The philosophy of evidence-based medicine -- What is EBM? -- What is good evidence for a clinical decision? -- Ruling out plausible rival hypotheses and confounding factors : a method -- Resolving the paradox of effectiveness : when do observational studies offer the same degree of evidential support as randomized trials? -- Questioning double blinding as a universal methodological virtue of clinical trials : resolving the Philip's paradox -- Placebo controls : problematic and misleading baseline measures of effectiveness -- Questioning (...) the methodological superiority of "placebo" over "active" controlled trials -- Examining the paradox that traditional roles for mechanistic reasoning and expert -- Judgment have been up-ended by EBM -- A qualified defence of the EBM stance on mechanistic reasoning -- Knowledge that versus knowledge how : situating the EBM position on expert clinical judgment -- Moving EBM forward. (shrink)

Philosophers of science have insisted that evidence of underlying mechanisms is required to support claims about the effects of medical interventions. Yet evidence about mechanisms does not feature on dominant evidence-based medicine “hierarchies.” After arguing that only inferences from mechanisms (“mechanistic reasoning”)—not mechanisms themselves—count as evidence, I argue for a middle ground. Mechanistic reasoning is not required to establish causation when we have high-quality controlled studies; moreover, mechanistic reasoning is more problematic than has been assumed. Yet where the problems can (...) be overcome, mechanistic reasoning can and should be used as evidence. (shrink)

Debates about the ethics and effects of placebos and whether ‘placebos’ in clinical trials of complex treatments such as acupuncture are adequate rage. Yet there is currently no widely accepted definition of the ‘placebo’. A definition of the placebo is likely to inform these controversies. Grünbaum’s characterization of placebos and placebo effects has been touted by some authors as the best attempt thus far, but has not won widespread acceptance largely because Grünbaum failed to specify what he means by a (...) therapeutic theory and because he does not stipulate a special role for expectation effects. Grünbaum claims that placebos are treatments whose ‘characteristic features’ do not have therapeutic effects on the target disorder. I show that with four modifications, Grünbaum’s definition provides a defensible account of placebos for the purpose of constructing placebo controls within clinical trials. The modifications I introduce are: adding a special role for expectations, insisting that placebo controls control for all and only the effects of the incidental treatment features, relativizing the definition of placebos to patients, and introducing harmful interventions and nocebos to the definitional scheme. I also provide guidance for classifying treatment features as characteristic or incidental. (shrink)

Proponents of evidence-based medicine and some philosophers of science seem to agree that knowledge of mechanisms can help solve the problem of applying results of controlled studies to target populations (‘the problem of extrapolation’). We describe the problem of extrapolation, characterize mechanisms, and outline how mechanistic knowledge might be used to solve the problem. Our main thesis is that there are four often overlooked problems with using mechanistic knowledge to solve the problem of extrapolation. First, our understanding of mechanisms is (...) often (and arguably, likely to remain) incomplete. Secondly, knowledge of mechanisms is not always applicable outside the tightly controlled laboratory conditions in which it is gained. Thirdly, mechanisms can behave paradoxically. Fourthly, as Daniel Steel points out, using mechanistic knowledge faces the problem of the ‘extrapolator’s circle’. At the same time, when the problems with mechanistic knowledge have been addressed, such knowledge can and should be used to mitigate (nothing can entirely solve) the problem of extrapolation. (shrink)

A resilient issue in research ethics is whether and when a placebo-controlled trial is justified if it deprives research subjects of a recognized treatment. The clinicians' moral duty to provide the best available care seems to require the use of ‘active’ controlled trials that use an established treatment as a control whenever such a therapy is available. In another regard, ACTs are supposedly methodologically inferior to PCTs. Hence, the moral duty of the clinical researcher to use the best methods will (...) favor PCTs. In this target article, I analyze the three reasons for believing that ACTs are inferior to PCTs namely: 1) ACTs lack ‘assay sensitivity’; 2) ACTs do not measure absolute effect size; and 3) ACTs require more participants; and I contend that none are acceptable. Consequently the tension between clinical and research ethics dissolves: the moral duty of the clinician to avoid PCTs is unopposed by methodological considerations. (shrink)

