Functional MRI shows promise as a candidate prognostication method in acutely comatose patients following severe brain injury. However, further research is needed before this technique becomes appropriate for clinical practice. Drawing on a clinical case, we investigate the process of obtaining informed consent for this kind of research and identify four ethical issues. After describing each issue, we propose potential solutions which would make a patient’s participation in research compatible with her rights and interests. First, we defend the need for (...) traditional proxy consent against two alternative approaches. Second, we examine the impact of the intensive care unit environment on the informed consent process. Third, we discuss the therapeutic misconception and its potential influence on informed consent. Finally, we deal with issues of timing in recruiting participants and related factors which may affect the risks of participation. (shrink)

Over the last few decades, neuroimaging techniques have transformed our understanding of the brain and the effect of neurological conditions on brain function. More recently, light-based modalities such as functional near-infrared spectroscopy have gained popularity as tools to study brain function at the bedside. A recent application is to assess residual awareness in patients with disorders of consciousness, as some patients retain awareness albeit lacking all behavioural response to commands. Functional near-infrared spectroscopy can play a vital role in identifying these (...) patients by assessing command-driven brain activity. The goal of this review is to summarise the studies reported on this topic, to discuss the technical and ethical challenges of working with patients with disorders of consciousness, and to outline promising future directions in this field. (shrink)

Patient outcome after serious brain injury is highly variable. Following a period of coma, some patients recover while others progress into a vegetative state (unresponsive wakefulness syndrome) or minimally conscious state. In both cases, assessment is difficult and misdiagnosis may be as high as 43%. Recent advances in neuroimaging suggest a solution. Both functional magnetic resonance imaging and electroencephalography have been used to detect residual cognitive function in vegetative and minimally conscious patients. Neuroimaging may improve diagnosis and prognostication. These techniques (...) are beginning to be applied to comatose patients soon after injury. Evidence of preserved cognitive function may predict recovery, and this information would help families and health providers. Complex ethical issues arise due to the vulnerability of patients and families, difficulties interpreting negative results, restriction of communication to “yes” or “no” answers, and cost. We seek to investigate ethical issues in the use of neuroimaging in behaviorally nonresponsive patients who have suffered serious brain injury. The objectives of this research are to: (1) create an approach to capacity assessment using neuroimaging; (2) develop an ethics of welfare framework to guide considerations of quality of life; (3) explore the impact of neuroimaging on families; and, (4) analyze the ethics of the use of neuroimaging in comatose patients. (shrink)

Non-therapeutic research with imminently dying patients in intensive care presents complex ethical issues. The vulnerabilities of the imminently dying, together with societal disquiet around death and dying, contribute to an intuition that such research is beyond the legitimate scope of scientific inquiry. Yet excluding imminently dying patients from research hinders the advancement of medical science to the detriment of future patients. Building on existing ethical guidelines for research, we propose a framework for the ethical design and conduct of research involving (...) the imminently dying. To enable rapid translation to practice, we frame the approach in the form of eight ethical questions that researchers and research ethics committees ought to answer prior to conducting any research with this patient population. (1) Does the study hypothesis require the inclusion of imminently dying patients? (2) Are non-therapeutic risks and burdens minimised consistent with sound scientific design? (3) Are the risks of these procedures no more than minimal risk? (4) Are these non-therapeutic risks justified insofar as they are reasonable in relation to the anticipated benefits of the study? (5) Will valid informed consent be obtained from an authorised surrogate decision maker? (6) How will incidental findings be handled? (7) What additional steps are in place to protect families and significant others of research participants? (8) What additional steps are in place to protect clinical staff and researchers? Several ethical challenges hinder research with imminently dying patients. Nonetheless, provided adequate protections are in place, non-therapeutic research with imminently dying patients is ethically justifiable. Applying our framework to an ongoing study, we demonstrate how our question-driven approach is well suited to guiding investigators and research ethics committees. (shrink)

