As a study involving diabetes care demonstrates, children sometimes have a much more sophisticated capacity for taking charge of their own health care decisions than is usually recognized in bioethics. Protecting these children from their disease means involving them in their treatment as much as possible, helping them to understand it and take responsibility for it so that they can navigate the multitude of daily decisions that become part of the diabetes medical regimen.

A belief that high school students have the cognitive ability to analyze and assess moral choices and should be encouraged to do so but have rarely been helped to do so was the motivation for developing Exploring Bioethics, a six-module curriculum and teacher guide for grades nine through twelve on ethical issues in the life sciences. A multidisciplinary team of bioethicists, science educators, curriculum designers, scientists, and high school biology teachers worked together on the curriculum under a contract between the (...) National Institutes of Health and Education Development Center, a nonprofit research and development organization with a long history of innovation in science education. At the NIH, the Department of Bioethics within the Clinical Center and the Office of Science Education within the Office of the Director guided the project.Our overarching goal for Exploring Bioethics was to introduce students to bioethics as a field of inquiry and to enable them to develop ethical reasoning skills so they could move beyond “gut reactions” to more nuanced positions. (shrink)

An eighteen‐year‐old with sickle cell disease was admitted to the pediatric hematology service at his local children's hospital for management of an acute pain crisis, one of many such admissions. He had a good relationship with his primary hematologist and primary nurse, but with other health care providers, there was evident friction. Sometimes, he was simply rude, rolling over and pretending to sleep in response to questions about his symptoms. When frustrated or convinced that his pain was not being addressed (...) appropriately, he was prone to yelling and cursing at his nurses. After members of the health care team complained, their supervisor decided to transfer the patient to an adult general medicine service. Reasons cited for the transition included the stressful work environment created by the patient's actions, his refusal to follow directives from staff (although he was generally adherent to treatment), and the hypothetical harm to other young patients who might witness his behavior. Was this a just outcome? Is it ever permissible to deny access to pediatric care to a patient whose best interests would be served by it? Can access be withheld for “bad” behavior, and can transfer of care be wielded as a punishment? (shrink)

In this chapter I explore how epistemic injustice (as discussed by Miranda Fricker) can arise in connection with knowledge how. I attempt to bypass the question of whether knowledge how is a type of propositional knowledge, and instead focus on some distinctive ways in which knowledge how is sometimes sought, identified or ignored.

Hastings Center Report, Volume 52, Issue S1, Page S66-S68, March‐April 2022.

I outline a number of parallels between trust and distrust, emphasising the significance of situations in which both trust and distrust would be an imposition upon the (dis)trustee. I develop an account of both trust and distrust in terms of commitment, and argue that this enables us to understand the nature of trustworthiness. Note that this article is available open access on the journal website.

Social groups—like teams, committees, gender groups, and racial groups—play a central role in our lives and in philosophical inquiry. Here I develop and motivate a structuralist ontology of social groups centered on social structures (i.e., networks of relations that are constitutively dependent on social factors). The view delivers a picture that encompasses a diverse range of social groups, while maintaining important metaphysical and normative distinctions between groups of different kinds. It also meets the constraint that not every arbitrary collection of (...) people is a social group. In addition, the framework provides resources for developing a broader structuralist view in social ontology. (shrink)

In this paper I argue for a view of groups, things like teams, committees, clubs and courts. I begin by examining features all groups seem to share. I formulate a list of six features of groups that serve as criteria any adequate theory of groups must capture. Next, I examine four of the most prominent views of groups currently on offer—that groups are non-singular pluralities, fusions, aggregates and sets. I argue that each fails to capture one or more of the (...) criteria. Last, I develop a view of groups as realizations of structures. The view has two components. First, groups are entities with structure. Second, since groups are concreta, they exist only when a group structure is realized. A structure is realized when each of its functionally defined nodes or places are occupied. I show how such a view captures the six criteria for groups, which no other view of groups adequately does, while offering a substantive answer to the question, “What are groups?”. (shrink)

