This paper evaluates four recent randomized clinical trials in which the informed consent of participants was either not sought at all, or else was conducted with critical information missing from the consent documents. As these studies have been taking place, various proposals to conduct randomized clinical trials without consent have been appearing in the medical literature. Some of the explanations offered for why it is appropriate to bypass consent or disclosure requirements appear to represent a fundamental misunderstanding of applicable government (...) regulations and even the research enterprise. Others are the result of conceptual disagreements about the importance and application of traditional research ethics norms to ‘comparative effectiveness research’ and modern research environments. Common among these explanations, however, is a failure to appreciate when a research intervention, rather than merely an observation or review of data, is taking place. Review committees and investigators are failing to see, or choosing to ignore, interventions in the lives of research subjects. When these studies have come to light, government agencies with oversight authority have done little or backed down. Prestigious medical journals have published research results knowing that the required consent was not obtained, or they have stood by the published studies even after the inadequacy of consent is discovered. This article critically examines this erosion of consent in theory and practice and calls for restoring the requirement of informed consent to its proper place as a priority in human subjects research. (shrink)

The Office for Human Research Protections was correct in determining that the consent forms for the National Institutes of Health -sponsored SUPPORT study were seriously flawed. Several articles defended the consent forms and criticized the OHRP's actions. Disagreement focuses on three central issues: how risks and benefits should be described in informed consent documents; the meaning and application of the concept of “standard of care” in the context of research; and the proper role of OHRP. Examination of the consent forms (...) reveals that they failed to disclose the reasonably foreseeable risks of the experimental interventions in the study, as well as the potential for differences in the degree of risk between these interventions. Although the concept of “standard of care” may be helpful in determining the ethical acceptability of other aspects of research, such as clinical equipoise, it is not helpful in discussing consent requirements. (shrink)

Ruth Garrett Millikan presents a strikingly original account of how we get to grips with the world in thought. Her question is Kant's 'How is knowledge possible?', answered from a contemporary naturalist standpoint. We begin with an understanding of what the world is like prior to cognition, then develop a theory of cognition within that world.

This book reassesses theories of agency and gender identity against the backdrop of changing relations between men and women in contemporary societies.

‘According to informational semantics, if it's necessary that a creature can't distinguish Xs from Ys, it follows that the creature can't have a concept that applies to Xs but not Ys.’ There is, indeed, a form of informational semantics that has this verificationist implication. The original definition of information given in Dretske'sKnowledge and the Flow of Information, when employed as a base for a theory of intentional representation or ‘content,’ has this implication. I will argue that, in fact, most of (...) what an animal needs to know about its environment is not available as natural information of this kind. It is true, I believe, that there is one fundamental kind of perception that depends on this kind of natural information, but more sophisticated forms of inner representation do not. It is unclear, however, exactly what ‘natural information’ is supposed to mean, certainly in Fodor's, and even in Dretske's writing. In many places, Dretske seems to employ a softer notion than the one he originally defines. I will propose a softer view of natural information that is, I believe, at least hinted at by Dretske, and show that it does not have verificationist consequences. According to this soft informational semantics, a creature can perfectly well have a representation of Xs without being able to discriminate Xs from Ys. (shrink)

This paper shows how the mythology surrounding rape enters into a criterion of reasonableness which operates through the legal system to make women vulnerable to unscrupulous victimization. It explores the possibility for changes in legal procedures and presumptions that would better serve women's interests and leave them less vulnerable to sexual violence. This requires that we reformulate the criterion of consent in terms of what is reasonable from a woman's point of view.

I conclude that it is more accurate to say that, rather than trying to make logic metaphysical, Leibniz tries, in the context of a theistic system, to make metaphysics logical. ;I begin with a study of the principle of identity of indiscernibles, and show how it is best thought of as a principle which follows from a metaphysical interpretation of the principle of sufficient reason. It has been traditional to interpret the principle of identity of indiscernibles as primarily a merely (...) logical principle, and thus as either trivially true, if Leibniz succeeds in proving it, or else false or contingently true. I argue that it is instead necessarily true in a non-trivial or metaphysical sense, because the principles on which it is based are themselves of this metaphysical character, contrary to what is often assumed. ;In the second chapter, I show how God's activity and a metaphysical interpretation of the principle of sufficient reason underlie Leibniz's account of space and time. ;In the third chapter, I discuss the principle of sufficient reason in detail, showing that it actually consists of three separate principles: the principle of grounds, that every true proposition has a proof a priori; the principle of reason, that God does nothing without a sufficient reason; and the principle of causation, that every event has a cause. That each of these is considered a principle of sufficient reason is explained by Leibniz's equivocal use of the term 'reason.' I show that, of the various versions of the principle of sufficient reason, only the principle of reasons provides an adequate foundation for Leibniz's principle of identity of indiscernibles and theory of space and time. Furthermore, since chapters one and two show how the activity of God is presupposed by Leibniz's metaphysics, for Leibniz to derive his metaphysics from his logic, as some would have us suppose, he would have to provide a satisfactory a priori demonstration of God's existence. But this, I argue, he cannot do. Thus God's existence and rationality, rather than subject-predicate logic, are the foundations of Leibniz's metaphysics. ;It is commonplace, when writing about Leibniz, to give primacy to his logic over his metaphysics, and indeed to try to assimilate the latter to the former. In this essay, however, I give priority to Leibniz's metaphysical pronouncements, apart, as much as possible, from logical and linguistic considerations. (shrink)

