Many adoptees face a number of challenges relating to separation from biological parents during the adoption process, including issues concerning identity, intimacy, attachment, and trust, as well as language and other cultural challenges. One common health challenge faced by adoptees involves lack of access to genetic-relative family health history. Lack of GRFHx represents a disadvantage due to a reduced capacity to identify diseases and recommend appropriate screening for conditions for which the adopted person may be at increased risk. In this (...) article, we draw out common features of traditionally understood “health disparities” in order to identify analogous features in the context of adoptees’ lack of GRFHx. (shrink)

Two experiments investigated the mechanism by which listeners adjust their interpretation of accented speech that is similar to a regional dialect of American English. Only a subset of the vowels of English (the front vowels) were shifted during adaptation, which consisted of listening to a 20‐min segment of the “Wizard of Oz.” Compared to a baseline (unadapted) condition, listeners showed significant adaptation to the accented speech, as indexed by increased word judgments on a lexical decision task. Adaptation also generalized to (...) test words that had not been presented in the accented passage but that contained the shifted vowels. A control experiment showed that the adaptation effect was specific to the direction of the shift in the vowel space and not to a general relaxation of the criterion for what constitutes a good exemplar of the accented vowel category. Taken together, these results provide evidence for a context‐specific vowel adaptation mechanism that enables a listener to adjust to the dialect of a particular talker. (shrink)

This paper argues that it will be important for new genomic technologies to recognize the limits of traditional approaches to informed consent, so that other-regarding implications of genomic information can be properly contextualized and individual rights respected. Respect for individual autonomy will increasingly require dynamic consideration of the interrelated dimensions of individual and broader community interests, so that the interests of one do not undermine fundamental interests of the other. In this, protection of individual rights will be a complex interplay (...) between individual and community concerns. (shrink)

Clinical ethics committees, with their typical threefold function of education, policy formation, and consultation, are present in nearly all U.S. hospitals today, and they are increasingly common in other healthcare settings such as long-term care and even home care. Ethics committees are at least as prevalent in Canadian hospitals as they are in U.S. hospitals, and their presence is growing in Europe, much of Asia, and Central and South America. Although ethics committees serve a variety of needs, their ultimate goal (...) ought to be to promote ethical practices or, in other words, to engender the integration of ethics into the life of the medical center. Of the three primary functions of ethics committees, ethics consultation has historically been the most controversial and problematic, and consult services in many healthcare institutions have struggled to thrive. (shrink)

Arguably no concept is more fundamental to science than that of causality, for investigations into cases of existence, persistence, and change in the natural world are largely investigations into the causes of these phenomena. Yet the metaphysics and epistemology of causality remain unclear. For example, the ontological categories of the causal relata have been taken to be objects (Hume 1739), events (Davidson 1967), properties (Armstrong 1978), processes (Salmon 1984), variables (Hitchcock 1993), and facts (Mellor 1995). (For convenience, causes and effects (...) will usually be understood as events in what follows.) Complicating matters, causal relations may be singular (Socrates’s drinking hemlock caused Socrates’s death) or general (Drinking hemlock causes death); hence the relata might be tokens (e.g., instances of properties) or types (e.g., types of events) of the category in question. Other questions up for grabs are: Are singular causes metaphysically and/or epistemologically prior to general causes or vice versa (or neither)? What grounds the intuitive asymmetry of the causal relation? Are macro-causal relations reducible to micro-causal relations? And perhaps most importantly: Are causal facts (e.g., the holding of causal relations) reducible to non-causal facts (e.g., the holding of certain spatiotemporal relations)? (shrink)

Some claim that Non-reductive Physicalism is an unstable position, on grounds that NRP either collapses into reductive physicalism, or expands into emergentism of a robust or ‘strong’ variety. I argue that this claim is unfounded, by attention to the notion of a degree of freedom—roughly, an independent parameter needed to characterize an entity as being in a state functionally relevant to its law-governed properties and behavior. I start by distinguishing three relations that may hold between the degrees of freedom needed (...) to characterize certain special science entities, and those needed to characterize their composing physical entities; these correspond to what I call ‘reductions’, ‘restrictions’, and ‘eliminations’ in degrees of freedom. I then argue that eliminations in degrees of freedom, in particular—when strictly fewer degrees of freedom are required to characterize certain special science entities than are required to characterize their composing physical entities—provide a basis for making sense of how certain special science entities can be both physically acceptable and ontologically irreducible to physical entities. (shrink)

The debate about the ethical implications of Artificial Intelligence dates from the 1960s :741–742, 1960; Wiener in Cybernetics: or control and communication in the animal and the machine, MIT Press, New York, 1961). However, in recent years symbolic AI has been complemented and sometimes replaced by Neural Networks and Machine Learning techniques. This has vastly increased its potential utility and impact on society, with the consequence that the ethical debate has gone mainstream. Such a debate has primarily focused on principles—the (...) ‘what’ of AI ethics —rather than on practices, the ‘how.’ Awareness of the potential issues is increasing at a fast rate, but the AI community’s ability to take action to mitigate the associated risks is still at its infancy. Our intention in presenting this research is to contribute to closing the gap between principles and practices by constructing a typology that may help practically-minded developers apply ethics at each stage of the Machine Learning development pipeline, and to signal to researchers where further work is needed. The focus is exclusively on Machine Learning, but it is hoped that the results of this research may be easily applicable to other branches of AI. The article outlines the research method for creating this typology, the initial findings, and provides a summary of future research needs. (shrink)

