Anti-vascular endothelial growth factor therapy has revolutionised the treatment of a variety of ophthalmic conditions and has become the first-line therapy for a range of retinal diseases. Bevacizumab, a VEGF inhibitor first approved for the treatment of colorectal cancer, has been shown to be nearly or virtually as effective and safe as other anti-VEGF therapies in the treatment of certain retinal diseases but is not approved or registered by the Food and Drug Administration or European Medicines Agency. While other anti-VEGF (...) options are approved and registered, they are generally more expensive and less accessible. Accordingly, despite its off-label status, bevacizumab is frequently used for a variety of disabling retinal diseases. Indeed, bevacizumab is included on the World Health Organization’s list of essential medicines. However, its use in some parts of the world remains restricted due to its off-label status. How, then, should healthcare authorities approach this situation? What are the ethical and societal implications of adhering to a standard and generally effective evaluation and approval system while restricting access to a potentially cost-saving therapy? In countries where its use is not restricted, how should providers approach off-label treatment with bevacizumab? By examining the evidence behind bevacizumab’s efficacy and safety and evaluating the individual and societal implications of off-label use and restriction, this paper illustrates the ethical factors providers and policy makers must consider in the off-label use of bevacizumab and ultimately argues for increased access to bevacizumab in the treatment of retinal disease. (shrink)

Background Despite the growth of biomedical research in South Africa, there are few insights into the operation of Research Ethics Committees (RECs) in this setting. We investigated the composition, operations and training needs of health RECs in South Africa against the backdrop of national and international guidelines. Methods The 12 major health RECs in South Africa were surveyed using semi-structured questionnaires that investigated the composition and functions of each REC as well as the operational issues facing committees. Results Health RECs (...) in SA have an average of 16 members and REC members are predominantly male and white. Overall, there was a large discrepancy in findings between under-resourced RECs and well resourced RECs. The majority of members (56%) are scientists or clinicians who are typically affiliated to the same institution as the health REC. Community representatives account for only 8% of membership. Training needs for health REC members varied widely. Conclusion Most major health RECs in South Africa are well organized given the resource constraints that exist in relation to research ethics in developing countries. However, the gender, racial and occupational diversity of most of these RECs is suboptimal, and most RECs are not constituted in accordance with South African guidelines. Variability in the operations and training needs of RECs is a reflection of apartheid-entrenched influences in tertiary education in SA. While legislation now exists to enforce standardization of research ethics review systems, no provision has been made for resources or capacity development, especially to support historically-disadvantaged institutions. Perpetuation of this legacy of apartheid represents a violation of the principles of justice and equity. (shrink)

William Lane Craig's defence of the kalam cosmological argument rests heavily on two philosophical arguments against a past-eternal universe. In this article I take issue with one of these arguments, what I call the – namely, that the metaphysical absurdity of an actually infinite number of things existing precludes the possibility of a beginningless past. After explaining this argument, I proceed to raise some initial doubts. After setting those aside, I show that the argument is ineffective against proponents of presentism. (...) The remainder of the article considers and rejects possible replies on Craig's behalf. (shrink)

Former Google advertising strategist, now Oxford-trained philosopher James Williams launches a plea to society and to the tech industry to help ensure that the technology we all carry with us every day does not distract us from pursuing our true goals in life. As information becomes ever more plentiful, the resource that is becoming more scarce is our attention. In this 'attention economy', we need to recognise the fundamental impacts of our new information environment on our lives in order (...) to take back control. Drawing on insights ranging from Diogenes to contemporary tech leaders, Williams's thoughtful and impassioned analysis is sure to provoke discussion and debate. Williams is the inaugural winner of the Nine Dots Prize, a new Prize for creative thinking that tackles contemporary social issues. This title is also available as Open Access. (shrink)

This is the first critical study of The Logic of Sense, Gilles Deleuze's most important work on language and ethics, as well as the main source of his vital philosophy of the event.James Williams explains the originality of Deleuze's work with careful definitions of all his innovative terms and a detailed description of the complex structure he constructs. This reading makes connections to his ground-breaking work on literature, to his critical but also progressive relation to the sciences, and to (...) his controversial denial of the priority of standard logics, human values and 'meaning' in thinking.This book will open new debates and develop current ones around Deleuze's work in philosophy, politics, literature, linguistics, cultural studies and sociology. (shrink)

