Philosophers of science have had little to say about ‘middle-range theory’ although much of what is done in science and of what drives its successes falls under that label. These lectures aim to spark an interest in the topic and to lay groundwork for further research on it. ‘Middle’ in ‘middle range’ is with respect to the level both of abstraction and generality. Much middle-range theory is about things that come under the label ‘mechanism’. The lectures explore three different kinds (...) of mechanism: struc tural mechanisms or underlying systems that afford causal pathways; causal-chain mechanisms that are represented in what in policy contexts are called ‘theories of change’ and for which I give an extended account following the causal process theory of Wesley Salmon; and middle-range-law mechanisms like those discussed by Jon Elster, which I claim are —and rightly are— rampant throughout the social sciences. The theory of the democratic peace, that democracies do not go to war with democracies, serves as a running example. The discussions build up to the start of, first, an argument that reliability in social (and natural) science depends not so much on evidence as it does on the support of a virtuous tangle of practices (without which there couldn’t even be evidence), and second, a defence of a community-practice centred instrumentalist understanding of many of the central basic principles that we use (often successfully) in social (and in natural) science for explanation, prediction and evaluation. (shrink)

Wolfgang Spohn’s Frege prize lecture, like the work on which it is based, is a tour de force of rich, elegant, coherent argument about how the projected world that we experience is constructed. But we do not live in this projected world nor reason about it. The things Spohn constructs are there from the start—or so my Stanford School pragmatism teaches. This paper explores a deep difference in philosophical approaches—Spohn’s elegant proofs versus the stocky, tangled arguments I advocate—and illustrates how (...) these play out in far more detailed disputes about the nature of causality and causal inference. (shrink)

It is widely assumed that informing prospective subjects about the risks and possible benefits of research not only protects their rights as autonomous decisionmakers, but also empowers them to protect their own interests. Yet interviews with patient‐subjects conducted under the auspices of the Advisory Committee on Human Radiation Experiments suggest this is not always the case. Patient‐subjects often trust their physician to guide them through decisions on research participation. Clinicians, investigators, and IRBs must assure that such trust is not misplaced.

Probability is a guide to life partly because it is a guide to causality. Work over the last two decades using Bayes nets supposes that probability is a very sure guide to causality. I think not, and I shall argue that here. Almost all the objections I list are well-known. But I have come to see them in a different light by reflecting again on the original work in this area by Wolfgang Spohn and his recent defense of it in (...) a paper titled “Bayesian Nets Are All There Is to Causality”. (shrink)

As a response to Le Fils, a film directed by the Dardenne brothers (), we explore the idea of speaking as an invitation and juxtapose it against ideas of speaking as a transactional, calculative, calibrated, activity. Speaking tends to be understood as a relatively straightforward matter: as a means of communication structured by such values as the reciprocal balancing of rights and obligations, of clear communication of information, of the gaining of insight into what is happening. Speaking, then, is a (...) means by which we explain, prove or pass judgement on something. Understood this way, it is easily associated with ideas of empowerment or of the mediation of information: one directs or commits oneself to a (shared) orientation—for example to what Jürgen Habermas refers to as ‘communicative reason’. It presupposes a particular attitude of the subject; speaking that addresses the listener and the speaker herself in the name of an orientation or particular expertise to which access is claimed. In this article, by contrast, we would like to explore a different avenue of thought whereby speaking appears rather as an abandoning or exposing of oneself. It is less an activity than a passivity or passion, through which one becomes present in the present, which is at once also a kind of invitation. In exploring this form of speaking, we take up some ideas of Martin Buber. Our discussion relates speaking to being inspiring and being inspired, revealing in the process the way that to be inspiring is at the same time to be inspired. Speaking as invitation, we conclude, is what education is about. (shrink)

This paper raises health equity concerns about the use of passports for domestic and international travel to certify COVID-19 vaccination. Part I argues that for international travel, health equity objections undercut arguments defending vaccine passports, which are based on tholding people responsible, protecting global health, safeguarding individual liberty and continuing current practice. Part II entertains a proposal for a scaled down vaccine passport for domestic use in countries where vaccines are widely and equitably available. It raises health equity concerns related (...) to racial profiling and fairness to people who are vaccine cautious. Part III sets forth a proposal for a flexible pass that certifies people who have been vaccinated, tested, previously infected or granted a conscientious objection. It sets ethical guidelines for the timing and use of flexible passes that promote equity, public health education, antidiscrimination, privacy and flexibility. (shrink)