Is disability disadvantageous? Although many assume it is paradigmatically so, many disabled individuals disagree. Whom should we trust? On the one hand, pervasive mistrust of already underrepresented groups constitutes a serious epistemic injustice. Yet, on the other, individuals routinely adapt to mistreatment and deprivation and claim to be satisfied. If we take such “adaptive preferences” (APs) at face value, then injustice and oppression may not be recognized or rectified. Thus, we must achieve a balance between taking individuals’ preferences and self-assessment (...) as definitive, and ignoring them entirely. Furthermore, current accounts of APs suffer from an ambiguity: are APs an unreliable guide to individuals’ interests, or to just policy? This chapter argues that we should distinguish between those that are unreliable in the former sense (“well-being APs”), and the latter (“justice APs”). Although all APs are nonautonomous, only well-being APs are irrational. Thus, preferences may be diagnosed as unreliable from the perspective of justice without impugning individuals’ rational capacities. (shrink)

Note: this is the first published presentation and defense of the 'proper subset strategy' for making sense of non-reductive physicalism or the associated notion of realization; this is sometimes, inaccurately, called "Shoemaker's subset strategy"; if people could either call it the 'subset strategy' or better yet, add my name to the mix I would appreciate it. Horgan claims that physicalism requires "superdupervenience" -- supervenience plus robust ontological explanation of the supervenient in terms of the base properties. I argue that Horgan's (...) account fails to rule out physically unacceptable emergence. I rather suggest that this and other unacceptable possibilities may be ruled out by requiring that each individual causal power in the set associated with a given supervenient property be numerically identical with a causal power in the set associated with its base property. I go on to show that a wide variety of physicalist accounts, both reductive and non-reductive, are implicitly or explicitly designed to meet this condition, and so are more similar than they seem. In particular, non-reductive physicalism accounts typically appeal to a relation plausibly ensuring that the powers of a higher-level property are a proper subset of those of its physical base property. (shrink)

To what degree has biology influenced and shaped the development of moral systems? One way to determine the extent to which human moral systems might be the product of natural selection is to explore behaviour in other species that is analogous and perhaps homologous to our own. Many non-human primates, for example, have similar methods to humans for resolving, managing, and preventing conflicts of interests within their groups. Such methods, which include reciprocity and food sharing, reconciliation, consolation, conflict intervention, and (...) mediation, are the very building blocks of moral systems in that they are based on and facilitate cohesion among individuals and reflect a concerted effort by community members to find shared solutions to social conflict. Furthermore, these methods of resource distribution and conflict resolution often require or make use of capacities for empathy, sympathy, and sometimes even community concern. Non-human primates in societies in which such mechanisms are present may not be exactly moral beings, but they do show signs of a sense of social regularity that -- just like the norms and rules underlying human moral conduct -- promotes a mutually satisfactory modus vivendi. (shrink)

Is helping those whose subsistence needs are not meet a matter of charity or an obligation? What role should ordinary citizens of developed nations play? In a globalized world, the causes, connections, and responsibilities become complicated. Agriculture subsidies that keep food prices low for many in relatively rich countries may, for example, negatively impact poor farmers in developing countries. Students in Ethics/Philosophy 352 report on their project examining whether, and to what extent, a true obligation to aid exists.

The construct of wellbeing has been criticised as a neoliberal construction of western individualism that ignores wider systemic issues such as inequality and anthropogenic climate change. Accordingly, there have been increasing calls for a broader conceptualisation of wellbeing. Here we impose an interpretative framework on previously published literature and theory, and present a theoretical framework that brings into focus the multifaceted determinants of wellbeing and their interactions across multiple domains and levels of scale. We define wellbeing as positive psychological experience, (...) promoted by connections to self, community and environment, supported by healthy vagal function, all of which are impacted by socio-contextual factors that lie beyond the control of the individual. By emphasising the factors within and beyond the control of the individual and highlighting how vagal function both affects and are impacted by key domains, the biopsychosocial underpinnings of wellbeing are explicitly linked to a broader context that is consistent with, yet complementary to, multi-levelled ecological systems theory. Reflecting on the reciprocal relationships between multiple domains, levels of scale and related social contextual factors known to impact on wellbeing, our GENIAL framework may provide a foundation for a transdisciplinary science of wellbeing that has the potential to promote the wellbeing of individuals while also playing a key role in tackling major societal challenges. (shrink)

