We examined the management of completed advance directives including why participants completed a document, what procedures and values they chose, with whom they held end-of-life conversations, and where they stored their document. Participants elected to complete a SurveyMonkey survey that was made available to individuals who wrote an advance directive through Texas-LivingWill.org; 491 individuals elected to fill out the survey, aged 19 to 94 years. The survey asked multiple questions about why participants completed an advance directive, where they would store (...) it, and with whom they had conversations about their end-oflife wishes. A list of procedures and values allowed participants to indicate what they refused or requested in their advance directive. Advance directives are most often completed to allow patients to prepare and control the healthcare they wish to receive when dying. One-half to two-thirds of individuals refuse common end-of-life medical procedures, and the rest request the procedures. We found a correlation between the choice to refuse or request a procedure and the age of the participant. Participants reported that their end-of-life conversations most often occurred with their spouse. Respondents often reported that their advance directive was stored with their physician and power of attorney for healthcare, conversations with those individuals rarely happened. Advance directives document patients’ requests for and refusals of end-of-life care. Physicians and surrogates need to be better educated so that the documents are part of a meaningful conversation with the patient. Because patients’ choices change over their lifespan, these documents need to be revisited regularly and not completed as a onetime event. (shrink)

The branch of evolutionary theory known as signaling theory attempts to explain various forms of communication. Social scientists have explained many traditional rituals as forms of communication that promote cooperative social relationships among participants. Both evolutionists and social scientists have realized the importance of trust for the formation and maintenance of cooperative social relationships. These factors have led to attempts to apply signaling theory to traditional cultural rituals in various ways. This paper uses the traditional ritual of mumming in small (...) Newfoundland fishing villages to evaluate alternative hypotheses about the connection between rituals, communication, trust, and cooperation. Mumming is found to be most consistent with the hypothesis that it is a ritual of trust wherein participants take a specific type of risk: the risk of harm at the hands of other participants. Individuals who take this risk actively signal their trust. Conversely, individuals who restrain themselves from inflicting harm on other participants actively signal their trustworthiness. (shrink)

Research has consistently shown ‘ability’ grouping (tracking) to be prey to poor practice, and to perpetuate inequity. A feature of these problems is inequitable and inaccurate practice in allocation to groups or ‘tracks’. Yet little research has examined whether such practices might be improved. Here, we examine survey and interview findings from a large-scale intervention study of grouping practices in 126 English secondary schools. We find that when schools are encouraged to allocate students and move them between groups according to (...) equitable principles by participation in a ‘best practice’ intervention, there is some increased equity of practice (i.e. a reduction in non-attainment factors used in allocation). However, the majority of schools continue to use subjective and potentially biased information to group students. Furthermore, some schools that claim to be using attainment setting appear to be using the inequitable practice of streaming. Our findings show that improvements in equity are constrained by operational and strategic factors, including timetabling, finance, and teachers’ values and beliefs relating to student ability and progression. We suggest strategies for encouraging schools to change their grouping practices, drawing on approaches for working with complex organisations. (shrink)

The counterfactual mental state of negligent criminal activity invites skepticism from those who see mental states as essential to responsibility. Here, I offer a revision of the mental state of criminal negligence, one where the mental state at issue is actual and not merely counterfactual. This revision dissolves the worry raised by the skeptic and helps to explain negligence’s comparatively reduced culpability.

In On What Matters, Derek Parfit enters the debate between actualists and possibilists. This debate concerns mere possibilia, possible but non-actual things such as golden mountains and talking donkeys. Roughly, possibilism says that there are such things, and actualism says that there are not. Parfit not only argues for possibilism but also argues that some self-proclaimed actualists are, in fact, unwitting possibilists. -/- I argue that although Parfit’s arguments do not fully succeed, they do highlight a tension within the frameworks (...) of many actualists. Many actualists conscript abstract objects into the role of "possible worlds" to avoid quantifying over mere possibilia. But, in doing so, actualists must quantify over mere possibilia anyway. When we alleviate this tension, a Parfit-friendly form of actualism arguably remains. This form of actualism says that while everything that exists is actual, it is also true in some sense that there are mere possibilia. (shrink)