Dieser Aufsatz möchte zeigen, daß Leibniz Freiheit nur in dem Sinne Kontingenz voraussetzt, daß andere Handlungsweisen als absolut möglich denkbar sein müssen. Freiheit besteht nicht in der bloßen Illusion, daß unsere Handlungen nicht durch unseren vollständigen Begriff verursacht und bestimmt sind, sondern in der epistemischen Möglichkeit des Handelnden, anders zu handeln. Für endliche Wesen impliziert diese epistemische Möglichkeit die Unkenntnis des göttlichen Plans. Für Gott ist sie begründet in dem intellektuellen Bewußtsein, daß die Handlungen von seinem Willen, der aufgrund der (...) göttlichen Vollkommenheit stets das Beste wählt, abhängen. Daher wählt Gott die beste der möglichen Welten. Gott ist sich bewußt, daß er eine andere mögliche Welt erschaffen könnte, wenn er wollte, aber gleichzeitig ist er sich bewußt, daß er das niemals wollen wird. (shrink)

Since the last issue of Feminist Legal Studies, we editorial board members have had lots of conversations about comfort, displacement and alienation. As we developed the programme for #FLaK2016 we thought about it as a kind of pulling ourselves out of our comfort zone, if academic events and journals ever have a comfort zone. Drawing on a mix of feminist live performance methods and a science and technology studies-type curiosity for objects of experimentation, we tried out a kitchen table method (...) of hosting a live research conversation with activists, artists and academics over two days. But we had not fully anticipated the way that the Brexit result would contribute to and complicate discomfort. A fuller analysis of FLaK awaits a later moment, but here we pick out this one aspect of our gathering—feelings of discomfort – as they animate the contributions to this issue in interesting ways. (shrink)

Most of Christine Swanton’s quotations from and references to Nietzsche are drawn The Genealogy of Morals, Thus Spoke Zarathustra, and Beyond Good and Evil. I suggest that Human, All too Human and Daybreak, two of Nietzsche’s most neglected works, provide rich resources for Swanton’s interpretation of Nietzsche’s view of self-love and its defining role in genuinely ethical action. Self-love assumes a central place in these writings, as do its cognate concepts of egoism and vanity. I outline some of the reasons (...) why these two middle period writings recommend themselves powerfully for Swanton’s philosophical purposes. I examine to what extent passages on self-love from these neglected works nourish, but also to what extent they challenge or upset, the central place accorded to self-love in Swanton’s recalibration of virtue ethics. (shrink)

In view of a resurgence of concern about the measurement problem, it is pointed out that the Relativistic Transactional Interpretation remedies issues previously considered as drawbacks or refutations of the original TI. Specifically, once one takes into account relativistic processes that are not representable at the non-relativistic level, absorption is quantitatively defined in unambiguous physical terms. RTI therefore provides a well-defined terminus to what appears to be a necessary infinite regress concerning ‘absorption’ when only the non-relativistic level is considered. In (...) addition, specifics of the relativistic transactional model demonstrate that the Maudlin ‘contingent absorber’ challenge to the original TI cannot even be mounted: basic features of established relativistic field theories dictate that the ‘slow-moving offer wave’ required for the challenge scenario cannot exist. It is concluded that issues previously considered obstacles for TI are no longer legitimately viewed as such, and that reconsideration of the transactional picture is warranted in connection with solving the measurement problem. (shrink)

