As bioethics gains more prominence in public policy debates, it is time to more fully reflect on the following: what is its role in the public square, and what limitations relate to and barriers impede its fulfilment of this role? I contend we should consider the how of bioethics (as a policy influencer) rather than simply focus on the who or what of bioethical enquiry. This is not to suggest considerations of latter categories are not important, only that too little (...) attention has been paid to parallel or resulting policy involvement—involvement that will require specialised skills and knowledge that we can develop with a proactive (vs reactive) stance. Moreover, and equally critically, this how of public policy involvement will require more transparency regarding influences (eg, philosophical, ideological, cultural, socio-political) on what bioethicists bring to the table and what constituency base each represents—a humility as to the scope of one's role. In this vision, bioethics is not one single person or belief system for a policymaker to call to guide or give support to a position; rather, it offers tools—formed and utilised by a diverse disciplinary range of individuals—to help guide ethical analysis of biomedical endeavours, with the goal of infusion and diffusion of ethical enquiry and prioritisation in health policymaking, and greater humility among bioethicists who inform this discussion. (shrink)

Medical-legal partnerships (MLPs) — collaborative endeavors between health care clinicians and lawyers to more effectively address issues impacting health care — have proliferated over the past decade. The goal of this interdisciplinary approach is to improve the health outcomes and quality of life of patients and families, recognizing the many non-medical influences on health care and thus the value of an interdisciplinary team to enhance health. This article examines the unique, interrelated ethical issues that confront the clinical and legal partners (...) involved in MLPs. We contend that the ethical precepts of the clinical and legal professions should be seen as opportunities, not barriers, to further the interdisciplinary nature of MLPs. The commonalities in ethical approaches represent a potential bridge between legal and health care advocacy for patient/client well-being. Bioethics has a role to play in building and analyzing this bridge: bioethics may serve as a discourse and method to enhance collaboration by highlighting common ethical foundations and refocusing legal and clinical partners on their similar goals of service for patients/clients. This article explores this bridging role of bioethics, through a series of case studies. It concludes with recommendations to strengthen the collaborations. (shrink)

Medical-legal partnerships — collaborative endeavors between health care clinicians and lawyers to more effectively address issues impacting health care — have proliferated over the past decade. The goal of this interdisciplinary approach is to improve the health outcomes and quality of life of patients and families, recognizing the many non-medical influences on health care and thus the value of an interdisciplinary team to enhance health. There are currently over 180 MLPs at over 200 hospitals and health centers in the United (...) States, with increasing federal interest and potential legislative support of this model.This article examines the unique, interrelated, and often similar ethical issues that confront the clinical and legal partners involved in MLPs. We contend that the ethical precepts of the clinical and legal professions should be seen as opportunities, not barriers, to further the interdisciplinary nature of MLPs. (shrink)

Law is now routinely included in the medical school curriculum, often incorporated into bioethics and/or practice of medicine coursework. There seems to lack, however, a systematic understanding of what works in terms of getting across an effective depth and breadth of legal knowledge for medical students — or what such would even look like. Moreover, and more critically, while some literature addresses these what, when, how, and who questions, a more fundamental question is left unanswered: why teach law in medical (...) school? This article suggests a process to reveal a more consensual understanding of this latter question. The author highlights findings and recommendations of some of the leading literature to date related to teaching law in medical schools, and also recent U.K. projects addressing legal teaching in medical schools. Reflecting on these materials and activities, the author suggests that we take a “pause” before we argue for more or different legal topics within the medical curriculum. Before we alter the curricula for more and/or different “law,” first, it is critical to have a meaningful, stakeholder-driven, consensus-seeking discussion of the goals of legal education: why do we think it matters that medical students learn about “the law”? (shrink)

[T]each the law to empower physicians individually and collectively to use the law and law colleagues to serve patients and promote public welfare; in short to better foster the goals of the medical profession.And yet:[A]ntipathy appears to be deeper and more pervasive than ever before, making it hard to imagine that relations between attorneys and physicians can get much worse.It has long been recognized that an understanding of at least some core legal rules and concepts is an important piece of (...) medical training. To address this, law is now typically part of the core medical school curriculum, often incorporated into bioethics and/or practice of medicine coursework — whether as part of a distinct course or series of courses or threaded through the curriculum. While often this education focuses on rules, some have recommended that it also include fundamentals of legal reasoning, and go beyond knowledge to include skills, attitudes, and behaviors vis-à-vis the law. (shrink)

