Drawing on ethical and legal frameworks in the Netherlands, the United States and France, we examine whether physicians are expected to inform patients about potentially relevant opportunities for expanded access to investigational drugs. While we found no definitive legal obligation, we argue that physicians have a moral obligation to discuss opportunities for expanded access with patients who have run out of treatment options to prevent inequality, to promote autonomy, and to achieve beneficence.

When seriously ill patients reach the end of the standard treatment trajectory for their condition, they may qualify for the use of unapproved, investigational drugs regulated via expanded access programs. In medical-ethical discourse, it is often argued that expanded access to investigational drugs raises ‘false hope’ among patients and is therefore undesirable. We set out to investigate what is meant by the false hope argument in this discourse. In this paper, we identify and analyze five versions of the false hope (...) argument which we call: (1) the limited chance at benefit argument, (2) the side effects outweighing benefits argument, (3) the opportunity costs argument, (4) the impossibility of making informed decisions argument, and (5) the difficulty of gaining access argument. We argue that the majority of these five versions do not provide normative ground for disqualifying patients’ hopes as false. Only when hope is rooted in a mistaken belief, for example, about the likelihood of benefits or chances on medical risks, or when hope is directed at something that cannot possibly be obtained, should it be considered false. If patients are adequately informed about their odds of obtaining medical benefit, however small, and about the risks associated with an investigational treatment, it is unjustified to consider patients’ hopes to be false, and hence, to deny them access to investigational drug based on that argument. (shrink)

Recent developments regarding the pharmacology of psychoactive substances are significant for treating depressions or opioid addictions. Current theories, hypotheses, and models of drug effects assume a cause–effect narrative, which is based on a stimulus/response mechanism. These narratives prioritize effects rather than conscious experiences. In this sense, drug experiences are quickly subsumed into common categories and codes of biological determinism. If subjective experiences are in the focus of the research, it quickly becomes a link to mystical, spiritual, or transcendental (...) narratives. These classifications lead to epistemological doublets (Gadamer). In this article, psychedelic experiences of drug users are analyzed in the frame of the pharmaco-analysis by Deleuze/Guattari. These framed psychedelic experiences are interpreted by means of a non-philosophical approach through philo-fictions (Laruelle), i.e., contradictory assumptions and hyperspeculations. In this respect, the aim of this article is to bring philo-fictions in relation to psychedelic experiences and to discuss them with models of information science, quantum mechanics, new materialism, and the philosophy of immanence. The result will be an open synthesis, with the assumption of further reflections on the agency, immanence, and the wholeness of matter. (shrink)

Sociologists of science have argued that due to the institutional reward system negative research results, such as failed experiments, may harm scientific careers. We know little, however, of how scientists themselves make sense of negative research findings. Drawing from the sociology of work, the author discusses how researchers involved in a double-blind, placebo, controlled randomized clinical trial for methamphetamine dependency informally and formally interpret the emerging research results. Because the drug tested in the trial was not an effective treatment, (...) the staff considered the trial a failure. In spite of the disappointing results, the staff involved in the daily work with research subjects still reframed the trial as meaningful because they were able to treat people for their drug dependency. The authors of the major publication also framed the results as worthwhile by linking their study to a previously published study in a post hoc analysis. The author concludes that negative research findings offer a collective opportunity to define what scientific work is about and that the effects of failed experiments depend on individual biography and institutional context. (shrink)

We reply to the Ioannidis's paper "Effectiveness of antidepressants; an evidence based myth constructed from a thousand controlled trials." We disagree that antidepressants have no greater efficacy than placebo. We present the efficacy from hundreds of trials in terms of the percentage of patients with a substantial clinical response (a 50% improvement or more symptomatic reduction). This meta-analysis finds that 42-70% of depressed patients improve with drug and 21%-39% improve with placebo. The response benefit of antidepressant treatment is 33%-11% (...) greater than placebo. Ioannidis argues that it would be vanishingly smaller because systematic biasing in these clinical trials would reduce the drug-placebo difference to zero. Ioannidis' argument that antidepressants have no benefit is eroded by his failures of logic because he does not present any evidence that there are a large number of studies where placebo is substantially more effective than drug. (To reduce to zero, one would also have to show that some of the unpublished studies find placebo better than drug and have substantial systematic or methodological bias). We also present the empirical evidence showing that these methodological concerns generally have the opposite effect of what Ioannidis argues, supporting our contention that the measured efficacy of antidepressants likely underestimates true efficacy.Our most important criticism is Ioannidis’ basic underlying argument about antidepressants that if the existing evidence is imperfect and methods can be criticized, then this proves that antidepressant are not efficacious. He presents no credible evidence that antidepressants have zero effect size. Valid arguments can point out difficulties with the data but do not prove that a given drug had no efficacy. Indeed better evidence might prove it was more efficacious that originally found.We find no empirical or ethical reason why psychiatrists should not try to help depressed patients with drugs and/or with psychotherapeutic/behavioral treatments given evidence of efficacy even though our treatment knowledge has limitations. The immense suffering of patients with major depression leads to ethical, moral, professional and legal obligations to treat patients with the best available tools at our disposal, while diligently and actively monitoring for adverse effects and actively revising treatment components as necessary. (shrink)

Die Entwicklung einer „personalisierten Medizin“ ist zurzeit in aller Munde. Insbesondere die personalisierte Arzneimitteltherapie gewinnt infolge der pharmakologischen und molekulargenetischen Entwicklungen immer mehr an Bedeutung. Dies macht es erforderlich, die Auswirkungen der personalisierten Arzneimitteltherapie auf die gesetzliche Krankenversicherung (GKV) und die Patientenversorgung zu untersuchen. In diesem Zusammenhang stellt sich die Frage nach einer „Orphanisierung“: Könnten Arzneimittel der personalisierten Medizin regelmäßig als Orphan Drugs, also als Arzneimittel für seltene Leiden, ausgewiesen werden, würde für sie nach dem Arzneimittelneuordnungsgesetz (AMNOG) grundsätzlich kein Nachweis (...) des Zusatznutzens im Rahmen der vom Gemeinsamen Bundesausschuss (GBA) vorzunehmenden frühen Nutzenbewertung erforderlich werden. Entscheidend für die Ausweisung des Arzneimittels als Orphan Drug ist unter anderem die Prävalenzrate der Patientengruppe, deren Erkrankung mit dem Arzneimittel behandelt werden soll. In diesem Zusammenhang kommt der Stratifizierung von Patientengruppen im Rahmen der personalisierten Arzneimitteltherapie eine besondere Bedeutung zu. Eine solche „Orphanisierung“ hätte für die GKV wegen der mangelnden Kenntnis von dem Zusatznutzen des Arzneimittels insbesondere preisrechtliche Konsequenzen; für die Patienten sind die Folgen durchaus differenzierter zu betrachten. (shrink)

Millions of people in the developing world lack access to curative drugs. Pogge identifies the cause of this problem as a lack of redistribution across borders. In contrast, this article shows that institutional shortcomings within developing countries are the main issue. These different explanations are the result of diverging analytic approaches to ethics: a cosmopolitan approach versus an ordonomic approach. This article compares both approaches with regard to how they conceptualize and propose to solve the problem of providing life-saving pharmaceuticals (...) to the poor in developing countries. (shrink)

