Actor-Network-Theory (ANT) offers an ‘infra-language’ of the social that allows one to trace social relations very dynamically, while at the same time dissolving human agency, thus providing a flat and de-centred way into sociology. However, ANT struggles with its theoretical design that may lead us to reduce agency to causation and to conceptualize actor-networks as homogeneous ontologies of force. This article proposes to regard ANT’s inability to conceptualize reflexivity and the interrelatedness of different ontologies as the fundamental problem of the (...) theory. Drawing on Günther, it offers an ‘infra-language’ of reflexive relations while maintaining ANT’s de-centred approach. This would enable us to conceptualize actor-networks as non-homogeneous, dynamic and connecting different societal rationales while maintaining the main strengths of ANT. (shrink)

Introducing formal causation / Ludger Jansen and Petter Sandstad -- Form, intention, information : from scholastic logic to artificial intelligence / Gyula Klima -- Formal causation : accidental and substantial / David S. Oderberg -- A non-hylomorphic account of formal causation / Petter Sandstad and Ludger Jansen -- Formal causes for powers theorists / Giacomo Giannini and Stephen Mumford -- Away with dispositional essences in trope theory / Jani Hakkarainen and Markku Keinänen -- Functional powers / Michele Paolini (...) Paoletti -- An Aristotelian approach to existential dependence / Benjamin Schnieder and Jonas Werner -- Finean feature dependence and the Aristotelian alternative / Wolfgang Sattler -- A problem for natural-kind essentialism and formal causes / José Tomás Alvarado and Matthew Tugby -- Form as cause and the formal cause : Aristotle's answer / James G. Lennox -- Form, cause, and explanation in biology : a neo-Aristotelian perspective / Christopher J. Austin -- Formal explanation and mechanisms of conceptual representation / Sandeep Prasada. (shrink)

We are currently in the midst of a revival of interest in thevirtues. A number of contemporary moral philosophers havedefended a virtue-based approach to ethics. But does thisrenewal of interest in the virtues have much to contributeto medical ethics and medical practice? This paper criticallydiscusses this question. It considers and rejects a number ofimportant arguments that purport to establish the significanceof the virtues for medical practice. Against these arguments,the paper seeks to show that while the virtues have a genuinerole to (...) play in medical ethics, it is a limited role, one thatis subordinate to the role that other moral concepts such asrules and principles play. (shrink)

If people sometimes participate in research because of altruism—because they want to help in the search for treatments—should we revise our views about what kinds of experiments are ethical? If participants act out of altruism, we might let them accept greater risks than we would if they are motivated only by a desire for personal gain. But how can we know when participants are genuinely altruistic?

""Catching Ourselves in the Act" is no less than an attempt to explain intelligence. Delightful how the author dismantles traditional views in.

It is often claimed that the intentions of physicians are multiple, ambiguous, and uncertain—at least with respect to end-of-life care. This claim provides support for the conclusion that the principle of double effect is of little or no value as a guide to end-of-life pain management. This paper critically discusses this claim. It argues that proponents of the claim fail to distinguish two different senses of “intention,” and that, as a result, they are led to exaggerate the extent to which (...) clinical intentions in end-of-life contexts are ambiguous and uncertain. It argues further that physicians, like others who make life and death decisions, have a duty to get clear on what their intentions are. Finally, it argues that even if the principle of double effect should be rejected, clinical intentions remain ethically significant because they condition the meaning of extraordinary clinical interventions, such as that of palliative sedation. (shrink)

In order to develop the ontology of tendencies for use in the representation of medical knowledge, tendencies are compared with other kinds of entities possessing the realizable-realization structure, specifically: dispositions, propensities, abilities and virtues. The peculiarities of tendencies are discussed and a standard schema of tendency ascription is developed in order to represent the relations between the ascriptions of tendency tokens to particulars and the ascriptions of tendency types to universals. Two nonstandard cases and their epistemic variants are discussed.

