The IHME Covid-19 prediction model has been one of the most influential Covid models in the United States. Early on, it received heavy criticism for understating the extent of the epidemic. I argue that this criticism was based on a misunderstanding of the model. The model was best interpreted not as attempting to forecast the actual course of the epidemic. Rather, it was attempting to make a conditional projection: telling us how the epidemic would unfold, given certain assumptions. This misunderstanding (...) of the IHME’s model prevented the public from seeing how dire the model’s projections actually were. (shrink)

There is a growing consensus among philosophers of science that core parts of the scientific process involve non-epistemic values. This undermines the traditional foundation for public trust in science. In this article I consider two proposals for justifying public trust in value-laden science. According to the first, scientists can promote trust by being transparent about their value choices. On the second, trust requires that the values of a scientist align with the values of an individual member of the public. I (...) argue that neither of these proposals work and suggest an alternative that does better. When scientists must appeal to values in the course of their research, they should appeal to democratic values: the values of the public or its representatives. (shrink)

Summary measures of health, such as the quality-adjusted life year and disability-adjusted life year, have long been known to incorporate a number of value choices. In this paper, though, I show that the value choices in the construction of such measures extend far beyond what is generally recognized. In showing this, I hope both to improve the understanding of those measures by epidemiologists, health economists and policy-makers, and also to contribute to the general debate about the extent to which such (...) measures should be adjusted to reflect ethical values. (shrink)

Philosophers of science now broadly agree that doing good science involves making non-epistemic value judgments. I call attention to two very different normative standards which can be used to evaluate such judgments: standards grounded in ethics and standards grounded in political philosophy. Though this distinction has not previously been highlighted, I show that the values in science literature contain arguments of each type. I conclude by explaining why this distinction is important. Seeking to determine whether some value-laden determination meets substantive (...) ethical standards is a very different endeavor from seeking to determine if it is politically legitimate. (shrink)

What makes science trustworthy to the public? This chapter examines one proposed answer: the trustworthiness of science is based at least in part on its independence from the idiosyncratic values, interests, and ideas of individual scientists. That is, science is trustworthy to the extent that following the scientific process would result in the same conclusions, regardless of the particular scientists involved. We analyze this "idiosyncrasy-free ideal" for science by looking at philosophical debates about inductive risk, focusing on two recent proposals (...) which offer different methods of avoiding idiosyncrasy: the high epistemic standards proposal and the democratic values proposal. (shrink)

Much academic work (in philosophy, economics, law, etc.), as well as common sense, assumes that ill health reduces well-being. It is bad for a person to become sick, injured, disabled, etc. Empirical research, however, shows that people living with health problems report surprisingly high levels of well-being - in some cases as high as the self-reported well-being of healthy people. In this chapter, I explore the relationship between health and well-being. I argue that although we have good reason to believe (...) that health problems causing pain and death typically do reduce well-being, health problems that limit capabilities probably don't reduce well-being nearly as much as most people suppose. I then briefly explore the consequences of this conclusion for political philosophy and ethics. If many health problems don't significantly reduce well-being, why should governments go to great expense to prevent or treat them? Why should parents be obliged to ensure the health of their children? (shrink)

Mainstream views of medical research tell us it should be a fact-based, value-free endeavor: what a scientist (or her funding source) wants or cares about should not influence her findings. At the same time, we also sometimes criticize medical research for failing to embody certain values, e.g. when we criticize pharmaceutical companies for largely ignoring the diseases that affect the global poor. This chapter seeks to reconcile these perspectives by distinguishing appropriate from inappropriate influences of values on medical research. It (...) divides this broad question into two narrower ones, the Role Question (at what points in the research process is value influence potentially acceptable?) and the Content Question (when value influence is potentially acceptable, what specific values should researchers use?), and then draws on the philosophical literature on values in science to explore answers to each of them. (shrink)

Theorists of health have, to this point, focused exclusively on trying to define a state—health—that an organism might be in. I argue that they have overlooked the possibility of a comparativist theory of health, which would begin by defining a relation—healthier than—that holds between two organisms or two possible states of the same organism. I show that a comparativist approach to health has a number of attractive features, and has important implications for philosophers of medicine, bioethicists, health economists, and policy (...) makers. (shrink)

