Randomized controlled trial trial designs exist on an explanatory-pragmatic spectrum, depending on the degree to which a study aims to address a question of efficacy or effectiveness. As conceptualized by Schwartz and Lellouch in 1967, an explanatory approach to trial design emphasizes hypothesis testing about the mechanisms of action of treatments under ideal conditions, whereas a pragmatic approach emphasizes testing effectiveness of two or more available treatments in real-world conditions. Interest in, and the number of, pragmatic trials has grown substantially (...) in recent years, with increased recognition by funders and stakeholders worldwide of the need for credible evidence to inform clinical decision-making. This increase has been accompanied by the onset of learning healthcare systems, as well as an increasing focus on patient-oriented research. However, pragmatic trials have ethical challenges that have not yet been identified or adequately characterized. The present study aims to explore the views of key stakeholders with respect to ethical issues raised by the design and conduct of pragmatic trials. It is embedded within a large, four-year project that seeks to develop guidance for the ethical design and conduct of pragmatic trials. As a first step, this study will address important gaps in the current empirical literature with respect to identifying a comprehensive range of ethical issues arising from the design and conduct of pragmatic trials. By opening up a broad range of topics for consideration within our parallel ethical analysis, we will extend the current debate, which has largely emphasized issues of consent, to the range of ethical considerations that may flow from specific design choices. Semi-structured interviews with key stakeholders, across multiple jurisdictions, identified based on their known experience and/or expertise with pragmatic trials. We expect that the study outputs will be of interest to a wide range of knowledge users including trialists, ethicists, research ethics committees, journal editors, regulators, healthcare policymakers, research funders and patient groups. All publications will adhere to the Tri-Agency Open Access Policy on Publications. (shrink)

1The opinions contained in this article are those of the authors and should not be construed as policies of the American Medical Association.

Sex differences in aggressive behavior are probably adaptive but the costs and benefits of risky aggression to women and men may be different from those suggested in Campbell's target article. Moreover, sex differences are more likely to reflect differences in the costs of aggression to females and males rather than differences in its benefits.

ObjectivesTo describe reporting of informed consent in pragmatic trials, justifications for waivers of consent and reporting of alternative approaches to standard written consent. To identify factors associated with (1) not reporting and (2) not obtaining consent.MethodsSurvey of primary trial reports, published 2014–2019, identified using an electronic search filter for pragmatic trials implemented in MEDLINE, and registered in ClinicalTrials.gov.ResultsAmong 1988 trials, 132 (6.6%) did not include a statement about participant consent, 1691 (85.0%) reported consent had been obtained, 139 (7.0%) reported a (...) waiver and 26 (1.3%) reported consent for one aspect (eg, data collection) but a waiver for another (eg, intervention). Of the 165 trials reporting a waiver, 76 (46.1%) provided a justification. Few (53, 2.9%) explicitly reported use of alternative approaches to consent. In multivariable logistic regression analyses, lower journal impact factor (p=0.001) and cluster randomisation (p<0.0001) were significantly associated with not reporting on consent, while trial recency, cluster randomisation, higher-income country settings, health services research and explicit labelling as pragmatic were significantly associated with not obtaining consent (all p<0.0001).DiscussionNot obtaining consent seems to be increasing and is associated with the use of cluster randomisation and pragmatic aims, but neither cluster randomisation nor pragmatism are currently accepted justifications for waivers of consent. Rather than considering either standard written informed consent or waivers of consent, researchers and research ethics committees could consider alternative consent approaches that may facilitate the conduct of pragmatic trials while preserving patient autonomy and the public’s trust in research. (shrink)

In this article we describe our approach to understanding wrongdoing in medical research and practice, which involves the statistical analysis of coded data from a large set of published cases. We focus on understanding the environmental factors that predict the kind and the severity of wrongdoing in medicine. Through review of empirical and theoretical literature, consultation with experts, the application of criminological theory, and ongoing analysis of our first 60 cases, we hypothesize that 10 contextual features of the medical environment (...) (including financial rewards, oversight failures, and patients belonging to vulnerable groups) may contribute to professional wrongdoing. We define each variable, examine data supporting our hypothesis, and present a brief case synopsis from our study that illustrates the potential influence of the variable. Finally, we discuss limitations of the resulting framework and directions for future research. (shrink)