Ontologies aim to represent what is general, by means of universal statements. In contrast, dispositional predications capture knowledge about what is likely to happen if a certain set of circumstances obtain, which is crucial in investigative research such as in drug discovery and systems biology, where entities which are constitutionally dissimilar can nevertheless have similar behavior in a biological context. While such dispositional properties are increasingly included in biomedical ontologies, the circumstances under which the dispositions are realized are seldom (...) explicitly modeled, and doing so is problematic due to the necessary restriction to binary relations in OWL ontologies. In this paper we address this shortcoming, focusing on the bioactivity of small molecules at varying levels of concentration within a living organism as our problem domain, although our approach is generalizable to other problems. We discuss the ontological nature and representation of dispositions and their realization; consider the nature of concentrations and their representation; and finally we detail an approach to linking dispositions to the conditions for their realization which regards conditions as triggers for the process in which the disposition is realized. (shrink)

ABSTRACT I argue that this examination and appreciation for the shift to abductive reasoning should be extended to the intersection of neuroscience and novel brain-computer interfaces too. This paper highlights the implications of applying abductive reasoning to personalized implantable neurotechnologies. Then, it explores whether abductive reasoning is sufficient to justify insurance coverage for devices absent widespread clinical trials, which are better applied to one-size-fits-all treatments. INTRODUCTION In contrast to the classic model of randomized-control trials, often with a large number of (...) subjects enrolled, precision medicine attempts to optimize therapeutic outcomes by focusing on the individual.[i] A recent publication highlights the strengths and weakness of both traditional evidence-based medicine and precision medicine.[ii] Plus, it outlines a tension in the shift from evidence-based medicine’s inductive reasoning style (the collection of data to postulate general theories) to precision medicine’s abductive reasoning style (the generation of an idea from the limited data available).[iii] The paper’s main example is the application of precision medicine for the treatment of cancer.[iv] I argue that this examination and appreciation for the shift to abductive reasoning should be extended to the intersection of neuroscience and novel brain-computer interfaces too. As the name suggests, brain-computer interfaces are a significant advancement in neurotechnology that directly connects someone’s brain to external or implanted devices.[v] Among the various kinds of brain-computer interfaces, adaptive deep brain stimulation devices require numerous personalized adjustments to their settings during the implantation and computation stages in order to provide adequate relief to patients with treatment-resistant disorders. What makes these devices unique is how adaptive deep brain stimulation integrates a sensory component to initiate the stimulation. While not commonly at the level of sophistication as self-supervising or generative large language models,[vi] they currently allow for a semi-autonomous form of neuromodulation. This paper highlights the implications of applying abductive reasoning to personalized implantable neurotechnologies. Then, it explores whether abductive reasoning is sufficient to justify insurance coverage for devices absent widespread clinical trials, which are better applied to one-size-fits-all treatments.[vii] ANALYSIS I. The State of Precision Medicine in Oncology and the Epistemological Shift While a thorough overview of precision medicine for the treatment of cancer is beyond the scope of this article, its practice can be roughly summarized as identifying clinically significant characteristics a patient possesses (e.g., genetic traits) to land on a specialized treatment option that, theoretically, should benefit the patient the most.[viii] However, in such a practice of stratification patients fall into smaller and smaller populations and the quality of evidence that can be applied to anyone outside these decreases in turn.[ix] As inductive logic helps to articulate, the greater the number of patients that respond to a particular therapy the higher the probability of its efficacy. By straying from this logical framework, precision medicine opens the treatment of cancer to more uncertainty about the validity of these approaches to the resulting disease subcategories.[x] Thus, while contemporary medical practices explicitly describe some treatments as “personalized”, they ought not be viewed as inherently better founded than other therapies.[xi] A relevant contemporary case of precision medicine out of Norway focuses on the care of a patient with cancer between the ventricles of the heart and esophagus, which had failed to respond to the standard regimen of therapies over four years.[xii] In a last-ditch effort, the patient elected to pay out-of-pocket for an experimental immunotherapy (nivolumab) at a private hospital. He experienced marked improvements and a reduction in the size of the tumor. Understandably, the patient tried to pursue further rounds of nivolumab at a public hospital. However, the hospital initially declined to pay for it given the “lack of evidence from randomised clinical trials for this drug relating to this [patient’s] condition.”[xiii] In rebuttal to this claim, the patient countered that he was actually similar to a subpopulation of patients who responded in “open‐label, single arm, phase 2 studies on another immune therapy drug” (pembrolizumab).[xiv] Given this interpretation of the prior studies and the patient’s response, further rounds of nivolumab were approved. Had the patient not had improvements in the tumor’s size following a round of nivolumab, then pembrolizumab’s prior empirical evidence in isolation would have been insufficient, inductively speaking, to justify his continued use of nivolumab.[xv] The case demonstrates a shift in reasoning from the traditional induction to abduction. The phenomenon of ‘cancer improvement’ is considered causally linked to nivolumab and its underlying physiological mechanisms.[xvi] However, “the weakness of abductions is that there may always be some other better, unknown explanation for an effect. The patient may for example belong to a special subgroup that spontaneously improves, or the change may be a placebo effect. This does not mean, however, that abductive inferences cannot be strong or reasonable, in the sense that they can make a conclusion probable.”[xvii] To demonstrate the limitations of relying on the abductive standard in isolation, commentators have pointed out that side effects in precision medicine are hard to rule out as being related to the initial intervention itself unless trends from a group of patients are taken into consideration.[xviii] As artificial intelligence (AI) assists the development of precision medicine for oncology, this uncertainty ought to be taken into consideration. The implementation of AI has been crucial to the development of precision medicine by providing a way to combine large patient datasets or a single patient with a large number of unique variables with machine learning to recommend matches based on statistics and probability of success upon which practitioners can base medical recommendations.[xix] The AI is usually not establishing a causal relationship[xx] – it is predicting. So, as AI bleeds into medical devices, like brain-computer interfaces, the same cautions about using abductive reasoning alone should be carried over. II. Responsive Neurostimulation, AI, and Personalized Medicine Like precision medicine in cancer treatment, computer-brain interface technology similarly focuses on the individual patient through personalized settings. In order to properly expose the intersection of AI, precision medicine, abductive reasoning, and implantable neurotechnologies, the descriptions of adaptive deep brain stimulation systems need to deepen.[xxi] As a broad summary of adaptive deep brain stimulation, to provide a patient with the therapeutic stimulation, a neural signal, typically referred to as a local field potential,[xxii] must first be detected and then interpreted by the device. The main adaptive deep brain stimulation device with premarket approval, the NeuroPace Responsive Neurostimulation system, is used to treat epilepsy by detecting and storing “programmer-defined phenomena.”[xxiii] Providers can optimize the detection settings of the device to align with the patient’s unique electrographic seizures as well as personalize the reacting stimulation’s parameters.[xxiv] The provider adjusts the technology based on trial and error. One day machine learning algorithms will be able to regularly aid this process in myriad ways, such as by identifying the specific stimulation settings a patient may respond to ahead of time based on their electrophysiological signatures.[xxv] Either way, with AI or programmers, adaptive neurostimulation technologies are individualized and therefore operate in line with precision medicine rather than standard treatments based on large clinical trials. Contemporary neurostimulation devices are not usually sophisticated enough to be prominent in AI discussions where the topics of neural networks, deep learning, generative models, and self-attention dominate the conversation. However, implantable high-density electrocorticography arrays (a much more sensitive version than adaptive deep brain stimulation systems use) have been used in combination with neural networks to help patients with neurologic deficits from a prior stroke “speak” through a virtual avatar.[xxvi] In some experimental situations, algorithms are optimizing stimulation parameters with increasing levels of independence.[xxvii] An example of neurostimulation that is analogous to the use of nivolumab in Norway surrounds a patient in the United States who was experiencing both treatment-resistant OCD and temporal lobe epilepsy.[xxviii]Given the refractory nature of her epilepsy, implantation of an adaptive deep brain stimulation system was indicated. As a form of experimental therapy, her treatment-resistant OCD was also indicated for the off-label use of an adaptive deep brain stimulation set-up. Another deep brain stimulation lead, other than the one implanted for epilepsy, was placed in the patient’s right nucleus accumbens and ventral pallidum region given the correlation these nuclei had with OCD symptoms in prior research. Following this, the patient underwent “1) ambulatory, patient-initiated magnet-swipe storage of data during moments of obsessive thoughts; (2) lab-based, naturalistic provocation of OCD-related distress (naturalistic provocation task); and (3) lab-based, VR [virtual reality] provocation of OCD-related distress (VR provocation task).”[xxix] Such signals were used to identify when to deliver the therapeutic stimulation in order to counter the OCD symptoms. Thankfully, following the procedure and calibration the patient exhibited marked improvements in their OCD symptoms and recently shared her results publicly.