ObjectivesTo describe reporting of informed consent in pragmatic trials, justifications for waivers of consent and reporting of alternative approaches to standard written consent. To identify factors associated with (1) not reporting and (2) not obtaining consent.MethodsSurvey of primary trial reports, published 2014–2019, identified using an electronic search filter for pragmatic trials implemented in MEDLINE, and registered in ClinicalTrials.gov.ResultsAmong 1988 trials, 132 (6.6%) did not include a statement about participant consent, 1691 (85.0%) reported consent had been obtained, 139 (7.0%) reported a (...) waiver and 26 (1.3%) reported consent for one aspect (eg, data collection) but a waiver for another (eg, intervention). Of the 165 trials reporting a waiver, 76 (46.1%) provided a justification. Few (53, 2.9%) explicitly reported use of alternative approaches to consent. In multivariable logistic regression analyses, lower journal impact factor (p=0.001) and cluster randomisation (p<0.0001) were significantly associated with not reporting on consent, while trial recency, cluster randomisation, higher-income country settings, health services research and explicit labelling as pragmatic were significantly associated with not obtaining consent (all p<0.0001).DiscussionNot obtaining consent seems to be increasing and is associated with the use of cluster randomisation and pragmatic aims, but neither cluster randomisation nor pragmatism are currently accepted justifications for waivers of consent. Rather than considering either standard written informed consent or waivers of consent, researchers and research ethics committees could consider alternative consent approaches that may facilitate the conduct of pragmatic trials while preserving patient autonomy and the public’s trust in research. (shrink)

Work on farms and in restaurants is characterized by highly gendered and racialized divisions of labor, low wages, and persistent inequalities. Gender, race, and ethnicity often determine the spaces where people work in the food system. Although some research focuses on gendered divisions of labor in restaurants and on farms, few efforts look more broadly at intersectional inequalities in food work. Our study examines how inequality is perpetuated through restaurant and farm work in the United States and, specifically, how gender (...) and race/ethnicity influence where people work, their tasks and responsibilities, and their work experiences. In describing restaurant work, people in the restaurant industry typically refer to the front and back of the house to distinguish between different working spaces, jobs, and workers. We use this spatial metaphor of front and back of the house to analyze intersectional inequalities of food work in restaurants and on farms. The data derive from conversations with 63 restaurant and farm owners, managers, and workers in California and Pennsylvania. Our findings suggest that gendered and racialized bodies often define who works in the front and back of the “house,” and that owners and workers often naturalize gender and racial divisions of labor in food work. Despite these patterns, we found evidence of attempts to reduce these inequalities on farms and in restaurants. (shrink)

To raise the question of the nature of narrative is to invite reflection on the very nature of culture and, possibly, even on the nature of humanity itself. So natural is the impulse to narrate, so inevitable is the form of narrative for any report of the way things really happened, that narrativity could appear problematical only in a culture in which it was absent—absent or, as in some domains of Western intellectual and artistic culture, programmatically refused. As a panglobal (...) fact of culture, narrative and narration are less problems than simply data. As the late Roland Barthes remarked, narrative "is simply there like life itself . . . international, transhistorical, transcultural."1 Far from being a problem, then, narrative might well be considered a solution to a problem of general human concern, namely, the problem of how to translate knowing into telling,2 the problem of fashioning human experience into a form assimilable to structures of meaning that are generally human rather than culture-specific. We may not be able fully to comprehend specific thought patterns of another culture, but we have relatively less difficulty understanding a story coming from another culture, however exotic that culture may appear to us. As Barthes says, "narrative...is translatable without fundamental damage" in a way that a lyric poem or a philosophical discourse is not. · 1. Roland Barthes, "Introduction to the Structural Analysis of Narratives," Music, Image, Text, trans. Stephen Heath , p. 79.· 2. The words "narrative," "narration," "to narrate," and so on derive via the Latin gnārus and narro from the Sanskrit root gnâ . The same root yields γνωριμος : see Emile Boisacq, Dictionnaire étymologique de la langue grecque , under the entry for this word. My thanks to Ted Morris of Cornell, one of our greatest etymologists. Hayden White, professor in the program of history of consciousness at the University of California, Santa Cruz, is the author of The Tropics of Discourse: Essays in Cultural Criticism, The Greco-Roman Tradition, and Metahistory: The Historical Imagination in Nineteenth Century Europe. " The Narrativization of Real Events" appeared in the Summer 1981 issue of Critical Inquiry. Critical Responses to the present essay include Louis O. Mink's "Everyman His or Her Own Annalist", and Marilyn Robinson Waldman's "The Otherwise Unnoteworthy Year 711: A Reply to Hayden White," both in the Summer 1981 issue of Critical Inquiry. (shrink)

