This text provides a critique of the subjective Bayesian view of statistical inference, and proposes the author's own error-statistical approach as an alternative framework for the epistemology of experiment. It seeks to address the needs of researchers who work with statistical analysis.

Research has found that children possess a broad bias in favor of teleological - or purpose-based - explanations of natural phenomena. The current two experiments explored whether adults implicitly possess a similar bias. In Study 1, undergraduates judged a series of statements as "good" or "bad" explanations for why different phenomena occur. Judgments occurred in one of three conditions: fast speeded, moderately speeded, or unspeeded. Participants in speeded conditions judged significantly more scientifically unwarranted teleological explanations as correct, but were not (...) more error-prone on control items. Study 2 extended these findings by examining the relationship between different aspects of adults’ "promiscuous teleology" and other variables such as scientific knowledge, religious beliefs, and inhibitory control. Implications of these findings for scientific literacy are discussed. (shrink)

the philosophical writings ofx Lady Mary Shepherd were apparently well regarded in her own time, but dropped out of view in the mid-nineteenth century.1 Some historians of philosophy have recently begun attending to the distinctive arguments in Shepherd's two books, but the secondary literature that exists so far has largely focused on her critiques of Hume and Berkeley. However, many other themes and arguments in Shepherd's writings have not yet been explored. This paper takes up one such issue, what Shepherd (...) means by 'mind,' 'soul,' and 'self.' Shepherd held the unusual view that the mind is an enduring capacity that causes (whether on its own or in conjunction with other partial causes, such as... (shrink)

This guide leads readers systematically through the arguments of Mary Shepherd's two books. Chapters 1-4 cover the arguments in the Essay Upon the Relation of Cause and Effect (1824), where Shepherd argues that causal principles can be known by reason to be necessary truths and that causal inferences can be rationally justified. Shepherd's primary target in this work is Hume, but she also addresses the views of Thomas Brown and William Lawrence. Shepherd considered her second book, Essays on the Perception (...) of an External Universe, and Other Subjects Connected with the Doctrine of Causation (1827), to be an extension of the earlier project on causation; here she appeals to the causal principles established in the first book to argue that we can know through reason that an external world of continually-existing objects must exist independently of us, as the causes of our sensations. Chapter 5 of this Guide addresses Shepherd's accounts of sensation and reasoning; Chapters 6-9 lead the reader through the arguments of the Essays, as well laying out Shepherd's views on skepticism and Berkeleyan idealism, her accounts of mind and body, her philosophy of religion, and the solutions she offers to two puzzles about vision. (shrink)

The Well-Ordered Universe argues that Cavendish's natural philosophy, social and political philosophy, and medical theory share an underlying concern with order. This reveals interesting connections among Cavendish's natural philosophy and her views on gender, animals and the environment, and human health, and explains her commitment to monarchy and social hierarchy.

Philosophers of language are increasingly engaging with derogatory terms or slurs. Only few theorists take such language as a starting point for addressing puzzles in philosophy of language with little connection to our real-world problems. This paper aims to show that the political nature of derogatory language use calls for non-ideal theorising as we find it in the work of feminist and critical race scholars. Most contemporary theories of slurs, so I argue, fall short on some desiderata associated with a (...) non-ideal approach. They neglect crucial linguistic or political aspects of morally and politically significant meaning. I argue that a two-stage project is necessary to understand the perniciousness of slurs: accounting for the derogatory content of derogatory terms in general and, additionally, explaining the communicative function of slurs more specifically. I end by showing how inferentialism is well-suited to account for the content of derogatory terms whilst allowing for further explanations of the communicative functions of slurs. (shrink)

This article argues that the fact that an action will compound a prior injustice counts as a reason against doing the action. I call this reason The Anti-Compounding Injustice principle or aci. Compounding injustice and the aci principle are likely to be relevant when analyzing the moral issues raised by “big data” and its combination with the computational power of machine learning and artificial intelligence. Past injustice can infect the data used in algorithmic decisions in two distinct ways. Sometimes prior (...) injustice undermines the accuracy of the data itself. In these contexts, improving accuracy will also help to avoid compounding injustice. Other times, past injustice produces real-world differences among people with regard to skills, health, wealth, and other traits that employers, lenders, and others seek to measure. When decisions are based on accurate data that itself results from prior injustice, these decisions can also compound injustice. This second dynamic has received less attention than the first but is especially important because improving the accuracy of data will not mitigate this unfairness. (shrink)