[xxx] In both cases, there is a similar level of abductive justification for the efficacy of the delivered therapy. In the case study in which the patient was treated with adaptive deep brain stimulation, they at least had their neural activity tested in various settings to determine the optimum parameters for treatment to avoid them being based on guesswork. Additionally, the adaptive deep brain stimulation lead was already placed before the calibration trials were conducted, meaning that the patient had already taken on the bulk of the procedural risk before the efficacy could be determined. Such an efficacy test could have been replicated in the first patient’s cancer treatment, had it been biopsied and tested against the remaining immunotherapies in vitro. Yet, in the case of cancer with few options, one previous dose of a drug that appeared to work on the patient may justify further doses. However, as the Norwegian case presents, corroboration with known responses to a similar drug (from a clinical trial) could be helpful to validate the treatment strategy. (It should be noted that both patients were resigned to these last resort options regardless of the efficacy of treatment.) There are some elements of inductive logic seen with adaptive deep brain stimulation research in general. For example, abductively the focus could be that patient X’s stimulation parameters are different from patient Y’s and patient Z’s. In contrast, when grouped as subjects who obtained personalized stimulation, patients X, Y, and Z demonstrate an inductive aspect to this approach’s safety and/or efficacy. The OCD case holds plenty of abductive characteristics in line with precision medicine’s approach to treating cancer and as more individuals try the method, there will be additional data. With the gradual integration of AI into brain-computer interfaces in the name of efficacy, this reliance on abduction will continue, if not grow, over time. Moving forward, if a responsive deep brain stimulation treatment is novel and individualized (like the dose of nivolumab) and there is some other suggestion of efficacy (like clinical similarities to other patients in the literature), then it may justify insurance coverage for the investigative intervention, absent other unrelated reasons to deny it. III. Ethical Implications and Next Steps While AI’s use in oncology and neurology is not yet as prominent as its use in other fields (e.g., radiology), it appears to be on the horizon for both.[xxxi] AI can be found in both the functioning of the neurotechnologies as well as the implementation of precision medicine. The increasing use of AI may serve to further individualize both oncologic and neurological therapies. Given these implications and the handful of publications cited in this article, it is important to have a nuanced evaluation of how these treatments, which heavily rely on abductive justification, ought to be managed. The just use an abductive approach may be difficult as AI infused precision medicine is further pursued. At baseline, such technology relies on a level of advanced technology literacy among the general public and could exclude populations who lack access to basic technological infrastructure or know-how from participation.[xxxii] Even among nations with adequate infrastructure, as more patients seek out implantable neurotechnologies, which require robust healthcare resources, the market will favor patient populations that can afford this complex care.[xxxiii] If patients already have the means to pay for an initial dose/use of a precision medicine product out of pocket, should insurance providers be required to cover subsequent treatments?[xxxiv] That is, if a first dose of a cancer drug or a deep brain stimulator over its initial battery life is successful, patients may feel justified in having the costs of further treatments covered. The Norwegian patient’s experience implies there is a precedent for the idea that some public insurance companies ought to cover successful cancer therapies, however, insurance companies may not all see themselves as obligated to cover neurotechnologies that rely on personalized settings or that are based on precision/abductive research more than on clinical trials. CONCLUSION The fact that the cases outlined above rely on abductive style of reasoning implies that there may not be as strong a justification for coverage by insurance, as they are both experimental and individualized, when compared to the more traditional large clinical trials in which groups have the same or a standardized protocol (settings/doses). If a study is examining the efficacy of a treatment with a large cohort of patients or with different experimental groups/phases, insurance companies may conclude that the resulting symptom improvements are more likely to be coming from the devices themselves. A preference for inductive justification may take priority when ruling in favor of funding someone’s continued use of an implantable neurostimulator. There are further nuances to this discussion surrounding the classifications of these interventions as research versus clinical care that warrant future exploration, since such a distinction is more of a scale[xxxv] than binary and could have significant impacts on the “right-to-try” approach to experimental therapies in the United States.[xxxvi] Namely, given the inherent limitations of conducting large cohort trials for deep brain stimulation interventions on patients with neuropsychiatric disorders, surgically innovative frameworks that blend abductive and inductive methodologies, like with sham stimulation phases, have traditionally been used.[xxxvii] Similarly, for adaptive brain-computer interface systems, if there are no large clinical trials and instead only publications that demonstrate that something similar worked for someone else, then, in addition to the evidence that the first treatment/dose worked for the patient in question, the balance of reasoning would be valid and arguably justify insurance coverage. As precision approaches to neurotechnology become more common, frameworks for evaluating efficacy will be crucial both for insurance coverage and for clinical decision making. ACKNOWLEDGEMENT This article was originally written as an assignment for Dr. Francis Shen’s “Bioethics & AI” course at Harvard’s Center for Bioethics. I would like to thank Dr. Shen for his comments as well as my colleagues in the Lázaro-Muñoz Lab for their feedback. - [i] Jonathan Kimmelman and Ian Tannock, “The Paradox of Precision Medicine,” Nature Reviews. Clinical Oncology 15, no. 6 (June 2018): 341–42, https://doi.org/10.1038/s41571-018-0016-0. [ii] Henrik Vogt and Bjørn Hofmann, “How Precision Medicine Changes Medical Epistemology: A Formative Case from Norway,” Journal of Evaluation in Clinical Practice 28, no. 6 (December 2022): 1205–12, https://doi.org/10.1111/jep.13649. [iii] David Barrett and Ahtisham Younas, “Induction, Deduction and Abduction,” Evidence-Based Nursing 27, no. 1 (January 1, 2024): 6–7, https://doi.org/10.1136/ebnurs-2023-103873. [iv] Vogt and Hofmann, “How Precision Medicine Changes Medical Epistemology,” 1208. [v] Wireko Andrew Awuah et al., “Bridging Minds and Machines: The Recent Advances of Brain-Computer Interfaces in Neurological and Neurosurgical Applications,” World Neurosurgery, May 22, 2024, S1878-8750(24)00867-2, https://doi.org/10.1016/j.wneu.2024.05.104. [vi] Mark Riedl, “A Very Gentle Introduction to Large Language Models without the Hype,” Medium (blog), May 25, 2023, https://mark-riedl.medium.com/a-very-gentle-introduction-to-large-language-models-without-the-hype-5 f67941fa59e. [vii] David E. Burdette and Barbara E. Swartz, “Chapter 4 - Responsive Neurostimulation,” in Neurostimulation for Epilepsy, ed. Vikram R. Rao (Academic Press, 2023), 97–132, https://doi.org/10.1016/B978-0-323-91702-5.00002-5. [viii] Kimmelman and Tannock, 2018. [ix] Kimmelman and Tannock, 2018. [x] Simon Lohse, “Mapping Uncertainty in Precision Medicine: A Systematic Scoping Review,” Journal of Evaluation in Clinical Practice 29, no. 3 (April 2023): 554–64, https://doi.org/10.1111/jep.13789. [xi] Kimmelman and Tannock, “The Paradox of Precision Medicine.” [xii] Vogt and Hofmann, 1206. [xiii] Vogt and Hofmann, 1206. [xiv] Vogt and Hofmann, 1206. [xv] Vogt and Hofmann, 1207. [xvi] Vogt and Hofmann, 1207. [xvii] Vogt and Hofmann, 1207. [xviii] Vogt and Hofmann, 1210. [xix] Mehar Sahu et al., “Chapter Three - Artificial Intelligence and Machine Learning in Precision Medicine: A Paradigm Shift in Big Data Analysis,” in Progress in Molecular Biology and Translational Science, ed. David B. Teplow, vol. 190, 1 vols., Precision Medicine (Academic Press, 2022), 57–100, https://doi.org/10.1016/bs.pmbts.2022.03.002. [xx] Stefan Feuerriegel et al., “Causal Machine Learning for Predicting Treatment Outcomes,” Nature Medicine 30, no. 4 (April 2024): 958–68, https://doi.org/10.1038/s41591-024-02902-1. [xxi] Sunderland Baker et al., “Ethical Considerations in Closed Loop Deep Brain Stimulation,” Deep Brain Stimulation 3 (October 1, 2023): 8–15, https://doi.org/10.1016/j.jdbs.2023.11.001. [xxii] David Haslacher et al., “AI for Brain-Computer Interfaces,” 2024, 7, https://doi.org/10.1016/bs.dnb.2024.02.003. [xxiii] Burdette and Swartz, “Chapter 4 - Responsive Neurostimulation,” 103–4; “Premarket Approval (PMA),” https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfpma/pma.cfm?id=P100026. [xxiv] Burdette and Swartz, “Chapter 4 - Responsive Neurostimulation,” 104. [xxv] Burdette and Swartz, 126. [xxvi] Sean L. Metzger et al., “A High-Performance Neuroprosthesis for Speech Decoding and Avatar Control,” Nature 620, no. 7976 (August 2023): 1037–46, https://doi.org/10.1038/s41586-023-06443-4. [xxvii] Hao Fang and Yuxiao Yang, “Predictive Neuromodulation of Cingulo-Frontal Neural Dynamics in Major Depressive Disorder Using a Brain-Computer Interface System: A Simulation Study,” Frontiers in Computational Neuroscience 17 (March 6, 2023), https://doi.org/10.3389/fncom.2023.1119685; Mahsa Malekmohammadi et al., “Kinematic Adaptive Deep Brain Stimulation for Resting Tremor in Parkinson’s Disease,” Movement Disorders 31, no. 3 (2016): 426–28, https://doi.org/10.1002/mds.26482. [xxviii] Young-Hoon Nho et al., “Responsive Deep Brain Stimulation Guided by Ventral Striatal Electrophysiology of Obsession Durably Ameliorates Compulsion,” Neuron 0, no. 0 (October 20, 2023), https://doi.org/10.1016/j.neuron.2023.09.034. [xxix] Nho et al. [xxx] Nho et al.; Erik Robinson, “Brain Implant at OHSU Successfully Controls Both Seizures and OCD,” OHSU News, accessed March 3, 2024, https://news.ohsu.edu/2023/10/25/brain-implant-at-ohsu-successfully-controls-both-seizures-and-ocd. [xxxi] Awuah et al., “Bridging Minds and Machines”; Haslacher et al., “AI for Brain-Computer Interfaces.” [xxxii] Awuah et al., “Bridging Minds and Machines.” [xxxiii] Sara Green, Barbara Prainsack, and Maya Sabatello, “The Roots of (in)Equity in Precision Medicine: Gaps in the Discourse,” Personalized Medicine 21, no. 1 (January 2024): 5–9, https://doi.org/10.2217/pme-2023-0097. [xxxiv] Green, Prainsack, and Sabatello, 7. [xxxv] Robyn Bluhm and Kirstin Borgerson, “An Epistemic Argument for Research-Practice Integration in Medicine,” The Journal of Medicine and Philosophy: A Forum for Bioethics and Philosophy of Medicine 43, no. 4 (July 9, 2018): 469–84, https://doi.org/10.1093/jmp/jhy009. [xxxvi] Vijay Mahant, “‘Right-to-Try’ Experimental Drugs: An Overview,” Journal of Translational Medicine 18 (June 23, 2020): 253, https://doi.org/10.1186/s12967-020-02427-4. [xxxvii] Michael S. Okun et al., “Deep Brain Stimulation in the Internal Capsule and Nucleus Accumbens Region: Responses Observed during Active and Sham Programming,” Journal of Neurology, Neurosurgery & Psychiatry 78, no. 3 (March 1, 2007): 310–14, https://doi.org/10.1136/jnnp.2006.095315. (shrink)