Some language encourages essentialist thinking. While philosophers have largely focused on generics and essentialism, I argue that nouns as a category are poised to refer to kinds and to promote representational essentializing. Our psychological propensity to essentialize when nouns are used reveals a limitation for anti-essentialist ameliorative projects. Even ameliorated nouns can continue to underpin essentialist thinking. I conclude by arguing that representational essentialism does not doom anti-essentialist ameliorative projects. Rather it reveals that would-be ameliorators ought to attend to the (...) propensities for our representational devices to essentialize and to the complex relationship between essentialism and prejudice. (shrink)

In this chapter, I examine Lewis's ideas about ontological innocence, ontological commitment and double-counting, in his discussion of composition as identity in Parts of Classes. I attempt to understand these primarily as epistemic or methodological claims: how far can we get down this route without adopting radical metaphysical theses about composition as identity?

This essay shows how South African Pentecostal teachings about sexuality, particularly HIV prevention and divorce, constrain women’s real and imagined choices. Institutional Review Board–approved fieldwork revealed the prevalence of wives remaining faithful to unfaithful husbands despite high risks of physical abuse and HIV infection. Maintaining the “ideal” of abstinence and faithfulness, male pastors actively oppose condom use and emphasize that “God hates divorce”. In this essay I engage and resist such hermeneutics. Using scripture as source and norm, I construct an (...) A-B-C-D prevention strategy to enhance women’s freedom: Abstain, Be faithful, use Condoms, or Divorce. (shrink)

It has been argued that humans can face an ethical/epistemic dilemma over the automatic stereotyping involved in implicit bias: ethical demands require that we consistently treat people equally, as equally likely to possess certain traits, but if our aim is knowledge or understanding our responses should reflect social inequalities meaning that members of certain social groups are statistically more likely than others to possess particular features. I use psychological research to argue that often the best choice from the epistemic perspective (...) is the same as the best choice from the ethical perspective: to avoid automatic stereotyping even when this involves failing to reflect social realities in our judgements. This argument has an important implication: it shows that it is not possible to successfully defend an act of automatic stereotyping simply on the basis that the stereotype reflects an aspect of social reality. An act of automatic stereotyping can be poor from an epistemic perspective even if the stereotype that is activated reflects reality. (shrink)

Biomedicine has opened up new possibilities for parenthood. Once resigned to remaining childless or pursuing adoption, infertile couples can now pursue options such as gamete donation, in-vitro fer...

As concerns about the negative health effects of unhealthy eating, overweight and obesity have increased, so too have policy efforts to promote healthy eating. Federal, state, and local governments have proposed and implemented a variety of healthy eating policies. Many of these policies are controversial, facing objections that range from the practical (e.g., the policy won’t succeed at improving people’s diets) to the ethical (e.g., the policy is paternalistic or inequitable). Especially controversial have been policies limiting the options offered in (...) the marketplace, limiting access to certain options, or providing disincentives for the purchase of certain options. Examples of such policies include proposed .. (shrink)

Findings from the cognitive sciences suggest that the cognitive mechanisms responsible for some memory errors are adaptive, bringing benefits to the organism. In this paper we argue that the same cognitive mechanisms also bring a suite of significant epistemic benefits, increasing the chance of an agent obtaining epistemic goods like true belief and knowledge. This result provides a significant challenge to the folk conception of memory beliefs that are false, according to which they are a sign of cognitive frailty, indicating (...) that a person is less reliable than others or their former self. Evidence of memory errors can undermine a person’s view of themselves as a competent epistemic agent, but we show that false memory beliefs can be the result of the ordinary operation of cognitive mechanisms found across the species, which bring substantial epistemic benefits. This challenge to the folk conception is not adequately captured by existing epistemological theories. However, it can be captured by the notion of epistemic innocence, which has previously been deployed to highlight how beliefs which have epistemic costs can also bring significant epistemic benefits. We therefore argue that the notion of epistemic innocence should be expanded so that it applies not just to beliefs but also to cognitive mechanisms. (shrink)

