Old habits die hard; so, it seems, do old arguments. Proponents of thoracoabdominal normothermic regional perfusion (TA-NRP, but more commonly referred to as NRP) continue to proffer arguments and...

Global short-term medical volunteerism is growing, and properly conducted, is a tool in the fight for greater global health equity. It is intrinsically ethical (i.e., it involves ethics at every step) and depends upon ethical conduct for its success. At present, ethical guidelines remain in their infancy, which presents a unique opportunity. This paper presents a set of basic ethical principles, building on prior work in this area and previously developed guidelines for international clinical research. The content of these principles, (...) and the benchmarks used to evaluate them, remain intentionally vague and can only be filled by collaboration with those on-the-ground in local communities where this work occurs. Ethical review must additionally take into consideration the different obligations arising from the type of institution, type of intervention, and type of relationship involved. This paper argues that frequent and formalized ethical review, conducted from the beginning with the local community (where this community helps define the terms of debate), remains the most important ethical safeguard for this work. (shrink)

Contemporary medical practice and health policy are increasingly animated by the concept of providing high value care. Nevertheless, there can be disagreements about how value is defined and from whose perspective. Individual patients suffering from terminal cancer, for example, may have a different perception of the value of an expensive chemotherapy when compared to health policymakers, insurers, or others responsible for the financial solvency of health care organizations. Thus it seems reasonable to ask what is meant by “value” in high (...) value care. In light of Edmund Pellegrino’s significant contributions to the philosophy of medicine, medical humanities, and bioethics, it seems equally reasonable to examine how he might answer it. This paper describes a Pellegrino-inspired theory of value that is instrumental, agent relative, and pluralistic. It then compares and contrasts this to the contemporary view and argues that only when individual patients incorporate concern for societal-level value into their conceptions of the highest good can the Pellegrino-inspired and contemporary views of value be reconciled. (shrink)

Volume 24, Issue 10, October 2024, Page 70-72.

While acknowledging the potential benefits of pharmacogenomics as a methodology, a number of comprehensive reports in the past several years examine a multitude of ethical, legal, and social factors that may limit the extent to which these benefits are realized — and realized in ethically acceptable ways. This article aims to identify and explore the most basic ethical and regulatory issues that are likely to arise if pharmacogenomics becomes widely enough used to have a significant impact on research and clinical (...) practice. First, however, it addresses the question of whether pharmacogenomic tests are unique when compared to other genetic tests and thus deserving of more or less stringent ethical and regulatory requirements. (shrink)

Medical aid in dying (MAiD), despite being legal in many jurisdictions, remains controversial ethically. Existing surveys of physicians’ perceptions of MAiD tend to focus on the legal or moral permissibility of MAiD in general. Using a novel sampling strategy, we surveyed physicians likely to have engaged in MAiD-related activities in Colorado to assess their attitudes toward contemporary ethical issues in MAiD.

"The overall aim of this book is to understand the character of moral progress, so that making moral progress may become more systematic and secure, less chancy and less bloody. Drawing on three historical examples - the abolition of chattel slavery, the expansion of opportunities for women, and the increasing acceptance of same-sex love - it asks how those changes were brought about, and seeks a methodology for streamlining the kinds of developments that occurred. Moral progress is conceived as pragmatic (...) progress, progress from rather than progress to, achieved by overcoming the problems and limits of the current situation. Two kinds of problems are distinguished: problems of exclusion, found when the complaints of some people are ignored; and problems of false consciousness, present when the oppressed adopt judgments from the ambient society and do not protest their condition. The proposed methodology advocates procedures for listening to voiced complaints and for systematically reviewing the way in which particular self-conceptions, ideals and identities are taken to be appropriate for various groups of people. Through outlining a picture of moral practice, at both the individual and the societal levels, the book seeks to orient moral philosophy away from metaethical questions of realism and towards moral methodology"--. (shrink)

The American Journal of Bioethics, Volume 12, Issue 8, Page 36-38, August 2012.

