The worldwide COVID-19 pandemic has shed more light on the difficulty of making health care decisions integrating scientific knowledge and values associated to life and death issues, human suffering, quality of life, economic losses, liberty of movement, etc. But the difficulties related to health care decisions and the use of innovative drugs or technologies are not new, and many countries have created agencies that have the mandate to evaluate new technologies in health care. Health Technological Assessment (HTA) reports’ aim is (...) to guide the decision makers in these difficult matters. There are two ethical components in HTA. The first is the report’s presentation of an ethical evaluation of the technology. The second is the value-ladenness of the HTA decision-making process itself. When implicit value judgments are not elicited, the justification of the final decision cannot be transparent. The present paper aims to identify and elicit the implicit value-judgments related to each step of the HTA process. This research is grounded on an applied ethics decision-making paradigm based on the role of value judgments in the decision-making process. The first part discusses two different approaches to values and value judgments in HTA. In the second part, citations mentioning value judgments extracted from a systematic review on the integration of ethics into HTA were categorized to elicit the value judgments and their criteria for each different HTA decision-making steps. The results show that there are 18 decision-making steps in the HTA process where 23 implicit value-judgments can be recognized. The range of these value judgments encompasses the whole HTA process: from the initial request, the presenting of the principal issues, to the final report’s dissemination. Since stakeholders need to understand which value judgments the conclusion of a report relies on, eliciting the implicit value judgments in the HTA decision-making process should yield more transparency. (shrink)

Nous voulons mieux comprendre les lois circonscrivant le rôle social de l’Évaluation des technologies en santé (ETS) et les raisons empêchant l’inclusion de l’éthique en ETS. Nous avons ciblé un débat qui est au coeur du rôle perçu du droit réglementaire dans le développement de technologies en santé : l’opposition entre les enjeux environnementaux, sécuritaires et sanitaires (EHSI) et les enjeux éthiques, légaux et sociaux (ELSI), issus de la gouvernance technologique. La collecte de données est basée sur une revue de (...) la littérature issue de travaux antérieurs, et sur une analyse de cas où trois agences d’ETS ont été sélectionnées en utilisant différentes catégories d’obligation légale selon leur degré de force contraignante. La revue de littérature a révélé cinq thèmes relatifs au rôle social de l’ETS et une distinction entre le rôle/utilisation du droit dur et du droit souple dans le droit réglementaire, permettant ainsi de comprendre comment les agences ont utilisé le droit pour intégrer (ou non) l’éthique en ETS. Les deux approches ont démontré que le débat, EHSI/ELSI observé initialement dans la gouvernance et l’évaluation de technologies est reproduit en ETS. La principale tendance confirmée par ces analyses est la présence d’un pacte entre la science et le droit réglementaire. La demande sociale d’intégrer les ELSI, particulièrement l’évaluation éthique en ETS, n’est pas prise en compte par le droit réglementaire traditionnel régissant l’ETS et doit plutôt être considérée par le droit souple. Les difficultés d’intégration de l’éthique en ETS démontrent la nécessité de repenser la gouvernance juridique de l’ETS. (shrink)

The integration of ethical analysis in Health Technology Assessment (HTA) has proven difficult to implement even though it is explicitly recognized as an important component of such assessments in HTA literature. When compared to the standardized scientific method for systematic reviews in HTA, the diversity of ethical analysis has been characterized as a fundamental barrier to the integration of ethics. The present paper aims to identify the theoretical and practical differences between the approaches underpinning ethical analysis in HTA and clarify (...) the reasons for such diversity. Our systematic review of HTA literature pertaining to the barriers to the integration of ethics in HTA identified nine ethical approaches: Principlism, Casuistry, Coherence Analysis, Wide Reflective Equilibrium, Axiology, the Socratic approach, the Triangular model, Constructive Technology Assessment and Social Shaping of Technology. Citations pertaining to each approach were extracted and categorized according to three constitutive components of ethical argumentation established in a previous research evaluating nanotechnologies: i) the disciplinary foundation that grounds the validity of the ethical evaluation, ii) the characteristics of such evaluation, iii) the operational process involved in applying it to a particular case (i.e., its practical reasoning). This comparison shows that, 1) the difference between these approaches rests primarily on their disciplinary foundation (rooted in philosophy, philosophy/theology, or sociology), 2) their complexity can be observed in the distinct characteristics of ethical evaluation deriving from their differing disciplinary foundation, and 3) although four different types of operationalization procedure were identified, little information was available in regards to the practical reasoning associated with these approaches. (shrink)

