Patients have received experimental pharmaceuticals outside of clinical trials for decades. There are no industry-wide best practices, and many companies that have granted compassionate use, or ‘preapproval’, access to their investigational products have done so without fanfare and without divulging the process or grounds on which decisions were made. The number of compassionate use requests has increased over time. Driving the demand are new treatments for serious unmet medical needs; patient advocacy groups pressing for access to emerging treatments; internet platforms (...) enabling broad awareness of compelling cases or novel drugs and a lack of trust among some that the pharmaceutical industry and/or the FDA have patients’ best interests in mind. High-profile cases in the media have highlighted the gap between patient expectations for compassionate use and company utilisation of fair processes to adjudicate requests. With many pharmaceutical manufacturers, patient groups, healthcare providers and policy analysts unhappy with the inequities of the status quo, fairer and more ethical management of compassionate use requests was needed. This paper reports on a novel collaboration between a pharmaceutical company and an academic medical ethics department that led to the formation of the Compassionate Use Advisory Committee. Comprising medical experts, bioethicists and patient representatives, CompAC established an ethical framework for the allocation of a scarce investigational oncology agent to single patients requesting non-trial access. This is the first account of how the committee was formed and how it built an ethical framework and put it into practice. (shrink)

or Browse over 3500 reviews in " by Valerie Hardcastle, Ph.D. " _Metapsychology_.

:Since the advent of recombinant DNA technology, expectations about the potential for altering genes and controlling our biology at the fundamental level have been sky high. These expectations have gone largely unfulfilled. But though the dream of being able to control our biology is still far off, gene editing research has made enormous strides toward potential clinical use. This paper argues that when it comes to determining permissible uses of gene editing in one important medical context—germline intervention in reproductive medicine—issues (...) about enhancement and eugenics are, for the foreseeable future, a red herring. Current translational goals for gene editing research involve a different kind of editing than would be required to achieve manipulation of complex traits such as intelligence, and there are more pressing questions that need attention if clinical use of gene editing in reproductive medicine ever becomes a possibility. (shrink)

In this article, we describe a project in which philosophy, in combination with methods drawn from mental modeling, was used to structure dialogue among stakeholders in a region-scale climate adaptation process. The case study we discuss synthesizes the Toolbox dialogue method, a philosophically grounded approach to enhancing communication and collaboration in complex research and practice, with a mental modeling approach rooted in risk analysis, assessment, and communication to structure conversations among non-academic stakeholders who have a common interest in planning for (...) a sustainable future. We begin by describing the background of this project, including details about climate resiliency efforts in West Michigan and the Toolbox dialogue method, which was extended in this project from academic research into community organization involving the West Michigan Climate Resiliency Framework Initiative. This extension involved application of several methods, which are the focus of the Methods section. We then present and discuss preliminary results that suggest the potential for philosophical dialogue to enhance mutual understanding in complex community initiatives that focus on sustainable responses to climate change. Overall, the article supplies a detailed, instructive example of how philosophy can support policy-relevant decision-making processes at the community level. (shrink)

The distinction between germline and somatic gene editing is fundamental to the ethics of human gene editing. Multiple conferences of scientists, ethicists, and policymakers, and multiple professional bodies, have called for moratoria on germline gene editing, and editing of human germline cells is considered to be an ethical “red line” that either never should be crossed, or should only be crossed with great caution and care. However, as research on germline gene editing has progressed, it has become clear that not (...) all germline interventions are alike, and that these differences make a significant moral difference, when it comes to ethical questions about research, regulation, clinical application, and medical justification. In this paper, I argue that, rather than lumping all germline interventions together, we should distinguish between revising, correcting, and transferring genes, and I assess the consequences of this move for the ethics of gene editing. (shrink)

The first study, along with edition and translation, of Chrysostomus Javelli’s epitome of the _Liber de bona fortuna_ (1531), a work permitting insight into the early modern understanding of fortune, fate, and free will.

