This article traces the rapid progression of policy pertaining to human genome germline modifications using genome editing. It provides an overview of how one fertility physician implemented and advertised experimental techniques as part of his fertility clinic services, examines US law and policy, and assesses the impact of rhetoric influencing global policy and interpretation of the law. This article provides an in-depth examination of the medical rationale driving the acceptance of genome editing human embryos in two contexts: to cure disease (...) and treat infertility. It describes complexities in genomics and outlines risks currently associated with genome editing, asserting the available evidence fails to demonstrate genome editing constitutes a curative therapy. (shrink)

In July 2018, the Nuffield Council on Bioethics released the report Genome editing and human reproduction: Social and ethical issues, concluding that human germline modification of human embryos for implantation is not ‘morally unacceptable in itself’ and could be ethically permissible in certain circumstances once the risks of adverse outcomes have been assessed and the procedure appears ‘reasonably safe’. The Nuffield Council set forth two main principles governing anticipated uses and envisions applications that may include health enhancements as a public (...) health measure. This essay provides a critique of three aspects in the Nuffield Council’s Report: its presumption of therapeutic efficacy, its inflation of parental rights to create a certain type of child, and its reliance on a specially commissioned report that appears to distort key definitions in international law. (shrink)

Until recently, scientific consensus held firm that genetically manipulated embryos created through methods including Mitochondrial Replacement Therapy or human germline genome editing should not be used to initiate a pregnancy. In countries that have relevant laws pertaining to heritable human germline modifications, the vast majority prohibit or restrict this practice. In the last several years, scholars have observed a transformation of scientific and policy restrictions with insistent calls for creating a regulatory pathway. Multiple stakeholders highlight the role of social consensus (...) and public engagement for governance of heritable human germline modifications. However, in the drive to gain public acceptance and lift restrictions, some proponents provide distorted or misleading narratives designed to influence public perception and incrementally shift the consensus. This article describes eight discrete strategies that proponents employ to influence framing, sway public opinion, and revise policymaking of human germline modifications in a manner that undermines honest engagement. (shrink)

In the United States at this time, no uniform federal law exists regarding commercial surrogacy, and state statutory schemes vary vastly, ranging from criminalization to legal recognition with contract enforcement. The authors examine how commercial surrogacy agencies utilize the Internet as a means for attracting parents and surrogates by employing emotional cultural rhetoric. By inducing both parents and surrogates to their jurisdiction, agencies circumvent vast discrepancies in state statutory regulative schemes and create a distinct interstate business, absent an efficient regulatory (...) framework or legal recourse in some circumstances. The authors propose a uniform federal regulatory scheme premised upon regulating interstate business transactions to create accountability and legal remedies for both the parents and the surrogate. (shrink)

In July of 2005, Indianapolis witnessed streaming headlines in the local newspaper attempting to distill the confusion surrounding the adoption of two premature infants by an adoptive parent. Thirteen articles and opinion pieces introduced the public to a murky legal and ethical transaction. Stating his overwhelming desire to have children, a New Jersey schoolteacher hired the services of a local attorney. The attorney procured a South Carolina woman for a compensated gestational surrogacy contract. Under the contract, the surrogate and the (...) attorney would meet in Indiana to complete the execution of the contract and transfer parental rights via adoption after the birth of the twins. (shrink)

Recently, an agonizing twist intersecting predictive genetic tests and surrogacy contracts made news headlines in Canada. The intended parents, a couple from British Columbia, instructed the surrogate mother with whom they were working to undergo First Trimester Screening and Chorionic Villi Sampling, which revealed the fetus likely had Down syndrome. The parents directed the surrogate to terminate the fetus or they would abdicate their parental claim upon birth. This story raised numerous legal and ethical questions relating to the transferability of (...) decision making for prenatal screening, diagnostic tests, and the connected decision of termination when additional interested parties – the intended parents – are involved in the medical decision-making relationship. First, although the surrogate is the patient, what are the implications when the intended parents' wishes influence or even dictate the relationship between her and her obstetrician and genetic counselor? Second, if the intended parents' level of authority reaches explicit demands, may the intended parents ethically and legally require the surrogate to waive her right to informed consent for prenatal screening and diagnosis? (shrink)