How can mental properties bring about physical effects, as they seem to do, given that the physical realizers of the mental goings-on are already sufficient to cause these effects? This question gives rise to the problem of mental causation (MC) and its associated threats of causal overdetermination, mental causal exclusion, and mental causal irrelevance. Some (e.g., Cynthia and Graham Macdonald, and Stephen Yablo) have suggested that understanding mental-physical realization in terms of the determinable/determinate relation (henceforth, 'determination') provides the key to (...) solving the problem of MC: if mental properties are determinables of their physical realizers, then (since determinables and determinates are distinct, yet don't causally compete) all three threats may be avoided. Not everyone agrees that determination can do this good work, however. Some (e.g., Douglas Ehring, Eric Funkhauser, and Sven Walter) object that mental-physical realization can't be determination, since such realization lacks one or other characteristic feature of determination. I argue that on a proper understanding of the features of determination key to solving the problem of MC these arguments can be resisted. (shrink)

Motivated by the seeming structure of the sciences, metaphysical emergence combines broadly synchronic dependence coupled with some degree of ontological and causal autonomy. Reflecting the diverse, frequently incompatible interpretations of the notions of dependence and autonomy, however, accounts of emergence diverge into a bewildering variety. Here I argue that much of this apparent diversity is superficial. I first argue, by attention to the problem of higher-level causation, that two and only two strategies for addressing this problem accommodate the genuine emergence (...) of special science entities. These strategies in turn suggest two distinct schema for metaphysical emergence---'Weak' and 'Strong' emergence, respectively. Each schema imposes a condition on the powers of entities taken to be emergent: Strong emergence requires that higher-level features have more token powers than their dependence base features, whereas Weak emergence requires that higher-level features have a proper subset of the token powers of their dependence base features. Importantly, the notion of “power” at issue here is metaphysically neutral, primarily reflecting commitment just to the plausible thesis that what causes an entity may bring about are associated with how the entity is---that is, with its features. (shrink)

Feminists continue to express concerns over the legalization of physician-assisted death. Some worry that women are more likely than men to request PAD due to societal stereotypes and the pressures put on women to be self-sacrificing. Others worry that women will have their requests ignored more often than men because women’s voices are traditionally silenced or disregarded in western culture. Rather than join in the above argument of speculating which way women may be marginalized, I accept PAD as potentially dangerous (...) and offer a solution in order to avoid the risks of injustice associated with PAD. I reframe the concerns as epistemological worries, and ultimately, I turn to Benjamin McMyler’s virtue epistemology as a way to avoid testimonial injustice in requests for life hastening medication, suggesting that the injustice comes from a narrow and individualistic perception of knowledge, and injustice can be avoided if we understand testimonial knowledge to be both cognitive and social. (shrink)

I argue that an adequate account of non-reductive realization must guarantee satisfaction of a certain condition on the token causal powers associated with (instances of) realized and realizing entities---namely, what I call the 'Subset Condition on Causal Powers' (first introduced in Wilson 1999). In terms of states, the condition requires that the token powers had by a realized state on a given occasion be a proper subset of the token powers had by the state that realizes it on that occasion. (...) Accounts of non-reductive realization conforming to this condition are implementing what I call 'the powers-based subset strategy'. I focus on the crucial case involving mental and brain states; the results may be generalized, as appropriate. I first situate and motivate the strategy by attention to the problem of mental causation; I make the case, in schematic terms, that implementation of the strategy makes room (contra Kim 1989, 1993, 1998, and elsewhere) for mental states to be ontologically and causally autonomous from their realizing physical states, without inducing problematic causal overdetermination, and compatible with both Physicalism and Non-reduction; and I show that several contemporary accounts of non-reductive realization (in terms of functional realization, parthood, and the determinable/determinate relation) are plausibly seen as implementing the strategy. As I also show, implementation of the powers-based strategy does not require endorsement of any particular accounts of either properties or causation---indeed, a categoricalist contingentist Humean can implement the strategy. The schematic location of the strategy in the space of available responses to the problem of mental (more generally, higher-level) causation, as well as the fact that the schema may be metaphysically instantiated, strongly suggests that the strategy is, appropriately generalized and instantiated, sufficient and moreover necessary for non-reductive realization. I go on to defend the sufficiency and necessity claims against a variety of objections, considering, along the way, how the powers-based subset strategy fares against competing accounts of purportedly non-reductive realization in terms of supervenience, token identity, and constitution. (shrink)

Contemporary philosophers commonly suppose that any fundamental entities there may be are maximally determinate. More generally, they commonly suppose that, whether or not there are fundamental entities, any determinable entities there may be are grounded in, hence less fundamental than, more determinate entities. So, for example, Armstrong takes the physical objects constituting the presumed fundamental base to be “determinate in all respects” (1961, 59), and Lewis takes the properties characterizing things “completely and without redundancy” to be “highly specific” (1986, 60). (...) Here I look at the usually cited reasons for these suppositions as directed against the case of determinable properties, in particular, and argue that none is compelling (Sections 1 to 3). The discussion in Section 3 moreover identifies positive reason for taking some determinable properties to be part of a fundamental (or relatively fundamental) base. I close (Section 4) by noting certain questions arising from the possibility of fundamental determinables, as directions for future research. (shrink)

