Whose values should count – those of patients or the general public – when adopting the quality-adjusted life year framework for healthcare decision making is a long-standing debate. Specific disciplines, such as economics, are not wedded to a particular side of the debate, and arguments for and against the use of patient values have been discussed at length in the literature. In 2012, Sinclair proposed an approach, grounded within patient preference theory, which sought to avoid a perceived unfair discrimination against (...) people with disabilities when using values from the general public. Key assumptions about general public values that beget this line of thinking were that ‘disabled states always tally with lower quality of life’, and the use of standardised instruments means that ‘you are forced into a fixed view of disability as a lower value state’. Drawing on recent contributions to the health economics literature, we contend that such assumptions are not inherent to the incorporation of general public values for the estimation of QALYs. In practice, whether health states of people with disabilities are of ‘lower value’ is, to some extent, a reflection of the health state descriptions that members of the public are asked to value. (shrink)

This book makes an important contribution to ongoing efforts in the fields of medical law and bioethics to answer the challenges posed by the limitations of the principle of respect for autonomy, especially as these pertain to human research ethics. The principle of respect for autonomy seems to have become firmly embedded in human research ethics since its inclusion in the 1947 Nuremberg Code, which was a response to atrocities committed by Nazi doctors. Nonetheless, there is an increasing awareness of (...) the limitations of the principle of respect for autonomy and the underlying conceptualisations of human autonomy. (shrink)

The paper maps out and responds to some of the main areas of disagreement over the nature of Wittgenstein’s philosophy: (1) Between defenders of a “two Wittgensteins” reading (which draws a sharp distinction between early and late Wittgenstein) and the opposing “one Wittgenstein” interpretation. (2) Among “two-Wittgensteins” interpreters as to when the later philosophy emerged, and over the central difference between early and late Wittgenstein. (3) Between those who hold that Wittgenstein opposes only past philosophy in order to do philosophy (...) better and those who hold that Wittgenstein aimed to bring an end to philosophy and teach us to get by without a replacement. It is shown that each of these debates depends on some deeply un-Wittgensteinian, and quite mistaken, assumptions. It is concluded that Wittgenstein’s most polished writing, most notably in Philosophical Investigations I §§ 1–425, is best understood as a kind of Pyrrhonism which aims to subvert philosophical theorizing, by means of a polyphonic dialogue. Because this delicate balance between philosophical questions and their dissolution is not achieved in most of his other published and unpublished writings, we should be very cautious when using the theories and methods we find in those other writings as a guide to reading the Philosophical Investigations. (shrink)

One of the great contributions of postmodern thinkers like Michel Foucault and Jacques Derrida to the human sciences generally, in which Education is situated, has been the concept of "discourse." To call a particular way of thinking and acting a discourse is to reference the way meaning is achieved amongst actors by a mutual agreement, direct or tacit, about key terms and actions. A discourse is a kind of self-enclosed semantic and practical universe within which people operate "as if" everyone (...) knew what everyone else is talking about. (shrink)

This paper derives a mathematical expression giving the development of the probability of a scientific hypothesis with the number of confirming tests, as determined by Bayes's theorem, in a special case in which all the tests are "independent" of one another. The simple expression obtained shows clearly how the various factors influence the growth of the probability. The result is used to set a numerical lower bound on the probabilities representing the a priori beliefs of humans in generalizations that become (...) accepted. By making a comparison with the predictions of a "logical atomic" model in the case of physical laws, it is argued that humans have significant a priori "knowledge" in a weak sense. (shrink)

This chapter contains section titled: Introduction: Baker on the Private Language Argument Strawson's and Malcolms Interpretations of the Beetle Story Pitcher's, Cook's, and Donagan's Interpretations of the Beetle Story Cohen's Repudiation of the Beetle Story Hacker's and Baker's Interpretations of the Beetle Story.

The discovery of homeobox genes in vertebrates may allow analysis of a basic problem in developmental neurobiology: how regional differences in CNS organization are specified during development. This view is based on the roles defined for homologous genes in Drosophila development, and is supported by studies of the patterns of homeobox gene expression in vertebrate embryos. Homeobox genes comprise a multigene family, members of which are expressed in different spatially restricted domains along the anterior‐posterior axis of the CNS. These observations (...) are consistent with homeobox genes having roles in the positional specification of CNS organization, and experimental tests of this should be forthcoming shortly. (shrink)

Examining the significance of Kant's account of "rational faith," this study argues that he profoundly revises his account of the human will and the moral philosophy of it in his later religious writings.

The essay begins by briefly reviewing the complex history of the collaborative long-distance editing work that led to the publication of Wittgenstein: Lectures, Cambridge 1930-1933 (Cambridge UP, 2016). It then turns to a discussion of the rationale for the innovative editorial policies we ultimately developed and implemented, and some of the broader methodological issues that they raise.