This article challenges recent assumptions that physicians may ethically and legally prescribe psychopharmacological enhancement drugs to patients and the counterintuitive notion that in some cases ingesting an enhancement drug constitutes the more ethical choice than forgoing this option. Enhancement proponents have touted modafinil as an ideal mechanism to improve concentration, alertness, and forgo sleep and keep pace with our society's demands. However, patients who use modafinil for these reasons risk potentially severe side effects and addiction, and face unintended consequences related (...) to their cognitive, emotive, and physiological functioning. Importantly, prescribing a controlled substance such as modafinil for performance enhancement and sleep avoidance runs contrary to a physician's ethical duty to the patient and the standard of practice set forth in legal requirements governing the prescription of controlled substances. (shrink)

In the March 2010 edition of Mayo Clinic Proceedings, Drs. Rose and Curry declared that resident physicians have an ethical duty to reduce error during periods of fatigue. Problematically, however, they argued this means ingesting a stimulant for performance enhancement and sleep avoidance during a shift when a resident physician is experiencing fatigue as the more ethical choice than forgoing ingesting a stimulant. Rather than accepting enhancement as an unstoppable technological imperative, this article will examine the underlying motivations for enhancement (...) embedded in our culture and the corresponding legal framework relating to stimulant drugs. Although our society seems to be engaged in a pharmacological arms race of efficiency, competition, and self “betterment,” the FDA has not approved stimulant drugs such as modafinil for PESA. As a result, the off-label use of modafinil for PESA means these individuals are part of a large-scale experiment that poses serious immediate and long-term side effects to the individual user as well as society. (shrink)

Although prisons provide on-site primary care, the corrections system relies on external hospitals to provide a variety of healthcare services. Compared to the general population, incarcerated patients experience higher rates of chronic medical conditions, mental illness, substance abuse, cancer, traumatic brain injury, assault, and communicable disease. Certain specialties of clinicians are likely to encounter patients who are incarcerated, which makes it important for clinicians to understand how medical decision-making may differ when the patient is a prisoner. The corrections system retains (...) custody of inmates and is responsible for their welfare, including facilitating necessary medical care. However, this does not permit corrections personnel or a warden to automatically assume the role of the patient's medical decision-maker. Except for narrow exceptions, prisoners do not lose their rights to medical decision-making. In some instances, corrections staff or the prison warden have improperly asserted authority to act as the patient's medical decision-maker, such as when the patient lacks decision-making capacity. This violates ethical principles of bodily integrity, respect, and fairness. This paper provides an overview of medical decision-making for incarcerated patients, how surrogate decision-maker hierarchies apply to incarcerated patients without decision-making capacity, and special considerations for this subset of patients. (shrink)

Many state laws specify procedures for determining surrogate or proxy decision-makers for end-of-life care in the absence of an advance directive, living will, or other designation. Some laws also set forth criteria that the decision-maker must follow when making medical decisions for an incapacitated patient and determining whether to withdraw life-sustaining treatment. This article provides analysis of a medical ethics case on the question of how to address family allegations that the proxy decision-maker suffers from dementia and is unable to (...) make decisions for the patient. Cases such as this involve interwoven legal and ethical considerations including: how to address concerns that the proxy is making questionable or unreasonable decisions, how to evaluate the proxy's decisional capacity, strategies for enhancing communication, and standards for removing a proxy. This article suggests that “surrogacy ladders” in state law serve not only as a procedural mechanism, but also protect important ethical values such as tiers of moral authority for decision-making, relational autonomy, and privacy. (shrink)