With substance dualism and the existence of God, Swinburne (2004, The Existence of God, Oxford University Press, Oxford) and Moreland (2010, Consciousness and the Existence of God, Routledge, New York) have argued for a very powerful explanatory mechanism that can readily explain several philosophical problems related to consciousness. However, their positions come with presuppositions and ontological commitments which many are not prepared to share. The aim of this paper is to improve on the Swinburne-Moreland argument from consciousness by developing an (...) argument for the existence of God from consciousness without being committed to substance dualism. The argument proceeds by suggesting a solution to the exceptional-point-of-view problem, i.e., the question how it can be explained that there is a conscious being lucky enough to experience the point of view of a relatively tiny brain amidst a giant universe that is indifferent about which physical entities it brings about according to the laws of physics. (shrink)

In recent years, many states in the United States have passed legislation requiring laboratories to report the names of patients with low CD4 cell counts to their state Departments of Health. This name reporting is an integral part of the growing number of “HIV Reporting and Partner Notification Laws” which have emerged in response to recently revised guidelines suggested by the National Centers for Disease Control (CDC). Name reporting for patients with low CD4 cell counts allows for a more accurate (...) tracking of the natural history of HIV disease. However, given that this test is now considered to be an “indicator” of HIV, should it be subject to the same strict consent required for HIV testing? While the CDC has recommended that each state develop its own consent requirements for CD4 cell testing, most states have continued to rely on the presumed consent standards for CD4 cell testing that were in place before the passage of name reporting statutes. This allows physicians who treat patients who refuse HIV testing to order a CD4 cell blood analysis to gather information that is indicative of their patient’s HIV status. This paper examines the ethical and legal issues associated with the practice of “conscientious subversion” as it arises when clinicians use CD4 cell counts as a surrogate for HIV testing. (shrink)

In this article I address the idea that in Husserl’s eidetic ontology all possibilities are fixed ‘in advance’ so that actual objects and events—despite their contingency—can only ever unfold possibilities that are ‘permitted’ to them by their essences. I show how this view distorts Husserl’s ontology and argue that this distortion stems from a misconstrual of the relations between essences and facts, and between ideal and real possibilities. These ‘local’ misconstruals reflect, I contend, a ‘global’ misunderstanding that mistakes descriptive distinctions (...) for ‘real’ separations, and that remains indebted to a non-Husserlian understanding of the a priori–a posteriori-distinction. In support of this argument, I first lay out the relevant objection to Husserl’s eidetics as I understand it. Then, I clarify the relation between ideal and real possibilities in the context of Husserl’s eidetics as I see it. Finally, I make a general point about the status of Husserl’s ontological differentiations ‘in the midst of life,’ namely in how what they differentiate is effective and (tacitly) manifest ever only as one moment (amongst many) of the complex whole that is a concrete life of consciousness. I end with some remarks on what this might mean for future phenomenological research on the imagination. (shrink)

Functional explanations apply not only in cases of normal functioning, but also in the case of malfunctioning. According to a straightforward analysis, a bearer of the function to F is malfunctioning if and only if it does not F although it should do so. This makes malfunctions and malfunctionings analogous to negative causation and thus peculiarly problematic, because they seem to involve absent dispositions and absent processes. This analysis seems also to require that the function to F cannot be identical (...) with the disposition to F. Then we seem to be trapped in a dilemma: Either the realm of functions is separated from the realm of dispositions; then it seems that functions cannot be causally efficacious. Alternatively, functions are considered to be identical with dispositions; but then malfunctioning seems to be conceptually impossible. The paper defends and further develops the thesis of Röhl and Jansen that functions are not a special type of dispositions. For this purpose, it first reviews different varieties of malfunction and malfunctioning and suggests definitions of both malfunction and malfunctioning. It reviews how causal, etiological and intentional theories of functions can deal with these problems. In particular, the paper discusses the special-disposition account of the Basic Formal Ontology. Spear, Ceusters and Smith :103--128, 2016) have defended the special-disposition account of the Basic Formal Ontology by suggesting various strategies how a special-disposition account can deal with malfunctions. On the one side, the paper evaluates these strategies and indicates several problems arising from them. On the other hand, it describes how to account for the non-optionality and the causal efficacy of functions, if functions are not dispositions. While function types are not identical to disposition types, there are important interrelations between functions and dispositions, namely heuristically, from a design perspective for artefact functions, and from an evolutionary perspective for types of biological functions. (shrink)

We study logic translations from an abstract perspective, without any commitment to the structure of sentences and the nature of logical entailment, which also means that we cover both proof- theoretic and model-theoretic entailment. We show how logic translations induce notions of logical expressiveness, consistency strength and sublogic, leading to an explanation of paradoxes that have been described in the literature. Connectives and quantifiers, although not present in the definition of logic and logic translation, can be recovered by their abstract (...) properties and are preserved and reflected by translations under suitable conditions. (shrink)