Explanatory realism is the view that explanations work by providing information about relations of productive determination such as causation or grounding. The view has gained considerable popularity in the last decades, especially in the context of metaphysical debates about non-causal explanation. What makes the view particularly attractive is that it fits nicely with the idea that not all explanations are causal whilst avoiding an implausible pluralism about explanation. Another attractive feature of the view is that it allows explanation to be (...) a partially epistemic, context-dependent phenomenon. In spite of its attractiveness, explanatory realism has recently been subject to criticism. In particular, Taylor :197–219, 2018). has presented four types of explanation that the view allegedly cannot account for. This paper defends explanatory realism against Taylor’s challenges. We will show that Taylor’s counterexamples are either explanations that turn out to provide information about entities standing in productive determination relations or that they are not genuine explanations in the first place. (shrink)

How ought you to evaluate your options if you’re uncertain about which axiology is true? One prominent response is Expected Moral Value Maximisation, the view that under axiological uncertainty, an option is better than another if and only if it has the greater expected moral value across axiologies. EMVM raises two fundamental questions. First, there’s a question about what it should even mean. In particular, it presupposes that we can compare moral value across axiologies. So to even understand EMVM, we (...) need to explain what it is for such comparisons to hold. Second, assuming that we understand it, there’s a question about whether EMVM is true. Since there are many plausible rivals, we need an argument to defend it. In this paper, I’ll introduce a representation theorem for axiological uncertainty to answer these two questions. Roughly, the theorem shows that if all our axiologies satisfy the von Neumann–Morgenstern axioms, and if the facts about which options are better than which in light of your uncertainty also satisfy these axioms as well as a Pareto condition, then these facts have a relevantly unique expected utility representation. If I’m right, this theorem at once affords us a compelling way to understand EMVM—and specifically intertheoretic comparisons—and a systematic argument for its truth. (shrink)