Objective To develop an ethically, legally, and clinically appropriate ventilator allocation policy for AdventHealth Tampa and AdventHealth Carrollwood in Tampa, Florida, which could be enacted swiftly during the Covid-19 pandemic. Methods During Spring 2020, a subcommittee of the Medical Ethics Committee established consensus on the fundamental principles of the policy, then built on existing ethical, legal, and clinical guidance. Results The plan was finalized in May 2020. The plan triages patients based on exclusion criteria, prognosis and expected benefit of ventilation, (...) and change in prognosis over time. Decisions are made by committee in order to minimize moral distress among individual patient care providers. Conclusions Due to international concerns about healthcare resource shortages during the Covid-19 pandemic, hospitals need allocation policies informed by the crisis standard of care, the hospital’s ethical duty to plan for an emergency, and federal civil rights laws Policy Implications: This type of policy can serve as a model for other institutions to develop crisis standards of care resource allocation policies, which are a necessary component of disaster planning. (shrink)

In an article in this journal, Katherine Drabiak argues that green lighting genome editing of human embryos is contrary to “fundamental human rights law.” According to the author, genome editing of human embryos violates what we should recognize as a fundamental human right to inherit a genome without deliberate manipulation. In this reply article, we assess Drabiak's legal analysis and show methodological and substantive flaws. Methodologically, her analysis omits the key international legal instruments that form the so‐called (...) International Bill of Rights and thus fails to provide a full and accurate account of the fundamental international human rights standards. Substantively, Drabiak invokes, as a basis for prohibiting gene editing of human embryos, a legal standard (the rights and integrity of the future child) that is unknown to international law. Contrary to Drabiak's account, genome editing of human embryos is not prohibited under international law. Indeed, the right to health and the right to benefit from scientific progress may be interpreted as the basis of a legal duty to provide equality of access to germline gene editing, once determined it is beneficial and safe to use. (shrink)

One of Martin Heidegger’s enduring philosophical legacies is his overall vision of what it is to be us. We—whoever that turns out to include—are cases of Dasein, and as such we are distinctively open to entities, including others and ourselves. In this essay, I paint a picture of that openness that aims to capture why Heidegger’s vision has so powerfully gripped so many. Drawing on Heidegger’s thought both early and late, I present a synoptic view of us as open to (...) the encounter with entities' bursting forth into presencing. We can be more or less closed off to this upsurge, but we can also allow it in its full power: in philosophical and poetic openness. I draw on Borgmann, Buber, Plato’s Socrates, Rilke, and others to capture our openness at its Heideggerian best—and we ourselves at our best, showing up radiantly for encounter. (shrink)

Things get to us. We are moved or affected by 'things' in the ordinary sense-the paraphernalia of our daily lives-and also by ourselves, by others, and by ontological phenomena such as being and time. How can such things get to us? How can things matter to me? Heidegger answers this question with his concepts of finding (Befindlichkeit) and attunement (Stimmung). In this text, Withy explores how being finding allows things to matter to us in attunements such as fear and hope (...) by allowing those things to show up as benefits or detriments to our pursuits and so to put those pursuits at stake. She also explores how we can be affected ontologically-that is, affected by being-in special attunements such as angst and boredom, as well as how Heidegger's account of being affected has contributed to our understanding of emotions, moods, and affective disorders. (shrink)

Should companies make explicit external statements of their ethical stance? If so, at what point in their ethical development? And, what form might such a statement take? The authors, MBA students at London Business School, researched these questions among the stakeholders of a large financial services organisation in the UK, and recommended what they term “the drip effect” approach. The implications of the project offer insights to other companies which may be deliberating whether and how to produce an external statement (...) of ethics. (shrink)

Although the principle of fair subject selection is a widely recognized requirement of ethical clinical research, it often yields conflicting imperatives, thus raising major ethical dilemmas regarding participant selection. In this paper, we diagnose the source of this problem, arguing that the principle of fair subject selection is best understood as a bundle of four distinct sub-principles, each with normative force and each yielding distinct imperatives: (1) fair inclusion; (2) fair burden sharing; (3) fair opportunity; and (4) fair distribution of (...) third-party risks. We first map out these distinct sub-principles, and then identify the ways in which they yield conflicting imperatives for the design of inclusion and exclusion criteria, and the recruitment of participants. We then offer guidance for how decision makers should navigate these conflicting imperatives to ensure that participants are selected fairly. (shrink)

