In their forthcoming article, ‘What makes a medical intervention invasive?’ De Marco, Simons, and colleagues explore the meaning and usage of the term ‘invasive’ in medical contexts. They describe a ‘Standard Account’, drawn from dictionary definitions, which defines invasiveness as ‘incision of the skin or insertion of an object into the body’. They then highlight cases wherein invasiveness is employed in a manner that is inconsistent with this account (eg, in describing psychotherapy) to argue that the term invasiveness is often (...) used to explicitly or implicitly reference interventions that do not fall under the standard account. The authors offer an alternative ‘schematic’ definition of invasiveness, whereby medical interventions entail an underlying context-independent property of ‘basic invasiveness’ and may be understood both relative to each other and to a context-specific threshold of what is ‘invasive’.1 We propose that the meaning of terms such as ‘invasiveness’ is necessarily heterogeneous, and that what is implied by its usage will certainly depend on context, particularly in medical settings. Hence, the creation of a unifying definition is less critical than clarification of the implied and intended meanings of each instance of the term’s use. We further argue that interpreting the use of terms like ‘invasiveness’ in medical practice is complicated by the embedding of each use of this term in a different ‘language game’, whereby words and their meanings are understood by an in-group familiar with …. (shrink)

In this response to the commentary “Disabling Bioethics Futures”, I offer support for the author’s argument that bioethics theory and pedagogy ought to be reframed to better incorporate the perspectives of disabled persons. Specifically, I argue that it is not only a pedagogical flaw but an active harm when bioethics pedagogy preserves disrespectful or discriminatory views by using outdated literature.

In many jurisdictions, legal frameworks afford patients the opportunity to make prospective medical decisions or to create directives that contain a special provision forfeiting their own ability to object to those decisions at a future time point, should they lose decision‐making capacity. These agreements have been described with widely varying nomenclatures, including Ulysses Contracts, Odysseus Transfers, Psychiatric Advance Directives with Ulysses Clauses, and Powers of Attorney with Special Provisions. As a consequence of this terminological heterogeneity, it is challenging for healthcare (...) providers to understand the terms and uses of these agreements and for ethicists to engage with the nuances of clinical decision‐making with such unique provisions surrounding patient autonomy. In theory, prospective self‐binding agreements may safeguard patient's “authentic” wishes from future “inauthentic” changes of mind. In practice, it is unclear what may be comprised within these agreements or how—and to what effect—they are used. The primary focus of this integrative review is to curate the existing literature describing Ulysses Contracts (and analogous decisions) used in the clinical arena, in order to empirically synthesize their shared essence and provide insights into the traditional components of these agreements when used in practice, the requirements of their consent processes, and the outcomes of their utilization. (shrink)

The aim of a theoretically ideal process of informed consent is to promote the autonomy of the patient and to limit unethical physician paternalism. However, in practice, the nature of the medical profession requires physicians to act as ontological decision architects—based on the medical knowledge that they acquire through their experience and training, physicians ontologically determine a subset of viable courses of action for their patient. What is observed is not an unethical physician limitation or biasing of the patient towards (...) certain treatment options that violates patient autonomy or consciously undermines informed consent, but rather a more foundational paternalism that is necessarily inherent to the physician–patient relationship. In this article we argue for a recognition of this underlying physician paternalism and posit that this necessary paternalism is not a foil to patient autonomy, but rather a foundational aspect of the duties of the medical professional within the physician–patient relationship. (shrink)

The aim of a theoretically ideal process of informed consent is to promote the autonomy of the patient and to limit unethical physician paternalism. However, in practice, the nature of the medical profession requires physicians to act as ontological decision architects—based on the medical knowledge that they acquire through their experience and training, physicians ontologically determine a subset of viable courses of action for their patient. What is observed is not an unethical physician limitation or biasing of the patient towards (...) certain treatment options that violates patient autonomy or consciously undermines informed consent, but rather a more foundational paternalism that is necessarily inherent to the physician–patient relationship. In this article we argue for a recognition of this underlying physician paternalism and posit that this necessary paternalism is not a foil to patient autonomy, but rather a foundational aspect of the duties of the medical professional within the physician–patient relationship. (shrink)