In recent discussions on the meaning of derogatory terms, most theorists base their investigations on the assumption that slurring terms could in principle have some neutral, i.e. purely descriptive, counterpart. Lauren Ashwell has recently shown that this assumption does not generalize to gendered slurs. This paper aims to challenge the point and benefit of approaching the meaning of derogatory terms in contrast to their allegedly purely descriptive counterparts. I argue that different discursive practices among different communities of practice sometimes change (...) the semantics of a term. By the example of the term ‘black,’ I show in what ways these different practices may amount to semantic contestations which complicate the assessment of whether a specific politically significant term is purely descriptive. My discussion of politically significant terms provides insights into further phenomena such as the appropriation of derogatory terms by the target group or meaning change more generally. Moreover, it not only accounts for the political aspects of a linguistic phenomenon, but equally highlights and explains the oft-neglected but crucial role that language plays in social and political struggles. It thus contributes to ongoing discussions both in philosophy of language and in social and political philosophy. (shrink)

Humans have become increasingly datafied with the use of digital technologies that generate information with and about their bodies and everyday lives. The onto-epistemological dimensions of human–data assemblages and their relationship to bodies and selves have yet to be thoroughly theorised. In this essay, I draw on key perspectives espoused in feminist materialism, vital materialism and the anthropology of material culture to examine the ways in which these assemblages operate as part of knowing, perceiving and sensing human bodies. I draw (...) particularly on scholarship that employs organic metaphors and concepts of vitality, growth, making, articulation, composition and decomposition. I show how these metaphors and concepts relate to and build on each other, and how they can be applied to think through humans’ encounters with their digital data. I argue that these theoretical perspectives work to highlight the material and embodied dimensions of human–data assemblages as they grow and are enacted, articulated and incorporated into everyday lives. (shrink)

There are different narratives on mathematics as part of our world, some of which are more appropriate than others. Such narratives might be of the form ‘Mathematics is useful’, ‘Mathematics is beautiful’, or ‘Mathematicians aim at theorem-credit’. These narratives play a crucial role in mathematics education and in society as they are influencing people’s willingness to engage with the subject or the way they interpret mathematical results in relation to real-world questions; the latter yielding important normative considerations. Our strategy is (...) to frame current narratives of mathematics from a virtue-theoretic perspective. We identify the practice of mathematizing, put forward by Freudenthal’s ‘Realistic mathematics education’, as virtuous and use it to evaluate different narratives. We show that this can help to render the narratives more adequately, and to provide implications for societal organization. (shrink)

Scholarly interest in Margaret Cavendish's philosophical views has steadily increased over the past decade, but her epistemology has received little attention, and no consensus has emerged; Cavendish has been characterized as a skeptic, as a rationalist, as presenting an alternative epistemology to both rationalism and empiricism, and even as presenting no clear theory of knowledge at all. This paper concludes that Cavendish was only a modest skeptic, for she believed that humans can achieve knowledge through sensitive and rational perception as (...) well as through self-knowledge and can form probable opinions through reasoning. (shrink)

The fact that much of our knowledge is gained through the testimony of others challenges a certain form of epistemic individualism. We are clearly not autonomous knowers. But the discussion surrounding testimony has maintained a commitment to what I have elsewhere called epistemic agent individualism. Both the reductionist and the anti-reductionist have focused their attention on the testimony of individuals. But groups, too, are sources of testimony - or so I shall argue. If groups can be testifiers, a natural question (...) to ask is whether our beliefs based on the testimony of groups are ever justified and whether such a justification is to be conferred inferentially or non-inferentially. I consider and dismiss the possibility of extending an anti-reductionist account of justification to our group testimonial beliefs. I also argue against a version of reductionism that would have our group testimonial beliefs justified only in so far as we were able to monitor the trustworthiness of members of the group. However, there are forms of reductionism that can be extended to make sense of the justification of our group testimonial beliefs. There are mechanisms for monitoring the trustworthiness and competency of a group (rather than its members) and, further, a variety of background beliefs allow us to assess the testimony of a group for reliability. (shrink)