Unlike its friendly cousin the placebo effect, the nocebo effect (the effect of expecting a negative outcome) has been almost ignored. Epistemic and ethical confusions related to its existence have gone all but unnoticed. Contrary to what is often asserted, adverse events following from taking placebo interventions are not necessarily nocebo effects; they could have arisen due to natural history. Meanwhile, ethical informed consent (in clinical trials and clinical practice) has centred almost exclusively on the need to inform patients about (...) intervention risks with patients to preserve their autonomy. Researchers have failed to consider the harm caused by the way in which the information is conveyed. In this paper, I argue that the magnitude of nocebo effects must be measured using control groups consisting of untreated patients. And, because the nocebo effect can produce harm, the principle of non-maleficence must be taken into account alongside autonomy when obtaining (ethical) informed consent and communicating intervention risks with patients. (shrink)

Objectives -/- Surveys in various countries suggest 17% to 80% of doctors prescribe ‘placebos’ in routine practice, but prevalence of placebo use in UK primary care is unknown. Methods -/- We administered a web-based questionnaire to a representative sample of UK general practitioners. Following surveys conducted in other countries we divided placebos into ‘pure’ and ‘impure’. ‘Impure’ placebos are interventions with clear efficacy for certain conditions but are prescribed for ailments where their efficacy is unknown, such as antibiotics for suspected (...) viral infections. ‘Pure’ placebos are interventions such as sugar pills or saline injections without direct pharmacologically active ingredients for the condition being treated. We initiated the survey in April 2012. Two reminders were sent and electronic data collection closed after 4 weeks. Results -/- We surveyed 1715 general practitioners and 783 (46%) completed our questionnaire. Our respondents were similar to those of all registered UK doctors suggesting our results are generalizable. 12% (95% CI 10 to 15) of respondents used pure placebos while 97% (95% CI 96 to 98) used impure placebos at least once in their career. 1% of respondents used pure placebos, and 77% (95% CI 74 to 79) used impure placebos at least once per week. Most (66% for pure, 84% for impure) respondents stated placebos were ethical in some circumstances. Conclusion and implications -/- Placebo use is common in primary care but questions remain about their benefits, harms, costs, and whether they can be delivered ethically. Further research is required to investigate ethically acceptable and cost-effective placebo interventions. (shrink)

Unlike its friendly cousin the placebo effect, the nocebo effect has been almost ignored. Epistemic and ethical confusions related to its existence have gone all but unnoticed. Contrary to what is often asserted, adverse events following from taking placebo interventions are not necessarily nocebo effects; they could have arisen due to natural history. Meanwhile, ethical informed consent has centred almost exclusively on the need to inform patients about intervention risks with patients to preserve their autonomy. Researchers have failed to consider (...) the harm caused by the way in which the information is conveyed. In this paper, I argue that the magnitude of nocebo effects must be measured using control groups consisting of untreated patients. And, because the nocebo effect can produce harm, the principle of non-maleficence must be taken into account alongside autonomy when obtaining informed consent and communicating intervention risks with patients. There are no data in this work. (shrink)

AI, in the form of artificial carers, provides a possible solution to the problem of a growing elderly population Yet, concerns remain that artificial carers ( such as care-or chat-bots) could not emphathize with patients to the extent that humans can. Utilising the concept of empathy perception,we propose a Turing-type test that could check whether artificial carers could do many of the menial tasks human carers currently undertake, and in the process, free up more time for doctors to offer empathy. (...) -/- . (shrink)

