The Ethics of Need: Agency, Dignity, and Obligation argues for the philosophical importance of the notion of need and for an ethical framework through which we can determine which needs have moral significance. In the volume, Sarah Clark Miller synthesizes insights from Kantian and feminist care ethics to establish that our mutual and inevitable interdependence gives rise to a duty to care for the needs of others. Further, she argues that we are obligated not merely to meet others’ needs (...) but to do so in a manner that expresses "dignifying care," a concept that captures how human interactions can grant or deny equal moral standing and inclusion in a moral community. She illuminates these theoretical developments by examining two cases where urgent needs require a caring and dignifying response: the needs of the elderly and the needs of global strangers. Those working in the areas of feminist theory, women’s studies, aging studies, bioethics, and global studies should find this volume of interest. (shrink)

An assessment of America's preference for "extra-large" shares examples ranging from mega churches and breast augmentation to landfills and mega-malls, in a cautionary report that reveals some of the consequences of these choices.

Traditional philosophical discussions of knowledge have focused on the epistemic status of full beliefs. In this book, Moss argues that in addition to full beliefs, credences can constitute knowledge. For instance, your .4 credence that it is raining outside can constitute knowledge, in just the same way that your full beliefs can. In addition, you can know that it might be raining, and that if it is raining then it is probably cloudy, where this knowledge is not knowledge of propositions, (...) but of probabilistic contents. -/- The notion of probabilistic content introduced in this book plays a central role not only in epistemology, but in the philosophy of mind and language as well. Just as tradition holds that you believe and assert propositions, you can believe and assert probabilistic contents. Accepting that we can believe, assert, and know probabilistic contents has significant consequences for many philosophical debates, including debates about the relationship between full belief and credence, the semantics of epistemic modals and conditionals, the contents of perceptual experience, peer disagreement, pragmatic encroachment, perceptual dogmatism, and transformative experience. In addition, accepting probabilistic knowledge can help us discredit negative evaluations of female speech, explain why merely statistical evidence is insufficient for legal proof, and identify epistemic norms violated by acts of racial profiling. Hence the central theses of this book not only help us better understand the nature of our own mental states, but also help us better understand the nature of our responsibilities to each other. (shrink)

This paper develops a precise understanding of the thesis of moral encroachment, which states that the epistemic status of an opinion can depend on its moral features. In addition, I raise objections to existing accounts of moral encroachment. For instance, many accounts fail to give sufficient attention to moral encroachment on credences. Also, many accounts focus on moral features that fail to support standard analogies between pragmatic and moral encroachment. Throughout the paper, I discuss racial profiling as a case study, (...) arguing that moral encroachment can help us identify one respect in which racial profiling is epistemically problematic. (shrink)

Introduction: The humanities enrich and transform the practice of medicine. What remains to be seen, however, is how best to integrate humanities into the medical curriculum to optimize both educational and patient-related outcomes. The present study considers the structure of an innovative student-driven humanities curriculum and seeks to understand its strengths and limitations, as well as make recommendations for improvement. Methods: The Penn State College of Medicine, University Park Regional Campus uses an inquiry-based approach to education, whereby students are responsible (...) for creating learning objectives in four core pillars of exploration: Foundational Science, Clinical Science, Health Systems Science, and Health Humanities. This study explores student-derived humanities learning objectives (HLO) across four years of the curriculum. Results: 420 HLOs met criteria for analysis and were coded as instrumental (developing direct clinical skill), non-instrumental (non-skill based), or both. Of these, 125 (30%) were instrumental, 239 (57%) were non-instrumental, and 56 (13%) were coded as both. Most instrumental HLO centered around communication skills. Non-instrumental HLO most commonly focused on bearing witness and critiquing a particular experience within a social and/or political context. Conclusions: Findings from this study contribute to the development of a humanities curriculum in a student-directed learning program. Non-instrumental HLO lacked a theoretical framework to guide student’s investigations to a deeper level of analysis. Student-directed learning offers many strengths, but can be enhanced through external direction from humanities trained faculty, particularly given that many medical students have a limited humanities background. (shrink)

An investigation into Aristotle's metaphysics of nature as expounded in the Physics. It focuses in particular his conception of change, a concept which is shown to possess a unique metaphysical structure, with implications that should engage the attention of contemporary analysis. First published in hardback in 1982, the book is now available for the first time in paperback. 'A powerful and appealing explanatory scheme which succeeds on the whole in drawing together a great many seemingly disparate elements in the Physics (...) into a neat unitary stucture.' Canadian Philosophical Review. (shrink)