This article describes implementation of a longitudinal curriculum in public health law, building on doctrinal coursework with skills-based coursework and opportunities for interdisciplinary, community-based engagement and service learning. It specifically describes development of a Policy Practicum, giving an example of how law students can learn policy skills and skills of effective community coalition work through a healthy homes partnership, highlighting areas where the curriculum can incorporate interdisciplinary education. It offers lessons learned during the curriculum-building process, and concludes with a more (...) intensive service-learning strategy through the development of a Policy Lab. (shrink)

Cultural effects can influence the results of causal genetic analyses, such as Mendelian randomisation, but the potential influences of culture on genotype–phenotype associations are not currently well understood. Different genetic variants could be associated with different phenotypes in different populations, or culture could confound or influence the direction of the association between genotypes and phenotypes in different populations.

The comorbidity of chronic pain and opioid addiction is a serious problem that has been growing with the practice of prescribing opioids for chronic pain. Neuroimaging research has shown that chronic pain and opioid dependence both affect brain structure and function, but this is the first study to evaluate the neurophysiological alterations in patients with comorbid chronic pain and addiction. Eighteen participants with chronic low back pain and opioid addiction were compared with eighteen age- and sex-matched healthy individuals in a (...) pain-induction fMRI task. Unified structural equation modeling (SEM) with Lagrange multiplier (LM) testing yielded a network model of pain processing for patient and control groups based on 19 a priori defined regions. Tests of differences between groups on specific regression parameters were determined on a path-by-path basis using z-tests corrected for the number of comparisons. Patients with the chronic pain and addiction comorbidity had increased connection strengths; many of these connections were interhemispheric and spanned regions involved in sensory, affective, and cognitive processes. The affected regions included those that are commonly altered in chronic pain or addiction alone, indicating that this comorbidity manifests with neurological symptoms of both disorders. Understanding the neural mechanisms involved in the comorbidity is crucial to finding a comprehensive treatment, rather than treating the symptoms individually. (shrink)

Drug Safety Communications are used by the Food and Drug Administration to inform health care providers, patients, caregivers, and the general public about safety issues related to FDA-approved drugs. To assess patient knowledge of the messaging contained in DSCs related to the sleep aids zolpidem and eszopiclone, we conducted a large, cross-sectional patient survey of 1,982 commercially insured patients selected by stratified random sampling from the Optum Research Database who had filled at least two prescriptions for either zolpidem or eszopiclone (...) between July 1, 2012 and June 30, 2013. Among the 594 respondents, two-thirds reported hearing generally about drug safety information prior to starting a new drug, with the remaining one-third “rarely” or “never” hearing such information. Providers and pharmacists were primary sources of drug safety information. Two-thirds of zolpidem users and half of eszopiclone users reported having heard about the related DSC messages, ability to accurately identify the major factual messages was limited. Respondents reacted to new drug safety information about their sleep aids by reporting that they would want to learn about alternative ways to help them sleep and seek out more information about the safety of their specific sleeping pill. Opportunities may exist for the FDA to work with providers and pharmacies to help ensure the DSC information is more widely received and is more fully understood by those taking the affected medications. (shrink)

Against the background of the exclusion of many feminist methodologies from mainstream philosophy, and in light of the methodological challenges of providing accounts of experience responsive to the lives of agents, in this paper I return to early feminist philosophers of emotion to highlight how they anticipate and respond to methodological criticisms. Sue Campbell (1956–2011) was one philosopher who used methodological quandaries to strengthen her account of the formation and expression of feelings (Campbell ). By rereading selected texts (...) together intentionally for their structural and methodological strategies, I emphasize the power of formal characteristics to make insightful claims about experience possible. I consider how feminist philosophers of “experienced agency” can put these strategies to use in facing ongoing methodological criticisms, taking as a case study an account of how it can feel to act responsibly against injustice. (shrink)

This case describes an adolescent in a crisis of a chronic medical condition whose situation is complicated by substance abuse and mental illness. D. Micah Hester provides an analytic approach, teasing apart the multiple layers of medical, developmental, and moral issues at hand and describing possible responses and outcomes. Amy T. Campbell examines existing legal guidelines for adolescent decision making, arguing that greater space exists for clinical discretion in these matters than commonly thought. Cheryl D. Lew discusses the development (...) of agency in adolescent patients, the ideal of autonomous decision making in the context of impairment and chronic illness, and the obligation of healthcare teams to examine an adolescent patient’s decisions in relation to her identity. (shrink)

