The Institute of Medicine’s 2005 publication, Dietary Supplements: A Framework for Evaluating Safety, is authoritative and thorough, and thus representative of other reports by the Institute of Medicine. What makes this report particularly interesting, however, is the rich political subtext that exists in the interstices of the report, popping up here and there in brief comments and barely suppressed yelps of exasperation. To understand this context, it is useful to reflect for a moment on the special nature of the IOM (...) and its relationship to government.IOM is part of the National Academy of Sciences, and is a private, non-governmental organization that does not receive direct federal funding for its work. Rather, IOM studies are often funded by contract with governmental entities that request reports on particular topics. As a case in point, the dietary supplement study was requested and paid for by the FDA. (shrink)

This article examines the relationship between banking access and farm household investment. The assets we examine are non-retirement financial assets, retirement financial assets, and real estate assets not owned by the farm operation. Using data from the Agricultural Resource Management Survey and the universe of commercial bank branches from the Federal Deposit Insurance Corporation, we find that distance to commercial banks is negatively related to the degree of investment in each of these assets for farm households. We also find that (...) internet availability, as measured by the share of farms in the county with internet, is positively associated with farm households’ investment in each of these assets. Further our results show that farm households that are located in the South have the lowest bank access as measured by bank proximity and internet availability. (shrink)

‘Free action’ is subject to the causal theory of reference and thus that The essential nature of free actions can be discovered only by empirical investigation, not by conceptual analysis. Heller ’s proposal, if true, would have significant philosophical implications. Consider the enduring issue we will call the Compatibility Issue : whether the thesis of determinism is logically compatible with the claim that.

Older adults in the United States have been the age group hardest hit by the Covid pandemic. They have suffered a disproportionate number of deaths; Covid patients eighty years or older on ventilators had fatality rates higher than 90 percent. How could we have better protected older adults? Both the popular press and government entities blamed nursing homes, labeling them “snake pits” and imposing harsh fines and arduous new regulations. We argue that this approach is unlikely to improve protections for (...) older adults. Rather than focusing exclusively on acute and critical resources, including ventilators, a plan that respected the best interests of older adults would have also supported nursing homes, a critical part of the health care system. Better access to protective equipment for staff members, early testing of staff members and patients, and enhanced means of communication with families were what was needed. These preventive measures would have offered greater benefit to the oldest members of our population than the exclusive focus on acute care. (shrink)

Dawes points out the fallacy in many commonly held beliefs in therapy and takes issue with many current treatment methods.

New York City hospitals expanded resources to an unprecedented extent in response to the COVID pandemic. Thousands of beds, ICU beds, staff members, and ventilators were rapidly incorporated into h...

In this timely study, Dawes defends the methodological naturalism of the sciences. Though religions offer what appear to be explanations of various facts about the world, the scientist, as scientist, will not take such proposed explanations seriously. Even if no natural explanation were available, she will assume that one exists. Is this merely a sign of atheistic prejudice, as some critics suggest? Or are there good reasons to exclude from science explanations that invoke a supernatural agent? On the one (...) hand, Dawes concedes the bare possibility that talk of divine action could constitute a potential explanation of some state of affairs, while noting that the conditions under which this would be true are unlikely ever to be fulfilled. On the other hand, he argues that a proposed explanation of this kind would rate poorly, when measured against our usual standards of explanatory virtue. (shrink)

Ethical lapses associated with the first facial transplant included breaches of confidentiality, bending of research rules, and film deals. However, discussions of the risk-benefit ratio for face transplantation are often deficient in that they ignore the needs, experience, and decision-making capability of potential recipients.

If animism is regarded as an ontology—a set of beliefs regarding the kinds of entities that exist—it is incompatible with naturalism: the idea that the only causal entities and powers are those identified by our best science. But an enactivist and practice-based theory of knowledge enables us to see that ontologies emerge from practices. An animistic ontology is one way of theorizing ‘animic’ practices, while naturalism is one way of theorizing the practice of science. There exist different ways of theorizing (...) each set of practices, only some of which lead to a verdict of incompatibility. But an enactivist and practice-based theory of knowledge takes us further. By lending support to a cognitive pluralism, it gives us reason to reject naturalism and opens the door to a defence of animism. (shrink)

1The opinions expressed are solely those of the author and not those of the New York State Task Force on Life & the Law, nor of New York State government.

