Over a 20-year period, the United States has developed a consensus of legal opinion concerning living wills and other advance directives. At the heart of this consensus are two interconnected principles. First, the state should minimally interfere with the wishes of patients and surrogates and the decisions of physicians about foregoing life-sustaining treatments. Second, state interference is permissible for the sake of protecting a compelling state interest. The overwhelming majority of states with advance directive laws have attained this balance of (...) minimal interference and compelling state interest in developing their laws. (shrink)

In The Structure of Scientific Inference, Mary Hesse has argued for a realist interpretation of science. Her realism, however, is not to be understood in the context of the traditional realist/instrumentalist debate within the philosophy of science. That debate focused on the question of whether or not science did anything other than systematize the empirical data given in our experience. The traditional realist answered “yes” and most frequently described the theoretical statements of science, not only as true, but also as (...) providing descriptions of the world. The instrumentalist on the other hand answered “no” and ascribed no descriptive force to the theoretical statements of science. However, according to Hesse, neither party in the contemporary realism debate assumes the notion of an empirical given. Consequently, the present dispute must be understood as taking place on a level which is logically prior to its predecessor. (shrink)

This article begins with a criticism of Mclntyre and Gorovitz's account of medical error. Their theory implies that error, at least sometimes, it a necessary consequence of the inductive character of medical inquiry. The counter intuitive consequences of this account suggest that the issues surrounding induction may not be the most fertile area for developing a coherent interpretation of medical error. Given these shortcomings, I develop a new theory which assumes that the best philosophical soil for constructing a theory of (...) medical trror is the problem of universals. I then explain the problem and how the medical universal functions within arguments concerning diagnosis and treatment. A Wittgensteinian solution to the problem is presented which emphasizes the "borderline" character of some, if not many, medical judgments. Next, an argument is offered to establish that questions of medical error are not purely professional questions. This is because the theories used to make such professional judgments permit borderline cases even under the best circumstances. Finally, while there are a number of legitimate responses to this situation, I recommend one which involves legislative action. CiteULike Connotea Del.icio.us What's this? (shrink)

This volume consists of fourteen chapters selected from papers presented at the conference 'Ethics, Medicine and Health Care: An Appraisal of the Thought of H. Tristram Engelhardt, Jr.' along with a response to those chapters by Engelhardt and a Foreword by Laurence B. McCullough. The chapters direct primary attention to various aspects of Engelhardt's philosophy of medicine and bioethics as presented in The Foundations of Bioethics and Bioethics and Secular Humanism: The Search for a Common Morality. Among the topics treated (...) are the economics of health care and the medical profession, the libertarian and communitarian aspects of Engelhardt's thought, the moral status of children, abortion, the moral foundations for a health care system, feminism and clinical epistemology, and the relation between secular and religious moralities. In response to the various challenges posed by the authors, Engelhardt considers the implications of the failure of the modern philosophical project, the role of reason in ethics, and the resolution of conflict among communities that do not share the same moral vision. The book will be of interest to professionals in medicine, philosophy, theology, health policy, and law, and to graduate students in those disciplines. (shrink)

Bas van Fraassen has formulated a semantical or model theoretic analysis of the structure of scientific theories. He contrasts his semantical approach with the syntactic approach of the logical positivists and argues that his theory is preferable on a number of grounds. The aims of this paper are threefold. First, a brief description of van Fraassen's approach is presented. Secondly, his theory is compared with that of the logical positivists and, in so doing, the virtues that van Fraassen believes recommend (...) his theory over the positivist theory are identified. Finally, an objection that is positivist in spirit is raised which suggests that, epistemically, his account is indistinguishable from classical historicism. (shrink)

I am grateful to Brendan Minogue for his careful and detailed discussion of the concept of “intensional reference” as it appears in my book The Structure of Scientific Inference. He concludes that my account contains some important inconsistencies that vitiate my attempt to reconcile the idea of cumulative acquisition of scientific knowledge with radically changing theories. He rightly sees that this attempt depends crucially on the account of translatability between theories, and this in turn upon the notion of (...) “identity of intensional reference.” This means that the attempt fails if there are inconsistencies in the concept of IR. Since Minogue's careful analysis nevertheless contains some misunderstandings, I must plead guilty to a number of unclarities, but I do not believe there are basic inconsistencies. Let me try again. (shrink)