Various decision theories share a troubling implication. They imply that, for any finite amount of value, it would be better to wager it all for a vanishingly small probability of some greater value. Counterintuitive as it might be, this fanaticism has seemingly compelling independent arguments in its favour. In this paper, I consider perhaps the most prima facie compelling such argument: an Egyptology argument (an analogue of the Egyptology argument from population ethics). I show that, despite recent objections from Russell (...) (2023) and Goodsell (2021), the argument’s premises can be justified and defended, and the argument itself remains compelling. (shrink)

Introduction -- Elucidating complexity theories -- Complexity in the natural sciences -- Complexity in social theory -- Towards transdisciplinarity -- Complexity in philosophy: complexification and the limits to knowledge -- Complexity in ethics -- Earth in the anthropocene -- Complexity and climate change -- American dreams, ecological nightmares and new visions -- Complexity and sustainability: wicked problems, gordian knots and synergistic solutions -- Conclusion.

Which is better: a guarantee of a modest amount of moral value, or a tiny probability of arbitrarily large value? To prefer the latter seems fanatical. But, as I argue, avoiding such fanaticism brings severe problems. To do so, we must decline intuitively attractive trade-offs; rank structurally identical pairs of lotteries inconsistently, or else admit absurd sensitivity to tiny probability differences; have rankings depend on remote, unaffected events ; and often neglect to rank lotteries as we already know we would (...) if we learned more. Compared to these implications, fanaticism is highly plausible. (shrink)

In this international and interdisciplinary collection of critical essays, distinguished contributors examine a crucial premise of traditional readings of Plato's dialogues: that Plato's own doctrines and arguments can be read off the statements made in the dialogues by Socrates and other leading characters. The authors argue in general and with reference to specific dialogues, that no character should be taken to be Plato's mouthpiece. This is essential reading for students and scholars of Plato.

Radical and autopoietic enactivists disagree concerning how to understand the concept of sense-making in enactivist discourse and the extent of its distribution within the organic domain. I situate this debate within a broader conflict of commitments to naturalism on the part of radical enactivists, and to phenomenology on the part of autopoietic enactivists. I argue that autopoietic enactivists are in part responsible for the obscurity of the notion of sense-making by attributing it univocally to sentient and non-sentient beings and following (...) Hans Jonas in maintaining a phenomenological dimension to life-mind continuity among all living beings, sentient or non-sentient. I propose following Merleau-Ponty instead, who offers a properly phenomenological notion of sense-making for which sentience is a necessary condition. Against radicalist efforts to replace sense-making with a deflationary, naturalist conception of intentionality, I discuss the role of the phenomenological notion of sense-making for understanding animal behavior and experience. (shrink)

This paper clarifies Merleau-Ponty’s distinction between speaking and spoken speech, and the relation between the two, in his Phenomenology of Perception. Against a common interpretation, I argue on exegetical and philosophical grounds that the distinction should not be understood as one between two kinds of speech, but rather between two internally related dimensions present in all speech. This suggests an interdependence between speaking and spoken aspects of speech, and some commentators have critiqued Merleau-Ponty for claiming a priority of speaking over (...) spoken speech. However, there is a sense in which Merleau-Ponty is right to emphasize the priority, namely, in terms of the ontological priority of the speaking subject with respect to language understood as a constituted cultural ideality. The latter only maintains its ontological status insofar as it is taken up by a language community. I favorably contrast Merleau-Ponty’s views on this question to those of the late Heidegger and de Saussure, and suggest potential applications of this clarified position for contemporary discussions in philosophy of language. (shrink)