Rationale and objectives: Medical humanities are becoming increasingly recognized as positively impacting medical education and medical practice. However, the extent of medical humanities teaching in medical schools is largely unknown. We reviewed medical school curricula in Canada, the UK and the US. We also explored the relationship between medical school ranking and the inclusion of medical humanities in the curricula. -/- Methods: We searched the curriculum websites of all accredited medical schools in Canada, the UK and the US to check (...) which medical humanities topics were taught, and whether they were mandatory or optional. We then noted rankings both by Times Higher Education and U.S. News and World Report and calculated the average rank. We formally explored whether there was an association between average medical school ranking and medical humanities offerings using Spearman's correlation and inverse variance weighting meta-analysis. -/- Results: We identified 18 accredited medical school programmes in Canada, 41 in the UK, and 154 in the US. Of these, nine (56%) in Canada, 34 (73%) in the UK and 124 (80%) in the US offered at least one medical humanity that was not ethics. The most common medical humanities were medical humanities (unspecified), history, and literature (Canada); sociology and social medicine, medical humanities (unspecified), and art (UK); and medical humanities (unspecified), literature and history (US). Higher ranked medical schools appeared less likely to offer medical humanities. -/- Conclusions: The extent and content of medical humanities offerings at accredited medical schools in Canada, the UK and the US varies, and there appears to be an inverse relationship between medical school quality and medical humanities offerings. Our analysis was limited by the data provided on the Universities' websites. Given the potential for medical humanities to improve medical education and medical practice, opportunities to reduce this variation should be exploited. (shrink)

The American Journal of Bioethics, Volume 12, Issue 3, Page 33-34, March 2012.

Since its introduction just over two decades ago, evidence-based medicine (EBM) has come to dominate medical practice, teaching, and policy. There are a growing number of textbooks, journals, and websites dedicated to EBM research, teaching, and evidence dissemination. EBM was most recently defined as a method that integrates best research evidence with clinical expertise and patient values and circumstances in the treatment of patients. There have been debates throughout the early 21st century about what counts as good research evidence between (...) EBM proponents and philosophical critics and even within the EBM community itself. Similar controversy arises about the relative worth of patient values and clinical expertise (and how these can be integrated). EBM has also evolved in ways that have come under scrutiny. Specifically, policymakers have used EBM research methodology to increase the relative importance of clinical guidelines that some clinicians have argued are tyrannical. Philosophers have addressed all of these controversies, and with very few exceptions have been critical of EBM. In addition most philosophical attention has been on the epistemic role of Randomization and evidence hierarchies, with relatively little attention being paid to the role of Diagnosis, expertise, patient values, and Systematic Reviews within EBM. (shrink)

Introduction Current treatments for pain have limited benefits and worrying side effects. Some studies suggest that pain is reduced when clinicians deliver positive messages. However, the effects of positive messages are heterogeneous and have not been subject to meta-analysis. We aimed to estimate the efficacy of positive messages for pain reduction. -/- Methods We included randomized trials of the effects of positive messages in a subset of the studies included in a recent systematic review of context factors for treating pain. (...) Several electronic databases were searched. Reference lists of relevant studies were also searched. Two authors independently undertook study selection, data extraction, risk of bias assessment, and analyses. Our primary outcome measures were differences in patient- or observer-reported pain between groups who were given positive messages and those who were not. -/- Results Of the 16 randomized trials (1703 patients) that met the inclusion criteria, 12 trials had sufficient data for meta-analysis. The pooled standardized effect size was −0.31 (95% confidence interval [CI] −0.61 to −0.01, p = 0.04, I2 = 82%). The effect size remained positive but not statistically significant after we excluded studies considered to have a high risk of bias (standard effect size −0.17, 95% CI −0.54 to 0.19, P = 0.36, I2 = 84%). -/- Conclusion Care of patients with chronic or acute pain may be enhanced when clinicians deliver positive messages about possible clinical outcomes. However, we have identified several limitations of the present study that suggest caution when interpreting the results. We recommend further high-quality studies to confirm (or falsify) our result. -/- FUNDING -/- Alexander Mebius research has been funded through the ERC grant "Philosophy of Pharmacology: Safety, Statistical Standards, and Evidence Amalgamation" (GA: 639276). (shrink)