Scientists are frequently called upon to “democratize” science, by bringing the public into scientific research. One appealing point for public involvement concerns the nonepistemic values involved in science. Suppose, though, a scientist invites the public to participate in making such value-laden determinations but finds that the public holds values the scientist considers morally unacceptable. Does the argument for democratizing science commit the scientist to accepting the public’s objectionable values, or may she veto them? I argue that there are a limited (...) set of cases in which scientists can, consistently with a commitment to democratized science, set aside the public’s judgments. (shrink)

Scientists have the ability to influence policy in important ways through how they present their results. Surprisingly, existing codes of scientific ethics have little to say about such choices. I propose that we can arrive at a set of ethical guidelines to govern scientists’ presentation of information to policymakers by looking to bioethics: roughly, just as a clinician should aim to promote informed decision-making by patients, a scientist should aim to promote informed decision-making by policymakers. Though this may sound like (...) a natural proposal, I show it offers guidance that conflicts with standard scientific practices. I conclude by considering one cost of the proposal: that it would prevent scientists from acting as advocates in a way that is currently common in certain fields. I accept that the proposal would restrict scientists’ political advocacy rights, but argue that the benefits of adopting it — promoting democratic governance — justify the restriction. (shrink)

I look at the two main approaches used to count COVID-19 deaths and show how each of those approaches can appear to both overcount COVID deaths (including deaths it should exclude) and undercount COVID deaths (excluding deaths it should include). I trace this to the fact - well-known to philosophers - that causal attribution is interest-relative. Which deaths we should attribute to COVID (as opposed to other causes) will depend on our particular interests and values. Contrary to what many journalists (...) and researchers report, there is therefore no such thing as the "true" COVID death toll. Understanding this can help us to become more sophisticated consumers of COVID information. I conclude by suggesting that scientists, by reflecting on society's varied interests and values, are in a position to construct measures of COVID-caused mortality that are potentially as useful, or more useful, than the measures we currently have. (shrink)

Many economic measures are structured to reflect ethical values. I describe three attitudes towards this: maximalism, according to which we should aim to build all relevant values into measures; minimalism, according to which we should aim to keep values out of measures; and an intermediate view. I argue the intermediate view is likely correct, but existing versions are inadequate. In particular, economists have strong reason to structure measures to reflect fixed, as opposed to user-assessable, values. This implies that, despite disagreement (...) about precisely how to do so, economists should standardly adjust QALYs and DALYs to reflect egalitarian values. (shrink)

Recently, a number of philosophers have argued that we can and should “consequentialize” non-consequentialist moral theories, putting them into a consequentialist framework. I argue that these philosophers, usually treated as a group, in fact offer three separate arguments, two of which are incompatible. I show that none represent significant threats to a committed non-consequentialist, and that the literature has suffered due to a failure to distinguish these arguments. I conclude by showing that the failure of the consequentializers’ arguments has implications (...) for disciplines, such as economics, logic, decision theory, and linguistics, which sometimes use a consequentialist structure to represent non-consequentialist ethical theories. (shrink)

There is virtually no philosophical consensus on what, exactly, imperfect duties are. In this paper, I lay out three criteria which I argue any adequate account of imperfect duties should satisfy. Using beneficence as a leading example, I suggest that existing accounts of imperfect duties will have trouble meeting those criteria. I then propose a new approach: thinking of imperfect duties as duties held by groups, rather than individuals. I show, again using the example of beneficence, that this proposal can (...) satisfy the criteria, explaining how something can both have the necessity characteristic of duty, while also allowing agents the latitude which seems to attach to imperfect duties. (shrink)

Define teleology as the view that requirements hold in virtue of facts about value or goodness. Teleological views are quite popular, and in fact some philosophers (e.g. Dreier, Smith) argue that all (plausible) moral theories can be understood teleologically. I argue, however, that certain well-known cases show that the teleologist must at minimum assume that there are certain facts that an agent ought to know, and that this means that requirements can't, in general, hold in virtue of facts about value (...) or goodness. I then show that even if we grant those 'ought's teleology still runs into problems. A positive justification of teleology looks like it will require an argument of this form: O(X); if X, then O(Y); therefore O(Y). But this form of argument isn't in general valid. I conclude by offering two positive suggestions for those attracted to a teleological outlook. (shrink)