After severe brain injury, one of the key challenges for medical doctors is to determine the patient’s prognosis. Who will do well? Who will not do well? Physicians need to know this, and families need to do this too, to address choices regarding the continuation of life supporting therapies. However, current prognostication methods are insufficient to provide a reliable prognosis. -/- Functional Magnetic Resonance Imaging (MRI) holds considerable promise for improving the accuracy of prognosis in acute brain injury patients. Nonetheless, (...) research on functional MRI in the intensive care unit context is ethically challenging. These studies raise several ethical issues that have not been addressed so far. In this article, Prof. Charles Weijer and his co-workers provide a framework for researchers and ethics committees to design and review these studies in an ethically sound way. (shrink)

Twitter, an online application, allows users to post microblog statements in real time. Have psychologists in leadership positions adopted Twitter? What ethical standards are navigated in doing so? Little research has examined the adoption rate of Twitter within a sample of psychologists. This article outlines a series of case vignettes depicting ethical dilemmas encountered by psychologists who adopt Twitter. Data reviewing Twitter adoption by professional psychologists who served as president within psychology advocacy organizations reveal higher adoption rates from student group (...) leaders than professional organization advocacy presidents. Implications for ethical standards and professional development are discussed. (shrink)

Consider an object or property a and the predicate F. Then a is vague if there are questions of the form: Is a F? that have no yes-or-no answers. In brief, vague properties and kinds have borderline instances and composite objects have borderline constituents. I'll use the expression "borderline cases" as a covering term for both. ;Having borderline cases is compatible with precision so long as every case is either borderline F, determinately F or determinately not F. Thus, in addition (...) to borderline cases, vagueness requires "fuzzy borders". A has fuzzy borders if there is no sharp line between a's borderline cases, a's determinate cases and a's determinate non-cases. To illustrate, loudness is vague because in a continuum of gradually increasing volume, there is no fact about where the last definite loud noise is and where the first borderline noise is. ;Actual borderline cases are not required for vagueness. Suppose actual noises are either ear-shatteringly loud or silent. Even so, loudness is vague since it could have borderline instances. Just so for objects. Suppose a table is cleanly bounded such that there is a sharp break between the table and its surroundings. Still, that table is vague since there are worlds at which it is indeterminate whether some wood molecule a is, or is not, part of that table. ;There are three views about which things can be vague. On the linguistic view, vagueness is solely a feature of expressions. On the nihilistic view, nothing is vague because vagueness is incoherent. Pitted against these views is the ontological conception of vagueness according to which borderline instances and constituents arise due to genuine indeterminacy in nature. ;My dissertation defends the ontological conception. I argue against the adequacy of the theory's rivals, disarm a damaging objection and demonstrate the causal superiority of vague events. Anyone familiar with the literature on vagueness will notice that only a subset of issues are discussed. What I offer is preliminary--I hope only to make the theory of ontological vagueness attractive enough to merit future work. (shrink)

I am interested in exploring the usefulness and limits of traditional categories of feminist theory, such as those laid out by Alison Jaggar. I begin the analysis by critically comparing various treatments of liberal feminism. I focus throughout this investigation on uncovering ways that current frameworks privilege white authors and concerns, recreate the split between theory and activism, and obscure long histories of theoretical and practical coalition and alliance work.

Introduction -- Healing justice and whole self-care -- Oppression, trauma, and healing justice -- Stress and the self-care revolution -- The whole self -- A skillful path of healing justice -- Holistic self-care practices and skills -- Connecting to the body -- Befriending the mind-heart -- Rediscovering spirit -- In the fabric of community -- Cultivating connections between person and planet -- Where the rubber meets the road -- The healing justice organization -- Healing justice on the frontlines -- Widening (...) the circle and coming home -- Notes -- Index. (shrink)

Religious Pluralism Religious pluralism, broadly construed, is a response to the diversity of religious beliefs, practices, and traditions that exist both in the contemporary world and throughout history. The terms “pluralism” and “pluralist” can, depending on context or intended use, signify anything from the mere fact of religious diversity to a particular kind of philosophical … Continue reading Pluralism, Religious →.