Equal Justice explores the role of the idea of equality in liberal theories of justice. The title indicates the book’s two-part thesis: first, I claim that justice is the central moral category in the socio-political domain; second, I argue for a specific conceptual and normative connection between the ideas of justice and equality. This pertains to the age-old question concerning the normative significance of equality in a theory of justice. The book develops an independent, systematic, and comprehensive theory of equality (...) and egalitarianism. The principal question is about the importance of equality in a theory of justice. More precisely, we should pose questions in four contracting circles: 1. Is justice the supreme value guiding our setup of the basic structure of society, or are there other, equally important values, such as recognition, care, communal belonging? 2. If justice is the highest guiding principle, which competing ideals—especially equality and freedom—ought to have precedence in a policy oriented toward justice? What status does the ideal of equality have in that framework? 3. If equality is a basic ideal of just policy, how should it be practically realized? What sort of equality (equal opportunity, equality of welfare, resource equality) should be demanded? 4. What patterned distribution of which specific goods does the ideal of equality demand? Which principles of distribution can be justified according to our justice ideal? To conclude and summarize: 5. What is the essential core of an egalitarian theory of justice, as opposed to an inegalitarian theory? These five questions structure the work’s order of argumentation. Part A elaborates the conceptual foundations and basic moral principles of justice and equality. Chapter I sets out to install justice as the central moral category in the socio-political domain. At the beginning of the first chapter, the conceptual foundations of justice are clarified. While not eliminating the classical distinctions between different forms of justice, I argue that the distributive paradigm is of primary importance. The primacy of justice in the socio-political domain is developed out of a confrontation with alternative positions, those which maintain either that justice generally, or distributive justice in particular, are subsidiary virtues. At the end of Chapter I, the first of the questions mentioned above is answered in a way that establishes justice as the guiding normative concept for the foundation and evaluation of any social order. To clarify the role of equality in a theory of justice, Chapter II separates the idea of equality into four different principles. They are organized in a way that begins with the most general and uncontroversial principle of equality, and progresses towards increasingly detailed and contested principles. There are two theses that articulate and defend the significance of equality for justice: First there is a conceptual connection between justice and equality, in that principles of formal and proportional equality are necessary in order to explicate the concept of justice. These two principles establish an unbreakable bond between justice and equality. Justice can only be explained—or so I argue—by reference to these and other (normative) principles of equality. The second thesis posits a normative relationship between justice and equality, which is disclosed by three substantive principles of equality: moral equality, the presumption of equality, and the principle of responsibility. I argue that the normative core of an egalitarian theory of justice is expressed by the latter two principles, which are themselves based on the first principle, that of moral equality. When we view one another as persons, what form of equality or equal treatment is normatively demanded? I argue that the answer to this question is given by the procedural principle of the presumption of equality: regardless of their apparent differences, all persons deserve strictly equal treatment, unless certain kinds of differences have whatever particular relevance would justify, on generally acceptable grounds, unequal treatment or unequal distribution. The justification of the presumption of equality is central to this work and has considerable importance. If the presumption principle’s validity can be justified by enlisting the principle of general justification, then the primacy of equality, and the essential argument for an egalitarian theory of justice, is established. This would likewise provide a procedure for the construction of a material theory of justice. The second question is answered thereby at the end of Chapter II: Equality should have primacy over competing ideals within a justice-oriented policy. The presumption of equality establishes this primacy and, at the same time, offers an appropriate metric and guideline for the construction of a material theory of distributive justice. The presumption of equality in Part B offers an elegant procedure for the development of a theory of distributive justice. Chapter III clearly sets out the necessary prerequisites that a theory of distribution must satisfy in order to determine a liberal-egalitarian distributional framework. We need to specify in which situation the distribution takes place; which goods are and are not to be distributed; in which respect the presumptive equality is to be produced; and by and to whom, and for what period, the relevant goods are to be distributed. The distribution is based on resources understood as general-purpose means. It is necessary to divide goods into different categories, since the justification for unequal treatment in one domain will not carry over into another. This makes presumptive equality necessarily complex. To that end, four spheres of justice are distinguished: (1) the political sphere, which involves allocating rights through the distribution of civil liberties; (2) the democratic sphere, in which political power and the rights of political participation are regulated; (3) the economic sphere, in which income and property are distributed; (4) the social sphere, in which social positions and opportunities are distributed. This framework of distributive justice answers the third of our guiding questions, about the nature of equality, in terms of equality of resources. Chapters IV and V set out the egalitarian distributive criteria for each sphere. I argue that the generally accepted, fundamental rights of classical liberalism are more effectively reconstructed by reference to the equal resource distribution presumptively required in those spheres. Chapter IV shows that when it comes to the first two spheres, those involving basic rights and freedoms and entitlement political participation, there can be no justified exceptions to the equal distribution of the relevant goods. That section argues, contrary to what we commonly find in theories of freedom or popular sovereignty, that the value of freedom and self-determination as the political basis of autonomy is best realized through the presumption of equal distribution. Chapter V deals with the other two spheres, those of economic goods and social positions, and argues for justified exceptions to equal distribution. In the economic sphere we find one principal reason favouring unequal distribution of resources, and three restrictions and compensations limiting that inequality. The basic exception to equal economic distribution arises from the unequal consequences of personal responsibility. From a suitably egalitarian standpoint, the principle of responsibility is the normative principle that determines which reasons justify economic inequality. Here the basic idea is that unequal shares of social goods are fair if they result from the choices and deliberate actions of the relevant parties. That individuals have to bear the costs of their own choices is a condition of autonomy. However, benefits or disadvantages arising from arbitrary and unmerited differences in social circumstances or natural endowments is unfair. The unequal consequences of independent decision-making and action must therefore be limited by compensating first for preferences, secondly for disadvantages, and thirdly by redistributing wealth in aid of the worse-off. I situations of emergency, compensating for disadvantages has priority over all other claims, owing to the urgency of the situation. Social inequalities go beyond the permissible limit if it is possible to improve the long-term social or economic situation of the worse-off by redistributing wealth to them. These exceptions lead to a complex system of free economic action within a framework of compensatory tax and transfer mechanisms. Finally, in the social sphere, the distribution of social positions, offices and opportunities must be structured to ensure that equally talented and motivated citizens have roughly equal chances of obtaining those offices or positions, irrespective of their economic or social class backgrounds. This compromise is permissible for reasons of freedom and prudence, and it makes a certain measure of inequality acceptable. The fourth of our guiding questions is answered accordingly. There are five principles of justice for the basic structure of society, and five legal principles that govern the special distribution of goods in the respective spheres—all are ranked according to their most defensible grounds of priority, ensuring that everyone is accorded equal justice. Chapter VI recapitulates the initial question of equality’s value. The conception of equal justice developed in this work postulates five principles of equality and five principles of law; these constitute an egalitarian framework because they support and promote social justice. Equality has value with respect to them, but is not given any independent, intrinsic value. That is why I call the account developed here a form of constitutive egalitarianism: justice is realized through the realization of equality, itself accomplished by applying the five postulates of equality and five distributive principles of law. This is an egalitarianism on two levels. The first level is involves the claim that morality or justice is conceptually connected with equality. The second level gives equality a substantial weight in what is conceptually validated at the first level, namely the presumption of equality, and constructs an appropriate interpretation and conception of distributive justice through principles of distribution for the individual spheres. The weight and importance of equality is shown by the distributive criteria applied to those spheres. This answers our final guiding question about the nature of an egalitarian theory. (shrink)

The fact that the standard probabilistic calculus does not define probabilities for sentences with embedded conditionals is a fundamental problem for the probabilistic theory of conditionals. Several authors have explored ways to assign probabilities to such sentences, but those proposals have come under criticism for making counterintuitive predictions. This paper examines the source of the problematic predictions and proposes an amendment which corrects them in a principled way. The account brings intuitions about counterfactual conditionals to bear on the interpretation of (...) indicatives and relies on the notion of causal (in)dependence. (shrink)

According to the standard account of forgiveness, you forgive your wrongdoer by overcoming your resentment towards them. But how exactly must you do so? And when is such overcoming fitting? The aim of this paper is to introduce a novel version of the standard account to answer these questions. Its core idea is that the reactive attitudes are a fitting response not just to someone’s blameworthiness, but to their blameworthiness being significant for you, or worthy of your caring, in virtue (...) of your relationship to it. Someone’s blameworthiness is significant for you to the extent you’re bound up with what grounds it––e.g. with the wrongdoer’s being a participant in human relationships, with their attitudes, or with the victim’s being a source of demands. So you may fittingly not care about someone’s blameworthiness if it’s sufficiently insignificant for you in this manner––e.g. if their wrong happened far off in place and time. And forgiveness revolves around this. You forgive your wrongdoer if and only if, partly out of goodwill towards them, you cease to care about their blameworthiness––a bit as if their wrong had happened far off. If I’m right, this agent-relativity-based account can resolve the apparent ‘paradoxy of forgiveness’, satisfies a number of desiderata, and is plausible on an intuitive level. (shrink)