Although the referents of the term social capital merit sustained inquiry, the term impedes understanding because of the historical association of the word capital with economic discourse. As a result of this association, applying the term social capital to civic engagement blurs crucial analytic distinctions. Moreover, there are important ideological consequences to considering things such as bowling leagues to be a form of capital and urging citizens to become social capitalists. The term social capacity, the authors argue, provides the same (...) heuristic benefits as the term social capital without extending illusory promises of theoretical parsimony with the financial/human/social capital trinity. (shrink)

References to the ‘natural’ are common in public health messaging about breastfeeding. For example, the WHO writes that ‘Breast milk is the natural first food for babies’ and the U.S. Department of Health and Human Services has a breastfeeding promotion campaign called ‘It’s only natural’, which champions breastfeeding as the natural way to feed a baby. This paper critically examines the use of ‘natural’ language in breastfeeding promotion by public health and medical bodies. A pragmatic concern with selling breastfeeding as (...) ‘natural’ is that this may reinforce the already widespread perspective that natural options are presumptively healthier, safer and better, a view that works at cross-purposes to public health and medicine in other contexts. An additional concern is that given the history of breastfeeding in the USA, ‘natural’ evokes specific and controversial conceptions of gender and motherhood. (shrink)

The COVID-19 pandemic has presented a global threat to physical and mental health worldwide. Research has highlighted adverse impacts of COVID-19 on wellbeing but has yet to offer insights as to how wellbeing may be protected. Inspired by developments in wellbeing science and guided by our own theoretical framework, we examined the role of various potentially protective factors in a sample of 138 participants from the United Kingdom. Protective factors included physical activity, tragic optimism, gratitude, social support, and nature connectedness. (...) Initial analysis involved the application of one-sample t-tests, which confirmed that wellbeing in the current sample was significantly lower compared to previous samples. Protective factors were observed to account for up to 50% of variance in wellbeing in a hierarchical linear regression that controlled for a range of sociostructural factors including age, gender, and subjective social status, which impact on wellbeing but lie beyond individual control. Gratitude and tragic optimism emerged as significant contributors to the model. Our results identify key psychological attributes that may be harnessed through various positive psychology strategies to mitigate the adverse impacts of hardship and suffering, consistent with an existential positive psychology of suffering. (shrink)

References to the ‘natural’ are common in public health messaging about breastfeeding. For example, the WHO writes that ‘Breast milk is the natural first food for babies’ and the U.S. Department of Health and Human Services has a breastfeeding promotion campaign called ‘It’s only natural’, which champions breastfeeding as the natural way to feed a baby. This paper critically examines the use of ‘natural’ language in breastfeeding promotion by public health and medical bodies. A pragmatic concern with selling breastfeeding as (...) ‘natural’ is that this may reinforce the already widespread perspective that natural options are presumptively healthier, safer and better, a view that works at cross-purposes to public health and medicine in other contexts. An additional concern is that given the history of breastfeeding in the USA, ‘natural’ evokes specific and controversial conceptions of gender and motherhood. (shrink)

In this paper I provide a theoretical framework for conceptualising the use of moral education in P4C by drawing on Ann Sharp’s work. I use this framework to present my own pedagogical action research in an elementary school in Taiwan. I use both quantitative and qualitative data to document students’ moral growth. The results indicate that moral education takes place in a morally stimulating environment, namely, a thinking and caring community of inquiry, with a morally-infused approach to doing P4C in (...) a Confucian society like Taiwan. In this study I employed a Confucian interpretative lens to develop relevant classroom rituals and strategies for creating moral winds in the classroom. The conception of moral education presented in this study provides a glimpse of what P4C classrooms may look like in a global context. (shrink)

The mining and energy industries present unique challenges to engineers, who must navigate sometimes competing responsibilities and codes of conduct, such as personal senses of right and wrong, professional ethics codes, and their employers’ corporate social responsibility policies. Corporate social responsibility is the current dominant framework used by industry to conceptualize firms’ responsibilities to their stakeholders, yet has it plays a relatively minor role in engineering ethics education. In this article, we report on an interdisciplinary pedagogical intervention in a petroleum (...) engineering seminar that sought to better prepare engineering undergraduate students to critically appraise the strengths and limitations of CSR as an approach to reconciling the interests of industry and communities. We find that as a result of the curricular interventions, engineering students were able to expand their knowledge of the social, rather than simply environmental and economic dimensions of CSR. They remained hesitant, however, in identifying the links between those social aspects of CSR and their actual engineering work. The study suggests that CSR may be a fruitful arena from which to illustrate the profoundly sociotechnical dimensions of the engineering challenges relevant to students’ future careers. (shrink)