Societal aging raises challenging ethical questions regarding the just distribution of health care between young and old. This article considers a proposal for age-based rationing of health care, which is based on the prudential life span account of justice between age groups. While important objections have been raised against the prudential life span account, it continues to dominate scholarly debates. This article introduces a new objection, one that develops out of the well-established disability critique of social contract theories. I show (...) the implications of this critique for the prudential life span account and for the special case of age-group justice. The result is that age-based rationing based on the prudential life span approach is not supported, and that the prudential life span approach itself is not the best way to think about allocating health care between age groups. I propose an alternative approach that avoids the disability objection, and consider its implications for specific proposals for age-based rationing of health care. (shrink)

An advertising firm''s ethical culture (as defined by the firm''s managerial and peer ethical behaviors) may affect the employees'' comfort levels and ethical behaviors. In this research, scenarios were used to describe advertising firms with various ethical cultures. Respondents'' perceived comfort levels in working for the firms described in the scenarios and the respondents'' behavioral intentions when faced with various advertising situations were assessed. Results of the study indicate that peer ethical behavior exerts a strong influence on the comfort or (...) discomfort level and the ethical behavioral intentions of potential advertising employees. Further, the strong influence exerted by peers seems to transcend the ethical behavior of the manager and carry over to the attitude toward the entire corporate advertising environment. This study provides insights for firms and researchers interested in assessing the impact of an advertising firm''s ethical culture on potential employees. (shrink)

Baconian science, a tool for plundering nature, has impelled physicians to insist on medical treatment even when it is futile. The Hippocratic tradition of medicine teaches us instead to acknowledge nature's limits.

A caregiver from the dominant U.S. culture and a patient from a very different culture can resolve cross‐cultural disputes about treatment, not by compromising important values, but by focusing on the patient's goals.

The precautionary principle is an emerging principle of international law but has only recently been proposed in North America as a new basis for environmental policy. On the surface it is a simple, common-sense proposition: in the face of possible harm, exercise precaution. But the enthusiasm the principle has stirred among public advocates suggests it has a deeper appeal. It is, in fact, based on values related to “forecaring for life” and the natural world. The principle cannot effectively be invoked (...) without stating these values up front. The principle makes it clear that decisions and developments in science and technology are based first of all on values and only secondarily on scientific and technological fact and process. Moreover, a precautionary approach is best carried out in the context of goals that embody the values of communities and societies. (shrink)

This paper addresses bioethics in the context of the coronavirus disease 2019 (COVID‐19) pandemic. The Introduction (Section 1) highlights that at the field's inception, infectiousness was not front and center. Instead, infectious disease was widely perceived as having been conquered. This made it possible for bioethicists to center values such as individual autonomy, informed consent, and a statist conception of justice. Section 2 urges shifting to values more fitting for the moment the world is in. To find these, it directs (...) attention to the Global South, and in particular, Africa, and to the values of ubuntu, solidarity, dignity, kinship, and humility. The paper concludes (in Section 3) that 21st‐century challenges facing bioethics are increasingly global, and calls on bioethicists themselves to be more globally inclusive in their approaches. (shrink)

Conventional accounts like the deductive‐nomological model suppose that high‐level theories couched in abstract language encompass or imply more low‐level laws expressed in more concrete language. The truth of phenomenological laws is then supposed to provide evidence for the truth of the theory. This chapter argues that, to the contrary, approximations are required to arrive at phenomenological laws and generally these approximations improve on theory and are not dictated by the facts. Examples include an amplifier model, exponential decay and the Lamb (...) shift. (shrink)

I argue that Nelson's feminist transformation of empiricism provides the basis of a dialogue across three currently competing feminist epistemologies: feminist empiricism, feminist standpoint theories, and postmodern feminism, a dialogue that will result in a dissolution of the apparent tensions between these epistemologies and provide an epistemology with the openness and fluidity needed to embrace the concerns of feminists.

