Books by Sarah Clark Miller
The Ethics of Need: Agency, Dignity, and Obligation argues for the philosophical importance of th... more The Ethics of Need: Agency, Dignity, and Obligation argues for the philosophical importance of the notion of need and for an ethical framework through which we can determine which needs have moral significance. In the volume, Sarah Clark Miller synthesizes insights from Kantian and feminist care ethics to establish that our mutual and inevitable interdependence gives rise to a duty to care for the needs of others. Further, she argues that we are obligated not merely to meet others’ needs but to do so in a manner that expresses "dignifying care," a concept that captures how human interactions can grant or deny equal moral standing and inclusion in a moral community. She illuminates these theoretical developments by examining two cases where urgent needs require a caring and dignifying response: the needs of the elderly and the needs of global strangers. Those working in the areas of feminist theory, women’s studies, aging studies, bioethics, and global studies should find this volume of interest.
Papers by Sarah Clark Miller
Journal of Global Ethics, 2022
My aim in this paper is to move toward a relational moral theory of harm through examination of ... more My aim in this paper is to move toward a relational moral theory of harm through examination of a common yet underexplored form of child maltreatment: childhood psychological abuse. I draw on relational theory to consider agential, intrapersonal, and interpersonal ways in which relational harms develop and evolve both in intimate relationships and in conditions of oppression. I set forth three distinctive yet interconnected forms of relational harm that childhood psychological abuse causes: harm to the relational agency of individuals, harm to the relationships individuals hold with themselves, especially with regard to how they respect, know, and trust themselves, and harm to interpersonal relationships of both a direct and indirect nature in present and future timeframes. I close by noting that while relationships can be the site of human brutality that destroys the relational self, paradoxically and promisingly, they also can be a primary means of the relational reconstitution of the self. Ultimately, relational analyses of the harms of childhood psychological abuse reveal several key elements of a relational theory of harm and demonstrate the significance of relational harms for moral philosophy.
Social Philosophy Today
In this article I engage Susan Brison’s “What’s Consent Got to Do with It?” by offering multiple ... more In this article I engage Susan Brison’s “What’s Consent Got to Do with It?” by offering multiple contributions regarding the limitations of the language and culture of consent. I begin by briefly appreciating what consent reveals to us morally about the harms of nonconsensual sex. I then offer five points regarding the language and culture of consent: (1) Conceptualizing rape as nonconsensual sex hides from view the moral harm of having one’s will subjugated by another. (2) The framework of consent renders women’s desires insignificant and invisible. (3) Epistemic gaslighting represents one major and underappreciated form of epistemic injustice that consent-based views of rape propagate. (4) Consent-centered accounts of sexual violence impede our ability to imagine better sexual futures. And (5) consent not only functions to normalize gender-based violence but also to normalize other forms of violence, such as those that erupt in light of race, ability, nationality, weight, and age.
Care Ethics in the Age of Precarity, 2021
After offering an opening consideration of the hazards of neoliberalism, I address the general sh... more After offering an opening consideration of the hazards of neoliberalism, I address the general shape of the crisis of care that has evolved under its auspices. Two aspects of this crisis require greater attention: the moral precarity of caregivers and the relational harms of neoliberal capitalism. Thus, I first consider the moral precarity that caregivers experience by drawing on a concept that originates in scholarly work on the experiences of healthcare workers and combat veterans, namely, moral injury. Through this concept, we can see how caregivers in late-stage capitalism face a seemingly unavoidable violation of their own significant moral beliefs. Second, I examine how the crisis of care results not only in individual harms of moral injury but also in harms to relationships themselves, as I continue to track the impact of moral injury on our intrapersonal and interpersonal lives. Ultimately, I argue that an important facet of the crisis of care is how it operates as a crisis of relationality in which our intrapersonal and interpersonal connections are placed under practical and moral strain. In taking a broader view, we can see how the fraying of particular intrapersonal and interpersonal connections can accumulate, resulting in the unraveling of wider webs of interdependency, just when we need them most. Throughout the paper, I zero in on the moral implications of the crisis of care driven by neoliberalism, featuring the damages that caregivers and their relationships sustain when situated in morally precarious ways. In doing so, I drive home the point that the crisis of care under neoliberalism is as much a moral and relational crisis as it is a political and economic one.