This paper argues that promises are proposals in joint practical deliberation, the activity of deciding together what to do. More precisely: to promise to ϕ is to propose (in a particular way) to decide together with your addressee(s) that you will ϕ. I defend this deliberative theory by showing that the activity of joint practical deliberation naturally gives rise to a speech act with exactly the same properties as promises. A certain kind of proposal to make a joint decision regarding (...) one's own actions turns out to have the very same normative effects, under the very same conditions, as a promise. I submit that this cannot be a coincidence: we should conclude that promises and the relevant kind of proposals in joint practical deliberation are one and the same. (shrink)

Recent work in moral philosophy has emphasized the foundational role played by interpersonal accountability in the analysis of moral concepts such as moral right and wrong, moral obligation and duty, blameworthiness, and moral responsibility (Darwall 2006; 2013a; 2013b). Extending this framework to the field of moral psychology, we hypothesize that our moral attitudes, emotions, and motives are also best understood as based in accountability. Drawing on a large body of empirical evidence, we argue that the implicit aim of the central (...) moral motives and emotions is to hold people - whether oneself or others - accountable for compliance with the demands of morality. Moral condemnation is based in a motive to get perpetrators to hold themselves accountable for their wrongdoing, not, as is commonly supposed, a mere retributive motive to make perpetrators suffer (�2). And moral conscience is based in a genuine motive to hold oneself accountable for behaving in accordance with moral demands, not, as is commonly supposed, a mere egoistic motive to appear moral to others (�3). The accountability-based theory of the moral motives and emotions we offer provides better explanations of the extant empirical data than any of the major alternative theories of moral motivation. Moreover, conceiving of moral psychology in this way gives us a new and illuminating perspective on what makes morality distinctive: its essential connection to our practice of holding one another accountable (�4). (shrink)

In this paper, we contend that the psychology of addiction is similar to the psychology of ordinary, non-addictive temptation in important respects, and explore the ways in which these parallels can illuminate both addiction and ordinary action. The incentive salience account of addiction proposed by Robinson and Berridge (1993; 2001; 2008) entails that addictive desires are not in their nature different from many of the desires had by non-addicts; what is different is rather the way that addictive desires are acquired, (...) which in turn affects their strength. We examine these “incentive salience” desires, both in addicts and non-addicts, contrasting them with more cognitive desires. On this account, the self-control challenge faced by addicted agents is not different in kind from that faced by non-addicted agents – though the two may, of course, differ greatly in degree of difficulty. We explore a general model of self-control for both the addict and the non-addict, stressing that self-control may be employed at three different stages, and examining the ways in which it might be strengthened. This helps elucidate a general model of intentional action. (shrink)

Burt's argument relies on a motte-and-bailey fallacy. Burt aims to argue against the value of genetics for social science; instead she argues against certain interpretations of a specific kind of genetics tool, polygenic scores (PGSs). The limitations, previously identified by behavioural geneticists including ourselves, do not negate the value of PGSs, let alone genetics in general, for social science.

When in the sixth century Dionysius the Areopagite declared beauty to be a name for God, he gave birth to something that had long been gestating in the womb of philosophical and theological thought. In doing so, Dionysius makes one of his most pivotal contributions to Christian theological discourse. It is a contribution that is enthusiastically received by the schoolmen of the Middle Ages, and it comes to permeate the thought of scholasticism in a multitude of ways. But perhaps nowhere (...) is the Dionysian influence more pronounced than in the thought of Thomas Aquinas. This book examines both the historical development of beauty's appropriation as a name for God in Dionysius and Thomas, and the various contours of what it means. The argument that emerges from this study is that given the impact that the divine name theological tradition has within the development of Christian theological discourse, beauty as a divine name indicates the way in which beauty is most fundamentally conceived in the Christian theological tradition as a theological theme. As a phenomenon of inquiry, beauty proves itself to be enigmatic and elusive to even the sharpest intellects in the Greek philosophical tradition. When it is absorbed within the Christian theological synthesis, however, its enigmatic content proves to be a powerful resource for theological reasoning. (shrink)