A resilient issue in research ethics is whether and when a placebo-controlled trial is justified if it deprives research subjects of a recognized treatment. The clinicians' moral duty to provide the best available care seems to require the use of ‘active’ controlled trials that use an established treatment as a control whenever such a therapy is available. In another regard, ACTs are supposedly methodologically inferior to PCTs. Hence, the moral duty of the clinical researcher to use the best methods will (...) favor PCTs. In this target article, I analyze the three reasons for believing that ACTs are inferior to PCTs namely: 1) ACTs lack ‘assay sensitivity’; 2) ACTs do not measure absolute effect size; and 3) ACTs require more participants; and I contend that none are acceptable. Consequently the tension between clinical and research ethics dissolves: the moral duty of the clinician to avoid PCTs is unopposed by methodological considerations. (shrink)

Five reasons why teaching medical humanities in medical schools improves student performance, enhances wellbeing, and ameliorates patient outcomes.

This is a protocol for a Cochrane Review (Intervention). The objectives are as follows: -/- The main aim of this review will be to assess the effects of changing practitioner empathy or patient expectations for all conditions. The main objective is to conduct a systematic review of randomised trials where the intervention involves manipulating either (a) practitioner empathy or (b) patient expectations, or (c) both.

The feature of being ‘double blind’, where neither patients nor physicians are aware of who receives the experimental treatment, is universally trumpeted as being a virtue of clinical trials. The rationale for this view is unobjectionable: double blinding rules out the potential confounding influences of patient and physician beliefs. Nonetheless, viewing successfully double blind trials as necessarily superior leads to the paradox that very effective experimental treatments will not be supportable by best (double-blind) evidence. It seems strange that an account (...) of evidence should make a priori judgments that certain claims can never be supported by ‘best evidence’. So far as treatments with large effects go, the claim that they are effective is highly testable and intuitively they should receive greater support from the evidence. In this paper I argue that the two potential confounders ruled out by double blinding are often not actual confounders outside placebo controlled trials of treatments with mild effects and that have subjective outcome measures. (shrink)

The revised Declaration of Helsinki allows placebo-controlled trials to be used even when there is an established therapy, provided there are adequate ‘methodological’ reasons for doing so. This seems to violate the principle of beneficence: where there is an established therapy, physicians treating patients with a placebo are withholding a known effective therapy. Because of this problem, we hypothesised that clinical researchers may be unwilling to risk violating the principle of beneficence and employ placebo-controlled trials in cases where there is (...) an established therapy. In this paper, we began to investigate this hypothesis. After summarising the arguments for and against using placebo controls in clinical practice, we exploredthe extent to which placebo-controlled trials are used in cases where there is an established therapy. To do this, we conducted as systematic search for all placebo-controlled trials published in 2015 in the five highest impact general medical journals. We identified 70 placebo-controlled trials. Of these, 66 were for indications where there was no established effective therapy. Only four used a placebo control in spite of there being an available effective therapy. The infrequent use of placebo controlled trials where established therapy exists highlights a seeming discrepancy between what the Declaration of Helsinki allows and what clinical investigators believe to be ethically acceptable. The evidence presented in this paper suggests that the Declaration of Helsinki be reconsidered, and perhaps revised, in light of actual practice. (shrink)

Evidence-based medicine has always required integration of patient values with ‘best’ clinical evidence. It is widely recognized that scientific practices and discoveries, including those of EBM, are value-laden. But to date, the science of EBM has focused primarily on methods for reducing bias in the evidence, while the role of values in the different aspects of the EBM process has been almost completely ignored.