Bostrom rejects Nietzsche as an ancestor of the transhumanist movement, as he claims that there were merely some “surface-level similarities with the Nietzschean vision” (Bostrom 2005a, 4). In contrast to Bostrom, I think that significant similarities between the posthuman and the overhuman can be found on a fundamental level. In addition, it seems to me that Nietzsche explained the relevance of the overhuman by referring to a dimension which seems to be lacking in transhumanism. In order to explain my position, (...) I will progress as follows. First, I will compare the concept of the posthuman to that of Nietzsche’s overhuman, focusing more on their similarities than their differences. Second, I will contextualise the overhuman in Nietzsche’s general vision, so that I can point out which dimension seems to me to be lacking in transhumanist thought. (shrink)

I argue for an account of know‐how as a capacity for practical judgment—a view I derive from Gilbert Ryle. I begin by offering an interpretation of Ryle and by correcting a number of widespread misconceptions about his views in the current debate. I then identify some problems with Ryle's account and finally present my own view which, I argue, retains Ryle's insights while avoiding his mistakes.

By using the notions of exact truth and exact falsity, one can give 16 distinct definitions of classical consequence. This paper studies the class of relations that results from these definitions in settings that are paracomplete, paraconsistent or both and that are governed by the Strong Kleene schema. Besides familiar logics such as Strong Kleene logic, the Logic of Paradox and First Degree Entailment, the resulting class of all Strong Kleene generalizations of classical logic also contains a host of unfamiliar (...) logics. We first study the members of our class semantically, after which we present a uniform sequent calculus that is sound and complete with respect to all of them. Two further sequent calculi and \ calculus) will be considered, which serve the same purpose and which are obtained by applying general methods to construct sequent calculi for many-valued logics. Rules and proofs in the SK calculus are much simpler and shorter than those of the \ and the \ calculus, which is one of the reasons to prefer the SK calculus over the latter two. Besides favourably comparing the SK calculus to both the \ and the \ calculus, we also hint at its philosophical significance. (shrink)

In the past few decades, a growth in ethical consumerism has led brands to increasingly develop conscientiousness and depict ethical image at a corporate level. However, most of the research studying business ethics in the field of corporate brand management is either conceptual or has been empirically conducted in relation to goods/products contexts. This is surprising because corporate brands are more relevant in services contexts, because of the distinct nature of services and the key role that employees have in the (...) services sector. Accordingly, this article aims at empirically examining the effects of customer perceived ethicality in the context of corporate services brands. Based on data collected for eight service categories using a panel of 2179 customers, the hypothesized structural model is tested using path analysis. The results show that, in addition to a direct effect, customer perceived ethicality has a positive and indirect effect on customer loyalty, through the mediators of customer affective commitment and customer perceived quality. Further, employee empathy positively influences the impact of customer perceived ethicality on customer affective commitment, and customer loyalty positively impacts customer positive word-of-mouth. The first implication of these results is that corporate brand strategy needs to be aligned with human resources policies and practices if brands want to turn ethical strategies into employee behavior. Second, corporate brands should build more authentic communications grounded in their ethical beliefs and supported by evidence from actual employees. (shrink)

The academic debate why and how companies are dealing with sustainability is dominated by two main arguments—the profit-seeking and the legitimacy-seeking view. While the first argues that companies establish sustainability management measures if this helps to increase their economic success, others emphasize that companies predominantly react on societal pressure dealing with sustainability to secure legitimacy. Whereas both lines of argument have gained a lot of attention in academia, little is known about their relative importance in shaping corporate practice. This papers (...) aims to fill this gap with an empirical analysis of corporate practices of large companies in ten countries worldwide. To capture the organizations’ rationale in sustainability management practice, we systematically applied various measures related to actors and operational activities focusing on the companies’ intention to pursue sustainability management, the integration of sustainability management to the core business, and the actual implementation of related measures. Overall the findings indicate that seeking legitimacy dominates corporate sustainability management practices. (shrink)

Machine learning is used more and more in scientific contexts, from the recent breakthroughs with AlphaFold2 in protein fold prediction to the use of ML in parametrization for large climate/astronomy models. Yet it is unclear whether we can obtain scientific explanations from such models. I argue that when machine learning is used to conduct causal inference we can give a new positive answer to this question. However, these ML models are purpose-built models and there are technical results showing that standard (...) machine learning models cannot be used for the same type of causal inference. Instead, there is a pathway to causal explanations from predictive ML models through new explainability techniques; specifically, new methods to extract structural equation models from such ML models. The extracted models are likely to suffer from issues though: they will often fail to account for confounders and colliders, as well as deliver simply incorrect causal graphs due to ML models tendency to violate physical laws such as the conservation of energy. In this case, extracted graphs are a starting point for new explanations, but predictive accuracy is no guarantee for good explanations. (shrink)

The number of legal and nonlegal ethical regulations in the biomedical field has increased tremendously, leaving present-day practitioners and researchers in a virtual crossfire of legislations and guidelines. Judging by the production and by the way these regulations are motivated and presented, they are held to be of great importance to ethical practice. This view is shared by many commentators. For instance, Commons and Baldwin write that, within the nursing profession, patient care can be performed unethically or ethically depending on (...) the professional standards the nurses have set for themselves. They also hold that such standards are set when nurses become aware of the ethical codes available. As nurses are often not familiar with the codes, they do not all conform to them. Commons and Baldwin argue that nurses' ability to deal with ethical dilemmas is effectively secured with education on guidelines, creating a “barrier” between personal and professional values. (shrink)

It is widely recognized that the innate versus acquired distinction is a false dichotomy. Yet many scientists continue to describe certain traits as “innate” and take this to imply that those traits are not acquired, or “unlearned.” This article asks what cognitive role, if any, the concept of innateness should play in the psychological and behavioural sciences. I consider three arguments for eliminating innateness from scientific discourse. First, the classification of a trait as innate is thought to discourage empirical research (...) into its developmental origin. Second, this concept lumps together a number of different biological properties that ought to be treated as distinct. Third, innateness is associated with the outmoded folk biological theory of essentialism. In response to these objections, I consider two attempts to revise the concept of innateness which aim to make it more suitable for scientific explanation and research. One proposal is that innateness can be defined in terms of the biological property of environmental canalization. On this view, a trait is innate to the extent that it is developmentally buffered against a range of different environments. Another proposal is that innateness serves as an explanatory primitive for cognitive science. This view holds that there exist a sharp boundary between psychological and biological explanations and that to identify a trait as innate means that it falls into the latter explanatory domain. This essay ends with some questions for future research. (shrink)

In this paper I offer an anti-Humean critique to Williamson and Russo’s approach to medical mechanisms. I focus on one of the specific claims made by Williamson and Russo, namely the claim that micro-structural ‘mechanisms’ provide evidence for the stability across populations of causal relationships ascertained at the (macro-) level of (test) populations. This claim is grounded in the epistemic account of causality developed by Williamson, an account which—while not relying exclusively on mechanistic evidence for justifying causal judgements—appeals nevertheless to (...) mechanisms, and rejects their anti-Humean interpretation in terms of capacities, powers, potencies, etc. By using (and expanding on) Cartwright’s basic critique against Humean mechanisms, I suggest that, in order to move beyond the level of plausibility, Williamson and Russo’s position is in need of a clarification as to the occurent reading of the components, functioning and interferences of mechanisms. Relatedly, as concerns Williamson’s epistemic account of causation, I argue that this account is in need of a more straightforward answer as to what truth-makers its causal claims should have. (shrink)