According to current hierarchies of evidence for EBM, evidence of correlation is always more important than evidence of mechanisms when evaluating and establishing causal claims. We argue that evidence of mechanisms needs to be treated alongside evidence of correlation. This is for three reasons. First, correlation is always a fallible indicator of causation, subject in particular to the problem of confounding; evidence of mechanisms can in some cases be more important than evidence of correlation when assessing a causal claim. Second, (...) evidence of mechanisms is often required in order to obtain evidence of correlation. Third, evidence of mechanisms is often required in order to generalise and apply causal claims. While the EBM movement has been enormously successful in making explicit and critically examining one aspect of our evidential practice, i.e., evidence of correlation, we wish to extend this line of work to make explicit and critically examine a second aspect of our evidential practices: evidence of mechanisms. (shrink)

Philosophy and Kafka is a collection of original essays interrogating the relationship of literature and philosophy. The essays either discuss specific philosophical commentaries on Kafka’s work, consider the possible relevance of certain philosophical outlooks for examining Kafka’s writings, or examine Kafka’s writings in terms of a specific philosophical theme, such as communication and subjectivity, language and meaning, knowledge and truth, the human/animal divide, justice, and freedom.

Several times, when faced with a difficult passage of scripture in Sermones ad populum, Augustine implores his audience, “knock and it shall be opened” (Matt. 7:7c; par. Luke 11:9c). Augustine uses this phrase to stress humility and the human need for God’s activity when interpreting scripture. Studying the archeological record of domestic architecture of locked doors in Roman North Africa elucidates Augustine’s message. Knowledge of the material culture shows that Augustine calls upon Christians to “knock” upon scripture as if it (...) were a door, locked and barred in such a way that it could only be opened from inside. Thus, a reader of scripture is like a petitioner calling from outside a locked door, needing God to open its meaning. Augustine’s use of “knocking” contrasts with the metaphor of “keys” to scripture, which was favored by Tyconius and other early Christian writers. In De doctrina Christiana, Augustine expresses concern that “keys” could lead a person into overconfidence, expecting to unlock obscure passages of the Bible by his or her own power. Augustine’s frequent use of Matt. 7:7c is a call for exegetes to approach scripture with humility. All members of the totus Christus, great and small, must humbly knock. The image of “knocking” provides a versatile theological message: human effort is important, but the meaning of the Bible is ultimately unlocked by God’s activity. (shrink)

In the context of transgender health, most people are not comfortable with allowing a twelve‐year‐old child with gender dysphoria to elect to undergo gender reassignment surgery. The likelihood is too high that the child would be unable to fully comprehend the scope of a decision that carries significant, permanent consequences, particularly because the decision to surgically change gender is based upon a conception of gender that can fluctuate during adolescent years. Conversely, however, most people would not contend that this fluidity (...) is reason to wholly deny certain medical care such as hormonal treatments to transgender youth, a demographic with extremely high rates of violent behavior, self‐harm, and suicide. This paper will explore ethical considerations to this emerging debate of what therapeutic options should be offered to transgender children and adolescents.Pediatric endocrinologists have been treating gender dysphoric adolescents with puberty‐suppressing drugs and, to a lesser extent, with cross‐sex hormone therapies for more than twenty years. Clinicians and thought leaders have mentioned ethical components of this emerging practice in the few cohort studies and clinical review articles about the subject. However, ethics have generally been a secondary consideration in the medical academic literature. In this paper, I will provide a brief overview of the practice, summarize the current research on hormone treatment for transgender minors, and provide an ethical analysis of the practice. (shrink)

Quentin Skinner's The Foundations of Modern Political Thought is primarily of interest to philosophers not for its excellent account of European thought about the state but for the self–conscious philosophy which has gone into it. It is a rare historian who pauses to get his philosophy in order before he embarks on a major enterprise, though such a policy is possibly less unusual in intellectual history than in other fields. In Skinner's case, however, this order of doing things has been (...) pushed so far that he counts as a philosopher in his own right, rather than as merely someone who is unusually careful to think about what he is doing. The publication of this major work thus provides a convenient opportunity to make a few remarks about the relation between historical theory and practice. (shrink)