This innovative approach to freedom starts from an account of what we mean by describing someone, in a psychological vein, as a free subject. Pettit develops an argument as to what it is that makes someone free in that basic sense; and then goes on to derive the implications of the approach for issues of freedom in political theory. Freedom in the subject is equated with the person's being fit to be held responsible and to be authorized as a partner (...) in interaction. This book is unique among contemporary approaches - although it is true to the spirit of classical writers like Hobbes and Kant - in seeking a theory that applies to psychological issues of free agency and free will as well as to political issues in the theory of the free state and the free constitution. The driving thesis is that it is only by connecting up the different issues of freedom, psychological and political, that we can fully appreciate the nature of the questions involved, and the requirements for their resolution. The book does not not seek a comprehensive reach just for its own sake, but rather for the sake of the illumination it provides._ _ _A Theory of Freedom_ is a ground-breaking volume which will be of wide interest to scholars and students in political philosophy and political science. (shrink)

Studdert-Kennedy, Gerald, Evidence and Explanation in Social Science. ... Kauffman, Stuart, "Articulation of Parts Explanation in Biology and the Rational ...

The debate about the credentials of sociobiology has persisted because scholars have failed to distinguish the varieties of sociobiology and because too little attention has been paid to the details of the arguments that are supposed to support the provocative claims about human social behavior. I seek to remedy both deficiencies. After analysis of the relationships among different kinds of sociobiology and contemporary evolutionary theory, I attempt to show how some of the studies of the behavior of nonhuman animals meet (...) the methodological standards appropriate to evolutionary research. I contend that the efforts of E. O. Wilson, Richard Alexander, Charles Lumsden, and others to generate conclusions about human nature are flawed, both because they apply evolutionary ideas in an unrigorous fashion and because they use dubious assumptions to connect their evolutionary analyses with their conclusions. This contention rests on analyses of many of the major sociobiological proposals about human social behavior, including: differences in sex roles, racial hostility, homosexuality, conflict between parents and adolescent offspring, incest avoidance, the avunculate, alliances in combat, female infanticide, and gene–culture coevolution.Vaulting Ambitionthus seeks to identify what is good in sociobiology, to expose the errors of premature speculations about human nature, and to prepare the way for serious study of the evolution of human social behavior. (shrink)

Experiments in particle physics have hitherto failed to produce any significant evidence for the many explicit models of physics beyond the Standard Model (BSM) that had been proposed over the past decades. As a result, physicists have increasingly turned to model-independent strategies as tools in searching for a wide range of possible BSM effects. In this paper, we describe the Standard Model Effective Field Theory (SM-EFT) and analyse it in the context of the philosophical discussions about models, theories, and (bottom-up) (...) effective field theories. We find that while the SM-EFT is a quantum field theory, assisting experimentalists in searching for deviations from the SM, in its general form it lacks some of the characteristic features of models. Those features only come into play if put in by hand or prompted by empirical evidence for deviations. Employing different philosophical approaches to models, we argue that the case study suggests not to take a view on models that is overly permissive because it blurs the lines between the different stages of the SM-EFT research strategies and glosses over particle physicists' motivations for undertaking this bottom-up approach in the first place. Looking at EFTs from the perspective of modelling does not require taking a stance on some specific brand of realism or taking sides in the debate between reduction and emergence into which EFTs have recently been embedded. (shrink)

There has recently been a revival of interest in panpsychism as a theory of consciousness. The hope of the contemporary proponents of panpsychism is that the view enables us to integrate consciousness into our overall theory of reality in a way that avoids the deep difficulties that plague the more conventional options of physicalism on the one hand and dualism on the other. However, panpsychism comes in two forms — strong and weak emergentist — and there are arguments that seem (...) to show that weak emergentist panpsychism faces problems analogous to those of physicalism whilst strong emergentist panpsychism faces problems analogous to those of dualism. In this paper, I will develop a new hybrid of the strong and weak emergentist forms of panpsychism, a view according to which subjects of experience are strongly emergent but their phenomenal properties are weakly emergent. I will argue that this hybrid view manages to avoid the challenges facing both physicalism and dualism, and the analogues of those challenges that seem to undermine standard forms of panpsychism. (shrink)

Technology is a practically indispensible means for satisfying one’s basic interests in all central areas of human life including nutrition, habitation, health care, entertainment, transportation, and social interaction. It is impossible for any one person, even a well-trained scientist or engineer, to know enough about how technology works in these different areas to make a calculated choice about whether to rely on the vast majority of the technologies she/he in fact relies upon. Yet, there are substantial risks, uncertainties, and unforeseen (...) practical consequences associated with the use of technological artifacts and systems. The salience of technological failure (both catastrophic and mundane), as well as technology’s sometimes unforeseeable influence on our behavior, makes it relevant to wonder whether we are really justified as individuals in our practical reliance on technology. Of course, even if we are not justified, we might nonetheless continue in our technological reliance, since the alternatives might not be attractive or feasible. In this chapter I argue that a conception of trust in technological artifacts and systems is plausible and helps us understand what is at stake philosophically in our reliance on technology. Such an account also helps us understand the relationship between trust and technological risk and the ethical obligations of those who design, manufacture, and deploy technological artifacts. (shrink)