The view that allegiance to characters is a matter of general moral assessment, as developed by Carroll (1984) and Smith (1995), has the resources to respond to counterexamples proposed in the literature, including appeals to anti-heroes, rough heroes and other ‘reprehensible characters’ that garner our allegiance. It can even admit non-moral factors as subterranean influences on moral assessment. Nevertheless, the view requires that the characters we most favour are those with the highest moral standing, and this does not seem (...) to be true of the character arc story (Kelly, 2020). Rather, the mixture of good and bad impulses in the protagonist is set off by the unalloyed moral example of the moral centre, a supporting character whose fate may barely interest us. We conclude that narrative theory is better served by allowing the moral hierarchy of a story to differ from the rank order of its allegiances, and hence that audience affiliation is not simply a matter of moral assessment. (shrink)

Noel Carroll’s A Philosophy of Mass Art is intended as a contribution to a “systematic” philosophy of mass art, but his more immediate aim is to clarify and criticize the principles and presuppositions that contemporary theorists bring—mistakenly, he argues—to their reflections on mass art. In a sense, Carroll offers to provide for the philosophy of mass art what he claims mass art can provide for morality, namely, clarificationism : “Logical argumentation and conceptual clarification are its major research tools”. (...) The general result of this strategy is a classification of mass art that is ontological, as he explains what is unique about a mass artwork ; structuralist, as he claims there are common emotional, moral, and ideological structures of mass art ; and functionalist, as he argues that it is the function of mass art to be produced intentionally to be accessible to a mass audience. Moreover, Carroll’s ontological theory is essentialist, for he is committed to developing and defending “a series of necessary conditions that are jointly sufficient for calling something a mass artwork”. This commitment culminates in what he calls a “real” definition of a mass artwork, which is as follows. (shrink)

Business and Society: Ethics and Stakeholder Management, 5th edition employs a stakeholder management framework, emphasizing business' social and ethical responsibilities to both external and internal stakeholder groups. A twin theme of business ethics to illustrate how ethical or moral considerations are included the public issues facing organizations and the decision making process of managers. The text is written from a managerial perspective that along with the twin themes of stakeholders and ethics, shows how to identify stakeholders, incorporate their concerns into (...) the organization's strategy and operations, and also integrate ethical wisdom into their decision making process. In addition, 35 case histories are included to help connect theory and practice through timely and interesting examples. (shrink)

Discussion of partial grounds that aren't parts of full grounds; definition of full grounding in terms of partial grounding.

Beyond Aesthetics brings together philosophical essays addressing art and related issues by one of the foremost philosophers of art at work today. Countering conventional aesthetic theories - those maintaining that authorial intention, art history, morality and emotional responses are irrelevant to the experience of art - Noël Carroll argues for a more pluralistic and commonsensical view in which all of these factors can play a legitimate role in our encounter with art works. Throughout, the book combines philosophical theorizing with (...) illustrative examples including works of high culture and the avant-garde, as well as works of popular culture, jokes, horror novels, and suspense films. (shrink)

A selection of essays written by one of the leading critics of film over the last two decades, this volume examines theoretical aspects of film and television through penetrating analyses of such genres as soap opera, documentary, comedy, and such topics as 'sight gags', film metaphor, point-of-view editing, and movie music. Throughout, individual films are considered in depth. Carroll's essays, moreover, represent the cognitivist turn in film studies, containing in-depth criticism of existing approaches to film theory, and heralding a (...) new approach. (shrink)

The moral/conventional task has been widely used to study the emergence of moral understanding in children and to explore the deficits in moral understanding in clinical populations. Previous studies have indicated that moral transgressions, particularly those in which a victim is harmed, evoke a signature pattern of responses in the moral/conventional task: they are judged to be serious, generalizable and not authority dependent. Moreover, this signature pattern is held to be pan‐cultural and to emerge early in development. However, almost all (...) the evidence for these claims comes from studies using harmful transgressions of the sort that primary school children might commit in the schoolyard. In a study conducted on the Internet, we used a much wider range of harm transgressions, and found that they do not evoke the signature pattern of responses found in studies using only schoolyard transgressions. Paralleling other recent work, our study provides preliminary grounds for skepticism regarding many conclusions drawn from earlier research using the moral/conventional task. (shrink)

Epistemology -- Power I -- Power II -- Subjectivity -- Resistance -- Critique -- Ethics.

