Dementia patients in the moderate-late stage of the disease can, and often do, express different preferences than they did at the onset of their condition. The received view in the philosophical literature argues that advance directives which prioritize the patient’s preferences at onset ought to be given decisive moral weight in medical decision-making. Clinical practice, on the other hand, favors giving moral weight to the preferences expressed by dementia patients after onset. The purpose of this article is to show that (...) the received view in the philosophical literature is inadequate and is out of touch with real clinical practice. I argue that having dementia is a cognitive transformative experience and that preference changes which result from this are legitimate and ought to be given moral weight in medical decision-making. This argument ought to encourage us to reduce our confidence in the moral weight of advance directives for dementia patients. (shrink)

What kinds of issues does the global crisis of climate change present to aesthetics, and how will they challenge the field to respond? This paper argues that a new research agenda is needed for aesthetics with respect to global climate change (GCC) and outlines a set of foundational issues which are especially pressing: (1) attention to environments that have been neglected by philosophers, for example, the cryosphere and aerosphere; (2) negative aesthetics of environment, in order to grasp aesthetic experiences, meanings, (...) and dis/values in light of the catastrophic effects of GCC; (3) bringing intergenerational thinking into aesthetics through concepts of temporality and ‘future aesthetics’ (4) understanding the relationship between aesthetic and ethical values as they arise in regard to GCC. (shrink)

Growing interest in embedded research approaches—where research is incorporated into clinical care—has spurred numerous studies to generate knowledge relevant to the real-world needs of patients and other stakeholders. However, it also has presented ethical challenges. An emerging challenge is how to understand the nature and extent of investigators’ obligations to patient-subjects. Prior scholarship on investigator duties has generally been grounded upon the premise that research and clinical care are distinct activities, bearing distinct duties. Yet this premise—and its corresponding implications—are challenged (...) when research and clinical care are deliberately integrated. After presenting three case studies from recent pragmatic clinical trials, we identify six differences between explanatory trials and embedded research that limit the application of existing scholarship for ascertaining investigator duties. We suggest that these limitations indicate a need to account for the implications of usual care and to move beyond a narrow focus on the investigator-subject dyad, one that better reflects the team- and institution-based nature of contemporary health systems. (shrink)

Physicists are increasingly beginning to take seriously the possibility of laws outside the traditional time-evolution paradigm; yet many popular definitions of determinism are still predicated on a time-evolution picture, making them manifestly unsuited to the diverse range of research programmes in modern physics. In this article, we use a constraint-based framework to set out a generalization of determinism which does not presuppose temporal evolution, distinguishing between strong, weak and delocalised holistic determinism. We discuss some interesting consequences of these generalized notions (...) of determinism, and we show that this approach sheds new light on the long-standing debate surrounding the nature of objective chance. (shrink)

An epistemic account of constitutive relevance lists the criteria by which scientists can identify the components of mechanisms in empirical practice. Three prominent claims from Craver form a promising basis for an account. First, constitutive relevance is established by means of interlevel experiments. Second, interlevel experiments are executions of interventions. Third, there is no interlevel causation between a mechanism and its components. Currently, no account on offer respects all three claims. I offer my causal situationist account of constitutive relevance that (...) respects the claims. By situating a part of a mechanism on the causal chain between the mechanism’s input and output, components can be identified with interventions, without the interventions suggesting interlevel causation. The causal situationist account is the only account on offer so far that clearly fits within Craver’s framework. (shrink)

The Theory of Planned Behavior predicts that a combination of attitudes, perceived norms, and perceived behavioral control predict intentions, and that intentions ultimately predict behavior. Previous studies have found that the TPB can predict students’ engagement in plagiarism. Furthermore, the General Theory of Crime suggests that self-control is particularly important in predicting engagement in unethical behavior such as plagiarism. In Study 1, we incorporated self-control in a TPB model and tested whether norms, attitudes, and self-control predicted intention to plagiarize and (...) plagiarism behavior. The best statistical fit for the path-analytic model was achieved when a direct path from self-control to plagiarism engagement was specified. In Study 2, we added a measure of perceived behavioral control and split the measurement of norms into descriptive and injunctive components. This study found that both self-control and perceived-behavioral control additively contributed to the prediction of plagiarism and the path-analytic model achieved its best fit when direct paths from perceived norms to plagiarism behavior were specified. These studies suggest that setting strong anti-plagiarism norms, such as by the use of honor codes, and seeking to enhance students’ self-control may reduce engagement in plagiarism. (shrink)