How do things persist? Are material objects spread out through time just as they are spread out through space? Or is temporal persistence quite different from spatial extension? This key question lies at the heart of any metaphysical exploration of the material world, and it plays a crucial part in debates about personal identity and survival. This book explores and compares three theories of persistence — endurance, perdurance, and stage theories — investigating the ways in which they attempt to account (...) for the world around us. Having provided valuable clarification of its two main rivals, the book concludes by advocating stage theory. Such a basic issue about the nature of the physical world naturally has close ties with other central philosophical problems. This book includes discussions of change and parthood, of how we refer to material objects at different times, of the doctrine of Humean supervenience, and of the modal features of material things. In particular, it contains new accounts of the nature of worldly vagueness, and of what binds material things together over time, distinguishing the career of a natural object from an arbitrary sequence of events. Each chapter concludes with a reflection about the impact of these metaphysical debates upon questions about our personal identity and survival. (shrink)

You can trust your friends. You should trust your friends. Not all of your friends all of the time: you can reasonably trust different friends to different degrees, and in different domains. Still, we often trust our friends, and it is often reasonable to do so. Why is this? In this paper I explore how and whether friendship gives us reasons to trust our friends, reasons which may outstrip or conflict with our epistemic reasons. In the final section, I will (...) sketch some related questions concerning trust based on the trustee’s race, gender, or other social identity. (shrink)

Research on value congruence rests on the assumption that values denote desirable behaviors and ideals that employees and organizations strive to approach. In the present study, we develop and test the argument that a more complete understanding of value congruence can be achieved by considering a second type of congruence based on employees’ and organizations’ counter-ideal values. We examined this proposition in a time-lagged study of 672 employees from various occupational and organizational backgrounds. We used difference scores as well as (...) polynomial regression and response surface analyses to test our hypotheses. Consistent with our hypotheses, results reveal that counter-ideal value congruence has unique relations to employees’ trust in the organization that go beyond the effects of ideal value congruence. We discuss theoretical and practical implications of this expanded perspective on value congruence. (shrink)

If you love someone, is it good to believe better of her than epistemic norms allow? The partiality view says that it is: love, on this view, issues norms of belief that clash with epistemic norms. The partiality view is supposedly supported by an analogy between beliefs and actions, by the phenomenology of love, and by the idea that love commits us to the loved one’s good character. I argue that the partiality view is false, and defend what I call (...) the epistemic view. On the epistemic view, love also issues norms of belief. But these say simply that you should adhere to epistemic norms in forming and maintaining beliefs about loved ones. I offer two arguments for the epistemic view. The first appeals to the emotional responses of love, which, when sensitive to what the loved one is really like, can make love great and be morally transformative. The second is a new argument for why caring for a loved one requires true beliefs about him. We see that there may be some boundaries, such as stuffy traditions, that love is right to defy, but that epistemic boundaries are not among them. (shrink)

Stereotypes sometimes lead us to make poor judgements of other people, but they also have the potential to facilitate quick, efficient, and accurate judgements. How can we discern whether any individual act of stereotyping will have the positive or negative effect? How Stereotypes Deceive Us addresses this question. It identifies various factors that determine whether or not the application of a stereotype to an individual in a specific context will facilitate or impede correct judgements and perceptions of the individual. It (...) challenges the thought that stereotyping only and always impedes correct judgement when the stereotypes that are applied are inaccurate, failing to reflect social realities. It argues instead that stereotypes that reflect social realities can lead to misperceptions and misjudgements, and that inaccurate but egalitarian social attitudes can therefore facilitate correct judgements and accurate perceptions. The arguments presented in this book have important implications for those who might engage in stereotyping and those who are at risk of being stereotyped. They have implications for those who work in healthcare and those who have mental health conditions. How Stereotypes Deceive Us provides a new conceptual framework-evaluative dispositionalism-that captures the epistemic faults of stereotypes and stereotyping, providing conceptual resources that can be used to improve our own thinking by avoiding the pitfalls of stereotyping, and to challenge other people's stereotyping where it is likely to lead to misperception and misjudgement. (shrink)