This chapter reviews the literature on experimental political philosophy. Much of the literature considers individuals’ intuitions about distributive justice, retributive justice, and key concepts such as the doing/allowing distinction. The chapter argues that although there is relatively little experimental political philosophy proper, there are many avenues for future research. It presumes some familiarity with political philosophy, but its main aim is not to explain the relevance of studies to particular debates. The chapter provides an overview of interesting empirical results that (...) may be of some broad interest and suggests that there is reason for those interested in experimental political philosophy to do new kinds of empirical work and employ new methods from many disciplines. Experimental philosophy need not model itself primarily on the discipline of psychology. There are many useful methods available for answering important questions experimental philosophers might want to address in these other disciplines. (shrink)

Hermeneutical injustice, as a species of epistemic injustice, is when members of marginalized groups are unable to make their experiences communicatively intelligible due to a deficiency in collective hermeneutical resources, where this deficiency is traditionally interpreted as a lack of concepts. Against this understanding, this paper argues that even if adequate concepts that describe marginalized groups’ experiences are available within the collective hermeneutical resources, hermeneutical injustice can persist. This paper offers an analysis of how this can happen by introducing the (...) notion of hermeneutical excess: the introduction of additional concepts into collective hermeneutical resources that function to obscure agents’ understanding of the lived experiences of marginalized groups. The injustice of hermeneutical excesses happens not due to hermeneutical marginalization (the exclusion of members of marginalized groups from the construction of hermeneutical resources), but rather hermeneutical domination: when members of dominant groups have been inappropriately included in the construction of hermeneutical resources. By taking as exemplary cases the concepts of “reverse racism” and “non-consensual sex” this paper shows how such excesses are introduced as a kind of defensive strategy used by dominant ideologies precisely when progress with social justice is made. (shrink)

Various strands of religious thought distinguish veneration from worship. According to these traditions, believers ought to worship God alone. To worship anything else, they say, is idolatry. And yet many of these same believers also claim to venerate—but not worship—saints, angels, images, relics, tombs, and even each other. But what's the difference? Tim Bayne and Yujin Nagasawa (2006: 302) are correct that “it seems to be extremely difficult to distinguish veneration from worship.” Many have argued throughout history that veneration collapses (...) into worship and that those who venerate saints or icons are guilty of idolatry. In this essay, we distinguish worship from veneration in two stages. First, we give a formal account of their difference. Drawing from St. John of Damascus (c. 675-749 AD), we argue that worship is a determinate of the determinable veneration. Second, we give more substantive accounts of both that explain their differences and similarities. Drawing again from St John, we argue that acts of veneration and worship signify subordination. Their difference, however, lies in the fact that worship alone requires absolute subordination. (shrink)

This study aims to investigate the relationship between job burnout and employee performance in the feed industry during the ASF outbreak. Further, the researchers employed a descriptive-correlational research design in order to analyze the acquired data and produce pertinent findings. Thus, the researchers gathered data from one hundred two (102) feed industry employees. The Maslach Burnout Inventory (MBI) and Individual Work Performance Questionnaire (IWPQ) were employed to ascertain the extent of job burnout experienced by the respondents and evaluate employee performance, (...) respectively. Based on the statistical analysis, there is a significant relationship between job burnout and employee performance. Moreover, the study's findings were thoroughly analyzed and discussed. (shrink)

A framework for pragmatic analysis is proposed which treats discourse as a game, with context as a scoreboard organized around the questions under discussion by the interlocutors. The framework is intended to be coordinated with a dynamic compositional semantics. Accordingly, the context of utterance is modeled as a tuple of different types of information, and the questions therein — modeled, as is usual in formal semantics, as alternative sets of propositions — constrain the felicitous flow of discourse. A requirement of (...) Relevance is satisfied by an utterance (whether an assertion, a question or a suggestion) iff it addresses the question under discussion. Finally, it is argued that the prosodic focus of an utterance canonically serves to reflect the question under discussion (at least in English), placing additional constraints on felicity in context. (shrink)

Craig Eisendrath reinterprets and unifies the writings of the late-nineteenth-century psychologist William James and the twentieth-century philosopher Alfred North Whitehead. James's psychology achieves greater depth by its grounding in philosophic doctrine, and Whitehead's abstract and frequently abstruse philosophy gains greater specificity through the concrete illustrations provided by a wealth of psychological evidence. The result is an extension of James and an exegesis of Whitehead. The merging of James's theory of will and Whitehead's theory of concrescence and organism is the (...) central pivot of the book. Eisendrath discusses as well the philosophical traditions behind both men and analyzes their theories on perception, time, space, causality, the nature and role of ideas, the laws of nature, God and civilization. (shrink)