[OPEN ACCESS] Commentaries on the ethics of Covid lockdowns nearly all focus on offering substantive guidance to policy‐makers. Lockdowns, however, raise many ethical questions that admit of a range of reasonable answers. In such cases, policy‐making in a liberal democracy ought to be sensitive to which reasonable views the public actually holds—a topic existing bioethical work on lockdowns has not explored in detail. In this essay, I identify several important questions connected to the kind of influence the public ought to (...) have on lockdown decision‐making, including how policy‐makers ought to handle misinformed or morally suspect viewpoints, and how policy‐makers ought to respond to minority viewpoints. I argue that questions like this, concerning the appropriate influence of the public on decision‐making, will be central to the field of bioethics as it increasingly focuses on policy and population‐level issues and therefore ought to be priorities for future work. (shrink)

I compare two different arguments for the importance of bringing new voices into science: arguments for increasing the representation of women, and arguments for the inclusion of the public, or for “citizen science”. I suggest that in each case, diversifying science can improve the quality of scientific results in three distinct ways: epistemically, ethically, and politically. In the first two respects, the mechanisms are essentially the same. In the third respect, the mechanisms are importantly different. Though this might appear to (...) suggest a broad similarity between the cases, I show that the analysis reveals an important respect in which efforts to include the public are more complex. With citizen science programs, unlike with efforts to bring more women into science, the three types of improvement are often in conflict with one another: improvements along one dimension may come at a cost on another dimension, suggesting difficult trade-offs may need to be made. (shrink)

In their insightful article, ‘The Disvalue of Death in the Global Burden of Disease’, Solberg et al argue that there is a potential incoherence in the way disability-adjusted life years are calculated. Morbidity is measured in years lived with disability in a way quite unlike the way mortality is measured in years of life lost. This potentially renders them incommensurable, like apples and oranges, and makes their aggregate—DALYs—conceptually unsound. The authors say that it is ‘vital’ to address this problem, that (...) ‘[n]eglecting [it] is not an option’, and that ‘one cannot add YLLs and YLDs together in [their] current form’.1 Though one might object to their argument in various ways, let us assume the authors are correct that there is a potential inconsistency here. I want to ask why we should be troubled by that. Now, this question may scarcely seem worth asking. Consistency and coherence are regarded as non-negotiable in so many domains that of course we should demand them in a measure such as the DALY. And this desire for coherence is clearly shared by both the architects of the DALY and their critics.2 3 I think, though, that things are more complicated. In 2012, I wrote an article discussing the epidemiological perspective from which DALYs should be calculated.4 Simplifying greatly, here is the problem: both YLDs and YLLs can be calculated either from prevalence data or from incidence data. The most natural way to calculate YLDs bases them on prevalences, because when we think about morbidity our initial thought is of people who are suffering. The most natural way to calculate YLLs bases them on an incidence measure, because when …. (shrink)

When disability-adjusted life years are used to measure the burden of disease on a population in a time interval, they can be calculated in several different ways: from an incidence, pure prevalence, or hybrid perspective. I show that these calculation methods are not equivalent and discuss some of the formal difficulties each method faces. I show that if we don’t discount the value of future health, there is a sense in which the choice of calculation method is a mere question (...) of accounting. Such questions can be important, but they don’t raise deep theoretical concerns. If we do discount, however, choice of calculation method can change the relative burden attributed to different conditions over time. I conclude by recommending that studies involving disability-adjusted life years be explicit in noting what calculation method is being employed and in explaining why that calculation method has been chosen. (shrink)