International Journal of Philosophical Studies
ABSTRACT The ethics of care addresses aspects of the human condition that other moral theories ov... more ABSTRACT The ethics of care addresses aspects of the human condition that other moral theories overlook—our vulnerability to injury, inevitable dependencies, and ubiquitous needs. In the grip of these experiences, we require care from others to survive and flourish. The precarious nature of human existence represents a related experience, one less thoroughly explored within care ethics. Through examination of these occasions for care, this article offers two contributions: First, a map of the conceptual relations between care ethics’ four key concepts: need, vulnerability, dependency, and precariousness. As a subset of these efforts, I investigate the relevance of precariousness and precarity for care ethics by asking what they require of caring relations that vulnerability does not. Second, a more precise articulation of care ethics’ normative foundations and accompanying elucidation of the alternative vision of moral responsibility care ethics advances. Examining need, vulnerability, dependency, and precariousness through the lenses of finitude and embodiment exposes two common forms of conflation: between precarity and vulnerability and between dependency and vulnerability. Analysis of the moral significance of the body as a site for care reveals a novel portrayal of the normative foundations of care ethics and the reasons why we care for one another ethically.
Analyzing Violence Against Women, 2019
Ethics and Social Welfare
I reconsider the concept of dignity in several ways in this article. My primary aim is to move di... more I reconsider the concept of dignity in several ways in this article. My primary aim is to move dignity in a more relational direction, drawing on care ethics to do so. After analyzing the power and perils of dignity and tracing its rhetorical, academic, and historical influence, I discuss three interventions that care ethics can make into the dignity discourse. The first intervention involves an understanding of the ways in which care can be dignifying. The second intervention examines whether the capacity to care should be considered a distinguishing moral poweras rationality often isin light of which humans have dignity. In the third intervention, I cast dignity as a fundamentally relational concept and argue that relationality is constitutive not only of dignity but also of the wider enterprise of normativity. I understand relationality as the condition of connection in which all human beings stand with some other human beings. A thought experiment involving the last person on earth helps to reframe the normative significance of human relatedness. Dignity emerges as fundamentally grounded in relationality.
2016 IEEE International Symposium on Ethics in Engineering, Science and Technology (ETHICS), 2016
In early spring of 2015, an engineering faculty member approached the Director of the Leonhard Ce... more In early spring of 2015, an engineering faculty member approached the Director of the Leonhard Center for Enhancement of Engineering Education and asked for a four-hour ethics workshop for Penn State University graduate students who were involved with the National Science Foundation Nanosystems Engineering Research Center for Advanced Self-Powered Systems of Integrated Sensors and Technologies (ASSIST). The faculty member explained that the training should be completed before the end of the same semester. This paper reports the process through which an interdisciplinary team designed an ethics workshop for graduate students. It also discusses the strategies used by the design team to overcome multiple constraints. The workshop consists of three components: a pre-assignment, a two-hour presentation and discussion, and a brief survey after the meeting. The design objectives for the workshop were: (1) Increasing participants' awareness of the sociotechnical systems within which their research exists and the fact that achieving the goals of ASSIST requires synergy from different components within the systems. (2) Helping participants to recognize that a variety of ethical issues-related to research integrity, broader impacts, and embedded value choices-arise from distinct actors and connections in the system, and to improve their moral perception. (3) Introducing the participants to resources and frameworks to support them as they engage in ethical reflection and reasoning. The design team was confronted with, and successfully overcame, multiple constraints: developing an ethics workshop in a short timeframe; providing a learning experience relevant to students whose research field is unfamiliar to most of the team members; and adapting to the busy schedules of graduate students. The post-workshop survey showed that some of our objectives, especially assisting students' development of a broad, systemic view of ethics related to their own research, were successfully met. The survey also indicated areas for improvement.
International Encyclopedia of Ethics, 2013
Journal of Social Philosophy, 2015
In this article, I seek to address an aspect of the general inattention to miscarriage by examini... more In this article, I seek to address an aspect of the general inattention to miscarriage by examining a pressing topic: the moral meanings of pregnancy loss. I focus primarily on the import of such meanings for women in their ethical relationship with themselves, while also finding significant the meaning of miscarriage in community, that is, for our shared moral lives. Exploring miscarriage as a moral phenomenon is critical for figuring out miscarriage’s impact on our ethical self-conception—on how we understand ourselves as moral agents—and in forming and deforming how we understand one another in the broader context of our moral communities—in intimate realms, in public realms, and in various realms in between. I begin by articulating the need for a dedicated perinatal ethics, then developing an overview of this approach. It is against this backdrop that miscarriage’s complex moral meaning can best emerge. I then consider a few promising yet problematic concepts for comprehending the moral meanings of miscarriage, including moral agency, reactive attitudes (in this case, betrayal and guilt), moral responsibility, and moral standing.