The ongoing generation of expectations is fundamental to listeners’ experience of music, but research into types of statistical information that listeners extract from musical melodies has tended to emphasize transition probabilities and n‐grams, with limited consideration given to other types of statistical learning that may be relevant. Temporal associations between scale degrees represent a different type of information present in musical melodies that can be learned from musical corpora using expectation networks, a computationally simple method based on activation and decay. (...) Expectation networks infer the expectation of encountering one scale degree followed in the near (but not necessarily immediate) future by another given scale degree, with previous work suggesting that scale degree associations learned by expectation networks better predict listener ratings of pitch similarity than transition probabilities. The current work outlines how these learned scale degree associations can be combined to predict melodic continuations and tests the resulting predictions on a dataset of listener responses to a musical cloze task previously used to compare two other models of melodic expectation, a variable‐order Markov model (IDyOM) and Temperley's music‐theoretically motivated model. Under multinomial logistic regression, all three models explain significant unique variance in human melodic expectations, with coefficient estimates highest for expectation networks. These results suggest that generalized scale degree associations informed by both adjacent and nonadjacent relationships between melodic notes influence listeners’ melodic predictions above and beyond n‐gram context, highlighting the need to consider a broader range of statistical learning processes that may underlie listeners’ expectations for upcoming musical events. (shrink)

Some individuals facing dementia contemplate hastening their own death: weighing the possibility of living longer with dementia against the alternative of dying sooner but avoiding the later stages of cognitive and functional impairment. This weighing resonates with an ethical and legal consensus in the United States that individuals can voluntarily choose to forgo life‐sustaining interventions and also that medical professionals can support these choices even when they will result in an earlier death. For these reasons, whether and how a terminally (...) ill individual can choose to control the timing of their death is a topic that cannot be avoided when considering the dementia trajectory. With a focus on the U.S. context, this landscape review considers the status of provisions that would legally permit people facing dementia to hasten death with appropriate support from medical professionals. This review can be used to plan and guide clinical and legal practitioner discussion and policy development concerning evolving questions not fully covered by existing medical decision‐making provisions. (shrink)

In the Philebus, Socrates maintains two theses about the relationship between pleasure and the good life: the mixed life of pleasure and intelligence is better than the unmixed life of intelligence, and: the unmixed life of intelligence is the most divine. Taken together, these two claims lead to the paradoxical conclusion that the best human life is better than the life of a god. A popular strategy for avoiding this conclusion is to distinguish human from divine goods; on such a (...) reading, pleasure has merely instrumental value, and it benefits human beings only as a result of their imperfect nature. I argue that certain ‘pure’ pleasures are full-fledged, intrinsic goods in the Philebus, which are even worthy of the gods . This positive evaluation of pure pleasure results from a detailed examination of pleasure, which reveals that different types of pleasures have fundamentally different natures. (shrink)

This article examines discourse on immunity in general public engagements with pandemic influenza in light of critical theory on immuno-politics and bodily integrity. Interview and focus group discussions on influenza with members of the general public reveal that, despite endorsement of government advice on how to avoid infection, influenza is seen as, ultimately, unavoidable. In place of prevention, members of the general public speak of immunity as the means of coping with influenza infection. Such talk on corporeal life under microbial (...) threat is informed by self/not-self, network and ‘choice’ immunity, and therefore makes considerable allowance for cosmopolitan traffic with others, microbes, ‘dirt’ and immune-boosting consumer products. The immuno-political orientation of members of the general public, therefore, appears to trend towards a productive cosmopolitanism that contrasts with more orthodox bioscientific and governmental approaches to pandemic influenza. We reflect on the implications of the immuno-cosmopolitanism of everyday life for the advent of global public health emergency and for biopolitical rule in general. (shrink)