Some claim that Non- reductive Physicalism is an unstable position, on grounds that NRP either collapses into reductive physicalism, or expands into emergentism of a robust or ‘strong’ variety. I argue that this claim is unfounded, by attention to the notion of a degree of freedom—roughly, an independent parameter needed to characterize an entity as being in a state functionally relevant to its law-governed properties and behavior. I start by distinguishing three relations that may hold between the degrees of freedom (...) needed to characterize certain special science entities, and those needed to characterize their composing physical entities; these correspond to what I call ‘reductions’, ‘restrictions’, and ‘eliminations’ in degrees of freedom. I then argue that eliminations in degrees of freedom, in particular—when strictly fewer degrees of freedom are required to characterize certain special science entities than are required to characterize their composing physical entities—provide a basis for making sense of how certain special science entities can be both physically acceptable and ontologically irreducible to physical entities. (shrink)

Intuitively, one who counts a morally bad person as a friend has gone wrong somewhere. But it is far from obvious where exactly they have gone astray. Perhaps in cultivating a friendship with a bad person, one extends to them certain goods that they do not deserve. Or perhaps the failure lies elsewhere; one may be an abettor to moral transgressions. Yet another option is to identify the mistake as a species of imprudence—one may take on great personal risk in (...) counting a bad person as a friend. In this paper, I argue that none of these intuitive explanations are entirely convincing; for many such proposals run contrary to widely accepted features of friendship. However, they do point us in the direction of a more satisfying explanation—one which concerns a person’s moral priorities. An individual who counts a morally bad person as a friend is, I propose, one who betrays a distinct kind of defect in her values. (shrink)

New scientific advances have created previously unheard of possibilities for enhancing combatants' performance. Future war fighters may be smarter, stronger, and braver than ever before. If these technologies are safe, is there any reason to reject their use? In this article, I argue that the use of enhancements is constrained by the importance of maintaining the moral responsibility of military personnel. This is crucial for two reasons: the military's ethical commitments require military personnel to be morally responsible agents, and moral (...) responsibility is necessary for integrity and the moral emotions of guilt and remorse, both of which are important for moral growth and psychological well-being. Enhancements that undermined combatants' moral responsibility would therefore undermine the military's moral standing and would harm combatants' well-being. A genuine commitment to maintaining the military's ethical standards and the well-being of combatants therefore requires a careful analysis of performance-enhancing technologies before they are implemented. (shrink)

Background: Noninvasive prenatal testing (NIPT) is a new prenatal screening technology that became commercially available in the United States in 2011. NIPT's increased accuracy and low false positive rate compared to previous screening methods enable many women to avoid invasive diagnostic testing and receive much desired reassurance. NIPT has received much attention for both its benefits and drawbacks. Methods: Observation of genetic counseling sessions and qualitative interviews with women offered NIPT at a large academic medical center were conducted. Two ethnographic (...) cases studies derived from the overall data set are used to illustrate the study findings. Results: Many fundamental ethical questions about prenatal screening, such as abortion or the value of disabled children, often do not emerge during clinical sessions, enabling most women to defer thinking about these issues until the future, when and if the need should arise. It may only be in the rare case when a woman receives a positive test result that she may be forced to confront ethical issues that she had up until then been able to avoid. Conclusions: Women want, and are grateful to have, access to NIPT, which offers much desired reassurance. This desire for reassurance may come at the expense of having contemplated the potential negative outcomes and limitations of testing. In the rare circumstance where women do not receive reassuring results, they may be unprepared and shocked by what NIPT can and cannot reveal. The routinization of NIPT as the latest and best available prenatal screening test does not necessarily create new ethical issues, but this study highlights ethical continuities following its arrival. However, the continued expansion of NIPT to include more conditions and women will increase the number of women who receive positive results, including false positives, and who may be shocked and unprepared as a result. (shrink)

Newtonian forces are pushes and pulls, possessing magnitude and direction, that are exerted (in the first instance) by objects, and which cause (in particular) motions. I defend Newtonian forces against the four best reasons for denying or doubting their existence. A running theme in my defense of forces will be the suggestion that Newtonian Mechanics is a special science, and as such has certain prima facie ontological rights and privileges, that may be maintained against various challenges.

When subjects violate epistemic standards or norms, we sometimes judge them blameworthy rather than blameless. For instance, we might judge a subject blameworthy for dogmatically continuing to believe a claim even after receiving evidence which undermines it. Indeed, the idea that one may be blameworthy for belief is appealed to throughout the contemporary epistemic literature. In some cases, a subject seems blameworthy for believing as she does even though it seems prima facie implausible that she is morally blameworthy or professionally (...) blameworthy. Such cases raise the question of whether one can be blameworthy for a belief in a specifically epistemic sense rather than in some already recognised sense, such as being morally or professionally blameworthy. A number of authors have recently argued that there is a moral or social sense in which one ought to conform one’s beliefs to the evidence. In this paper, I argue that even while accepting that there are moral and social norms governing belief, there are cases in which a subject is blameworthy for a belief but isn’t plausibly morally or socially blameworthy. If this latter view is correct, then we may need to develop a new account of blame which can be applied to beliefs which are not morally or socially blameworthy. (shrink)