When William of Ockham lectured on Lombard's Sentences in 1317-1319, he articulated a new theory of knowledge. Its reception by fourteenth-century scholars was, however, largely negative, for it conflicted with technical accounts of vision and with their interprations of Duns Scotus. This study begins with Roger Bacon, a major source for later scholastics' efforts to tie a complex of semantic and optical explanations together into an account of concept formation, truth and the acquisition of certitude. After considering the challenges of (...) Peter Olivi and Henry of Ghent, Part I concludes with a discussion of Scotus's epistemology. Part II explores the alternative theories of Peter Aureol and William of Ockham. Part III traces the impact of Scotus, and then of Aureol, on Oxford thought in the years of Ockham's early audience, culminating with the views of Adam Wodeham. Part IV concerns Aureol's intellectual legacy at Paris, the introduction of Wodeham's thought there, and Autrecourt's controversies. (shrink)

In their article on the limited duty to reinterpret genetic variants, Watts and Newson argue that clinical labs are not morally obligated to conduct routine reinterpretation despite its potential clinical and personal value.1 We endorse the authors’ argument for a circumscribed duty to reclassify genomic variants in certain cases, including to promote diagnostic equity for racial and ethnic minority populations that have been historically excluded from and exploited by genomic research and medicine. However, given the history and resilience of scientific (...) racism, the use of socially constructed racial and ethnic categories to enhance diagnostic equity raises several ethical and practical challenges. In the short term, using socially constructed racial and ethnic categories to identify patients for variant reclassification is a practical approach for addressing concerns of diagnostic equity. In contrast, diagnostic accuracy depends on patients’ genetic similarity to reference genomes, rather than their socially determined race or ethnicity.2 Thus, in the long term, securing both diagnostic equity and diagnostic accuracy through targeted variant reclassification will require a shift away from relying on race and ethnicity and towards assessing genetic similarity. Critically, the identification of patients for genomic variant reclassification using socially constructed race or ethnicity runs the risk of perpetuating the harmful …. (shrink)

Highlighting main issues and controversies, this book brings together current philosophical discussions of symmetry in physics to provide an introduction to the subject for physicists and philosophers. The contributors cover all the fundamental symmetries of modern physics, such as CPT and permutation symmetry, as well as discussing symmetry-breaking and general interpretational issues. Classic texts are followed by new review articles and shorter commentaries for each topic. Suitable for courses on the foundations of physics, philosophy of physics and philosophy of science, (...) the volume is a valuable reference for students and researchers. (shrink)

Between 1820 and 1870, middle-class Americans became convinced of the role nonhuman animals could play in socializing children. Companion animals in and around the household were the medium for training children into self-consciousness about, and abhorrence of, causing pain to other creatures including, ultimately, other people. In an age where the formation of character was perceived as an act of conscious choice and self-control, middle-class Americans understood cruelty to animals as a problem both of individual or familial deficiency and of (...) good and evil. Training children to be self-conscious about kindness became an important task of parenting. Domestic advisors also argued that learning kindness was critical for boys who were developmentally prone to cruelty and whose youthful cruelty had implications both for the future of family life and for the body politic. The practice of pet keeping, where children became stewards of companion animals who were then able to teach young humans such virtues as gratitude and fidelity, became a socially meaningful act. (shrink)

Symmetry considerations dominate modern fundamental physics, both in quantum theory and in relativity. Philosophers are now beginning to devote increasing attention to such issues as the significance of gauge symmetry, quantum particle identity in the light of permutation symmetry, how to make sense of parity violation, the role of symmetry breaking, the empirical status of symmetry principles, and so forth. These issues relate directly to traditional problems in the philosophy of science, including the status of the laws of nature, the (...) relationships between mathematics, physical theory, and the world, and the extent to which mathematics suggests new physics.This entry begins with a brief description of the historical roots and emergence of the concept of symmetry that is at work in modern science. It then turns to the application of this concept to physics, distinguishing between two different uses of symmetry: symmetry principles versus symmetry arguments. It mentions the different varieties of physical symmetries, outlining the ways in which they were introduced into physics. Then, stepping back from the details of the various symmetries, it makes some remarks of a general nature concerning the status and significance of symmetries in physics. (shrink)