The allocation of vaccines and therapeutics for Covid‐19 obviously raises ethical questions, and physicians and ethicists have begun to address them. Writers have identified various criteria that should guide allocation decisions, but the criteria often conflict and need to be balanced against one another. This article proposes a model for thinking about how different considerations that are relevant to the distribution of vaccines and scarce treatments for Covid‐19 could be integrated into an allocation procedure. The model employs the construct of (...) a weighted lottery, which is a construct that has been employed in other contexts that involve the distribution of scarce resources. The article highlights the advantages of applying a weighted lottery to the Covid‐19 context and offers an illustration for how it might work in practice. The primary aim of the article is to articulate the structural features of a weighted lottery for this context and to bring out its advantages over other methods for allocating Covid‐19 medications. (shrink)

Recent years have witnessed a growing concern that terminally illpatients are needlessly suffering in the dying process. This has ledto demands that physicians become more attentive in the assessment ofsuffering and that they treat their patients as `whole persons.'' Forthe most part, these demands have not fallen on deaf ears. It is nowwidely accepted that the relief of suffering is one of the fundamentalgoals of medicine. Without question this is a positive development.However, while the importance of treating suffering has generally (...) beenacknowledged, insufficient attention has been paid to the question ofwhether different types of terminal suffering require differnt responsesfrom health care professionals. In this paper we introduce a distinctionbetween two types of suffering likely to be present at the end of life,and we argue that physicians must distinguish between these types if theyare to respond appropriately to the suffering of their terminally illpatients. After introducing this distinction and explaining its basis,we further argue that the distinction informs a (novel) principle ofproportionality, one that should guide physicians in balancing theircompeting obligations in responding to terminal suffering. As weexplain, this principle is justified by reference to the intereststerminally ill patients have in restoration, as well as in therelief of suffering, at the end of life. (shrink)

This paper provides a new rationale for equating brain death with the death of the human organism, in light of well-known criticisms made by Alan D Shewmon, Franklin Miller and Robert Truog and a number of other writers. We claim that these criticisms can be answered, but only if we accept that we have slightly redefined the concept of death when equating brain death with death simpliciter. Accordingly, much of the paper defends the legitimacy of redefining death against objections, before (...) turning to the specific task of defending a new rationale for equating brain death with death as slightly redefined. (shrink)

The human body can be regarded in at least two ways: objectively, as a physical and organic body; and subjectively, as the center of orientation and lived affective unity. However, this distinction can lose sight of the fact that the ‘lived body’ is not reducible to subjective idiosyncrasies. Trans-individual norms are embodied too, as Michel Foucault and Judith Butler have shown. Phenomenological investigations of normalization and habitualization help bring these two important dimensions of embodiment together and overcome simplistic oppositions between (...) phenomenological and poststructuralist approaches. These investigations lead into issues of female body optimization and control that we take to be characteristic of contemporary neoliberalist embodiment. (shrink)

The article Do translocal networks matter for agricultural innovation? A case study on advice sharing in small scale farming communities in Northeast Thailand, written by Till Rockenbauch, Patrick Sakdapolrak and Harald Sterly, was originally published electronically on the publisher’s internet portal on 10 April 2019 without open access.

This article presents an analysis and evaluation of what I call the “I’m not stupid” argument. This argument has ancient roots, which lie in Aristotle’s famous description of the weak man’s and strong man’s arguments. An “I’m not stupid” argument is typically used in a context of accusation and defense, by a defendant who argues that they did not commit the act of which they have been accused. The analysis of this type of argument takes the shape of an argumentative (...) pattern, which displays a full-fledged representation of its argumentation structure. It is based on a collection of ten contemporary instances of the “I’m not stupid” argument. Although ten instances constitute a small collection, the wide variation in the argumentative elements that they express explicitly or leave implicit made it possible to identify five new key premises in comparison with previous analyses of the weak man’s and strong man’s arguments (Walton, Tindale and Gordon 2014 in _Argumentation_ 28:85–119, 2014; Walton 2019 in _Argumentation_ 33:45–74, 2019). These new premises show that the crucial point of an evaluation of this argument is the arguer's supposedly rational character in making a gain-loss calculation. They also show that we need empirical data to strengthen our analyses of argument schemes and argumentation structures. (shrink)