The purpose of this article is to investigate how cultural meanings associated with the left ventricular assist device inform acceptance and experience of this innovative technology when it is used as a destination therapy. We conducted open-ended, semistructured interviews with family caregivers and patients who had undergone LVAD-DT procedures at six U.S. hospitals. A grounded theory approach was used for the analysis. Thirty-nine patients and 42 caregivers participated. Participants described a sense of obligation to undergo the procedure because of its (...) promise for salvation. However, once the device was implanted, patients described being placed into a liminal state of being neither sick nor healthy, with no culturally scripted role. Consideration of end-of-life decisions was complicated by the uncertainties about how patients with LVADs die. Pre-implantation communications among patient, family, and clinicians should take into account the impact of the technology on meaning, identity, and patient experience. (shrink)

We start with an observation about implicit quantifier domain restriction: certain implicit restrictions (e.g., restricting objects by location and time) appear to be more natural and widely available than others (e.g., restricting objects by color, aesthetic, or historical properties). Our aim is to explain why this is. That is, we aim to explain why some implicit domain restriction possibilities are available by default. We argue that, regardless of their other explanatory virtues, extant pragmatic and metasemantic frameworks leave this question unanswered. (...) We then motivate a partially nativist account of domain restriction that involves a minimal view of joint planning around broad shared goals about navigating and influencing our environments augmented with cognitive heuristics that facilitate these. Finally, we sketch how the view can be extended to account for the ways non-default restriction possibilities become available when conversationalists have shared idiosyncratic goals. (shrink)

Ontology is the philosophical discipline which aims to understand how things in the world are divided into categories and how these categories are related together. This is exactly what information scientists aim for in creating structured, automated representations, called 'ontologies,' for managing information in fields such as science, government, industry, and healthcare. Currently, these systems are designed in a variety of different ways, so they cannot share data with one another. They are often idiosyncratically structured, accessible only to those who (...) created them, and unable to serve as inputs for automated reasoning. This volume shows, in a nontechnical way and using examples from medicine and biology, how the rigorous application of theories and insights from philosophical ontology can improve the ontologies upon which information management depends. (shrink)

Identity politics has been critiqued in various ways. One central problem—the Reinforcement Problem—claims that identity politics reinforces groups rooted in oppression thereby undermining its own liberatory aims. Here I consider two versions of the problem—one psychological and one metaphysical. I defang the first by drawing on work in social psychology. I then argue that careful consideration of the metaphysics of social groups and of the practice of identity politics provides resources to dissolve the second version. Identity politics involves the creation (...) or transformation of groups in ways that do not succumb to the metaphysical Reinforcement Problem. (shrink)

A large body of existing research suggests that people think very differently about categories that are seen as kinds (e.g., women) and categories that are not seen as kinds (e.g., people hanging out in the park right now). Drawing on work in linguistics, we suggest that people represent these two sorts of categories using fundamentally different representational formats. Categories that are not seen as kinds are simply represented as collections of individuals. By contrast, when it comes to kinds, people have (...) two distinct representations: a representation of a collection of individual people and a representation of the kind itself. The distinction between these two representational formats helps to shed light on otherwise puzzling findings about stereotyping and essentialism. Stereotyping appears to involve a representation of a collection of people, while essentialism involves a representation of a kind itself. (shrink)

Cooperation has been analyzed primarily in the context of theories of collective intentionality. These discussions have primarily focused on interactions between pairs or small groups of agents who know one another personally. Cooperative game theory has also been used to argue for a form of cooperation in large unorganized groups. Here I consider a form of minimal cooperation that can arise among members of potentially large organized groups (e.g., corporate teams, committees, governmental bodies). I argue that members of organized groups (...) can be minimally cooperative in virtue of playing roles in an organizational structure and having a common goal. The minimal form of cooperation I argue for is not grounded in collective intentions involving symmetric mental states, special collective intentional modes, or joint commitments. More generally, I show how considering minimal cooperation in the context of organized groups provides an opportunity to reevaluate the extent to which the social world and social phenomena depend on internalist mental factors (e.g., intentions, beliefs) and externalist non-mental factors (e.g., documents, laws, job descriptions). The view of minimal cooperation among members of organized groups I offer provides support for an externalist rather than internalist theory of at least one social phenomenon. (shrink)