In this paper I develop a novel account of the phenomenality of language by focusing on characteristics of perceived speech. I explore the extent to which the spoken word can be said to have a horizonal structure similar to that of spatiotemporal objects: our perception of each is informed by habitual associations and expectations formed through past experiences of the object or word and other associated objects and experiences. Specifically, the horizonal structure of speech in use can fruitfully be compared (...) to that of a tool in use. The comparison suggests an account of our linguistic faculty as continuous with more foundational faculties of perception and action. I provide empirical corroboration of this account by drawing on recent neuroimaging studies of the multimodal, sensorimotor bases of speech comprehension. I then discuss how such an understanding of our linguistic ability helps advocates of embodied, non-representationalist accounts of cognition respond to a common objection. Critics grant that embodied approaches may be adequate to account for lower-level, online modes of cognition, such as perception and action, which directly engage their object. But they question whether such approaches can “scale up” to higher modes of cognition, such as imagination, memory, thought, and language, which can entertain absent, non-existent, or abstract objects. By providing a plausible account of the continuity of lower cognition and language-involving cognition, my approach responds to this objection, at least where language is concerned. (shrink)

For aggregative theories of moral value, it is a challenge to rank worlds that each contain infinitely many valuable events. And, although there are several existing proposals for doing so, few provide a cardinal measure of each world's value. This raises the even greater challenge of ranking lotteries over such worlds—without a cardinal value for each world, we cannot apply expected value theory. How then can we compare such lotteries? To date, we have just one method for doing so (proposed (...) separately by Arntzenius, Bostrom, and Meacham), which is to compare the prospects for value at each individual location, and to then represent and compare lotteries by their expected values at each of those locations. But, as I show here, this approach violates several key principles of decision theory and generates some implausible verdicts. I propose an alternative—one which delivers plausible rankings of lotteries, which is implied by a plausible collection of axioms, and which can be applied alongside almost any ranking of infinite worlds. (shrink)

Approaches to the naturalization of phenomenology usually understand naturalization as a matter of rendering continuous the methods, epistemologies, and ontologies of phenomenological and natural scientific inquiry. Presupposed in this statement of the problematic, however, is that there is an original discontinuity, a rupture between phenomenology and the natural sciences that must be remedied. I propose that this way of thinking about the issue is rooted in a simplistic understanding of the phenomenological reduction that entails certain assumptions about the subject matter (...) of phenomenology and its relationship to the natural sciences. By contrast, Merleau‐Ponty's first work, The Structure of Behavior, presents a radically different approach to the phenomenological reduction, one that traverses the natural sciences and integrates them into phenomenology from the outset. I outline the argument for this position in The Structure of Behavior and then discuss consequences for current methodological issues surrounding the naturalization of phenomenology, focusing on the relationship between empirical sciences of mind, phenomenological psychology, and transcendental phenomenology. This novel exegesis of Merleau‐Ponty's view on the reduction offers new insight into his oft‐quoted remark that the phenomenological reduction is impossible to complete. (shrink)

I have two objectives in this article. The first is methodological: I elaborate a minimal phenomenological method and attempt to show its importance in studies of infant behavior. The second objective is substantive: Applying the minimal phenomenological approach, combined with Meltzoff’s “like-me” developmental framework, I propose the hypothesis that infants learn the pointing gesture at least in part through imitation. I explain how developments in sensorimotor ability (posture, arm and hand control and coordination, and locomotion) in the first year of (...) life prepare the infant for acquiring the pointing gesture. The former may directly enable the latter by allowing the infant to experience its own body as being “like those” of others, thus allowing it to imitatively appropriate a broader range of adult behavior. My proposal emphasizes the embodiment of mind in the development of cognition, contrary to latent dualistic tendencies in some developmental literature. (shrink)

Background:The public domain of midwifery practice, represented by the educational and hospital institutions could be blamed for a subconscious ethical dilemma for midwifery practitioners. The result of such tension can be seen in complaints from maternity service users of dehumanised care. When expectations are not met, women report dehumanising experiences that carry long term consequences to both them and their child.Objectives:To revisit the ethical foundation of midwifery practice to reflect the feminist Ethic of Care and reframe what is valuable to (...) women and midwives during the childbirth experience.Research Design:A comprehensive literature review is presented from the midwifery and feminist ethics discourse.Ethical Considerations:Nil to report.Findings:Women are vulnerable during childbirth as they need care, yet they prioritise elements of relationship in their experience. The Ethic of Care approach equalises the relationship between the midwife and the woman, providing the space for relationship building and allowing midwives to meet the expectations of their accepted responsibility.Discussion:Some midwives manage to balance the demands of the institution with the needs of the woman. This is described as both an emotional and professionally challenging balancing act.Conclusion:Until there is a formal acknowledgement of the different ethical approach to midwifery practice from within the profession and the Institution, midwifery identity and practice will continue to be compromised. (shrink)

