Although decision‐making algorithms are not new to medicine, the availability of vast stores of medical data, gains in computing power, and breakthroughs in machine learning are accelerating the pace of their development, expanding the range of questions they can address, and increasing their predictive power. In many cases, however, the most powerful machine learning techniques purchase diagnostic or predictive accuracy at the expense of our ability to access “the knowledge within the machine.” Without an explanation in terms of reasons or (...) a rationale for particular decisions in individual cases, some commentators regard ceding medical decision‐making to black box systems as contravening the profound moral responsibilities of clinicians. I argue, however, that opaque decisions are more common in medicine than critics realize. Moreover, as Aristotle noted over two millennia ago, when our knowledge of causal systems is incomplete and precarious—as it often is in medicine—the ability to explain how results are produced can be less important than the ability to produce such results and empirically verify their accuracy. (shrink)

How do you know what you want? The question is neglected by epistemologists. This paper attempts an answer.

Recent debates over the use of sham surgery as a control for studies of fetal tissue transplantation for Parkinson’s disease have focused primarily on rival interpretations of the US federal regulations governing human-subjects research. Using the core ethical and methodological considerations that underwrite the equipoise requirement, we nd strong prima facie reasons against using sham surgery as a control in studies of cellular-based therapies for Parkinson’s disease and more broadly in clinical research. Additionally, we believe that these reasons can be (...) generalized to apply to the use of other placebo controls that carry signi cant risks of positive harms in and of themselves. As a result, our arguments are centrally relevant to the emerging drive to subject therapies with a surgical component to the same rigorous standards of evaluation as those governing the approval of new pharmaceuticals. (shrink)

Book synopsis: Our mental lives are entwined with the world. There are worldly things that we have beliefs about and things in the world we desire to have happen. We find some things fearsome and others likable. The puzzle of intentionality — how it is that our minds make contact with the world — is one of the oldest and most vexed issues facing philosophers. Many contemporary philosophers and cognitive scientists have been attracted to the idea that our minds represent (...) the world. This book explores an important assumption about representation, namely, that when we represent things in the world, we represent them as having properties, and in this way our representations have "propositional" structure. The contributors examine what the commitment to propositionalism amounts to; illuminate why one might find the thesis attractive ; and consider ways in which one might depart from propositionalism. The hope is that this will lead towards a more complete understanding of how the mind and world are connected. (shrink)

There is near universal agreement within the scientific and ethics communities that a necessary condition for the moral permissibility of cross-national, collaborative research is that it be responsive to the health needs of the host community. It has proven difficult, however, to leverage or capitalize on this consensus in order to resolve lingering disputes about the ethics of international medical research. This is largely because different sides in these debates have sometimes provided different interpretations of what this requirement amounts to (...) in actual practice. The goal of the discussion that follows is to clarify the nature of this important moral requirement. The first section explains the requirement for responsiveness to host community health needs in the context of international medical research. The second section examines various formulations of this requirement as they are enunciated in some of the core consensus documents in research ethics. The third section then defends a particular interpretation of this requirement, and the final sections examine more liberal alternatives with the aim of highlighting points of agreement and assessing the significance of areas of disagreement. (shrink)

On the assumption that we may learn from our elders and betters, this paper approaches some fundamental questions in perceptual epistemology through a dispute between McDowell and Wright about external world scepticism.

It is widely held in contemporary philosophy of mind that states with underived representational content are ipso facto psychological states. This view—the Content View—underlies a number of interesting philosophical projects, such as the attempt to pick out a psychological level of explanation, to demarcate genuinely psychological from non-psychological states, and to limn the class of states with phenomenal character. The most detailed and influential theories of underived representation in philosophy are the tracking theories developed by Fodor, Dretske, Millikan and others. (...) Tracking theorists initially hoped to ‘naturalize’ underived representation by showing that although it is distinctively psychological it is not irreducibly so, yet they ended up developing theories of representation that by their own lights don’t pick out a distinctively psychological phenomenon at all. Burge sets out to develop a theory of underived representation that does pick out a distinctively psychological phenomenon. His theory promises to vindicate the Content View and the various philosophical projects that depend on it. In this paper I argue that Burge’s theory dementalizes representation for the same reason tracking theories do: These theories hold that representations are states with underived accuracy conditions, yet such states are found in all sorts of mindless systems, like plants. (shrink)

Stephen Finlay’s book Confusion of Tongues is extraordinarily sophisticated, ambitious and thought-provoking. I highly commend it to those who haven’t read it yet. I will begin this commentary with a summary of which big-picture issues Finlay and I agree on and which we disagree on.