Increasing philosophical attention is being directed to the rapidly growing discipline of evidence-based medicine. Philosophical discussions of EBM, however, remain narrowly focused on randomization, mechanisms, and the sociology of EBM. Other aspects of EBM have been all but ignored, including the nature of clinical reasoning and the question of whether it can be standardized; the application of EBM principles to the logic, value, and ethics of diagnosis and prognosis; evidence synthesis ; and the nature and ethics of placebo controls. Philosophical (...) analysis in each of these areas has the potential to enhance the discussion of EBM methodology and practice. (shrink)

The idea that prescribing physicians should be guided by the most reliable scientific evidence seems obvious, but the actual methodology of evidence-based medicine was only introduced in the early 1990s by an international group of clinicians and researchers led by Gordon Guyatt. Since then it has provided a new paradigm for the scientific foundation of medicine and has influenced other disciplines outside of medicine, for example, evidence-based psychotherapy, science and government. The novel concept of evidence-based medicine is based on hierarchies (...) of evidence from opinions of respected authorities, mechanistic reasoning, and reports of expert committees at the bottom to... (shrink)

We characterize a type of functional explanation that addresses why a homologous trait originating deep in the evolutionary history of a group remains widespread and largely unchanged across the group’s lineages. We argue that biologists regularly provide this type of explanation when they attribute conserved functions to phenotypic and genetic traits. The concept of conserved function applies broadly to many biological domains, and we illustrate its importance using examples of molecular sequence alignments at the intersection of evolution and cell biology. (...) We use these examples to show how the study of conserved functions can integrate knowledge of a trait’s causal effects on fitness and its history of natural selection without invoking adaptation. We also show how conserved function provides a novel basis for addressing objections against evolutionary functions raised by Robert Cummins. (shrink)

This chapter offers an opinionated introduction to higher-order formal languages with an eye towards their applications in metaphysics. A simply relationally typed higher-order language is introduced in four stages: starting with first-order logic, adding first-order predicate abstraction, generalizing to higher-order predicate abstraction, and finally adding higher-order quantification. It is argued that both β-conversion and Universal Instantiation are valid on the intended interpretation of this language. Given these two principles, it is then shown how we can use pure higher-order logic to (...) ask, and begin to answer, metaphysical questions with non-trivial implications. In particular, while we must reject the popular idea that structural differences between sentences correspond to parallel distinctions in the logical structure of extra-linguistic reality, it may still be possible to give a purely logical characterization of objectual aboutness and related notions. (shrink)

Principles of legislation.--Principles of the civil code.--Principles of the penal code.

Jeremy Sherman distills Terrence Deacon's breakthrough natural science hypothesis for the emergence of agents and agency, selves and aims in an otherwise aimless universe. The theory cuts a new path through the dualistic spirit vs. mechanism debate, unifying the hard and soft sciences and suggesting new solutions to philosophical mysteries.

Although the pedagogy literature indicates significant relationships between cheating intentions and both personal and situational factors, no published research has examined the joint effect of personal moral philosophy and perceived moral intensity components on students’ cheating intentions. Hence, a structural equation model that relates magnitude of consequences, relativism, and idealism to willingness to cheat, is developed and tested. Using data from undergraduate business students, the empirical results provide insight into these relationships and evidence of mediation for magnitude of consequences on (...) idealism and students’ cheating intentions. Implications for educators are offered. (shrink)

In considering the debate about the meaning of ‘disease’, the positions are generally presented as falling into two categories: naturalist, e.g., Boorse, and normativist, e.g., Engelhardt and many others. This division is too coarse, and obscures much of what is going on in this debate. I therefore propose that accounts of the meaning of ‘disease’ be assessed according to Hare’s (1997) taxonomy of evaluative terms. Such an analysis will allow us to better understand both individual positions and their inter-relationships. Most (...) importantly, it will show that it is unlikely that there is a single unique disease-concept at issue. Rather, different authors are, for the most part, considering different concepts. (shrink)

Many philosophers think that free will requires alternative possibilities. Other philosophers deny this. There are plenty of philosophical arguments on both sides of this debate, but here I want to highlight various theological pressures that might push Christians into rejecting the principle of alternative possibilities. In this paper, I explore six cases that might push Christians in that direction: the case of divine foreknowledge, the case of prophecy, the case of the blessed in heaven, the case of Christ's human freedom, (...) the case of Mary's fiat in light of her immaculate conception, and the case of prayers for the past. As I will argue, in each of these cases, given certain other standard theological commitments, it seems that Christians are pushed to admit that the agent in question does indeed act freely but also that he or she did not possess alternative possibilities at the moment of decision. (shrink)