Various philosophers accept moral views that are impartial, additive, and risk-neutral with respect to moral betterness. But, if that risk neutrality is spelt out according to expected value theory alone, such views face a dire reductio ad absurdum. If the expected sum of value in humanity's future is undefined--if, e.g., the probability distribution over possible values of the future resembles the Pasadena game, or a Cauchy distribution--then those views say that no option is ever better than any other. And, as (...) I argue, this holds in practice: our evidence supports such a probability distribution. Indeed, it supports a probability distribution that cannot be evaluated even if we adopt one of the various extensions of expected value theory proposed in the literature. Must we therefore reject all impartial, additive, risk-neutral moral theories? It turns out that we need not. I develop an alternative solution: a new method of extending expected value theory, which allows us to deal with this distribution and to salvage those moral views. I also examine how this solution affects one of the most notable implications of those views--namely, longtermism. (shrink)

Testimony is an invaluable source of knowledge. We rely on the reports of those around us for everything from the ingredients in our food and medicine to the identity of our family members. Recent years have seen an explosion of interest in the epistemology of testimony. Despite the multitude of views offered, a single thesis is nearly universally accepted: testimonial knowledge is acquired through the process of transmission from speaker to hearer. In this book, Jennifer Lackey shows that this (...) thesis is false and, hence, that the literature on testimony has been shaped at its core by a view that is fundamentally misguided. She then defends a detailed alternative to this conception of testimony: whereas the views currently dominant focus on the epistemic status of what speakers believe, Lackey advances a theory that instead centers on what speakers say. The upshot is that, strictly speaking, we do not learn from one another's beliefs - we learn from one another's words. Once this shift in focus is in place, Lackey goes on to argue that, though positive reasons are necessary for testimonial knowledge, testimony itself is an irreducible epistemic source. This leads to the development of a theory that gives proper credence to testimony's epistemologically dual nature: both the speaker and the hearer must make a positive epistemic contribution to testimonial knowledge. The resulting view not only reveals that testimony has the capacity to generate knowledge, but it also gives appropriate weight to our nature as both socially indebted and individually rational creatures. The approach found in this book will, then, represent a radical departure from the views currently dominating the epistemology of testimony, and thus is intended to reshape our understanding of the deep and ubiquitous reliance we have on the testimony of those around us. (shrink)

Philosophy & Public Affairs, Volume 50, Issue 2, Page 202-238, Spring 2022.

Dispositionality is a modal notion of a certain sort. When an object is said to have a disposition, we typically understand this to mean that under certain circumstances, the object would behave in a certain way. For instance, a fragile object is disposed to break when dropped onto a concrete surface. It need not actually break - its being fragile has implications that, so to speak, point beyond the actual world. According to dispositionalism, all modal features of the world may (...) be accounted for in terms of its dispositional features. My aim in this paper is to assess the prospects for dispositionalism by examining the most promising theories. Sections 1 and 2 clarify the assumptions and desiderata of a successful dispositionalist theory of modality. Section 3 introduces the principles governing the dispositionalist theories that apparently meet the desiderata. Sections 4 through 6 show that dispositionalism nonetheless faces three problems: while dispositions help account for modal features of the world that are local, diachronic, or gradable, they cannot account for certain modal features of the world that are global, synchronic, or absolute. I end by discussing the costs of preserving dispositionalism. (shrink)

Hayden White probes the notion of authority in art and literature and examines the problems of meaning - its production, distribution, and consumption - in different historical epochs. In the end, he suggests, the only meaning that history can have is the kind that a narrative imagination gives to it. The secret of the process by which consciousness invests history with meaning resides in the content of the form, in the way our narrative capacities transforms the present into a (...) fulfillment of a past from which we would wish to have desceneded. (shrink)

1. Lying -- 2. The problem of what is said -- 3. What is said -- 4. Is lying worse than merely misleading? -- 5. Some interesting cases.