In social cognition, knowledge-based validation of information is usually regarded as relying on strategic and resource-demanding processes. Research on language comprehension, in contrast, suggests that validation processes are involved in the construction of a referential representation of the communicated information. This view implies that individuals can use their knowledge to validate incoming information in a routine and efficient manner. Consistent with this idea, Experiments 1 and 2 demonstrated that individuals are able to reject false assertions efficiently when they have validity-relevant (...) beliefs. Validation processes were carried out routinely even when individuals were put under additional cognitive load during comprehension. Experiment 3 demonstrated that the rejection of false information occurs automatically and interferes with affirmative responses in a nonsemantic task. Experiment 4 also revealed complementary interference effects of true information with negative responses in a nonsemantic task. These results suggest the existence of fast and efficient validation processes that protect mental representations from being contaminated by false and inaccurate information. (shrink)

In the Book of Common Prayer’s Rite II version of the Eucharist, the congregation confesses, “we have sinned against you in thought, word, and deed”. According to this confession we wrong God not just by what we do and what we say, but also by what we think. The idea that we can wrong someone not just by what we do, but by what think or what we believe, is a natural one. It is the kind of wrong we feel (...) when those we love believe the worst about us. And it is one of the salient wrongs of racism and sexism. Yet it is puzzling to many philosophers how we could wrong one another by virtue of what we believe about them. This paper defends the idea that we can morally wrong one another by what we believe about them from two such puzzles. The first puzzle concerns whether we have the right sort of control over our beliefs for them to be subject to moral evaluation. And the second concerns whether moral wrongs would come into conflict with the distinctively epistemic standards that govern belief. Our answer to both puzzles is that the distinctively epistemic standards governing belief are not independent of moral considerations. This account of moral encroachment explains how epistemic norms governing belief are sensitive to the moral requirements governing belief. (shrink)

In the 1960s, Peter Geach and John Searle independently posed an important objection to the wide class of 'noncognitivist' metaethical views that had at that time been dominant and widely defended for a quarter of a century. The problems raised by that objection have come to be known in the literature as the Frege-Geach Problem, because of Geach's attribution of the objection to Frege's distinction between content and assertoric force, and the problem has since occupied a great deal of the (...) attention both of defenders of broadly noncognitivist views, and of their critics. In this article I explain Geach and Searle's historical objections, and put the subsequent discussion into dialectical context, paying some attention to the developments along the way and how they have enhanced our overall understanding of the problem. The article covers a lot of territory, so we will only be able to see the highlights, along the way. For further reading, see the Works Cited. (shrink)

This chapter suggests that descriptive epidemiological studies like the Global Burden of Disease Study can usefully be divided into four tasks: describing individuals’ health states over time, assessing their health states under a range of counterfactual scenarios, summarizing the information collected, and then packaging it for presentation. The authors show that each of these tasks raises important and challenging ethical questions. They comment on some of the philosophical issues involved in measuring health states, attributing causes to health outcomes, choosing the (...) counterfactual against which to assess causes, aggregating and summarizing complex information across multiple domains, discounting, age-weighting, handling fetal deaths, measuring health inequalities, representing uncertainty, and assessing personal responsibility for health outcomes. (shrink)

Expressivists have a problem with negation. The problem is that they have not, to date, been able to explain why ‘murdering is wrong’ and ‘murdering is not wrong’ are inconsistent sentences. In this paper, I explain the nature of the problem, and why the best efforts of Gibbard, Dreier, and Horgan and Timmons don’t solve it. Then I show how to diagnose where the problem comes from, and consequently how it is possible for expressivists to solve it. Expressivists should accept (...) this solution, I argue, because it is demonstrably the only way of avoiding the problem, and because it generalizes. Once we see how to solve the negation problem, I show, it becomes easy to state a constructive, compositional expressivist semantics for a purely normative language with the expressive power of propositional logic, in which we can for the first time give explanatory, formally adequate expressivist accounts of logical inconsistency, logical entailment, and logical validity. As a corollary, I give what I take to be the first real expressivist explanation of why Geach’s original moral modus ponens argument is genuinely logically valid. This proves that the problem with expressivism cannot be that it can’t account for the logical properties of complex normative sentences. But it does not show that the same solution can work for a language with both normative and descriptive predicates, let alone that expressivists are able to deal with more complex linguistic constructions like tense, modals, or even quantifiers. In the final section, I show what kind of constraints the solution offered here would place expressivists under, in answering these further questions. (shrink)