Existing discussions of legal proof address a host of apparently disparate questions: What does it take to prove a fact beyond a reasonable doubt? Why is the reasonable doubt standard notoriously elusive, sometimes considered by courts to be impossible to define? Can the standard of proof by a preponderance of the evidence be defined in terms of probability thresholds? Why is statistical evidence often insufficient to meet the burden of proof? -/- This paper defends an account of proof that addresses (...) each of these questions. Where existing theories take a piecemeal approach to these puzzles, my theory develops an insight that unifies them—namely, the thesis that legal proof requires knowledge. Although this thesis may seem radical at first, I answer several common objections to it, and I argue that it does better than several competing accounts when it comes to making sense of our intuitions about what legal proof requires. (shrink)

This paper motivates and develops a novel semantics for several epistemic expressions, including possibility modals and indicative conditionals. The semantics I defend constitutes an alternative to standard truth conditional theories, as it assigns sets of probability spaces as sentential semantic values. I argue that what my theory lacks in conservatism is made up for by its strength. In particular, my semantics accounts for the distinctive behavior of nested epistemic modals, indicative conditionals embedded under probability operators, and instances of constructive dilemma (...) containing epistemic vocabulary. (shrink)

Traditionally, discussions of moral participation – and in particular moral agency – have focused on fully formed human actors. There has been some interest in the development of morality in humans, as well as interest in cultural differences when it comes to moral practices, commitments, and actions. However, until relatively recently, there has been little focus on the possibility that nonhuman animals have any role to play in morality, save being the objects of moral concern. Moreover, when nonhuman cases are (...) considered as evidence of moral agency or subjecthood, there has been an anthropocentric tendency to focus on those behaviors that inform our attributions of moral agency to humans. For example, some argue that the ability to evaluate the principles upon which a moral norm is grounded is required for full moral agency. Certainly, if a moral agent must understand what makes an action right or wrong, then most nonhuman animals would not qualify (and perhaps some humans too). However, if we are to understand the evolution of moral psychology and moral practice, we need to turn our attention to the foundations of full moral agency. We must first pay attention to the more broadly normative practices of other animals. Here, we begin that project by considering evidence that great apes and cetaceans participate in normative practices. (shrink)

This paper argues that just as full beliefs can constitute knowledge, so can properties of your credence distribution. The resulting notion of probabilistic knowledge helps us give a natural account of knowledge ascriptions embedding language of subjective uncertainty, and a simple diagnosis of probabilistic analogs of Gettier cases. Just like propositional knowledge, probabilistic knowledge is factive, safe, and sensitive. And it helps us build knowledge-based norms of action without accepting implausible semantic assumptions or endorsing the claim that knowledge is interest-relative.

This paper defends an account of full belief, including an account of its relationship to credence. Along the way, I address several familiar and difficult questions about belief. Does fully believing a proposition require having maximal confidence in it? Are rational beliefs closed under entailment, or does the preface paradox show that rational agents can believe inconsistent propositions? Does whether you believe a proposition depend partly on your practical interests? My account of belief resolves the tension between conflicting answers to (...) these questions that have been defended in the literature. In addition, my account complements fruitful probabilistic theories of assertion and knowledge. (shrink)

Ducks lay eggs' is a true sentence, and `ducks are female' is a false one. Similarly, `mosquitoes carry the West Nile virus' is obviously true, whereas `mosquitoes don't carry the West Nile virus' is patently false. This is so despite the egg-laying ducks' being a subset of the female ones and despite the number of mosquitoes that don't carry the virus being ninety-nine times the number that do. Puzzling facts such as these have made generic sentences defy adequate semantic treatment. (...) However complex the truth conditions of generics appear to be, though, young children grasp generics more quickly and readily than seemingly simpler quantifiers such as `all' and `some'. I present an account of generics that not only illuminates the strange truth conditions of generics, but also explains how young children find them so comparatively easy to acquire. I then argue that generics give voice to our most cognitively primitive generalizations and that this hypothesis accounts for a variety of facts ranging from acquisition patterns to cross-linguistic data concerning the phonological articulation of operators. I go on to develop an account of the nature of these cognitively fundamental generalizations and argue that this account explains the strange truth-conditional behavior of generics. (shrink)