The notion that something can exist a se is central to Descartes’s overall metaphysics of causation. In the Meditations, divine aseity plays the role of explaining not only God’s existence but ultimately the existence of everything else apart from God. Yet in the Meditations proper, as well as in the early Replies, Descartes does little to clarify exactly what his view of divine aseity is and how it might differ from the sort of aseity commonly posited by the Scholastics. Despite (...) Descartes’s later attempts to assuage this worry and clarify his position, the positive aseity charge has not gone away. Here I shall argue that the charge is unjustified on all counts. Baldly stated, Descartes’s notion of aseity is no different than the negative sense of aseity endorsed by his Scholastic predecessors - especially Aquinas. Understanding this not only helps in clarifying the overall picture of Cartesian causality but also aids in seeing how commentaries on the Meditations, old and new, have obscured it. (shrink)

The semantic paradoxes are often associated with self-reference or referential circularity. Yablo (Analysis 53(4):251–252, 1993), however, has shown that there are infinitary versions of the paradoxes that do not involve this form of circularity. It remains an open question what relations of reference between collections of sentences afford the structure necessary for paradoxicality. In this essay, we lay the groundwork for a general investigation into the nature of reference structures that support the semantic paradoxes and the semantic hypodoxes. We develop (...) a functionally complete infinitary propositional language endowed with a denotation assignment and extract the reference structural information in terms of graph-theoretic properties. We introduce the new concepts of dangerous and precarious reference graphs, which allows us to rigorously define the task: classify the dangerous and precarious directed graphs purely in terms of their graph-theoretic properties. Ungroundedness will be shown to fully characterize the precarious reference graphs and fully characterize the dangerous finite graphs. We prove that an undirected graph has a dangerous orientation if and only if it contains a cycle, providing some support for the traditional idea that cyclic structure is required for paradoxicality. This leaves the task of classifying danger for infinite acyclic reference graphs. We provide some compactness results, which give further necessary conditions on danger in infinite graphs, which in conjunction with a notion of self-containment allows us to prove that dangerous acyclic graphs must have infinitely many vertices with infinite out-degree. But a full characterization of danger remains an open question. In the appendices we relate our results to the results given in Cook (J Symb Log 69(3):767–774, 2004) and Yablo (2006) with respect to more restricted sentences systems, which we call $\mathcal{F}$ -systems. (shrink)

Why is American punishment so cruel? While in continental Europe great efforts are made to guarantee that prisoners are treated humanely, in America sentences have gotten longer and rehabilitation programs have fallen by the wayside. Western Europe attempts to prepare its criminals for life after prison, whereas many American prisons today leave their inhabitants reduced and debased. In the last quarter of a century, Europe has worked to ensure that the baser human inclination toward vengeance is not reflected by state (...) policy, yet America has shown a systemic drive toward ever increasing levels of harshness in its criminal policies. Why is America so short on mercy? In this deeply researched, comparative work, James Q. Whitman reaches back to the 17th and 18th centuries to trace how and why American and European practices came to diverge. Eschewing the usual historical imprisonment narratives, Whitman focuses instead on intriguing differences in the development of punishment in the age of Western democracy. European traditions of social hierarchy and state power, so consciously rejected by the American colonies, nevertheless supported a more merciful and dignified treatment of offenders. The hierarchical class system on the continent kept alive a tradition of less-degrading "high-status" punishments that eventually became applied across the board in Europe. The distinctly American, draconian regime, on the other hand, grows, Whitman argues, out of America's longstanding distrust of state power and its peculiar, broad-brush sense of egalitarianism. Low-status punishments were evenly meted out to all offenders, regardless of class or standing. America's unrelentingly harsh treatment of trangressors--this "equal opportunity degradation"-- is, in a very real sense, the dark side of the nation's much vaunted individualism. A sobering look at the growing rift between the United States and Europe, Harsh Justice exposes the deep cultural roots of America's degrading punishment practices. (shrink)

A revised, expanded and fully up-to-date critical introduction to Deleuze's most important work of philosophyBy critically analysing Deleuze's methods, principles and arguments, James Williams helps readers to engage with the revolutionary core of Deleuze's philosophy and take up positions for or against its most innovative and controversial ideas.

Prior to their announcement of the birth of gene-edited twins in China, Dr. He Jiankui and colleagues published a set of draft ethical principles for discussing the legal, social, and ethical aspects of heritable genome interventions. Within this document, He and colleagues made it clear that their goal with these principles was to “clarify for the public the clinical future of early-in-life genetic surgeries” or heritable genome editing. In light of He’s widely criticized gene editing experiments it is of interest (...) to place these draft principles in the larger ethical debate surrounding heritable genome editing. Here we examine the principles proposed by He and colleagues through the lens of Beauchamp and Childress’ Principles of Biomedical Ethics. We also analyze the stated goal that the “clinical future” of heritable genome editing was clarified by He and colleagues’ proposed principles. Finally, we highlight what might be done to help prevent individual actors from pushing forward ahead of broad societal consensus on heritable genome editing. (shrink)

Patients -- Clients -- Welfare assessment -- Clinical choices -- Achieving animal welfare goals -- Beyond the clinic.

