The requirements of the UK Equality Act 2010 and some high profile criticism for using a potentially ageist methodology have prompted the National Institute for Health and Clinical Excellence (NICE) to assess the processes and methodology it uses to make appraisal decisions. This paper argues that NICE has established rigorous systems to protect against ageist decisions, has no track record of ageism and is well placed to meet the requirements of new UK equality legislation.

In order to create sustainable health systems, many countries are introducing ways to prioritize health services underpinned by a process of health technology assessment. While this approach requires technical judgments of clinical effectiveness and cost-effectiveness, these are embedded in a wider set of social (societal) value judgments, including fairness, responsiveness to need, non-discrimination and obligations of accountability and transparency. Implementing controversial decisions faces legal, political and public challenge. To help generate acceptance for the need for health prioritization and the resulting (...) decisions, the purpose of this paper is to develop a novel way of encouraging key stakeholders, especially patients and the public, to become involved in the prioritization process. (shrink)

As health policy-makers around the world seek to make progress towards universal health coverage, they must navigate between two important ethical imperatives: to set national spending priorities fairly and efficiently; and to safeguard the right to health. These imperatives can conflict, leading some to conclude that rights-based approaches present a disruptive influence on health policy, hindering states’ efforts to set priorities fairly and efficiently. Here, we challenge this perception. We argue first that these points of tension stem largely from inadequate (...) interpretations of the aims of priority setting as well as the right to health. We then discuss various ways in which the right to health complements traditional concerns of priority setting and vice versa. Finally, we set out a three-step process by which policy-makers may navigate the ethical and legal considerations at play. (shrink)

Health systems that provide for universal patient access through a scheme of prepayments—whether through taxes, social insurance, or a combination of the two—need to make decisions on the scope of coverage that they secure. Such decisions are inherently controversial, implying, as they do, that some patients will receive less than comprehensive health care, or less than complete protection from the financial consequences of ill-heath, even when there is a clinically effective therapy to which they might have access.Controversial decisions of this (...) sort call for a public justification for covering or not covering a given treatment. Priority-setting agencies play a key role in providing such a justification. A recent... (shrink)

One rationale policy-makers sometimes give for declining to fund a service or intervention is on the grounds that it would be ‘unaffordable’, which is to say, that the total cost of providing the service or intervention for all eligible recipients would exceed the budget limit. But does the mere fact that a service or intervention is unaffordable present a reason not to fund it? Thus far, the philosophical literature has remained largely silent on this issue. However, in this article, we (...) consider this kind of thinking in depth. Albeit with certain important caveats, we argue that the use of affordability criteria in matters of public financing commits what Parfit might have called a ‘mistake in moral mathematics’. First, it fails to abide by what we term a principle of ‘non-perfectionism’ in moral action: the mere fact that it is practically impossible for you to do all the good that you have reason to do does not present a reason not to do whatever good you can do. And second, when used as a means of arbitrating between which services to fund, affordability criteria can lead to a kind of ‘numerical discrimination’. Various attendant issues around fairness and lotteries are also discussed. (shrink)

ABSTRACT Sixteenth-century English Protestants struggled with the legacy left them by the Lutheran reformation: a strict disjunction between inward and outward that hindered the development of a robust theology of worship. For Luther, outward forms of worship had more to do with the edification of the neighbour than they did with pleasing God. But what exactly did ‘edification’ mean? On the one hand, English Protestants sought to avoid the Roman Catholic view that certain elements of worship held an intrinsic spiritual (...) value; on the other hand, many did not want to imply that forms of worship were spiritually arbitrary and had a merely civil value. Richard Hooker developed his theology of worship in response to this challenge, seeking to maintain a clear distinction between the inward worship of the heart and the outward forms of public worship, while refusing to disassociate the two. The result was a concept of edification which sought to do justice to both civil and spiritual concerns, without, pace Peter Lake and other scholars, conceding an inch to a Catholic theology of worship. (shrink)

Review of Littlejohn, "Justification and the Truth Connection".