Philosophers of science often make reference — whether tacitly or explicitly — to the notion of a scientific community. Sometimes, such references are useful to make our object of analysis tractable in the philosophy of science. For others, tracking or understanding particular features of the development of science proves to be tied to notions of a scientific community either as a target of theoretical or social intervention. We argue that the structure of contemporary scientific research poses two unappreciated, or at (...) least underappreciated, challenges to this concept of the “scientific community” in the philosophy of science. In particular, we will present two case studies from robotics research, broadly construed, which show that (1) the boundedness of the scientific community is threatened when private citizens can develop scientific and technological advances at minimal expense (democratization), and (2) the discreteness of scientific research programs is threatened by the complexly interrelated environment of contemporary scientific work (interconnectivity). Taken together, the extent of democratization and interconnectivity present a significant challenge for any practically oriented philosophy of science, one which we hope will be taken on directly by philosophers in the future. (shrink)

We argue that the economy of nature constitutes an invocation of structure in the biological sciences, one largely missed by philosophers of biology despite the turn in recent years toward structural explanations throughout the philosophy of science. We trace a portion of the history of this concept, beginning with the theologically and economically grounded work of Linnaeus, moving through Darwin’s adaptation of the economy of nature and its reconstitution in genetic terms during the first decades of the Modern Synthesis. What (...) this historical case study reveals, we argue, is a window into the shifting landscape of the explanatory and ontic uses of structural concepts. In Linnaeus, the economy of nature has both ontic and explanatory import; in Darwin the ontic and explanatory aspects start to come apart ; and finally, in the Modern Synthesis, the economy of nature is replaced by the conceptual toolkit of population genetics, the structural elements of which are nearly entirely explanatory. Having traced a historical trajectory of structural concepts that moves from an ontic formulation to an increasingly explanatory one, we conclude by outlining some insights for structural realism. (shrink)

Moses Maimonides was arguably the single most important Jewish thinker of the Middle Ages, with an impact on the later Jewish tradition that was unparalleled by any of his contemporaries. In this volume of new essays, world-leading scholars address themes relevant to his philosophical outlook, including his relationship with his Islamicate surroundings and the impact of his work on subsequent Jewish and Christian writings, as well as his reception in twentieth-century scholarship. The essays also address the nature and aim of (...) Maimonides' philosophical writing, including its connection with biblical exegesis, and the philosophical and theological arguments that are central to his work, such as revelation, ritual, divine providence, and teleology. Wide-ranging and fully up-to-date, the volume will be highly valuable for those interested in Jewish history and thought, medieval philosophy, and religious studies. (shrink)

DRGs may contain costs, but they threaten to restrict access to health care, to compromise its quality, and to impede the development of new medical technologies. Immediate corrections are necessary to ensure that hospitals continue to serve the poorest and sickest.

This is the first comprehensive evaluation of Charles Taylor's work and a major contribution to leading questions in philosophy and the human sciences as they face an increasingly pluralistic age. Charles Taylor is one of the most influential contemporary moral and political philosophers: in an era of specialisation he is one of the few thinkers who has developed a comprehensive philosophy which speaks to the conditions of the modern world in a way that is compelling to specialists in (...) various disciplines. This collection of specially commissioned essays brings together twelve distinguished scholars from a variety of fields to discuss critically Taylor's work. The topics range from the history of philosophy, to truth, modernity and postmodernity, theism, interpretation, the human sciences, liberalism, pluralism and difference. Taylor responds to all the contributions and re-articulates his own views. (shrink)

Cognitively engaging physical activity has been suggested to have superior effects on cognition compared to PA with low cognitive demands; however, there have been few studies directly comparing these different types of activities. The aim of this study is to compare the cognitive effects of a combined physically and cognitively engaging bout of PA to a physical or cognitive activity alone in children. Children were randomized in pairs to one of three 20-min conditions: a cognitive sedentary activity; a non-cognitively engaging (...) PA; and a cognitively engaging PA. Executive function was assessed using a modified Eriksen flanker task immediately before and 10–15 min following the experimental condition. Children ages 6–8 years were included in the study. A repeated measures ANOVA found no significant difference between groups with respect to scores on the flanker task. The results do not support the hypotheses that a cognitively engaging bout of PA enhances cognitive performance over non-cognitively engaging PA or sedentary activities. Possible explanations for our findings include overexertion during the acute bout of PA and depletion of positive affect prior to performing the post-intervention EF tasks. (shrink)