Recently many have argued that agents must sometimes have credences that are imprecise, represented by a set of probability measures. But opponents claim that fans of imprecise credences cannot provide a decision theory that protects agents who follow it from foregoing sure money. In particular, agents with imprecise credences appear doomed to act irrationally in diachronic cases, where they are called to make decisions at earlier and later times. I respond to this claim on behalf of imprecise credence fans. Once (...) we appreciate the complexity of our intuitions about rational decision making, we can see that diachronic cases are in fact evidence for the essential claims motivating imprecise credence models. I argue that our decision theory for imprecise agents should mirror our decision theory for agents in moral dilemmas, and I develop permissive norms that explain our intuitions about both sorts of agents. (shrink)

Scholars such as Nancy Leys Stepan, Alexandra Minna Stern, Marius Turda and Aaron Gillette have all argued that the rejection of coerced sterilization was a defining feature of “Latin” eugenic theory and practice. These studies highlight the influence of neo-Lamarckism in this development not only in Latin America but also in parts of Europe in the first half of the twentieth century. This article builds upon this historiographical framework to examine an often-neglected site of Latin American eugenic knowledge production: Chile. (...) By focusing on Chilean eugenicists’ understandings of environment and coerced sterilization, this article argues that there was no uniquely Latin objection to the practice initially. In fact, Chilean eugenicists echoed concerns of eugenicists from a variety of locations, both “mainstream” and Latin, who felt that sterilization was not the most effective way to ensure the eugenic improvement of national populations. Instead, the article contends that it was not until the implementation of the 1933 German racial purity laws, which included coerced sterilization legislation, that Chilean eugenicists began to define their objections to the practice as explicitly Latin. Using a variety of medical texts which appeared in popular periodicals as well as professional journals, this article reveals the complexity of eugenic thought and practice in Chile in the early twentieth century. (shrink)

One of the main themes that has emerged from behavioral decision research during the past three decades is the view that people's preferences are often constructed in the process of elicitation. This idea is derived from studies demonstrating that normatively equivalent methods of elicitation (e.g., choice and pricing) give rise to systematically different responses. These preference reversals violate the principle of procedure invariance that is fundamental to all theories of rational choice. If different elicitation procedures produce different orderings of options, (...) how can preferences be defined and in what sense do they exist? This book shows not only the historical roots of preference construction but also the blossoming of the concept within psychology, law, marketing, philosophy, environmental policy, and economics. Decision making is now understood to be a highly contingent form of information processing, sensitive to task complexity, time pressure, response mode, framing, reference points, and other contextual factors. (shrink)

This paper discusses three potential varieties of update: updates to the common ground, structuring updates, and updates that introduce discourse referents. These different types of update are used to model different aspects of natural language phenomena. Not-at-issue information directly updates the common ground. The illocutionary mood of a sentence structures the context. Other updates introduce discourse referents of various types, including propositional discourse referents for at-issue information. Distinguishing these types of update allows a unified treatment of a broad range of (...) phenomena, including the grammatical evidentials found in Cheyenne (Algonquian) as well as English evidential parentheticals, appositives, and mood marking. An update semantics that can formalize all of these varieties of update is given, integrating the different kinds of semantic contributions into a single representation of meaning. (shrink)

Many languages grammatically mark evidentiality, i.e., the source of information. In assertions, evidentials indicate the source of information of the speaker while in questions they indicate the expected source of information of the addressee. This dissertation examines the semantics and pragmatics of evidentiality and illocutionary mood, set within formal theories of meaning and discourse. The empirical focus is the evidential system of Cheyenne (Algonquian: Montana), which is analyzed based on several years of fieldwork by the author.

Since Mill's seminal work On Liberty, philosophers and political theorists have accepted that we should respect the decisions of individual agents when those decisions affect no one other than themselves. Indeed, to respect autonomy is often understood to be the chief way to bear witness to the intrinsic value of persons. In this book, Sarah Conly rejects the idea of autonomy as inviolable. Drawing on sources from behavioural economics and social psychology, she argues that we are so often irrational (...) in making our decisions that our autonomous choices often undercut the achievement of our own goals. Thus in many cases it would advance our goals more effectively if government were to prevent us from acting in accordance with our decisions. Her argument challenges widely held views of moral agency, democratic values and the public/private distinction, and will interest readers in ethics, political philosophy, political theory and philosophy of law. (shrink)