Much work in social ontology analyzes how social entities are based on collective intentionality. A neglected perspective is, however, the distinction between those social entities that are explicitly established (often called formal institutions, like marriages), those that are established but not explicitly (informal institutions, like friendships), and those that are not established at all (social macro entities, like episodes of inflation). To shed more light on this trichotomy, a collection of examples taken from the works of John Searle will be (...) discussed, comprising money, marriages, friendship, cocktail parties, natural language, and episodes of inflation. The chapter argues that explicit establishment confers certain typical characteristics on formal institutions that informal institutions lack, thus explaining the typical differences between marriages and friendship. The focus on explicit establishment further develops Khalidi’s classification of social kinds, and it contributes to Epstein’s quest for grounds and anchors of social entities. It can thus contribute to overcoming the narrow focus on collective intentionality. (shrink)

: "Clinical pragmatism" is an important new method of moral problem solving in clinical practice. This method draws on the pragmatic philosophy of John Dewey and recommends an experimental approach to solving moral problems in clinical practice. Although the method may shed some light on how clinicians and their patients ought to interact when moral problems are at hand, it nonetheless is deficient in a number of respects. Clinical pragmatism fails to explain adequately how moral problems can be solved experimentally, (...) it underestimates the relevance and importance of judgment in clinical ethics, and it presents a questionable account of the role that moral principles should play in moral problem solving. (shrink)

This book gives a convincing philosophical explanation for the strong persistence of our diverse folk psychological intuitions about the self. For this purpose it introduces, on the one hand, the distinction between subject and self model as proposed by Metzinger, on the other hand, the distinction between a social/normative and a cognitive/organic perspective on the self. The book argues that one needs to take into account both distinctions, if one wants to answer notoriously difficult questions like the one that gives (...) the book its title: Is the self real? (shrink)

The term “exploitation” has gained wide currency in recent discussions of biomedical and research ethics. This is due in no small measure to the influence of Alan Wertheimer’s path-breaking work on the topic (Wertheimer 1999, 2011). Wertheimer presented a clear and compelling non-Marxist account of the concept of exploitation—one that stressed the connection between exploitation and unfair distributive outcomes. On this account, when one party exploits another, she takes advantage of the other to gain unfairly. A number of contemporary bioethicists (...) have accepted Wertheimer’s account of exploitation and have proceeded to apply it to a range of issues in research ethics (Hawkins and Emanuel 2008; Miller and Brody .. (shrink)

The book then discusses another group of issues ("whether it is, what it is, how and why it is"), which determined the argumentation, the axiomatic ordering of the sciences, and concludes with a demonstration on the basis of concrete ...

The Making of the Economy uses Husserl's critique of formalism in natural science in The Crisis of the European Sciences work as the template for an analogous critique of formalism in economic science. The historical narrative focuses on the emergence of formal economic analysis out of a series of successive life-worlds, or concrete historical situations. This generates new substantive understanding of both the historical material and the current discourse of crisis surrounding economics. It will appeal to historians and philosophers of (...) economics, as well as scholars of history, philosophy, and sociology. (shrink)

The concept of imagination is notoriously ambiguous. Thus one must be cautious not to use ‘imagination’ as a placeholder for diverse phenomena and processes that perhaps have not much more in common than that they are difficult to assign to some other, better defined domain, such as perception, conceptual thought, or artistic production. However, this challenge also comes with great opportunities: the fecundity and openness of ‘imagination’ appeal to researchers from different disciplines with different approaches and questions, and it draws (...) together fields of enquiry that are initially considered far apart. Hence, arguably, the field of imagination is particularly poised for interdisciplinary enquiry. In the section on Imagination in Interdisciplinary Research, I will talk about some of the issues that have already entered that field of interdisciplinary inquiry. (shrink)

This article analyses how recent critiques of secularism in political philosophy and cultural anthropology might productively be combined and contrasted with each other. I will show that Jürgen Habermas' postsecularism takes insufficient account of elementary criticisms of secularism on the part of anthropologists such as Talal Asad and Saba Mahmood. However, I shall also criticize Saba Mahmood’s reading of secularism by arguing that, in the end, she replaces the secular–religious divide with a secularity–piety divide; for example, in her reading of (...) Nasr Abu Zayd’s secular Islamic hermeneutics. This inhibits the use of her framework of analysis for a criticism of a problem central to Habermas' postsecularism, namely that it remains focused on specific intensities of belief. I shall then argue that, combined with the anthropological critiques of the secular, the political-historical nature of the fanaticism–piety–violence nexus should be integrated into political philosophical debates on secularism and postsecularism. (shrink)