ABSTRACT:Translational ethics is a practice that aims to apply bioethics insights and process to the real-world contexts of clinical medicine, but also government policy, systems issues, and public health. This work has been a career focus for a relatively small number of bioethicists over the years, but it has drawn greater attention due to the pandemic and a greater realization of the impact of health inequities and systemic injustice. This essay discusses the pathway, rewards, and challenges of translational bioethics as (...) experienced by one bioethicist working with state and national groups on a range of translational ethics issues, often related to public health disasters. There is much remaining work to be done, and the goal of the essay is to encourage rising bioethicists to engage in translational bioethics. (shrink)

Le devenir socioprofessionnel des ex-apprentis footballeurs est un phénomène social encore insuffisamment analysé à ce jour. Les différents travaux de Frédéric Rasera, explorant les conditions sociales individuelles de la recomposition vocationnelle chez un ex-apprenti footballeur, font office d’exception. Face à ce constat, cet article entend contribuer à la réflexion portant sur ces jeunes sportifs. À travers l’étude des trajectoires d’une vingtaine d’ex-apprentis footballeurs, nous verrons qu’il est possible de trouver des similarités biographiques caractérisant leur processus de recomposition vocationnelle. Plus précisément, (...) nous montrerons qu’une analyse en termes de temporalités vécues permet de dévoiler la résurgence de quatre séquences de vie au cours de leur recomposition vocationnelle, révélant ainsi, les dimensions collectives de ce processus. (shrink)

Proper linear models are those in which predictor variables are given weights such that the resulting linear composite optimally predicts some criterion of interest; examples of proper linear models are standard regression analysis, discriminant function analysis, and ridge regression analysis. Research summarized in P. Meehl's book on clinical vs statistical prediction and research stimulated in part by that book indicate that when a numerical criterion variable is to be predicted from numerical predictor variables, proper linear models outperform clinical intuition. Improper (...) linear models are those in which the weights of the predictor variables are obtained by some nonoptimal method. The present article presents evidence that even such improper linear models are superior to clinical intuition when predicting a numerical criterion from numerical predictors. In fact, unit weighting is quite robust for making such predictions. The application of unit weights to decide what bullet the Denver Police Department should use is described; some technical, psychological, and ethical resistances to using linear models in making social decisions are considered; and arguments that could weaken these resistances are presented. (shrink)

This book offers a philosophical approach to religion that acknowledges both the diversity of religions and the many and varied dimensions of the religious life. Rather than restricting itself to Christian theism, it covers a wide range of religious traditions, examining their beliefs in the context of the actual practice of the religious life. After outlining the aims of religion, the book focuses on claims to knowledge. What kinds of knowledge do religions purport to offer? In what idiom is it (...) couched? From what sources do devotees draw their claims to knowledge? Are these sources reliable? Rather than trying to settle age-old questions about religious belief, the book offers its readers a set of criteria with which they can make informed decisions in matters of faith. Gregory W. Dawes is Associate Professor in Philosophy at the University of Otago, New Zealand. He completed his first graduate degree at the Pontifical Biblical Institute in Rome before returning to New Zealand to complete PhD degrees in both biblical studies and philosophy. His previous books include The Historical Jesus Question, Theism and Explanation, and Galileo and the Conflict between Religion and Science. (shrink)

For over 30 years, Tias Little has explored yoga as a spiritual path. In this book he offers key teachings from his journey that will resonate with anyone who has dedicated themself to a mind/body discipline. In short, accessible chapters, Little shares his struggles and joys as a yogi and chronicles the transformation of his understanding and practice along the way.