This paper critically compares a deliberative system based on parliamentary elections (an electoral system) and a deliberative system based on sortition (a lottocratic system). Both systems are analyzed in three dimensions. The epistemic dimension concerns the rational quality of the democratic process. The power dimension concerns the distribution of power and the extent to which citizens genuinely control all decisions. The motivational dimension, finally, concerns citizens’ identification with the decision-making process and their willingness to abide by its outcomes. We argue (...) that an electoral system is, in all three dimensions, normatively superior to a sortition-based system. Most prominently, we claim that electoral mechanisms provide visibility to the decision-making process. This enables a form of interactive representation in which citizens and their representatives engage in a joint process of opinion and will formation. Sortition, in contrast, is characterized by a democratically much poorer form of descriptive representation. The selected citizens are a representative sample of the wider citizenry, but they deliberate in a forum that remains mostly disconnected from that wider citizenry and therefore cannot shoulder the process of collective self-government. (shrink)

The subject of my dissertation is "rationality". In this book I undertake a comprehensive, systematic and independent treatment of the problem of rationality. This furthers progress toward a general theory of rationality, one that represents and defends a uniform conception of reason. The structure and general outline are as follows: Part I: General Definition of the Concept; Part II: Rationality in the Theoretical Realm; Part III: Rationality in the Practical Realm (parts II and III are divided respectively into A. Relative (...) Reasons and B. Absolute Reasons); Part IV: Grounds for the Principle of Reason. My aim in this work is to prove that a conception of rationality as justification of our usage of language is more significant than has been classically recognized, without, however, reducing the concept of rationality. After a definition of the term is provided in the first chapter by means of language analysis, the following three questions are dealt with in the subsequent chapters: a) Exhaustion of rationality in relative reasons—i.e., is reasoning exhausted by reference to existing views and goals, or does rationality also exist in a strong sense? The latter would be the case if the views and goals referred to the relative conception must themselves be justified de novo. I argue that such an absolute justification of views and goals cannot be provided. To this end, in the theoretical domain, I discuss a question prominent in the debate over the rationality of worldviews, namely the question of whether the standards of theoretical rationality are merely culturally relative (chapter V.). Here I arrive at the position that standards of theoretical rationality are only transcultural insofar as there are goals which are not themselves culturally-dependent. With regard to practically fundamental goals, the core standards of modern science can be justified. This justification strategy therefore requires that such goals be established. In practical terms, first I address (in Chapter VII) the so-called "final justification" of norms problem. Here I discuss above all the transcendental-pragmatic proposal and the contractualist conception. According to my view, neither succeed in providing a final rational grounding for norms. That grounding pertains instead to the rationale for objectives, and Chapter VIII demonstrates that even a final justification of objectives is impossible. This does not mean, however, that a person's goals cannot be criticized as irrational. But the warrant in this case depends on the rules that govern the genesis of desires being accepted by the subject. b) If substantive rationality does not exist because no absolute grounding for opinions and goals can obtain, then the question of how strong or weak the concept of rationality is acquires further weight. On that basis, relative theoretical and practical rationality is examined in detail. I aim with this analysis of (relative) rationality to apprehend the structural parallelism between rationality in both the practical and the theoretical domain, and therefore to defend a uniform conception of reason or rationality. This is accomplished by identifying a concept that exhibits the same structure in both theoretical and practical domains: the term "rational" is applied to actions and opinions in order to claim, first of all, that they are "well-founded." For example, one must inquire into the precise rational justification for opinions or actions. To determine the individually necessary and jointly sufficient conditions required for an opinion or action to be rational, one must first provide a formal characterization of the rationality of those opinions or actions. What is to count as a rational ground can only be explained by formal procedures and results achievable via those procedures. To be more specific, I claim that the process of opinion formation and practical reflection is subject to rational justification based on internalist rules. The rules governing theoretical rationality can have their content transformed in a further move, if one takes the result of the process of rational opinion-formation as the product of an epistemological determination, that is, as a decision about which opinion to hold that is made on the basis of epistemological or prudential goals. Implicit in this position is the controversial idea that one can actually decide to believe something. The rules of practical reason are the rules that guide the rational selection of objectives and actions. The structural parallelism of theoretical and practical rationality consists, therefore, in the fact that both refer to mental processes that are controlled by rules which one freely accepts and follows. In both cases, these rules are to be understood as governing the rational choice of a mental or physical action. c) Therefore, the question of whether rationality—being rational—can in turn be grounded by reasons can be answered in the following way: The rules of rationality can only be justified with reference to a person’s goals, as the best strategy for achieving those goals. If someone does not desire the optimal realization of his goals, there is no other way of arguing directly for rationality. One can only attempt to demonstrate—if the person is open to argument—that it is typically in the person's own best interest to adhere to the rules of rationality. (shrink)

A measure of coherence is said to be reliability conducive if and only if a higher degree of coherence (as measured) among testimonies implies a higher probability that the witnesses are reliable. Recently, it has been proved that several coherence measures proposed in the literature are reliability conducive in scenarios of equivalent testimonies (Olsson and Schubert 2007; Schubert, to appear). My aim is to investigate which coherence measures turn out to be reliability conducive in the more general scenario where the (...) testimonies do not have to be equivalent. It is shown that four measures are reliability conducive in the present scenario, all of which are ordinally equivalent to the Shogenji measure. I take that to be an argument for the Shogenji measure being a fruitful explication of coherence. (shrink)

This essay is the first attempt to compare Reinhart Koselleck's Historik with Hannah Arendt's political anthropology and her critique of the modern concept of history. Koselleck is well-known for his work on conceptual history as well as for his theory of historical time. It is my contention that these different projects are bound together by Koselleck's Historik, that is, his theory of possible histories. This can be shown through an examination of his writings from Critique and Crisis to his final (...) essays on historical anthropology, most of which have not yet been translated into English. Conversely, Arendt's political theory has in recent years been the subject of numerous interpretations that do not take into account her views about history. By comparing the anthropological categories found in Koselleck's Historik with Arendt's political anthropology, I identify similar intellectual lineages in them as well as shared political sentiments, in particular the anti-totalitarian impulse of the postwar era. More importantly, Koselleck's theory of the preconditions of possible histories and Arendt's theory of the preconditions of the political, I argue, transcend these lineages and sentiments by providing essential categories for the analysis of historical experience. (shrink)

What is life? A gathering consensus in anthropology, science studies, and philosophy of biology suggests that the theoretical object of biology, “life,” is today in transformation, if not dissolution. Proliferating reproductive technologies, along with genomic reshufflings of biomatter in such practices as cloning, have unwound the facts of life.