Scholars have recognized that contentious political action typically draws on relatively stable scripts for the enactment of claims making. But if such repertoires of political practice are generally reproduced over time, why and how do new modes of practice emerge? Employing a pragmatist perspective on social action, this article argues that change in political repertoires can be usefully understood as a result of situated political innovation—i.e., of the creative recombination of existing practices, through experimentation over time, by interacting political agents (...) for whom old repertoires were proving inadequate to the changing context of action. The utility of this approach is demonstrated by applying it to explain the historical emergence of a new set of populist mobilizing practices in early twentieth-century Peru. The results have implications for the study of political action and historical change. (shrink)

Paediatric Intensive Care Units (PICU) are complex interdisciplinary environments where challenging, high stakes decisions are frequently encountered. We assert that appropriate decisions are more likely to be made if the decision-making process is comprehensive, reasoned, and grounded in thoughtful deliberation. Strategies to overcome barriers to high quality decision-making including, cognitive and implicit bias, group think, inadequate information gathering, and poor quality deliberation should be incorporated. Several general frameworks for decision-making exist, but specific guidance is scarce. In this paper, we provide (...) specific guidance on collaborative complex decision-making for PICUs. The proposed approach is on principles of procedural justice and pragmatic hermeneutics. The process encompasses set-up/planning, information gathering, question formulation, analysis (perspectives, values, and principles), action plan development, decision documentation, and a review and appeal mechanism. The process can be adapted to suit other clinical contexts. Research evaluating the process, exploring how best to develop education for clinicians, and how to build a culture that values high quality deliberation, is worthwhile. (shrink)

We introduce a new metric for interdisciplinarity, based on co-author publication history. A published article that has co-authors with quite different publication histories can be deemed relatively “interdisciplinary,” in that the article reflects a convergence of previous research in distinct sets of publication outlets. In recent work, we have shown that this interdisciplinarity metric can predict citations. Here, we show that the journal Cognitive Science tends to contain collaborations that are relatively high on this interdisciplinarity metric, at about the 80th (...) percentile of all journals across both social and natural sciences. Following on Goldstone and Leydesdorff, we describe how scientometric tools provide a valuable means of assessing the role of cognitive science in broader scientific work, and also as a tool to investigate teamwork and distributed cognition. We describe how data-driven metrics of this kind may facilitate this exploration without relying upon rapidly changing discipline and topic keywords associated with publications. (shrink)

This article critically analyzes the principle of beneficence and the principle of nonmaleficence in clinical medical ethics. It resists some recent skepticism about the principle of nonmaleficence, and then seeks to explain its role in medicine. The article proposes that the two principles are informed by different accounts of what is in the patient’s best interests. The principle of beneficence is tied to the patient’s best overall interests, whereas the principle of nonmaleficence is tied to the patient’s best medical interests (...) only. The article argues that the principle of nonmaleficence takes priority over the principle of beneficence in that it filters the treatment options that are appropriately subject to the principle of beneficence. Understanding how both principles can play an important role in medical practice, and how they relate when they come into conflict, can help clinicians to avoid certain mistakes in thinking about their duties to their patients. (shrink)

Background In this article, the sources and features of moral distress as experienced by acute psychiatric care nurses are explored. Research design A qualitative design with 16 individual in-depth interviews was chosen. Braun and Clarke’s six analytic phases were used. Ethical considerations Approval was obtained from the Norwegian Social Science Data Services. Participation was confidential and voluntary. Findings Based on findings, a somewhat wider definition of moral distress is introduced where nurses experiencing being morally constrained, facing moral dilemmas or moral (...) doubt are included. Coercive administration of medicines, coercion that might be avoided and resistance to the use of coercion are all morally stressful situations. Insufficient resources, mentally poorer patients and quicker discharges lead to superficial treatment. Few staff on evening shifts/weekends make nurses worry when follow-up of the most ill patients, often suicidal, in need of seclusion or with heightened risk of violence, must be done by untrained personnel. Provision of good care when exposed to violence is morally challenging. Feelings of inadequacy, being squeezed between ideals and clinical reality, and failing the patients create moral distress. Moral distress causes bad conscience and feelings of guilt, frustration, anger, sadness, inadequacy, mental tiredness, emotional numbness and being fragmented. Others feel emotionally ‘flat’, cold and empty, and develop high blood pressure and problems sleeping. Even so, some nurses find that moral stress hones their ethical awareness. Conclusion Moral distress in acute psychiatric care may be caused by multiple reasons and cause a variety of reactions. Multifaceted ethical dilemmas, incompatible demands and proximity to patients’ suffering make nurses exposed to moral distress. Moral distress may lead to reduced quality care, which again may lead to bad conscience and cause moral distress. It is particularly problematic if moral distress results in nurses distancing and disconnecting themselves from the patients and their inner selves. (shrink)