We can enrich the explanation of how we should treat kid wrongdoers by recognizing that it matters who does the blaming and punishing. That we should think about who does the blaming and punishing is perhaps unsurprising, but it is nonetheless often underappreciated. Here, I offer two lessons about blame and punishment by thinking about who judges kids. First, the right account of moral and legal responsibility should allow that kids may rightly blame each other, and I argue that we (...) can best accommodate this by relativizing the threshold of competence needed for responsibility. Second, although each kid is an individual and, as a result, the implications of immaturity vary signifi- cantly from kid to kid, we should give kids a break as kids, that is, based on our categorizing them as kids. That we should and do categorize in that way reflects the nature of the criminal justice system as an institution and the nature of us as social beings. (shrink)

Nicole Shukin pursues a resolutely materialist engagement with the "question of the animal," challenging the philosophical idealism that has dogged the question by tracing how the politics of capital and of animal life impinge on one ...

The standard philosophical project of analysing the concept of knowledge has radical defects in its arbitrary restriction of the subject matter, and its risky theoretical presuppositions. Edward Craig suggests a more illuminating approach, akin to the `state of nature' method found in political theory, which builds up the concept from a hypothesis about the social function of knowledge and the needs it fulfils. Light is thrown on much that philosophers have written about knowledge, about its analysis and the obstacles (...) to its analysis, and on the debate over scepticism. It becomes apparent why many languages not only have such constructions as `knows whether' and `knows that', but also have equivalents of `knows how to' and `know' followed by a direct object. Thus the inquiry is both broadened in scope and made theoretically less fragile. (shrink)

Many want to know what bitcoin is and how it works. But bitcoin is as complex as it is controversial, and relatively few have the technical background to understand it. In this paper, I offer an accessible on-ramp for understanding bitcoin in the form of a model. My model reveals both what bitcoin is and how it works. More specifically, it reveals that bitcoin is a fictional substance in a massively coauthored story on a network that automates and distributes jobs (...) normally entrusted to centralized publishing institutions. My model therefore falsifies a popular view according to which each bitcoin is a chunk of code. (shrink)

How can we talk meaningfully about the past if it does not exist to be talked about? What gives time its direction? Is time travel possible? This defence of presentism - the view that only the present exists - makes an original contribution to a fast growing and exciting debate.

This paper attempts to show how Adorno’s thought can illuminate our reflections on the future of work. It does so by situating Adorno’s conception of genuine activity in relation to his negativist critical epistemology and his subtle account of the distinction between true and false needs. What emerges is an understanding of work that can guide our aspirations for the future of work, and one we illustrate via discussions of creative work and care work. These are types of work which (...) cater to persistent human needs, albeit ones that are distorted under present social conditions. Adorno’s thought helps us to understand why this is the case. (shrink)

Deliberative democracy is an embattled political project. It is accused of political naiveté for it only talks about power without taking power. Others, meanwhile, take issue with deliberative democracy’s dominance in the field of democratic theory and practice. An industry of consultants, facilitators, and experts of deliberative forums has grown over the past decades, suggesting that the field has benefited from a broken political system. This book is inspired by these accusations. It argues that deliberative democracy’s tense relationship with power (...) is not a pathology but constitutive of deliberative practice. Deliberative democracy gains relevance when it navigates complex relations of power in modern societies, learns from its mistakes, remains epistemically humble but not politically meek. These arguments are situated in three facets of deliberative democracy—norms, forums, and systems—and concludes by applying these ideas to three of the most pressing issues in contemporary times—post-truth politics, populism, and illiberalism. (shrink)

Is there any difference between playing video games in which the player’s character commits murder and video games in which the player’s character commits pedophilic acts? Morgan Luck’s “Gamer’s Dilemma” has established this question as a puzzle concerning notions of permissibility and harm. We propose that a fruitful alternative way to approach the question is through an account of aesthetic engagement. We develop an alternative to the dominant account of the relationship between players and the actions of their characters, and (...) argue that the ethical difference between so-called “virtual murder” and “virtual pedophilia” is to be understood in terms of the fiction-making resources available to players. We propose that the relevant considerations for potential players to navigate concern (1) attempting to make certain characters intelligible, and (2) using aspects of oneself as resources for homomorphic representation. (shrink)