Thought experiments feature prominently in both scientific and philosophical methods. In this paper, I investigate two questions surrounding knowledge in the thought experiment process. First, on what implicit knowledge do thought experiments rely? Second, what provides epistemic justification for beliefs acquired through the process? I draw upon neo-Aristotelian metaphysics and Husserlian phenomenology to argue that essence is the object of implicit knowledge that anchors the imagined possibilities involved in thought experiments to the actual world, and that this essentialist knowledge enables (...) the possibility of prima facie justification being conferred by the phenomenological givenness of thought experiment scenarios. (shrink)

In a recent article, ‘Why lockdown of the elderly is not ageist and why levelling down equality is wrong’, Savulescu and Cameron argue that a selective lockdown of older people is not ageist because it would treat people unequally based on morally relevant differences. This response argues that a selective lockdown of older people living in long-term care homes would be unjust because it would allow the expansive liberties of the general public to undermine the basic liberties of older people, (...) and because it would discriminate on the basis of extrinsic disadvantages. (shrink)

Ethical codes have been hailed as an explicit vehicle for achieving more sustainable and defensible organizational practice. Nonetheless, when legal compliance and corporate governance codes are conflated, codes can be used to define organizational interests ostentatiously by stipulating norms for employee ethics. Such codes have a largely cosmetic and insurance function, acting subtly and strategically to control organizational risk management and protection. In this paper, we conduct a genealogical discourse analysis of a representative code of ethics from an international corporation (...) to understand how management frames expectations of compliance. Our contribution is to articulate the problems inherent in codes of ethics, and we make some recommendations to address these to benefit both an organization and its employees. In this way, we show how a code of ethics can provide a foundation for ethical sustainability, while addressing management intentions and employees’ ethical satisfaction. (shrink)

There is a puzzle concerning the essences of fundamental entities that arises from considerations about essence, on one hand, and fundamentality, on the other. The Essence-Dependence Link (EDL) says that if x figures in the essence of y, then y is dependent upon x. EDL is prima facie plausible in many cases, especially those involving derivative entities. But consider the property negative charge. A negatively charged object exhibits certain behaviors that a positively charged object does not: it moves away from (...) other negatively charged objects, towards positively charged objects, etc. It is commonly thought that negative charge disposes its bearer to move away from other negatively charged objects, towards positively charged objects, etc. But if negative charge is fundamental, then no other entities—including the property positive charge—can figure in its essence. We thus have a prima facie puzzle: How can we say anything interesting about the essences of fundamental entities without running afoul of EDL? In this paper, I present and discuss the consequences of EDL for the debate between causal essentialists and quidditists about properties, and propose solutions to the puzzle. (shrink)

Properties seem to play an important role in causal relations. But philosophers disagree over whether or not properties play their causal or nomic roles essentially. Causal essentialists say that they do, while quidditists deny it. This article surveys these two views, as well as views that try to find a middle ground.

How might we extend aggregative moral theories to compare infinite worlds? In particular, how might we extend them to compare worlds with infinite spatial volume, infinite temporal duration, and infinitely many morally valuable phenomena? When doing so, we face various impossibility results from the existing literature. For instance, the view we adopt can endorse the claim that worlds are made better if we increase the value in every region of space and time, or that they are made better if we (...) increase the value obtained by every person. But they cannot endorse both claims, so we must choose. In this paper I show that, if we choose the latter, our view will face serious problems such as generating incomparability in many realistic cases. Opting instead to endorse the first claim, I articulate and defend a spatiotemporal, expansionist view of infinite aggregation. Spatiotemporal views such as this do face some difficulties, but I show that these can be overcome. With modification, they can provide plausible comparisons in cases that we care about most. (shrink)

Jennifer Lackey presents a ground-breaking exploration of the epistemology of groups, and its implications for group agency and responsibility. She argues that group belief and knowledge depend on what individual group members do or are capable of doing, while being subject to group-level normative requirements.