What is Heidegger talking about when he says that being conceals itself? This is the first study to systematically address that question. Katherine Withy analyses texts from across Heidegger's philosophical career and sorts the various phenomena of concealing and concealment that Heideggerdiscusses into a highly-structured taxonomy. The taxonomy clarifies the relationships and differences between such phenomena as lethe, the nothing, earth, excess, the backgrounding of the world, and un-truth, as well as speaking falsely, talking idly, secrets, mysteries, seeming, andinauthentic (...) discovering. But in relating and differentiating these phenomena, the taxonomy shows that none of them is the self-concealing of being.Having established what the self-concealing of being is not, Withy establishes what it is. She argues that being conceals itself in that it shows up to us as lacking the sorts of contrast cases that render entities determinate and intelligible. This novel and powerful interpretation of theself-concealing of being explains why the secondary literature to date has discussed it in vague and metaphorical terms, as well as why Heidegger tends to collapse being's self-concealing into the concealment of lethe. Withy's interpretation is both a clarification of and a corrective to Heidegger'snotoriously difficult and sometimes misleading discussions of being as self-concealing. (shrink)

Simon Saunders argues that, although distinct objects must be discernible, they need only be weakly discernible (Saunders 2003, 2006a). I will argue that this combination of views is unmotivated: if there can be objects which differ only weakly, there can be objects which don’t differ at all.

There are moments when things suddenly seem strange - objects in the world lose their meaning, we feel like strangers to ourselves, or human existence itself strikes us as bizarre and unintelligible. Through a detailed philosophical investigation of Heidegger's concept of uncanniness (Unheimlichkeit), Katherine Withy explores what such experiences reveal about us. She argues that while others (such as Freud, in his seminal psychoanalytic essay, 'The Uncanny') take uncanniness to be an affective quality of strangeness or eeriness, Heidegger uses (...) the concept to go beyond feeling uncanny to reach the ground of this feeling in our being uncanny. -/- "Heidegger on Being Uncanny" answers those who wonder whether human existence is fundamentally strange to itself by showing that we can be what we are only if we do not fully understand what it is to be us. This fundamental finitude in our self-understanding is our uncanniness. In this first dedicated interpretation of Heidegger's uncanniness, Withy tracks this concept from his early analyses of angst through his later interpretations of the choral ode from Sophocles's Antigone. Her interpretation uncovers a novel and robust continuity in Heidegger's thought and in his vision of the human being as uncanny, and it points the way toward what it is to live well as an uncanny human being. (shrink)

It has been argued that humans can face an ethical/epistemic dilemma over the automatic stereotyping involved in implicit bias: ethical demands require that we consistently treat people equally, as equally likely to possess certain traits, but if our aim is knowledge or understanding our responses should reflect social inequalities meaning that members of certain social groups are statistically more likely than others to possess particular features. I use psychological research to argue that often the best choice from the epistemic perspective (...) is the same as the best choice from the ethical perspective: to avoid automatic stereotyping even when this involves failing to reflect social realities in our judgements. This argument has an important implication: it shows that it is not possible to successfully defend an act of automatic stereotyping simply on the basis that the stereotype reflects an aspect of social reality. An act of automatic stereotyping can be poor from an epistemic perspective even if the stereotype that is activated reflects reality. (shrink)

Katherine Hawley investigates what trustworthiness means in our lives. We become untrustworthy when we break promises, miss deadlines, or give unreliable information. But we can't be sure about what we can commit to. Hawley examines the social obstacles to trustworthiness, and explores how we can steer between overcommitment and undercommitment.