Many contemporary theorists charge that naïve realists are incapable of accounting for illusions. Various sophisticated proposals have been ventured to meet this charge. Here, we take a different approach and dispute whether the naïve realist owes any distinctive account of illusion. To this end, we begin with a simple, naïve account of veridical perception. We then examine the case that this account cannot be extended to illusions. By reconstructing an explicit version of this argument, we show that it depends critically (...) on the contention that perceptual experience is diaphanous, or more minimally and precisely, that there can be no difference in phenomenal properties between two experiences without a difference in the scenes presented in those experiences. Finding no good reason to accept this claim, we develop and defend a simple, naïve account of both veridical perception and illusion, here dubbed Simple, Austere Naïve Realism. (shrink)

Justification for psychiatric paternalism is most easily established where mental illness renders the person mentally incompetent, depriving him of the capacity for rational agency and for autonomy, hence undermining the basis for liberal rights against paternalism. But some philosophers, and no doubt some doctors, have been deeply concerned by the inadequacy of the concept of mental incompetence to encapsulate some apparently appealing cases for psychiatric paternalism. We ought to view mental incompetence as just one subset of a broader justification for (...) psychiatric paternalism. The very basis of liberal limitations on psychiatric paternalism, whether described in terms of rights to autonomy or as respect for differences in values and lifestyles, presupposes a sense of moral persistence, and hence some sufficiently persistent self. Paternalistic intervention is warranted when we are unable to govern our lives in a manner consistent with the goals and values that comprise that ‘self’. One way that can occur is when we lack the mental capacities required for autonomy, such that we are unable to interpret and interact with our environment in order to meaningfully pursue our goals, i.e. mental incompetence. But it can also occur when we are subject to impositions that alter our goals without altering our capacity to pursue them — i.e. when it is our ‘self’ that is impaired rather than our competence. (shrink)

In the bitcoin whitepaper, Satoshi Nakamoto (2008: 2) defines an electronic coin as a chain of digital signatures. Many have since defined a bitcoin as a chain of digital signatures. This latter definition continues to appear in reports from central banks, advocacy centers, and governments, as well as in academic papers across the disciplines of law, economics, computer science, cryptography, management, and philosophy. Some have even used it to argue that what we now call bitcoin is not the real bitcoin. (...) The definition fails, however. This is important because the Chain Definition obscures Satoshi’s solution to a dilemma in the design of electronic cash, as well as the truth about bitcoin’s privacy and fungibility. In this article, I explain why the Chain Definition fails and what Satoshi likely endorsed instead. Along the way, I untangle some issues around bitcoin fungibility and clarify some others around the ontology of digital assets. (shrink)

In order to determine whether a particular course of conduct is ethically permissible it is important to have a concept of what it means to be harmed. The dominant theory of harm is the counterfactual account, most famously proposed by Joel Feinberg. This determines whether harm is caused by comparing what actually happened in a given situation with the ‘counterfacts’ i.e. what would have occurred had the putatively harmful conduct not taken place. If a person's interests are worse off than (...) they otherwise would have been, then a person will be harmed. This definition has recently faced challenges from bioethicists such as John Harris, Guy Kahane and Julian Savulescu who, believing it to be severely flawed, have proposed their own alternative theories of the concept. In this article I will demonstrate that the shortcomings Harris, Kahane and Savulescu believe are present in Feinberg's theory are illusory and that it is their own accounts of harm that are fraught with logical errors. I maintain that the arguments presented to refute Feinberg's theory not only fail to achieve this goal and can be accommodated within the counterfactual account but that they actually undermine the theories presented by their respective authors. The final conclusion will be that these challenges are misconceived and fail to displace the counterfactual theory. (shrink)

This paper aims to demonstrate the contemporary relevance of Adorno’s thought for business ethicists working in the critical tradition by showing how his critique of modern social life anticipated, and ofers continuing illumination of, recent technological transformations of capitalism. It develops and extrapolates Adorno’s thought regarding three central spheres of modern society, which have seen radical changes in light of recent technological developments: work, in which employee monitoring has become ever more sophisticated and intrusive; leisure consumption, in which the algorithmic (...) developments of the culture industry have paved the way for entertainment products to dominate us; and political discourse, in which social media has exacerbated the anti-democratic tendencies Adorno warned of in the mid-twentieth century. We conclude by presenting, as a rejoinder to these developments, the contours of an Adornian ethics of resistance to the reifcation and dehumanisation of such developments. (shrink)