The human imagination remains one of the last uncharted terrains of the mind. People often imagine how events might have turned out something had been different. The of reality, those aspects more readily changed, indicate that counterfactual thoughts are guided by the same principles as rational thoughts. In the past, rationality and imagination have been viewed as opposites. But research has shown that rational thought is more imaginative than cognitive scientists had supposed. In The Rational Imagination, I argue that imaginative (...) thought is more rational than scientists have imagined. People exhibit remarkable similarities in the sorts of things they change in their mental representation of reality when they imagine how the facts could have turned out differently. For example, they tend to imagine alternatives to actions rather than inactions, events within their control rather than those beyond their control, and socially unacceptable events rather than acceptable ones. Their thoughts about how an event might have turned out differently lead them to judge that a strong causal relation exists between an antecedent event and the outcome, and their thoughts about how an event might have turned out the same lead them to judge that a weaker causal relation exists. In a simple temporal sequence, people tend to imagine alternatives to the most recent event. The central claim in the book is that counterfactual thoughts are organised along the same principles as rational thought. The idea that the counterfactual imagination is rational depends on three steps: (1) humans are capable of rational thought; (2) they make inferences by thinking about possibilities; and (3) their counterfactual thoughts rely on thinking about possibilities, just as rational thoughts do. The sorts of possibilities that people envisage explain the mutability of certain aspects of mental representations and the immutability of other aspects. (shrink)

Subject & Object is a thematic collection of classic works by Max Horkheimer, Theodor Adorno, and Herbert Marcuse, designed to foreground the authors' philosophical concerns, especially in the areas of epistemology, ontology, and method. The volume, which includes lucid introductions to all of the selections, illustrates Frankfurt School approaches to questions such as the nature of reason; the limits of empiricism, pragmatism and Kantian transcendental idealism; the case for materialism; the difficulty of thinking counterfactually; and the ideological character of mainstream (...) social science. Many of the pieces in the volume are otherwise out of print. Subject & Object will be a resource for social, political, and cultural theorists who may be less familiar with the philosophical aspects of the Frankfurt School, for analytic philosophers who may not have had previous exposure to their work at all, and for anyone wanting access to these seminal texts. (shrink)

This quotation from the London Review of Books is an example of a turn—a different way of looking at things that involves a redefinition of the kind of thing higher education is and how it should be provided. It is a turn away from a public good perspective—the opposite, it might be said, of the kind of turn addressed in this article.

The relation between leibniz's logical and his metaphysical views is the subject of much modern scholarship. Some commentators have argued that his metaphysics is based on his logic; others have taken the opposite position. However, Both sides pose the question in terms of 'priority'. On the contrary, I argue that it is likely that leibniz means the psr to play "both" a logical and a metaphysical role. The ambiguity of leibniz's psr indicates that he equates the metaphysical notion of causation (...) with the logical notion of deduction. The psr's ambiguity results less from any confusion on leibniz's part between the notions of cause and reason, Than from his desire to identify logic and metaphysics. That identity is achieved not by reducing one to the other, But by incorporating them on an equal basis into a single discipline. (shrink)

In February 2020, the British Medical Association will be surveying members for their views on what the BMA’s position on physician-assisted dying should be. The BMA is currently opposed to physician-assisted dying in all its forms, a position that was agreed in 2006 at the annual representative meeting, the Association’s policy-making conference.1 As previously reported in Ethics briefing,2 the decision to survey members follows a motion passed at last year’s ARM which called on the BMA to “carry out a poll (...) of members to ascertain their views on whether the BMA should adopt a neutral position with respect to a change in the law on assisted dying”. The results from the survey will not determine BMA policy. Rather, the results be published ahead of this year’s ARM and provided to those attending to inform a debate and discussion on the BMA’s policy position. More information about the survey, including a briefing pack of useful information, and information for BMA members on how to participate can be found online at www.bma.org.uk/PAD. ### High Court rejects Judicial reviews on assisted suicide The High Court has refused permission for two separate challenges to the law on assisted suicide in the UK to proceed to a full hearing. In the first case, Phil Newby, who has motor neuron disease, applied for judicial review of the law on assisted suicide and asked for the court to carry out a detailed examination of what he termed “legislative facts” – that is, an examination of the existing evidence on the “costs, risks and benefits” of regulating assisted suicide – including a cross-examination of relevant expert witnesses.1 Handing down the judgement, Lord Justice Irwin and Mrs Justice May, held that assisted dying …. (shrink)