In writing these essays, we were asked to consider, “What makes a good life in late life?” I thought instantly, perhaps like many people, of photos and stories of older people taking up new careers and new hobbies—running marathons and soup kitchens, starting organic farms. This response is right and proper. Older people can leverage wisdom and creativity to make wonderful contributions to their communities and should be celebrated for doing so. But this happy picture is incomplete. We live longer (...) than ever before, and with that long life, many of us can expect disability. This is the product of medical success. We are less likely to die from cancer, a heart attack, or a stroke; we survive with chronic illnesses and their associated disabilities. A good life in late life, for many of us, will be a life with disability.For this essay, I focus on dementia, a common and ultimately fatal illness, and one that typically lasts many years from the start of symptoms to the end. More than five million Americans currently suffer from dementia; fifteen million paid and volunteer caregivers help support them. What would a good life with dementia look like? How would it change from the early phase, when cognitive impairment and other challenges are relatively modest, to the final phase marked by severe cognitive and physical decline? (shrink)

Our goal in producing this special issue is to encourage our colleagues to incorporate topics related to LGBT populations into bioethics curricula and scholarship. Bioethics has only rarely examined the ways in which law and medicine have defined, regulated, and often oppressed sexual minorities. This is an error on the part of bioethics. Medicine and law have served in the past as society's enforcement arm toward sexual minorities, in ways that robbed many people of their dignity. We feel that bioethics (...) has an obligation to discuss that history and to help us as a society take responsibility for it.We can address only a small number of topics in this special issue of the Hastings Center Report, and we selected topics we believe will stimulate discourse. Andrew Solomon offers an elegant overview of the challenges that bioethics faces in articulating a solid basis for LGBT rights. Timothy F. Murphy asks whether bioethics still faces issues related to lesbian, gay, and bisexual people, given the deletion of homosexuality as a disease and the progress toward same‐sex marriage. Jamie Lindemann Nelson's essay addresses the search for identity for transgender persons and the role of science in that search. Two articles, those by Brendan S. Abel and by Jack Drescher and Jack Pula, take up the complex issue of medical treatment for children who reject their assigned birth gender. Celia B. Fisher and Brian Mustanski address the special challenges of engaging LGBT youth in research, balancing the need for better information about this vulnerable group against the existing restrictions on research involving children. Tia Powell and Edward Stein consider the merits of legal bans on psychotherapies intended to change sexual orientation, particularly in the light of current research on orientation. Mary Beth Foglia and Karen I. Fredricksen‐Goldsen highlight health disparities and resilience among LGBT older adults and then discuss the role of nonconscious bias in perpetuating disparities. Stephan Davis and Nancy Berlinger assess the challenges of access to care and health policy for transgender persons. Edward J. Callahan et al. tackle the ways in which diverse aspects of medicine should change to better incorporate the needs of LGBT patients, including through use of the electronic medical record, education of health professionals, and recruitment efforts for LGBT health professionals. Virginia Ashby Sharpe and Uchenna S. Uchendu describe multifaceted efforts within Veterans Administration facilities to create change for LGBT veterans across the largest integrated health care network in the United States. Lance Wahlert and Autumn Fiester find a mixed record in the use of case studies in teaching about LGBT issues. (shrink)

A good death is hard to find. Family members tell us that loved ones die in the wrong place—the hospital—and do not receive high-quality care at the end of life. This issue of the Hastings Center Report offers two articles from authors who strive to provide good end-of-life care and to prevent needless suffering. We agree with their goals, but we have substantial reservations about the approaches they recommend. Respect for the decisions of patients and their surrogates is a relatively (...) new and still vulnerable aspect of medical care. For thousands of years, patients and surrogates had no say in medical decision-making. Today, standards support shared decision-making, but these articles both carve out exceptions to those standards, limiting the rights of patients and families in decisions about specific end-of-life treatments. As bioethics consultants in an acute care setting, we frequently confront conflicts similar to those described by Jeffrey Berger and by Ellen Robinson and colleagues. In such cases, our service emphasizes redoubled efforts at communication and mediation. Focusing on goals and values, rather than interventions, produces the best possible collaboration in health care decision-making. Cases in which we would overturn a surrogate's recommendations regarding palliative sedation or do-not-resuscitate orders are rare and require careful processes and clear evidence that the surrogate's choice is contrary to patient values. (shrink)

This book presents a new understanding of Nietzsche’s view of Socrates, Plato, and Aristotle. Through a careful study of how these philosophers appropriate reason in both life-negating and life-affirming ways, Daw-Nay N. R. Evans Jr. offers a fresh perspective on Nietzsche and classical Greek philosophy.

