Antimicrobial therapy is a cornerstone of therapy in critically ill patients; however, the wide use of antibiotics has resulted in increased antimicrobial resistance and outbreaks of resistant disease. To counter this, many hospitals have instituted antimicrobial stewardship programmes as a way to reduce the inappropriate use of antibiotics. However, uptake of antimicrobial stewardship programmes has been variable, as many clinicians fear that they may put individual patients at risk of treatment failure. In this paper, I argue that antimicrobial stewardship programmes (...) are indeed a form of bedside rationing, and explore the risks and benefits of such programmes for individual patients in the intensive care unit, and the critically ill population in general. Using Norman Daniels’ Accountability for Reasonableness as a framework for evaluating resource allocation policies, I conclude that antimicrobial stewardship programmes are an ethically sound form of bedside rationing. (shrink)

Antimicrobial resistance kills people. According to a recent estimate, ‘7 00 000 people die of resistant infections every year’, and ‘by 2050 10 million lives a year are at risk due to drug resistant infections, as are 100 trillion USD of economic output’.1 Today, ‘bacteria are resistant to nearly all antibiotics that were earlier active against them’.2 For all these reasons, antimicrobial resistance is considered a ‘slowly emerging disaster’3 and a ‘global health security issue’.4 The prospect we are facing is (...) that of a ‘post antibiotic era’,5 in which we risk losing the availability of effective antibiotics and, with them, of medical interventions that require effective antibiotics, such as chemotherapy, transplantation and major surgery. One of the causes of antimicrobial resistance is antimicrobial consumption. As put by the Centers for Disease Control and Prevention, ‘the use of antibiotics is the single most important factor leading to antibiotic resistance around the world: simply using antibiotics creates resistance’.6 According to the 2016 Review on Antimicrobial Resistance commissioned by the UK Government, ‘more consumption of antibiotics directly leads to more resistance’.1 This is because microbes that are not killed by antimicrobials are more likely to reproduce and proliferate and to pass their resistance genes on to other microbes. Thus, exactly like the consumption of many other finite resources, antibiotic and antimicrobial consumption gives rise to the collective action problem known as ‘tragedy of the commons’: consuming a certain resource, such as antimicrobials, is in an individual’s best short-term interest, but many instances of individual consumption erode the resource and therefore conflict with the collective interest in preserving the good. How to solve a tragedy of the commons? As is the case with the consumption of other finite resources, the answer is quite simple: by rationing the resource. Simon Oczkowski’s article …. (shrink)

Loss aversion can occur in riskless and risky choices. We present novel evidence on both in a non-student sample (660 randomly selected customers of a car manufacturer). We measure loss aversion in riskless choice in endowment effect experiments within and between subjects and find similar levels of average loss aversion in both. The subjects of the within study also participate in a simple lottery choice task which arguably measures loss aversion in risky choices. We find substantial heterogeneity in both measures (...) of loss aversion. Loss aversion in riskless choice and loss aversion in risky choice are strongly positively correlated, but on average riskless loss aversion is higher than risky loss aversion. We find that in both choice tasks, loss aversion increases in age, income, and wealth, and decreases in education. Our results provide novel supportive input to the debate about the reality of loss aversion. (shrink)

Existing indexing systems used to arrange philosophical works have been shown to misrepresent the discipline in ways that reflect and perpetuate exclusionary attitudes within it. In recent years, there has been a great deal of effort to challenge those attitudes and to revise them. But as the discipline moves toward greater equality and inclusivity, the way it has indexed its work has unfortunately not. To course correct, we identify in this article some of the specific changes that are needed within (...) current indexing systems and propose a new model that could embody them. We use the Diversity Reading List in Philosophy as a case study and PhilPapers as a basis for comparison. The model we propose not only represents the discipline in a more inclusive and fair way, but it is also efficient, easy to use or implement, and adaptable for a variety of contexts. (shrink)

Few studies have considered in detail the ethical issues surrounding research in which investigators ask community members to engage in research subject recruitment within their own communities. Peer-driven recruitment and its variants are useful for accessing and including certain populations in research, but also have the potential to undermine the ethical and scientific integrity of community-based research. This paper examines the ethical implications of utilizing community members as recruiters of human subjects in the context of PDR, as well as the (...) authors' experience with a variant of PDR in a research project in South Africa. The importance of situating PDR in a comprehensive community engagement process that is responsive to the constraints of science and local needs and interests is emphasized. The paper will have relevance to bioethicists, health researchers, and research regulators concerned about the appropriate use of peer-driven recruitment strategies in health research. (shrink)