The key problem in the controversy over group selection is that of defining a criterion of group selection that identifies a distinct causal process that is irreducible to the causal process of individual selection. We aim to clarify this problem and to formulate an adequate model of irreducible group selection. We distinguish two types of group selection models, labeling them type I and type II models. Type I models are invoked to explain differences among groups in their respective rates of (...) production of contained individuals. Type II models are invoked to explain differences among groups in their respective rates of production of distinct new groups. Taking Elliott Sober's model as an exemplar, we argue that although type I models have some biological importance--they force biologists to consider the role of group properties in influencing the fitness of organisms--they fail to identify a distinct group-level causal selection process. Type II models if properly framed, however, do identify a group-level causal selection process that is not reducible to individual selection. We propose such a type II model and apply it to some of the major candidates for group selection. (shrink)

The growing availability of computer power and statistical software has greatly increased the ease with which practitioners apply statistical methods, but this has not been accompanied by attention to checking the assumptions on which these methods are based. At the same time, disagreements about inferences based on statistical research frequently revolve around whether the assumptions are actually met in the studies available, e.g., in psychology, ecology, biology, risk assessment. Philosophical scrutiny can help disentangle 'practical' problems of model validation, and conversely, (...) a methodology of statistical model validation can shed light on a number of issues of interest to philosophers of science. (shrink)

In the final chapters of her 1824 Essay upon the Relation of Cause and Effect, Lady Mary Shepherd considers what it means for an organism to be alive. The physician William Lawrence had...

This paper examines how unethical behavior in the workplace occurs when management places inordinately strong emphasis on goalattainment without a corresponding emphasis on following legitimate procedures. Robert Merton's theory of sodal structure and anomie provides a foundation to discuss this argument. Key factors affecting ethical climates in work organizations are also addressed. Based on this analysis, the paper proposes strategies for developing and changing aspects of organizational culture to reduce anomie, thereby creating work climates which discourage unethical practices and provide (...) employees with mechanisms to resolve ethical conflicts in a constructive way. (shrink)

The concept of agency as applied to technological artifacts has become an object of heated debate in the context of AI research because some AI researchers ascribe to programs the type of agency traditionally associated with humans. Confusion about agency is at the root of misconceptions about the possibilities for future AI. We introduce the concept of a triadic agency that includes the causal agency of artifacts and the intentional agency of humans to better describe what happens in AI as (...) it functions in real-world contexts. We use the VW emission fraud case to explain triadic agency since in this case a technological artifact, namely software, was an essential part of the wrongdoing and the software might be said to have agency in the wrongdoing. We then extend the case to include futuristic AI, imagining AI that becomes more and more autonomous. (shrink)

Germund Hesslow has argued recently [2] that a probabilistic theory of causality as advocated by Patrick Suppes [4] has two problems that a deterministic theory avoids. In this paper, I argue that Suppes' probabilistic causal calculus is free of each of these problems and, moreover, that several broader issues raised by Hesslow's discussion tend to support a probabilistic conception of causes.

The debate surrounding the issue of collective moral responsibility is often steeped in metaphysical issues of agency and personhood. I suggest that we can approach the metaphysical problems surrounding the issue of collective responsibility in a roundabout manner. My approach is reminiscent of that taken by P.F. Strawson in “Freedom and Resentment” (1968). Strawson argues that the participant reactive attitudes – attitudes like resentment, gratitude, forgiveness and so on – provide the justification for holding individuals morally responsible. I argue that (...) the framework of the reactive attitudes extends to collectives and provides the justification for holding collectives morally responsible. (shrink)

Recently, there has been growing interest in methodological issues of non-ideal theoretical philosophy. While some explicitly commit to non-ideal theorising, others doubt that there is anything useful about the ideal/non-ideal distinction in theoretical philosophy. The aim of this paper is twofold. On the one hand, I propose a way of doing non-ideal theoretical philosophy, once we realise how limited certain idealised projects are. Since there is a big overlap between projects that are called non-ideal and applied, the second aim is (...) to distinguish between these categories in order to show that applied theoretical philosophy is only worth pursuing if it operates in a non-ideal framework. I argue that we should be pluralistic about possible non-ideal theories and view the ideal/non-ideal differences as a matter of degree, rather than kind. As an example, I show how my version of non-ideal theory is useful to a concrete debate in philosophy of language. My proposal allows us to identify already existing non-ideal approaches to linguistic meaning and encourages us to further engage in the debate on non-ideal theoretical philosophy. (shrink)