Defences of inference to the best explanation (IBE) frequently associate IBE with scientific realism, the idea that it is reasonable to believe our best scientific theories. I argue that this linkage is unfortunate. IBE does not warrant belief, since the fact that a theory is the best available explanation does not show it to be (even probably) true. What IBE does warrant is acceptance: taking a proposition as a premise in theoretical and/or practical reasoning. We ought to accept our best (...) scientific theories since they are the theories that are most likely to lead to the goal of science, which is that of knowledge. In support of this claim I invoke Bill Lycan's Panglossian reflections regarding Mother Nature.1. (shrink)

Mrs. K is a thirty-one-year-old Russian-speaking mother of two, who was brought in by ambulance after attempting suicide by jumping in front of train. Probable depression x months. Stressor: lost custody battle over older child. Current status: deep coma, ventilator-dependent, and prognosis grim. Next of kin is estranged husband; he demands participation in medical decision making. Legal proxy is patient's boyfriend; forcibly removed from the intensive care unit for agitated behavior and alcohol intoxication.I magine the difficulty for the ICU staff (...) as it tries to patch together the broken body of Mrs. K, described above. If, as appears likely, the physicians’ efforts begin to fail, who will speak for this patient, who can no longer speak for herself, and determine the appropriate goals and limits of intensive medical care? (shrink)

History and the modern sciences are characterized by what is sometimes called a methodological naturalism that disregards talk of divine agency. Some religious thinkers argue that this reflects a dogmatic materialism: a non-negotiable and a priori commitment to a materialist metaphysics. In response to this charge, I make a sharp distinction between procedural requirements and metaphysical commitments. The procedural requirement of history and the sciences—that proposed explanations appeal to publicly-accessible bodies of evidence—is non-negotiable, but has no metaphysical implications. The metaphysical (...) commitment is naturalistic, but is both a posteriori and provisional, arising from the fact that for more than 400 years no proposed theistic explanation has been shown capable of meeting the procedural requirement. I argue that there is nothing to prevent religious thinkers from seeking to overturn this metaphysically naturalistic stance. But in order to do so they would need to show that their proposed theistic explanations are the best available explanations of a range of phenomena. Until this has been done, the metaphysical naturalism of history and the sciences remains defensible. (shrink)

In a recent defence of what he calls "study by religion," Robert Ensign suggests that alleged divine revelations represent public forms of knowledge, which should not be excluded from the academy. But at least according to two major Christian thinkers, namely Thomas Aquinas and John Calvin, revelation is received by an act of faith, which rests on evidence that is person-relative and therefore not open to public scrutiny. If religious studies is to remain a public discipline, whose arguments may be (...) evaluated by believers and non-believers alike, it should maintain its defeasible but not yet defeated presumption of naturalism. (shrink)

Objective: The present study examines the validity of 11 new Holtzman Inkblot Technique indices. These were chosen from Exner’s Comprehensive System indices using two criteria: first, they had to be valid according to meta-analysis, and second, they must be computed using the HIT standard scoring system.Methods: Both techniques were administrated with a retest interval from 1 to 7days to a sample of 139 subjects from the general population. The validity of the new indices was studied through Pearson correlation with the (...) corresponding RCS indices.Results: Nine of the 11 new indices showed significant correlations with Rorschach scales, confirming our hypotheses. The correlation ranged from a minimum of 0.144 to a maximum of 0.414.Conclusions: The results provide support for the validity of the new HIT indices and have important implications for both clinical and research fields. (shrink)