The intentionalist about consciousness holds that the qualitative character of experience, “what it’s like,” is determined by the contents of a select group of special intentional states of the subject. Fred Dretske (1995), Mike Thau (2002), Michael Tye (1995) and many others have embraced intentionalism, but these philosophers have not generally appreciated that, since we are intimately familiar with the qualitative character of experience, we thereby have special access to the nature of these contents. In this paper, we take advantage (...) of this fact to show that intentionalism is incompatible with the idea that these contents are singular or general propositions, and thus that intentionalism is incompatible with one dominant trend in thinking about contents in general. In particular, there appear to be insoluble difficulties in explaining how the phenomenology of place and time can be explained by any intentionalist theory appealing to singular or general propositions. (shrink)

Benefit sharing has been a recurrent theme in international debates for the past two decades. However, despite its prominence in law, medical ethics and political philosophy, the concept has never been satisfactorily defined. In this conceptual paper, a definition that combines current legal guidelines with input from ethics debates is developed. Philosophers like boxes; protective casings into which they can put concisely-defined concepts. Autonomy is the human capacity for self-determination; beneficence denotes the virtue of good deeds, coercion is the intentional (...) threat of harm and so on. What about benefit sharing? Does the concept have a box and are the contents clearly defined? The answer to this question has to be no. The concept of benefit sharing is almost unique in that various disciplines use it regularly without precise definitions. In this article, a definition for benefit sharing is provided, to eliminate unnecessary ambiguity. (shrink)

Expressivism’s central idea is that normative sentences bear the same relation to non-cognitive attitudes that ordinary descriptive sentences bear to beliefs: the expression relation. Allan Gibbard teIls us that “that words express judgments will be accepted by almost everyone” - the distinctive contribution of expressivism, his claim goes, is only a view about what kind of judgments words express. But not every account of the expression relation is equally suitable for the expressivist’s purposes. In fact, what I argue in this (...) paper, considering four possible accounts of expression, is that how suitable each account is for the expressivist’s purpose varies in proportion to how controversial it is. So Gibbard is wrong - if expression is to get expressivism off the ground, then it will be enormously controversial whether words do express judgments. And thus expressivism is committed to strong claims about the semantics of non-normative language. (shrink)

Wittgenstein shows that understanding is a capacity, and cannot be accounted for by mental representations of what is understood. But if a person’s understanding or thinking cannot be accounted for by occurrences of mental representations, then understanding that person cannot be a matter of knowing what is going on inside him or her: what representations he or she has in his or her mind. That, I argue, is the point of Wittgenstein’s famous and frequently misunderstood saying, “If a lion could (...) talk we wouldn’t be able to understand it.” Our inability to understand a strange creature would not be overcome if that creature could speak and lay open to us on the mental operations inside its mind. Finally, I explain in what way understanding other people is not an entirely intellectual affair, but also has moral and aesthetic dimensions. -/- . (shrink)

Moral theories usually aspire to be explanatory – to tell us why something is wrong, why it is good, or why you ought to do it. So it is worth knowing how moral explanations differ, if they do, from explanations of other things. This paper uncovers a common unarticulated theory about how normative explanations must work – that they must follow what I call the Standard Model. Though the Standard Model Theory has many implications, in this paper I focus primarily (...) on only one. It plays a crucial role in an argument originally due to Cudworth that has been widely held to conclusively establish that voluntaristic ethical theories are incoherent. But if Cudworth’s argument works, then so would similar arguments against many other moral theories. All of these theories therefore need a different model for how normative explanations can work. So I also motivate and sketch one such alternative model. The result enables us to make progress in evaluating the prospects for a successful reductive view about the normative. (shrink)

This article considers how we should frame the ethical issues raised by current proposals for large-scale genebanks with on-going links to medical and lifestyle data, such as the Wellcome Trust and Medical Research Council's 'UK Biobank'. As recent scandals such as Alder Hey have emphasised, there are complex issues concerning the informed consent of donors that need to be carefully considered. However, we believe that a preoccupation with informed consent obscures important questions about the purposes to which such collections are (...) put, not least that they may be only haphazardly used for research —an end that would not fairly reflect the original altruistic motivation of donors, and the trust they must invest. We therefore argue that custodians of such databases take on a weighty pro-active duty, to encourage public debate about the ends of such collections and to sponsor research that reflects publicly agreed priorities and provides public benefits. (shrink)