This book develops a comprehensive framework for ethics in the helping professions based on bioethicist Bernard Gert's theory of common morality. The prevailing model of ethics education is built upon adherence to codes of ethics applied largely through the use of decision-making trees. While a firm understanding of a professions code of ethics and all relevant laws is essential to responsible practice, this approach to teaching ethics excludes the opportunity for students to acquire a holistic, and grounded understanding of moral (...) action. The framework proposed in this text moves beyond codes of ethics, and allows students to develop a cohesive sense of ethical reasoning that both validates their moral intuition and challenges moral assumptions. The theory of a common morality uses a systematic, step-by-step approach that readers and practitioners can apply to all questions of moral action and behaviour. While there is no such thing as a single right answer to any ethical question, by following this approach practitioners can confidently eliminate the bad decisions, allowing them to feel more secure in their decision and practice. (shrink)

Design of clinical trials for germline gene editing stretches current accepted standards for human subjects research. Among the challenges involved is a set of issues concerningintergenerational monitoring—long-term follow-up study of subjects and their descendants. Because changes made at the germline would be heritable, germline gene editing could have adverse effects on individuals’ health that can be passed on to future generations. Determining whether germline gene editing is safe and effective for clinical use thus may require intergenerational monitoring. The aim of (...) this paper is to identify and argue for the significance of a set of ethical issues raised by intergenerational monitoring in future clinical trials of germline gene editing. Though long-term, multigenerational follow-up study of this kind is not without precedent, intergenerational monitoring in this context raises unique ethical challenges, challenges that go beyond existing protocols and standards for human subjects research. These challenges will need to be addressed if clinical trials of germline gene editing are ever pursued. (shrink)

In debates about the moral foundations of intellectual property, one very popular strand concerns the role of labor as a moral basis for intellectual property rights. This idea has a great deal of intuitive plausibility; but is there a way to make it philosophically precise? That is, does labor provide strong reasons to grant intellectual property rights to intellectual laborers? In this paper, I argue that the answer to that question is “yes”. I offer a new view, different from existing (...) labor theories of intellectual property, which I call the productive capacities view. This view gives us a way to make sense of the idea of labor as the basis for intellectual property rights, as well as a tool for critically evaluating existing intellectual property institutions. (shrink)

Volume 20, Issue 8, August 2020, Page W1-W3.

When developing computational models to analyze the tradeoffs between climate risk management strategies (i.e., mitigation, adaptation, or geoengineering), scientists make explicit and implicit decisions that are influenced by their beliefs, values and preferences. Model descriptions typically include only the explicit decisions and are silent on value judgments that may explain these decisions. Eliciting scientists’ mental models, a systematic approach to determining how they think about climate risk management, can help to gain a clearer understanding of their modeling decisions. In order (...) to identify and represent the role of values, beliefs and preferences on decisions, we used an augmented mental models research approach, namely values-informed mental models (ViMM). We conducted and qualitatively analyzed interviews with eleven climate risk management scientists. Our results suggest that these scientists use a similar decision framework to each other to think about modeling climate risk management tradeoffs, including eight specific decisions ranging from defining the model objectives to evaluating the model’s results. The influence of values on these decisions varied between our scientists and between the specific decisions. For instance, scientists invoked ethical values (e.g., concerns about human welfare) when defining objectives, but epistemic values (e.g., concerns about model consistency) were more influential when evaluating model results. ViMM can (i) enable insights that can inform the design of new computational models and (ii) make value judgments explicit and more inclusive of relevant values. This transparency can help model users to better discern the relevance of model results to their own decision framing and concerns. (shrink)

To what extent should we focus on implicit bias in order to eradicate persistent social injustice? Structural prioritizers argue that we should focus less on individual minds than on unjust social structures, while equal prioritizers think that both are equally important. This article introduces the framework of transactive memory into the debate to defend the equal priority view. The transactive memory framework helps us see how structure can emerge from individual interactions as an irreducibly social product. If this is right, (...) then debiasing interventions are structural interventions. One upshot is that the utility of the individual versus structural distinction is not apparent for the purposes of intervention. (shrink)

Social problems such as racism, sexism, and inequality are often cited as structural rather than individual in nature. What does it mean to invoke a social structural explanation, and how do such explanations relate to individualistic ones? This article explores recent philosophical debates concerning the nature and usages of social structural explanation. I distinguish between two central kinds of social structural explanation: those that are autonomous from psychology, and those that are not. This distinction will help clarify the explanatory power (...) that each type of SSE has, points of convergence with methodological traditions such as critical theory and rational choice theory, and the difficulties that each type of SSE faces. (shrink)