Social license reflects environmental and social change, and sees community as an important stakeholder and partner. Science, scientists, and science policy have a key role in the processes that generate social license. In this paper, we focus on the interaction between science and social license in salmon aquaculture in south-eastern Tasmania. This research suggests that social license will be supported by distributed and credible knowledge co-production. Drawing on qualitative, interpretive social research we argue that targeted science, instilled by appropriate science (...) policy, can underpin social license by supporting emerging, distributed, and pluralistic knowledge production. Where social license is important and environmental contexts are complex, such knowledge production might support environmental governance, and so improve outcomes in coastal zone management and beyond. (shrink)

Halley and colleagues highlight important aspects of advocacy and justice in rare disease and provide recommendations for stakeholders to encourage progress toward equity and justice. In the rare d...

The role of demographic terminology in the fields of medicine and public health is critical in the identification and allocation of resources to the communities that most benefit from intervention...

The Novelty Seeking Model (NSM) places “novelty” at center stage in characterizing the mechanisms behind curiosity. We argue that the NSM's conception of novelty is too broad, obscuring distinct constructs. More critically, the NSM underemphasizes triggers of curiosity that better unify these constructs and that have received stronger empirical support: those that signal the potential for useful learning.

Uterus transplants provide another treatment for infertility. Some might think that we should embrace such transplants as one more way to assist people to have children. However, in this paper I argue that uterus transplants are not something that we ought to fund, nor something that we should make easy to access. First, I argue that any justification of providing uterus transplants must be based on the value of the experience of gestation, rather than on claims of meeting medical need (...) or promoting normal functioning. Second, I demonstrate that such a justification has limited prospects of success. The value of experiencing gestation is unlikely to be sufficient to justify state funding of uterus transplants and, further, we have reason to refrain from enabling such transplants. (shrink)

Some fictions seem to involve branching time, where one time series ‘splits’ into two or two time series ‘fuse’ into one. We provide a new framework for thinking about these fictional representations: not as representations of branching time series but rather as branching representations of linear time series. We explain how branching at the level of the representation creates a false impression that the story describes a branching of the time series in the fictional world itself. This involves explaining away (...) the illusion of various causal connections which may at first appear essential to understanding the story as a unified whole. This provides a more accurate account of the relationship between the representation and what is represented, which in turn reveals the extent to which it is legitimate to draw conclusions about actual time from fictional representations. (shrink)

We consider the extent to which artistic and scientific representations can give us knowledge of how things are or could be. Focusing on representations of time, we take two case studies: simultaneity and temporal order; time-travel to the past. We analyse relevant scientific representations – from Special Theory of Relativity and General Theory of Relativity – alongside relevant artistic representations – fictions which are non-committal about temporal order, and time-travel stories. In all the cases, we argue, drawing reliable conclusions from (...) the representations requires an understanding of the metaphysics of their subject matter and of the nature of representation itself. If we attempt to work out what is represented from the representation alone, then, far from acquiring knowledge, we risk obscuring the representation’s subject matter. (shrink)

: In this paper we discuss ethical and aesthetic questions in relation to the gardening practice of topiary. We begin by considering the ethical concerns arising from the uneasiness some appreciators might feel when experiencing topiary as a manipulation or contortion of natural processes. We then turn to ways in which topiary might cause an 'aesthetic affront' through the humanizing effects of sentimentality and falsification of nature (most often found in representational rather than abstract topiary). Our contention is that successful (...) topiary emerges through a dynamic and positive relationship between topiarist and tree, where the gardener works with nature's forms instead of in strong opposition to them. Appreciation of successful topiary, we shall argue, is marked by an experience of both the tree as a living thing and the artifice which has shaped it. (shrink)

IN THE UNITED STATES, 25 PERCENT OF PEOPLE LIVING WITH HIV/AIDS HAVE spent time in the correctional system. HIV is known to spread among incarcerated individuals through high-risk behaviors including unprotected sex, injection drug use, tattooing, and body piercing. When released from prison, persons living with HIV can spread the disease in the wider community. This essay explores the complex problem of HIV infection among US prisoners from a common good approach rooted in Catholic social teachings by examining available data (...) on US prison populations, describing recent trends in the prosecution of drug-related crimes, and proposing concrete policy recommendations for HIV prevention interventions in US prisons. (shrink)

Given the primary mandate for institutional review boards (IRBs) to protect potential participants from harm, the egregious history of research abuses, and the fact that there is no mention of incl...

