In the history of palliative care, all roads lead back to Dame Cicely Saunders, a remarkable social worker/nurse/physician who promoted the concept of total pain and founded the first modern hospic...

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

There is little information about the content of ethics consultations in pediatrics. We sought to describe the reasons for consultation and ethical principles addressed during EC in pediatrics through retrospective review and directed content analysis of EC records at St. Jude Children's Research Hospital. Patient-based EC were highly complex and often involved evaluation of parental decision making, particularly consideration of the risks and benefits of a proposed medical intervention, and the physician's fiduciary responsibility to the patient. Nonpatient consultations provided guidance (...) in the development of institutional policies that would broadly affect patients and families. This is one of the few existing reviews of the content of pediatric EC and indicates that the distribution of ethical issues and reasons for moral distress are different than with adults. Pediatric EC often facilitates complex decision making among multiple stakeholders, and further prospective research is need.. (shrink)

The American Journal of Bioethics, Volume 12, Issue 10, Page 18-20, October 2012.

The world’s third largest producer of scientific research, Germany, is the origin of the research university and the independent, extra-university research institute. Its dual-pillar research policy differentiates these organizational forms functionally: universities specialize in advanced research-based teaching; institutes specialize intensely on research. Over the past decades this policy affected each sector differently: while universities suffered a lingering “legitimation crisis,” institutes enjoyed deepening “favored sponsorship”—financial and reputational advantages. Universities led the nation’s reestablishment of scientific prominence among the highly competitive European and (...) global science systems after WWII. But sectoral analysis of contributions to science, technology, engineering, mathematics, and medical and health journal publications finds that Germany’s small to medium-sized independent research institutes have made significant, growing contributions, particularly in publishing in higher impact journals proportionally more than their size. Simultaneously—despite dual-pillar policy implications—the university sector continues to be absolutely and relatively successful; not eclipsed by the institutes. Universities have consistently produced two-thirds of the nation’s publications in the highest quality journals since at least 1980 and have increased publications at a logarithmic rate; higher than the international mean. Indeed, they led Germany into the global mega-science style of production. Contrary to assumed benefits of functional differentiation, our results indicate that relative to their size, each sector has produced approximately similar publication records. While institutes have succeeded, the larger university sector, despite much less funding growth, has remained fundamental to German science production. Considering these findings, we discuss the future utility of the dual-pillar policy. (shrink)

Humean promotionalists about reasons think that whether there is a reason for an agent to ϕ depends on whether her ϕ-ing promotes the satisfaction of at least one of her desires. Several authors have recently defended probabilistic accounts of promotion, according to which an agent’s ϕ-ing promotes the satisfaction of one of her desires just in case her ϕ-ing makes the satisfaction of that desire more probable relative to some baseline. In this paper I do three things. First, I formalize (...) an argument, due to Jeff Behrends and Joshua DiPaolo, to the effect that Mark Schroeder’s and Stephen Finlay’s probabilistic accounts of promotion cannot be correct. Next, I extend this argument to a recent alternative offered by D. Justin Coates and show how Coates’ attempt to avoid the argument by introducing a distinction between ‘intrinsic’ and ‘extrinsic’ probability doesn’t help. Finally, I suggest an alternative way of understanding promotion in terms of increase in degree of fit between the causal upshot of an action and the content of a desire. I show how this view, disjunctively paired with probabilism about promotion, solves the problems with previous accounts. (shrink)

The antireductionist arguments of many philosophers (e.g., Baker, Fodor and Davidson) are motivated by a worry that successful reduction would eliminate rather than conserve the mental. This worry derives from a misunderstanding of the empiricist account of reduction, which, although it does not underwrite "cognitive suicide", should be rejected for its positivist baggage. Philosophy of psychology needs more detailed attention to issues in natural science which serve as analogies for reduction of the mental. I consider a range of central cases, (...) including water and H 2 O, genes and DNA, and common sense and scientific solidity. The last case is illuminated by Eddington's Two Tables paradox, a resolution which suggests the plasticity of the mental under reduction. If reduction of the mental is like any of these cases, it is neither empiricist nor eliminative. (shrink)