According to the Causal Theory of Memory, remembering a particular past event requires a causal connection between that event and its subsequent representation in memory, specifically, a connection sustained by a memory trace. The CTM is the default view of memory in contemporary philosophy, but debates persist over what the involved memory traces must be like. Martin and Deutscher argued that the CTM required memory traces to be structural analogues of past events. Bernecker and Michaelian, contemporary CTM proponents, reject structural (...) analogues in favor of memory traces as distributed patterns of event features. The proposals are understood as distinct accounts of how memory traces represent past events. But there are two distinct questions one could ask about a trace’s representational features. One might ask how memory traces, qua mental representations, have their semantic properties. Or, what makes memory traces, qua mental representations of memories, distinct from other mental representations. Proponents of the CTM, both past and present, have failed to keep these two questions distinct. The result is a serious but unnoticed problem for the CTM in its current form. Distributed memory traces are incompatible with the CTM. Such traces do not provide a way to track the causal history of individual memories, as the CTM requires. If memory traces are distributed patterns of event features, as Bernecker and Michaelian each claim, then the CTM cannot be right. (shrink)

The third edition of this popular book has been updated to take account of the latest developments in policy and social work practice. It includes new sections on radical/emancipatory and postmodern approaches to ethics, analysis of the latest codes of ethics from over 30 different countries, additional case studies of ethical problems and dilemmas, practical exercises, and annotated further reading lists at the end of each chapter.

The present paper focuses on essentialism about natural kinds as a case study in order to illustrate this more general point. Saul Kripke and Hilary Putnam famously argued that natural kinds have essences, which are discovered by science, and which determine the extensions of our natural kind terms and concepts. This line of thought has been enormously influential in philosophy, and is often taken to have been established beyond doubt. The argument for the conclusion, however, makes critical use of intuitions, (...) and I note that the intuitions are of the sort had by preschool children, and that they are traceable to a deep-seated cognitive outlook, which is often called “psychological essentialism.” Further, if we did not have such a cognitive outlook or implicit belief set—a belief set which is in fact in place by at least age 4—then we would not have the relevant philosophical intuitions. In light of this, I consider the question of whether natural kinds actually have scientifically discovered or discoverable essences, and whether these putative essences could determine the extensions of our terms and concepts as Kripke, Putnam, and many others have supposed. In fact, a number of philosophers of biology and chemistry have argued that biological and chemical kinds do not have such essences, yet these arguments—particularly in the case of chemistry—have not been assimilated by philosophers more generally. The reason for this poor assimilation is, I suggest, that the Kripke/Putnam view is just so intuitive. But this fact, I argue, is due to a deep-seated cognitive bias, rather than to any special insight into the nature of reality. (shrink)

Paralleling the recent work by Reichle, Reineberg, and Schooler , we explore the use of eye movements as an objective measure of mind wandering while participants performed a reading task. Participants were placed in a self-classified probe-caught mind wandering paradigm while their eye movements were recorded. They were randomly probed every 2–3 min and were required to indicate whether their mind had been wandering. The results show that eye movements were generally less complex when participants reported mind wandering episodes, with (...) both duration and frequency of within-word regressions, for example, becoming significantly reduced. This is consistent with the theoretical claim that the cognitive processes that normally influence eye movements to enhance semantic processing during reading exert less control during mind wandering episodes. (shrink)

Sarah Waterlow; II*—The Good of Others in Plato's Republic, Proceedings of the Aristotelian Society, Volume 73, Issue 1, 1 June 1973, Pages 19–36, https://doi.o.

Too often, we as individuals do things that harm us, that seriously interfere with our being able to live in the way that we want. We eat food that makes us obese, that promotes diabetes, heart failure and other serious illness, while at the same time, we want to live long and healthy lives. Too many of us smoke cigarettes, even while acknowledging we wish we had never begun. We behave in ways that undercut our ability to reach some of (...) our most valued goals, despite education and despite incentives to choose the right thing. What should be done?If I were to try to harm someone else in a way that alters his future seriously and perhaps irrevocably for the worse, I would be stopped. When it comes to hurting myself, though, we have a common belief that it is wrong to interfere, even if I foresee that I will very much regret what I have done, often when it is too late to fix what I have let happen. I think this makes no sense. If it is permissible, even obligatory, to stop me when I do something that seriously interferes with someone else's chances of achieving the life he wants, I think …. (shrink)

Philosophy and Phenomenological Research, Volume 103, Issue 3, Page 620-638, November 2021.

The present article explores the views of al-Jāḥiẓ, Abū Bakr al-Rāzī, and Fakhr al-Dīn al-Rāzī - three pre-modern thinkers of the Islamic world outside the Peripatetic tradition - on the question o...