The Epicurean philosophical system has enjoyed much recent scrutiny, but the question of its philosophical ancestry remains largely neglected. It has often been thought that Epicurus owed only his physical theory of atomism to the fifth-century BC philosopher Democritus, but this study finds that there is much in his ethical thought which can be traced to Democritus. It also finds important influences on Epicurus in Democritus' fourth-century followers such as Anaxarchus and Pyrrho, and in Epicurus' disagreements with his own Democritean (...) teacher Nausiphanes. The result is not only a fascinating reconstruction of a lost tradition, but also an important contribution to the philosophical interpretation of Epicureanism, bearing especially on its ideal of tranquillity and on the relation of ethics to physics. (shrink)

As interest in Owen Barfield grows, we aim to meet the need for a scholarly introduction to his thought. Our primary purpose is to present an overview, analysis, and synthesis of Barfield's most salient ideas in a manner that will be of interest to neophytes and initiates alike. Barfield's work can, at time, be difficult to understand; C. S. Lewis put it well when he described Barfield's style of argument as 'dark, labyrinthine,' and 'pertinacious.' But Lewis ardently promoted Barfield's work (...) because he knew that people who willingly walk in those dim and winding corridors are, in time, richly rewarded by the bright light at their end. We offer the present work in service to those who wish to undertake this adventure. While the present book will help those readers who wish to engage Barfield for the sake of achieving a greater understanding of and appreciation for other writers who have been associated with or influenced by him, we aim first and foremost to present Barfield as a profound and original thinker in his own right. (shrink)

Though the interaction of philosophy with pop culture has so far mostly taken the form of books for nonphilosophers that use various shows and movies as sources of examples to illustrate “traditional” philosophical issues, this article contends that serious engagement with the informal philosophical discussions expressed in popular entertainments constitutes a kind of “ethnophilosophy” and should be considered an important part of the discipline. Our disciplinary responsibility for maintaining and considering the history of philosophy ought to include even the philosophical (...) conversations that occur outside the academy; however unlike “proper” philosophy this material may be, it nonetheless represents engagement—sometimes substantial engagement—with the same issues that concern those of us who are considered “professional” philosophers, and thus is legitimately of interest to us. (shrink)

The infant mortality rate in Liberia is 50 times higher than it is in Sweden, whilst a child born in Japan has a life expectancy at birth of more than double that of one born in Zambia. 1 And within countries, we see differences which are nearly as great. For example, if you were in the USA and travelled the short journey from the poorer parts of Washington to Montgomery County Maryland, you would find that ‘for each mile travelled life (...) expectancy rises about a year and a half. There is a twenty-year gap between poor blacks at one end of the journey and rich whites at the other’. (Marmot, 2004, p.2). There are two types of questions which it is important to ask about inequalities in health such as these. The first are social scientific questions about the extent of inequalities in health and the factors which are causally responsible for these inequalities. Examples of social scientific questions to ask might be: how do infant mortality rates in the UK differ according to social class? What is the difference in life expectancy between Japanese who emigrate to the US and those who remain in Japan? Why do civil servants in higher ranked jobs tend to live longer than civil servants in lower ranked jobs? The second type are normative questions about the reasons we have to care about inequalities in health. Important normative questions to answer are: which inequalities in health should we care about (all inequalities or merely some of them)? When is an inequality in health unjust? How should we weigh our concern for equality in health against other factors such as maximising the.. (shrink)

This paper will set out in plain language the basic ontology of “Deleuze’s Spinoza”; it will then critically examine whether such a Spinoza has, or indeed could have, ever truly existed. In this, it will be shown that Deleuze’s reading of Spinoza involves the imposition of three interlocking, formal principles. These are (1) Necessitarianism, (2) Immanence, and (3) Univocity. The uncovering of Deleuze’s use of these three principles, how they relate to one another, and what they jointly imply in terms (...) of ontology, will occupy Part 1 of this paper. The critique of these principles from a Spinozist perspective, i.e. that their use by Deleuze is incompatible with Spinoza’s own metaphysics, will occupy Part 2 of this paper. (shrink)