The focus of this paper is a fascinating but hitherto unstudied 1742 manuscript treatise by Johannes Daniel Schlichting (1705–1765) titled “Sapientiæ Problema” that contains something extremely rare in the mid-eighteenth century: a full-blown speculative cosmogony. As this article reveals, Schlichting developed a distinctive vital liquid matter in an effort to account for the generation of all natural bodies and combat the stamina-based theories that were dominant in his day. He hoped that his treatise would be published in the Philosophical Transactions (...) of the Royal Society, but an accompanying abridgment by the FRS Henry Baker (1698–1774) strongly implies that Schlichting’s speculative bent and desire to divulge causal explanations were unacceptable to the Englishman and generally ill-suited to the intellectual climate of mid-century England. (shrink)

We are all guilty of it. We call people terrible names in conversation or online. We vilify those with whom we disagree, and make bolder claims than we could defend. We want to be seen as taking the moral high ground not just to make a point, or move a debate forward, but to look a certain way--incensed, or compassionate, or committed to a cause. We exaggerate. In other words, we grandstand. Nowhere is this more evident than in public discourse (...) today, and especially as it plays out across the internet. To philosophers Justin Tosi and Brandon Warmke, who have written extensively about moral grandstanding, such one-upmanship is not just annoying, but dangerous. As politics gets more and more polarized, people on both sides of the spectrum move further and further apart when they let grandstanding get in the way of engaging one another. The pollution of our most urgent conversations with self-interest damages the very causes they are meant to forward. Drawing from work in psychology, economics, and political science, and along with contemporary examples spanning the political spectrum, the authors dive deeply into why and how we grandstand. Using the analytic tools of psychology and moral philosophy, they explain what drives us to behave in this way, and what we stand to lose by taking it too far. Most importantly, they show how, by avoiding grandstanding, we can re-build a public square worth participating in. (shrink)

Do epistemic requirements vary along with facts about what promotes agents' well-being? Epistemic instrumentalists say 'yes', and thereby earn a lot of contempt. This contempt is a mistake on two counts. First, it is incorrectly based: the reasons typically given for it are misguided. Second, it fails to distinguish between first- and second-order epistemic instrumentalism; and, it happens, only the former is contemptible. -/- In this book, Nathaniel P. Sharadin argues for rejecting epistemic instrumentalism as a first-order view not (...) because it suffers extensional failures, but because it suffers explanatory ones. By contrast, he argues that epistemic instrumentalism offers a natural, straightforward explanation of why being epistemically correct matters. What emerges is a second-order instrumentalist explanation for epistemic authority that is neutral between competing first-order epistemic theories. -/- Epistemic Instrumentalism Explained will be of interest to researchers and advanced students working in epistemology, ethics, and philosophy of mind. (shrink)

One problem for Molinism that critics of the view have pressed, and which Molinists have so far done little to address, is that even if there are true counterfactuals of freedom, it is puzzling how God could possibly know them. I defuse this worry by sketching a plausible model of the mechanics of middle knowledge which draws on William Alston’s direct acquaintance account of divine knowledge.

I articulate the challenge disagreement poses for epistemic contextualism, and then discuss several possible replies on behalf of the contextualist.

The moral of Buridan's Ass is that it can sometimes be rational to perform one action rather than another even though one lacks stronger reason to do so. Yet it is also commonly believed that it cannot ever be rational to believe one proposition rather than another if one lacks stronger reason to do so. This asymmetry has been taken to indicate a deep difference between epistemic and practical rationality. According to the view articulated here, the asymmetry should instead be (...) explained by the difference between rational intentions and rational actions. Thus, it turns out, Buridan's Ass-style cases do not indicate an asymmetry between epistemic and practical rationality as such. (shrink)

Epistemicists claim that vague predicates have precise but unknow- able cutoffs. I argue against against the standard, Williamsonian, answer, that appeals to metalinguistic safety: we can know that p even if our true belief that p is metalinguistically lucky. I then propose that epistemicists should be diagonalized epistemicists and show how this alternative formulation of the view avoids the chal- lenge. However, in an M. Night Shyamalan-style twist, I then argue we should not be diagonalized epistemicists either.