Perceptual grouping has traditionally been thought to be governed by innate, universal principles. However, recent work has found differences in Japanese and English speakers' non-linguistic perceptual grouping, implicating language in non-linguistic perceptual processes (Iversen, Patel, & Ohgushi, 2008). Two experiments test Japanese- and English-learning infants of 5-6 and 7-8 months of age to explore the development of grouping preferences. At 5-6 months, neither the Japanese nor the English infants revealed any systematic perceptual biases. However, by 7-8 months, the same age (...) as when linguistic phrasal grouping develops, infants developed non-linguistic grouping preferences consistent with their language's structure (and the grouping biases found in adulthood). These results reveal an early difference in non-linguistic perception between infants growing up in different language environments. The possibility that infants' linguistic phrasal grouping is bootstrapped by abstract perceptual principles is discussed. (shrink)

This is a short response to Aaron Cotnoir's 'Composition as General Identity', in which I suggest some further applications of his ideas, and try to press the question of why we should think of his 'general identity relation' as a genuine identity relation.

Research has consistently revealed gender differences in attitudes toward science and technology. One explanation is that women are more personally affected by particular technologies, so they consider them differently. However, not all women universally experience biomedical technologies. We use the concept of technological salience to address how differences in subjective implications of a technology might explain differences in women’s attitudes toward biotechnology. In a sample of U.S. women from the National Survey of Fertility Barriers, we examine how women with and (...) without a biomedical barrier to fertility evaluate biotechnology for infertility, which, we argue, reflects differences in technological salience. For women with a biomedical barrier, various experiences, beliefs, and values impacted their attitudes; yet, most of these did not affect attitudes if women had not experienced a fertility barrier. Results suggest that technological salience contextualizes women’s attitudes toward these biotechnologies and may also have broader implications for other biotechnologies. (shrink)

Recent research in social psychology suggests that many beliefs are formed as a result of implicit biases in favour of members of certain groups and against members of other groups. This article argues that beliefs of this sort present a counterexample to accessibilism in epistemology because the position cannot account for how the epistemic status of a belief that is the result of an implicit bias can differ from that of a counterpart belief that is the result of an unbiased (...) response to the available evidence. (shrink)

Critical Notice on Organizations as Wrongdoers By Stephanie Collins Oxford University Press, 2023. -/- Extract: What, if any, role does metaphysics have to play in addressing moral questions? When answering questions about moral responsibility, many theories rely on answers to questions about the nature of agency and agents, the persistence of persons and the existence and nature of free will. In recent work in social ontology, philosophers have argued for views of social categories or identities that take ethical and social–political (...) desiderata into consideration in several ways. Some argue for views of gender identities that depend on epistemic and ethical considerations (Bettcher, 2009). Others develop views of gender categories in ways they take to be metaphysically realist, tracking robust explanatory patterns in the world. For instance, Barnes (2017) argues for this interpretation of Haslanger’s views of racial and gender categories. Others argue that injustice and oppression are reflected in the nature of social categories. For instance, while it ought not to be this way, some gender categories are, for instance, trans-exclusionary (Ásta 2018). Indeed, one might even argue that social categories can involve a distinctively metaphysical form of oppression (Jenkins 2020, 2023). It is clear that many philosophers argue in ways that draw close connections between metaphysical and moral theorizing. ... (shrink)

We welcome Ballantyne & Schaefer’s discussion of the issues concerning consent and use of health data for research. In response to their acknowledgement of the need for public debate and discussion, we provide evidence from our own public consultation on this topic.

This paper unifies the disparate analyses in Heidegger's lecture course, The Fundamental Concepts of Metaphysics: World, Finitude, Solitude, in a single therapeutic and philosophical project. By taking seriously the text's claim to lead us towards authenticity, I show how Heidegger's analysis of boredom works together with his comparative analysis of man and animal to diagnose and lead us out of our contemporary complacency about being. This reading puts both analyses in a new light, reveals the hidden strategic unity of the (...) lecture course, and brings out the therapeutic dimension of Heidegger's phenomenology. (shrink)