This commentary is an attempt to begin to identify and think through some of the ways in which sociocultural theory may contribute to understandings of the relationship between humans and digital data. I develop an argument that rests largely on the work of two scholars in the field of science and technology studies: Donna Haraway and Annemarie Mol. Both authors emphasised materiality and multiple ontologies in their writing. I argue that these concepts have much to offer critical data studies. I (...) employ the tropes of companion species, drawn from Haraway, and eating data, from Mol, and demonstrate how these may be employed to theorise digital data–human assemblages. (shrink)

In seeking general accounts of evidence, confirmation, or inference, philosophers have looked to logical relationships between evidence and hypotheses. Such logics of evidential relationship, whether hypothetico-deductive, Bayesian, or instantiationist fail to capture or be relevant to scientific practice. They require information that scientists do not generally have (e.g., an exhaustive set of hypotheses), while lacking slots within which to include considerations to which scientists regularly appeal (e.g., error probabilities). Building on my co-symposiasts contributions, I suggest some directions in which a (...) new and more adequate philosophy of evidence can move. (shrink)

Has the diversity of corporate boards of directors improved? Should it? What role does diversity play in reducing corporate wrongdoing? Will diversity result in a more focused board of directors or more board autonomy? Examining the state of Tennessee as a case study, the authors collected data on the board composition of publicly traded corporations and compared those data to an original study conducted in 1995. Data indicate only a modest improvement in board diversity. This article discusses reasons for the (...) scarcity of women on boards and concludes that, to enhance strategic decisions, board membership should reflect the corporation''s consumer population. Thus, women are a critical but overlooked resource. Areas for future research are also considered. (shrink)

Economists and other social scientists in this century have often supported economic arguments by referring to positions taken by philosophers of science. This important new book looks at the reliability of this practice and, in the process, provides economists, social scientists, and historians with the necessary background to discuss methodological matters with authority. Redman first presents an accurate, critical, yet neutral survey of the modern philosophy of science from the Vienna Circle to the present, focusing particularly on logical positivism, sociological (...) explanations of science (Polanyi, Fleck, Kuhn), the Popper family, and the history of science. She then deals with economic methodology in the twentieth century, looking at a wide range of methodological positions, especially those supported by positions from the philosophy of science. She considers the myth of the feasibility of falsification in economics and, within the context of its significance for economics, discusses the interpretation of Kuhn's philosophy of science as consensus and the danger such a view represents to science. Appendices review the history of the is-ought dispute and list economists whose first works deal with methodological topics. Comprehensive, readable, and accessible to those with little background knowledge, Redman's book will appeal to a wide range of social scientists and philosophers of science. (shrink)

Adorno and Foucault are among the 20th century’s most renowned social critics but little work has been done to compare their ideas about the activity of critique. ‘Adorno, Foucault and Critique’ attempts to fill this lacuna. It takes as its starting point the Kantian legacy that informs Adorno’s and Foucault’s notions of critique, or their ‘ontologies of the present’, as Foucault calls them. Exploring the ontological foundations of critique, the article then addresses the principal objects of critique: domination and fascism. (...) It ends with a comparative account of the central aims of Adorno’s and Foucault’s critiques of western societies. (shrink)

Inferentialism seems to be an unpopular theory where derogatory terms are concerned. Contrary to most theorists in the debate on the meaning of derogatory terms, I think that inferentialism constitutes a promising theory to account for a broad range of aspects of derogatory language use. In order to make good on that promise, however, inferentialism must overcome four main objections that are usually raised against Michael Dummett's and Robert Brandom's inferentialist explanations of derogatory terms. This paper aims at debunking these (...) objections and thereby further developing the inferentialist interpretation of derogatory terms. I shall first discuss and reject three of the objections by pointing to the core assumptions of Brandomian inferentialism. Overcoming the fourth objection requires adjusting Dummett's and Brandom's explanation of the meaning of derogatory terms. In order to do so, I shall elaborate on the role that the explication of implicit material inferences plays with regard to different kinds of derogatory terms. The inferentialist account I am proposing fares better in terms of its explanatory power and broadness of application than Dummett's and Brandom's sketchy and oft-criticised views. (shrink)