In recent years combinations of tense and modality have moved intothe focus of logical research. From a philosophical point of view, logical systems combining tense and modality are of interest because these logics have a wide field of application in original philosophical issues, for example in the theory of causation, of action, etc. But until now only methods yielding completeness results for propositional languages have been developed. In view of philosophical applications, analogous results with respect to languages of predicate logic (...) are desirable, and in this paper I present two such results. The main developments in this area can be split into two directions, differing in the question whether the ordering of time is world-independent or not. Semantically, this difference appears in the discussion whether T x W-frames or Kamp-frames (resp. Ockham-frames) provide a suitable semantics for combinations of tense and modality. Here, two calculi are presented, the first adequate with respect to Kamp-semantics, the second to T x Wsemantics. (Both calculi contain an appropriate version of Gabbay's irreflexivity rule.) Furthermore, the proposed constructions of canonical frames simplify some of those which have hitherto been discussed. (shrink)

This paper describes and discusses the phenomenon ‘predatory publishing’, in relation to both academic journals and books, and suggests a list of characteristics by which to identify predatory journals. It also raises the question whether traditional publishing houses have accompanied rogue publishers upon this path. It is noted that bioethics as a discipline does not stand unaffected by this trend. Towards the end of the paper it is discussed what can and should be done to eliminate or reduce the effects (...) of this development. The paper concludes that predatory publishing is a growing phenomenon that has the potential to greatly affect both bioethics and science at large. Publishing papers and books for profit, without any genuine concern for content, but with the pretence of applying authentic academic procedures of critical scrutiny, brings about a worrying erosion of trust in scientific publishing. (shrink)

In recent years, interest in pre-reflective self-consciousness has increased significantly. One of the central points of inquiry is whether pre-reflective self-consciousness ubiquitously accompanies phenomenal consciousness. This paper explores a phenomenological justification for the thesis that pre-reflective self-consciousness ubiquitously accompanies phenomenal consciousness. Allegedly, the ubiquity of pre-reflective self-consciousness can be proved on the basis of phenomenological description. The aim of this paper is to develop a new objection against this justification of the ubiquity thesis.

Links between musicality and vocal emotion perception skills have only recently emerged as a focus of study. Here we review current evidence for or against such links. Based on a systematic literature search, we identified 33 studies that addressed either (a) vocal emotion perception in musicians and nonmusicians, (b) vocal emotion perception in individuals with congenital amusia, (c) the role of individual differences (e.g., musical interests, psychoacoustic abilities), or (d) effects of musical training interventions on both the normal hearing population (...) and cochlear implant users. Overall, the evidence supports a link between musicality and vocal emotion perception abilities. We discuss potential factors moderating the link between emotions and music, and possible directions for future research. (shrink)

The normative mechanics of promising seem complex. The strength and content of promissory obligations, and the residual duties they entail upon being violated, have various prima facie surprising features. We give an account to explain these features. Promises have a point. The point of a promise to φ is a promise-independent reason to φ for the promisee’s sake. A promise turns this reason into a duty. This explains the mechanics of promises. And it grounds a nuanced picture of immoral promises, (...) an argument against promissory bare wrongings, and a constraint on theories of why we have promissory obligations at all. (shrink)

In der Auseinandersetzung mit Nietzsches Kritik der Menschenwürde nimmt dieses Buch zugleich Stellung zur aktuellen Diskussion. Wie ist die gegenwärtige Norm der Menschenwürde, wie sie auch im Grundgesetz enthalten ist, vor dem Hintergrund der Theorien des vehementen Moralkritikers Nietzsche einzuschätzen? Welchen Stellenwert hat die Würde des Menschen im Zeitalter des Posthumanismus überhaupt? Im ersten Teil skizziert der Autor zunächst die wichtigsten philosophischen Konzeptionen der Menschenwürde von Cicero bis Kant. Dabei macht er deutlich, welche Probleme die gegenwärtige Rezeption historischer Konzeptionen aufwirft. (...) Der zweite Teil ist der ausführlichen Darstellung von Nietzsches Kritik der Menschenwürde gewidmet. Daraus ergeben sich wichtige Impulse für die gegenwärtige Diskussion und konkrete Hinweise, wie ein tragbarer Begriff der Menschenwürde für die Zukunft aussehen könnte. (shrink)

Landgrebe and Smith provide an argument for the impossibility of Artificial General Intelligence based on the limits of simulating complex systems. However, their argument presupposes a very contemporary vision of artificial intelligence as a model trained on data to produce an algorithm executable in a modern digital computing system. The present contribution explores what it means to be artificial. Current artificial intelligence approaches on modern computing systems are not the only conceivable way in which artificial intelligence technology might be created. (...) If there are conceivable routes by which an artificial intelligence might be developed that are not constrained in the same way as the current generation of artificial neural networks, then these might be plausible routes towards the engineered generation of artificial general intelligence that are not precluded by the Landgrebe and Smith argument against the possibility of artificial general intelligence. (shrink)

I am focusing here on the main counterarguments that were raised against a thesis I put forward in my article “Nietzsche, the Overhuman, and Transhumanism” (2009), namely that significant similarities can be found on a fundamental level between the concept of the posthuman, as put forward by some transhumanists, and Nietzsche’s concept of the overhuman. The articles with the counterarguments were published in the recent “Nietzsche and European Posthumanisms” issue of The Journal of Evolution and Technology (January-July 2010). As several (...) commentators referred to identical issues, I decided that it would be appropriate not to respond to each of the articles individually, but to focus on the central arguments and to deal with the counterarguments mentioned in the various replies. I am concerned with each topic in a separate section. The sections are entitled as follows: 1. Technology and evolution; 2. Overcoming nihilism; 3. Politics and liberalism; 4. Utilitarianism or virtue ethics?; 5. The good Life; 6. Creativity and the will to power; 7. Immortality and longevity; 8. Logocentrism; 9. The Third Reich. When dealing with the various topics, I am not merely responding to counterarguments; I also raise questions concerning transhumanism and put forward my own views concerning some of the questions I am dealing with. (shrink)

Research on patients with damage to ventromedial frontal cortices suggests a key role for emotions in practical decision making. This field of investigation is often associated with Antonio Damasio’s Somatic Marker Hypothesis—a putative account of the mechanism through which autonomic tags guide decision making in typical individuals. Here we discuss two questionable assumptions—or ‘myths’—surrounding the direction and interpretation of this research. First, it is often assumed that there is a single somatic marker hypothesis. As others have noted, however, Damasio’s ‘hypothesis’ (...) admits of multiple interpretations (Dunn et al. [2006]; Colombetti [2008]). Our analysis builds upon this point by characterizing decision making as a multi-stage process and identifying the various potential roles for somatic markers. The second myth is that the available evidence suggests a role for somatic markers in the core stages of decision making, that is, during the generation, deliberation, or evaluation of candidate options. On the contrary, we suggest that somatic markers most likely have a peripheral role, in the recognition of decision points, or in the motivation of action. This conclusion is based on an examination of the past twenty-five years of research conducted by Damasio and colleagues, focusing in particular on some early experiments that have been largely neglected by the critical literature. 1 Introduction2 What is the Somatic Marker Model?3 Multiple Somatic Marker Hypotheses3.1 Are somatic markers necessary for practical decision making?3.2 Speed, accuracy, or both?3.3 At which of the five stages of decision making are somatic markers engaged?4 Anecdotal Evidence Suggests a Peripheral Role for Somatic Markers4.1 Chronic indecisiveness4.2 Extreme impulsiveness4.3 Enhanced decision making in the lab4.4 Lack of motivation. 5 Early Experiments Suggest that VMF Damage Leaves Core Processes Intact5.1 The evocative images study5.2 Five problem solving tasks6 Recent Experiments Fail to Discriminate among Alternate Versions of SMH7 Conclusion. (shrink)

In a recent article, Emanuel Rutten has presented a novel argument for the existence of God, defined as a personal being that is the first cause of reality. An interesting feature of the argument, which caused quite a stir, is that it does not fall within any of the traditional categories of arguments for God’s existence. Rutten calls his argument a modal-epistemic one, which reflects the fact that the first premise of his argument states that all possible truths are knowable. (...) The main purpose of this article is a simple one: to point out that Rutten’s modal-epistemic argument is flawed. (shrink)

In a recent article, Emanuel Rutten defends his Modal-Epistemic Argument (MEA) for the existence of God against various objections that I raised against it. In this article, I observe that Rutten’s defence fails for various reasons. Most notably though, the defence is self-undermining: the very claims that Rutten argues for in his defence yield novel counterexamples to the first premise of the MEA.

Business Ethics, the Environment &Responsibility, Volume 32, Issue 2, Page 415-418, April 2023.