Except in extraordinary circumstances, patients' clinical care should reflect their preferences. Incapacitated patients cannot report their preferences. This is a problem. Extant solutions to the problem are inadequate: surrogates are unreliable, and advance directives are uncommon. In response, some authors have suggested developing algorithmic "patient preference predictors" (PPPs) to inform care for incapacitated patients. In a recent paper, Earp et al. propose a new twist on PPPs. Earp et al. suggest we personalize PPPs using modern machine learning (ML) techniques. In (...) this paper, I argue that, contrary to Earp et al.'s claim, personalized patient preference predictors are neither technically feasible nor ethically desirable. (shrink)

Jokes are sometimes morally objectionable, and sometimes they are not. What’s the relationship between a joke’s being morally objectionable and its being funny? Philosophers’ answers to this question run the gamut. In this paper I present a new argument for the view that the negative moral value of a joke can affect its comedic value both positively and negatively.

Margaret MacDonald (1907–56) was a central figure in the history of early analytic philosophy in Britain due to both her editorial work as well as her own writings. While her later work on aesthetics and political philosophy has recently received attention, her early writings in the 1930s present a coherent and, for its time, strikingly original blend of common-sense and scientific philosophy. In these papers, MacDonald tackles the central problems of philosophy of her day: verification, the problem of induction, and (...) the relationship between philosophical and scientific method. MacDonald’s philosophy of science starts from the principle that we should carefully analyse the elements of scientific practice (particularly its temporal features) and the ways that scientists describe that practice. That is, she applies the techniques of ordinary language philosophy to actual scientific language. MacDonald shows how ‘scientific common-sense’ is inconsistent with both of the dominant schools of philosophy of her day. Bringing MacDonald back into the story of analytic philosophy corrects the impression that in early analytic philosophy, there are fundamental dichotomies between the style of Moore and Wittgenstein, on the one hand, and the Vienna Circle on the other. (shrink)

The mesostriatal dopamine system is prominently implicated in model-free reinforcement learning, with fMRI BOLD signals in ventral striatum notably covarying with model-free prediction errors. However, latent learning and devaluation studies show that behavior also shows hallmarks of model-based planning, and the interaction between model-based and model-free values, prediction errors, and preferences is underexplored. We designed a multistep decision task in which model-based and model-free influences on human choice behavior could be distinguished. By showing that choices reflected both influences we could (...) then test the purity of the ventral striatal BOLD signal as a model-free report. Contrary to expectations, the signal reflected both model-free and model-based predictions in proportions matching those that best explained choice behavior. These results challenge the notion of a separate model-free learner and suggest a more integrated computational architecture for high-level human decision-making. (shrink)

It is widely agreed that the intelligibility of modal metaphysics has been vindicated. Quine's arguments to the contrary supposedly confused analyticity with metaphysical necessity, and rigid with non-rigid designators.2 But even if modal metaphysics is intelligible, it could be misconceived. It could be that metaphysical necessity is not absolute necessity – the strictest real notion of necessity – and that no proposition of traditional metaphysical interest is necessary in every real sense. If there were nothing otherwise “uniquely metaphysically significant” about (...) metaphysical necessity, then paradigmatic metaphysical necessities would be necessary in one sense of “necessary”, not necessary in another, and that would be it. The question of whether they were necessary simpliciter would be like the question of whether the Parallel Postulate is true simpliciter – understood as a pure mathematical conjecture, rather than as a hypothesis about physical spacetime. In a sense, the latter question has no objective answer. In this article, I argue that paradigmatic questions of modal metaphysics are like the Parallel Postulate question. I then discuss the deflationary ramifications of this argument. I conclude with an alternative conception of the space of possibility. According to this conception, there is no objective boundary between possibility and impossibility. Along the way, I sketch an analogy between modal metaphysics and set theory. (shrink)