Given the long-standing controversy about whether the brain-dead should be considered alive in an irreversible coma or dead despite displaying apparent signs of life, the ethical and policy issues posed when family members insist on continued treatment are not as simple as commentators have claimed. In this article, we consider the kind of policy that should be adopted to manage a family's insistence that their brain-dead loved one continues to receive supportive care. We argue that while it would be ethically (...) inappropriate to continue to devote scarce acute care resources to such patients in a hospital setting, it may not be ethically inappropriate for patients to receive these resources in certain other settings. Thus, if a family insists on continuing to care for their brain-dead loved at their home, we should not, from a policy perspective, interfere with the family's wishes. We also argue that healthcare professionals should make some effort to facilitate the transfer of brain-dead patients to these other settings when families insist on continued treatment despite being informed about the lack of any potential for recovery of consciousness. Our arguments are strengthened by the fact that patients in a persistent vegetative state, who, when correctly diagnosed, also have no potential for recovery of consciousness, are routinely transferred from hospitals to nursing homes or long-term care facilities where they continue to be ventilated, tube fed and to receive other supportive care. We also briefly explore the question of who should be responsible for the costs of such treatment at the long-term care facility. (shrink)

As children and adolescents receive increased research attention, ethical issues related to obtaining informed consent for pediatric intervention research have come into greater focus. In this article, we conceptualize parent permission and child assent within a goodness-of-fit framework that encourages investigators to create consent procedures “fitted” to the research context, the child's cognitive and emotional maturity, and the family system. Drawing on relevant literature and a hypothetical case example, we highlight four factors investigators may consider when constructing consent procedures that (...) best reflect participants' rights, concerns, and well-being: (a) the child's current assent capacity and the likely impact of study information on the child's mental and physical development, (b) parents' understanding of their child's treatment needs and distinctions between treatment and clinical trials research, (c) the family's history of shared decision making, and (d) the child's strivings for autonomy within the context of their parents' duty to make decisions in the child's best interest. (shrink)

The paper asks whether diagrams in mathematics are particularly fruitful compared to other types of representations. In order to respond to this question a number of examples of propositions and their proofs are considered. In addition I use part of Peirce’s semiotics to characterise different types of signs used in mathematical reasoning, distinguishing between symbolic expressions and 2-dimensional diagrams. As a starting point I examine a proposal by Macbeth. Macbeth explains how it can be that objects “pop up”, e.g., as (...) a consequence of the constructions made in the diagrams of Euclid, that is, why they are fruitful. It turns out, however, that diagrams are not exclusively fruitful in this sense. By analysing the proofs given in the paper I introduce the notion of a ‘faithful representation’. A faithful representation represents as either an image or as a metaphor. Secondly it represents certain relevant relations. Thirdly manipulations on the representations respect manipulations on the objects they represent, so that new relations may be found. The examples given in the paper illustrate how such representations can be fruitful. These examples include proofs based on both symbolic expressions as well as diagrams and so it seems diagrams are not special when it comes to fruitfulness. Having said this, I do present two features of diagrams that seem to be unique. One consists of the possibility of exhibiting the type of relation in a diagram—or simply showing that a relation exists—as a contrast to stating in words that it exists. The second is the spatial configurations possible when using diagrams, e.g., allowing to show multiple relations in a single diagram. (shrink)

The physician-patient relationship has changed over the last several decades, requiring a systematic reevaluation of the competing demands of patients, physicians, and families. In the era of genetic testing, using a model of patient care known as the family covenant may prove effective in accounting for these demands. The family covenant articulates the roles of the physician, patient, and the family prior to genetic testing, as the participants consensually define them. The initial agreement defines the boundaries of autonomy and benefit (...) for all participating family members. The physician may then serve as a facilitator in the relationship, working with all parties in resolving potential conflicts regarding genetic information. The family covenant promotes a fuller discussion of the competing ethical claims that may come to bear after genetic test results are received. (shrink)

It has become recently popular to suggest that knowledge is the epistemic norm of practical reasoning and that this provides an important constraint on the correct account of knowledge, one which favours subject-sensitive invariantism over contextualism and classic invariantism. I argue that there are putative counterexamples to both directions of the knowledge norm. Even if the knowledge norm can be defended against these counterexamples, I argue that it is a delicate issue whether it is true, one which relies on fine (...) distinctions among a variety of relevant notions of propriety which our intuitions may reflect. These notions variously apply to the agent herself, her character traits, her beliefs, her reasoning and any resultant action. Given the delicacy of these issues, I argue that the knowledge norm is not a fixed point from which to defend substantive and controversial views in epistemology. Rather, these views need to be defended on other grounds. (shrink)