The Philosophy of Need, 2006
All humans experience needs. At times needs cut deep, inhibiting persons' abilities to act a... more All humans experience needs. At times needs cut deep, inhibiting persons' abilities to act as agents in the world, to live in distinctly human ways, or to achieve life goals of significance to them. In considering such potentialities, several questions arise: Are any needs morally ...
This presentation is part of the Technology and Intervention in Pregnancy and Childbirth track. T... more This presentation is part of the Technology and Intervention in Pregnancy and Childbirth track. Three main questions are the focus of this paper: First, how does ultrasound shape the relationship between woman and fetus? Second, which major cultural models of pregnancy does ultrasound mobilize? Third, what potential risks, harms and wrongs for women does ultrasound entail? In answering these questions, I consider multiple varieties of this medical biotechnology, including 2D, 3D and 4D ultrasound. I argue that ultrasound intervenes in the woman-fetus relationship to alter both woman-fetus bonding and the social visibility of the pregnant woman. Ultrasound distances a woman from her fetus such that she must engage in a process of forming intimacy with the fetus through her interactions with the image provided. Negating the woman’s embodied intimacy with the fetus, pregnancy becomes a process of acquainting oneself with an interior entity which has been separated through a cultural un...
Southwest Philosophy Review, 2008
A shocking number of people worldwide currently suffer from malnutrition, disease, violence, and ... more A shocking number of people worldwide currently suffer from malnutrition, disease, violence, and poverty. Their difficult lives evidence the intractability and pervasiveness of global need.1 In this paper I draw on recent developments in metaethical and normative theory to reframe one aspect of the conversation regarding whether moral agents are required to respond to the needs of distant strangers. In contrast with recent treatments of the issue of global poverty, as found in the work of Peter Singer (1972 and 2002), who employs a broadly consequentialist framework focusing on suffering, and Thomas Pogge (2002), who inventively reframes the issue in terms of a negative duty not to harm, I explore this issue through an alternative approach: a social view of deontic moral reasons that features the idea of relational normativity. I address whether moral agents must respond to needy others by considering how the needs of distant strangers make implicit claims on those able to help them.2 Ultimately, I demonstrate why indifference in the face of global need is morally unacceptable, hence supporting the idea of an obligation that requires response to others’ basic needs.3
Journal of Social Philosophy, 2009
... Aisha Adam, Darfuri rape survivor. ... and Forgiveness: Essays in Honor of Claudia Card, ed. ... more ... Aisha Adam, Darfuri rape survivor. ... and Forgiveness: Essays in Honor of Claudia Card, ed. Andrea Veltman and Kathryn Norlock (Lanham, MD: Lexington Books, forthcoming); Bergoffen, February 22, 2001; Bergoffen, From Genocide to Justice; Sally J. Scholz, Just War ...
Journal of Philosophical Research, 2005
ABSTRACr: Healthcare rationing is here to stay. No one likes it and we would prefer to give every... more ABSTRACr: Healthcare rationing is here to stay. No one likes it and we would prefer to give everyone all the care they need and deserve. We know that there simply are not enough resources to do this, however. So resourceswill be rationed. In some cases, rationed resources will go to the young, not the aged. When this happens, there is a very good chance (indeed Miller claims it is fact) that there will not only be age bias, but sex bias in the rationing. Miller confronts us with the issue, and challenges us with the defense of such practices, and offers an alternative framework for dealing with the problem.
Hypatia, 2005
This text reconstructs the Kohlberg/Gilligan controversy between a male ethics of justice and a f... more This text reconstructs the Kohlberg/Gilligan controversy between a male ethics of justice and a female ethics of care. Using Karl-Otto Apel's transcendental pragmatics, the author argues for a mediation between both models in terms of a reciprocal co-responsibility. Against this backdrop, she defends the circular procedure of an exclusively argumentative-reflexive justification of a normative ethics. From this it follows for feminist ethics that it cannot do without either of the two types of ethics. The goal is to assure the evaluative variety of different types of an ethics of the good without endangering the normative boundaries of a deontological discourse ethics.