In his monograph On Numbers and Games, J. H. Conway introduced a real-closed field containing the reals and the ordinals as well as a great many less familiar numbers including $-\omega, \,\omega/2, \,1/\omega, \sqrt{\omega}$ and $\omega-\pi$ to name only a few. Indeed, this particular real-closed field, which Conway calls No, is so remarkably inclusive that, subject to the proviso that numbers—construed here as members of ordered fields—be individually definable in terms of sets of NBG, it may be said to contain (...) “All Numbers Great and Small.” In this respect, No bears much the same relation to ordered fields that the system ℝ of real numbers bears to Archimedean ordered fields. In Part I of the present paper, we suggest that whereas $\mathbb{R}$should merely be regarded as constituting an arithmetic continuum, No may be regarded as a sort of absolute arithmetic continuum, and in Part II we draw attention to the unifying framework No provides not only for the reals and the ordinals but also for an array of non-Archimedean ordered number systems that have arisen in connection with the theories of non-Archimedean ordered algebraic and geometric systems, the theory of the rate of growth of real functions and nonstandard analysis. In addition to its inclusive structure as an ordered field, the system No of surreal numbers has a rich algebraico-tree-theoretic structure—a simplicity hierarchical structure—that emerges from the recursive clauses in terms of which it is defined. In the development of No outlined in the present paper, in which the surreals emerge vis-à-vis a generalization of the von Neumann ordinal construction, the simplicity hierarchical features of No are brought to the fore and play central roles in the aforementioned unification of systems of numbers great and small and in some of the more revealing characterizations of No as an absolute continuum. (shrink)

This paper defends the view that trust is a moral attitude, by putting forward the Obligation-Ascription Thesis: If E trusts F to do X, this implies that E ascribes an obligation to F to do X. I explicate the idea of obligation-ascription in terms of requirement and the appropriateness of blame. Then, drawing a distinction between attitude and ground, I argue that this account of the attitude of trust is compatible with the possibility of amoral trust, that is, trust held (...) among amoral persons on the basis of amoral grounds. It is also compatible with trust adopted on purely predictive grounds. Then, defending the thesis against a challenge of motivational inefficacy, I argue that obligation-ascription can motivate people to act even in the absence of definite, mutually-known agreements. I end by explaining, briefly, the advantages of this sort of moral account of trust over a view based on reactive attitudes such as resentment. (shrink)

Cognitive phenomenalism is the view that occurrent thoughts are identical with, or constituted of, cognitive phenomenology. This paper raises a challenge for this view: the cognitive fine-tuning problem. In broad brushstrokes the difficulty is that, for the cognitive phenomenalist, there is a distinction between three kinds of fact: cognitive phenomenal facts, sensory phenomenal facts, and functional facts. This distinction gives rise to the challenge of explaining why, in actuality, these three phenomena tend to be matched together in ways that respect (...) norms of rationality. Various solutions to this problem are explored – divine intervention, value-involving laws of nature, or basic capacities to respond to reasons – all of which are wildly at odds with naturalism. If cognitive phenomenalists want their view to be consistent with naturalism, as many do, they must come up with a naturalistic solution to the cognitive fine-tuning problem. (shrink)

This article is concerned with reflection principles in the context of Cantor’s conception of the set-theoretic universe. We argue that within such a conception reflection principles can be formulated that confer intrinsic plausibility to strong axioms of infinity.