Could it be right to convict and punish defendants using only statistical evidence? In this paper, I argue that it is not and explain why it would be wrong. This is difficult to do because there is a powerful argument for thinking that we should convict and punish defendants using statistical evidence. It looks as if the relevant cases are cases of decision under risk and it seems we know what we should do in such cases (i.e., maximize expected value). (...) Given some standard assumptions about the values at stake, the case for convicting and punishing using statistical evidence seems solid. In trying to show where this argument goes wrong, I shall argue (against Lockeans, reliabilists, and others) that beliefs supported only by statistical evidence are epistemically defective and (against Enoch, Fisher, and Spectre) that these epistemic considerations should matter to the law. To solve the puzzle about the role of statistical evidence in the law, we need to revise some commonly held assumptions about epistemic value and defend the relevance of epistemology to this practical question. (shrink)

Margaret Macdonald was at the institutional heart of analytic philosophy in Britain in the mid-twentieth century. Yet, her views on the nature of philosophical theories diverge quite considerably from those of many of her contemporaries. In this paper, I focus on her 1953 article ‘Linguistic Philosophy and Perception’, a provocative paper in which Macdonald argues that the value of philosophical theories is more akin to that of poetry or art than science or mathematics. I do so for two reasons. First, (...) because it reveals just how far Macdonald’s meta- philosophical views diverged from those of many of her contemporaries. Second, because the discussion in LPP pre-empts recent literature on the nature of philosophical inquiry and the efficacy of philosophical arguments. Indeed, Macdonald’s paper is just as likely to provoke discussion today as it was in the 1950s. (shrink)

Berkeley’s likeness principle is the claim that “an idea can be like nothing but an idea”. The likeness principle is intended to undermine representationalism: the view (that Berkeley attributes to thinkers like Descartes and Locke) that all human knowledge is mediated by ideas in the mind which represent material objects. Yet, Berkeley appears to leave the likeness principle unargued for. This has led to several attempts to explain why Berkeley accepts it. In contrast to ‘metaphysical’ and ‘epistemological’ interpretations available in (...) the literature, in this paper I defend a ‘conceptual’ interpretation. I argue that Berkeley accepts the likeness principle on the basis of (i) his commitment to the transparency of ideas, and (ii) his account of resemblance which he sets out in his works on vision. Thus, I provide an explanation for Berkeley’s reasons for accepting the likeness principle which, appropriately, focuses on his views concerning ideas and likeness. (shrink)

Chinese Philosophy: Overview of Topics If Chinese philosophy may be said to have begun around 2000 B.C.E., then it represents the longest continuous heritage of philosophical reflection. Trying to mention each philosopher or every significant thinker is not possible. This article is highly selective by choosing philosophers according to two basic principles: Those who … Continue reading Chinese Philosophy: Overview of Topics →.

According to moral error theorists, moral claims necessarily represent categorically or robustly normative facts. But since there are no such facts, moral thought and discourse are systematically mistaken. One widely discussed objection to the moral error theory is that it cannot be true because it leads to an epistemic error theory. We argue that this objection is mistaken. Objectors may be right that the epistemic error theory is untenable. We also agree with epistemic realists that our epistemological claims are not (...) systematically in error. However, this is not because there are robustly normative facts, but rather because the truth of our epistemic claims doesn’t turn on whether there are such facts. Epistemic facts, we argue, are not robustly or categorically normative. Moral error theorists should therefore respond to the objection that their view does not commit them to the epistemic error theory. (shrink)

This paper provides a philosophical evaluation of the concept of handedness prevalent but largely unspoken in the scientific literature. This literature defines handedness as the preference or ability to use one hand rather than the other across a range of common activities. Using the philosophical discipline of phenomenology, I articulate and critique this conceptualization of handedness. Phenomenology shows defining a concept of handedness by focusing on hand use leads to a right hand biased concept. I argue further that a phenomenological (...) model based in spatial orientation rather than hand use provides a more inclusive concept of handedness. (shrink)

Laozi Laozi is the name of a legendary Daoist philosopher, the alternate title of the early Chinese text better known in the West as the Daodejing, and the moniker of a deity in the pantheon of organized “religious Daoism” that arose during the later Han dynasty. Laozi is … Continue reading Laozi →.