Intuitively, there is a difference between knowledge and mere belief. Contemporary philosophical work on the nature of this difference has focused on scenarios known as “Gettier cases.” Designed as counterexamples to the classical theory that knowledge is justified true belief, these cases feature agents who arrive at true beliefs in ways which seem reasonable or justified, while nevertheless seeming to lack knowledge. Prior empirical investigation of these cases has raised questions about whether lay people generally share philosophers’ intuitions about these (...) cases, or whether lay intuitions vary depending on individual factors (e.g. ethnicity) or factors related to specific types of Gettier cases (e.g. cases that include apparent evidence). We report an experiment on lay attributions of knowledge and justification for a wide range of Gettier Cases and for a related class of controversial cases known as Skeptical Pressure cases, which are also thought by philosophers to elicit intuitive denials of knowledge. Although participants rated true beliefs in Gettier and Skeptical Pressure cases as being justified, they were significantly less likely to attribute knowledge for these cases than for matched true belief cases. This pattern of response was consistent across different variations of Gettier cases and did not vary by ethnicity or gender, although attributions of justification were found to be positively related to measures of empathy. These findings therefore suggest that across demographic groups, laypeople share similar epistemic concepts with philosophers, recognizing a difference between knowledge and justified true belief. (shrink)

Diagnostic testing can be used for many purposes, including testing to facilitate the clinical care of individual patients, testing as an inclusion criterion for clinical trial participation, and both passive and active surveillance testing of the general population in order to facilitate public health outcomes, such as the containment or mitigation of an infectious disease. As such, diagnostic testing presents us with ethical questions that are, in part, already addressed in the literature on clinical care as well as clinical research (...) (such as the rights of patients to refuse testing or treatment in the clinical setting or the rights of participants in randomized controlled trials to withdraw from the trial at any time). However, diagnostic testing, for the purpose of disease surveillance also raises ethical issues that we do not encounter in these settings, and thus have not been much discussed. In this paper we will be concerned with the similarities and differences between the ethical considerations in these three domains: clinical care, clinical research, and public health, as they relate to diagnostic testing specifically. Via an examination of the COVID-19 case we will show how an appeal to the concept of diagnostic justice helps us to make sense of the (at times competing) ethical considerations in these three domains. (shrink)

Though questions about whether gene editing should be done at all have dominated ethical discussion, a literature about how it can be done ethically has been growing. Work on responsible translational pathways for human germline gene editing has been criticized for focusing on the wrong questions. But questions about responsible translational pathways—questions about how gene editing could be done ethically—are, in an important sense, prior to questions about whether it is desirable and permissible. Asking “whether” questions about gene editing requires (...) a model of what responsible clinical use of gene editing would look like. (shrink)

In this paper, I discuss the view defended by Manuel Rebuschi, Maxime Amblard, and Michel Musiol that schizophrenia is not entirely irrational but that the rationality of disordered discourse can be accounted for from the first-person point of view—which, by their account, is not wholly introspective but is rather defined by a certain use of the charity principle, by contrast with what they call third-person approaches. I argue in favor of the idea of continuity between the two points of view: (...) ordinary and schizophrenic. On the basis of this claim, I propose a hypothesis for understanding what Rebuschi et al. call the interactional deficiency of schizophrenic conversations, and I make further exploratory suggestions of ways of understanding the so-called rationality of schizophrenic discourse, notably in relation to the complex notions of “context” and “meaning”. (shrink)

La philosophie de l’action wittgensteinienne, par sa clarification conceptuelle, permet une critique radicale de la métaphysique dualiste impliquée par la psychologie empirique. Si le psychologique est constitué concrètement par nos pratiques, une philosophie wittgensteinienne de l’action peut aider la psychologie à sortir des impasses dues à ses confusions sur la nature de son objet, en substituant à la notion réductrice de comportement le concept d’action.

In this paper, I explore the difference between expression of intention and expression of emotion through a discussion of a passage from G.E.M. Anscombe’s Intention, where she claims that expression of intention, unlike expression of emotion, is “purely conventional”. I argue that this claim is grounded on the fact that, although emotions can be described, expressions of emotion are not descriptions at all. Similarly, expressions of intention are not descriptions of a present state of mind but are rather the expression (...) of a special sort of foreknowledge of a purported action. They are, in this respect, distinct from expression of emotion, since they are a description of some future happening. Now, the centrally descriptive character of expressions of intention is what makes them “purely conventional”. But of course, Anscombe argues, one can have an intention without expressing it. And having an intention does not amount to having some description in mind. (shrink)

Feminist Political Theory provides both a wide-ranging history of western feminist thought and a lucid analysis of contemporary debates. It offers an accessible and thought-provoking account of complex theories, which it relates to 'real-life' issues such as sexual violence, political representation and the family. This timely new edition has been thoroughly updated to incorporate the most recent developments in feminism and feminist scholarship throughout, in particular taking into account the impact of black and postmodern feminist thought on feminist political theory.

