I examine the moral ideal behind the normative claim to preserve labor. I show that the arguments in favor of a robot tax rely on doubtful moral convictions on the value of work and I conclude that a moral basis for imposing a robot tax is subject to justified scrutiny.

Beyond individualisation: towards a more contextualised understanding of women’s social egg freezing experiences

Recently, Petersen provided in this journal a critical discussion of individualisation arguments in the context of social egg freezing. This argument underlines the idea that it is morally problematic to use individual technological solutions to solve societal challenges that women face. So far, however, there is a lack of empirical data to contextualise his central normative claim that individualisation arguments are implausible. This article discusses an empirical study that supports a contextualised reading of the normative work of Petersen. Based on a qualitative interview study, we found that most women could make sense of this argument but addressed other concerns that are overlooked in the premises of moral individualisation arguments, for instance, the influence of relationship formation on the demand of egg freezing. Furthermore, women did not experience social egg freezing as morally problematic. Nonetheless, the interviewees pointed to a need of more societal solutions and even actively advocated for efforts to increase accessibility such as a partial reimbursement and better quality of information. The implications of these findings for empirical bioethics are discussed. While more research is needed, we argue that, in order to better address individualisation arguments and related ethical concerns, we need to contextualise normative evaluations within women’s moral reasoning.

Violence and Democracy in Colombia The Conviviality of Citizenship Defects in Colombia’s Nation-State

This essay aims to utilize the concept of conviviality for connecting the coexistence of seemingly contradictory phenomena in Colombia. It argues that while conviviality implies a normative content – a society in which members do not slaughter each other is better than one in which members resort to violence – the meekness of that normative claim suggests that it is better used as an analytical tool that seeks to connect the contradictions that coexist in the real lifeworld. Colombia’s history of violence and democracy is such a contradictory case. Comparativists have situated Colombia’s deficits on the “extra-institutional playing field”, lamenting that it is a “besieged” or “threatened democracy”. Conviviality helps us to specify these “extra-institutional” defects by suggesting impediments exogenous and endogenous to the state-building logic of the Colombian nation-state.