In the March 2010 edition of Mayo Clinic Proceedings, Drs. Rose and Curry declared that resident physicians have an ethical duty to reduce error during periods of fatigue. Problematically, however, they argued this means ingesting a stimulant for performance enhancement and sleep avoidance during a shift when a resident physician is experiencing fatigue as the more ethical choice than forgoing ingesting a stimulant. Rather than accepting enhancement as an unstoppable technological imperative, this article will examine the underlying motivations for enhancement (...) embedded in our culture and the corresponding legal framework relating to stimulant drugs. Although our society seems to be engaged in a pharmacological arms race of efficiency, competition, and self “betterment,” the FDA has not approved stimulant drugs such as modafinil for PESA. As a result, the off-label use of modafinil for PESA means these individuals are part of a large-scale experiment that poses serious immediate and long-term side effects to the individual user as well as society. (shrink)

This book presents an interpretive analysis of the major themes and purpose of Alexis de Tocqueville’s and Gustave de Beaumont’s first work, On the Penitentiary System, thereby offering new insights into Tocqueville as a moderate liberal statesman. The book explores Tocqueville’s thinking on penitentiaries as the best possible solution to recidivism, his approach to colonial imperialism, and his arguments on moral reformation of prisoners through a close reading of Tocqueville’s first published text. The unifying political concept of all three discussions (...) is Tocqueville’s underlying concern to pursue moderation between institutional and imaginative extremes in order to maintain liberal values. In both thinking moderately and advocating for moderate political action, Tocqueville’s On the Penitentiary System renews an emphasis on the importance of civic engagement and the balance between philosophy and praxis. (shrink)

Individuals with substance use disorders exhibit risk-taking behaviors, potentially leading to negative consequences and difficulty maintaining recovery. Non-invasive brain stimulation techniques such as transcranial direct current stimulation have yielded mixed effects on risk-taking among healthy controls. Given the importance of risk-taking behaviors among substance-using samples, this study aimed to examine the effects of tDCS on risk-taking among a sample of adults using cannabis. Using a double-blind design, 27 cannabis users [M age = 32.48, 41% female] were randomized, receiving one session (...) of active or sham tDCS over the bilateral dorsolateral prefrontal cortex. Stimulation parameters closely followed prior studies with anodal right dlPFC and cathodal left dlPFC stimulation. Risk-taking—assessed via a modified Cambridge Gambling Task—was measured before and during tDCS. Delay and probability discounting tasks were assessed before and after stimulation. No significant effects of stimulation on risk-taking behavior were found. However, participants chose the less risky option ∼86% of the trials before stimulation which potentially contributed to ceiling effects. These results contradict one prior study showing increased risk-taking among cannabis users following tDCS. There was a significant increase in delay discounting of a $1000 delayed reward during stimulation for the sham group only, but no significant effects for probability discounting. The current study adds to conflicting and inconclusive literature on tDCS and cognition among substance-using samples. In conclusion, results suggest the ineffectiveness of single session dlPFC tDCS using an established stimulation protocol on risk-taking, although ceiling effects at baseline may have also prevented behavior change following tDCS. (shrink)

Addressing religion and feminism on a global scale, this unprecedented book contains a nuanced and fine-tuned treatment of seven of the world's religions from a feminist perspective by leading women scholars. The fact that these authors share a dual but undivided commitment both to themselves as women and to their traditions as adherents imparts to their voices a prophetic quality, and if Mahatma Gandhi is to be believed, even scriptural value.

We show that for random bit strings, Up, with probability, image, the first order quantifier depth D) needed to distinguish non-isomorphic structures is Θ, with high probability. Further, we show that, with high probability, for random ordered graphs, G≤,p with edge probability image, D)=Θ, contrasting with the results for random graphs, Gp, given by Kim et al. [J.H. Kim, O. Pikhurko, J. Spencer, O. Verbitsky, How complex are random graphs in first order logic? Random Structures and Algorithms 26 119–145] of (...) D)=log1/pn+O. (shrink)

Newman’s dramatic poem, “The Dream of Gerontius”, was set to music by Edward Elgar in 1900. This essay brings out the sympathy of mind and heart between poet and composer, and perhaps between them both and the listener of today, as well as the universality and depth of the human stake in some kind of personal and peopled life after death.