Extracorporeal membrane oxygenation (ECMO) is currently reserved predominantly for bridging patients to a different destination therapy, but the use of ECMO as a destination therapy itself (ECMO-DT...

The COVID-19 pandemic has been unprecedented, in every sense of the word. At the time of writing, there have been nearly 80 million confirmed cases of coronavirus and nearly 2 million deaths worldw...

In many ways, Maddie’s case brings together some of the most challenging features seen in clinical ethics consultation. First, it centers around a heart-wrenching event—the near-drowning of a young...

An anthropocentric scope for clinical medical ethics (CME) has largely separated this area of bioethics from environmental concerns. In this article, we first identify and reconcile the ethical issues imposed on CME by climate change including the dispersion of related causes and effects, the transdisciplinary and transhuman nature of climate change, and the historic divorce of CME from the environment. We then establish how several moral theories undergirding modern CME, such as virtue ethics, feminist ethics, and several theories of justice, (...) promote both a flourishing of human medical practice and the environment. We conclude by defining an expanded the scope of CME as inclusive of not only patients, families, physicians, and other health professionals but other humans, non-humans, and their shared environment. We then apply this scope and theory to a widely used framework for applying CME, the Four Topics model, to construct a climate conscious approach to CME. (shrink)

There is societal consensus that cancer clinical trial participation is unjust because some sociodemographic groups have been systematically underrepresented. Despite this, neither a definition nor an ethical explication for the justice norm of equity has been clearly articulated in this setting, leading to confusion over its application and goals. Herein we define equity as acknowledging sociodemographic circumstances and apportioning resource and opportunity allocation to eliminate disparities in outcomes, and we explore the issues and tensions this norm generates through practical examples. (...) We assess how equality-based enrollment structures in clinical cancer research have perpetuated historical disparities and what equity-based alternatives are necessary to achieve representativeness and an expansive conception of participatory justice in clinical cancer research. This framework addresses the breadth from normative to applied by defining the justice norm of equity and translating it into practical strategies for addressing participation disparities in clinical cancer research. (shrink)

: In this paper I offer some criticisms of Jonathan Dancy’s moral particularism. In Dancy’s version moral particularism states that there are neither general nor universal moral principles, that moral action is not the application of principles to particular cases, that moral reasoning has no motivational force because it deduces what must be done by moral principles, and that the agent who acts morally is not a person who has moral principles. However, Dancy’s proposal fails to explain the regularity (...) of moral behavior and the function of stability that moral agents and moral psychology play within social cooperation, nor is it able to explain the possibility of moral progress. Keywords: Jonathan Dancy; Moral Progress; Moral Psychology; Principles; Cooperation La mente morale particolarista Riassunto: In questo articolo espongo alcune critiche al particolarismo morale di Jonathan Dancy. Nella versione di Dancy il particolarismo morale afferma che non ci sono né principi morali generali né universali, che l’azione morale non è l’applicazione di principi a casi particolari, che il ragionamento morale non ha forza motivazionale perché deduce ciò che deve essere fatto dai principi morali, e che l’agente che agisce moralmente non è una persona che ha principi morali. Tuttavia, la proposta di Dancy non riesce a spiegare la regolarità del comportamento morale e la funzione di stabilità che gli agenti morali e la psicologia morale svolgono all’interno della cooperazione sociale, né è in grado di spiegare la possibilità del progresso morale. Parole chiave: Jonathan Dancy; Progresso morale; Psicologia morale; Principi; Cooperazione. (shrink)

Originally published in 1982, this was an extensive and up-to-date review of research into the psychology of deductive reasoning, Jonathan Evans presents an alternative theoretical framework to the rationalist approach which had dominated much of the published work in this field at the time. The review falls into three sections. The first is concerned with elementary reasoning tasks, in which response latency is the prime measure of interest. The second and third sections are concerned with syllogistic and propositional reasoning (...) respectively, in which interest has focused on the explanation of frequently observed logical errors. In an extended discussion it is argued that reasoning processes are content specific, and give little indication of the operation of any underlying system of logical competence. Finally, a dual process theory of reasoning, with broad implications and connections with other fields of psychology, is elaborated and assessed in the light of recent evidence. (shrink)

