Selective reporting is prevalent in the medical literature, particularly in industry-sponsored research. In this paper, we expose selective reporting that is not evident without access to internal company documents. The published report of study 329 of paroxetine in adolescents sponsored by GlaxoSmithKline claims that “paroxetine is generally well tolerated and effective for major depression in adolescents”. By contrast, documents obtained during litigation reveal that study 329 was negative for efficacy on all 8 protocol specified outcomes and positive for harm.

Despite popular representations to the contrary, creative people are rarely insane. But creativity and madness may be connected in other ways; we find suggestions of schizotypy in the biographies of many artists, and schizophrenia and related conditions seem to be disproportionately represented in talented and creative families. There are attractions, therefore, in the idea that creativity depends on the controlled deployment of capacities that are uncontrolled in psychosis: an idea explored by psychoanalytically inclined writers such as Ernst Kris and Hanna (...) Segal. (shrink)

The lingering controversy concerning the usefulness and safety of antidepressants for children and adolescents is likely to confuse clinicians. Recent papers perpetuate the claim that antidepressants are shown to be safe and effective in randomised controlled trials. Others claim that antidepressants have been shown to prevent suicides. In this editorial we address the manipulation of outcomes that result from academics’ alliance with industry. We explain how industry and key opinion leaders have distorted the clinician’s perception of the safety and usefulness (...) of antidepressants for the treatment of depression in children and adolescents through publication bias, poor methodology, and selective reporting. (shrink)

We outline a theory of one puzzling aspect of human cognition: a tendency to exaggerate the degree to which agency is manifested in the world. We call this over‐coherent thinking. We use Pylyshyn's idea of cognitive penetrability to help characterize this notion. We argue that this kind of thinking is essentially narrative in form rather than theoretical. We develop a theory of the relation between the degree of narrativity in a representation and its aptness to represent, and to express, mind. (...) We review the prospects for several theories about how over‐coherent thinking gains a purchase on motivation. We argue that progress in this difficult area may require the abandonment of a categorical belief/imagination distinction in favour of vaguely specified clusterings in a many‐dimensional cognitive space. We conclude with the idea that an error‐prone system for the retention of ideas that are low in some of the characteristics generally thought desirable in belief might emerge as a result of an arms‐race between deceivers and deceiver‐detectors. (shrink)

In recent years, a number of contemporary proponents of psychoanalysis have sought to derive support for their conjectures about the _dynamic_ unconscious from the empirical evidence in favor of the _cognitive_ unconscious. It is our contention, however, that far from supporting the dynamic unconscious, recent work in cognitive science suggests that the time has come to dispense with this concept altogether. In this paper we defend this claim in two ways. First, we argue that any attempt to shore up the (...) dynamic unconscious with the cognitive unconscious is bound to fail, simply because the latter, as it is understood in contemporary cognitive science, is incompatible with the former, as it is traditionally conceived by psychoanalytic theory. Second, we show how psychological phenomena traditionally cited as evidence for the operation of a dynamic unconscious can be accommodated more parsimoniously by other means. (shrink)

© 2003 by The Johns Hopkins University Press.

In this case study from litigation, we show how ghostwriting of clinical trial results can contribute to the manipulation of data to favor the study medication. Study 329 for paroxetine pediatric use was negative for efficacy and positive for harm. Yet the ghostwritten publication from this study concluded that paroxetine provided evidence of efficacy and safety and continues to be influential. Despite the role of named authors in revisions of the manuscript, the sponsor company remained in control of the message.

This paper is a deconstruction of a ghostwritten report of a randomized, double-blind, placebo-controlled efficacy and safety trial of citalopram in depressed children and adolescents conducted in the United States. Court documents revealed that protocol-specified outcome measures showed no statistically significant difference between citalopram and placebo. However, the published article concluded that citalopram was safe and significantly more efficacious than placebo for children and adolescents, with possible adverse effects on patient safety.