Objective: To examine the role of explainability in machine learning for healthcare (MLHC), and its necessity and significance with respect to effective and ethical MLHC application. Study Design and Setting: This commentary engages with the growing and dynamic corpus of literature on the use of MLHC and artificial intelligence (AI) in medicine, which provide the context for a focused narrative review of arguments presented in favour of and opposition to explainability in MLHC. Results: We find that concerns regarding explainability are (...) not limited to MLHC, but rather extend to numerous well-validated treatment interventions as well as to human clinical judgment itself. We examine the role of evidence-based medicine in evaluating unexplainable treatments and technologies, and highlight the analogy between the concept of explainability in MLHC and the related concept of mechanistic reasoning in evidence-based medicine. Conclusion: Ultimately, we conclude that the value of explainability in MLHC is not intrinsic, but is instead instrumental to achieving greater imperatives such as performance and trust. We caution against the uncompromising pursuit of explainability, and advocate instead for the development of robust empirical methods to successfully evaluate increasingly inexplicable algorithmic systems. (shrink)

How do we understand the agency and significance of material forces and their interface with human bodies? What does it mean to be human in these times, with bodies that are inextricably interconnected with our physical world? Bodily Natures considers these questions by grappling with powerful and pervasive material forces and their increasingly harmful effects on the human body. Drawing on feminist theory, environmental studies, and the sciences, Stacy Alaimo focuses on trans-corporeality, or movement across bodies and nature, which (...) has profoundly altered our sense of self. By looking at a broad range of creative and philosophical writings, Alaimo illuminates how science, politics, and culture collide, while considering the closeness of the human body to the environment. (shrink)

By insisting on the importance of materiality, this volume breaks new ground in philosophy, feminist theory, cultural studies, science studies, and other fields where the body and nature collide.

Journal of Global Ethics, Volume 9, Issue 3, Page 293-310, December 2013.

Physical laws are strikingly simple, although there is no a priori reason they must be so. I propose that nomic realists of all types (Humeans and non-Humeans) should accept that simplicity is a fundamental epistemic guide for discovering and evaluating candidate physical laws. This principle of simplicity clarifies and addresses several problems of nomic realism and simplicity. A consequence is that the oft-cited epistemic advantage of Humeanism over non-Humeanism disappears, undercutting an influential epistemological argument for Humeanism. Moreover, simplicity is shown (...) to be more tightly connected to lawhood than to mere truth. (shrink)

I argue that judgments of what is ‘true in a fiction’ presuppose the Reality Assumption: the assumption that everything that is true is fictionally the case, unless excluded by the work. By contrast with the more familiar Reality Principle, the Reality Assumption is not a rule for inferring implied content from what is explicit. Instead, it provides an array of real-world truths that can be used in such inferences. I claim that the Reality Assumption is essential to our ability to (...) understand stories, drawing on a range of empirical evidence that demonstrates our reliance on it in narrative comprehension. However, the Reality Assumption has several unintuitive consequences, not least that what is fictionally the case includes countless facts that neither authors nor readers could ever consider. I argue that such consequences provide no reason to reject the Reality Assumption. I conclude that we should take fictions, like non-fictions, to be about the real world. (shrink)

Overdiagnosis is an emerging problem in health policy and practice: we address its definition and ethical implications. We argue that the definition of overdiagnosis should be expressed at the level of populations. Consider a condition prevalent in a population, customarily labelled with diagnosis A. We propose that overdiagnosis is occurring in respect of that condition in that population when the condition is being identified and labelled with diagnosis A in that population ; this identification and labelling would be accepted as (...) correct in a relevant professional community; but the resulting label and/or intervention carries an unfavourable balance between benefits and harms. We identify challenges in determining and weighting relevant harms, then propose three central ethical considerations in overdiagnosis: the extent of harm done, whether harm is avoidable and whether the primary goal of the actor/s concerned is to benefit themselves or the patient, citizen or society. This distinguishes predatory, misdirected and tragic overdiagnosis; the degree of harm moderates the justifiability of each type. We end with four normative challenges: methods for adjudicating between professional standards and identifying relevant harms and benefits should be procedurally just; individuals, organisations and states are differently responsible for addressing overdiagnosis; overdiagnosis is a matter for distributive justice: the burdens of both overdiagnosis and its prevention could fall on the least-well-off; and communicating about overdiagnosis risks harming those unaware that they may have been overdiagnosed. These challenges will need to be addressed as the field develops. (shrink)

In Undomesticated Ground, Stacy Alaimo issues a bold call to reclaim nature as feminist space.