Personal autonomy is often lauded as a key value in contemporary Western bioethics. Though the claim that there is an important relationship between autonomy and rationality is often treated as uncontroversial in this sphere, there is also considerable disagreement about how we should cash out the relationship. In particular, it is unclear whether a rationalist view of autonomy can be compatible with legal judgments that enshrine a patient's right to refuse medical treatment, regardless of whether the reasons underpinning the choice (...) are known and rational, or indeed whether they even exist. Jonathan Pugh brings recent philosophical work on the nature of rationality to bear on the question of how we should understand personal autonomy in contemporary bioethics. In doing so, he develops a new framework for thinking about the concept of autonomy, one that is grounded in an understanding of the different roles that rational beliefs and rational desires have to play in it. Pugh's account allows for a deeper understanding of d the relationship between our freedom to act and our capacity to decide autonomously. His rationalist perspective is contrasted with other prominent accounts of autonomy in bioethics, and the revisionary implications it has for practical questions in biomedicine are also outlined. (shrink)

This paper develops and defends a new account of B-theoretic endurantism and a new account of the metaphysics of the quantum state, and highlights the parallels between the considerations that motivate them. These new accounts are both fragmentalist, in the sense that they follow Fine (2005) in invoking a symmetric coordination relation between facts, such that facts that are pairwise incompatible (like Hugh's being happy and Hugh's being sad) can both obtain provided that they are not related by this relation. (...) However, while Fine allows that fragments can be logically incoherent— P can obtain in one fragment while not-P obtains in another—the fragmentalist accounts defended here are motivated even if we insist on logical coherence between fragments. (shrink)

A neurologist presents evidence for locating the unconscious--Freud's concept--within the actual physiology of the brain, in a study that explains current knowledge about perception, memory, sleep, dreams, and Freud's theory of the unconscious.

Task unrelated thought (TUT) refers to thought directed away from the current situation, for example a daydream. Three experiments were conducted on healthy participants, with two broad aims. First, to contrast distributed and encapsulated views of cognition by comparing the encoding of categorical and random lists of words (Experiments One and Two). Second, to examine the consequences of experiencing TUT during study on the subsequent retrieval of information (Experiments One, Two, and Three). Experiments One and Two demonstrated lower levels of (...) TUT and higher levels of word-fragment completion whilst encoding categorical relative to random stimuli, supporting the role of a distributed resource in the maintenance of TUT. In addition the results of all three experiments suggested that experiencing TUT during study had a measurable effect on subsequent retrieval. TUT was associated with increased frequency of false alarms at retrieval (Experiment One). In the subsequent experiments TUT was associated with no advantage to retrieval based on recollection, by manipulating instructions at encoding (Experiment Two), and/or at retrieval (Experiment Three). The implications of the results of all three experiments are discussed in terms of recent accounts of memory retrieval and conscious awareness. (shrink)

When is it morally permissible to engage in self-defense or the defense of others? Jonathan Quong gives an original philosophical account of the central moral principles that should regulate the use of defensive force. The morality of defensive force needs to be understood in the context of a more general account of justice and moral rights.

Enkratic reasoning—reasoning from believing that you ought to do something to an intention to do that thing—seems good. But there is a puzzle about how it could be. Good reasoning preserves correctness, other things equal. But enkratic reasoning does not preserve correctness. This is because what you ought to do depends on your epistemic position, but what it is correct to intend does not. In this paper, I motivate these claims and thus show that there is a puzzle. I then (...) argue that the best solution is to deny that correctness is always independent of your epistemic position. As I explain, a notable upshot is that a central epistemic norm directs us to believe, not simply what is true, but what we are in a position to know. (shrink)

'If' is one of the most important words in the English language, being used to express hypothetical thought. The use of conditional terms such as 'if' distinguishes human intelligence from that of all other animals. In this volume, Jonathan Evans and David Over present a new theoretical approach to understanding conditionals. The book draws on studies from the psychology of judgement and decision making, as well as philosophical logic.

