It is unarguable that the implementation and use of noninvasive prenatal testing (NIPT) should be critical and appropriate. After all, decisions that influence when and how to have children have ut...

Genomic screening at population scale generates many ethical considerations. One is the normative role that people’s preferences should play in determining access to genomic information in screening contexts, particularly information that falls beyond the scope of screening. We expect both that people will express a preference to receive such results and that there will be interest from the professional community in providing them. In this paper, we consider this issue in relation to the just and equitable design of population screening (...) programs like reproductive genetic carrier screening (RGCS). Drawing on a pluralistic public health ethics perspective, we claim that generating and reporting information about genetic variants beyond the scope of the screening program usually lacks clinical, and perhaps personal, utility. There are both pragmatic and ethical reasons to restrict information provision to that which fits the stated purpose of the program. (shrink)

In their analysis of how much fetal genetic information prospective parents should be able to access, Bayefsky and Berkman determine that parents should only be able to access information th...

Artificial intelligence systems advising healthcare professionals will be widely introduced into healthcare settings within the next 5–10 years. This paper considers how this will sit with tort/negligence based legal approaches to compensation for medical error. It argues that the introduction of AI systems will provide an additional argument pointing towards no-fault compensation as the better legal solution to compensation for medical error in modern health care systems. The paper falls into four parts. The first part rehearses the main arguments for (...) and against no-fault compensation. The second explains why it is likely that AI systems will be widely introduced. The third part analyses why it is difficult to fit AI systems into fault-based compensation systems while the final part suggests how no-fault compensation could provide a possible solution to such challenges. (shrink)

Background: The factors influencing parents’ willingness to enroll their children in biobanks are poorly understood. This study sought to assess parents’ willingness to enroll their children, and their perceived benefits, concerns, and information needs under different consent and data-sharing scenarios, and to identify factors associated with willingness. Methods: This large, experimental survey of patients at the 11 eMERGE Network sites used a disproportionate stratified sampling scheme to enrich the sample with historically underrepresented groups. Participants were randomized to receive one of (...) three consent and data-sharing scenarios. Results: In total, 90,000 surveys were mailed and 13,000 individuals responded (15.8% response rate). 5737 respondents were parents of minor children. Overall, 55% (95% confidence interval 50–59%) of parents were willing to enroll their youngest minor child in a hypothetical biobank; willingness did not differ between consent and data-sharing scenarios. Lower educational attainment, higher religiosity, lower trust, worries about privacy, and attitudes about benefits, concerns, and information needs were independently associated with less willingness to allow their child to participate. Of parents who were willing to participate themselves, 25% were not willing to allow their child to participate. Being willing to participate but not willing to allow one’s child to participate was independently associated with multiple factors, including race, lower educational attainment, lower annual household income, public health care insurance, and higher religiosity. Conclusions: Fifty-five percent of parents were willing to allow their youngest minor child to participate in a hypothetical biobank. Building trust, protecting privacy, and addressing attitudes may increase enrollment and diversity in pediatric biobanks. (shrink)

The COVID-19 pandemic has highlighted the risks that can be involved in healthcare work. In this paper, we explore the issue of staff safety in clinical work using the example of personal protective equipment in the COVID-19 crisis. We articulate some of the specific ethical challenges around PPE currently being faced by front-line clinicians, and develop an approach to staff safety that involves balancing duty to care and personal well-being. We describe each of these values, and present a decision-making framework (...) that integrates the two. The aim of the framework is to guide the process of balancing these two values when staff safety is at stake, by facilitating ethical reflection and/or decision-making that is systematic, specific and transparent. It provides a structure for individual reflection, collaborative staff discussion, and decision-making by those responsible for teams, departments and other groups of healthcare staff. Overall the framework guides the decision maker to characterise the degree of risk to staff, articulate feasible options for staff protection in that specific setting and identify the option that ensures any decrease in patient care is proportionate to the increase in staff well-being. It applies specifically to issues of PPE in COVID-19, and also has potential to assist decision makers in other situations involving protection of healthcare staff. There are no data in this work. (shrink)