Kidfluencing, a social media business in which children serve as primary influencers of audience opinions or behavior, is a rapidly growing entrepreneurial phenomenon where parents build enterprises around the likability and antics of their children. Proponents argue that kidfluencing is simply monetizing the existing antics of kids, critics argue that it is child labor. We explore the ethical implications of kidfluencing through the abductive lens of four leading kidfluencer cases—Ryan’s World, Vlad and Nicki, Ninja Kidz, and The Bucket List Family—in (...) light of the United Nations Convention on the Rights of the Child. Through a comparative case analysis of these four highly successful kidfluencing channels, we demonstrate both the ethical challenges as well as the trade-offs between rewards and rights risks within kidfluencing. We develop a model of five fundamental threats to the rights and freedoms of children involved in social media influencing, proposing a framework by which parents, platforms, and policy-makers can assess and regulate this industry. In so doing, we make contributions to the literatures of child labor and the ethics of care. (shrink)

The third volume of The History of Evil encompasses the early modern era from 1450–1700. This revolutionary period exhibited immense change in both secular knowledge and sacred understanding. It saw the fall of Constantinople and the rise of religious violence, the burning of witches and the drowning of Anabaptists, the ill treatment of indigenous peoples from Africa to the Americas, the reframing of formal authorities in religion, philosophy, and science, and it produced profound reflection on good and evil in the (...) genius of Shakespeare, Milton, Bacon, Teresa of Avila, and the Cambridge Platonists. This superb treatment of the history of evil during a formative period of the early modern era will appeal to those with interests in philosophy, theology, social and political history, and the history of ideas. (shrink)

Most works on moral psychology direct our attention to the positive role morality plays for us as individuals, as a society, even as a species. In What's Wrong with Morality?, C. Daniel Batson takes a different approach: he looks at morality as a problem. The problem is not that it is wrong to be moral, but that our morality often fails to produce these intended results. Why? Some experts believe the answer lies in lack of character. Others say we (...) are victims of poor judgment. If we could but discern what is morally right, whether through logical analysis and discourse, through tuned intuition and a keen moral sense, or through feeling and sentiment, we would act accordingly. Implicit in these different views is the assumption that if we grow up properly, if we can think and feel as we should, and if we can keep a firm hand on the tiller through the storms of circumstance, all will be well. We can realize our moral potential. Many of our best writers of fiction are less optimistic. Astute observers of the human condition like Austen, Balzac, Dickens, Dostoyevsky, Eliot, Tolstoy, and Twain suggest our moral psychology is more complex. These writers encourage us to look more closely at our motives, emotions, and values, at what we really care about in the moral domain. In this volume, Batson examines this issue from a social-psychological perspective. Drawing on research suggesting our moral life is fertile ground for rationalization and deception, including self-deception, Batson offers a hard-nosed analysis of morality and its limitations in this expertly written book. (shrink)

Anthropologists have documented substantial cross-society variation in people’s willingness to treat strangers with impartial, universal norms versus favoring members of their local community. Researchers have proposed several adaptive accounts for these differences. One variant of the pathogen stress hypothesis predicts that people will be more likely to favor local in-group members when they are under greater infectious disease threat. The material security hypothesis instead proposes that institutions that permit people to meet their basic needs through impartial interactions with strangers reinforce (...) a tendency toward impartiality, whereas people lacking such institutions must rely on local community members to meet their basic needs. Some studies have examined these hypotheses using self-reported preferences, but not with behavioral measures. We conducted behavioral experiments in eight diverse societies that measure individuals’ willingness to favor in-group members by ignoring an impartial rule. Consistent with the material security hypothesis, members of societies enjoying better-quality government services and food security show a stronger preference for following an impartial rule over investing in their local in-group. Our data show no support for the pathogen stress hypothesis as applied to favoring in-groups and instead suggest that favoring in-group members more closely reflects a general adaptive fit with social institutions that have arisen in each society. (shrink)

Heyes suggests that selective social learning comes in two varieties. One is common, domain general, and associative. The other is rare, domain specific, and metacognitive. We argue that this binary distinction cannot quite do the work she assigns it and sketch a framework in which additional strategies for selective social learning might be accommodated.

In June of 2012 scholars from Europe and North America met in Montreal to commemorate the 300th anniversary of the publication of George Berkeley's *Passive Obedience*. In this article Stephen Daniel summarizes the English presentations, and Sébastien Charles summarizes the French presentations, on how Berkeley invokes naturalistic themes in developing a moral theory while still allowing a role for God.