Most studies investigating the relationship between cultural constructs and ethical perception have focused on individual- and societal-level values without much attention to other type of cultural constructs such as social beliefs. In addition, we need to better understand how social beliefs are linked to ethical perception and the level of analysis at which social beliefs may best predict ethical perceptions. This research contributes to the cross-cultural ethical perception literature by examining the relationship of individual-level social cynicism belief, one of five (...) universally endorsed social beliefs, together with individual social dominance orientation and the perception of unethical behavior. By means of two studies, we examine these relationships across societies that significantly differ on societal-level social cynicism belief. Using 371 business students from Russia and the U.S. in Study 1 and 268 professionals from Portugal and the U.S. in Study 2, we found that individual-level social cynicism belief was positively associated with social dominance orientation. Social dominance orientation, in turn, mediated the relationship between individual social cynicism belief and the perception of unethical behavior. Although we found significant societal-level differences in social cynicism belief in both studies, the relationships between individual-level social cynicism belief, social dominance orientation, and the perception of unethical behavior were structurally equivalent across societies in both studies, suggesting that societal-level differences did not significantly affect these relationships. Implications for cross-cultural business ethics research and practice are discussed. (shrink)

Legal systems in the Western world currently regard animals as property. This status implies that they are not subjects of rights. None of the recent legal measures aimed at protecting animals have conferred on them the legal status of person, which is arguably a necessary condition to benefit from the most fundamental individual rights. In this chapter, we argue that the type of control of animals that is based on property rights and domination is ethically unacceptable. We also argue that (...) extending personhood and its corresponding rights to all sentient beings is the best way to ensure that they are not made to suffer unnecessarily and that they are protected from domination. While there may exist morally legitimate occurrences of human control over other animals, justice requires that we abolish all forms of their exploitation. (shrink)

The data discussed strongly suggest that neural imaging does not unduly sway judges and jurors; in fact, it is often counterproductive. The percentage of appellate cases in which the decision was favorable to defendants with brain scan data mirrored those of decisions without such proffered evidence. Moreover, fully two-thirds of the scans admitted were either inconclusive or showed normal brain structures. In decisions referencing brain scans, judges mentioned defendant behavior significantly more often than they referred to the defendant’s brain. Finally, (...) in the actual decisions themselves, judges often ignored relevant imaging data in favor of case precedent or misinterpreted the data so that they would fit with the judges’ initial reactions and opinions. (shrink)

Sugar, pork, beer, corn, cider, scrapple, and hoppin' John all became staples in the diet of colonial America. The ways Americans cultivated and prepared food and the values they attributed to it played an important role in shaping the identity of the newborn nation. In A Revolution in Eating, James E. McWilliams presents a colorful and spirited tour of culinary attitudes, tastes, and techniques throughout colonial America. Confronted by strange new animals, plants, and landscapes, settlers in the colonies and West (...) Indies found new ways to produce food. Integrating their British and European tastes with the demands and bounty of the rugged American environment, early Americans developed a range of regional cuisines. From the kitchen tables of typical Puritan families to Iroquois longhouses in the backcountry and slave kitchens on southern plantations, McWilliams portrays the grand variety and inventiveness that characterized colonial cuisine. As colonial America grew, so did its palate, as interactions among European settlers, Native Americans, and African slaves created new dishes and attitudes about food. McWilliams considers how Indian corn, once thought by the colonists as "fit for swine," became a fixture in the colonial diet. He also examines the ways in which African slaves influenced West Indian and American southern cuisine. While a mania for all things British was a unifying feature of eighteenth-century cuisine, the colonies discovered a national beverage in domestically brewed beer, which came to symbolize solidarity and loyalty to the patriotic cause in the Revolutionary era. The beer and alcohol industry also instigated unprecedented trade among the colonies and further integrated colonial habits and tastes. Victory in the American Revolution initiated a "culinary declaration of independence," prompting the antimonarchical habits of simplicity, frugality, and frontier ruggedness to define American cuisine. McWilliams demonstrates that this was a shift not so much in new ingredients or cooking methods, as in the way Americans imbued food and cuisine with values that continue to shape American attitudes to this day. (shrink)