Political conspiracy theories—e.g., unsupported beliefs about the nefarious machinations of one’s cunning, powerful, and evil opponents—are adopted enthusiastically by a great many people of widely varying political orientations. In many cases, these theories posit that there exists a small group of individuals who have intentionally but secretly acted to cause economic problems, political strife, and even natural disasters. This group is often held to exist “in the shadows,” either because its membership is unknown, or because “the real nature” of its (...) members’ allegiances, motives, and methods has been concealed from the public at large. Paradigmatic examples of these political conspiracy theories include anti-Semitic beliefs of the sort associated with The Protocols of the Elder of Zion, the “Red Scare” of the 1950s, claims about the “New World Order,” and many others. -/- Why do these theories attract so many adherents? In this essay, I’ll attempt to spread some light on this issue by applying Kahneman and Tversky’s highly influential work on reasoning under uncertainty. I’ll proceed by first providing a brief introduction to Kahneman and Tversky’s work on reasoning under uncertainty, and the way in which this relates to standard economic and philosophic accounts of rational behavior, as well as philosophical ideas about the role of intuition. Next, I’ll move onto some specific interconnected aspects of this work that are relevant to understanding conspiracy theories, including errors involving probabilistic reasoning (“Prospect Theory”), those involving the inappropriate use of heuristics, and those related to the “framing” of certain outcomes as losses from a baseline. This essay will conclude by making two related points. First, some of the most important reasoning errors committed by adherents of conspiracy theories are errors that many of us regularly commit. Given that self-awareness of these errors provides only minimal protection from committing them, this suggests that many of use may be more vulnerable to conspiratorial reasoning than we may like to believe. Second, in the light of this danger, I will outline a few steps that might be taken to help inoculate ourselves against the appeal of these theories, and to help respond to the conspiratorial arguments of others. (shrink)

Evolutionary fitness threats and rewards are associated with subjectively unpleasant and pleasant sensations, respectively. Initially, these correlations appear explainable via adaptation by natural selection. But here I analyse the major metaphysical perspectives on consciousness – physicalism, dualism, and panpsychism – and conclude that none help to understand the adaptive-seeming correlations via adaptation. I also argue that a recently proposed explanation, the phenomenal powers view, has major problems that mean it cannot explain the adaptive-seeming correlations via adaptation either. So the mystery (...) – call it the evolutionary paradox of consciousness – remains. Some have used this mystery to argue for non-naturalistic (e.g. theistic) explanations. But I propose a naturalistic, non-adaptive explanation of the adaptive-seeming correlations: namely, ‘sensational associative learning’ during development. In this perspective, pairing of particular sensations with unconditioned stimuli – fitness rewards or threats – cause the sensations themselves to come to be interpreted as good or bad, respectively. Sensations, like colours, that are not reliably paired with either fitness rewards or threats remain largely unvalenced. Sensational associative learning also provides explanations for adaptive-seeming structural aspects of sensations, such as the observation that sounds of different pitch are experienced as ordinal in correspondence to their wavelengths while the same is not true of colours of different hue. The sensational associative learning perspective appears compatible with physicalism, panpsychism, and dualism (though not epiphenomenalism). (shrink)

In this thesis, I give a metascientific account of causality in medicine. I begin with two historical cases of causal discovery. These are the discovery of the causation of Burkitt’s lymphoma by the Epstein-Barr virus, and of the various viral causes suggested for cervical cancer. These historical cases then support a philosophical discussion of causality in medicine. This begins with an introduction to the Russo- Williamson thesis (RWT), and discussion of a range of counter-arguments against it. Despite these, I argue (...) that the RWT is historically workable, given a small number of modifications. I then expand Russo and Williamson’s account. I first develop their suggestion that causal relationships in medicine require some kind of evidence of mechanism. I begin with a number of accounts of mechanisms and produce a range of consensus features of them. I then develop this consensus position by reference to the two historical case studies with an eye to their operational competence. In particular, I suggest that it is mechanistic models and their representations which we are concerned with in medicine, rather than the mechanism as it exists in the world. -/- I then employ these mechanistic models to give an account of the sorts of evidence used in formulating and evaluating causal claims. Again, I use the two human viral oncogenesis cases to give this account. I characterise and distinguish evidence of mechanism from evidence of difference-making, and relate this to mechanistic models. I then suggest the relationship between types of evidence presents us with a means of tackling the reference-class problem. This sets the scene for the final chapter. Here, I suggest the manner in which these two different classes of evidence become integrated is also reflected in the way that developing research programmes change as their associated causal claims develop. (shrink)