The objective of this work is to explore the notion of “action” and “agency” in artificial intelligence (AI). It employs a metaphysical notion of action and agency as an epistemological tool in the critique of the notion of “action” and “agency” in artificial intelligence. Hence, both a metaphysical and cognitive analysis is employed in the investigation of the quiddity and nature of action and agency per se, and how they are, by extension employed in the language and science of artificial (...) intelligence. The advent of the science of artificial intelligence and cognitive science, and the technological applications of artificial intelligence in the production of agents such as driverless cars and expert systems, have raised the question of moral, ethical and/or legal responsibility in AI agents. This has re-emphasized the importance of the philosophical discourse on the notions of action and agency, which in contemporary intellectual discourse are now perceived to be phenomena within the epistemic competence of the natural sciences. This paper argues that AI systems do not and cannot possess free agency and autonomy, thus cannot be morally and ethically responsible, hence, it recommends a socio-political response to the question of responsibility in AI. It is then the duty of individual nations, or the global community to define and enact policies on who shoulders the responsibility of actions executed by AIs. (shrink)

Perhaps the most fundamental disagreement concerning Nietzsche's view of metaphysics is that some commentators believe Nietzsche has a positive, systematic metaphysical project, and others deny this. Those who deny it hold that Nietzsche believes metaphysics has a special problem, that is, a distinctively problematic feature that distinguishes metaphysics from other areas of philosophy. In this paper, I investigate important features of Nietzsche's metametaphysics in order to argue that Nietzsche does not, in fact, think metaphysics has a special problem. The result (...) is that, against a long-standing view held in the literature, we should be reading Nietzsche as a metaphysician. (shrink)

Introduction In recent years there has been a welcome reawakening of philosophical interest in the emotions. A significant number of contemporary ...

Both in everyday life and in moral philosophy, many think that our own past wrongdoing can undermine our standing to indignantly blame others for similar wrongdoing. In recent literature on the ethics of blame, we find two different kinds of explanation for this. Relative moral status accounts hold that to have standing to blame, you must be better than the person you are blaming, in terms of compliance with the norm. Fault-based accounts hold that those who blame others for things (...) of which they are also guilty exhibit familiar moral faults, such as making an exception of oneself, and that these faults explain why they lack standing. I argue in support of relative moral status accounts, showing that they both better trace our practice of dismissing blame on the basis of lack of standing, and that they have more explanatory resources than has been appreciated. (shrink)

The introduction explain the need for how an international, inclusive discussion about the range of different methodological approaches from different traditions of philosophy can be read alongside each other and be seen in sometimes very critical conversation with each other. In addition, the introduction identifies four broad themes in the volume: the largest group of chapters advocate methods that promote history of philosophy as an unapologetic, autonomous enterprise with its own criteria within philosophy. Second, three chapters can be seen as (...) historicizing the history of philosophy from within. Third, four chapters argue for history of philosophy as a means toward making contributions to contemporary philosophy. Finally, two chapters explore the relationship between the history of philosophy and the history of science. (shrink)

In this paper I seek to shed light on Spinoza’s understanding of the relationship between the citizen and the state by briefly examining two interpretative questions: (1) Is the state an individual? (2) What grounds Spinoza’s claim that the human individual ought always to comply with civil laws? Several scholars, whom I refer to as Restrictive Individualists, have worried that answering (1) in the affirmative would entail an intolerable understanding of (2), according to which the human individual would be engulfed (...) in the functioning of the state. I argue that (1) should be answered affirmatively and that the worries of the Restrictive Individualists are unfounded. I then propose a way of answering (2) that is consistent with the normative priority of the human individual. (shrink)

In this chapter, I explicate several general views and arguments that bear on the notion and contemporary theories of human welfare, as found in two foundational Daoist texts, the Daodejing and the Zhuangzi. Ideas drawn from the Daodejing include its objections to desire theories of human welfare and its distinction between natural and acquired desires. Insights drawn from the Zhuangzi include its arguments against the view that death is bad for the dead, its attempt to develop a workable theory of (...) well-being for those who are skeptical about such theories, and the prudential benefits of what I call "philosophical double-vision.". (shrink)

Recently, some authors have argued that experiences of poignant evils provide non-inferential support for crucial premisses in arguments from evil. Careful scrutiny of these experiences suggests that the impermissibility of permitting a horrendous evil might be characterized by a deontological insensitivity to consequences. This has significant implications for the project of theodicy.