The end of the cold war has elevated environmental issues to the highest level of concern for humanity while creating a world order dominated by the United States of America and other Western nations. This new power structure may likely lead to increased business activity in many parts of the world, as nations formerly preoccupied with the cold war turn their attention to economic development. This paper examines the linkages among ethics, economic development and protection and restoration of the environment (...) in The New World Order. (shrink)

Everyday ethics refers to those issues which have a sometimes unrecognized moral dimension and that arise regularly within healthcare and research. These issues are often contrasted to dramatic ethics issues (i.e. issues that have seemingly higher stakes such as those arising in acute care situations or with invasive or life-threatening interventions). Claims have been made that scholarly bioethics tends to focus on dramatic ethics to the detriment of everyday ethics discussions. However, empirical evidence showing this has been lacking. Our own (...) research investigating bioethics discussions in the Parkinson’s disease literature suggested this trend. Consequently, we decided to characterize the context and content of the Parkinson’s disease bioethics literature to empirically test the hypothesis that everyday ethics is under discussed. We conducted a broad literature search using the keywords “Parkinson’s disease” AND (“ethics” OR “bioethics”) and classified results inductively based on the context in which the bioethics discussion occurred. In line with our hypothesis and initial observations, we found that there is indeed a greater focus on dramatic ethics where topics such as deep brain stimulation and neuronal cell transplantations, dominated bioethics discussions. Given the potential utility of everyday ethics in improving healthcare and research, this mismatch in focus ought to be addressed. There is a clear need for further understanding and discussion of everyday ethical issues in scholarly bioethics. (shrink)

Empirical psychology documents widespread evidence of bias in the ways that people select, interpret, and selectively interpret evidence in forming and revising their beliefs. These biases can function to create and perpetuate epistemologies of ignorance. I argue that virtue epistemology can help us explain what goes epistemically wrong in these cases, and can offer positive advice, orienting us toward ways to right it. In particular, I defend the virtue approach from epistemic situationist worries about the empirical plausibility of individual agents' (...) ability to develop corrective virtues. I argue that situational virtues are genuine responsibilist virtues, and are one of the tools at our disposal for overcoming epistemologies of ignorance. (shrink)

*The views expressed are the author's own and should not be construed as representing the policies and opinions of the American Medical Association.

Canada’s Tri-Council Policy Statement: Ethical Conduct for Research Involving Humans mandates that all research involving human subjects be reviewed and approved by a research ethics board . We have little evidence on how researchers are dealing with this requirement in multisite studies, which involve more than one REB. We retrospectively examined 22 REB submissions for two minimal-risk, multisite studies in leading Canadian institutions. Most REBs granted expedited review to the studies, while one declared the application to be exempt from review. (...) Time between submission and approval ranged greatly, from four to 546 days. We received a total of 155 REB queries for changes and clarifications, most of which asked for further information, clarification, or additional documents. Less than a third of the REB queries were requests for specific changes, and a vast majority had a very limited impact on the research projects. Institutions also varied broadly in their description of what was required of local principal investigators. We conclude that the organizational and practical challenges these results imply could deter researchers from embarking on multisite research projects, and that recently proposed changes to the TCPS will not solve these problems. (shrink)

The concept of self-gaslighting has recently become prevalent in popular discourse but has yet to be subjected to detailed philosophical analysis. In this paper, I examine one context in which self-gaslighting is often discussed: situations in which someone has experienced trauma. I argue that the phenomenon currently described as self-gaslighting fails to display core features of manipulative gaslighting and that therefore we should seek other conceptual resources for understanding such cases. I suggest that self-gaslighting, at least in some paradigmatic cases, (...) amounts to either extremely successful interpersonal gaslighting or to internalized oppression. Utilizing these concepts instead of self-gaslighting avoids conceptual difficulties and also has a significant practical payoff. By moving away from the language of self-gaslighting we can move away from feelings of self-blame that so often accompany trauma. (shrink)