Hegel has had a remarkable, yet largely unremarked, role in Canada's intellectual development. In the last half of the twentieth-century, as Canada was coming to define itself in the wake of World War Two, some of Canada's most thoughtful scholars turned to the work of G.W.F. Hegel for insight. Hegel and Canada is a collection of essays that analyses the real, but under-recognized, role Hegel has played in the intellectual and political development of Canada. The volume focuses on the generation (...) of Canadian scholars who emerged after World War Two: James Doull, Emil Fackenheim, George Grant, Henry S. Harris, and Charles Taylor. These thinkers offer a uniquely Canadian view of Hegel's writings, and, correspondingly, of possible relations between situated community and rational law. Hegel provided a unique intellectual resource for thinking through the complex and opposing aspects that characterize Canada. The volume brings together key scholars from each of these five schools of Canadian Hegel studies and provides a richly nuanced account of the intellectually significant connection of Hegel and Canada. (shrink)

Unreasonable expectations about the nature and character of scientific knowledge support the widespread political assumption that predictive scientific assessments are a necessary precursor to environmental decision making. All too often, the practical outcome of this assumption is that scientific uncertainty becomes a ready-made dodge for what is in reality just a difficult political decision. Interdisciplinary assessments necessary to address complex environmental policy issues invariably result in findings that are inherently contestable, especially when applied in the unrestrained realm of partisan politics. (...) In this article, the authors argue that predictive scientific assessments are inherently limited in the extent to which they can guide policy development and that rigorous scientific assessments can be much more valuable in the role of ex post policy evaluation than they can in the context of ex ante policy formulation. (shrink)

In [2] a semantics for implication is offered that makes use of stories — sets of sentences assembled under various constraints. Sentences are evaluated at an actual world and in each member of a set of stories. A sentence B is true in a story s just when B s. A implies B iff for all stories and the actual world, whenever A is true, B is true. In this article the first-order language of [2] is extended by the addition (...) of the operator the story... says that..., as in The story Flashman among the Redskins says that Flashman met Sitting Bull. The resulting language is shown to be sound and complete. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Is Oedipus Smart?Charles B. DanielsWhat does it amount to, to ask whether Oedipus is smart, intelligent, clever? I take this to mean that he is quicker than most to gain understanding about difficult matters. Now, does Sophocles in Oedipus Rex portray Oedipus to be an intelligent, clever man?The Yes AnswerA "yes" answer to the title question may rest upon three grounds:Y1. Everyone in the play, including Oedipus himself (...) and the citizens of Thebes who have been his subjects for some 15 to 20 years, everyone, that is, save Teiresias, thinks that Oedipus is intelligent.Y2. In both legend and Sophocles' play, the only person smart enough to solve the Sphinx's riddle is Oedipus. Everyone in the play, as well as in the play's audiences, knows that Oedipus has solved the Sphinx's riddle. This is a major reason why everyone in the play, again excepting Teiresias, believes Oedipus to have a first-class mind. Oedipus is renown for this deed and thought by his subjects to be very clever in doing of it.Y3. John P. Carroll, in his interesting study of the extraordinary number of questions posed by Oedipus in Oedipus Rex (one in each nine lines of text uttered by him), concludes, "King Oedipus was endowed at birth with the heritage of the 'riddler's mind,' which by constant use throughout the course of his life he sharpened and brought to greater [End Page 562] perfection than it ever had had in his parents." 1 Oedipus is clever because he has a "riddler's mind": he asks lots of questions.Y1, Y2, and Y3, I believe, constitute the sole evidential textual base for the "yes" response to the title question. 2The No AnswerThe "no" answer, the view that Oedipus is not clever, rests upon four grounds:N1. The first consists of events from Oedipus' past that took place prior to the opening scene of the play and hence do not occur on stage. These are disclosed as the play progresses and its characters relate in dialogue what they believe to have taken place. We discover that Oedipus has lived his entire adult life with unresolved doubts about who his parents are. Worse yet, at the very beginning of his adult life, his inquiry at the Delphic Oracle met with terrible, enigmatic pronouncements that raised the ante on these doubts and made the tenor of his whole subsequent life up to the present worrisome to say the least. We learn of six questions of high moment to Oedipus—questions that touch him as profoundly as did the Sphinx's riddle, "What walks on two, three, and four legs?"—questions which he continues to be aware of and yet has not resolved, or in some cases even probed. A truly clever person, one with a "riddler's mind," would have done so. But the mature Oedipus we meet at the beginning of the play has yet to puzzle out correct answers to the questions:1. Where did the scars on my feet come from?2. Who are my real parents, Polybus and Merope, or some other couple?3. How can I best avoid doing the terrible things the Oracle foretells I shall do—killing my father and marrying my mother—given I am not sure who my father and mother really are?4. Is this old man who has just forced me off the road and arrogantly swatted me from his passing carriage my father?5. Who killed the king whose throne I have just been given?6. Is this widow I am about to marry my mother?The Oedipus we see at the beginning of the play is a man who has solved the riddle of the Sphinx, but has not solved a single one of these six questions from his own past life, which, it turns out, are easily of comparable importance to him. [End Page 563]N2. Another source of evidence in support of a "no" answer consists of failures on Oedipus' part to evince a quick wit concerning two puzzles that arise in the dramatic present among the events we see unfold on stage:7. The riddles... (shrink)