Critical discussion of Chris Hill's perceptual theory of pain.

In the literature on health, naturalism and normativism are typically characterized as espousing and rejecting, respectively, the view that health is objective and value-free. This article points out that there are two distinct dimensions of disagreement, regarding objectivity and value-ladenness, and thus arranges naturalism and normativism as diagonal opposites on a two-by-two matrix of possible positions. One of the remaining quadrants is occupied by value-dependent realism, holding that health facts are value-laden and objective. The remaining quadrant, which holds that they (...) are non-objective but value-free, is unexplored. The article endorses a view in the latter quadrant, namely, the view that health is a secondary property. The article argues that a secondary property framework provides the resources to respond to the deepest objections to a broadly Boorsean account of natural function, and so preserves the spirit, though not the letter, of that account. Treating health as a secondary property permits a naturalistic explanation—specifically, an evolutionary explanation—of the health concept, in terms of the assistance such a concept might have provided to the survival and reproduction of those organisms that had it. This provides the explanation, missing from Boorse's account, for the fact that function is determined with reference to the contribution to the goals of survival and reproduction, relative to the age of the sex of the species, rather than some other equally natural goals or reference classes. _1_ Introduction _2_ Two Ways to Disagree about Health _3_ Secondary Properties _4_ Health as a Secondary Property _5_ Conclusion. (shrink)

This paper is a critique of Norman Daniels' and James Sabin's ‘Accountability for Reasonableness’ framework for making priority-setting decisions in health care in the face of widespread disagreement about values. Accountability for Reasonableness has been rapidly gaining worldwide acceptance, arguably to the point of becoming the dominant paradigm in the field of health policy. The framework attempts to set ground rules for a procedure that ensures that whatever decisions result will be fair, reasonable, and legitimate to the extent that even (...) those who would be adversely affected will have reason to abide by them. I argue that the framework's four conditions are inadequate to this task. While we certainly require a fair and legitimate procedure for making priority setting decisions in health care despite a lack of consensus on relevant ethical and political issues, we must significantly revise the four conditions, and we cannot avoid facing our substantive disagreements head on if we hope to arrive at decisions that would (and should) be acceptable to everyone. I offer two suggestions. First, there is need for greater public involvement in all stages of deliberation. Second, we should give up on the idea that we can simplify the task of democratic deliberation by disallowing particular kinds or reasons and types of reasoning. Reasons of all kinds should be on the table, but then should be judged on their merits, such as consistency, plausibility and explanatory power, without any regard for their alleged sources of authority. (shrink)

Positive logics are $\{ \wedge, \vee, \to \}$-fragments of intermediate logics. It is clear that the positive fragment of $Int$ is not structurally complete. We give a description of all hereditarily structurally complete positive logics, while the question whether there is a structurally complete positive logic which is not hereditarily structurally complete, remains open.

Three arguments for the thesis that sex is socially constructed are examined and rejected. No such argument could succeed, because sex is not socially constructed.

This study provides evidence for implicit learning in syntactic comprehension. By reanalyzing data from a syntactic priming experiment (Thothathiri & Snedeker, 2008), we find that the error signal associated with a syntactic prime influences comprehenders' subsequent syntactic expectations. This follows directly from error‐based implicit learning accounts of syntactic priming, but it is unexpected under accounts that consider syntactic priming a consequence of temporary increases in base‐level activation. More generally, the results raise questions about the principles underlying the maintenance of implicit (...) statistical knowledge relevant to language processing, and about possible functional motivations for syntactic priming. (shrink)

Russell had two theories of definite descriptions: one for singular descriptions, another for plural descriptions. We chart its development, in which ‘On Denoting’ plays a part but not the part one might expect, before explaining why it eventually fails. We go on to consider many-valued functions, since they too bring in plural terms—terms such as ‘4’ or the descriptive ‘the inhabitants of London’ which, like plain plural descriptions, stand for more than one thing. Logicians need to take plural reference seriously (...) if only because mathematicians take many-valued functions seriously. We assess the objection (by Russell, Frege and others) that many-valued functions are illegitimate because the corresponding terms are ambiguous. We also assess the various methods proposed for getting rid of them. Finding the objection ill-founded and the methods ineffective, we introduce a logical framework that admits plural reference, and use it to answer some earlier questions and to raise some more. (shrink)