This article explores the idea that there is a spectrum of individuals who feel compelled to dwell in the past, either due to psychological or social conditions. I analyze both conditions respectively by critically examining two cases: post-traumatic stress disorder and racialized oppression. I propose that individuals with PTSD can feel psychologically compelled to dwell in the past in a dually negative sense: the individual lives in the past but also broods on it, causing them to feel “stuck” in the (...) past. This kind of “dwelling” can cause individuals to suffer disruptions to their sense of self and intersubjectivity. After exploring the psychological case of dwelling in the past, I explore the social sense in which individuals can dwell in the past due to oppressive social structures by examining the case of racialized oppression. The case of racialization is philosophically stimulating because of its intersubjective dimensions—it subverts the idea that dwelling in the past is simply a psychological phenomenon by capturing that others can help or hinder us with maintaining a sense of self and future-directed intentionality. By putting the phenomenological work of Al-Saji into conversation with recent phenomenological research on incarceration, I propose that racialization can be similarly disruptive to one’s sense of self and intersubjectivity. The proposed account is suggestive that traumatic and oppressive experiences may amplify and compound each other in ways not yet well elucidated in the literature. If this account is taken to be persuasive, it is indicative that both psychological and social conditions mediate one’s temporality and well-being. (shrink)

An incisive exploration of the way Greek myths empower us to defeat tyranny. As tyrannical passions increasingly plague twenty-first-century politics, tales told in ancient Greek epics and tragedies provide a vital antidote. Democracy as a concept did not exist until the Greeks coined the term and tried the experiment, but the idea can be traced to stories that the ancient Greeks told and retold. From the eighth through the fifth centuries BCE, Homeric epics and Athenian tragedies exposed the tyrannical potential (...) of individuals and groups large and small. These stories identified abuses of power as self-defeating. They initiated and fostered a movement away from despotism and toward broader forms of political participation. Following her highly praised book Enraged: Why Violent Times Need Ancient Greek Myths, the classicist Emily Katz Anhalt retells tales from key ancient Greek texts and proceeds to interpret the important message they hold for us today. As she reveals, Homer's Iliad and Odyssey, Aeschylus's Oresteia, and Sophocles's Antigone encourage us—as they encouraged the ancient Greeks—to take responsibility for our own choices and their consequences. These stories emphasize the responsibilities that come with power (any power, whether derived from birth, wealth, personal talents, or numerical advantage), reminding us that the powerful and the powerless alike have obligations to each other. They assist us in restraining destructive passions and balancing tribal allegiances with civic responsibilities. They empower us to resist the tyrannical impulses not only of others but also in ourselves. In an era of political polarization, Embattled demonstrates that if we seek to eradicate tyranny in all its toxic forms, ancient Greek epics and tragedies can point the way. (shrink)

In this thoughtful and provocative work, scholar Emily Herman explores the ideas of two of the most important philosophers of the 20th century and their relevance to Christian thought. From the concept of time to the nature of human existence, this book offers important insights into some of the most pressing questions of our time. This work has been selected by scholars as being culturally important, and is part of the knowledge base of civilization as we know it. This (...) work is in the "public domain in the United States of America, and possibly other nations. Within the United States, you may freely copy and distribute this work, as no entity (individual or corporate) has a copyright on the body of the work. Scholars believe, and we concur, that this work is important enough to be preserved, reproduced, and made generally available to the public. We appreciate your support of the preservation process, and thank you for being an important part of keeping this knowledge alive and relevant. (shrink)