Is bioethics consultation a profession? Withfew exceptions, the arguments andcounterarguments about whether healthcareethics consultation is a profession haveignored the historical and cultural developmentof professions in the United States, the wayssocial changes have altered the work andboundaries of all professions, and theprofessionalization theories that explain howmodern societies institutionalize expertise inprofessions. This interdisciplinary analysisbegins to fill this gap by framing the debatewithin a larger theoretical context heretoforemissing from the bioethics literature. Specifically, the question of whether ethicsconsultation is a profession is examined fromthe (...) perspectives of trait theory, Wilensky''sfive-stage process of professionalization,Abbott''s interdependent system of professions,and Haug''s deprofessionalization thesis. Whilehealthcare ethics consultation does not meetthe criteria to claim professional status,neither could most professions pass these idealtheoretical standards. Instead of a yes or nodichotomous response to the question, it ismore helpful to envision a professionalizationcontinuum with sales clerks or carpenters atone end and medicine or law at the other. During the past decade healthcare ethicsconsultation has been moving along thiscontinuum toward greater professional status. (shrink)

Digital health technologies are often advocated as a way of helping people monitor, promote and manage their health, care for others and reduce the burden on healthcare systems. Yet these technologies have also been subject to criticism for limiting human flourishing and exacerbating socioeconomic disadvantage. Bioethical appraisals of digital health technologies tend to take a conventional risk‐benefit approach, positioning the human subject as a rational, autonomous agent who is acted on by technologies. In this paper, I present a case for (...) adopting an alternative more‐than‐human perspective on bioethics. A more‐than‐human approach considers human‐technological assemblages and agencies as distributed, relational, situated and emergent. To illustrate the insights that this perspective can offer, I draw on the findings of four empirical projects I have conducted on people’s use of digital devices and platforms used for health‐related purposes, including social media groups and online forums, mobile apps and wearable devices. I conclude with the argument that a more‐than‐human approach to bioethics can begin to incorporate a new ‘zoë ethics’ that can acknowledge and address the deeper affective, multisensory and relational dimensions of humans’ encounters with and enactments of material things and nonhuman creatures. (shrink)

Community engagement to protect and empower participating individuals and communities is an ethical requirement in research. There is however limited evidence on effectiveness or relevance of some of the approaches used to improve ethical practice. We conducted a study to understand the rationale, relevance and benefits of community engagement in health research. This paper draws from this wider study and focuses on factors that shaped Community Advisory Group members’ selection processes and functions in Malawi. A qualitative research design was used; (...) two participatory workshops were conducted with CAG members to understand their roles in research. Workshop findings were triangulated with insights from ethnographic field notes, key informant interviews with stakeholders, focus group discussions with community members and document reviews. Data were coded manually and thematic content analysis was used to identify main issues. Results have shown that democratic selection of CAG members presented challenges in both urban and rural settings. We also noted that CAG members perceived their role as a form of employment which potentially led to ineffective representation of community interests. We conclude that democratic voting is not enough to ensure effective representation of community's interests of ethical relevance. CAG members’ abilities to understand research ethics, identify potential harms to community and communicate feedback to researchers is critical to optimise engagement of lay community and avoid tokenistic engagement. (shrink)

Exploring the philosophical foundations of discrimination law as it exists in several jurisdictions, this collection of all new essays bridges the gap between abstract philosophical work on justice and fairness and legal work on specific types of discrimination.

After some general remarks about the interrelation between philosophical and statistical thinking, the discussion centres largely on significance tests. These are defined as the calculation of p-values rather than as formal procedures for ‘acceptance‘ and ‘rejection‘. A number of types of null hypothesis are described and a principle for evidential interpretation set out governing the implications of p- values in the specific circumstances of each application, as contrasted with a long-run interpretation. A number of more complicated situ- ations are discussed (...) in which modification of the simple p-value may be essential. (shrink)

In his Feature Article ‘Represent me: please: Towards an ethics of digital twins in medicine’1, Mattias Braun considers several important bioethical issues in relation to the use of digital twin simulations in health and medical contexts. He focuses on the ways these simulations are used or are proposed to be deployed in these domains, including to what extent they are a ‘true’ or ‘real’ representation of human bodies. In this response, I want to take a step back and delve into (...) the metaphor of the ‘digital twin’. I consider the implications of using this metaphor in the context of medical care and how this choice of language participates in what science and technology scholars term the ‘sociomaterial imaginaries’ that are used to support and promote novel technologies.2 Language is important. It matters. The choice of language is both symbolic and persuasive. It intervenes in political and policy debates and research and healthcare funding decisions.2 It has material effects and affects: to some of which Braun has gestured in his piece. The …. (shrink)