As a graduate student in Linguistics at UMass/Amherst in the 1980s, I was fortunate to be exposed to a number of new developments bearing on the relationship between formal semantics and pragmatics. In the 1970s under the influence of Cresswell, Lewis, Montague, and Partee, enormous progress in semantics was made possible by narrowing the focus of the field mainly to the consideration of the conventional, truth conditional content of an indicative utterance, calculated compositionally as a function of the semantic contributions (...) of its parts and its syntactic structure. Context was typically relegated to the background, in the form of indices of evaluation, though occasionally popping out for more serious consideration, as in the work of Kaplan, Karttunen, and Stalnaker. But eventually the nature of the rigorous formal enterprise itself, confronted with phenomena like Geach’s donkey sentences, presupposition projection, and the context-dependence of tense and aspect, forced the field into a more careful, thorough reconsideration of the relationship between context and content. Hence were born the dynamic theories of interpretation, beginning with Hans Kamp (1981) and Irene Heim (1982), who were both at UMass during my stay there, Heim completing her dissertation and Kamp on the faculty in Philosophy. Such frameworks posit a dynamic interchange between content and context, each dependent on the other, even in the course of interpreting a single utterance. Mats Rooth was also a graduate student at UMass at that time, and wrote his influential dissertation (1985) proposing an alternative semantics for the interpretation of prosodic focus, inter alia shedding light on how focus contributes to the contextual domain restriction of various operators. (shrink)

Digital medicine is a medical treatment that combines technology with drug delivery. The promises of this combination are continuous and remote monitoring, better disease management, self-tracking, self-management of diseases, and improved treatment adherence. These devices pose ethical challenges for patients, providers, and the social practice of medicine. For patients, having both informed consent and a user agreement raises questions of understanding for autonomy and informed consent, therapeutic misconception, external influences on decision making, confidentiality and privacy, and device dependability. For providers, (...) digital medicine changes the relationship where trust can be verified, clinicians can be monitored, expectations must be managed, and new liability risks may be assumed. Other ethical questions include direct third-party monitoring of health treatment, affordability, and planning for adverse events in the case of device malfunction. This article seeks to lay out the ethical landscape for the implementation of such devices in patient care. (shrink)

Adopting a broadly compatibilist approach, this volume's authors argue that the behavioral and mind sciences do not threaten the moral foundations of legal responsibility. Rather, these sciences provide fresh insight into human agency and updated criteria as well as powerful diagnostic and intervention tools for assessing and altering minds.

“Ghosting”, the act of ceasing all communication with someone with whom you have been romantically involved, is now a normal part of modern dating. The common moral judgment of ghosting is negative, that it is a bad behavior that treats people disrespectfully, and trains up a lack of empathy and accountability in those who engage in it (Abad-Santos 2017; Guilluame 2016; G 2017; Smith 2017). These behaviors and traits are at least morally undesirable if not outright wrong, and so, consequently, (...) it isn’t permissible for anyone to ghost. But is this the whole story to be told about ghosting? In this paper, I offer quite different responses to these two questions about ghosting. Focusing here on gender identity, I claim that it is permissible for women to ghost men. This is because, I contend, women’s practices of ghosting are a justified response to men’s practices of misogyny within the context of heterosexual dating. As such, I argue that contrary to the common perception that ghosting is rude or disrespectful, it rather serves a self-protective function for women and can at times qualify as an act of resistance against women’s oppression. In this way, not only is ghosting done by women minimally permissible, it might even be considered laudable. (shrink)

Soumettre l’histoire de la médecine à l’épreuve du genre depuis l’Antiquité et dans divers espaces géographiques, telle est l’ambition de ce numéro de Clio. Les années 1970 en France ont connu tout à la fois la naissance d’une histoire de la médecine et d’une histoire des femmes qui ne négligea ce domaine ni à ses débuts, ni dans le cadre d’une histoire sociale de la médecine qui se déploya dans les années 1990. Les historien-ne-s de la médecine et des femmes (...) s’intéressèrent d’abord à la natu... (shrink)