Psychiatry is rapidly adopting digital phenotyping and artificial intelligence/machine learning tools to study mental illness based on tracking participants’ locations, online activity, phone and text message usage, heart rate, sleep, physical activity, and more. Existing ethical frameworks for return of individual research results (IRRs) are inadequate to guide researchers for when, if, and how to return this unprecedented number of potentially sensitive results about each participant’s real-world behavior. To address this gap, we convened an interdisciplinary expert working group, supported by (...) a National Institute of Mental Health grant. Building on established guidelines and the emerging norm of returning results in participant-centered research, we present a novel framework specific to the ethical, legal, and social implications of returning IRRs in digital phenotyping research. Our framework offers researchers, clinicians, and Institutional Review Boards (IRBs) urgently needed guidance, and the principles developed here in the context of psychiatry will be readily adaptable to other therapeutic areas. (shrink)

Introduction: Motherese, or emotional infant directed speech, is the specific form of speech used by parents to address their infants. The prosody of IDS has affective properties, expresses caregiver involvement, is a marker of caregiver-infant interaction quality. IDS prosodic characteristics can be detected with automatic analysis. We aimed to explore whether pregnant women “speak” to their unborn baby, whether they use motherese while speaking and whether anxio-depressive or obstetrical status impacts speaking to the fetus.Participants and Methods: We conducted an observational (...) study of pregnant women with gestational ages from 26 to 38 weeks. Women were recruited in a university hospital department of obstetrics. Thirty-five women agreed to participate in the study, and 26 audio records were exploitable. We collected obstetrical and sociodemographic data, pregnancy outcomes, anxiety and depressive status using the Covy and Raskin Scales, and life events using the Sensations During Pregnancy and Life Event Questionnaire. Each participant was left alone with an audio recorder with a recommendation to feel free to speak to her fetus as she would have done at home. The recording was stopped after 3 min. Audio recordings were analyzed by two methods: psycholinguist experts' annotation and computational objective automatic analyses.Results: Most mothers reported speaking to their fetuses. We found a correlation between maternal first perceptions of fetal movements and the start of mother's speaking to fetus. Motherese prosody was detected with both annotation and automatic analysis with a significant correlation between the two methods. In this exploratory study, motherese use was not associated with maternal anxiodepressive or obstetrical status. However, the more future mothers were depressed, the less they spoke with their fetuses during the recording.Conclusion: Fetal directed speech can be detected during pregnancy, and it contains a period of prosody that shares the same characteristics of motherese that can be described as prenatal motherese or emotional fetal-directed speech. This means that pregnant women start using motherese much earlier than expected. FDS seems to be correlated with maternal first perceptions of fetal movements and depression scores. However, more research is needed to confirm these exploratory results. (shrink)

We discuss the social-epistemic aspects of Catherine Elgin’s theory of reflective equilibrium and understanding and argue that it yields an argument for the view that a crucial social-epistemic function of epistemic authorities is to foster understanding in their communities. We explore the competences that enable epistemic authorities to fulfil this role and argue that among them is an epistemic virtue we call “epistemic empathy”.

This topical collection of Synthese is in honor of Catherine Z. Elgin. The idea for it arose in the context of an international book symposium dedicated to Elgin's latest book, organized by Katherine Dormandy, Christoph Jäger, and myself, which took place at the University of Innsbruck in March 2018. The topical collection comprises fourteen papers addressing a broad array of issues related to True Enough and to Elgin’s work more generally, plus a contribution by Elgin with detailed comments and (...) replies. True Enough is an extraordinarily rich, wide-ranging book; it reflects both the breadth and sharpness of Elgin’s philosophical gaze and exemplifies the impressive variety of her philosophical interests. In this introduction, I give an overview of the topical collection’s content, zooming in on the aspects of Elgin’s work which captured the contributors’ attention. My discussion will not remotely do justice to the complexity of Elgin’s system, but I hope that it will help the reader navigate the topical collection and appreciate how the fourteen papers relate to Elgin’s overall project. (shrink)

Review of Frederic R. Kellogg, Oliver Wendell Holmes, Jr., _Legal Theory And Judicial Restraint_ (Cambridge University Press 2007).