We live in an age alleged devoted to evidence-based medicine. Evidence-based medicine, however, depends on reliable data and if the data are largely, if not completely, manipulated by the manufacturer of pharmaceuticals, then the data are not reliable. Evidence-based medicine is an illusion. This book raises and attempts to answer the following questions: What are the ways in which the profit motive of industry undermines the integrity of science? How is science protected from corporate malfeasance in a capitalist economy? Our (...) particular focus is the relationship between the pharmaceutical industry and medicine. We argue that medicine desperately needs to re-evaluate its relationship with the pharmaceutical industry and re-affirm the ideal of evidence-based medicine. In our view, Karl Popper’s philosophy of science, Falsificationism and Critical Rationalism, provides a rigorous conception of science required to preserve the integrity of the scientific basis of medicine against the commercial influences. (shrink)

Corporate interests corrupt clinical trials, physicians and universities, undermining the foundation of evidence-based medicine. Philosopher Leemon McHenry and psychiatrist Jon Jureidini argue that the principles underlying Popper’s philosophy of science can protect clinical research from corporate malfeasance in a capitalist economy. -/- Evidence-based medicine was a paradigm shift that is often praised as one of the greatest achievements of medicine in the twentieth century. This radical change in medical practice is based on epistemological hierarchies of evidence, from opinions of (...) respected authorities, mechanistic reasoning and reports of expert committees at the bottom to various levels of observational studies and finally to randomized, placebo-controlled clinical trials at the apex. Randomized, placebo-controlled clinical trials, recognized as the gold standard of clinical experimentation, generally maintain their position in the hierarchies because when well-designed and well-conducted, they provide a basis for assessing harms and benefits, and help deter extravagant claims of efficacy and safety. (shrink)

Journals are failing in their obligation to ensure that research is fairly represented to their readers, and must act decisively to retract fraudulent publications. Recent case reports have exposed how marketing objectives usurped scientific testing and compromised the credibility of academic medicine. But scant attention has been given to the role that journals play in this process, especially when evidence of research fraud fails to elicit corrective measures. Our experience with The Journal of the American Academy of Child and Adolescent (...) Psychiatry (JAACAP) illustrates the nature of the problem. The now-infamous Study 329 of paroxetine in adolescent depression was negative for efficacy on all eight protocol-specified outcomes and positive for harm, but JAACAP published a report of this study that concluded that “paroxetine is generally well tolerated and effective for major depression in adolescents.” The journal’s editors not only failed to exercise critical judgment in accepting the paper, but when shown evidence that the paper misrepresented the science, refused either to convey this information to the medical community or to retract the article. (shrink)

The goal of this paper is to expose the research misconduct of pharmaceutical industry-sponsored clinical trials via three short case studies of corrupted psychiatric trials that were conducted in the United States. We discuss the common elements that enable the misrepresentation of clinical trial results including ghostwriting for medical journals, the role of key opinion leaders as co-conspirators with the pharmaceutical industry and the complicity of top medical journals in failing to uphold standards of science and peer review. We conclude (...) that the corruption of industry-sponsored clinical trials is one of the major obstacles facing evidence-based medicine. (shrink)

A task force of pharmaceutical industry employees and medical journal editors propose ten recommendations to address the problem of erosion of confidence in reporting industry-sponsored clinical trial results. These recommendations do not solve the fundamental problem of industry-sponsored biomedical research. A radical solution is required that severs the relationship between the industry and the journals and restores the integrity of the medical literature.

Scientific and ethical misconduct has increased at an alarming rate as a result of the privatization of knowledge. What began as an effort to stimulate entrepreneurship and increase discovery in biomedical research by strengthening the ties between industry and academics has led to an erosion of confidence in the reporting of research results. Inherent tensions between profit-directed inquiry and knowledge-directed inquiry are instantiated in psychopharmacology, especially in the co-option of academic activity to corporate objectives. The effects of these tensions are (...) visible in research agendas, publication practices, postgraduate education, academic-industry partnerships and product promotion. (shrink)

The advent of evidence-based medicine was a paradigm shift intended to provide a solid scientific foundation for medicine. The validity of this paradigm, however, depends on reliable data from clinical trials, mostly conducted by the pharmaceutical industry and reported in the names of senior academics. The release of previously confidential pharmaceutical industry documents into the public domain has given the medical community valuable insight into the degree to which industry-sponsored clinical trials are manipulated and misrepresented. Until this problem is corrected, (...) evidence-based medicine is an illusion. (shrink)

This chapter presents an overview of the major interpretations of probability followed by an outline of the objective Bayesian interpretation and a discussion of the key challenges it faces. I discuss the ramifications of interpretations of probability and objective Bayesianism for the philosophy of mathematics in general.