What's the Use of Philosophy? aims to answer the question posed in its title, whether the questioner intends to dismiss philosophy, or seeks a positive answer. The first three chapters explore the grounds for dismissal. Chapter 1 expresses skepticism about the value of much professional Anglophone philosophy, while recognizing virtues in work often viewed as peripheral. Chapter 2 studies a philosophical subfield, the philosophy of science, arguing that, while its condition may be better than the norm, it is far from (...) perfect. In Chapter 3, a more systematic critique is offered, in the form of a pathology report. Its diagnosis identifies six justifiable philosophical impulses that, when pursued obsessively, generate distortions and diseases: clarity becomes a fetish, formalism becomes obfuscation, "intuition" is given burdens it cannot bear, appeals to the a priori sprinkle fairy dust on controversial claims, ideas grabbed from other fields are used in cartoon forms, and questions no longer relevant are treated as if they were "timeless." Chapter 4 attempts to identify the legitimate goals of philosophy. It sees value in attempts to respond to questions arising from the difficulties of the age, in attempts to reform methods of inquiry, and, above all, in the construction of syntheses capable of helping people as they struggle to make sense of their lives. Philosophy is renewed when these traditional goals once again become central to its discussions. The final chapter responds to a frequently voiced worry in a letter to young philosophers who wonder how they can align their aspirations with the hyper-professionalism expected of them. (shrink)

Engineers are traditionally regarded as trustworthy professionals who meet exacting standards. In this chapter I begin by explicating our trust relationship towards engineers, arguing that it is a linear but indirect relationship in which engineers “stand behind” the artifacts and technological systems that we rely on directly. The chapter goes on to explain how this relationship has become more complex as engineers have taken on two additional aims: the aim of social engineering to create and steer trust between people, and (...) the aim of creating automated systems that take over human tasks and are meant to invite the trust of those who rely on and interact with them. (shrink)

Some recent accounts of testimonial warrant base it on trust, and claim that doing so helps explain asymmetries between the intended recipient of testimony and other non-intended hearers, e.g. differences in their entitlement to challenge the speaker or to rebuke the speaker for lying. In this explanation ‘dependence-responsiveness’ is invoked as an essential feature of trust: the trustor believes the trustee to be motivationally responsive to the fact that the trustor is relying on the trustee. I argue that dependence-responsiveness is (...) not essential to trust and that the asymmetries, where genuine, can be better explained without reference to trust. (shrink)

Hilbert's program attempts to show that our mathematical knowledge can be certain because we are able to know for certain the truths of elementary arithmetic. I argue that, in the absence of a theory of mathematical truth, Hilbert does not have a complete theory of our arithmetical knowledge. Further, while his deployment of a Kantian notion of intuition seems to promise an answer to scepticism, there is no way to complete Hilbert's epistemology which would answer to his avowed aims.

With respect to the metaphysics of infinity, the tendency of standard debates is to either endorse or to deny the reality of ‘the infinite’. But how should we understand the notion of ‘reality’ employed in stating these options? Wittgenstein’s critical strategy shows that the notion is grounded in a confusion: talk of infinity naturally takes hold of one’s imagination due to the sway of verbal pictures and analogies suggested by our words. This is the source of various philosophical pictures that (...) in turn give rise to the standard metaphysical debates: that the mathematics of infinity corresponds to a special realm of infinite objects, that the infinite is profoundly huge or vast, or that the ability to think about infinity reveals mysterious powers in human beings. First, I explain Wittgenstein’s general strategy for undermining philosophical pictures of ‘the infinite’ – as he describes it in Zettel; and then show how that critical strategy is applied to Cantor’s diagonalization proof in Remarks on the Foundations of Mathematics II. (shrink)

A typical approach to semantics for relevance (and other) logics: specify a class of algebraic structures and take amodelto be one of these structures, α, together with some function or relation which associates with every formulaAa subset ofα. (This is the approach of, among others, Urquhart, Routley and Meyer and Fine.) In some cases there are restrictions on the class of subsets of α with which a formula can be associated: for example, in the semantics of Routley and Meyer [1973], (...) a formula can only be associated with subsets which are closed upwards. It is natural to take apropositionof α to be such a subset of α, and, further, to take the propositional quantifiers to range over these propositions. (Routley and Meyer [1973] explicitly consider this interpretation.) Given such an algebraic semantics, we call (following Routley and Meyer [1973], who follow Henkin [1950]) the above-described interpretation of the quantifiers theprimaryinterpretation associated with the semantics. (shrink)