The Prologue offers an overview of the Reformation of method from Augustine of Hippo through to the Ramist movement, providing an orientation to the rest of the book. It highlights and explains an important nexus of Realism, exemplarism and illumination fundamental to Ramism. Beginning with Augustine it shows how these themes coalesced into a distinctive Christian philosophy taken up and refined by Franciscans such as Bonaventure of Bagnoregio and John Duns Scotus, as well as by Ramon Lull, the Franciscan-inspired encyclopaedist. (...) It traces the continuation of this methodological impulse into the Platonism and Christian humanism of the Renaissance, highlighting especially the topical and Realist (Scotistic) reform of logic pioneered by Lorenzo Valla and Rudolph Agricola. It concludes by showing the reception of this topical and biblical reform in Philipp Melanchthon and the movement of Reformed scholasticism, revealing Reformed Scotism and Christian philosophy as important preconditions for Ramism. (shrink)

The mindshaping hypothesis proposes a “de-intellectualized” explanation for human unique cooperation. In contrast to standard mindreading accounts, which emphasize the evolution of sophisticated reasoning about others’ propositional attitudes to explain how our ancestors became hyper cooperators, the hypothesis holds that sophisticated mindreading was a late-arriving product of our ancestors becoming better cooperators via the evolution of mechanisms that shape and regulate the minds of members of human groups to be suited to cooperation. Comparative research with nonhumans, especially our closest living (...) relatives, the great apes, is of utmost importance for evaluating the mindshaping hypothesis—for instance, to what extent can apes maintain relatively complex forms of culture and cooperation without reasoning about propositional attitudes? The concept of mindshaping also opens up new questions in comparative cognition that are worth exploring in their own right, such as whether apes regulate each other’s behavior via social norms. This chapter assesses what we currently do and do not know about the nature and extent of various mindshaping mechanisms in nonhuman great apes, focusing on culture and social learning, pedagogy, and social norms. (shrink)

Signaling games provide basic insights into some fundamental questions concerning the explanation of meaning. They can be analyzed in terms of rational choice theory and in terms of evolutionary game theory. It is argued that an evolutionary approach provides better explanations for the emergence of simple communication systems. To substantiate these arguments, I will look at models similar to those of Skyrms (2000) and Komarova and Niyogi (2004) and study their dynamical properties. My results will lend partial support to the (...) thesis that evolution leads to communication. In general, states of partial communication may evolve with positive probability under standard evolutionary dynamics. However, unlike states of perfect communication, they are unstable relative to neutral drift. (shrink)

The return to religion has perhaps become the dominant cliche of contemporary theory, which rarely offers anything more than an exaggerated echo of a political reality dominated by religious war. Somehow, the secular age seems to have been replaced by a new era, where political action flows directly from metaphysical conflict. The Faith of the Faithless asks how we might respond. Following Critchley's Infinitely Demanding, this new book builds on its philosophical and political framework, also venturing into the questions of (...) faith, love, religion and violence. Should we defend a version of secularism and quietly accept the slide into a form of theism--or is there another way? From Rousseau's politics and religion to the return to St. Paul in Taubes, Agamben and Badiou, via explorations of politics and original sin in the work of Schmitt and John Gray, Critchley examines whether there can be a faith of the faithless, a belief for unbelievers. Expanding on his debate with Slavoj Zizek, Critchley concludes with a meditation on the question of violence, and the limits of non-violence. (shrink)

Introduction -- Marx and postwar French philosophy -- A writer full of affects : Marx through Lyotard -- Messianic without messianism : Marx through Derrida -- The history of the present : Marx through Foucault -- Becoming revolutionary : Marx through Deleuze -- Marx through post-structuralism.

The Everett interpretation of quantum mechanics divides naturally into two parts: first, the interpretation of the structure of the quantum state, in terms of branching, and second, the interpretation of this branching structure in terms of probability. This is the second of two reviews of the Everett interpretation, and focuses on probability. Branching processes are identified as chance processes, and the squares of branch amplitudes are chances. Since branching is emergent, physical probability is emergent as well.