"Il faudrait que quelqu'un chez vous fasse un roman sur un intellectuel d'Europe centrale sous le coup des derniers événements. Pas seulement pour la curiosité psychologique. Pour apprendre à voir ce que vous n'aimez pas regarder", écrivait le phénoménologue tchèque Jan Patocka, en juillet 1949, à son ami Robert Campbell, philosophe et mathématicien français, auteur, en 1945, du premier ouvrage consacré aux écrits et à la pensée de Jean-Paul Sartre. Mieux qu'un roman, la correspondance amicale et philosophique que les (...) deux hommes échangeront pendant une trentaine d'années, avec deux hiatus dus aux aléas des circonstances, publiques et privées, depuis le lendemain de la Seconde Guerre mondiale, à travers le virage totalitaire de l'"autre Europe", le relatif dégel des années 1960 et l'avant-"printemps de Prague", jusqu'à l'engagement de Patocka dans le mouvement de la Charte 77 pour la défense des droits de l'homme, représente, dans ses trois dimensions indissolublement enchevêtrées de l'intime-quotidien, de l'historico-politique et de la pensée, un document d'une rare valeur précisément en ce sens. Un document qui nous met sous les yeux un exemple concret de ce que Patocka nomme "la vie dans l'idée". (shrink)

The puzzle of imaginative desire arises from the difficulty of accounting for the surprising behaviour of desire in imaginative activities such as our engagement with fiction and our games of pretend. Several philosophers have recently attempted to solve this puzzle by introducing a class of novel mental states—what they call desire-like imaginings or i-desires. In this paper, I argue that we should reject the i-desire solution to the puzzle of imaginative desire. The introduction of i-desires is both ontologically profligate and (...) unnecessary, and, most importantly, fails to make sense of what we are doing in the imaginative contexts in question. (shrink)

While post- and decolonial theorists have thoroughly debunked the idea of historical progress as a Eurocentric, imperialist, and neocolonialist fallacy, many of the most prominent contemporary thinkers associated with the Frankfurt School--Jürgen Habermas, Axel Honneth, and Rainer Forst--have persistently defended ideas of progress, development, and modernity and have even made such ideas central to their normative claims. Can the Frankfurt School's goal of radical social change survive this critique? And what would a decolonized critical theory look like? Amy Allen fractures (...) critical theory from within by dispensing with its progressive reading of history while retaining its notion of progress as a political imperative, so eloquently defended by Adorno. Critical theory, according to Allen, is the best resouce we have for achieving emancipatory social goals. In reimagining a decolonized critical theory after the end of progress, she rescues it from oblivion and gives it a future. (shrink)

Human languages vary in many ways but also show striking cross-linguistic universals. Why do these universals exist? Recent theoretical results demonstrate that Bayesian learners transmitting language to each other through iterated learning will converge on a distribution of languages that depends only on their prior biases about language and the quantity of data transmitted at each point; the structure of the world being communicated about plays no role (Griffiths & Kalish, , ). We revisit these findings and show that when (...) certain assumptions about the relationship between language and the world are abandoned, learners will converge to languages that depend on the structure of the world as well as their prior biases. These theoretical results are supported with a series of experiments showing that when human learners acquire language through iterated learning, the ultimate structure of those languages is shaped by the structure of the meanings to be communicated. (shrink)

In this book John Campbell shows that the general structural features of human thought can be seen as having their source in the distinctive ways in which we...

Imagination is celebrated as our vehicle for escape from the mundane here and now. It transports us to distant lands of magic and make-believe, and provides us with diversions during boring meetings or long bus rides. Yet the focus on imagination as a means of escape from the real world minimizes the fact that imagination seems also to furnish us with knowledge about it. Imagination seems an essential component in our endeavor to learn about the world in which we live--whether (...) we're planning for the future, aiming to understand other people, or figuring out whether two puzzle pieces fit together. But how can the same mental power that allows us to escape the world as it currently is also inform us about the world as it currently is? Ten original essays grapple with this neglected question; in doing so, they present a diverse array of positions ranging from cautious optimism to deep-seated pessimism. Blending perspectives from philosophy of mind, cognitive science, epistemology, aesthetics, and ethics, Knowledge Through Imagination sheds new light on the epistemic role of imagination. (shrink)