Despite the prevalence of externalization, much work in the ethics of immigration continues to assume that the admission of immigrants is determined by state immigration officials who decide whether to admit travelers at official crossings. This assumption neglects how decisions about entrance have been increasingly relocated abroad – to international waters, consular offices, airports, or foreign territories – often with non-governmental or private actors, as well as foreign governments functioning as intermediaries. Externalization poses a fundamental challenge to achieving just migration (...) policies. It reliably harms vulnerable people, prevents refugees from receiving protection, leads to human rights abuses, and dissipates blame and accountability, creating a serious lacuna in assigning moral responsibility. (shrink)

David Lewis claims that a simple sort of anti-Humeanism-that the rational agent desires something to the extent he believes it to be good-can be given a decision-theoretic formulation, which Lewis calls 'Desire as Belief' (DAB). Given the (widely held) assumption that Jeffrey conditionalising is a rationally permissible way to change one's mind in the face of new evidence, Lewis proves that DAB leads to absurdity. Thus, according to Lewis, the simple form of anti-Humeanism stands refuted. In this paper we investigate (...) whether Lewis's case against DAB can be strengthened by examining how it fares under rival versions of decision theory, including other conceptions of rational ways to change one's mind. We argue that the anti-Humean may escape Lewis's argument either by adopting a version of causal decision theory, or by claiming that the refutation only applies to hyper-idealised rational agents, or by denying that the decision-theoretic framework has the expressive capacity to formulate anti-Humeanism. (shrink)

John Campbell has claimed that the interventionist account of causation must be amended if it is to be applied to causation in psychology. The problem, he argues, is that it follows from the so-called ‘surgical’ constraint that intervening on psychological states requires the suspension of the agent’s rational autonomy. In this paper, I argue that the problem Campbell identifies is in fact an instance of a wider problem for interventionism, extending beyond psychology, which I call the problem of ‘abrupt transitions’. (...) I then defend a solution to the problem, which replaces the surgical constraint with a weaker constraint on interventions that nevertheless does all the work the surgical constraint was designed to do. I conclude by exploring some interesting consequences of this weaker constraint for causation in psychology. (shrink)

The often poorly explained notion of gender identity, and the attendant cisgender/transgender distinction, are critically examined.

There have been many readings of Mead's work, and this paper proposes yet another: Mead, theorist of the social act. It is argued that Mead's core theory of the social act has been neglected, and that without this theory, the concept of taking the attitude of the other is inexplicable and the contemporary relevance of the concept of the significant symbol is obfuscated. The paper traces the development of the social act out of Dewey's theory of the act. According to (...) Mead, Dewey's theory does not sufficiently account for consciousness. Grappling with this problematic leads Mead to several key ideas, which culminate in his theory of the social act. The social act and taking the attitude of the other are then illustrated by the analysis of a game of football. The interpretation presented has two novel aspects: first, symbolisation arises not simply through self taking the attitude of the other, but through the pairing of this attitude with the complementary attitude in self; second, self is able to take the attitude of the other to the extent that self has in actuality or in imagination previously been in the social position of the other. From this standpoint the key issue is how the attitude of self and other become integrated. New directions for empirical research, aimed at advancing this question are outlined. Finally, the paper shows how the social act can contribute to our contemporary concerns about the nature of the symbolic. (shrink)

Death and immortality played a central role in Greek and Roman thought, from Homer and early Greek philosophy to Marcus Aurelius. In this book A. G. Long explains the significance of death and immortality in ancient ethics, particularly Plato's dialogues, Stoicism and Epicureanism; he also shows how philosophical cosmology and theology caused immortality to be re-imagined. Ancient arguments and theories are related both to the original literary and theological contexts and to contemporary debates on the philosophy of death. The book (...) will be of major interest to scholars and students working on Greek and Roman philosophy, and to those wishing to explore ancient precursors of contemporary debates about death and its outcomes. (shrink)

Short commentary on a paper by Ned Block.

. The ‘common good’ spirituality of Louis-Joseph Lebret and his influence in the Constitution and development thinking in Brazil. Journal of Global Ethics: Vol. 17, Lebret and the Projects of Économie Humaine, Integral Human Development, and Development Ethics, Guest Editors Des Gasper and Lori Keleher, pp. 185-203.