In the current U.S. context, we are facing a Constitutional crisis with frequent government shutdowns and new policy debates surrounding immigration, climate change, budgeting practices, and the balance of power. With competing interests, unclear policy, and inconsistent leadership directives, the question becomes: How do contemporary bureaucrats make sense of this ethically turbulent environment? This collection provides a lens for viewing administrative decision-making and behavior from a Constitutional basis, as contemporary bureaucrats attempt to navigate uncharted territory. Ethics for Contemporary Bureaucrats is (...) organized around three constitutional values: freedom, property, and social equity. These themes are based on emerging trends in public administration and balanced with traditional ethical models. Each chapter provides an overview of a contemporary ethical issue, identifies key actors, institutions, legal and legislative policy, and offers normative and practical recommendations to address the challenges the issue poses. Rooted in a respected and time-tested intellectual history, this volume speaks to bureaucrats in a modern era of governance. It is ideally suited to educate students, scholars, and public servants on Constitutional values and legal precedent as a basis for ethics in the public sector. (shrink)

Background: Legislation on physician-assisted suicide is being considered in a number of states since the passage of the Oregon Death With Dignity Act in 1994. Opinion assessment surveys have historically assessed particular subsets of physicians.Objective: To determine variables predictive of physicians’ opinions on PAS in a rural state, Vermont, USA.Design: Cross-sectional mailing survey.Participants: 1052 physicians licensed by the state of Vermont.Results: Of the respondents, 38.2% believed PAS should be legalised, 16.0% believed it should be prohibited and 26.0% believed it should (...) not be legislated. 15.7% were undecided. Males were more likely than females to favour legalisation . Physicians who did not care for patients through the end of life were significantly more likely to favour legalisation of PAS than physicians who do care for patients with terminal illness . 30% of the respondents had experienced a request for assistance with suicide.Conclusions: Vermont physicians’ opinions on the legalisation of PAS is sharply polarised. Patient autonomy was a factor strongly associated with opinions in favour of legalisation, whereas the sanctity of the doctor–patient relationship was strongly associated with opinions in favour of not legislating PAS. Those in favour of making PAS illegal overwhelmingly cited moral and ethical beliefs as factors in their opinion. Although opinions on legalisation appear to be based on firmly held beliefs, approximately half of Vermont physicians who responded to the survey agree that there is a need for more education in palliative care and pain management. (shrink)

Logics—that is to say logical systems—are generally conceived of as describing the logical forms of arguments as well as endorsing cer- tain principles or rules of inference specified in terms of these forms. From this perspective, a correct logic is a system which captures only (and perhaps all) of the correct principles, and good—i.e. logical— reasoning is reasoning which at the level of logical form conforms to the principles of a correct logic. In contrast, as logical particularists we reject the (...) idea that logical validity is a property of logical forms or schema, and instead take validity to be a property of particular in- ferences. In this paper we describe and defend this radically different approach to validity, and explore the particularist understanding of the relationship between logical systems and logical reasoning. (shrink)

Calls to abolish race as a proxy for biology or genetics in clinical care have reached a fever pitch in the latter half of 2020, including articles in the New England Journal of Medicine, and urgent letters from prominent Senators.

This paper draws from the fields of history, sociology, psychology, moral philosophy, and organizational theory to establish a theoretical connection between a social/organizational influence (ethical work climate) and an individual cognitive element of moral behavior (moral awareness). The research was designed to help to fill a gap in the existing literature by providing empirical evidence of the connection between organizational influences and individual moral awareness and subsequent ethical choices, which has heretofore largely been merely assumed. Results of the study provide (...) evidence that ethical work climate (EWC) is a primary predictor of individual moral awareness, and that the influence of social factors often overrides the effects of individual differences in a work group setting. Implications for future research are provided. (shrink)

We bring together recent discussions on data capitalism and biocapitalization by studying value flows in consumer genomics firms—an industry at the intersection between health care and technology realms. Consumer genomics companies market genomic testing services to consumers as a source of fun, altruism, belonging and knowledge. But by maintaining a multisided or platform business model, these firms also engage in digital capitalism, creating financial profit from data brokerage. This is a precarious balance to strike: If these companies’ business models consist (...) of assetizing the pool of genomic data that they assemble, then part of their work has to revolve around obscuring to consumers any uncertainties that would potentially impinge on these processes of assemblage. We reflect on the nature of these practices and the market relationships that enable them, and we relate this reflection to debates around alternative market arrangements that would potentially mitigate the extractive tendencies of these and other digital health firms. (shrink)