Where there is trust, there is also vulnerability, and vulnerability can be exploited. Epistemic trust is no exception. This chapter maps the phenomenon of the exploitation of epistemic trust. I start with a discussion of how trust in general can be exploited; a key observation is that trust incurs vulnerabilities not just for the party doing the trusting, but also for the trustee (after all, trust can be burdensome), so either party can exploit the other. I apply these considerations to (...) epistemic trust, specifically in testimonial relationships. There, we standardly think of a hearer trusting a speaker. But we miss an important aspect of this relationship unless we consider too that the speaker standardly trusts the hearer. Given this mutual trust, and given that both trustees and trusters can exploit each other, we have four possibilities for exploitation in epistemic-trust relationships: a speaker exploiting a hearer (a) by accepting his trust or (b) by imposing her trust on him, and a hearer exploiting a speaker (c) by accepting her trust or (d) by imposing his trust on her. One result is that you do not need to betray someone to exploit him – you can exploit him just as easily by doing what he trusts you for. (shrink)

Fear generalisation is a psychological phenomenon that occurs when fear that is elicited in response to a frightening stimulus spreads to similar or related stimuli. The practical harms of pathological fear generalisation related to trauma are well-documented, but little or no attention has been given so far to its epistemic harms. This paper fills this gap in the literature. It shows how the psychological phenomenon, when it becomes pathological, substantially curbs the epistemic agency of those who experience the fear that (...) generalizes, limiting their ability to respond to evidence, and substantially limiting their epistemic horizons. It is argued that when these epistemic harms are caused by wrongful actions and decisions of individuals or institutions, because the fear is elicited in response to a traumatic experience inflicted by them, the harms should be considered epistemic wrongs. The epistemic wrongs are closely akin to agential epistemic injustice, a variety of distributive epistemic injustice, and sometimes also involve epistemic exclusion. The paper thereby identifies a previously underexplored psychological mechanism that can be a vehicle through which both individuals and institutions can epistemically wrong others. The argument has implications for how both epistemic wrongs and epistemic injustice should be conceived, suggesting that both can occur without being caused by primarily epistemic flaws or errors, or a bad epistemic character. Finally, it highlights the advantage of taking a victim-centred approach to understanding epistemic harm. (shrink)

What is epistemic self-trust? There is a tension in the way in which prominent accounts answer this question. Many construe epistemic trust in oneself as no more than reliance on our sub-personal cognitive faculties. Yet many accounts – often the same ones – construe epistemic trust in others as a normatively laden attitude directed at persons whom we expect to care about our epistemic needs. Is epistemic self-trust really so different from epistemic trust in others? I argue that it is (...) not. We certainly do rely on our cognitive faculties to achieve epistemic ends; but I argue that we also have the normatively rich sort of epistemic trust in ourselves. Moreover, there is a theoretical need for this normatively rich notion of epistemic self-trust: positing it yields the best account of how we secure important epistemic goods, including knowledge and recognition as knowers. I argue this by giving an account of epistemic trust in others and showing that it can be generalized to epistemic trust in oneself. (shrink)

Anselm holds that God is timeless, time is tenseless, and humans have libertarian freedom. This combination of commitments is largely undefended incontemporary philosophy of religion. Here I explain Anselmian eternalism with its entailment of tenseless time, offer reasons for accepting it, and defend it against criticisms from William Hasker and other Open Theists. I argue that the tenseless view is coherent, that God’s eternal omniscience is consistent with libertarian freedom, that being eternal greatly enhances divine sovereignty, and that the Anselmian (...) view supports the contention that the Bible is relevant today far better than does Open Theism. (shrink)

The COVID-19 pandemic laid bare systemic inequities shaped by social determinants of health (SDoH). Public health agencies, legislators, health systems, and community organizations took notice, and there is currently unprecedented interest in identifying and implementing programs to address SDoH. This special issue focuses on the role of medical-legal partnerships (MLPs) in addressing SDoH and racial and social inequities, as well as the need to support these efforts with evidence-based research, data, and meaningful partnerships and funding.