We have two aims. The main one is to expound the idea of renormalization in quantum field theory, with no technical prerequisites. Our motivation is that renormalization is undoubtedly one of the great ideas—and great successes--of twentieth-century physics. Also it has strongly influenced in diverse ways, how physicists conceive of physical theories. So it is of considerable philosophical interest. Second, we will briefly relate renormalization to Ernest Nagel's account of inter-theoretic relations, especially reduction. One theme will be a contrast between (...) two approaches to renormalization. The old approach, which prevailed from ca. 1945 to 1970, treated renormalizability as a necessary condition for being an acceptable quantum field theory. On this approach, it is a piece of great good fortune that high energy physicists can formulate renormalizable quantum field theories that are so empirically successful. But the new approach to renormalization explains why the phenomena we see, at the energies we can access in our particle accelerators, are described by a renormalizable quantum field theory. For whatever non-renormalizable interactions may occur at yet higher energies, they are insignificant at accessible energies. Thus the new approach explains why our best fundamental theories have a feature, viz. renormalizability, which the old approach treated as a selection principle for theories. That is worth saying since philosophers tend to think of scientific explanation as only explaining an individual event, or perhaps a single law, or at most deducing one theory as a special case of another. Here we see a framework in which there is a space of theories. And this framework is powerful enough to deduce that what seemed “manna from heaven” is to be expected: the good fortune is generic. We also maintain that universality, a concept stressed in renormalization theory, is essentially the familiar philosophical idea of multiple realizability; and that it causes no problems for reductions of a Nagelian kind. (shrink)

I argue that racism is essentially a civic character trait: to be a racist is to have a character that rationally reflects racial supremacist sociopolitical values. As with moral vice accounts of racism, character is my account’s primary evaluative focus: character is directly evaluated as racist, and all other racist things are racist insofar as, and because, they cause, are caused by, express or are otherwise suitably related to racist character. Yet as with political accounts of racism, sociopolitical considerations provide (...) my account’s primary evaluative standard: satisfying the sociopolitical standard of racial supremacy is what makes racist character racist. (shrink)

"Arguing that debates over legitimacy, political violence, freedom, and justice would benefit greatly from cross-tradition theorizing, this book shows how putting analytic and continental political theory in conversation would help us to overcome these intractable problems"--.

The epsilon calculus is a logical formalism developed by David Hilbert in the service of his program in the foundations of mathematics. The epsilon operator is a term-forming operator which replaces quantifiers in ordinary predicate logic. Specifically, in the calculus, a term εx A denotes some x satisfying A(x), if there is one. In Hilbert's Program, the epsilon terms play the role of ideal elements; the aim of Hilbert's finitistic consistency proofs is to give a procedure which removes such terms (...) from a formal proof. The procedures by which this is to be carried out are based on Hilbert's epsilon substitution method. The epsilon calculus, however, has applications in other contexts as well. The first general application of the epsilon calculus was in Hilbert's epsilon theorems, which in turn provide the basis for the first correct proof of Herbrand's theorem. More recently, variants of the epsilon operator have been applied in linguistics and linguistic philosophy to deal with anaphoric pronouns. (shrink)

A rigorous, authoritative new anthology which brings together some of the most significant contemporary scholarship on the theory of knowledge Carefully-calibrated and judiciously-curated, this strong and contemporary new anthology builds upon Epistemology: An Anthology, Second Edition (Wiley Blackwell, 2008) by drawing a concise and well-balanced selection of higher-level readings from a large, diverse, and evolving body of research. Includes 17 readings that represent a broad and vital part of contemporary epistemology, including articles by female philosophers and emerging thought leaders Organized (...) into seven thoughtful and distinct sections, including virtue epistemology, practical reasons for belief, and epistemic dysfunctions among others Designed to sit alongside the highly-successful anthology of canonical essays, Epistemology: An Anthology, Second Edition (Wiley Blackwell, 2008) Edited by a distinguished editorial team, including Ernie Sosa, one of the most influential active epistemologists Highlights cutting edge methodologies and contemporary topics for advanced students, instructors, and researchers. (shrink)