I am interested in exploring the usefulness and limits of traditional categories of feminist theory, such as those laid out by Alison Jaggar (1977; 1983). I begin the analysis by critically comparing various treatments of liberal feminism. I focus throughout this investigation on uncovering ways that current frameworks privilege white authors and concerns, recreate the split between theory and activism, and obscure long histories of theoretical and practical coalition and alliance work.

Introduction -- Membership -- Employment -- Property disputes -- The family -- Goods and services -- Conclusion.

This paper offers a new account of metaphysical explanation. The account is modelled on Kitcher’s unificationist approach to scientific explanation. We begin, in Sect. 2, by briefly introducing the notion of metaphysical explanation and outlining the target of analysis. After that, we introduce a unificationist account of metaphysical explanation before arguing that such an account is capable of capturing four core features of metaphysical explanations: irreflexivity, non-monotonicity, asymmetry and relevance. Since the unificationist theory of metaphysical explanation inherits irreflexivity and non-monotonicity (...) directly from the unificationist theory of scientific explanation that underwrites it, we focus on demonstrating how the account can secure asymmetry and relevance. (shrink)

David and Mary Norton present the definitive scholarly edition of Hume's Treatise, one of the greatest philosophical works ever written. This set comprises the two volumes of texts and editorial material, which are also available for purchase separately. -/- David Hume (1711 - 1776) is one of the greatest of philosophers. Today he probably ranks highest of all British philosophers in terms of influence and philosophical standing. His philosophical work ranges across morals, the mind, metaphysics, epistemology, religion, and aesthetics; (...) he had broad interests not only in philosophy as it is now conceived but in history, politics, economics, religion, and the arts. He was a master of English prose. -/- The Clarendon Hume Edition will include all of his works except his History of England and minor historical writings. It is the only thorough critical edition, and will provide a far more extensive scholarly treatment than any previous editions. This edition (which has been in preparation since the 1970s) offers authoritative annotation, bibliographical information, and indexes, and draws upon the major advances in textual scholarship that have been made since the publication of earlier editions - advances both in the understanding of editorial principle and practice and in knowledge of the history of Hume's own texts. (shrink)

The view that identity can be vague is the view that there are statements of identity which are neither true or false. The view that composition can be vague is the view that unities can have borderline-constituents—elements that are neither parts nor non-parts of some larger unity. The case for vague identity is typically made by way of an argument for the vagueness of composition. In what follows, I argue that vague identity does not depend on the vagueness of composition; (...) furthermore, the thesis that composition can be vague is actually incompatible with the thesis of vague identity. (shrink)

The view that identity can be vague holds that there are statements of identity which are neither true nor false. The view that composition can be vague holds that unities can have borderline constituents — that is, elements that are neither parts nor non-parts of some larger unity. The case for vague identity is typically made by way of an argument for the vagueness of composition. In this paper, however, I argue that the thesis that composition can be vague is (...) actually incompatible with the thesis of vague identity. The argument for the incompatibility of these two views arises out of a demonstration of the way in which constituency facts are grounded in the other facts about how a larger unity is configured. Thus, I show that composites that are allegedly vaguely identical are actually different configurations. Hence, the alliance of vague composition with vague identity is taken to be all that is needed in order to show that compositional vagueness is indefensible. (shrink)

My purpose in this chapter is to survey some of the principal approaches to inductive inference in the philosophy of science literature. My first concern will be the general principles that underlie the many accounts of induction in this literature. When these accounts are considered in isolation, as is more commonly the case, it is easy to overlook that virtually all accounts depend on one of very few basic principles and that the proliferation of accounts can be understood as efforts (...) to ameliorate the weaknesses of those few principles. In the earlier sections, I will lay out three inductive principles and the families of accounts of induction they engender. In later sections I will review standard problems in the philosophical literature that have supported some pessimism about induction and suggest that their import has been greatly overrated. In the final sections I will return to the proliferation of accounts of induction that frustrates efforts at a final codification. I will suggest that this proliferation appears troublesome only as long as we expect inductive inference to be subsumed under a single formal theory. If we adopt a material theory of induction in which individual inductions are licensed by particular facts that prevail only in local domains, then the proliferation is expected and not problematic. (shrink)

Roots presents articles on major discoveries that laid the basis for contemporary molecular and cellular biology. In this article, Norton D. Zinder reviews the first findings about the single‐stranded DNA‐containing bacteriophages and what is known today about the genetics and molecular biology of these phages.

