Trust in the nurse—patient relationship is maintained not by how professionals perceive their actions but rather by how the public perceives them. However, little is known about the public's view of nurses and other health care professionals who participate in pharmaceutical marketing. Our study describes public perceptions of health care providers' role in pharmaceutical marketing and compares their responses with those of a random sample of licensed family nurse practitioners. The family nurse practitioners perceived their participation in marketing activities as (...) significantly more ethically appropriate than did the public responders. Further research is warranted before conclusions can be drawn, but these early findings suggest that nurse practitioners should consider a conservative approach to participating in pharmaceutical marketing. (shrink)

It is a current commonplace that if the concept of deity is incoherent then no significant truth-claim is made for a formula like ‘God exists’, for it is neither true nor false but meaningless. This is the problem of factual meaning on which such emphasis is laid by critics like A. Flew, R. W. Hepburn, C. B. Martin, K. Nielsen and P. Edwards. I wish here to counter their challenge.

This article revisits long-standing questions about consent, membership and emigration in Locke’s thought. Commentators such as A John Simmons have argued that Locke opens political membership to both express consenters and some kind of tacit consenters, and not just to the former, as some have suggested. Simmons’s reading seems to render Locke more sensible in that it does not exclude large numbers of people from membership or burden the few members with all the civic duties, and also in that it (...) allows at least tacit-consenting members the right to relocate, while this right is denied to express-consenting members. Against this reading, the article shows, by resolving seemingly conflicting claims in the text, that people become members only by express consent. It also responds to the criticism that the express-consent-only reading would limit membership to a few and so would render Locke’s account implausible from a practical point of view. The article then addresses the purported restriction Locke imposes on express consenters’ right to emigrate, arguing that the restriction concerns the change of membership and not the right to relocate. (shrink)

These comments, which take the form of criticism and response, were the basis of a zoom conversation at the Eastern APA, January 2021. Josh is putting them up on philpapers (with permission from all involved) in case they are helpful to people interested in the themes of this book.

In every generation the overwhelming majority of those who inhabited the imperium Romanum worked on the land and derived their sustenance directly from it. The notion is commonplace and scarcely admits of debate, but its implications for long have suffered unwarranted neglect. The well-being of any society ultimately rests upon the quantity and diversity of its food supplies, but the immediacy of their contact with the soil continually reminded the Roman people of this platitude with a force which few students (...) of their history today can readily appreciate. The annual yield of wheat in particular, always a staple item in the Roman diet, and to a lesser extent of such cereals as panic and millet, acutely affected every segment of the Roman community. One example will serve to illustrate the point. The dependence of the plebs urbana upon imported surpluses is notorious, equally the intense suffering and violence which typically accompanied any disruption of their supply. Such outbreaks frequently punctuated the chaotic final decades of the Republic, but they also scarred more than one régime during the first two centuries of the Principate. (shrink)

Intentional action is, in some sense, non-accidental, and one common way action theorists have attempted to explain this is with reference to control. The idea, in short, is that intentional action implicates control, and control precludes accidentality. But in virtue of what, exactly, would exercising control over an action suffice to make it non-accidental in whatever sense is required for the action to be intentional? One interesting and prima facie plausible idea that we wish to explore in this paper is (...) that control is non-accidental in virtue of requiring knowledge—either knowledge-that or knowledge-how (e.g., Beddor and Pavese 2021; cf., Setiya 2008; 2012 and Habgood-Coote 2018). We review in detail some key recent work defending such knowledge-centric theories of control, and we show that none of these accounts holds water. We conclude with some discussion about how control opposes the sort of luck intentional action excludes without doing so by requiring knowledge (that- or how). (shrink)

Intentional action is, in some sense, non-accidental, and one common way action theorists have attempted to explain this is with reference to control. The idea, in short, is that intentional action implicates control, and control precludes accidentality. But in virtue of what, exactly, would exercising control over an action suffice to make it non-accidental in whatever sense is required for the action to be intentional? One interesting and prima facie plausible idea that we wish to explore in this paper is (...) that control is non-accidental in virtue of requiring knowledge – either knowledge-that or knowledge-how (e.g., Beddor and Pavese 2021; cf., Setiya 2008; 2012 and Habgood-Coote 2018). We review in detail some key recent work defending such knowledge-centric theories of control, and we show that none of these accounts holds water. We conclude with some discussion about how control opposes the sort of luck intentional action excludes without doing so by requiring knowledge (that- or how). (shrink)