It can be hard to see where money fits in the world. Money seems both real and imaginary, since it has obvious causal powers, but is also, just as obviously, something humans have just made up. Recent philosophical accounts of money have declared it to be real, but for very different reasons. John Searle and Francesco Guala disagree over whether money is just whatever acts like money, or just whatever people believe to be money. In developing their accounts of institutions (...) as a part of social reality, each uses money as a paradigm institution, but they disagree on how institutions exist. Searle argues that the institution of money belongs to an ontological level separate from the physical world, held up by the collective intentions of a group, while Guala claims that money is a part of the ordinary physical world and is just whatever performs a “money-like function” in a group, regardless of what that group believes about it. Here, we argue that any purely functional account like Guala’s will be unable to capture the distinctive phenomenon of money, since monetary transactions are defined by the attitudes transactors hold toward them. Money will be obscured or misidentified if defined functionally. As we go on to show by examining recent work by Smit et al., belief in money does not require taking on all of Searle’s ontological commitments, but money and mental contents will stand or fall together. (shrink)

The domain of professional ethics -- Virtue, ethics, and professional life -- Virtues, vices, and situations -- Professional wisdom -- Care -- Respectfulness -- Trustworthiness -- Justice -- Courage -- Integrity.

"One of the most careful and intensive among the introductory texts that can be used with a wide range of students. It builds remarkably sophisticated technical skills, a good sense of the nature of a formal system, and a solid and extensive background for more advanced work in logic.... The emphasis throughout is on natural deduction derivations, and the text's deductive systems are its greatest strength. Lemmon's unusual procedure of presenting derivations before truth tables is very effective." --Sarah Stebbins, (...) The Journal of Symbolic Logic. (shrink)

Some omissions seem to be causes. For example, suppose Barry promises to water Alice’s plant, doesn’t water it, and that the plant then dries up and dies. Barry’s not watering the plant – his omitting to water the plant – caused its death. But there is reason to believe that if omissions are ever causes, then there is far more causation by omission than we ordinarily think. In other words, there is reason to think the following thesis true.

The psychological contract refers to the implicit and subjective beliefs regarding a reciprocal exchange agreement, predominantly examined between employees and employers. While contemporary contract research is investigating a wider range of exchanges employees may hold, such as with team members and clients, it remains silent on a rapidly emerging form of workplace relationship: employees’ increasing engagement with technically, socially, and emotionally sophisticated forms of artificially intelligent (AI) technologies. In this paper we examine social robots (also termed humanoid robots) as likely (...) future psychological contract partners for human employees, given these entities transform notions of workplace technology from being a tool to being an active partner. We first overview the increasing role of robots in the workplace, particularly through the advent of sociable AI, and synthesize the literature on human–robot interaction. We then develop an account of a human-social robot psychological contract and zoom in on the implications of this exchange for the enactment of reciprocity. Given the future focused nature of our work we utilize a thought experiment, a commonly used form of conceptual and mental model reasoning, to expand on our theorizing. We then outline potential implications of human-social robot psychological contracts and offer a range of pathways for future research. (shrink)

Using artificial intelligence (AI) to make decisions in human resource management (HRM) raises questions of how fair employees perceive these decisions to be and whether they experience respectful treatment (i.e., interactional justice). In this experimental survey study with open-ended qualitative questions, we examine decision making in six HRM functions and manipulate the decision maker (AI or human) and decision valence (positive or negative) to determine their impact on individuals’ experiences of interactional justice, trust, dehumanization, and perceptions of decision-maker role appropriate- (...) ness. In terms of decision makers, the use of human decision makers over AIs generally resulted in better perceptions of respectful treatment. In terms of decision valence, people experiencing positive over negative decisions generally resulted in better perceptions of respectful treatment. In instances where these cases conflict, on some indicators people preferred positive AI decisions over negative human decisions. Qualitative responses show how people identify justice concerns with both AI and human decision making. We outline implications for theory, practice, and future research. (shrink)

In this paper, I develop a neglected puzzle for the moral realist. I then canvass some potential responses. Although I endorse one response as the most promising of those I survey, my primary goal is to make vivid how formidable the puzzle is, as opposed to offering a definitive solution.