Militant modern atheism, whose most eloquent champion is Richard Dawkins, provides an effective and necessary critique of fundamentalist forms of religion and their role in political life, both within states and across national boundaries. Because it is also presented as a more general attack on religion (tout court), it has provoked a severe reaction from scholars who regard its conception of religion as shallow and narrow. My aim is to examine this debate, identifying insights and oversights on both sides.Two distinct (...) conceptions of religion are in play. For Dawkins and his allies (most notably Dan Dennett) religions are grounded in doctrines, propositions about supernatural entities, events and processes which the devout believe. Their beliefs prompt them to actions, which they support or rationalize by reference to the doctrines. Dawkins and Dennett view the acceptance of the doctrines as resting on cognitive misfiring — these are delusions to be outgrown or spells to be broken.By contrast, the religious scholars who criticize the militant atheists often view religion as centered in social practices that inform and enrich human lives. To the extent that there are doctrines that atheists might subject to epistemic evaluation, these are to be viewed as pieces of scaffolding, that are, in principle, dispensable.I argue that militant modern atheism is incomplete (and likely counter-productive) so long as it fails to attend systematically to the roles religion fulfills in human lives. Yet it is important to achieve public clarity about the literal falsehood of the doctrines on which fundamentalists rely. The challenge is to develop a well-articulated and convincing version of secular humanism. Meeting that challenge is, I claim, one of the central problems of philosophy today. (shrink)

Arendt Contra Sociology re-assesses the relationship between Hannah Arendt's work and the theoretical foundations of sociology, bringing her insights to bear on key themes within contemporary theoretical sociology. Departing from the view of Arendt as a political theorist who sought to rescue politics from society, and political theory from the social sciences, this book re-examines her distinctions between labour, fabrication and action as a theory of the fundamental ontology of human societies, revisiting her criticism of the tendency of many sociological (...) paradigms to conflate the activity of fabrication with that of action. (shrink)

Periodic and unexpected shortages of drugs, biologics, and even medical devices have become commonplace in the United States. When shortages occur, hospitals and clinics need to decide how to ration their available stock. When such situations arise, institutions can choose from several different allocation schemes, such as first-come, first-served, a lottery, or a more rational and calculated approach. While the first two approaches sound reasonable at first glance, there are a number of problems associated with them, including the inability to (...) make fine, individual patient-centered decisions. They also do not discriminate between what kinds of patients and what types of uses may be more deserving or reasonable than others. In this article I outline an ethically acceptable procedure for rationing drugs during a shortage in which demand outstrips supply. (shrink)

Modern health data practices come with many practical uncertainties. In this paper, I argue that data subjects’ trust in the institutions and organizations that control their data, and their ability to know their own moral obligations in relation to their data, are undermined by significant uncertainties regarding the what, how, and who of mass data collection and analysis. I conclude by considering how proposals for managing situations of high uncertainty might be applied to this problem. These emphasize increasing organizational flexibility, (...) knowledge, and capacity, and reducing hazard. (shrink)

In this paper, we define some consequence relations based on supervaluation semantics for partial models, and we investigate their properties. For our main consequence relation, we show that natural versions of the following fail: upwards and downwards Lowenheim-Skolem, axiomatizability, and compactness. We also consider an alternate version for supervaluation semantics, and show both axiomatizability and compactness for the resulting consequence relation.

The case of pain asymbolia is a case study that provides evidence of the mechanisms underlying the relationship between bodily experience, affective experience, and self-awareness. On one account pain asymbolia is the result of an affective deficit. Sensory signals of bodily damage are not associated with characteristic negative affect. Cochrane endorses this account as part of his version of a “conceptual act” theory of affective experience. In contrast, I propose an active inference account of affect in general and pain asymbolia (...) in particular. In the active inference framework the self is inferred as the endogenous cause of bodily and affective experience in the process of organismic regulation. This preserves Cochranes ambition to ground affect in bodily regulation but avoids the problem for affective deficit accounts of asymbolia that cannot do justice to the neural correlates. (shrink)

In this paper, a critique will be developed and an alternative proposed to Luciano Floridi’s approach to Information Ethics (IE). IE is a macroethical theory that is to both serve as a foundation for computer ethics and to guide our overall moral attitude towards the world. The central claims of IE are that everything that exists can be described as an information object, and that all information objects, qua information objects, have intrinsic value and are therefore deserving of moral respect. (...) In my critique of IE, I will argue that Floridi has presented no convincing arguments that everything that exists has some minimal amount of intrinsic value. I will argue, however, that his theory could be salvaged in large part if it were modified from a value-based into a respect-based theory, according to which many (but not all) inanimate things in the world deserve moral respect, not because of intrinsic value, but because of their (potential) extrinsic, instrumental or emotional value for persons. (shrink)