Our everyday practices are meaningful in several ways. In addition to the linguistic meanings of our terms and sentences, we attach social meanings to actions and statuses. Philosophy of language and public debates often focus on contesting morally and politically pernicious linguistic practices. My aim is to show that this is too little: even if we are only interested in morally and politically problematic terms, we must counteract a pernicious linguistic practice on many levels, especially on the level of its (...) underlying social meanings. Otherwise, the critique of specific words as the most salient fruits of this practice will be futile. I trace out two paths through which pernicious social meanings feed into linguistic meanings and make the case for constructive contestations of social meanings as an alternative to criticising the use of a few highly pernicious terms in which these social meanings are manifest. My investigation into how social structures shape both social and linguistic meanings sheds further light on the ways in which social meanings enter linguistic exchanges. Moreover, it reveals that what is said in specific situations is more closely connected to our non-verbal actions than the current literature on semantics and the social sciences allows. (shrink)

Adorno thought that substantive change was not just desirable but also possible. He also offered ideas about what positive change might look like on the basis of his determinate negation of damaged life. This paper begins by exploring Adorno’s ideas about possibility and determinate negation. It also discusses his views about the sort of changes that might be made. Given Adorno’s ideas about the possibility of change, the paper ends by challenging Fabian Freyenhagen’s reading of Adorno as a methodological, epistemic, (...) and substantive negativist. (shrink)

This paper discusses the character of medical ethics and suggests that there are significant gaps that warrant greater attention. It describes ways in which the content and form of medical ethics may exclude or marginalise perspectives and contributions, thereby reducing its influence and its potential impact on, and value to, patients, students, carers and society. To consider what it is ‘to do good medical ethics’ suggests an active approach that seeks out, and learns from, contributions beyond the traditional boundaries of (...) scholarship. (shrink)

During the past decade there has been a very effective campaign against any explanation of remembering whose basic concept is that of a causally mediating trace. This paper attempts to provide such an explanation by presenting an explicit deductive argument for the existence of the memory trace. The conclusion is shown to follow from reasonable, empirical assumptions of which the most interesting is a spatiotemporal contiguity thesis. Set-theoretic techniques are used to provide a framework of analysis and probabilistic definitions of (...) some causal notions, as that of a causal chain, are presented. (shrink)

Much light has been shed on important features of teaching and learning by Alasdair MacIntyre's writings. Yet there are experiences that are crucial to teaching and learning that are unaddressed in MacIntyre's arguments; experiences that reveal education as a distinctive kind of practice. This paper examines one kind of such experience: an experience I call ‘being pulled up short’. Drawing on the work of Hans-Georg Gadamer and Gerald L. Bruns, I analyse an example of teaching King Lear to argue that (...) being pulled up short is a unique experience of disorientation that cannot be taught merely by pedagogical skill, including the modern tools and approaches provided by constructivist learning theory and meta-cognition. The paper concludes by identifying challenges that being pulled up short poses for the education of disposition, and for the aims and activities of teaching. (shrink)

An important theme to have emerged from the new experimentalist movement is that much of actual scientific practice deals not with appraising full-blown theories but with the manifold local tasks required to arrive at data, distinguish fact from artifact, and estimate backgrounds. Still, no program for working out a philosophy of experiment based on this recognition has been demarcated. I suggest why the new experimentalism has come up short, and propose a remedy appealing to the practice of standard error statistics. (...) I illustrate a portion of my proposal using Galison's experimental narrative on neutral currents. (shrink)

Theodor W. Adorno often made reference to Immanuel Kant’s famous essay on enlightenment. Although he denied that immaturity is self-incurred, the first section of this article will show that he adopted many of Kant’s ideas about maturity in his philosophically informed critique of monopoly conditions under late capitalism. The second section will explore Adorno’s claim that the educational system could foster maturity by encouraging critical reflection on the social conditions that have made us what we are. Finally, this article will (...) demonstrate that Adorno links enlightenment to Kant’s idea of a realm of ends. (shrink)

Clinical research employing the randomized clinical trial has, traditionally, been understood to pose an ethical dilemma. On the one hand, each patient ought to get the treatment that best meets her needs, as judged by the patient in consultation with her doctor. On the other hand, the method most helpful to advancing our understanding about what treatments are indeed best able to meet patient needs is the randomized trial, which necessitates that each patient's care is decided not by physician judgment (...) or patient choice but instead by random assignment. The tension can be described as a conflict between the interests of individual patients who are sick today, and the interests of the group of people who will become sick in the future and would benefit from advances in medical understanding. How one ought to balance these important and often competing interests is an important ethical question that resists easy resolution. (shrink)