Is there progress in philosophy? If so, how much? Philosophers have recently argued for a wide range of answers to these questions, from the view that there is no progress whatsoever to the view that philosophy has provided answers to all the big philosophical questions. However, these views are difficult to compare and evaluate, because they rest on very different assumptions about the conditions under which philosophy would make progress. This paper looks to the comparatively mature debate about scientific progress (...) for inspiration on how to formulate four distinct accounts of philosophical progress, in terms of truthlikeness, problem-solving, knowledge, and understanding. Equally importantly, the paper outlines a common framework for how to understand and evaluate these accounts. We distill a series of lessons from this exercise, to help pave the way for a more fruitful discussion about philosophical progress in the future. (shrink)

Classifying research proposals by risk of harm is fundamental to the approval process and the most pivotal risk category in most regulations is that of “minimal risk.” If studies have no more than a minimal risk, for example, a nearly worldwide consensus exists that review boards may sometimes: (1) expedite review, (2) waive or modify some or all elements of informed consent, or (3) enroll vulnerable subjects including healthy children, incapacitated persons and prisoners even if studies do not hold out (...) direct benefits to them. The moral and social purposes behind this threshold are discussed along with relevant views from the National Commission, NBAC, NHRPAC, Grimes v. Kennedy Krieger Institute, The Nuremberg Code, and The WMA's Declaration of Helsinki. Representative policies from Australia, Canada, South Africa, the U.S., and CIOMS are reviewed revealing different understandings of this sorting threshold. Six of nine frequently cited interpretations of “minimal risk” are untenable. The “absolute” interpretation of the “routine examination” standard is defended as best. (shrink)

Use of the word "Counter-Enlightenment" has become increasingly frequent in scholarly and journalistic writing. The word was almost certainly invented by the late Sir Isaiah Berlin, and it is owing to his enormous prestige and on-going influence that it has gained its current familiarity. In Berlin's view, two of the most important sources of the supposed Counter-Enlightenment are J. G. Hamann and J. G. Herder. But as I show, Berlin's numerous accounts of their thought are profoundly flawed and reflect not (...) Herder's or Hamann's own thought, but rather that of late nineteenth- and early twentieth-century German historians, who wished to legitimate their own anti-democratic, and hence anti-Enlightenment, ideology through the construction of a false historical genealogy. (shrink)

In Norton(2003), it was urged that the world does not conform at a fundamental level to some robust principle of causality. To defend this view, I now argue that the causal notions and principles of modern physics do not express some universal causal principle, brought to light by discoveries in physics. Rather they merely assert that, according to relativity theory, spacetime has an invariant velocity, that of light; and that theories of matter admit no propagations faster than light.

In recent years, several philosophers have argued that their discipline makes no progress (or not enough in comparison to the “hard sciences”). A key argument for this pessimistic position appeals to the purported fact that philosophers widely and systematically disagree on most major philosophical issues. In this paper, we take a step back from the debate about progress in philosophy specifically and consider the general question: How (if at all) would disagreement within a discipline undermine that discipline’s progress? We reject (...) two arguments from disagreement to a lack of progress, and spell out two accounts of progress on which progress is compatible with disagreements that persist or increase over time. However, we also argue that disagreement can undermine our ability to tell which developments are progressive (and to what degree). So, while disagreement can indeed be a threat to progress, the precise nature of the threat has not been appreciated. (shrink)

When making decisions for adults who lack decision-making capacity and have no discernable preferences, widespread support exists for using the Best Interests Standard. This policy appeals to adults and is compatible with many important recommendations for persons facing end-of-life choices.Common objections to the policy are discussed as well as different meanings of this Standard identified, such as using it to express goals or ideals and to make practical decisions incorporating what reasonable persons would want. For reasons of consistency, fairness, and (...) compassion, this standard should be used for all incapacitated persons. (shrink)