Introduction: Platonic dramatology -- The political and philosophical problems. Using pre-Socratic philosophy to support political reform: the Athenian stranger ; Plato's Parmenides: Parmenides' critique of Socrates and Plato's critique of Parmenides ; Becoming Socrates ; Socrates interrogates his contemporaries about the noble and good -- Paradigms of philosophy. Socrates' positive teaching ; Timaeus-Critias: completing or challenging Socratic political philosophy? ; Socratic practice -- The trial and death of Socrates. The limits of human intelligence ; The Eleatic challenge ; The trial (...) and death of Socrates -- Conclusion: Why Plato made Socrates his hero. (shrink)

This landmark study examines the role played by the rediscovery of the writings of the ancient atomists, Epicurus and Lucretius, in the articulation of the major philosophical systems of the seventeenth century, and, more broadly, their influence on the evolution of natural science and moral and political philosophy. The target of sustained and trenchant philosophical criticism by Cicero, and of opprobrium by the Christian Fathers of the early Church, for its unflinching commitment to the absence of divine supervision and the (...) finitude of life, the Epicurean philosophy surfaced again in the period of the Scientific Revolution, when it displaced scholastic Aristotelianism. Both modern social contract theory and utilitarianism in ethics were grounded in its tenets. Catherine Wilson shows how the distinctive Epicurean image of the natural and social worlds took hold in philosophy, and how it is an acknowledged, and often unacknowledged presence in the writings of Descartes, Gassendi, Hobbes, Boyle, Locke, Leibniz, Berkeley. With chapters devoted to Epicurean physics and cosmology, the corpuscularian or "mechanical" philosophy, the question of the mortality of the soul, the grounds of political authority, the contested nature of the experimental philosophy, sensuality, curiosity, and the role of pleasure and utility in ethics, the author makes a persuasive case for the significance of materialism in seventeenth-century philosophy without underestimating the depth and significance of the opposition to it, and for its continued importance in the contemporary world. Lucretius's great poem, On the Nature of Things, supplies the frame of reference for this deeply-researched inquiry into the origins of modern philosophy. (shrink)

IRBs often face dueling values in research: their historically grounded mission to protect research participants from harm conflicts with more recent attention to the importance of including underr...

Globalization is forcing us to rethink some of the categories -- such as "the people" -- that traditionally have been associated with the now eroding state. Italian political thinker Paolo Virno argues that the category of "multitude," elaborated by Spinoza and for the most part left fallow since the seventeenth century, is a far better tool to analyze contemporary issues than the Hobbesian concept of "people," favored by classical political philosophy. Hobbes, who detested the notion of multitude, defined it as (...) shunning political unity, resisting authority, and never entering into lasting agreements. "When they rebel against the state," Hobbes wrote, "the citizens are the multitude against the people." But the multitude isn't just a negative notion, it is a rich concept that allows us to examine anew plural experiences and forms of nonrepresentative democracy. Drawing from philosophy of language, political economics, and ethics, Virno shows that being foreign, "not-feeling-at-home-anywhere," is a condition that forces the multitude to place its trust in the intellect. In conclusion, Virno suggests that the metamorphosis of the social systems in the West during the last twenty years is leading to a paradoxical "Communism of the Capital.". (shrink)

Journal of Political Philosophy, EarlyView.