In this new introduction to a classic philosophical text, David Stern examines Wittgenstein's Philosophical Investigations. He gives particular attention to both the arguments of the Investigations and the way in which the work is written, and especially to the role of dialogue in the book. While he concentrates on helping the reader to arrive at his or her own interpretation of the primary text, he also provides guidance to the unusually wide range of existing interpretations, and to the reasons (...) why the Investigations have inspired such a diversity of readings. Following closely the text of the Investigations and meant to be read alongside it, this survey is accessible to readers with no previous background in philosophy. It is well-suited to university-level courses on Wittgenstein, but can also be read with profit by students in other disciplines. (shrink)

There are some things money literally cannot buy. Invariably transformable goods are such things because when they are exchanged for money, they become something else. These goods are destroyed rather than transferred in monetary exchanges. They mark out an impassable limit beyond which money and the market cannot reach. They cannot be for sale, in the strongest and most literal sense. Variably transformable goods are similar. They can be destroyed when offered or exchanged for money, but they differ in their (...) ability to sometimes emerge from financial transactions intact. -/- Analyzing transformable goods reveals informative and surprising results. Like other goods and commodities, they are agent relative, defined by the way particular agents value them. Inside the same transaction, a good could be transformable for one agent and not another, depending on how and what these agents value in the transaction. Applying this conceptual framework can reveal otherwise obscure facets of existing and future debates about the ethics and limits of markets. To demonstrate this, the framework is here applied to Richard Titmuss’s arguments about markets in blood, clarifying and illuminating some of his most confusing claims. Applying this framework to other debates may reveal even more striking results. (shrink)

Recent work has shown that segmentation underlies the patterning of the vertebrate hindbrain and its neural crest derivatives. Several genes have been identified with segment‐restricted expression, and evidence is now emerging regarding their function and regulatory relationships. The expression patterns of Hox genes and the phenotype of null mutants indicate roles in specifying segment identity. A zinc finger gene Krox‐20 is a segment‐specific regulator of Hox expression, and it seems probable that retinoic acid receptors also regulate Hox genes in the (...) hindbrain. The receptor tyrosine kinase gene Sek may mediate cell‐cell interactions that lead to segmentation. These studies provide a starting point for understanding the molecular basis of segmental patterning in the hindbrain. (shrink)

The "standard account" of Wittgenstein’s relations with the Vienna Circle is that the early Wittgenstein was a principal source and inspiration for the Circle’s positivistic and scientific philosophy, while the later Wittgenstein was deeply opposed to the logical empiricist project of articulating a "scientific conception of the world." However, this telegraphic summary is at best only half-true and at worst deeply misleading. For it prevents us appreciating the fluidity and protean character of their philosophical dialogue. In retrospectively attributing clear-cut positions (...) to Wittgenstein and his interlocutors, it is very easy to read back our current understanding of familiar distinctions into a time when those terms were used in a much more open-ended way. The paper aims to to provide a broader perspective on this debate, starting from the protagonists’ understanding of their respective positions. Too often, the programmatic statements about the nature of their work that are repeated in manifestoes, introductions, and elementary textbooks have occupied center stage in the subsequent secondary literature. Consequently, I focus on a detailed examination of a turning point in their relationship. That turning point is Wittgenstein's charge, in the summer of 1932, that a recently published paper of Carnap's, "Physicalistic Language as the Universal Language of Science", made such extensive and unacknowledged use of Wittgenstein's own ideas that Wittgenstein would, as he put it in a letter to Schlick, "soon be in a situation where my own work shall be considered merely as a reheated version or plagiarism of Carnap’s." While the leading parties in this dispute shared a basic commitment to the primacy of physicalistic language, and the view that all significant languages are translatable, there was a remarkable lack of mutual understanding between them, and deep disagreement about the nature of the doctrines they disputed. Three quarters of a century later, we are so much more conscious of the differences that separated them than the points on which they agreed that it takes an effort of historical reconstruction to appreciate why Wittgenstein once feared that his own work would be regarded as a pale shadow of Carnap’s. (shrink)

Preaching should be a speaking of Scripture and not about Scripture.

In light of recent criticisms of the concept of human dignity, this contribution offers a proposal for the continued relevance of the concept for tertiary chaplaincy. It is important to consider the concept of human dignity in tertiary chaplaincy because: many higher education institutions continue to identify human dignity as a key value; the kinds of ethical issues that tertiary students face will often involve appeals to human dignity; and the religious connotations that have come to be associated with the (...) concept fall within the scope of chaplains. Nevertheless, there have been recent calls for the concept of human dignity to be dismissed from ethical discourse as unhelpful. In ethical debate, dignity can be unhelpful when it leads to ‘dignity talk’, when there is disagreement about whether it is something human beings always already have or something that is realised through human activity, or when it conceals what people think is really at stake. In response to these criticisms, this contribution proposes a model for understanding human dignity that affirms the value of the human person as a multi-dimensional, historically-situated being in relationship to all that is, a being who is faced with difficult moral choices through which he or she makes meaning in his or her life. This model has both descriptive value in helping us to understand why people do what they do, and normative value in helping us evaluate what should be done. (shrink)