The central thesis of robust virtue epistemology (RVE) is that the difference between knowledge and mere true belief is that knowledge involves success that is attributable to a subject's abilities. An influential objection to this approach is that RVE delivers the wrong verdicts in cases of environmental luck. Critics of RVE argue that the view needs to be supplemented with modal anti-luck condition. This particular criticism rests on a number of mistakes about the nature of ability that I shall try (...) to rectify here. (shrink)

This paper looks at whether it is possible to unify the requirements of rationality with the demands of normative reasons. It might seem impossible to do because one depends upon the agent’s perspective and the other upon features of the situation. Enter Reasons Perspectivism. Reasons perspectivists think they can show that rationality does consist in responding correctly to reasons by placing epistemic constraints on these reasons. They think that if normative reasons are subject to the right epistemic constraints, rational requirements (...) will correspond to the demands generated by normative reasons. While this proposal is prima facie plausible, it cannot ultimately unify reasons and rationality. There is no epistemic constraint that can do what reasons perspectivists would need it to do. Some constraints are too strict. The rest are too slack. This points to a general problem with the reasons-first program. Once we recognize that the agent’s epistemic position helps determine what she should do, we have to reject the idea that the features of the agent’s situation can help determine what we should do. Either rationality crowds out reasons and their demands or the reasons will make unreasonable demands. (shrink)

It is argued that causal understanding originates in experiences of acting on objects. Such experiences have consistent features that can be used as clues to causal identification and judgment. These are singular clues, meaning that they can be detected in single instances. A catalog of 14 singular clues is proposed. The clues function as heuristics for generating causal judgments under uncertainty and are a pervasive source of bias in causal judgment. More sophisticated clues such as mechanism clues and repeated interventions (...) are derived from the 14. Research on the use of empirical information and conditional probabilities to identify causes has used scenarios in which several of the clues are present, and the use of empirical association information for causal judgment depends on the presence of singular clues. It is the singular clues and their origin that are basic to causal understanding, not multiple instance clues such as empirical association, contingency, and conditional probabilities. (shrink)

In this important new book in the IPPP series, a group of leading thinkers in psychiatry, psychology, and philosophy offer alternative perspectives that address both the scientific and clinical aspects of psychiatric validation, emphasizing throughout their philosophical and historical considerations.

Daoist Philosophy Along with Confucianism, “Daoism” is one of the two great indigenous philosophical traditions of China. As an English term, Daoism corresponds to both Daojia, an early Han dynasty term which describes so-called “philosophical” texts and thinkers such as Laozi and … Continue reading Daoist Philosophy →.

Although the new ethical challenges posed by biotechnology and digital surveillance have been the focus of close attention and heated debate among Christian ethicists, comparatively little attention has been dedicated to far more ubiquitous technologies: the internet and our smartphones. Yet evidence is mounting among cognitive scientists, sociologists, and psychologists that the internet and related media technology are profoundly reshaping human thought, behavior, and sociality. This is surely a matter for ethical concern if there ever was one. This essay argues (...) that the medieval concept of the vice of curiositas is an apt diagnosis of the ways in which digital media can absorb and scatter our attention, often in pathological ways. I first offer a summary of what earlier Christian authors meant by curiosity, and I classify their concerns into a typology of seven forms of vicious curiosity. I then show how the phenomenon of online pornography addiction in particular and other forms of internet addiction more generally confirm the explanatory power of this older concept and especially Augustine's distinction of the "lust of the flesh" and "the lust of the eyes." I conclude by suggesting how the grammar of "vice" and "virtue" allows us to embrace the value of new technologies while consciously cultivating strategies of resistance to their harmful tendencies. (shrink)

The internalism-externalism debate is one of the oldest debates in epistemology. Internalists assert that the justification of our beliefs can only depend on facts internal to us, while externalists insist that justification can depend on additional, for example environmental, factors. Clayton Littlejohn proposes and defends a new strategy for resolving this debate. Focussing on the connections between practical and theoretical reason, he explores the question of whether the priority of the good to the right might be used to defend an (...) epistemological version of consequentialism, and proceeds to formulate a new 'deontological externalist' view. On this view, the justificatory status of a belief depends upon whether it is fit for the purposes of practical reasoning. Only beliefs that meet externalist standards are fit for such a purpose. If we want to understand how a wide range of norms (e.g., moral norms) apply to rational agents regardless of what their evidence or outlook is like, we have to embrace an externalist account of the justification. (shrink)