This article discusses some philosophical theories of causation and their application to several areas of science. Topics addressed include regularity, counterfactual, and causal process theories of causation; the causal interpretation of structural equation models and directed graphs; independence assumptions in causal reasoning; and the role of causal concepts in physics. In connection with this last topic, this article focuses on the relationship between causal asymmetries, the time-reversal invariance of most fundamental physical laws, and the significance of differences among varieties of (...) differential equations in causal interpretation. It concludes with some remarks about “grounding” special science causal generalizations in physics. (shrink)

Don didn’t grasp what would eventually come to be one of the most successful ad campaigns ever because he didn’t recognise the person presenting the evidence as being appropriately trustworthy. He failed to know because Dr Guttman’s say-so was not enough to provide justification for a belief. But why would he think that? To get to the bottom of this, we need the help of an analytical approach known as standpoint theory.

Linguistic anthropologists have studied emotion in societies around the world for several decades. This article defines the discipline, introduces its general relevance to emotion theory, then presents five of the most important contributions linguistic anthropology has made to the study of emotion.

The use of the symbol ∨for disjunction in formal logic is ubiquitous. Where did it come from? The paper details the evolution of the symbol ∨ in its historical and logical context. Some sources say that disjunction in its use as connecting propositions or formulas was introduced by Peano; others suggest that it originated as an abbreviation of the Latin word for “or,” vel. We show that the origin of the symbol ∨ for disjunction can be traced to Whitehead and (...) Russell’s pre-Principia work in formal logic. Because of Principia’s influence, its notation was widely adopted by philosophers working in logic (the logical empiricists in the 1920s and 1930s, especially Carnap and early Quine). Hilbert’s adoption of ∨ in his Grundzüge der theoretischen Logik guaranteed its widespread use by mathematical logicians. The origins of other logical symbols are also discussed. (shrink)

Why battles matter -- Accepting the wager of battle -- Laying just claim to the profits of war -- The monarchical monopolization of military violence -- Were there really rules? -- The death of pitched battle.

Roughly half the essays in this collection engage directly with Augustine's theological animus and follow his thinking into self-division, perversity of will, grief, conversion, and the aspiration for transcendence.

This book presents a comprehensive, accessible survey of Western philosophy of music from Pythagoras to the present. Its narrative traces themes and schools through history, in a sequence of five chapters that survey the ancient, medieval, early modern, modern and contemporary periods. Its wide-ranging coverage includes medieval Islamic thinkers, Continental and analytic thinkers, and neglected female thinkers such as Vernon Lee (Violet Paget). All aspects of the philosophy of music are discussed, including music and the cosmos, music's value, music's relation (...) to the other arts, the problem of opera, the origins of musical genius, music's emotional impact, the moral effects of music, the ontology of musical works, and the relevance of music's historical context. The volume will be valuable for students and scholars in philosophy and musicology, and all who are interested in the ways in which philosophers throughout history have thought about music. (shrink)

When we talk about intellectual property, it is often implicitly assumed that we are talking about private intellectual property. However, private property and the idea of private ownership do not exhaust the possibilities for accounts of ownership and of property. There are other ways that ownership can operate, such as common property. A resource is common property if its use is ‘governed by rules whose point is to make them available for use by all or any members of the society.’.

This is the first modern, annotated and scholarly edition of Jean-Baptiste Du Bos’ _Critical Reflections on Poetry and Painting_, one of the seminal works of modern aesthetics in any language.

Curren and Metzger’s work makes a bold, normative claim: The moral goal of sustainability is human flourishing. Their eudaimonic theory has as its summum bonum ‘living well’ according to the fundam...

Should the state teach ethics? There is widespread disagreement on whether (and how) secular states should be in the business of promoting a particular moral viewpoint. This article attempts to schematize, and evaluate, these stances. It does so by posing three, simple questions: (1) Should the state explicitly promote certain ethical values over others? (2) Should the state have ultimate justifications for the values it promotes? (3) Should the state compel its citizens to accept these ultimate justifications? Logically, each question (...) in this series is a prerequisite for considering those questions further down the list. The result is that responses can be categorized into one of four possible permutations or ‘camps.’ These are: (1) The Libertarian (“No” to all three questions) (2) The Pluralist (“Yes” to question 1; “No” to questions 2 and 3) (3) The Rationalist Republican (“Yes” to questions 1 and 2; “No” to question 3) (4) The Rigorous Republican (“Yes” to all three questions) It will be shown that just one of these positions, the ‘rationalist republican,’ stands out from all the rest. For only the rationalist republican can account for a normative politics while also safeguarding the individual’s freedom of conscience. (shrink)

Discusses the work of G.I. Gurdjieff and his establishment of the Institute for the Harmonious Development of man, and examines the contributions of Gurdjieff's two major disciples, P.D. Ouspensky and A.R. Orage.