Is the brain really a computer? In particular, is our intelligence a computational achievement: is it because our brains are computers that we get on in the world as well as we do? In this paper I will evaluate an ambitious new argument to the contrary, developed in Landgrebe and Smith (2021a, 2022). Landgrebe and Smith begin with the fact that many dynamical systems in the world are difficult or impossible to model accurately (inter alia, because it is intractable to (...) find exact solutions to the differential equations that describe them—meaning we have to approximate—but at the same time they are such that small differences in starting conditions lead to big differences in final conditions, thwarting accurate approximation). Yet we manage to survive and thrive in a world full of such systems. Landgrebe and Smith argue from these premises that it is not because our brains are computers that we get on as well as we do: instead it is because of the various ways that we dynamically couple with such systems, these couplings themselves impossible to model well enough to emulate in silico. Landgrebe and Smith thus defend a dynamical systems model in the lineage of Gibson (1979), Van Gelder (1995), and Thompson (2007), though their focus is on decisively refuting the computationalist alternatives rather than developing the positive account. Here I will defend the claim that human intelligence is genuinely computational (and that whole brain emulation and others forms of AGI may be possible) against this argument. (shrink)

Eighteenth-century theologian_Jonathan Edwards remains a significant influence on modern religion, and this book constitutes his most important contribution to Christian thought. Edwards_raises timeless questions about desire, choice, good, and evil, contrasting the opposing Calvinist and Arminian views of free will and addressing issues related to God's foreknowledge, determinism, and moral agency.

This book provides readers with an introduction to epistemology within the Buddhist intellectual tradition. It is designed to be accessible to those whose primary background is in the “Western” tradition of philosophy and who have little or no previous exposure to Buddhist philosophical writings. The book examines many of the most important topics in the field of epistemology, topics that are central both to contemporary discussions of epistemology and to the classical Buddhist tradition of epistemology in India and Tibet. Among (...) the topics discussed are Buddhist accounts of: the nature of knowledge episodes, the defining conditions of perceptual knowledge and of inferential knowledge, the status of testimonial knowledge, and skeptical criticisms of the entire project of epistemology. The book seeks to put the field of Buddhist epistemology in conversation with contemporary debates in philosophy. It shows that many of the arguments and debates occurring within classical Buddhist epistemological treatises coincide with the arguments and disagreements found in contemporary epistemology. The book shows, for example, how Buddhist epistemologists developed an anti-luck epistemology—one that is linked to a sensitivity requirement for knowledge. Likewise, the book explores the question of how the study of Buddhist epistemology can be of relevance to contemporary debates about the value of contributions from experimental epistemology, and to broader debates concerning the use of philosophical intuitions about knowledge. (shrink)

Embodied cognition has attracted significant attention within cognitive science and related fields in recent years. It is most noteworthy for its emphasis on the inextricable connection between mental functioning and embodied activity and thus for its departure from standard cognitive science's implicit commitment to the unembodied mind. This article offers a review of embodied cognition's recent empirical and theoretical contributions and suggests how this movement has moved beyond standard cognitive science. The article then clarifies important respects in which embodied cognition (...) has not departed fundamentally from the standard view. A shared commitment to representationalism, and ultimately, mechanism, suggest that the standard and embodied cognition movements are more closely related than is commonly acknowledged. Arguments against representationalism and mechanism are reviewed and an alternative position that does not entail these conceptual undergirdings is offered. (shrink)

The practice of appealing to esoteric intuitions, long standard in analytic philosophy, has recently fallen on hard times. Various recent empirical results have suggested that philosophers are not currently able to distinguish good intuitions from bad. This paper evaluates one possible type of approach to this problematic methodological situation: calibration. Both critiquing and building on an argument from Robert Cummins, the paper explores what possible avenues may exist for the calibration of philosophical intuitions. It is argued that no good options (...) are currently available, but leaves open the real possibility of such a calibration in the future. (shrink)