Statements about fictional characters, such as “Gregor Samsa has been changed into a beetle,” pose the problem of how we can say something true (or false) using empty names. I propose an original solution to this problem that construes such utterances as reports of the “prescriptions to imagine” generated by works of fiction. In particular, I argue that we should construe these utterances as specifying, not what we are supposed to imagine—the propositional object of the imagining—but how we are supposed (...) to imagine. Most other theories of thought and discourse about fictional characters either fail to capture the intentionality of our imaginings, or else obscure the differences between imaginings directed toward fictional characters and those directed toward real individuals. I argue that once we have an account of prescriptions to imagine about real individuals, we can adapt the same framework to specify the contents of prescriptions to imagine about fictional characters, and thereby to account for the truth (or falsity) of statements about fictional characters. (shrink)

Why is education in the open society not open? Why is this option not even considered in the debate over which education is most suited for the open society? Many consider such an option irresponsible. What, then, are the minimal responsibilities of education? The present volume raises these questions and many more. It is a book we have been waiting for. It offers a rare combination of two seemingly opposite, unyielding attitudes: critical and friendly. Dr. Yehezkely applies a rigorous fallibilist-critical (...) approach to issues regarding contemporary education. His diagnosis is that the source of our trouble is the closed undemocratic character of education, which causes education to become, in effect, a fifth column in the open democratic society. Following Popper, he concedes that democracy is every bit as flawed and as problematic as its enemies accuse it of being, particularly in education; still it is our only hope, since open responsible debate of vital problems cannot do without it. Democracy is risky: yet its absence guarantees failure, especially in closed undemocratic education, even when inspired by the most progressive ideas extant, charged with tremendous good will, and executed with selfless love and devotion. Kibbutz education is a case in point. (shrink)

Realism about quantum theory naturally leads to realism about the quantum state of the universe. It leaves open whether it is a pure state represented by a wave function, or an impure one represented by a density matrix. I characterize and elaborate on Density Matrix Realism, the thesis that the universal quantum state is objective but can be impure. To clarify the thesis, I compare it with Wave Function Realism, explain the conditions under which they are empirically equivalent, consider two (...) generalizations of Density Matrix Realism, and answer some frequently asked questions. I end by highlighting an implication for scientific realism. (shrink)

Standard theories define fiction in terms of an invited response of imagining or make-believe. I argue that these theories are not only subject to numerous counterexamples, they also fail to explain why classification matters to our understanding and evaluation of works of fiction as well as non-fiction. I propose instead that we construe fiction and non-fiction as genres: categories whose membership is determined by a cluster of nonessential criteria, and which play a role in the appreciation of particular works. I (...) claim that this proposal captures the intuitions motivating alternative theories of fiction. (shrink)

The currently standard approach to fiction is to define it in terms of imagination. I have argued elsewhere that no conception of imagining is sufficient to distinguish a response appropriate to fiction as opposed to non-fiction. In her contribution Kathleen Stock seeks to refute this objection by providing a more sophisticated account of the kind of propositional imagining prescribed by so-called ‘fictive utterances’. I argue that although Stock's proposal improves on other theories, it too fails to provide an adequate criterion (...) of fictionality. I conclude by sketching an alternative account according to which fiction is a genre. (shrink)

Where do you begin the important conversation about professionalizing early childhood education (ECE) as a field of practice? This book is the tool you need to advance the conversation and shape the future of ECE. Professionalizing Early Childhood Education As a Field of Practice provides an overview of the topic, a participant guide, a conversation workbook, and a facilitator guide to move the conversation forward. Each section supports deep thought and creative discussions to make the overall conversation meaningful and productive (...) for the entire profession. Don't just sit back and listen; be a part of this important conversation.Stacie Goffin is a widely recognized authority in early childhood education with a passion for raising the competence of ECE as a field of practice. She received a degree in child development from the University of Massachusetts Amherst, followed by her master's in early childhood from George Washington University and her executive education certification from Harvard. Stacie currently serves as Principal of the Goffin Strategies Group, where she uses her experience consulting with educational programs to improve effectiveness and services for young children. (shrink)

My question, then, is how does Thank You For Smoking, in addition to othercultural and social phenomena such as Parrish’s stance, enact this same divorcebetween the abstract form of corporate America and its particular contents oremployees? My answer is that, to win its viewers’ identification with itscharacters and, through them, its ideological assumptions, the film organises itscontent around an ethical form, that of the tragic hero in Søren Kierkegaard’ssense. Consequently, what I hope to enact in this essay is the revenge (...) of contentupon form, because the form that produces the tragic hero, in Thank You ForSmoking and for Steve Parrish, ignores its own content and thereby threatens toundermine an authentic ethics, which is often intolerant and not necessarilyconsensual. In short, the film, based loosely on the ‘smoking wars’ that began inthe mid 1990s, ultimately champions an impoverished ethics, an ‘ethics ofconsumption’ with the ‘right to consume’ figuring as its first principle. (shrink)