A number of imposing problems now have our best minds in thrall. These include questions regarding the unity or plurality of the races of Man, whether his creation ought to be dated thousands of years or thousands of centuries past, whether species are fixed, or rather undergo a slow, progressive transformation into new species, how supposedly eternal matter relates to the nothingness outside of it, and whether the idea of God is useless. These are just a few of the issues (...) now subject to learned debate. You need, however, have no fear that my address tonight has any pretensions toward resolving any one of these earnest questions. But in the neighborhood of such mysteries lies another question, more or less closely related, to which I may, perhaps, venture to direct your attention; for its complexities, which I have made the object of concerted and conscientious study, are accessible to experiment. This is the question of what we call "spontaneous generations." Mightn't matter, perhaps, organize itself? Or posed differently, mightn't creatures enter the world without parents, without forebears? This is the question I seek to resolve. (shrink)

This essay explores aesthetics, affect, and educational politics through the thought of Gilles Deleuze and Jacques Rancière. It contextualizes and contrasts the theoretical valences of their ethical and democratic projects through their shared critique of Kant. It then puts Rancière's notion of dissensus to work by exploring it in relation to a social movement and hunger strike organized for educational justice in Chicago's Little Village neighborhood. This serves as a context for understanding how educational provisions are linked to the aesthetic (...) distribution of perception within the neoliberal city. It also serves as a powerful example of how these orders of perception are resisted and subverted at the local level by aesthetic and affective means. Through the Little Village hunger strike the essay argues that while Rancière allows us to recognize the aesthetic dimensions of the political, he falls short in addressing tactical and/or affective considerations. The essay concludes by seeking to extend the critical efficacy of Rancière's dissensus through a rendering of tactical affect within Deleuzian metaphysics. (shrink)

This paper considers an important recent contribution by Miguel Hernán to the ongoing debate about causal inference in epidemiology. Hernán rejects the idea that there is an in-principle epistemic distinction between the results of randomized controlled trials and observational studies: both produce associations which we may be more or less confident interpreting as causal. However, Hernán maintains that trials have a semantic advantage. Observational studies that seek to estimate causal effect risk issuing meaningless statements instead. The POA proposes a solution (...) to this problem: improved restrictions on the meaningful use of causal language, in particular “causal effect”. This paper argues that new restrictions in fact fail their own standards of meaningfulness. The paper portrays the desire for a restrictive definition of causal language as positivistic, and argues that contemporary epidemiology should be more realistic in its approach to causation. In a realist context, restrictions on meaningfulness based on precision of definition are neither helpful nor necessary. Hernán’s favoured approach to causal language is saved from meaninglessness, along with the approaches he rejects. (shrink)

People with severe learning disability are particularly difficult to include in the research process. As a result, researchers may be tempted to focus on those with learning disability who can be included. The problem is exacerbated in this field as the political agenda of inclusion and involvement is driven by those people with learning disability who are the higher functioning. To overcome this we should first detach the notion of consent from ideas about autonomy and think instead of it as (...) a way to avoid wronging others; this fits the original historical use of consent in research. This allows us to think in terms of including participants to the best of their abilities rather than in terms of a threshold of autonomy. Researchers could then use imaginative ways to include the least able and to ensure they are not wronged in research or by exclusion from it. (shrink)

Commentators usually understand the Epicureans to take friends and friendship to be worthwhile because they help us to eliminate and/or manage our bodily and/or mental pains and thus come closer to achieving tranquility. However, this understanding leaves unexplained why friends and friendship might be worthwhile to an advanced Epicurean with few or no pains to manage or eliminate. In this paper, I remedy this deficiency by offering three explanations for why friends and friendship could and maybe would remain worthwhile even (...) to the Epicurean who achieves tranquility. Along the way, I explore some problems with each explanation and consider ways to overcome them. Notwithstanding these problems, I conclude that friends and friendship could and perhaps would be worthwhile even to the Epicurean with few or no pains. (shrink)

In Key Concepts in Classical Social Theory individual entries introduce, explain and contextualize the key topics within classical social theory. Definitions, summaries and key words are developed throughout with careful cross-referencing, allowing students to move effortlessly between core ideas and themes. Each entry provides: • Clear definitions • Lucid accounts of key issues • Up-to-date suggestions for further reading • Informative cross-referencing Relevant, focused and accessible, this book will provide students with an indispensible guide to the central concepts of classical (...) social theory. (shrink)