Contemporary political theory has made the question of the “people” a topic of sustained analysis. This article identifies two broad approaches taken—norm-based and contestation-based—and, noting some problems left outstanding, goes on to advance a complementary account centred on partisan practice. It suggests the definition of “the people” is closely bound up in the analysis of political conflict, and that partisans engaged in such conflict play an essential role in constructing and contesting different principled conceptions. The article goes on to show (...) how such an account does not lead to a normatively hollow, purely historical conception of “the people,” but rather highlights the normative importance of practices that, at the minimum, de-naturalise undesirable conceptions of the people and, at their best, give political legitimacy and a representative basis to those one might wish to see prosper. (shrink)

This paper articulates a new understanding of Sartre’s philosophical methodology in his early publications up to and including Being and Nothingness. Through his critique of Husserl across these works, Sartre develops an original and sophisticated variety of transcendental phenomenology. He was attracted to Husserl’s philosophy for its promise to establish the foundations of empirical psychology but ultimately concluded that it could not fulfil this promise. Through the analyses that led him to this conclusion, Sartre formulated a new kind of phenomenological (...) reduction and a distinctive kind of transcendental argument to draw conclusions about mind-independent reality from phenomenological premises. His aims were to dissolve the traditional distinction between mind and world, to establish that the mind is accessible to empirical study, and to formulate the conceptual framework required to study the mind systematically. Sartre’s philosophy of psychology, therefore, drove the philosophical development of the methodological foundation of his philosophical project. (shrink)

A number of recent accounts of our first-person knowledge of our attitudes give a central role to transparency - our capacity to answer the question of whether we have an attitude by answering the question of whether to have it. In this paper I raise a problem for such accounts, by showing that there are clear cases of first-person knowledge of attitudes which are not transparent.

This article offers a brief synopsis of some of the main claims from The Morality of Defensive Force, and replies to the symposium contributions of Lars Christie, Lisa Hecht, and Jonathan Parry.

Imagine that the person you see through the looking glass is a real person, with her own experiences, living in an environment that is the mirror-reverse of yours. You look at your right-hand glove as you put it on your right hand; she looks at her left-hand glove as she puts it on her left hand. You feel your heart beating on your left side; she feels her heart beating on her right side. You hear a bird chirping out the (...) window to your left; she hears a bird chirping out the window to her right. Is there any difference between your experience—your what-it-is-like phenomenal character—and hers? She is looking at her left-hand glove, the mirror-reverse of you as you look at your right-hand glove. Does she see what you see, a right-hand glove, or the reverse of what you see, a left-hand glove? Since her environment is the mirror-reverse of yours, and she seems to get by in it just fine, you'd probably assume, if you had to guess, that she sees it correctly. She is looking at her left-hand glove, after all. So it stands to reason that she is having an experience as of a left-hand glove, not a right-hand glove. And it stands to reason—it seems obvious—that an experience as of a left-hand glove differs in what it is like from an experience as of a right-hand glove. In this paper, I will argue that this last presupposition, obvious though it may seem, is false. I'll argue that (unless dualism is true) there is no intrinsic difference between what it is like to experience a left-hand glove and what it is like to experience a right-hand glove: if there are any relevant experiential differences, these are either merely comparative (differences in what it is like to compare gloves) or cognitive (differences in what it is like to bring an experience of a glove under a concept like LEFT or RIGHT). So your mirror-reverse twin, who won't differ from you in what she is comparing or thinking, will have the same (type of) experience as you. I'll call the position I am arguing against orientation–experience categoricalism, and the position I am arguing for orientation–experience relationism. Orientation–experience relationism is a surprising thesis, one whose falsity you might take for granted. I will argue for it by cases. Things go wrong for the orientation–experience categoricalist in one sort of way if we imagine that you and your mirror-twin's experiences differ: basically, this leads to absurdity if we imagine that you and she both live at a world with a non-orientable spatial topology (in the sense in which a Möbius strip or Klein bottle are non-orientable). Things go wrong for the orientation–experience categoricalist in a different sort of way if we assume that you and your twin would experience the same, but that someone else might have the experience that we were just imagining that your twin might have. Under these assumptions, we have to accept the existence of partial zombies, who lack the relevant phenomenology but behave as if they have it, at very close, empirically possible worlds. In an appendix, I argue that property dualism is the best alternative for those who cannot bring themselves to accept orientation-experience relationism. (shrink)