William Molyneux was born in Dublin, studied in Trinity College Dublin, and was a founding member of the Dublin Philosophical Society (DPS), Ireland’s counterpart to the Royal Society in London. He was a central figure in the Irish intellectual milieu during the Early Modern period and – along with George Berkeley and Edmund Burke – is one of the best-known thinkers to have come out of that context and out of Irish thought more generally. In 1688, when Molyneux wrote the (...) letter to Locke in which he posed the now famous question about a man born blind made to see, he was an active member of the DPS and was on familiar terms with several other key figures in Irish philosophy at the time. For the most part, Irish thinkers in the seventeenth and eighteenth centuries answered “no” to Molyneux’s question of whether a blind man made to see could distinguish, by sight alone, between a cube and a sphere. (shrink)

According to the phenomenal conservatives, beliefs are justified by non-doxastic states we might speak of as ‘appearances’ or ‘seemings’. Those who defend the view say that there is something self-defeating about believing that phenomenal conservatism is mistaken. They also claim that the view captures an important internalist insight about justification. I shall argue that phenomenal conservatism is indefensible. The considerations that seem to support the view commit the phenomenal conservatives to condoning morally abhorrent behavior. They can deny that their view (...) forces them to condone morally abhorrent behavior, but then they undercut the defenses of their own view. (shrink)

According to Williamson, your evidence consists of all and only what you know (E = K). According to his critics, it doesn’t. While E = K calls for revision, the revisions it calls for are minor. E = K gets this much right. Only true propositions can constitute evidence and anything you know non-inferentially is part of your evidence. In this paper, I defend these two theses about evidence and its possession from Williamson’s critics who think we should break more (...) radically from E = K. (shrink)

"This book is an augmented and updated translation by the author of Theorie des Subjekts: Subjectiviteat und Identiteat zwischen Moderne und Postmoderne, Teubingen, Francke-UTB, 2010 (3rd ed.)"--Title page verso.

According to ‘ought’ implies ‘can’ (OIC), your obligation can never be to do what you cannot do. In a recent attack on OIC, Graham has argued that intuitions about justified intervention can help us determine whether the agent whose actions we use force to prevent would have acted permissibly or not. These intuitions, he suggests, cause trouble for the idea that you can be obligated to refrain from doing what you can refrain from doing. I offer a defense of OIC (...) and explain how non-consequentialists can accommodate his intuitions about his cases. (shrink)

In my contribution to this Concise Collection on Margaret Cavendish, I focus on teaching Cavendish’s work in the context of philosophy (and, more specifically, Early Modern Philosophy). I have three aims. First, to explain why teaching women from philosophy’s history is crucially important to the discipline. Second, to outline my own reflections on teaching Cavendish’s philosophy. Third, to defend a specific claim about the benefits of teaching Cavendish to philosophy students; namely, that introducing biographical detail alongside philosophical ideas enriches the (...) learning experience. (shrink)

Since its original publication in 1975, this groundbreaking work has awakened millions of people to the existence of "speciesism"—our systematic disregard of nonhuman animals—inspiring a worldwide movement to transform our attitudes to animals and eliminate the cruelty we inflict on them. In Animal Liberation, author Peter Singer exposes the chilling realities of today’s "factory farms" and product-testing procedures—destroying the spurious justifications behind them, and offering alternatives to what has become a profound environmental and social as well as moral issue. (...) An important and persuasive appeal to conscience, fairness, decency, and justice, it is essential reading for the supporter and the skeptic alike. (shrink)