Drawing on philosophy, political and social theory, decision-theory, economics, psychology, history and literature, Jon Elster's classic book Sour Grapes continues and complements the arguments of his acclaimed earlier book, Ulysses and the Sirens. Elster begins with an analysis of the notation of rationality, before tackling the notions of irrational behavior, desires and belief with highly sophisticated arguments that subvert the orthodox theories of rational choice. Presented in a fresh series livery and with a specially commissioned preface written by Richard Holton, (...) illuminating its continuing importance to philosophical enquiry, Sour Grapes has been revived for a new generation of readers. (shrink)

In this volume a diverse group of economists, philosophers, political scientists, and psychologists address the problems, principles, and practices involved in comparing the well-being of different individuals. A series of questions lie at the heart of this investigation: What is the relevant concept of well-being for the purposes of comparison? How could the comparisons be carried out for policy purposes? How are such comparisons made now? How do the difficulties involved in these comparisons affect the status of utilitarian theories? This (...) collection constitutes the most advanced and comprehensive treatment of one of the cardinal issues in social theory. (shrink)

Two different versions of the ending of the first additament to C. S. Peirce's 1908 article, "A Neglected Argument for the Reality of God," appear in the Collected Papers but were omitted from The Essential Peirce. In one, he linked the hypothesis of God's Reality to his entire theory of logic as semeiotic, claiming that proving the latter would also prove the former. In the other, he offered a final outline of his cosmology, in which the Reality of God as (...) Ens necessarium is indispensable to both the origin and order of our existing universe of Signs. Exploring these passages, as well as the unpublished manuscript drafts of the article, provides important insights into the key concepts of instinct and continuity within Peirce's comprehensive system of thought. (shrink)

The Problem of Iterated Ground is to explain what grounds truths about ground: if Γ grounds φ, what grounds that Γ grounds φ? This paper develops a novel solution to this problem. The basic idea is to connect ground to explanatory arguments. By developing a rigorous account of explanatory arguments we can equip operators for factive and non-factive ground with natural introduction and elimination rules. A satisfactory account of iterated ground falls directly out of the resulting logic: non- factive grounding (...) claims, if true, are zero-grounded in the sense of Fine. (shrink)

In this paper, I link philosophical discussion of policies for trans inclusion or exclusion, to a method of policy making. I address the relationship between concerns about safety, fairness, and inclusion in policy making about the inclusion of transwomen athletes into women’s sport. I argue for an approach based on lexical priority rather than simple ‘balancing’, considering the different values in a specific order. I present justifying reasons for this approach and this lexical order, based on the special obligations of (...) International Federations such as World Rugby. As a result, I provide a justificatory framework for the WR Guidelines that exclude transwomen from the women’s game in WR competitions. Finally, I give an account of a maximally safe, maximally fair and maximally inclusive form of sex categorisation in sport. (shrink)

Sour Grapes aims to subvert orthodox theories of rational choice through the study of forms of irrationality. Dr Elster begins with an analysis of the notation of rationality, to provide the background and terms for the subsequent discussions, which cover irrational behaviour, irrational desires and irrational belief. These essays continue and complement the arguments of Jon Elster's earlier book, Ulysses and the Sirens. That was published to wide acclaim, and Dr Elster shows the same versatility here in drawing on philosophy, (...) political and social theory, decision-theory, economics and psychology, as well as history and literature. (shrink)

I discuss three recent counterexamples to the transitivity of grounding due to Jonathan Schaffer. I argue that the counterexamples don’t work and draw some conclusions about the relationship between grounding and explanation.