Ethics and Social Welfare, 2010
... View all references, 200025. O'Neill, O. 2000. ... 3The related literature offer... more ... View all references, 200025. O'Neill, O. 2000. ... 3The related literature offers multiple lists of needs (eg lists by Terleckyj, Drewnowski, and Offe), which are nicely captured in Braybrooke's helpful list compilation (1987, pp. 35-38). ...
Catheterization and Cardiovascular Interventions, 2013
Interventional cardiologists are commonly faced with patients who prefer percutaneous coronary in... more Interventional cardiologists are commonly faced with patients who prefer percutaneous coronary intervention (PCI) rather than coronary artery bypass surgery (CABG). Many prefer PCI even when CABG is recommended. We may wonder whether (as the cardiac surgeons suspect) we consciously or unconsciously influence patients to choose PCI. The preceding article by Kipp et al. suggests that patients’ preference for PCI may not result from sinister mind control by cardiologists. They gave 585 patients scenarios posing different levels of risk for PCI compared to CABG. They found that 60% of patients preferred PCI even when the 1 year risk of death was one-third higher with PCI, and 50% still favored PCI when risk of death was twice as high with PCI. Similar responses were seen with the risk of repeat procedures, with 60% of patients favoring PCI when the risk of a repeat procedure was twice as high with PCI, and 50% favoring PCI when the risk was three times as high. In other words, for 1 year mortality, higher absolute risk of 3% and higher relative risk by twofold with PCI were not enough to convince many patients to avoid it. Similarly, for many patients, 10% absolute differences and threefold relative differences in repeat revascularization favoring CABG did not result in a choice for CABG. What could explain this apparently irrational behavior? Was the study an aberration? Likely not, since it concurs with Bowling et al. who found patients favored PCI over CABG by a 4:1 margin [1]. Are people really illogical? Perhaps not, for several reasons. The first may be CABG’s reputation as a major operation. A recent example is the book “Back to Life After a Heart Crisis: A Doctor and His Wife Share Their 8 Step Cardiac Comeback Plan” by Marc Wollack MD. After CABG, he suffered severe depression that he likened to post-traumatic stress disorder, and ended up writing a book that described his two-year journey to recovery. We can tell our patients that quality of life is better for CABG compared to PCI after six months of recovery [2], but few patients will volunteer for a surgery that requires the two-year recovery described by Dr Wollack. Hearing about this book amused a 62-year old friend of mine. He had just finished playing a full-contact tackle football game with his college alumni team against the current varsity team—two weeks after coronary stenting. A second reason why patients might prefer PCI is termed the “affect heuristic.” This refers to how a patient’s feelings affect decision-making. Negative emotions about CABG, perhaps fueled by apprehensions regarding its seemingly invasive and dramatic nature, may influence patients’ evaluation of risk and render them insensitive to estimates of probability [3]. A third reason for preferring PCI is temporal discounting [4]. Adverse events from CABG usually occur in the peri-operative period, whereas adverse events after PCI tend to be fewer initially and “catch up” later. The same risks and discomforts are perceived as greater when they occur immediately (e.g., during CABG) than when they occur later (e.g., “catching up” after PCI). Most patients will choose to delay their risks and discomforts when possible. Patients’ seeming preference for PCI even when presented with scenarios where its risks are higher than those of CABG raises the question of how best to communicate risk. Physicians have enormous influence over patients’ decisions regarding revascularization [5] and there are, in fact, risks in communicating risk. Is it
Contributions to Phenomenology, 2001
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Books by Sarah Clark Miller
Papers by Sarah Clark Miller
as justice, equality, independence, and autonomy? Does vulnerability have a fitting place alongside these concepts? And finally, and perhaps the boldest question of the group: Are we experiencing a pivotal moment in the discipline, in which the centrality of vulnerability to the human condition will finally receive appropriate philosophical attention? The twelve new essays in Vulnerability start us well on the path to answering these and related pressing questions.
The Gyges Test emerges not only as a handy mechanism by which we can determine who is ethically worthy of our political support. Advocating its use is a bold call for the increased significance of ethical leadership in our contemporary democracy. It is a way of endorsing and bolstering the productive trouble that ethics can create for politics, by calling for a democracy in which those who are genuinely ethical leaders are not seen as foolish, wretched idiots but instead as agents and agitators of radical change.