The number of distributors selling Fair Trade products is constantly increasing. What are their motivations to distribute Fair Trade products? How do they organise this distribution? Do they apply and communicate the Fair Trade values? This research, based on five case studies in Switzerland, aims at understanding and structuring the strategies and the managerial practices related to Fair Trade product distribution, as well as analysing if they denote an engagement with Fair Trade principles. The results show a high heterogeneity of (...) strategies and engagement. In general, strategies implemented by mainstream actors contribute to increase Fair Trade global sales but do not convey the transformative message of Fair Trade through their engagement. The latter is rather communicated through alternative channels. Problems and potential solutions to this issue are discussed. (shrink)

As of this writing, twenty‐one states have passed laws barring transgender youth‐athletes from competing on public‐school sports teams in accordance with their gender identity. Proponents of these regulations claim that transgender females in particular have inherent physiological advantages that threaten a “level playing field” for their cisgender competitors. Existing evidence is limited but does not support these restrictions. Gathering more robust data will require allowing transgender youth to compete (rather than preemptively barring them), but even if trans females are shown (...) to retain some advantage, this would not have greater moral significance than the many other “fair” physical and economic advantages found across sports. These regulations deprive transgender youth, an exceptionally vulnerable population, from the vast physical, mental, and social benefits of sports. While we advocate for transgender inclusion under our current, gender‐segregated model of sport, we propose changes to the overarching structure that would promote a more inclusive and fairer athletic environment. (shrink)

It is commonly accepted that what we ought to do collectively does not imply anything about what each of us ought to do individually. According to this line of reasoning, if cooperating will make no difference to an outcome, then you are not morally required to do it. And if cooperating will be personally costly to you as well, this is an even stronger reason to not do it. However, this reasoning results in a self-defeating, yet entirely predictable outcome. If (...) everyone is rational, no one will cooperate, resulting in an aggregate outcome that is devastating for everyone. This dismal analysis explains why climate change and other collective action problems are so difficult to ameliorate. The goal of this paper is to provide a different, exploratory framework for thinking about individual reasons for action in collective action problems. I argue that the concept of commitment gives us a new perspective on collective action problems. Once we take the structure of commitment into account, this activates requirements of diachronic rationality that give individuals instrumental reasons to cooperate in collective action problems. (shrink)

Platonism, Ficino to Foucault explores some key chapters in the history Platonic philosophy from the revival of Plato in the fifteenth century to the new reading of Platonic dialogues promoted by the so-called ‘Critique of Modernity’.

Trust and Governance asks several important questions: Is trust really essential to good governance, or are strong laws more important? What leads people either to trust or to distrust government, and what makes officials decide to be trustworthy? Can too much trust render the public vulnerable to government corruption, and if so what safeguards are necessary? In approaching these questions, the contributors draw upon an abundance of resources to offer different perspectives on the role of trust in government. Enriched by (...) perspectives from political science, sociology, psychology, economics, history, and philosophy, Trust and Governance opens a new dialogue on the role of trust in the vital relationship between citizenry and government. (shrink)

Despite what many critics see as an inability to deliver much in the way of therapeutic value (Hunter and Drazen 2019), genetics remains a bottomless source of fascination, trepidation, and reflect...

(2014). Tin Men: Ethics, Cybernetics and the Importance of Soul. Journal of Military Ethics: Vol. 13, No. 1, pp. 3-19. doi: 10.1080/15027570.2014.908011.

Global governance of emerging, disruptive biomedical technologies presents a multitude of ethical problems. The recent paper by Shoziet alraises some of these problems in the context of a discussion of what could be themostdisruptive (and most morally fraught) emerging biomedical technology—human germline genome editing. At the heart of their argument is the claim that, for something like gene editing, there is likely to be tension between the interests of specific states in crafting regulation for the technology, and disagreement about what (...) would be necessary to meet the requirements for responsible translation of gene editing into the clinic. This complicates hopes for a tidy, algorithmic process of crafting global governance via frameworks for regulation built around core ‘ethical values and principles’ (as they are called in the WHO Framework), and also forces us to confront deeper philosophical questions about biotechnology and global health. (shrink)

There is a burgeoning corner of the philosophical literature on germline gene editing (GGE) about whether GGE is “person-affecting” or “identify-affecting.” The distinction between actions that aff...