How do we balance the rights of aging physicians against the right of the public to competent health care? This version of a classic public health ethics dilemma is here now and likely to increase as the population ages. Peer review has long been the standard mechanism for assessing physician competence, but it is subjective and too easily subverted. New options are needed, both in medicine and throughout the professions, but they are challenging to implement. Physicians have an ethical obligation (...) to protect the health of the public by acknowledging, assessing, and addressing the cognitive effects of aging on medical competence. (shrink)

The United States has recently made significant and positive civil rights gains for LGB people, including expanded recognition of marriages between people of the same sex. Among the central tropes that have emerged in the struggle for the rights of LGB people are that they are “born that way,” that sexual orientations cannot change, and that one's sexual orientation is not affected by choice. Writer Andrew Sullivan put it this way: “[H]omosexuality is an essentially involuntary condition that can neither be (...) denied nor permanently repressed.… [S]o long as homosexual adults as citizens insist on the involuntary nature of their condition, it becomes politically impossible to deny or ignore the fact of homosexuality.… [The strategy for obtaining LGB rights is to] seek full public equality for those who, through no fault of their own, happen to be homosexual.”This idea of linking LGB rights to empirical claims about sexual orientations has become so central that casting doubt on these claims is, in many circles, tantamount to opposing LGB rights. Nonetheless, claims about innateness, immutability, and lack of choice about sexual orientation should not be the primary basis for LGB rights. (shrink)

Many philosophers have come to believe there is no single criterion by which one can distinguish between a science and a pseudoscience. But it need not follow that no distinction can be made: a multifactorial account of what constitutes a pseudoscience remains possible. On this view, knowledge-seeking activities fall on a spectrum, with the clearly scientific at one end and the clearly non-scientific at the other. When proponents claim a clearly non-scientific activity to be scientific, it can be described as (...) a pseudoscience. One feature of a scientific theory is that it forms part of a research tradition being actively pursued by a scientific community. If a theory lacks this form of epistemic warrant, this is a pro tanto reason to regard it as pseudoscientific. (shrink)

The sciences are characterized by what is sometimes called a “methodological naturalism,” which disregards talk of divine agency. In response to those who argue that this reflects a dogmatic materialism, a number of philosophers have offered a pragmatic defense. The naturalism of the sciences, they argue, is provisional and defeasible: it is justified by the fact that unsuccessful theistic explanations have been superseded by successful natural ones. But this defense is inconsistent with the history of the sciences. The sciences have (...) always exhibited what we call a domain naturalism. They have never invoked divine agency, but have always focused on the causal structure of the natural world. It is not the case, therefore, that the sciences once employed theistic explanations and then abandoned them. The naturalism of the sciences is as old as science itself. (shrink)

A review of the literature indicates that linear models are frequently used in situations in which decisions are made on the basis of multiple codable inputs. These models are sometimes used normatively to aid the decision maker, as a contrast with the decision maker in the clinical vs statistical controversy, to represent the decision maker "paramorphically" and to "bootstrap" the decision maker by replacing him with his representation. Examination of the contexts in which linear models have been successfully employed indicates (...) that the contexts have the following structural characteristics in common: each input variable has a conditionally monotone relationship with the output; there is error of measurement; and deviations from optimal weighting do not make much practical difference. These characteristics ensure the success of linear models, which are so appropriate in such contexts that random linear models may perform quite well. 4 examples involving the prediction of such codable output variables as GPA and psychiatric diagnosis are analyzed in detail. In all 4 examples, random linear models yield predictions that are superior to those of human judges. (shrink)

It is known from work of P. Young that there are recursively enumerable sets which have optimal orders for enumeration, and also that there are sets which fail to have such orders in a strong sense. It is shown that both these properties are widespread in the class of recursively enumerable sets. In fact, any infinite recursively enumerable set can be split into two sets each of which has the property under consideration. A corollary to this result is that there (...) are recursive sets with no optimal order of enumeration. (shrink)