Migration and Islamic Ethics, Issues of Residence, Naturalization and Citizenship addresses how Islamic ethical and legal traditions can contribute to current global debates on migration and displacement; how Islamic ethics of muʼakha, ḍiyāfa, ijāra, amān, jiwār, sutra, kafāla, among others, may provide common ethical grounds for a new paradigm of social and political virtues applicable to all humanity, not only Muslims. The present volume more broadly defines the Islamic tradition to cover not only theology but also to encompass ethics, customs (...) and social norms, as well as modern political, humanitarian and rights discourses. The first section addresses theorizations and conceptualizations using contemporary Islamic examples, mainly in the treatment of asylum-seekers and refugees; the second, contains empirical analyses of contemporary case studies; the third provides historical accounts of Muslim migratory experiences. (shrink)

This book is an expanded and revised edition of the author's critically acclaimed volume Nuts and Bolts for the Social Sciences. In twenty-six succinct chapters, Jon Elster provides an account of the nature of explanation in the social sciences. He offers an overview of key explanatory mechanisms in the social sciences, relying on hundreds of examples and drawing on a large variety of sources - psychology, behavioral economics, biology, political science, historical writings, philosophy and fiction. Written in accessible and jargon-free (...) language, Elster aims at accuracy and clarity while eschewing formal models. In a provocative conclusion, Elster defends the centrality of qualitative social sciences in a two-front war against soft and hard forms of obscurantism. (shrink)

This 1989 book is intended as an introductory survey of the philosophy of the social sciences. It is essentially a work of exposition which offers a toolbox of mechanisms - nuts and bolts, cogs and wheels - that can be used to explain complex social phenomena. Within a brief compass, Jon Elster covers a vast range of topics. His point of departure is the conflict we all face between our desires and our opportunities. How can rational choice theory help us (...) understand our motivation and behaviour? More significantly, what happens when the theory breaks down but we still cleave to a belief in the power of the rational? Elster describes the fascinating range of forms of irrationality - wishful thinking, the phenomenon of sour grapes, discounting the future in noncooperative behaviour. This is a remarkably lucid and comprehensive introduction to the social sciences for students of political science, philosophy, sociology and economics. (shrink)

The cumulative impact of enhancement technologies may alter the human species in the very long-term future. In this article, I will start showing how radical genetic enhancements may accelerate the conversion into a novel species. I will also clarify the concepts of ‘biological species’, ‘transhuman’ and ‘posthuman’. Then, I will summarize some ethical arguments for creating a transhuman or posthuman species with a substantially higher level of well-being than the human one. In particular, I will present what I shall call (...) the Principle of the Best Interests of Posthumanity, which states that the enhancement of the human and transhuman species must be directed towards the creation of a posthuman existence that is substantially more valuable than its predecessors. I suggest that human extinction may be considered, within that principle, as one of the best interests of posthumanity. Finally, I will develop three objections that make that principle unattractive and that show that pursuing a full-blown programme of posthuman evolution is ethically flawed. (shrink)

Bringing together powerful new tools from set theory and the philosophy of language, this book proposes a solution to one of the few unresolved paradoxes from antiquity, the Paradox of the Liar. Treating truth as a property of propositions, not sentences, the authors model two distinct conceptions of propositions: one based on the standard notion used by Bertrand Russell, among others, and the other based on J.L. Austin's work on truth. Comparing these two accounts, the authors show that while the (...) Russellian conception of the relation between sentences, propositions, and truth is crucially flawed in limiting cases, the Austinian perspective has fruitful applications to the analysis of semantic paradox. In the course of their study of a language admitting circular reference and containing its own truth predicate, Barwise and Etchemendy also develop a wide range of model-theoretic techniques--based on a new set-theoretic tool, Peter Aczel's theory of hypersets--that open up new avenues in logical and formal semantics. (shrink)

The present volume collects some of Barwise's papers written since then, those directly concerned with relations among logic, situation theory, and situation semantics. Several papers appear here for the first time.