Concepts like testimonial injustice (Fricker, 2007) and testimonial violence (Dotson, 2011) articulate that marginalized epistemic agents are unjustly undermined as testifiers when dominant agents cannot or will not hear, understand, or believe their testimony. This paper turns attention away from these constraints on uptake, and towards pragmatic, social, and political constraints on how dominant audiences receive and react to testimony. I argue that these constraints can also be sources of testimonial injustice and epistemic violence. Specifically, I explore a kind of (...) injustice that I call testimonial withdrawal, which occurs when a would-be speaker chooses to remain silent because they know or reasonably expect that there is pragmatic risk associated with speaking, given their unjust marginalization. I argue that this unjustly undermines epistemic agency, and that expanding Fricker and Dotson’s umbrella concepts to accommodate this idea results in a better understanding of the moral and epistemic contours of both testimonial withdrawal and these broader categories. (shrink)

We defend the guise of the good thesis in a tradition going back to Socrates and Plato, according to which persons act on the basis of what appears to them as good or the least bad or evil act available to them. This seems contrary to moral experience, but we defend the thesis against plausible counter-examples in life as well as fiction. We contend that the thesis makes wrong-doing and vice intelligible, but still wrong, dysfunctional and horrific.

Recent work in the philosophy of emotion focuses on challenging dualistic conceptualizations. Three of the most obvious dualisms are the following: 1. emotion opposes reason; 2. emotion is subjective, while reason is objective; 3. emotion lies internal to the subject, while reason is external. With challenges to these dualisms, one of the more interesting questions that has surfaced is the idea of emotional appropriateness in a particular context. Here, consider a widely held belief in the United States associates racialized groups (...) with specific emotions—most notably African American women with anger. Clearly these emotional attributions are essentialistic--and hence racist. But this response is too easy. The acknowledgement that emotion lies both internally in the subject and externally in the world opens the possibility of attributing an emotional temperament to a population group. Yet if an identity group has an emotional temperament, can they be accountable for emotionally appropriate behavior? (shrink)

It is widely agreed that clinical research should satisfy a number of ethical requirements. These include requirements to address a valuable question, to select subjects fairly, and to pose appropriate risks. In contrast, there remains considerable debate over the ethical relevance of investigator intentions: Does it matter ethically whether investigators intend to collect generalizable knowledge or to benefit subjects, or both? Some commentators do not mention investigator intentions when evaluating what makes clinical research ethical (Emanuel, Wendler, and Grady 2000). Others (...) regard investigator intentions as central to the ethics of clinical research (Jonas 1969). These commentators argue that .. (shrink)

At the dawn of the twentieth century, Henri Bergson (1859-1941) became the most famous philosopher on earth. Where prior thinkers sketched out a deterministic, predictable universe, he asserted the transformative power of individual consciousness and creativity. An international celebrity, he made headlines around the world debating luminaries like Bertrand Russell and Albert Einstein about free will and time. The vision of creative evolution and freedom he presented was so disruptive that the New York Times branded him "the most dangerous man (...) in the world." In Herald of a Restless World, Emily Herring recovers how Bergson captivated a society in flux. She shows how his celebration of the time-bending uniqueness of individual experience struck a chord with those shaken by modern technological and social change. Long after he faded from public view, his insights into memory, time, laughter, and the creative continue to shape how we see the world around us. Herald of a Restless World is an electrifying portrait of a singular intellect. Bergson's extraordinary insight into life's fundamental questions remains urgent and relevant to this day. (shrink)

Caesar's description of the Germans' social organization andmoresin the sixth book of hisBellum Gallicum(BG6.21–8) has long been the subject of multiple scholarly controversies. Its focus on various seemingly random ethnographical details – above all the description of the Hercynian forest and its fantastical beasts – has so surprised readers that the very authenticity of the passage has been questioned. It has been convincingly argued that interpolation is not likely. However, the internal excursus describing the Hercynian forest, and the final section (...) concerning its fauna in particular, remains a subject of intrigue, as a result of the extraordinary, semi-mythical nature of its contents. It is the latter portion of the excursus, concerning the beasts of the Hercynian forest, and the place and role of their portrayal within the ethnography as a whole, that I wish to elucidate in the present article. While it undeniably possesses great entertainment value, its presence cannot be justified merely on such grounds. (shrink)