This is part of an authors meets critics session on Daniel Star's wonderful book, Knowing Better. I discuss a potential problem with Kearns and Star's Reasons as Evidence thesis. The issue has to do with the difficulties we face is we treat normative reasons as evidence and impose no possession conditions on evidence. On such a view, it's hard to see how practical reasoning could be a non-monotonic process. One way out of the difficulty would be to allow for (potent) (...) unpossessed reasons but insist that all evidence is possessed evidence. This option, I argue, isn't open to proponents of the Reasons as Evidence thesis. Instead, it seems that they'll have to say that all normative reasons are identified with pieces of possessed evidence. This requires the proponents of the Reasons as Evidence thesis to impose epistemic constraints on norms that some of us find objectionable. (shrink)

Prospect Theory: For Risk and Ambiguity, provides a comprehensive and accessible textbook treatment of the way decisions are made both when we have the statistical probabilities associated with uncertain future events and when we lack them. The book presents models, primarily prospect theory, that are both tractable and psychologically realistic. A method of presentation is chosen that makes the empirical meaning of each theoretical model completely transparent. Prospect theory has many applications in a wide variety of disciplines. The material in (...) the book has been carefully organized to allow readers to select pathways through the book relevant to their own interests. With numerous exercises and worked examples, the book is ideally suited to the needs of students taking courses in decision theory in economics, mathematics, finance, psychology, management science, health, computer science, Bayesian statistics, and engineering. (shrink)

Many philosophers think that given the choice between saving the life of an innocent person and averting any number of minor ailments or inconveniences, it would be better to save the life. How, then, should one compare the risk of an innocent person’s life to such minor ailments and inconveniences? If lives are infinitely more important than insignificant factors then any risk cannot be outweighed, and that is untenable. An alternative approach seems more promising: let the values of such insignificant (...) factors be bounded, as then there will be well-behaved tradeoffs between insignificant things and the risk to an innocent life. We argue, however, that bounding the values of insignificant factors poses myriad problems. (shrink)

In Fallibilism: Evidence and Knowledge, Jessica Brown identifies a number of problems for the so-called knowledge view of justification. According to this view, we cannot justifiably believe what we do not know. Most epistemologists reject this view on the grounds that false beliefs can be justified if, say, supported by the evidence or produced by reliable processes. We think this is a mistake and that many epistemologists are classifying beliefs as justified because they have properties that indicate that something should (...) be excused. Brown thinks that previous attempts to make this case have been unsuccessful. While the difficulties Brown points to are genuine, I think they show that attempts to explain a classificatory judgment haven't been successful. Still, I would argue that the classification is correct. We need a better explanation of this classificatory judgment. I will try to clarify the justification-excuse distinction and explain why it's a mistake to insist that beliefs that violate epistemic norms might be justified. Just as it's possible for a rational agent to act without justification in spite of her best intentions, it's possible that a rational thinker who follows the evidence and meets our expectations might nevertheless believe without sufficient justification. If our justified beliefs are supposed to guide us in deciding what to do, we probably should draw on discussions from morality and the law about the justification/excuse distinction to inform our understanding of the epistemic case. (shrink)

In recent work, Thomas Kroedel has proposed a novel solution to the lottery paradox. As he sees it, we are permitted/justified in believing some lottery propositions, but we are not permitted/justified in believing them all. I criticize this proposal on two fronts. First, I think that if we had the right to add some lottery beliefs to our belief set, we would not have any decisive reason to stop adding more. Suggestions to the contrary run into the wrong kind of (...) reason problem. Reflection on the preface paradox suggests as much. Second, while I agree with Kroedel that permissions do not agglomerate, I do not think that this fact can help us solve the lottery paradox. First, I do not think we have any good reason to think that we’re permitted to believe any lottery propositions. Second, I do not see any good reason to think that epistemic permissions do not agglomerate. (shrink)

Must rational thinkers have consistent sets of beliefs? I shall argue that it can be rational for a thinker to believe a set of propositions known to be inconsistent. If this is right, an important test for a theory of rational belief is that it allows for the right kinds of inconsistency. One problem we face in trying to resolve disagreements about putative rational requirements is that parties to the disagreement might be working with different conceptions of the relevant attitudes. (...) My aim is modest. I hope to show that there is at least one important notion of belief such that a thinker might rationally hold a collection of beliefs (so understood) even when the thinker knows their contents entail a contradiction. (shrink)