Social groups—like teams, committees, gender groups, and racial groups—play a central role in our lives and in philosophical inquiry. Here I develop and motivate a structuralist ontology of social groups centered on social structures (i.e., networks of relations that are constitutively dependent on social factors). The view delivers a picture that encompasses a diverse range of social groups, while maintaining important metaphysical and normative distinctions between groups of different kinds. It also meets the constraint that not every arbitrary collection of (...) people is a social group. In addition, the framework provides resources for developing a broader structuralist view in social ontology. (shrink)

Findings from the cognitive sciences suggest that the cognitive mechanisms responsible for some memory errors are adaptive, bringing benefits to the organism. In this paper we argue that the same cognitive mechanisms also bring a suite of significant epistemic benefits, increasing the chance of an agent obtaining epistemic goods like true belief and knowledge. This result provides a significant challenge to the folk conception of memory beliefs that are false, according to which they are a sign of cognitive frailty, indicating (...) that a person is less reliable than others or their former self. Evidence of memory errors can undermine a person’s view of themselves as a competent epistemic agent, but we show that false memory beliefs can be the result of the ordinary operation of cognitive mechanisms found across the species, which bring substantial epistemic benefits. This challenge to the folk conception is not adequately captured by existing epistemological theories. However, it can be captured by the notion of epistemic innocence, which has previously been deployed to highlight how beliefs which have epistemic costs can also bring significant epistemic benefits. We therefore argue that the notion of epistemic innocence should be expanded so that it applies not just to beliefs but also to cognitive mechanisms. (shrink)

I give an overview of the trust literature and then of six central issues concerning epistemic trust. The survey of trust zeroes in on the kinds of expectations that trust involves, trust’s characteristic psychology, and what makes trust rational. The discussion of epistemic trust focuses on its role in testimony, the epistemic goods that we trust for, the significance of epistemic trust in contrast to reliance, what makes epistemic trust rational, and epistemic self-trust.

In his paper ‘Ethical problems with kindness in healthcare’, Jesudason sets out an interesting examination of the concept of kindness, arguing that it poses significant ethical challenges due to its discretionary nature. I suggest that kindness, a concept difficult to define, may still have a role to play in healthcare. Different treatments of kindness show us that it need not be discretionary, and that kind care can be provided to all. Finally, curiosity may also have a role to play in (...) medicine to help promote inclusiveness. (shrink)

The generation of three-dimensional cerebral organoids from human-induced pluripotent stem cells (hPSC) has facilitated the investigation of mechanisms underlying several neuropsychiatric disorders, including stress-related disorders, namely major depressive disorder and post-traumatic stress disorder. Generating hPSC-derived neurons, cerebral organoids, and even assembloids (or multi-organoid complexes) can facilitate research into biomarkers for stress susceptibility or resilience and may even bring about advances in personalized medicine and biomarker research for stress-related psychiatric disorders. Nevertheless, cerebral organoid research does not come without its own set (...) of ethical considerations. With increased complexity and resemblance to in vivo conditions, discussions of increased moral status for these models are ongoing, including questions about sentience, consciousness, moral status, donor protection, and chimeras. There are, however, unique ethical considerations that arise and are worth looking into in the context of research into stress and stress-related disorders using cerebral organoids. This paper provides stress research-specific ethical considerations in the context of cerebral organoid generation and use for research purposes. The use of stress research as a case study here can help inform other practices of in vitro studies using brain models with high ethical considerations. (shrink)

Closest-continuer or best-candidate accounts of persistence seem deeply unsatisfactory, but it’s hard to say why. The standard criticism is that such accounts violate the ‘only a and b’ rule, but this criticism merely highlights a feature of the accounts without explaining why the feature is unacceptable. Another concern is that such accounts violate some principle about the supervenience of persistence facts upon local or intrinsic facts. But, again, we do not seem to have an independent justification for this supervenience claim. (...) Instead, I argue that closest continuer accounts are committed to unexplained correlations between distinct existences, and that this is their fundamental flaw. We can have independent justification for rejecting such correlations, but what the justification is depends upon much broader issues in ontology. There is no one-size-fits all objection to closest-continuer accounts of persistence. (shrink)