In recent analytic metaphysics, the view that ‘ordinary inanimate objects such as sticks and stones, tables and chairs, simply do not exist’ has been defended by some noteworthy writers. Thomasson opposes such revisionary ontology in favour of an ontology that is conservative with respect to common sense. The book is written in a straightforward, methodical and down-to-earth style. It is also relatively non-specialized, enabling the author and her readers to approach problems that are often dealt with in isolation in a (...) more unified way.Thomasson's arguments are mainly counter-attacks on six ‘eliminativist’ arguments against ordinary objects. A causal redundancy argument espoused by Trenton Merricks holds that to suppose that there are ordinary objects is to suppose that these objects have distinctive causal powers. However, the casual efficacy of a baseball, for example, is exhausted by that of some suitably arranged …. (shrink)

Existence questions have been topics for heated debates in metaphysics, but this book argues that they can often be answered easily, by trivial inferences from uncontroversial premises. This 'easy' approach to ontology leads to realism about disputed entities, and to the view that metaphysical disputes about existence questions are misguided.

This paper examines the strategic use of corporate philanthropy in the 1990s by UK building societies faced with an intensification of societal pressure to change legal form from mutual to corporate status. While the economic case for mutuality has been made elsewhere, this paper examines the observation that community relationships were thought by management to be capable of assisting in the strategic positioning of mutual societies with regard to their legal form. By increasing charitable giving to respond to the level (...) of societal scrutiny and discussion on the issue of mutuality, this paper argues that charitable giving, as one proxy for community involvement, was used as a strategic tool to deflect calls for demutualisation, thereby preserving the existing mutual status of building societies. (shrink)

A fresh explication of the Thomist justification of self-defense casts off the hobbles of the principle of double effects to find a more secure footing in the historicaldevelopment of subjective natural rights by medieval jurists, and a straight-forward application to the latent threat of death in childbirth posed by non-consensual pregnancy. By articulating the implicit Thomistic right to defensive abortion in terms of conditional rights bestowed in Creation as correlative to particular natural law duties, justly proportionate limits to defensive abortion (...) are identified, and balanced against the forfeited or reserved natural rights variously imputed to conceptus and embryo in non-consensual pregnancies. Subsequently, the varieties of involuntary consent are examined from a Thomist perspective with a view to their relevance in justifying recourse to a rehabilitated practice of defensive abortion when free and full consent to impregnation and childbirth is absent. (shrink)

To 'consequentialise' is to take a putatively non-consequentialist moral theory and show that it is actually just another form of consequentialism. Some have speculated that every moral theory can be consequentialised. If this were so, then consequentialism would be empty; it would have no substantive content. As I argue here, however, this is not so. Beginning with the core consequentialist commitment to 'maximising the good', I formulate a precise definition of consequentialism and demonstrate that, given this definition, several sorts of (...) moral theory resist consequentialisation. My strategy is to decompose consequentialism into three conditions, which I call 'agent neutrality', 'no moral dilemmas', and 'dominance', and then to exhibit some moral theories which violate each of these. (shrink)

The most widely debated conception of democracy in recent years is deliberative democracy--the idea that citizens or their representatives owe each other mutually acceptable reasons for the laws they enact. Two prominent voices in the ongoing discussion are Amy Gutmann and Dennis Thompson. In Why Deliberative Democracy?, they move the debate forward beyond their influential book, Democracy and Disagreement.What exactly is deliberative democracy? Why is it more defensible than its rivals? By offering clear answers to these timely questions, Gutmann and (...) Thompson illuminate the theory and practice of justifying public policies in contemporary democracies. They not only develop their theory of deliberative democracy in new directions but also apply it to new practical problems. They discuss bioethics, health care, truth commissions, educational policy, and decisions to declare war. In "What Deliberative Democracy Means," which opens this collection of essays, they provide the most accessible exposition of deliberative democracy to date. They show how deliberative democracy should play an important role even in the debates about military intervention abroad.Why Deliberative Democracy? contributes to our understanding of how democratic citizens and their representatives can make justifiable decisions for their society in the face of the fundamental disagreements that are inevitable in diverse societies. Gutmann and Thompson provide a balanced and fair-minded approach that will benefit anyone intent on giving reason and reciprocity a more prominent place in politics than power and special interests. (shrink)