English mass noun phrases & count noun phrases differ only minimally grammatically. The basis for the difference is ascribed to a difference in the features +/-CT. These features serve the morphosyntactic function of determining the available options for the assigment of grammatical number, itself determined by the features +/-PL: +CT places no restriction on the available options, while -CT, in the unmarked case, restricts the available options to -PL. They also serve the semantic function of determining the sort of denotation (...) associated with demonstrative & quantified noun phrases. The feature -CT requires that the associated denotation be the set whose sole member is the greatest aggregate of which the noun phrase or noun is true; the feature +CT requires that the associated denotation be the set whose members are all & only those minimal aggregates of which the noun phrase or noun is true. At the same time, neither mass NPs nor count NPs that are arguments of a predicate have their predicate evaluated with respect to their denotations. Rather, the predicate is evaluated with respect to an aggregation, a set of aggregates constructed from the denotation of the noun phrase that is an argument of the predicate. 3 Tables, 4 Figures, 74 References. AA. (shrink)

What accounts for the capacity of ordinary speakers to comprehend utterances of their language? The phenomenology of hearing speech in one’s own language makes it tempting to many epistemologists to look to perception for an answer to this question. That is, just as a visual experience as of a red square is often taken to give the perceiver immediate justification for believing that there is a red square in front of her, perhaps an auditory experience as of the speaker asserting (...) that p gives the competent hearer immediate justification for believing that the speaker has asserted that p. My aim here is to offer reasons for resisting this temptation. I argue that the perceptual model cannot adequately account for the hearer’s justification in many cases. The arguments here also allow us to draw certain further morals about the role of phenomenology in the epistemology of perception. (shrink)

Evidence-based medicine (EBM) makes use of explicit procedures for grading evidence for causal claims. Normally, these procedures categorise evidence of correlation produced by statistical trials as better evidence for a causal claim than evidence of mechanisms produced by other methods. We argue, in contrast, that evidence of mechanisms needs to be viewed as complementary to, rather than inferior to, evidence of correlation. In this paper we first set out the case for treating evidence of mechanisms alongside evidence of correlation in (...) explicit protocols for evaluating evidence. Next we provide case studies which exemplify the ways in which evidence of mechanisms complements evidence of correlation in practice. Finally, we put forward some general considerations as to how the two sorts of evidence can be more closely integrated by EBM. (shrink)

One way to challenge the substantiveness of a particular philosophical issue is to argue that those who debate the issue are engaged in a merely verbal dispute. For example, it has been maintained that the apparent disagreement over the mind/brain identity thesis is a merely verbal dispute, and thus that there is no substantive question of whether or not mental properties are identical to neurological properties. The goal of this paper is to help clarify the relationship between mere verbalness and (...) substantiveness. I first argue that we should see mere verbalness as a certain kind of discourse defect that arises when the parties differ as to what each takes to be the immediate question under discussion. I then argue that mere verbalness, so understood, does not imply that the question either party is attempting to address is a non-substantive one. Even if it turns out that the parties to the mind/brain dispute are addressing subtly different questions, these might both be substantive questions to which their respective metaphysical views provide substantive answers. One reason it is tempting to reach deflationary conclusions from the charge of mere verbalness is that we fail to distinguish it from the claim that a sentence under dispute is, in a certain sense, indisputable. Another reason is that we fail to distinguish mere verbalness from a certain sort of indeterminacy. While indisputability and indeterminacy plausibly capture forms of nonsubstantiveness, I argue that mere verbalness is insufficient to establish either indisputability or indeterminacy. (shrink)

Category theory reveals commonalities between structures of all sorts. This book shows its potential in science, engineering, and beyond.