Hierarchy is a difficulty for theories of equality, and especially those that define equality in relational or social terms. In ideal egalitarian circumstances it seems that hierarchies should not exist. However, a liberal egalitarian defence of some types of hierarchies is common. Hierarchies of esteem have no further consequences than praise or admiration for valued individual features. Hierarchies of status, with differential reward, can, it is often argued, also be justified when they serve a justified social purpose and meet conditions (...) of genuine equality of opportunity. However, group hierarchies remain problematic, and evidence suggests that they are pervasive in human societies above a subsistence level of production. It has also been argued that group hierarchies are impossible to eliminate, and enormous cost is associated with attempting, and failing, to remove them. However, the perspective of ‘real-world’ political philosophy suggests measures to mitigate group hierarchy, starting with those that are either the easiest to address, the most damaging, or the most consequential. (shrink)

The Snowden leaks, first published in June 2013, provided unprecedented insights into the operations of state-corporate surveillance, highlighting the extent to which everyday communication is integrated into an extensive regime of control that relies on the ‘datafication’ of social life. Whilst such data-driven forms of governance have significant implications for citizenship and society, resistance to surveillance in the wake of the Snowden leaks has predominantly centred on techno-legal responses relating to the development and use of encryption and policy advocacy around (...) privacy and data protection. Based on in-depth interviews with a range of social justice activists, we argue that there is a significant level of ambiguity around this kind of anti-surveillance resistance in relation to broader activist practices, and critical responses to the Snowden leaks have been confined within particular expert communities. Introducing the notion of ‘data justice’, we therefore go on to make the case that resistance to surveillance needs to be conceptualized on terms that can address the implications of this data-driven form of governance in relation to broader social justice agendas. Such an approach is needed, we suggest, in light of a shift to surveillance capitalism in which the collection, use and analysis of our data increasingly comes to shape the opportunities and possibilities available to us and the kind of society we live in. (shrink)

This book explores the contributions to the philosophy of mind made by the Tibetan Buddhist thinker Phya pa Chos kyi seng ge (1109–1169) in his seminal text, the “Dispeller of the Mind’s Darkness.” This study, which includes a critical edition and English translation of those portions of the “Dispeller” devoted to explicating the nature of mental episodes and their objects, contributes to a deeper understanding of Tibetan intellectual history, while also facilitating a wider appreciation of both Phya pa’s theory of (...) mind and its significance within the global history of philosophy. (shrink)

Walter Sinnott-Armstrong has argued against moral intuitionism, according to which some of our moral beliefs are justified without needing to be inferred from any other beliefs. He claims that any prima facie justification some non-inferred moral beliefs might have enjoyed is removed because many of our moral beliefs are formed in circumstances where either (1) we are partial, (2) others disagree with us and there is no reason to prefer our moral judgement to theirs, (3) we are emotional in a (...) way that clouds our judgement, (4) the circumstances are conducive to illusion, or (5) the source of our moral beliefs is unreliable or disreputable. I take issue with the elements of Sinnott-Armstrong’s argument that centre on (1) to (3) and (5), concluding that his case against moral intuitionism is unpersuasive. (shrink)

Abstract:This article presents a case study in the complex of pressures and attitudes that shaped the professional lives and intellectual legacies of twentieth-century American philosophers, examining the writings and careers of two of the discipline's pioneering women: Ruth Barcan Marcus and Marjorie Glicksman Grene. As members of the small cohort of women trained in philosophy during the first half of the century who achieved permanent academic appointments, their stories illuminate the salience of gender within the professional world of mid-twentieth century (...) American academia. (shrink)