We sometimes wonder how health is distributed in our society. We may also want to know about the efficiency of different health programmes. Which public measures promise the greatest overall improvements in health? It can be hard to know how to go about answering questions like these, in large part because the varieties of ill health are heterogeneous, as are their consequences. The solution that health economists have long adopted is to appeal to summary or generic measures of health, such (...) as the QALY, which attempt to put all types of ill health on the same scale. Daniel Hausman works from the assumption that we have reason to want a scalar measure like the QALY. He subjects existing techniques for generating such measures to a thorough critique, ultimately concluding that significant methodological changes are needed. (shrink)

This paper deals with Popper's little-known work on deductive logic, published between 1947 and 1949. According to his theory of deductive inference, the meaning of logical signs is determined by certain rules derived from ?inferential definitions? of those signs. Although strong arguments have been presented against Popper's claims (e.g. by Curry, Kleene, Lejewski and McKinsey), his theory can be reconstructed when it is viewed primarily as an attempt to demarcate logical from non-logical constants rather than as a semantic foundation for (...) logic. A criterion of logicality is obtained which is based on conjunction, implication and universal quantification as fundamental logical operations. (shrink)

This is a rough draft of a critical notice of Sergio Tenenbaum’s book, Appearances of the Good, for Social Theory and Practice.

We address the relationship between a music performer and her instrument as a possible model for re-thinking wearable technologies. Both musical instruments and textiles invite participation and by engaging with them we intuitively develop a sense of their malleability, resistance and fragility. In the action of touching we not only sense, but more importantly we react. We adjust the nature of our touch according to a particular material’s property. In this paper we draw on musical practice as it suggests attitudes (...) of specificity rather than adaptability. This practice exposes the design of generalised multi-use devices, such as the all-in-one electronic organ, as rooted in utilitarian thinking. We argue that this tendency ignores the complexities of musical cultures and thus fails to provide technologies, which provoke creative action rather than aim for the promise of control and efficiency. (shrink)

On September 28, 2002, 11-year-old Jakob von Metzler, a banker's son, was abducted on the way to his parents' house in Frankfurt. A sum of one million Euro was demanded for his release. Three days after Jakob's disappearance, Magnus Gäfgen, a 32-year-old law student, collected the ransom from the arranged tram stop in Frankfurt during the night. While under observation by the police, he ordered a new Mercedes and booked a holiday abroad. Seventy-six hours after Jakob's disappearance, the police arrested (...) Gäfgen and his 16-year-old girlfriend while simultaneously searching his flat. There they found the missing ransom, but no sign of Jakob. a b. (shrink)

Like much in this book, the title and dust jacket illustration are clever. The first evokes Hume's remark in the Treatise that ‘Reason is, and ought only to be the slave of the passions.’ The second, which represents a cross between a dance-step and a clinch, links up with the title and anticipates an example used throughout the book to support its central claims: that Ronnie, unlike Bradley, has a reason to go to a party – namely, that there will (...) be dancing at the party – because Ronnie, unlike Bradley, loves dancing. So, the explanation of why Ronnie's and Bradley's reasons differ lies in their respective psychologies.Schroeder argues for a version of the Humean Theory of Reasons he calls Hypotheticalism, which says that every reason is explained by a desire in the same way as Ronnie's is. Schroeder argues that on almost every count, Hypotheticalism is as good as, or preferable to, the Humean and non-Humean alternatives; and he defends it against an array of objections. For example, he explains that while Hypotheticalism claims that ‘desires have to serve in the explanation of every reason because desires are part of the correct analysis of reasons’, it does not claim that a desire that explains a reason is part of that reason: rather it is a background condition for it. This, Schroeder argues, allows him to rebut a variety of objections that depend on conflating reasons with their background conditions. Other …. (shrink)