Australia’s punitive policy towards people seeking asylum deliberately causes severe psychological harm and meets recognised definitions of torture. Consequently, there is a tension between doctors’ obligation not to be complicit in torture and doctors’ obligation to provide best possible care to their patients, including those seeking asylum. In this paper, we explore the nature of complicity and discuss the arguments for and against a proposed call for doctors to boycott working in immigration detention. We conclude that a degree of complicity (...) is unavoidable when working in immigration detention, but that it may be ethically justifiable. We identify ways to minimise the harms associated with complicity and argue that it is ethical to continue working in immigration detention as long as due care and attention is paid to minimising the harms of complicity. (shrink)

This book discusses the philosophy of influential contemporary philosopher Peter van Inwagen. Looking at perennial philosophical problems from a modern point of view, Peter van Inwagen’s philosophy masterfully combines positions that have been considered irreconcilable: incompatibilism concerning free will, materialism, organicism, theism and realism concerning fictional entities. As readers will discover, his arguments are witty, surprising and deep. -/- The book includes Peter van Inwagen’s Münster Lecture of 2015 on free will, as well as eleven papers from the Münster colloquium (...) discussing central themes of his philosophy, and a reply to each paper by Peter van Inwagen himself. Introducing his philosophy and relating his work to other contemporary views, this book is of interest to graduate students and professionals in philosophy alike. (shrink)

This piece looks into the atmospheric and catastrophic environments that punctuate H of H: storms, ice-breaks, volcanic eruptions, and nuclear explosions that give the tragic narrative an electrifying edge. It draws attention to a “chemical” poetics at the heart of Carson’s translation technique and thinking about Euripides’ play. This mannerism, also found in Euripides’s “combustible mixture of realism and extremism” (Grief Lessons, blurb), is not exclusive to H of H. It can be detected across Carson’s oeuvre – a tendency to (...) combust the reader’s mind in ways that become a philosophy for re-reading Euripides and, more ambitiously, Carson’s own sense of the tragic. (shrink)

The network society is generally challenging for today's communication practitioners because they are no longer the sole entities responsible for communication processes. This is a major change for many of them. In this paper, it will be contended that the normative practice model as developed within reformational philosophy is beneficial for clarifying the structure of communication practices. Based on this model, we argue that government communication should not be considered as primarily an activity that focuses on societal legitimation of policy; (...) rather, it focuses on clarifying the meaning of the actions of the government. If the government can convincingly answer the question about the reason for their actions, societal legitimation will subsequently follow. Hence, it is argued that government communication is primarily linguistically qualified. (shrink)

Unrealistic optimism is a bias that leads people to believe, with respect to a specific event or hazard, that they are more likely to experience positive outcomes and/or less likely to experience negative outcomes than similar others. The phenomenon has been seen in a range of health-related contexts—including when prospective participants are presented with the risks and benefits of participating in a clinical trial. In order to test for the prevalence of unrealistic optimism among participants of early-phase oncology trials, we (...) conducted a survey with patients over 18 years of age who were enrolled in a phase I, phase I/II, or phase II clinical cancer trial in the New York City area between August 2008 and October 2009. Participants in our study were asked to compare their own chances of experiencing a range of risks and benefits related to the trial they were enrolled in with the chances of the other trial participants. We found a significant optimistic bias in their responses. Respondents tended to overestimate the benefits of the trial they were enrolled in and underestimate its risks. In addition, we found no significant relationship between respondents’ understanding of the trial’s purpose and how susceptible they were to unrealistic optimism. Our findings suggest that improving the consent process for oncology studies requires more than addressing deficits in understanding. (shrink)