In this paper thecanonicalmodal logics, a kind of complete modal logics introduced in K. Fine [4] and R. I. Goldblatt [5], will be characterized semantically using the concept of anultrafilter extension, an operation on frames inspired by the algebraic theory of modal logic. Theorem 8 of R. I. Goldblatt and S. K. Thomason [6] characterizing the modally definable Σ⊿-elementary classes of frames will follow as a corollary. A second corollary is Theorem 2 of [4] which states that any complete modal (...) logic defining a Σ⊿-elementary class of frames is canonical.The main tool in obtaining these results is the duality between modal algebras and general frames developed in R. I. Goldblatt [5]. The relevant notions and results from this theory will be stated in §2. The concept of a canonical modal logic is introduced and motivated in §3, which also contains the above-mentioned theorems. In §4, a kind of appendix to the preceding discussion, preservation of first-order sentences under ultrafilter extensions is discussed.The modal language to be considered here has an infinite supply of proposition letters, a propositional constant ⊥, the usual Boolean operators ¬, ∨, ∨, →, and ↔ —with ¬ and ∨ regarded as primitives—and the two unary modal operators ◇ and □ — ◇ being regarded as primitive. Modal formulas will be denoted by lower case Greek letters, sets of formulas by Greek capitals. (shrink)

Generic automorphisms of certain homogeneous structures are considered, for instance, the rationals as an ordered set, the countable universal homogeneous partial order, and the random graph. Two of these cases were discussed in [7], where it was shown that there is a generic automorphism of the second in the sense introduced in [10]. In this paper. I study various possible definitions of 'generic' and 'mutually generic', and discuss the existence of mutually generic automorphisms in some cases. In addition, generics in (...) the automorphism group of the rational circular order are considered. (shrink)

IN THE beginning Parmenides sought to deny the void. But he found himself trapped by his language and his thought into admitting what he sought to deny. Wisely, he counseled others to avoid the whole region in which the problem arises, lest they too be unwarily ensnared. Plato, being less easily intimidated and grasping for the first time the urgency of the paradox, unearthed each snare in turn until he felt he had found a safe path through the forbidden terrain (...) in a new conception of being and the derivation of its linguistic consequences in the Sophist. Aristotle evidently took Parmenides’ advice; and save for a few groping scholastics, perhaps Leibniz, Brentano, and Meinong, and Frege only in passing, no one else attempted the crossing before Russell made his spectacular dash through the posted ground from the completely new direction of linguistic reference. Again the problem lay dormant for half a century until Strawson constructed a new low road through ordinary language and Quine improved Russell’s high algebraic pass. Refinements of these routes have been forthcoming, especially from Searle and Kripke, until today it might appear that there are two super highways through Parmenides’ forbidden country of nonbeing. In this essay I will first argue that these new linguistic highways are no more than flimsy camouflage hiding but not resolving the old paradoxes. I will then show how Plato’s ontological way out, though more difficult, is the straight and narrow path. (shrink)

This article aims to show that Locke’s discussion of tacit consent and the right to punish aliens in the Second Treatise of Government has important bearings on the moral status of undocumented immigrants. It argues that Locke conceptualized both friendly and hostile aliens, counting the former as tacit consenters to whom host states owed rights and protection. Moreover, it highlights how his approach, unlike theorists before and after him, was one that saw individuals as capable of shaping their own relationship (...) with the host. The article also examines Locke’s discussion of the federative power of the state, which includes the power to vet aliens within the country. Seen through this Lockean lens, the article argues that the vast majority of undocumented immigrants can be understood as tacit consenters or potential citizens who should be judged by how they choose to relate to the host, and not by their country of origin. While noting that the Lockean approach is not incompatible with border control, the article also shows how it puts the onus on the host to justify the power it exercises and to engage in dialogue with undocumented immigrants about what their status should be in the country. (shrink)