Internalists and externalists disagree over how intimately normative judgment and motivation are linked. Proponents on both sides typically try to settle the issue by descriptively interpreting our concept of a normative judgment. Unfortunately, this approach has resulted in deep and apparently intractable disagreement. It is time to consider alternative strategies. In this paper, I argue that the internalist/externalist debate is particularly ripe for revisionary arguments that evaluate conceptions of normative judgment in light of the costs and benefits of their adoption. (...) I then develop a revisionary case for externalism by identifying three practical hazards that come with internalist conceptions of normative judgment. Along the way, I show how these internalist hazards are mirrored by externalist benefits. I also argue that two potential benefits of internalism are not very beneficial. Together, these considerations give us strong practical reasons to adopt externalist conceptions of normative judgment, regardless of which account is descriptively accurate. (shrink)

Karl Popper (1902-1994) was one of the most influential philosophers of science of the 20th century. He made significant contributions to debates concerning general scientific methodology and theory choice, the demarcation of science from non-science, the nature of probability and quantum mechanics, and the methodology of the social sciences. His work is notable for its wide influence both within the philosophy of science, within science itself, and within a broader social context. Popper’s early work attempts to solve the problem of (...) demarcation and offer a clear criterion that distinguishes scientific theories from metaphysical or mythological claims. Popper’s falsificationist methodology holds that scientific theories are characterized by entailing predictions that future observations might reveal to be false. When theories are falsified by such observations, scientists can respond by revising the theory, or by rejecting the theory in favor of a rival or by maintaining the theory as is and changing an auxiliary hypothesis. In either case, however, this process must aim at the production of new, falsifiable predictions. While Popper recognizes that scientists can and do hold onto theories in the face of failed predictions when there are no predictively superior rivals to turn to. He holds that scientific practice is characterized by its continual effort to test theories against experience and make revisions based on the outcomes of these tests. By contrast, theories that are permanently immunized from falsification by the introduction of untestable ad hoc hypotheses can no longer be classified as scientific. Among other things, Popper argues that his falsificationist proposal allows for a solution of the problem of induction, since inductive reasoning plays no role in his account of theory choice. Along with his general proposals regarding falsification and scientific methodology, Popper is notable for his work on probability and quantum mechanics and on the methodology of the social sciences. Popper defends a propensity theory of probability, according to which probabilities are interpreted as objective, mind-independent properties of experimental setups. Popper then uses this theory to provide a realist interpretation of quantum mechanics, though its applicability goes beyond this specific case. With respect to the social sciences, Popper argued against the historicist attempt to formulate universal laws covering the whole of human history and instead argued in favor of methodological individualism and situational logic. Table of Contents 1. Background 2. Falsification and the Criterion of Demarcation a. Popper on Physics and Psychoanalysis b. Auxiliary and Ad Hoc Hypotheses c. Basic Sentences and the Role of Convention d. Induction, Corroboration, and Verisimilitude 3. Criticisms of Falsificationism 4. Realism, Quantum Mechanics, and Probability 5. Methodology in the Social Sciences 6. Popper’s Legacy 7. References and Further Reading a. Primary Sources b. Secondary Sources -/- . (shrink)

Predenville discusses the historical, artistic, and critical contexts in which painting has taken a realist turn. Color illustrations.

Very few writers have had such an impact on their culture as Alexander Solzhenitsyn on Soviet society in the ‘60s and ‘70s Recently published documents from the KGB archives show the problem he posed to the Soviet leadership—not because he was the only one to point out the massive falsehood and injustice of Soviet society but primarily due to the scathing power of his artistic diagnosis. Many of Solzhenitsyn’s writings in fictional, autobiographical, and publicistic genres can helpfully be understood in (...) terms of Plato’s struggle in the Athens of his day for a “remembering” or anamnesis of what it is to be a human being, a human society, and the cosmos as transparent for divinity. That struggle, even though Plato doesn’t use the word “amnesia”, was against the refusal to remember. The Austrian writer Heimito von Doderer called that refusal the Apperzeptionsverweigerung or refusal to perceive. Here we’ll explore Solzhenitsyn’s work in terms of his struggle to remember over against the ideological “refusal to perceive” in the three fundamental dimensions of personal, social and historical existence. Solzhenitsyn expands Mikhail Bakhtin’s understanding of “polyphonic” characterization as a key technique for articulating his diagnosis of Soviet totalitarianism. The discussion will instantiate what can be seen as his understanding of personal amnesia and anamnesis in Cancer Ward, his exploration of social amnesia and anamnesis in In the First Circle, and his treatment of historical amnesia and anamnesis in The Red Wheel and The Gulag Archipelago. (shrink)