This case consultation offers three cases that illustrate a collaborative consultation model for psychiatric ethics that we have developed in outpatient clinic and in emergency psychiatry over the last 10 years. After we present these cases, we discuss three points of interest: 1) the characteristics we found to be important to our collaborative project, 2) the benefits of an integrative approach, and 3) ways that our collaborative moral reasoning developed our awareness of and sensitivity to ethical issues. We end by (...) raising some topics on which commentators could engage.Potter began working with El-Mallakh more than 10 years ago. Her impetus was that she was writing a critique of the criteria used in borderline... (shrink)

This paper considers the proposal to pay people to get vaccinated against the SARS-CoV-2 virus. The first section introduces arguments against the proposal, including less intrusive alternatives, unequal effects on populations and economic conditions that render payment more difficult to refuse. The second section considers arguments favouring payment, including arguments appealing to health equity, consistency, being worth the cost, respect for autonomy, good citizenship, the ends justifying the means and the threat of mutant strains. The third section spotlights long-term and (...) short-term best practices that can build trust and reduce ‘vaccine hesitancy’ better than payment. The paper concludes that people who, for a variety of reasons, are reluctant to vaccinate should be treated like adults, not children. Despite the urgency of getting shots into arms, we should set our sights on the long-term goals of strong relationships and healthy communities. (shrink)

« La liberté : ce singulier ne désigne pas ici une essence à laquelle rapporter toutes nos “libertés”. Il suspend au contraire toute détermination de ces “libertés”, qu’on sait bien “formelles”, sans pourtant vouloir le savoir… Il le fait au nom de l’expérience singulière de ce qui est sans essence : l’existence même. Cette expérience est un fait, lui aussi singulier, car il n’obéit pas à une logique du “fait” opposé à la “loi”. Ni fait, ni loi, mais l’être même (...) en tant que partage de l’existence. La pensée en provient, elle ne s’en empare pas. Quant elle s’ouvre à cette expérience, elle pense son possible hors d’elle-même, comme chose, force ou regard. La liberté est l’in-fini de la pensée. ». (shrink)

The indiscriminate use of cardiopulmonary resuscitation (CPR), untempered by evidence about outcomes, has been called “irrational exuberance” (Rosoff and Schneiderman 2017). There is much to be sai...

Work by social constructionists over the past decade and a half has reenforced the epistemological pessimist's despair that our system of science could ever be a mirror of nature. Realists argue that the amazing success of modern science at precise prediction and control indicates just the contrary. In response, social constructionists often point out that these successes seldom apply to the world as it comes naturally, but only as it is reconstructed in the scientist's laboratory. But this does not explain (...) how scientific accounts, which are as wide of the mark as constructionists suppose in their general descriptions of the natural world, could be so effective in a limited environment, even if that environment is as benignly constructed as possible. This paper suggests that a more wholistic view of nature than modern science usually presupposes may provide an answer. (shrink)

La création de la Commission de la santé et des services sociaux des Premières Nations du Québec et du Labrador (CSSSPNQL) date de 1994. L’Assemblée des Chefs des Premières Nations du Québec et du Labrador a entériné sa création afin de faire valoir le droit inhérent des Premières Nations de concevoir et de livrer des services de santé et sociaux culturellement convenables.L’Assemblée des Premières Nations du Québec et du Labrador (APNQL) est constituée de l’ensemble des Chefs des communautés..

Le 17 juillet 2017, Werner,Werner, toi ici avec nous, toi si proche et si lointain, aussi lointain que proche,Werner, plus loin…Werner je suis sans parole – et tu dis aussitôt : « Qui est sans parole a dans sa privation même quelque chose de la parole ».Quelque chose ou peut-être tout vas-tu dire car on ne parle qu’à partir du manque de parole et on cherche sa propre disparition.Parce que je suis sans parole, je me trouve là où tu veux. (...) Là où il est question de « l’aphasie structurelle du lan... (shrink)

In the first two chapters, Cohen deals with justice, freedom, and equality without mention of self-ownership, offering a devastating critique of the libertarian claim that despite great economic inequality, laissez-faire capitalism is the most just society because it is the most free. The assumption, made by liberals as well as libertarians, that we have to choose between liberty and equality fails to acknowledge that a system based on large-scale private property entails the unfreedom of the majority without property. Cohen shows (...) the libertarian claims to rest on circularity and on abuse of the ordinary language of freedom. (shrink)

Approximately 20% of adult cancer patients are eligible to participate in a clinical trial, but only 2.5-9% do so. Accrual is even less for minority and medically underserved populations. As a result, critical life-saving treatments and quality of life services developed from research studies may not address their needs. This study questions the utility of the bioethical concern with therapeutic misconception (TM), a misconception that occurs when research subjects fail to distinguish between clinical research and ordinary treatment, and therefore attribute (...) therapeutic intent to research procedures in the safety net setting. This paper provides ethnographic insight into the ways in which research is discussed and related to standard treatment. (shrink)