Jon Elster has written a comprehensive, wide-ranging book on the emotions in which he considers the full range of theoretical approaches. Drawing on history, literature, philosophy and psychology, Elster presents a complete account of the role of the emotions in human behaviour. While acknowledging the importance of neurophysiology and laboratory experiment for the study of emotions, Elster argues that the serious student of the emotions can learn more from the great thinkers and writers of the past, from Aristotle to Jane (...) Austen. He attaches particular importance to the work of the French moralists, notably La Rochefoucauld, who demonstrated the way esteem and self-esteem shape human motivation. The book also maintains a running dialogue with economists and rational-choice theorists. Combining methodological and theoretical arguments with empirical case-studies and written with Elster's customary verve and economy, this book has great cross-disciplinary appeal. (shrink)

In this paper I discuss a new conception that has arrived relatively recently on the scene, in the context of the debate over the inclusion of transwomen (hereafter TW) in female sport. That conception is ‘Meaningful Competition’ (hereafter MC) – a term used by some of those who advocate for the inclusion of TW in female sport if and only if they reduce their testosterone levels. I will argue that MC is not fair. I understand MC as a substitute concept, (...) as an attempt to substitute for the perfectly serviceable concept of fair competition. It is an attempt at conceptual engineering that should be resisted. This is important because some International Federations have accepted MC as good coin, and the underlying theory of MC, which I explicate for the first time, underpins the stance taken by the IOC (International Olympic Committee) in its Framework Document. To establish that the inclusion of TW in female sport meets the criteria of MC in the sense I explicate here, does not show that the inclusion of TW in female sport is fair. Such inclusion is not fair, and the proper currency of sport is fair competition. ‘Meaningful Competition’, on the other hand, is a snare and a delusion. (shrink)

This book was first published in 1984, as the revised edition of a 1979 original. The text is composed of studies in a descending sequence from perfect rationality, through imperfect and problematical rationality, to irrationality. Specifically human rationality is characterized by its capacity to relate strategically to the future, in contrast to the myopic 'gradient climbing' of natural selection. There is trenchant analysis of some of the parallels proposed in this connection between the biological and the social sciences. In the (...) chapter on imperfect rationality the crucial notion is that of 'binding oneself', as Ulysses did before setting out to the Sirens, when weakness of will may prevent us from using our capacity for perfect rationality. The second half of the book deals with rational-actor theory, comparing its logical power and success to rival approaches, and with the varieties of irrationality expressed in contradictory beliefs and desires. (shrink)

In this volume, first published in 1983, Jon Elster approaches the study of technical change from an epistemological perspective.

The essays in this volume consider the question of whether the self is a unity or whether it should be conceived without metaphor as divided - as a 'multiple self'. The issue is a central one for several disciplines. It bears directly on the account of rationality and the explanation of individual decision-making and behaviour. Is the hypothesis of a multiple self required to deal with the problems of self-deception and weakness of will; and can the conceptual tools developed in (...) the study of interpersonal conflict be applied to the analysis of intra-personal struggle? Most of the essays, by a number of leading philosophers, psychologists and economists, appear here for the first time. They bring out the interdisciplinary importance of the question, and will interest readers in all those areas. The volume will also usefully supplement The Foundations of Social Choice Theory, edited by Jon Elster and Aanund Hylland, which appears in the same series and is also concerned with the foundations of rationality. (shrink)

Traces the depiction of biological science in mass media and how it has shaped public perceptions.

In this volume a diverse group of economists, philosophers, political scientists, and psychologists address the problems, principles, and practices involved in comparing the well-being of different individuals. A series of questions lie at the heart of this investigation: What is the relevant concept of well-being for the purposes of comparison? How could the comparisons be carried out for policy purposes? How are such comparisons made now? How do the difficulties involved in these comparisons affect the status of utilitarian theories? This (...) collection constitutes the most advanced and comprehensive treatment of one of the cardinal issues in social theory. (shrink)

An interview exploring the complexity of contemporary French philosophical atheism, in the light of Difficult Atheism: Post-Theological Thinking in Badiou, Nancy and Meillassoux (Edinburgh UP, 2011).