In this paper I am not so much concerned with movements of the mind, as movements of the will. But my question bears a similarity to that of the tortoise. I want to ask whether the will is under the control of fact and reason, combined. I shall try to show that there is always something else, something that is not under the control of fact and reason, which has to be given as a brute extra, if deliberation is ever (...) to end by determining the will. This is, of course, a Humean conclusion, and the only novelty comes in the way I wish to argue for it. I believe that many philosophers think, erroneously, that Hume relies on a naive and outdated conception of facts, or on an even more naive and outdated conception of reason, in order to put passion on their throne. My tortoise defends Hume: what we do with our premises is not itself construed as acceptance of a premise. As it stands the project is only described metaphorically. Presumably everything, including movement of the will, is under the control of facts in some sense, for even if they are only facts about our physiology or chemistry, still, they make us move. I am interested only in cognitive control, or control by the apprehension of fact and reason. (shrink)

This paper draws on the account of second nature in Aristotle, Dewey and Hegel to examine the way in which norms become embodied. It discusses the implications of this for both the authority of norms and how they can be changed. Using the example of veganism it argues that changing norms requires more than just good reasons. The appreciation of the role of second nature in culture allows us to: firstly, better conceive the difficulty and resistance of individuals to changing (...) norms because of the material resilience of norms, habits and customs in a culture. Secondly, it argues that the effective adoption of a new norm such as veganism or the behavioral change necessary to respond to climate change, requires not just more good reasons but the creation of material pathways in the culture in which those revised norms can be inhabited. (shrink)

If critical momentum in European philosophy and theory has seemed to shift away from deconstruction over the past decade or so, nevertheless the indebtedness of contemporary key thinkers to Derrida's writing and the entire project of deconstruction is unquestionable, regardless of whether it is always fully acknowledged, and whether or not Derrida's influence manifests itself as a source of inspiration or the grounds of critical antagonism or opposition. Many of those who now reject deconstruction continue to write texts that engage (...) with Derrida's work, whether dismissively or not. In this context, how best to recall deconstruction as a continuing 'voice' across the various fields of the critical humanities, theory and philosophy? The starting point for this collection of essays is the idea that, rather than reduce deconstruction to an object of historical importance or memory, one might more fruitfully analyze its significance in terms of complex matrices of desire in which it continues to figure; ceaselessly provoked in this way, deconstruction may neither be dismissed as simply 'dead', nor unproblematically defended as still alive and well. Instead, it asks to be repositioned on the threshold of life-death (about which deconstruction has always had much to say), an intricate threshold which profoundly complicates its relationship to the 'present' field of critical thought. This is a field which-according to a highly complex set of desires-still struggles to memorialize, to inter, or indeed to cremate, reduce to ashes, the deconstructive corpus. This collection therefore brings together leading voices at the forefront of their critical fields, in order to address the question of the desires of deconstruction, in precisely these multiple senses. With contributions from Etienne Balibar, Catherine Malibou and Martin Hagglund, the volume includes key thinkers across various generations of scholarship: those whose careers took off in the 1960s, at the same time Derrida's importance was gaining acknowledgement; those who played their part in the Anglo-American reception and translation of Derrida in the subsequent two or three decades; those taught by him; and those who, without undue discipleship or hagiography, now seek to critically re-evaluate his work. (shrink)

The Everett interpretation of quantum mechanics divides naturally into two parts: first, the interpretation of the structure of the quantum state, in terms of branching, and second, the interpretation of this branching structure in terms of probability. This is the first of two reviews of the Everett interpretation, and focuses on structure, with particular attention to the role of decoherence theory. Written in terms of the quantum histories formalism, decoherence theory just is the theory of branching structure, in Everett's sense.

The concept of indistinguishable particles in quantum theory is fundamental to questions of ontology. All ordinary matter is made of electrons, protons, neutrons, and photons and they are all indistinguishable particles. Yet the concept itself has proved elusive, in part because of the interpretational difficulties that afflict quantum theory quite generally, and in part because the concept was so central to the discovery of the quantum itself, by Planck in 1900; it came encumbered with revolution. I offer a deflationary reading (...) of the concept ‘indistinguishable’ that is identical to Gibbs’ concept ‘generic phase’, save that it is defined for state spaces with only finitely-many states of bounded volume and energy. That, and that alone, makes for the difference between the quantum and Gibbs concepts of indistinguishability. This claim is heretical on several counts, but here we consider only the content of the claim itself, and its bearing on the early history of quantum theory rather than in relation to contemporary debates about particle indistinguishability and permutation symmetry. It powerfully illuminates that history. (shrink)

In this commentary we concur with Frost's view of the centrality of universal principles in models of word identification. However, we argue that other processes in sentence comprehension also fundamentally constrain the nature of written word identification. Furthermore, these processes appear to be universal. We, therefore, argue that universality in word identification should not be considered in isolation, but instead in the context of other linguistic processes that occur during normal reading.