In this study we compared the ethical attitudes of a group of experienced, predominantly female, registered nurses (n = 67) with those of a group of final year, mixed sex, medical students (n = 125). The purpose was to determine the basis of differences in attitudes that could lead to ethical disagreements between these two groups when they came to work together. A questionnaire developed to explore ethical attitudes was administered and the responses of the two groups were compared using (...) t-tests. Because of the preponderance of females among the nurses an analysis of variance of the gender-adjusted scores for each group was also carried out. On comparing the responses, the nurses differed significantly from the medical students in a number of ethical domains. A potential source of conflict between these two groups is that the nurses were inclined to adopt the perspective of patients but the medical students identified with their profession. When corrected for the effects of gender, the differences persisted, indicating that it was discipline that determined the differences. We recommend that students of nursing and medicine receive ethics education together, and that more open dialogue between doctors and nurses with respect to their different ethical viewpoints is needed in the work setting. This article will be of interest to educators of students of medicine and nursing, as well as to doctors and nurses who are eager to improve their professional relations and thereby improve patient care. (shrink)

On occasion, British in vitro fertilization practitioners look over the ocean to the practice of IVF and embryo research in the United States, wonder why these areas are subject to less regulation than in the United Kingdom, and ask how much less risky and more progressive IVF and embryo research might be if subject to additional federal, or at least state, regulation. To an American audience, imbued with the centuries‐old spirit of independence, regulation and autonomy can seem in tension. From (...) a British perspective, there is no necessary conflict. There is no dissent in the United Kingdom from the proposition that individual activities, services, and industries can be regulated and, at the same time, retain and exercise such autonomy as is their right within a safe sphere. From 1994 to 2002, I was the chair of the United Kingdom's Human Fertilisation and Embryology Authority, which regulates the practice of IVF and embryo research. The existence of the HFEA assures patients that safety and aspects of the practice of assisted reproduction are monitored, leaving them free to choose without worrying about danger, in the same way that the public may take only those drugs that have passed health and safety tests. I would propose that anxious and vulnerable patients do not have more autonomy in a less regulated, market‐driven field. (shrink)

In ihrem Beitrag: „Poisoning the well, or how economic theory damages moral imagination" (Nelson 2016) fragt Julie Nelson -/- "What if people might act out of social and other-regarding concerns, as well as reasonable self-interest in their economic lives, but are pushed by the economic theory of self-interested utility maximization to believe that it is permissible – and perhaps even appropriate – to be irresponsible, opportunistic, and selfish when participating in markets? What if business leaders might pay attention to the (...) implications of their decisions for workers, communities, the environment, and others who are affected by their firm's actions, but economic theory encourages them to believe that they should – and in fact must – focus on getting every last dollar of profit possible?" (Nelson 2016: 184) -/- Ich lese diese Fragen von Nelson als einen Appell, die Theorie der Ökonomie umfassend auf ihre Tauglichkeit für unsere Lebenswirklichkeit zu hinterfragen. Die Theorien der Ökonomie mögen Disziplinen-intern funktional sein, sie sind damit noch lange nicht lebenstauglich. Im Gegenteil, sie erweisen sich als Überlebens-avers, im schlimmsten Falle, Leben-zerstörend. Die Aufgabe, das Wozu der Wirtschaftsphilosophie lässt sich von hier aus schon trefflich bestimmen. Die Herausforderung jedoch bleibt, Umfang und Perspektive, von wo aus die Kritik und auch die In-Blicknahme des Ganzen geschehen kann, zu verorten, und genau dieses Anliegen ist im Beitrag von Ingo Pies und Marc Hübscher zentral: Aus welcher Perspektive kann diese Frage beantwortet werden, wenn diese Bestimmung als denkerische Selbstaufklärung realisiert werden soll? (shrink)

The Conservative Manifesto has to be scoured for policies which might improve the lives of women as a sex. There is a section on animal welfare but nothing on the welfare of women. Little attention is paid to women's special problems either at work or as carers in the home. Yet much Conservative social policy depends on women as unpaid carers. (St-John Brooks, 1987).

This article proposes a third way of reading Nietzsche's remarks on women, one that goes beyond misogyny and metaphor. Taking the depiction of women in the works of the middle period at face value shows that these works neither entirely demean women nor exclude them from the higher life. Nietzsche's middle period comprises HAH (1879-80, which includes "Assorted Opinions and Maxims" and "The Wanderer and His Shadow"), D (1881) and GS (1882). The works of this period do not disqualify women (...) from free spirithood, for some of their passages can be read as befitting some women of the future for this honour. (shrink)

The works of the middle period are sometimes labeled positivist, and one of their distinguishing features is the praise they contain for science. In these works, Friedrich Nietzsche repeatedly expresses his admiration for science’s methods and procedures, and for the values and characteristics of its practitioners. As part of his vision of an enlightened future, Nietzsche looks forward to the generation of a new aristocracy. This chapter explores the tension in these writings between his ideas of an aristocracy of spirit (...) and an aristocracy of birth. The significance of embodiment in each of these models of aristocracy is discussed, and a Nietzschean ethic of care of the self is adduced. (shrink)