COMMISSIONER KLAUS VERSEN: Counselors, I want to remind you both of two matters. First, this commission is not bound by the statutes or legal precedents of ...

Both advocates and critics of experimental philosophy often describe it in narrow terms as being the empirical study of people’s intuitions about philosophical cases. This conception corresponds with a narrow origin story for the field—it grew out of a dissatisfaction with the uncritical use of philosophers’ own intuitions as evidence for philosophical claims. In contrast, a growing number of experimental philosophers have explicitly embraced a broad conception of the sub-discipline, which treats it as simply the use of empirical methods to (...) inform philosophical problems. And this conception has a corresponding broad origin story—the field grew out of a recognition that philosophers often make empirical claims and that empirical claims call for empirical support. In this paper, I argue that the broad conception should be accepted, offering support for the broad origin story. (shrink)

Leading researchers in the philosophy of mind present and explore cutting edge research in the exciting new field of experimental philosophy.

This is a comprehensive collection of essays that explores cutting-edge work in experimental philosophy, a radical new movement that applies quantitative and empirical methods to traditional topics of philosophical inquiry. Situates the discipline within Western philosophy and then surveys the work of experimental philosophers by sub-discipline Contains insights for a diverse range of fields, including linguistics, cognitive science, anthropology, economics, and psychology, as well as almost every area of professional philosophy today Edited by two rising scholars who take a broad (...) and inclusive approach to the field Offers a complete introduction for non-specialists and students to the central approaches, findings, challenges, and controversies in experimental philosophy. (shrink)

The Morality First strategy for developing AI systems that can represent and respond to human values aims to first develop systems that can represent and respond to moral values. I argue that Morality First and other X-First views are unmotivated. Moreover, according to some widely accepted philosophical views about value, these strategies are positively distorting. The natural alternative, according to which no domain of value comes “first” introduces a new set of challenges and highlights an important but otherwise obscured problem (...) for e-AI developers. (shrink)

Experimental philosophy (or “x-phi”) is a way of doing philosophy. It is “traditional” philosophy, but with a little something extra: In addition to the expected philosophical arguments and engagement, x-phi involves the use of empirical methods to test the empirical claims that arise. This extra bit strikes some as a new, perhaps radical, addition to philosophical practice. We don’t think so. As this chapter will show, empirical claims have been common across the history of Western philosophy, as have appeals to (...) empirical observation in attempting to support or subvert these claims. While conceptions of philosophy have changed over time, across these changes we find philosophers employing empirical methods in pursuing their philosophical questions. Our primary aim in this chapter is to illustrate this fact. We begin by discussing the relevance of history to experimental philosophy (Section 2), then offer a necessarily condensed and highly selective history of empirical work in Western philosophy, ranging from the ancients (Section 3), to the early moderns (Section 4), to the late moderns (Section 5), and on to the present (Section 6). (shrink)

The desire to minimize the number of individual new entities postulated is often referred to as quantitative parsimony. Its influence on the default hypotheses formulated by scientists seems undeniable. I argue that there is a wide class of cases for which the preference for quantitatively parsimonious hypotheses is demonstrably rational. The justification, in a nutshell, is that such hypotheses have greater explanatory power than less parsimonious alternatives. My analysis is restricted to a class of cases I shall refer to as (...) additive. Such cases involve the postulation of a collection of qualitatively identical individual objects which collectively explain some particular observed phenomenon. Especially clear examples of this sort occur in particle physics. 1 Introduction 2 Particle physics: a case study 3 Three kinds of simplicity 4 Explanatory power 5 Explanation and non-observation 6 Parsimony and scientific methodology 7 Conclusions. (shrink)