ABSTRACT The article analyzes recent Western interpretations of the Theravāda Buddhist position on free will in order to reveal how differences in worldview and methodology impact claims about agency—exposing assumptions about the meaning of will, cause, and self—and how commonalities across traditions enable us to discover what may be at stake, more generally, in the philosophical problem of free will. Embedded in different ontologies and expressed by disparate means are similar intuitions about consciousness, coercion, and the transformative power of wisdom (...) as well as deeply human concerns about what we can and cannot change and with whom we should or should not find fault. Ultimately, this study of cross-cultural conversations aims to demonstrate how careful attention to assumptions underlying the concepts of will, causation, selfhood, and desert can prove both edifying and liberating. (shrink)

I argue that it is permissible for pregnant women to expose their unborn children to risks and injury. I begin with the premise that abortion is permissible. If so, then just as a pregnant woman may permissibly prevent an unborn child from experiencing any future wellbeing, she also may permissibly provide her child relatively poorer prospects for wellbeing. Therefore, it is permissible for pregnant women to take risks and cause prenatal injury. This argument has revisionary implications for policies that prevent (...) medical research and drug use during pregnancy. It also explains why moralistic criticism of pregnant women is unwarranted. (shrink)

What is the function of modal judgment? Why do we make judgments of possibility and necessity? Or are such judgments, in fact, dispensable? This paper introduces and develops an answer to these questions based on Kant’s remarks in section 76 of the Critique of Judgment. Here, Kant appears to argue the following: that a capacity to make modal judgments using modal concepts is required for a capacity for objective representation, in light of our split cognitive architecture. This split cognitive architecture (...) leaves room for a mismatch between our concepts and intuitions and, Kant argues, that is why we need modal concepts and modal judgments. In this paper, I develop this account of the function of modal judgment and to explore the extent to which it may improve upon contemporary alternatives. I focus on one particularly important challenge for the account: to explain why a distinction between the actual and the possible, rather than merely a distinction between the actual and the non-actual, is required. In order to answer this question, I supplement the account with a particular way of thinking about objectivity. (shrink)

Leading animal models are powerful tools for translational research, but they also present obstacles. Poorly conducted preclinical research in animals is a common cause of translational failure, but even when such research is well-designed and carefully executed, challenges remain. In particular, dominant models may bias research directions, elide essential aspects of human disease, omit important context, or subtly shift research targets. Recognizing these stumbling blocks can help us find ways to avoid them: employing a wider range of models, incorporating more (...) realistic environmental conditions, better aligning studies between animals and patients, and focusing on human biology and therapeutic goals. Such changes are costly; but insisting it would be impractical or unrealistic to change strategies offers no way out of the current impasse. Rather, we must acknowledge the obstacles as well as the advantages presented by core models, and direct some of our investments in translational research toward getting around them. The dominance of biomedical research by a handful of animal models introduces subtle but significant obstacles to translation. Recognizing these obstacles is a critical first step toward finding ways around them; this paper describes how dominant models can create roadblocks, and suggests strategies to improve the efficiency of translation from animal models to humans. (shrink)

Inadequate diet is the leading risk factor for morbidity and mortality worldwide. However, approaches to identifying inadequate diets in clinical practice remain inconsistent, and dietary interventions frequently focus on facilitating ‘healthy choices’, with limited emphasis on structural constraints. We examine the ethical implications of introducing a routine question in the medical history about ability to access food. Not collecting data on food security means that clinicians are unable to identify people who may benefit from support on an individual level, unable (...) to consider relevant dietary risk factors for disease and disease progression and unable to monitor population trends and inequalities in dietary access in order to design effective policy interventions. We argue that the current lack of routine screening for food insecurity is inconsistent with our approach to other health behaviours, as well as with doctors’ frequent informal role as gatekeepers to the food aid system, and recent calls for governmental action on food insecurity and health inequalities from individual clinicians and professional bodies. Potential ethical barriers to asking patients about food security are addressed, including concerns about stigma, limiting autonomy, fair resource allocation, unclear professional remits and clinicians’ ability to offer effective interventions. We suggest that there is an ethical imperative for doctors to ask patients about their ability to access healthy food. Gathering this data provides a valuable first step in re-framing the social determinants of health as modifiable risks, rather than inevitable inequities. No data are available. (shrink)

This chapter is an examination of the way aporiai are employed in Aristotle’s scientific account of animal reproduction, and how they are resolved. I argue that – surprising as it may be, given what Aristotle says in Metaphysics B about the importance of going through aporiai – there seems to be nothing of much significance about his use of them, at least if we assume that genuine cases of aporiai are being tracked by use of aporia-language. I demonstrate this negative (...) thesis by systematically going through the examples. There seems to be no common purpose for which they are raised, they have no single type of structure, and they are not caused by any one sort of difficulty. (shrink)

Stigma can lead to poor health outcomes. At the same time, people who are perceived as unhealthy may experience stigma as the result of that perception. As part of a larger project examining discrimination on the basis of health status or “healthism,” we explore the role of stigma in producing disadvantage based on health status. Specifically, we look to the principles of health equality and health justice. An intervention violates health equality when it is driven by animus, which can be (...) the result of stigma. Additionally, laws and policies offend health justice when they worsen health outcomes or they create or deepen health disparities. An intervention that produces stigma — whether intentionally or unintentionally — may offend health justice by making people worse off, in absolute or in comparative terms. Stigma-related health laws and policies can therefore be healthist in at least two ways. We therefore conclude that stigma should neither be the basis, nor the product, of efforts to improve health. (shrink)