Background Biobank participants often do not understand much of the information they are provided as part of the informed consent process, despite numerous attempts at simplifying consent forms and improving their readability. We report the first assessment of biobank enrollees’ comprehension under an "integrated consent” process, where patients were asked to enroll in a research biobank as part of their normal healthcare experience. A number of healthcare systems have implemented similar integrated consent processes for biobanking, but it is unknown how (...) much patients understand after enrolling under these conditions. Methods: We recruited patients who enrolled in a biobank while in a healthcare setting when receiving ordinary care. We assessed knowledge of consent materials using 11 true/false questions drawn from a well-known biobank knowledge test. After reviewing the results from 114 participants, we revised the consent form and repeated the knowledge assessment with 144 different participants. Results: Participants scored poorly on the knowledge test in both rounds, with no significant differences in overall scores or individual items between the rounds. In Phase 1, participants answered 53% of the questions correctly, 25% incorrectly, and 22% “I don’t know.” In Phase 2, participants answered 53% of questions correctly, 24% incorrectly, and 23% “I don’t know.” Participants scored particularly poorly on questions about data sharing and accessing medical records. Conclusions: Enrollees under an integrated consent model had significant misunderstandings that persisted despite an attempt to improve information specifically about those topics in a consent form. These results raise challenges for current approaches that attribute misunderstanding to overly complex consent forms. They also suggest that the pressures of the clinic may compound other problems with patient understanding of biobank consent. As health systems increasingly blend research and care, they may need to rethink their approach to educating patients about participation in a biobank. (shrink)

This volume offers an analysis of ethical concepts based on positive legal principles and court decisions, describing what actually happens in practice, or where there are no precedents available, what is most likely to happen. Broadly, it deals with the wide range of potentially difficult situations in which the community, as represented by the law, may come into conflict with the medical profession.

In this paper an attempt is made to establish that the parties on both sides of the disputes concerning whether reasons are causes have mischaracterized or misdescribed what is involved in acting from a reason. A characterization of acting from a reason is provided, and, as a result, it is shown why contradictory positions have been and still are maintained by opposing parties. As a consequence of this account, an attempt is made to show why all parties have missed the (...) nature and significance of empathetic understanding. (shrink)

We would like to thank Dolega and Dewhurst for a thought-provoking and informed deconstruction of our article, which we take as applause from valued members of our audience. In brief, we fully concur with the theatre-free formulation offered by Dolega and Dewhurst and take the opportunity to explain why we used the Cartesian theatre metaphor. We do this by drawing an analogy between consciousness and evolution. This analogy is used to emphasize the circular causality inherent in the free energy principle. (...) We conclude with a comment on the special forms of active inference that may be associated with selfawareness and how they may be especially informed by dream states. (shrink)

The power of technology to transform religions, science, and political institutions has often been presented as nothing short of revolutionary. Does technology have a similarly transformative influence on societies’ morality? Scholars have not rigorously investigated the role of technology in moral revolutions, even though existing research on technomoral change suggests that this role may be considerable. In this paper, we explore what the role of technology in moral revolutions, understood as processes of radical group-level moral change, amounts to. We do (...) so by investigating four historical episodes of radical moral change in which technology plays a noteworthy role. Our case-studies illustrate the plurality of mechanisms involved in technomoral revolutions, but also suggest general patterns of technomoral change, such as technology’s capacity to stabilize and destabilize moral systems, and to make morally salient phenomena visible or invisible. We find several leads to expand and refine conceptual tools for analysing moral change, specifically by crystallizing the notions of ‘technomoral niche construction’ and ‘moral payoff mechanisms’. Coming to terms with the role of technology in radical moral change, we argue, enriches our understanding of moral revolutions, and alerts us to the depths of which technology can change our societies in wanted and unwanted ways. (shrink)

In this paper I describe and analyze an economic situation involving two competitive organizations. I put forth the argument that because of the systemic nature of decision making relative to managing the requirements of utilizing a descriptive equation that determines how many people an economic system can support, that even if all the players in the situation act ethically, the results will still be harmful, and necessarily so, to the system and to many innocent people. I will demonstrate that harming (...) innocent people is required and morally defensible given the choices available. The best one can do is slow down the increase in disutilities and possibly operate the system within a range of acceptable behavior that minimizes the resulting harm to innocent people, even if we cannot entirely remove this harm. In this context ethics becomes the study of the acceptable as opposed to the preferable. (shrink)

This chapter contains sections titled: “I'm shocked, I tell you, shocked!” The Preacher and the Porn Star Picnic Sex and the Prudes “Don't look, Ethel!” Tease Me, Whip Me, Persuade Me Biting the Bullet Hard Cases If Porn Isn't Free Speech, What Is It? Notes.