This article serves as a brief constellation of thought working towards a ruderal futurism. Proposed as an alternative of the granary logic of state and capital, the ruderal is positioned as a force functioning in the aftermath of – and in opposition to – the composite human/state/cereal-turned-capitalist ordering of nature. The role of agriculture and cereal crop production in early states as well as its exalted status within modern nation state and attendant culture is examined as a departure point for (...) experimental approaches to their negation. (shrink)

Dummctt argues that classical quantification is illegitimate when the domain is given as the objects which fall under an indefinitely extensible concept, since in such cases the objects are not the required definite totality. The chief problem in understanding this complex argument is the crucial but unexplained phrase 'definite totality' and the associated claim that it follows from the intuitive notion of set that the objects over which a classical quantifier ranges form a set. 'Definite totality' is best understood as (...) disguised plural talk like Cantor's 'consistent multiplicity', although this does not help in understanding how a totality could be anything other than definite. Moreover, contrary to his claims, Dummett's own notion of set is not intuitive and he does not demystify the set-theoretic paradoxes. In conclusion, it is argued that Dummett's context principle is responsible for the incoherent projection of the haziness of a conception of some objects onto reality. (shrink)

This paper provides a unifying axiomatic account of the interpretation of recursive types that incorporates both domain-theoretic and realizability models as concrete instances. Our approach is to view such models as full subcategories of categorical models of intuitionistic set theory. It is shown that the existence of solutions to recursive domain equations depends upon the strength of the set theory. We observe that the internal set theory of an elementary topos is not strong enough to guarantee their existence. In contrast, (...) as our first main result, we establish that solutions to recursive domain equations do exist when the category of sets is a model of full intuitionistic Zermelo–Fraenkel set theory. We then apply this result to obtain a denotational interpretation of FPC, a recursively typed lambda-calculus with call-by-value operational semantics. By exploiting the intuitionistic logic of the ambient model of intuitionistic set theory, we analyse the relationship between operational and denotational semantics. We first prove an “internal” computational adequacy theorem: the model always believes that the operational and denotational notions of termination agree. This allows us to identify, as our second main result, a necessary and sufficient condition for genuine “external” computational adequacy to hold, i.e. for the operational and denotational notions of termination to coincide in the real world. The condition is formulated as a simple property of the internal logic, related to the logical notion of 1-consistency. We provide useful sufficient conditions for establishing that the logical property holds in practice. Finally, we outline how the methods of the paper may be applied to concrete models of FPC. In doing so, we obtain computational adequacy results for an extensive range of realizability and domain-theoretic models. (shrink)

The aim of this paper is to critically evaluate the thesis that ethics counselors constitute a new priesthood in the pejorative sense of this term. In defense of the thesis, an account is given of the diverse variety of fundamental ideas about ethics or morality. The underlying argument is simply that there is such a diversity of opinion about so many fundamental issues that most ethical appraisals, especially in committees, are probably very shallow and barely warranted. Following this negative work, (...) an attempt is made to try to find some positive benefits from the work of ethics counselors. Some potential benefits are identified, but there is a need for empirical research in order to construct a more persuasive case for such work. In the penultimate section of the paper I addressed some of my own second thoughts about the discussion and some provocative suggestions that friends gave me about earlier drafts. (shrink)

In recent years, scholars have paid considerable attention to moderation in Montesquieu’s De l’esprit des lois. Still, little scholarship has considered how Montesquieu develops moderation as a concept and practice. In this article, I argue Montesquieu’s complementary defense of moderation and critique of despotism rely on immoderate argumentative practices of omission that enable him to reshape extant laudatory narratives of China and Japan. Through an analysis of Montesquieu’s primary texts on climate and commerce, I demonstrate that, absent these practices, Montesquieu’s (...) “Asian despotism” collapses, revealing the moderate natures of both countries. This conclusion is paradoxical insofar as we take seriously Montesquieu’s claim that De l’esprit des lois upholds the spirit of moderation as of paramount importance. Moreover, I argue that this analysis of Montesquieu’s paradoxical spirit brings to light under-examined dimensions of Montesquieu’s work and alerts political theorists to how different reading practices can recast his “moderate” reputation. (shrink)