Background and Purpose The decision to perform decompressive craniectomy for patients with malignant MCA syndrome can be ethically complex. We investigated factors that clinicians consider in this decision-making process. Methods A survey including clinical vignettes and attitudes questions surrounding the use of hemicraniectomy in malignant MCA syndrome was distributed to 203 neurosurgeons, neurologists, staff and residents, and nurses and allied health members specializing in the care of neurological patients. These were practicing health care providers situated in an urban setting in (...) Canada where access to health care is covered by national policy and is a human right. Results Eighty-eight participants responded to survey. All participants unanimously supported the procedure for young and healthy patients. Advanced age, the presence of aphasia, comorbid medical conditions, and poor baseline functional status were dominant factors associated with increasing reluctance to offer surgical decompression. Patients’ previously expressed wishes were also an important consideration. Eighty-six percent of respondents agreed that withholding surgery is ethically justified if the outcome is perceived as futile. Conclusions Health care providers use similar factors to determine if aggressive management is justified given anticipated burden on patient quality of life and extended impact on society. This convergence can be harnessed beneficially for the transparent communication of medical options in the ethically complex setting of decompressive hemicraniectomy post-stroke. (shrink)

By the standards presented in the Introduction, CMFC2 is deficient on at least one ontological ground: ‘∀’ is a syncategorematic expression and so CMFC2 is not an ideal language. To some there may be an additional difficulty: any two wffs provably equivalent in the classical sense are provably identical. We hope in sequel to present systems free of these difficulties, free either of one or the other, or perhaps both.This work was done with the aid of Canada Council Grant S74-0551-S1.

In a recent article “Abortion and Simple Consciousness', Werner S. Pluhar puts forward the following view:A few words of explanation are in order. The reasoning can, I think, be summed up as follows: If one thinks that being conscious is what gives beings rights, then what justifies preferential treatment for humans as opposed to sentient members of other species? The fact, or so the answer goes, that humans have a higher degree of consciousness than do members of other species. But (...) human fetuses do not have a higher degree of consciousness than, say, adult dogs. What justifies preferential treatment of human fetuses as opposed to adult dogs? The fact that human fetuses have a higher potential for reaching a higher degree of consciousness than do adult dogs. The liberal who holds that future generations have rights, e.g., to a healthy environment, thereby holds that merely potentially conscious beings have rights. If we have a right to life, then future generations also have that right. But fetuses are no less potentially conscious beings than unconceived future generations. So even a liberal must concede that if we have a right to life, fetuses have a right to life, and that it is at least prima facie wrong to destroy them by abortion. (shrink)

The Jewish Philosophy Reader is the first comprehensive anthology of classic writings on Jewish philosophy from the Bible to postmodernism. The Reader is clearly divided into four separate parts: Foundations and First Principles, Medieval and Renaissance Jewish Philosophy, Modern Jewish Thought, and Contemporary Jewish Philosophy. Each part is clearly introduced by the editors. The readings featured are representative writings of each era listed above and are from the following major thinkers: Abrabanel, Baeck, Bergman, Borowitz, Buber, Cohen, Crescas, Fackenheim, Geiger, Gersonides, (...) Goodman, Graetz, Halevi, Hartman, Heschel, Hess, Hirsch, Ibn Ezra, Ibn Gabirol, Ibn Paquda, Kellner, Kook, Krochmal, Leibowitz, Levinas, Maimonides, Maybaum, Mendelssohn, Novak, Philo, Plaskow, Rosenzweig, Saadia, Scholem, Seeskin, Soloveitchik, Spinoza, Strauss, Wolf, Zunz. (shrink)