Written by an international team of leading political and legal theory scholars whose writings have contributed to shaping the field, Migration in Political Theory presents seminal new work on the ethics of movement and membership. The volume addresses challenging and under-researched themes on the subject of migration, and debates the question of whether we ought to recognize a human right to immigrate, and whether it might be legitimate to restrict emigration. The authors critically examine criteria for selecting would-be migrants, and (...) for acquiring citizenship, as well as the tensions between the claims of immigrants and existing residents, and tackle questions of migrant worker exploitation and responsibility for refugees. All of the chapters illustrate the importance of drawing on the tools of political theory to clarifying, criticize and challenge the current terms of the migration debate. (shrink)

As the usual regulatory framework did not fit well during the last Ebola outbreak, innovative thinking still needed. In the absence of an outbreak, randomised controlled trials of clinical efficacy in humans cannot be done, while during an outbreak such trials will continue to face significant practical, philosophical, and ethical challenges. This article argues that researchers should also test the safety and effectiveness of novel vaccines in wild apes by employing a pluralistic approach to evidence. There are three reasons to (...) test vaccines in wild populations of apes: i) protect apes; ii) reduce Ebola transmission from wild animals to humans; and iii) accelerate vaccine development and licensing for humans. Data obtained from studies of vaccines among wild apes and chimpanzees may even be considered sufficient for licensing new vaccines for humans. This strategy will serve to benefit both wild apes and humans. (shrink)

How fragile is our knowledge of morality, compared to other kinds of knowledge? Does knowledge of the difference between right and wrong fundamentally differ from knowledge of other kinds? Sarah McGrath offers new answers to these questions as she explores the possibilities, sources and characteristic vulnerabilities of moral knowledge.

As a number of high profile companies have found to their cost, corporate reputations can be significantly affected by firms' management of sustainability issue, including those that are outside their direct control, such as the environmental and social impacts of their supply networks. This paper begins by examining the relationship between corporate social responsibility, reputation, and supply network conditions. It then looks at the effectiveness of one tool for managing supply network sustainability issues, ethical sourcing codes of conduct, by examining (...) how the characteristics of three supply networks branded clothes, DIY wood products and branded confectionary affects the implementation ethical sourcing codes of conduct. It ends by setting out conclusions on why implementation of such codes has been so much more successful in some sectors than others and recommendations on effective approaches to managing sustainability issues in supply networks. (shrink)

Across cultures, people employ space to construct representations of time. English exhibits two deictic space–time metaphors: the “moving ego” metaphor conceptualizes the ego as moving forward through time and the “moving time” metaphor conceptualizes time as moving forward towards the ego. Earlier research investigating the psychological reality of these metaphors has shown that engaging in certain types of spatial-motion thinking may influence how people reason about events in time. More recently, research has shown that people’s interactions with cultural artifacts may (...) also influence their representations of time. Extending research on space–time mappings in new directions, three experiments investigated the role of cultural artifacts, namely calendars and clocks, in the interpretation of metaphorical expressions about time. Taken together, the results provide initial evidence that, in their interpretation of ambiguous metaphorical expressions about time, people automatically access and use spatial representations of absolute time, whereby moving forward in space corresponds with moving later in time. Moreover, asking participants to use a reverse space–time mapping causes interference, which is reflected through their temporal reasoning. (shrink)

Current orthodoxy in research ethics assumes that subjects of clinical trials reserve rights to withdraw at any time and without giving any reason. This view sees the right to withdraw as a simple extension of the right to refuse to participate all together. In this paper, however, I suggest that subjects should assume some responsibilities for the internal validity of the trial at consent and that these responsibilities should be captured by contract. This would allow the researcher to impose a (...) penalty on the subject if he were to withdraw without good reason and on a whim. This proposal still leaves open the possibility of withdrawing without penalty when it is in the subject's best interests to do so. Giving researchers recourse to legal remedy may now be necessary to protect the science, as existing methods used to increase retention are inadequate for one reason or another. (shrink)

Since its introduction in the 1980s, futility as a concept has held contested meaning and applications throughout medicine. There has been little discussion within the psychiatric literature about the use of futility in the care of individuals experiencing severe and persistent mental illness, despite some tacit acceptance that futility may apply in certain cases of psychiatric illness. In this paper, we explore the literature surrounding futility and argue that its connotation within medicine is to describe situations where patients believe that (...) interventions will almost certainly provide no meaningful benefit. We then provide two arguments in support of the use of futility within the care of individuals experiencing SPMI: that some SPMI can be considered a terminal illness, and that the risk-benefit ratio is a dynamic entity such that futility can help describe what Gillett calls the ‘risk of unacceptable badness’ when it comes to considering how an intervention might impact a patient’s quality of life. We posit that capacity should not pose an obstacle to declaring futility when caring for individuals experiencing SPMI and explain how futility is not antithetical to recovery in mental health. Finally, we describe how using futility within psychiatric practice can allow for a reorientation of care by signalling the need to shift to a palliative approach. (shrink)