Summary The paper discusses the political thought of Cesare Balbo (1789?1853), a leading Risorgimento moderate liberal and politician, in the context of the efforts by the Piedmontese political elite to support and legitimise the constitutional regime introduced by King Charles Albert in 1848. Revising current interpretations of Risorgimento moderate liberalism as backward and provincial, it seeks to locate the political thought of Balbo and his colleagues at the heart of contemporary European, and particularly French, debates regarding liberty and aristocracy. In (...) particular, it argues that the views of Balbo and more broadly Piedmontese moderate liberals on centralisation, the importance of a social elite to defend freedom, and equalisation, were conversant with the ideas of Guizot, Chateaubriand, Burke and Tocqueville. Their harsh condemnation of republican virtue, on the other hand, rendered their liberalism peculiar in the Italian context, where Tuscan moderate liberals continued to resort to the language of civic humanism after 1848 to defend their political and social model. (shrink)

Nussbaum attempts to undermine the sharp distinction between literature and philosophy by arguing that literary texts (tragic poetry particularly) distinctively appeal to emotion and imagination, that our emotional response itself is cognitive, and that Aristotle thought so too. I argue that emotional response is not cognitive but presupposes cognition. Aristotle argued that we learn from the mimesis of action delineated in the plot, not from our emotional response. The distinctions between emotional and intellectual writing, poetry and prose, literature and philosophy, (...) the imaginative and the unimaginative do not cut along the same lines. That between literature and philosophy is not hard and fast: philosophy can be dramatic (eg Plato's dialogues) and drama can be philosophical (eg some of Shakespeare's plays), but whether either is emotional or not, or written in poetry or prose, are other questions. (shrink)

Science relies on models and idealizations that are known not to be true. Even so, science is epistemically reputable. To accommodate science, epistemology should focus on understanding rather than knowledge and should recognize that the understanding of a topic need not be factive. This requires reconfiguring the norms of epistemic acceptability. If epistemology has the resources to accommodate science, it will also have the resources to show that art too advances understanding.

Multitude between Innovation and NegationPaolo Virnotranslated by James CascaitoThe publication of Paolo Virno's first book in English, Grammar of the Multitude, by Semiotext in 2004 was an event within the field of radical political thought and introduced post-'68 currents in Italy to American readers. Multitude between Innovation and Negation, written several years later, offers three essays that take the reader on a journey through the political philosophy of language."Wit and Innovative Action" explores the ambivalence inevitably arising when the semiotic and (...) the semantic, grammar and experience, rule and regularity, and right and fact intersect. Virno unravels the infinite potential and wonders of everyday linguistic praxis and ambiguity. Wit, he argues, is a public performance, and its modus operandi characterizes human action in a state of emergency; it is a reaction, an articulate response, and a possible solution to a state of crisis. "Mirror Neurons, Linguistic Negation, and Mutual Recognition" examines the relationship of language and intersubjective empathy: without language, would human beings be able to recognize other members of their species? And finally, in "Multitude and Evil," Virno challenges the distinction between the state of nature and civil society and argues for a political institution that resembles language in its ability to be at once nature and history.Few thinkers take the risks required by innovation. Like a philosophical entrepreneur, Virno is engaged in no less than rewriting the dictionary of political theory, an urgent and ambitious project when language, caught in a permanent state of emergency impossible to sustain, desperately needs to articulate and enact new practices of freedom for the multitude.Paolo Virno is the author of several books, including A Grammar of the Multitude, 2004). (shrink)

DeStefano, Oey, Brockbank, and Vul explore interdisciplinary collaboration using data‐driven measures of research topics and co‐authorship, constructed from a rich dataset of over 11,000 Cogsci conference papers. Findings suggest the cognitive science research community has become increasingly integrated in the last 19 years.

Chronically disabling health impairments affect an increasing number of people worldwide. In close relationships, disability is an interpersonal experience. Psychological distress is thus common in patients as well as their spouses. Dyadic coping can alleviate stress and promote adjustment in couples who face disabling health impairments. Much research has focused on dyadic coping with cancer. However, other health problems such as physical and sensory impairments are also common and may strongly impact couple relationships. In order to promote couples' optimal adjustment (...) to impaired health, the identification of disability-related relationship challenges is required. Furthermore, ways in which dyadic coping with these challenges may benefit couples could inform researchers and practitioners how to support couples in coping with health impairments. Accordingly, the aims of this study were to systematically review dyadic challenges and dyadic coping when one partner has a chronically disabling physical or sensory impairment. Out of 873 articles identified through database searches, 36 studies met inclusion criteria. The disability-related dyadic challenges identified in the review were changed roles and responsibilities within the couple, altered communication, compromised sexual intimacy, and reduced social participation. These challenges were reported to burden both partners and the couple relationship. Dyadic adjustment benefitted from a we-perspective, i.e., when couples viewed the disability as a shared challenge and engaged in conjoint dyadic coping. The results suggest that patient/care recipient and partner/caregiver roles should be de-emphasized and that disability should be recognized as an interpersonal experience. (shrink)