The Global Burden of Disease Study is one of the largest-scale research collaborations in global health, producing critical data for researchers, policy-makers, and health workers about more than 350 diseases, injuries, and risk factors. Such an undertaking is, of course, extremely complex from an empirical perspective. But it also raises complex ethical and philosophical questions. In this volume, a group of leading philosophers, economists, epidemiologists, and policy scholars identify and discuss these philosophical questions. Better appreciating the philosophical dimensions of a (...) study like the GBD can make possible a more sophisticated interpretation of its results, and it can improve epidemiological studies in the future, so that they are better suited to produce results that help us to improve global health. (shrink)

Douglas Portmore has recently argued in this journal for a "promising result" – that combining teleological ethics with "evaluator relativism" about the good allows an ethical theory to account for deontological intuitions while "accommodat[ing] the compelling idea that it is always permissible to bring about the best available state of affairs." I show that this result is false. It follows from the indexical semantics of evaluator relativism that Portmore's compelling idea is false. I also try to explain what might have (...) led to this misunderstanding. (shrink)

Sally Gadow's tenure as professor of nursing at the University of Colorado Health Sciences Center during my doctoral studies radically changed my view on science, nursing, relationships, and most importantly, the world. In this paper, I use ideas stimulated by Gadow's classes to argue that recognizing ambiguity through an attitude of metaphysical revolt can free nurses to form relationships with patients who are complex subjects rather than objects to be treated. I will first discuss Camus’ ideas of absurdity from the (...) Myth of Sisyphus, comparing the awake passions of Don Juan and the maniacal (and fatal) love of Romeo and Juliet (1955). Merleau‐Ponty's (1962) work on the dialectic of human sexuality sheds light on the intrinsic bodily ambiguity of human existence as seen through sexual attraction. de Beauvoir (1948) further lends insight into ideas of ambiguity, relationship, and freedom. Finally, I will argue that recognition of the intrinsic ambiguity of existence coupled with an attitude of metaphysical revolt may free nurses and patients from external frameworks that limit experience, impose meaning, and in the process, sever human relationship. (shrink)

ABSTRACT Benefit sharing aims to achieve an equitable exchange between the granting of access to a genetic resource and the provision of compensation. The Convention on Biological Diversity (CBD), adopted at the 1992 Earth Summit in Rio de Janeiro, is the only international legal instrument setting out obligations for sharing the benefits derived from the use of biodiversity. The CBD excludes human genetic resources from its scope, however, this article considers whether it should be expanded to include those resources, so (...) as to enable research subjects to claim a share of the benefits to be negotiated on a case‐by‐case basis. Our conclusion on this question is: ‘No, the CBD should not be expanded to include human genetic resources.’ There are essential differences between human and non‐human genetic resources, and, in the context of research on humans, an essentially fair exchange model is already available between the health care industry and research subjects. Those who contribute to research should receive benefits in the form of accessible new health care products and services, suitable for local health needs and linked to economic prosperity (e.g. jobs). When this exchange model does not apply, as is often the case in developing countries, individually negotiated benefit sharing agreements between researchers and research subjects should not be used as ‘window dressing’. Instead, national governments should focus their finances on the best economic investment they could make; the investment in population health and health research as outlined by the World Health Organization’s Commission on Macroeconomics and Health; whilst international barriers to such spending need to be removed. (shrink)

Often, when there is a reason for you to do something, it is the kind of thing to motivate you to do it. For example, if Max and Caroline are deciding whether to go to the Alcove for dinner, Caroline might mention as a reason in favor, the fact that the Alcove serves onion rings the size of doughnuts, and Max might mention as a reason against, the fact that it is so difficult to get parking there this time of (...) day. It is some sign—perhaps not a perfect sign, but some sign—that each of these really is a reason, that Max and Caroline feel the tug in each direction. Mention of the Alcove's onion rings makes them feel to at least some degree inclined to go, and mention of the parking arrangements makes them feel to at least some degree inclined not to. According to some philosophers, reasons for action always bear some relation like this to motivation. This idea is variously known as ‘ reasons internalism’, ‘internalism about reasons ’, or ‘the internal reasons theory’. According to other philosophers, not all reasons are related to motivation in any of the ways internalists say. This idea is known as ‘ reasons externalism’ or ‘externalism about reasons ’. (shrink)