The value of education is commonly measured in terms of its ability to improve economic growth or the earnings of individuals. According to that approach, education enables society or individuals to accumulate a stock of human capital, which can then be used to generate macro or micro level income growth.1 In this chapter our aim is to examine education in Turkey based on the human capabilities approach developed by Amartya Sen and, more recently, by Martha Nussbaum (Sen, 1999; Nussbaum, 2000). (...) The capabilities approach rejects a development strategy based on human capital, firstly, because it does not require that all individuals receive a sufficient education and, secondly, because it is based on an impoverished metric of human well-being. In the first place, an approach to development that is based on human capital may postpone extending a basic education to some children if that is the optimal strategy for expanding economic growth or combating income poverty. It may be argued, for example, that the social conditioning of gender roles means it is more costly to expand the educational attainment levels of female children. Thus, prioritizing investment in the length and quality of education available to male children may be seen as a more cost effective way of driving economic growth. The postponement strategy may be further defended on the grounds that income poverty can be best overcome by letting the fruits of growth trickle-down or be redistributed to the poor, rather than by directly improving the earnings potential of the poor. According to the capabilities approach each individual has a fundamental right to at least a basic education because without it they lack the necessary preconditions for doing things and achieving results that they have reason to value. In other words, society has a duty to ensure that each individual can acquire at least a sufficient education, irrespective of their relative ability to contribute towards income growth.. (shrink)

Simon D. Podmore claims that becoming a self before God is both a divine gift and an anxious obligation. Before we can know God, or ourselves, we must come to a moment of recognition. How this comes to be, as well as the terms of such acknowledgment, are worked out in Podmore’s powerful new reading of Kierkegaard. As he gives full consideration to Kierkegaard's writings, Podmore explores themes such as despair, anxiety, melancholy, and spiritual trial, and how they are (...) broken by the triumph of faith, forgiveness, and the love of God. He confronts the abyss between the self and the divine in order to understand how we can come to know ourselves in relation to a God who is apparently so wholly Other. (shrink)

The thesis of the paper is that persons are similar to a kind of group: multiple-expert epistemic unities (MEUs). MEUs are groups in which there are multiple experts on whom other members of the group model their opinion. An example would be a group of children playing Telephone. Any child nearer the source is an 'expert' for any child further away. I argue that, with certain important qualifications, it is both rational and necessary for persons to treat their future selves (...) as experts (i.e. to satisfy Bas Van Fraassen's Principle of Reflection). This makes a person a kind of MEU. (The paper "Epistemic Unities" gives more details about different kinds of epistemic unities.). (shrink)

In this paper I study dynamical models of rational deliberation within the context of Newcomb's problem. Such models have been used to argue against the soundness of the "tickle'" defense of evidential decision theory, which is based on the idea that sophisticated decision makers can break correlations between states and acts by introspecting their own beliefs and desires. If correct, this would show that evidential decision theory agrees with the recommendations of causal decision theory. I argue that an adequate understanding (...) of rational deliberation leads to deliberative processes for which this idea works. My proposal is modest, though. Evidential decision theory cannot always be reconciled with causal decision theory along the lines suggested here, but the agreement between the two theories is broader than previously thought. (shrink)

Journal of Social Philosophy, EarlyView.

Journal Name: Apeiron Issue: Ahead of print.

The Gibbs Paradox is essentially a set of open questions as to how sameness of gases or fluids are to be treated in thermodynamics and statistical mechanics. They have a variety of answers, some restricted to quantum theory, some to classical theory. The solution offered here applies to both in equal measure, and is based on the concept of particle indistinguishability. Correctly understood, it is the elimination of sequence position as a labelling device, where sequences enter at the level of (...) the tensor product of one-particle state spaces. In both cases it amounts to passing to the quotient space under permutations. ‘Distinguishability’, in the sense in which it is usually used in classical statistical mechanics, is a mathematically convenient, but physically muddled, fiction. (shrink)

Does Seneca entirely reject the utility of dialectical study for moral improvement? No, I argue here. Focusing on Letter 87, I propose that Seneca raises and disarms objections to formal Stoic arguments to help moral progressors avoid backsliding and advance towards ethical knowledge. I trace this method back to Chrysippus and show that reading Letter 87 in this Chrysippean framework yields a satisfying explanation of its otherwise puzzling features.

I argue that it is not ideally rational to believe that some of one's current beliefs are false, despite the impressive inductive evidence concerning others and our former selves. One's own current beliefs represent a commitment which would be undermined by taking some of them to be false. The nature of this commitment is examined in the light of Nagel's distinction between subjective and objective points of view. Finally, I suggest how we might acknowledge our fallibility consistently with this special (...) attitude to our own beliefs. (shrink)