Solar radiation management (SRM) has been proposed as a means of mitigating climate change. Although SRM poses new risks, it is sometimes proposed as the ‘lesser evil’. I consider how research and implementation of SRM could be regulated, drawing on what I call a ‘precautionary checklist’, which includes consideration of the longer term political implications of technical change. Particular attention is given to the moral hazard of ‘regulatory drift’, in which strong initial regulation softens through complacency, deliberate deregulation (‘regulatory gift’) (...) and the limited constituency of people with the skills to regulate (‘thin markets’). I propose the strengthening of civil society groups to keep regulators in check. (shrink)

Debates in fields studying the biological aspects of aging and longevity, such as biogerontology, are often split between ‘anti-aging’ approaches aimed largely at treating diseases and those focusing more on maintaining, promoting, and even enhancing health. However, it is far from clear what this ‘health’ is that would be maintained, promoted, or enhanced. Interestingly, what few have yet to fully reflect on is that there is still no theory of health within the health or aging sciences that would provide an (...) integrative explanatory framework akin to other scientific theories. After clarifying why such a theory could be useful, I discuss five general features of medical theories that could be used to evaluate the utility of a given proposal. With these features in hand, I suggest that philosophers and scientists work together on analyzing actual medical research (experimental analysis), and the ways in which a theoretical construct of ‘health’ is being progressively identified and measured therein. I conclude by suggesting that research fields studying stress and aging might be particularly helpful in developing candidates for theory construction due to their broad scope, increasing specificity, and potential for providing integrative explanations. (shrink)

The paradox of pain is that pain is in some ways like a bodily state and in other ways like a mental state. You can have a pain in your shin, but there is no denying that you are in pain if it feels like you are. How can a state be both in your shin and in your mind? Evaluativism is a promising answer. According to evaluativism, an experience of pain in your shin represents that there is a disturbance (...) in your shin, and that it is bad that this disturbance is there. Thus, the experience brings you to tend to your shin by telling you something about the state of your shin. But the paradox of pain still confronts evaluativism in the form of the killing the messenger objection: The evaluativist has a nice story about our body‐directed responses to pain, like tending to wounds, but this story does not explain responses to pain, like taking painkillers, that seem to be experience‐directed. Evaluativists have offered accounts of experience‐directed responses to pain, but I will argue that these accounts conflict with the Transparency thesis—the claim that we can only access our experiences inferentially. Evaluativism and Transparency are natural bedfellows, so this is a problem for evaluativists. Having argued as much, I will go on to develop a new evaluativist account of taking painkillers, which does not conflict with Transparency. I call it naïve evaluativism. According to naïve evaluativism, we experience painkillers as making tissue damage or disruption less bad, and absent further reflection, that is, why we take them. (shrink)

Moral injury results from the violation of deeply held moral commitments leading to emotional and existential distress. The phenomenon was initially described by psychologists and psychiatrists associated with the US Departments of Defense and Veterans Affairs but has since been applied more broadly. Although its application to healthcare preceded COVID-19, healthcare professionals have taken greater interest in moral injury since the pandemic’s advent. They have much to learn from combat veterans, who have substantial experience in identifying and addressing moral injury—particularly (...) its social dimensions. Veterans recognise that complex social factors lead to moral injury, and therefore a community approach is necessary for healing. We argue that similar attention must be given in healthcare, where a team-oriented and multidimensional approach is essential both for ameliorating the suffering faced by health professionals and for addressing the underlying causes that give rise to moral injury. (shrink)

This Routledge Philosophy GuideBook introduces John Stuart Mill and one of his major works, On Liberty. We see that in On Liberty Mill outlines the importance of moral rights, respect for rule of law, and individuality. Written with students in mind, Jonathan Riley gracefully eases the reader into Mill's work, life, and philosophy. An ideal read for those coming to Mill for the first time, and for anyone with an interest in political philosophy.