The main issue addressed in this paper is to provide a reassessment of the role and relevance of the body in social cognition from a radical embodied cognitive science perspective. Initially, I provide a historical introduction of the traditional account of the body in cognitive science, which I here call the cognitivist view. I then present several lines of criticism raised against the cognitivist view advanced by more embodied, enacted and situated approaches in cognitive science, and related disciplines. Next, I (...) analyze several approaches under the umbrella of embodied social cognition. My line of argument is that some of these approaches, although pointing toward the right direction of conceiving that the social mind is not merely contained inside the head, still fail to fully acknowledge the radically embodied social mind. I argue that the failure of these accounts of embodied social cognition could be associated with so-called ‘simple embodiment’. The third part of this paper focuses on elaborating an alternative characterization of the radically embodied social mind that also tries to reduce the remaining problems with ‘simple embodiment’. I draw upon two turns in radically embodied cognitive science, the enactive turn, and the social turn. On the one hand, there is the risk of focusing too much on the individual level in social cognition that may result in new kinds of methodological individualism that partly neglect the social dimension. On the other hand, socially distributed and socially extended approaches that pay more attention to the dynamics within social interaction may encounter the risk of ignoring the individual during social interaction dynamics and simultaneously not emphasizing the role of embodiment. The approach taken is to consider several ways of describing and incorporating the (individual) social mind at the social level that also includes language. I outline some ideas and motivations for how to study and expand the field of radical embodied social cognition in the future, as well as pose the ubiquitous hazard of falling back into a cognitivism view in several ways. (shrink)

The title of this book invites the question "what makes a metaphysical club real?" Overthinkers like myself may wonder whether metaphysical clubs can partake of varying degrees of reality or whether the distinction is, more likely, one between imposters and the genuine article. It only heightens the curiosity to read, in the general introduction to the book, that metaphysical clubs both preceded and followed the so-called "real" one and that the real one was itself divided into two phases. Given, then, (...) that there appear to have been more than one actual metaphysical club, what is the point of characterizing the subject of this anthology as real?The Real Metaphysical Club focuses entirely and thoroughly on the club... (shrink)

Humor is an indispensable element of George Santayana's philosophy. Santayana is, in many ways, philosophy's fool, poking fun at endeavors to obtain epistemological and moral mastery over existence. Moreover, he reminds us of the over-arching benefits of a humorous attitude, suggesting a humility by which we may put into relative perspective our otherwise totalizing aspirations and pursue a moral life without succumbing to moralism. Ultimately, a sense of humor reminds us that comedy is as honest a narrative as tragedy and (...) that the benefit in living is the fun of it. (shrink)

The choice argument against sweatshop regulations states that public officials should not prohibit workers from accepting jobs that require long hours, low pay, and poor working conditions, because enforcing such regulations would be disrespectful to the workers who choose to work in sweatshops. Critics of the choice argument reply that these regulations can be justified when workers only choose to work in sweatshops because they lack acceptable alternatives and are unable to coordinate to achieve better conditions for all workers. My (...) thesis is that the presence of unacceptable alternatives to sweatshop labor or barriers to coordination cannot justify sweatshop regulations such as minimum wage and maximum hour laws. Although officials should promote alternatives to difficult and dangerous sweatshop labor, they should not do so by limiting workers’ and employers’ options through coercive regulation. And the fact that sweatshop workers may face coordination problems does not undermine the claim that sweatshop workers choose to work in sweatshops, just as other workers face coordination problems but nevertheless make occupational choices. Furthermore, efforts to restrict sweatshop workers’ choices are morally risky and may not promote workers’ wellbeing or wellbeing in general. (shrink)

Disability through the Lens of Justice offers a contextual framework for considering the limitations that disability places on individuals. Specifically, those that prevent individuals from having control in certain domains of their life, by restricting the availability of acceptable options or the ability to choose between them. Begon argues that our theory of justice should be concerned with the lives individuals can lead, and not with whether their bodies and minds function typically. The problem that disability raises is not the (...) mere fact of difference, but the ways in which that difference is accommodated (or not) and the limitations it may cause. In Disability Through the Lens of Justice, Begon offers a new framework to the disability and justice model. She argues that achieving justice does not require 'normalisation', or the elimination of difference, but through implementating a model which enables all individuals to control their lives as they choose. (shrink)

Philosophy has become trapped by the belief that precision is our surest path to knowledge. It is my aim to challenge this assumption and to affirm in its place a wide variety of means by which we may “speak” philosophically. Drawing on George Santayana’s ontological realm of truth and his concept of literary psychology, I will argue that the varieties of human expression, in their relationship to truth, are not fundamental differences in kind but exist on a continuum of expression, (...) where the referent ranges from descriptions closest to the material facts to those closest to the human relationship to those facts. (shrink)