‘Universal benevolence’ may be defined as the goal of promoting the welfare of every individual, however remote, to the best of one’s ability. Currently, the commonest model of universal benevolence is that of ‘impartiality,’ the notion promoted by Peter Singer, Roderick Firth, and others, that every individual (including oneself) is of equal intrinsic worth. This paper contends that the impartialist model is seriously flawed. Specifically, it is demonstrated that impartialist accounts of benevolence (1) attempt to draw positive moral conclusions from (...) negative premises, (2) draw actual conclusions from merely counterfactual premises, (3) fail to live up to stated claims of naturalism, and (4) give no compelling account of moral motivation. By contrast, I propose an alternate model of universal benevolence, grounded in the Stoic, cosmopolitan theory of oikeiôsis, i.e. ‘appropriation.’ Such a model, in contradistinction to impartiality, would see benevolence as the positive identification between moral agent and moral patient, rather than a charitable sacrifice of oneself for a distinct but equal other. An ethics of oikeiôsis has the further benefit of avoiding each of the four abovementioned conceptual pitfalls common to impartialist theories. (shrink)

The international relations curriculum has long presented a dichotomy between the so-called “realist” and “idealist” positions. Idealists seek to embody universal norms of justice in foreign policy. Realists, by contrast, see competition between states, the balance of power, and relative advantage as basic to international politics. Though considered polar opposites, both the realist and idealist affirm the primacy of the nation state as a sovereign political unit, and so neither embraces cosmopolitanism in the strongest sense, i.e., the transcendence of national (...) divisions as such. Opening up the IR curriculum to such a radical possibility requires its reframing in terms of underlying, ethical worldviews. Under this lens, it becomes evident that the realist and idealist share far more in common than contemporary policy debates would suggest. It also points us toward the space for an alternate ethical worldview, provided by Stoic rationalism, which is more viable for grounding cosmopolitan thought. (shrink)

Beginning from an analysis of what factors disqualify a person from complaining about a given moral breach, I show that the prima facie presumption that a complaint is justified in the face of non-moral offense in the context of a business transaction must be balanced against the potential consequences to the object of the complaint, especially given the particular realities of popular employment practices. In particular, I will identify three cases in which complamts are justified, presuming unjust employment arrangements, as (...) a way of showing that complaints in other situations should be, contrary to naive intuition, considered inappropriate. (shrink)

Social scientists agree that women are generally more religious than men, but disagree about whether the differences are universal or contingent on social context. This study uses General Social Survey data to explore differences in religiosity between, as well as among, women and men by level of individual earned income. Extending previous research, I focus on high earners with other groups included for comparison. Predicted probabilities based upon fully interacted models provide four key findings: There are no significant gender differences (...) among high earners; high-earning women are less religious than low-earning women; high-earning men are more religious than low-earning men; and differences among women and among men at different earnings levels are just as large as average differences between women and men. Further analyses demonstrate that the relationship between gender, earnings, and religiosity varies by race. The findings demonstrate the utility of intersectional approaches for understanding gender differences in religiosity. Beyond the implications specific to the gender differences in religiosity literature, this study also indicates that religion is an important, yet often underemphasized, aspect of our intersectional selves. (shrink)

In this dissertation, I argue that aesthetic experience is a kind of valuing experience that has certain, objective features not dependent on the psychological state of the subject. Accounts of aesthetic experience can generally be divided into two categories: internalist and externalist. The former pick out aesthetic experience as a being a certain kind of psychological state on the part of the subject, whereas the latter specify it based on features external to the experience itself, usually by reference to the (...) object. My account is neither strictly internalist nor externalist, but combines features of both. Like an internalist account, it requires that the subject be in a certain mental state – the subject must be having a valuational experience. Like an externalist account, it insists that there are features of aesthetic experience that are not part of the phenomenal character of the experience – that is, the type of value assigned is in fact subjective, regardless of how the subject perceives it. It is my contention that such a hybrid account is broadly explanatory while avoiding the problems that plague other accounts. (shrink)

Don didn’t grasp what would eventually come to be one of the most successful ad campaigns ever because he didn’t recognise the person presenting the evidence as being appropriately trustworthy. He failed to know because Dr Guttman’s say-so was not enough to provide justification for a belief. But why would he think that? To get to the bottom of this, we need the help of an analytical approach known as standpoint theory.