Kendall Walton’s “Categories of Art” (1970) is one of the most important and influential papers in twentieth-century aesthetics. It is almost universally taken to refute traditional aesthetic formalism/empiricism, according to which all that matters aesthetically is what is manifest to perception. Most commentators assume that the argument of “Categories” applies to works of literature. Walton himself notes a word of caution: “The aesthetic properties of works of literature are not happily called ‘perceptual’ … (The notion of perceiving a work in (...) a category … is not straightforwardly applicable to literary works)” (335 n.5). However, he goes on to say that although he focuses “on visual and musical works … the central points I make concerning them hold, with suitable modifications, for novels, plays, and poems as well” (335 n.5). Here I consider what “suitable modifications” are required to extend the account to literature. (shrink)

If there are no fictional characters, how do we explain thought and discourse apparently about them? If there are, what are they like? A growing number of philosophers claim that fictional characters are abstract objects akin to novels or plots. They argue that postulating characters provides the most straightforward explanation of our literary practices as well as a uniform account of discourse and thought about fiction. Anti-realists counter that postulation is neither necessary nor straightforward, and that the invocation of pretense (...) provides a better account of the same phenomena. I outline and assess these competing theories. (shrink)

Two assumptions are common in discussions of the paradox of tragedy: (1) that tragic pleasure requires that the work be fictional or, if non-fiction, then non-transparently represented; and (2) that tragic pleasure may be provoked by a wide variety of art forms. In opposition to (1) I argue that certain documentaries could produce tragic pleasure. This is not to say that any sad or painful documentary could do so. In considering which documentaries might be plausible candidates, I further argue, against (...) (2), that the scope of tragic pleasure is limited to works that possess certain thematic and narrative features. (shrink)

Book synopsis: New work on a hot topic by an outstanding team of authors At the intersection of several central areas of philosophy It is the linguistic job of singular terms to pick out the objects that we think or talk about. But what about singular terms that seem to fail to designate anything, because the objects they refer to don't exist? We can employ these terms in meaningful thought and talk, which suggests that they are succeeding in fulfilling their (...) representational task. A team of leading experts presents new essays on the much-debated problem of empty reference and thought. In the 1960s and 1970s Keith Donnellan, David Kaplan, Saul Kripke and Hilary Putnam initiated a revolution in the then standard conception of reference—a concept at the core of philosophical inquiry. The repercussions of the revolution, particularly felt in metaphysics and epistemology, were soon refined by other influential writers such as Tyler Burge, Gareth Evans, and John Perry. They argued that some linguistic and mental representations have contents individuated by what they are about—by ordinary referents of expressions such as proper names, indexicals, definite descriptions and common nouns, i.e. by planets, people or natural kinds. The view was at odds with a central philosophical presumption at that time: that cognitive and linguistic access to objective reality is indirect and accidental, mediated by general descriptive characterizations, the only constitutive semantic feature of the expressions; hence its ontological and epistemological repercussions. A turning-point in the debate about how linguistic and mental representation reach external contents concerned the nature of empty mental and linguistic representations, framed by means of the very same expressions crucially invoked in the Donnellan-Kaplan-Kripke-Putnam arguments. The papers in this volume address different aspects of reference and thought about the non-existent. (shrink)

Despite its apparent complexity, our world seems to be governed by simple laws of physics. This volume provides a philosophical introduction to such laws. I explain how they are connected to some of the central issues in philosophy, such as ontology, possibility, explanation, induction, counterfactuals, time, determinism, and fundamentality. I suggest that laws are fundamental facts that govern the world by constraining its physical possibilities. I examine three hallmarks of laws-simplicity, exactness, and objectivity-and discuss whether and how they may be (...) associated with laws of physics. (shrink)

This dual methods study explored one social studies teacher education program as it attempted to incorporate a cycle of practice-based teacher education into a methods course for the purpose of democratizing the teacher education experience. In addition to detailing the pedagogical decisions of the course instructor, researchers followed two social studies teacher candidates into their student teaching experience. Findings suggested that promoting social studies practice through a pedagogy of enactment is not enough. Rather, mentor teachers, course instructors, and teacher candidates (...) need to be aligned pedagogically as to the purposes and practices of social studies education. (shrink)

A causal-comparative, mixed methods design was used to study a partnership between a university and school district formed with the goal of improving history teachers’ United States history content knowledge to raise student engagement and achievement. Data were collected from middle and high school history teachers including teacher interviews, classroom observations, and student work. Student engagement surveys and academic performance data were also collected. Student academic performance was positively impacted and changes in classroom practice were found in the treatment group. (...) However, differences in student engagement between groups were not found to be statistically significant. (shrink)