What does it take to understand a phenomenon ideally, or to the highest conceivable extent? In this paper, we answer this question by arguing for five necessary conditions for ideal understanding: (i) representational accuracy, (ii) intelligibility, (iii) truth, (iv) reasonable endorsement, and (v) fitting. Even if one disagrees that there is some form of ideal understanding, these five conditions can be regarded as sufficient conditions for a particularly deep level of understanding. We then argue that grasping, novel predictions, and transparency (...) are not reasonable conditions for ideal understanding. (shrink)

This paper examines the sense and extent to which emotions can be thought of as rational. Through considering a number of examples, it argues (a) that there is more than one way of understanding the claims that we often make about emotions being “rational” or “justified”; (b) that none of the models of rationality already available to us can singly account for all of the various senses in which we think of emotions as rational; yet (c) that they can do (...) so jointly, that is, by each explicating at least one of these senses. Thus, in the end it is suggested that, despite it not being right to identify emotions with either beliefs or actions, there is no obvious reason to believe that the claims we make about the rationality of our emotions need to be understood by appeal to any separate model of rationality, specific to the emotions, additional to the “cognitive” and “strategic” models already available to us for understanding the rationality of other states like beliefs and judgements on the one hand, and actions on the other. (shrink)

This paper presents a model of persuasion in terms of goals and beliefs. Among the various ways to influence people, that is, to raise or lower the likelihood for them to pursue some goal, ranging from threat to suggestion, persuasion is viewed as a case of communicative non-coercive goal hooking. A persuader leads a persuadee to pursue some goal out of a free choice, i.e., by convincing him/her that the proposed goal is useful for some other goal that the persuadee (...) already has. It is argued that the Aristotelian persuasive strategies of logos, ethos and pathos (rational argumentation, the speaker¿s credibility and reliability, and the appeal to emotion) are always present in every persuasive discourse, and that they are exploited to raise the value of the goal proposed and to strengthen the believability of the link between it and the persuadee¿s previous goals. The paper proposes an analysis of discourse in terms of a hierarchy of goals as a tool to single out these strategies within the discourse structure. By applying this model to different kinds of persuasive messages (political discourse, advertising, dialogues in the health domain), it shows how, in the fragments presented, this kind of analysis allows to clarify the relationships between the persuader¿s and the persuadee¿s goals and to elucidate how much and how directly the persuader appeals to logos, ethos and pathos in his/her discourse. (shrink)

relative to the actual world) of a propositional theory are defined. A theory is ‘closer to the truth’ the logically stronger its positive content and the logically weaker its negative content. This proposal delivers the same verisimilar preordering of theories that has been defined by Brink and Heidema as a ‘power ordering’. The preordering may be collapsed to a partial ordering and then embedded into a complete distributive lattice. The preordering may also be refined to a partial ordering by employing (...) the ‘convex content’ and the ‘non-convex content’ of each theory. Philosophical implications and historical relations are discussed. (shrink)

In the course of his critique on institutions and modern society, the historian and philosopher Ivan Illich seeks to understand how the conception of limitation has changed from antiquity to modernity. Illich speaks about the fading of an aesthetic of proportionality and complementarity, which has framed the perception of beings as well as that of space and time. Within this aesthetic, the experience of fundamental otherness was a constitutive element. The article illustrates Illich’s historical analysis and points out its significance (...) for a reflection on the Christian practice of friendship. In the practice of friendship, otherness and complementarity are experienced in a horizon of freedom. In this context, thresholds and visible passages do not function as divisions or mediums of exclusion, but as perceptible markers, which can enable personal action in qualitatively differing spaces. (shrink)