BackgroundThe terminal illness of late-stage Alzheimer’s and related dementias is progressively cruel, burdensome, and can last years if caregivers assist oral feeding and hydrating. Options to avoid prolonged dying are limited since advanced dementia patients cannot qualify for Medical Aid in Dying. Physicians and judges can insist on clear and convincing evidence that the patient wants to die—which many advance directives cannot provide. Proxies/agents’ substituted judgment may not be concordant with patients’ requests. While advance directives can be patients’ last resort (...) to attain a peaceful and timely dying consistent with their lifelong values, success depends on their being effective and acceptable. A single flaw can provide opponents justification to refuse the directive’s requests to cease assisted feeding.AimThis article considers 24 common advance directive flaws in four categories. Process flaws focus on how patients express their end-of-life wishes. Content flaws reflect drafters’ selection of conditions and interventions, and how they are described. Inherent flaws can make advance directives unacceptable to authorities concerned about premature dying. Strategies are needed to compel physicians to write needed orders and to prevent third parties from sabotaging these orders after they are implemented. The article includes excerpts from “dementia-specific” directives or supplements that exemplify each flaw—mostly from the US and Europe. No directive critiqued here included an effective strategy to resolve this long-debated bioethical conflict: the past directive requests “Cease assisted feeding” but the incapacitated patient apparently expresses the desire to “Continue assisted feeding.” Some opponents to the controversial request, cease assisted feeding, use this conflict as a conceptual wedge to practice hard paternalism. This article proposes a protocol to prevent this conflict from emerging. These strategies may prevent authorities from requiring patients to fulfill authorities’ additional clinical criteria as a prerequisite to honor the requests in patients directives.ConclusionThis critique of flaws may serve as a guide to drafting and to selecting effective and acceptable advance directives for dementia. It also poses several bioethical and clinical questions to those in authority: Does your paternalistic refusal to honor patients’ wishes respect their self-determination? Protect vulnerable patients from harm? Force patients to endure prolonged suffering? Violate the principles of bioethics? Violate the very foundation of patient-centered care? (shrink)

Many philosophers think the distinctive function of deontic evaluation is to guide action. This idea is used in arguments for a range of substantive claims. In this paper, we entirely do one completely destructive thing and partly do one not entirely constructive thing. The first thing: we argue that there is an unrecognized gap between the claim that the function of deontic evaluation is to guide action and attempts to put that claim to use. We consider and reject four arguments (...) intended to bridge this gap. The interim conclusion is thus that arguments starting with the claim that the function of deontic evaluation is to guide action have a lacuna. The second thing: we consider a different tack for making arguments of this sort work. We sketch a methodology one could accept that would do the trick. Unfortunately, as we’ll explain, although this methodology would bridge the gap in arguments that put claims about the function of deontic evaluation to work, it would do so in a way that vitiates any interest we might have in such arguments. As an aside, we’ll also point out how epistemologists, who have recently become interested in the function of epistemic evaluation, appear to already recognize this fact. The conclusion is hence a dilemma: either arguments from deontic function to substance have a lacuna or such arguments lack teeth. (shrink)

The overall moral status of an option—whether it is required, permissible, forbidden, or something we really should do—is explained by competition between the contributory reasons bearing on that option and the alternatives. A familiar challenge for accounts of this competition is to explain the existence of latitude: there are usually multiple permissible options, rather than a single required option. One strategy is to appeal to distinctions between reasons that compete in different ways. Philosophers have introduced various kinds of non-requiring reasons (...) that do not generate requirements, even if they win the competition. This paper rejects two familiar versions of this strategy, one appealing to merely justifying reasons and one appealing to merely commendatory reasons. It offers a new account of how reasons compete that instead appeals to a sharp distinction between the reasons against an option and the reasons for the alternatives to that option. (shrink)