This challenging study places fiction squarely at the centre of the discussion of metaphysics. Philosophers have traditionally treated fiction as involving a set of narrow problems in logic or the philosophy of language. By contrast Amie Thomasson argues that fiction has far-reaching implications for central problems of metaphysics. The book develops an 'artifactual' theory of fiction, whereby fictional characters are abstract artifacts as ordinary as laws or symphonies or works of literature. By understanding fictional characters we come to understand how (...) other cultural and social objects are established on the basis of the independent physical world and the mental states of human beings. (shrink)

Science and the originality of life -- Christian facticity -- Grasping life as a topic -- Ruinance -- The retrieval of history -- Facticity and ontology -- Factical speaking -- Rhetoric -- Sophistry.

Arguments that ordinary inanimate objects such as tables and chairs, sticks and stones, simply do not exist have become increasingly common and increasingly prominent. Some are based on demands for parsimony or for a non-arbitrary answer to the special composition question; others arise from prohibitions against causal redundancy, ontological vagueness, or co-location; and others still come from worries that a common sense ontology would be a rival to a scientific one. Until now, little has been done to address these arguments (...) in a unified and systematic way. Ordinary Objects is designed to fill this gap, demonstrating that the mistakes behind all of these superficially diverse eliminativist arguments may be traced to a common source. It aims to develop an ontology of ordinary objects subject to no such problems, providing perhaps the first sustained defense of a common sense ontology in two generations. The work done along the way addresses a number of major issues in philosophy of language and metaphysics, contributing to debates about analyticity, identity conditions, co-location and the grounding problem, vagueness, overdetermination, parsimony, and ontological commitment. In the end, the most important result of addressing these eliminativist arguments is not merely avoiding their conclusions; examining their failings also gives us reason to suspect that many apparent disputes in ontology are pseudo-debates. For it brings into question widely-held assumptions about which uses of metaphysical principles are appropriate, which metaphysical demands are answerable, and how we should go about addressing such fundamental questions as "What exists?". As a result, the work of Ordinary Objects promises to provide not only the route to a reflective understanding of our unreflective common-sense view, but also a better understanding of the proper methods and limits of metaphysics. (shrink)

Philosophical theories often hinge on claims about what is necessary or possible. But what are possibilities and necessities, and how could we come to know about them? This book aims to help demystify the methodology of philosophy, by treating such claims not as attempted descriptions of strange facts or distant 'possible worlds', but rather as ways of expressing rules or norms.

It is often noted that institutional objects and artifacts depend on human beliefs and intentions and so fail to meet the realist paradigm of mind‐independent objects. In this paper I draw out exactly in what ways the thesis of mind‐independence fails, and show that it has some surprising consequences. For the specific forms of mind‐dependence involved entail that we have certain forms of epistemic privilege with regard to our own institutional and artifactual kinds, protecting us from certain possibilities of ignorance (...) and error; they also demonstrate that not all cases of reference to these kinds can proceed along a purely causal model. As a result, realist views in ontology, epistemology, and semantics that were developed with natural scientific kinds in mind cannot fully apply to the kinds of the social and human sciences. In closing I consider some wider consequences of these results for social science and philosophy. (shrink)

The authors offer ways to encourage and educate Americans to participate in the public deliberations that make democracy work and lay out the principles of..

This paper examines the extent to which the voluntary adoption of codes of conduct by multinational corporations (MNCs) renders MNCs accountable for the performance of actions specified in a code of conduct. In particular, the paper examines the ways in which codes of conduct coordinate the expectations of relevant parties with regard to the provision of assistance by MNCs on grounds of rescue or justice. The paper argues that this coordinative role of codes of conduct renders MNCs more accountable for (...) the performance of actions specified in a code of conduct than they would be without a code of conduct. This interpretation of the significance of codes of conduct is contrasted with the view that codes of conduct render MNCs accountable for performing actions specified in a code of conduct by grounding contractual obligations for the performance of such actions. (shrink)

Taking a fundamentally critical approach to the subject of business ethics, this book deals with the traditional material of ethics in business, as well as introducing and surveying some of the most interesting developments in critical ethical theory which have not yet been introduced to the mainstream. Including chapters on different philosophical approaches to ethics, this is a highly structured and clearly written textbook, the first book of its kind on this often neglected aspect of business.

Irrelevant emotional stimuli often capture attention, disrupting ongoing cognitive processes. In two experiments, we examined whether availability of rewards can prevent...