One of the most important philosophical topics in the early twentieth century and a topic that was seminal in the emergence of analytic philosophy was the relationship between Kantian philosophy and modern geometry. This paper discusses how this question was tackled by the Neo-Kantian trained philosopher Ernst Cassirer. Surprisingly, Cassirer does not affirm the theses that contemporary philosophers often associate with Kantian philosophy of mathematics. He does not defend the necessary truth of Euclidean geometry but instead develops a kind of (...) logicism modeled on Richard Dedekind's foundations of arithmetic. Further, because he shared with other Neo-Kantians an appreciation of the developmental and historical nature of mathematics, Cassirer developed a philosophical account of the unity and methodology of mathematics over time. With its impressive attention to the detail of contemporary mathematics and its exploration of philosophical questions to which other philosophers paid scant attention, Cassirer's philosophy of mathematics surely deserves a place among the classic works of twentieth century philosophy of mathematics. Though focused on Cassirer's philosophy of geometry, this paper also addresses both Cassirer's general philosophical orientation and his reading of Kant. (shrink)

This article critically analyses the concept of evidence in evidence‐based policy, arguing that there is a key problem: there is no existing practicable theory of evidence, one which is philosophically‐grounded and yet applicable for evidence‐based policy. The article critically considers both philosophical accounts of evidence and practical treatments of evidence in evidence‐based policy. It argues that both fail in different ways to provide a theory of evidence that is adequate for evidence‐based policy. The article contributes to the debate about how (...) evidence can and should be used to reduce contingency in science and in policy based on science. (shrink)

This essay develops a framework for understanding what I call the ethics of reflexivity, that is, the norms that govern attitudes and actions with respect to one’s own worth. I distinguish five central aspects of the reflexive commitment to living in accordance with one’s personal ideals: the extent to which and manner in which one regards oneself from an evaluative point of view, the extent to which one cares about receiving the respect of others, the degree to which one interprets (...) one’s personal ideals in an individualistic or collective manner, the degree to which one’s commitment to living in accordance with one’s personal ideals is rigid or flexible, and the worthiness of one’s personal ideals. This framework, I argue, illuminates the nature and moral significance of virtuous and vicious forms of the character trait of pride. (shrink)

The present edition of 'Of the Limits of the Penal Branch of Jurisprudence' supersedes 'Of Laws in General,' edited by H.L.A. Hart and published by the Athlone Press in 1970, as a volume in The Collected Works of Jeremy Bentham." --P. xi.

The first five volumes of the Correspondence of Jeremy Bentham contain over 1,300 letters written both to and from Bentham over a 50-year period, beginning in 1752 (aged three) with his earliest surviving letter to his grandmother, and ending in 1797 with correspondence concerning his attempts to set up a national scheme for the provision of poor relief. Against the background of the debates on the American Revolution of 1776 and the French Revolution of 1789, to which he made (...) significant contributions, Bentham worked first on producing a complete penal code, which involved him in detailed explorations of fundamental legal ideas, and then on his panopticon prison scheme. Despite developing a host of original and ground-breaking ideas, contained in a mass of manuscripts, he published little during these years, and remained, at the close of this period, a relatively obscure individual. Nevertheless, these volumes reveal how the foundations were laid for the remarkable rise of Benthamite utilitarianism in the early nineteenth century. Bentham’s early life is marked by his extraordinary precociousness, but also family tragedy: by the age of 10 he had lost five infant siblings and his mother. The letters in this volume document his difficult relationship with his father and his increasing attachment to his surviving younger brother Samuel, his education, his interest in chemistry and botany, and his committing himself to a life of philosophy and legal reform. (shrink)