This essay explores the speech act of dogwhistling (sometimes referred to as ‘using coded language’). Dogwhistles may be overt or covert, and within each of these categories may be intentional or unintentional. Dogwhistles are a powerful form of political speech, allowing people to be manipulated in ways they would resist if the manipulation was carried outmore openly—often drawing on racist attitudes that are consciously rejected. If philosophers focus only on content expressed or otherwise consciously conveyed they may miss what is (...) most powerful and pernicious in the speech of political culture. This essay is a call to start paying attention to these more covert speech acts, and a first attempt at beginning to theorize them. It argues that dogwhistles present a complex and interesting case for the philosopher of language, and explores their implications for democratic politics. (shrink)

Suppose you found that the universe around you was infinite—that it extended infinitely far in space or in time and, as a result, contained infinitely many persons. How should this change your moral decision-making? Radically, it seems, according to some philosophers. According to various recent arguments, any moral theory that is ’minimally aggregative’ will deliver absurd judgements in practice if the universe is (even remotely likely to be) infinite. This seems like sound justification for abandoning any such theory. -/- My (...) goal in this thesis is simple: to demonstrate that we need not abandon minimally aggregative theories, even if we happen to live in an infinite universe. I develop and motivate an extension of such theories, which delivers plausible judgements in a range of realistic cases. I show that this extended theory can overcome key objections—both old and new—and that it succeeds where other proposals do not. With this proposal in hand, we can indeed retain minimally aggregative theories and continue to make moral decisions based on what will promote the good. (shrink)

The debate about genetic modification (GM) can be seen as characteristic of our time. Environmental groups, in challenging GM, are also challenging modernist faith in progress, and science and technology. In this paper we use the case of New Zealand's Royal Commission on Genetic Modification to explore the application of science discourses as used by environmental groups. We do this by situating the debate in the framework of modernity, discussing the use of science by environmental groups, and deconstructing the science (...) discourses evident within environmental groups' submissions to the Commission. We find science being called into question by the very movement that has relied on it to fight environmental issues for many years. The environmental groups are challenging the traditional boundaries of science, for although they use science they also present it as a culturally embedded activity with no greater epistemological authority than other knowledge systems. Their discourses, like that of the other main actors in the GM debate, are thus part of the constant re-negotiation of the cultural construct of 'science'. (shrink)

A view of knowledge—what I call the "Deserving Credit View of Knowledge" —found in much of the recent epistemological literature, particularly among so-called virtue epistemologists, centres around the thesis that knowledge is something for which a subject deserves credit. Indeed, this is said to be the central difference between those true beliefs that qualify as knowledge and those that are true merely by luck—the former, unlike the latter, are achievements of the subject and are thereby creditable to her. Moreover, it (...) is often further noted that deserving credit is what explains the additional value that knowledge has over merely lucky true belief. In this paper, I argue that the general conception of knowledge found in the DCVK is fundamentally incorrect. In particular, I show that deserving credit cannot be what distinguishes knowledge from merely lucky true belief since knowledge is not something for which a subject always deserves credit. (shrink)

Hurley’s is a difficult book to work through—partly because of its length and the complexity of its arguments, but also because each of the ten essays of which it is composed has a rather different starting point and focus, and because few of her arguments achieve real closure. Essay 2 discusses competing interpretations of Kant, essay 4 articulates nonconceptual forms of self-consciousness, essay 5 offers fresh interpretations of commissurotomy patients’ behavior, essay 6 develops an objection to Wittgenstein on rule following, (...) essay 8 attacks an alleged assumption of externalism, and chapter 10 explores the possibility of combining a “motor theory” and a “control theory” of perception. This is a very rich brew, and at least half the challenge this book presents consists in discerning its central argument and conclusion with enough precision to bring criticism to bear. (shrink)

Philosophers of language have long recognized that in opaque contexts, such as those involving propositional attitude reports, substitution of co-referring names may not preserve truth value. For example, the name ‘Clark Kent’ cannot be substituted for ‘Superman’ in a context like:1. Lois believes that Superman can flywithout a change in truth value. In an earlier paper, Jennifer Saul demonstrated that substitution failure could also occur in ‘simple sentences’ where none of the ordinary opacity-producing conditions existed, such as:2. Superman leaps (...) more tall buildings than Clark Kent does.Accounts focusing on opacity were unable to explain our ‘anti-substitution intuitions’ in such cases.In Simple Sentences, Substitution, and Intuitions, Saul extends her earlier work. She provides a comprehensive presentation and criticism of recent accounts of simple sentence substitution failure, and proposes a new approach drawing on psychological evidence about cognitive processing. Saul's purpose is not merely to solve the substitution puzzle cases, but to make …. (shrink)