There are three primary aims of the book. The first, set out in the book's introduction, is to explain how two fairly recent developments in philosophy, externalism and modalism, provide the basis for a promising account of knowledge - an account that achieves anti-skeptical results and avoids Gettier-style counterexamples that are based on an agent having warranted beliefs that are merely luckily true. Epistemological externalism is the thesis that not all the factors that make a true belief a case of (...) knowledge need to be cognitively accessible or "internal" to the agent. Modalism, as the author construes it, is the use of possible worlds talk in clarifying what would or might be the case and what is necessarily so." "The second objective is to work through the different modalized epistemologies extant in the literature, assessing their strengths and weaknesses, with a view toward constructing a working theory. Finally, the author proposes the theory that knowledge is reliably formed, sensitive true belief, and defends the theory against objections."--Jacket. (shrink)

Knowledge closure is the claim that, if an agent S knows P, recognizes that P implies Q, and believes Q because it is implied by P, then S knows Q. Closure is a pivotal epistemological principle that is widely endorsed by contemporary epistemologists. Against Knowledge Closure is the first book-length treatment of the issue and the most sustained argument for closure failure to date. Unlike most prior arguments for closure failure, Marc Alspector-Kelly's critique of closure does not presuppose any (...) particular epistemological theory; his argument is, instead, intuitively compelling and applicable to a wide variety of epistemological views. His discussion ranges over much of the epistemological landscape, including skepticism, warrant, transmission and transmission failure, fallibilism, sensitivity, safety, evidentialism, reliabilism, contextualism, entitlement, circularity and bootstrapping, justification, and justification closure. As a result, the volume will be of interest to any epistemologist or student of epistemology and related subjects. (shrink)

Effective Field Theory (EFT) is the successful paradigm underlying modern theoretical physics, including the "Core Theory" of the Standard Model of particle physics plus Einstein's general relativity. I will argue that EFT grants us a unique insight: each EFT model comes with a built-in specification of its domain of applicability. Hence, once a model is tested within some domain (of energies and interaction strengths), we can be confident that it will continue to be accurate within that domain. Currently, the Core (...) Theory has been tested in regimes that include all of the energy scales relevant to the physics of everyday life (biology, chemistry, technology, etc.). Therefore, we have reason to be confident that the laws of physics underlying the phenomena of everyday life are completely known. (shrink)

Epistemic luck has been the focus of much discussion recently. Perhaps the most general knowledge-precluding type is veritic luck, where a belief is true but might easily have been false. Veritic luck has two sources, and so eliminating it requires two distinct conditions for a theory of knowledge. I argue that, when one sets out those conditions properly, a solution to the generality problem for reliabilism emerges.

Art in Three Dimensions is a collection of essays by one of the most eminent figures in philosophy of art.

This book sets out first to explain how two fairly recent developments in philosophy, externalism and modalism, provide the basis for a promising account of knowledge, and then works through the different modalized epistemologies extant in the literature, assessing their strengths and weaknesses. Finally, the author proposes the theory that knowledge is reliably formed, sensitive true belief, and defends the theory against objections.

Introduction: The role of animals in philosophies of man -- Part I: What's wrong with animal rights? -- The right to remain silent -- Part II: Animal pedagogy -- You are what you eat : Rousseau's cat -- Say the human responded : Herder's sheep -- Part III: Difference worthy of its name -- Hair of the dog : Derrida's and Rousseau's good taste -- Sexual difference, animal difference : Derrida's sexy silkworm -- Part IV: It's our fault -- The (...) beaver's struggle with species-being : De Beauvoir and the praying mantis -- Answering the call of nature : Lacan walking the dog -- Part V: Estranged kinship -- The abyss between humans and animals : Heidegger puts the bee in being -- Strange kinship : Merleau-Ponty's sensuous stickleback -- Stopping the anthropological machine : Agamben's tick-tocking tick -- Psychoanalysis and the science of kinship -- Psychoanalysis as animal by-product : Freud's zoophilia -- Animal abjects, maternal abjects : Kristeva's strays -- Conclusion: Sustainable ethics. (shrink)

The sensitivity principle is a compelling idea in epistemology and is typically characterized as a necessary condition for knowledge. This collection of thirteen new essays constitutes a state-of-the-art discussion of this important principle. Some of the essays build on and strengthen sensitivity-based accounts of knowledge and offer novel defences of those accounts. Others present original objections to sensitivity-based accounts and offer comprehensive analysis and discussion of sensitivity's virtues and problems. The resulting collection will stimulate new debate about the sensitivity principle (...) and will be of great interest and value to scholars and advanced students of epistemology. (shrink)

Argument that full grounds modally entail what they ground.

Hellenistic philosophy concerns the thought of the Epicureans, Stoics, and Skeptics, the most influential philosophical groups in the era between the death of Alexander the Great and the defeat of the last Greek stronghold in the ancient world. The Routledge Handbook of Hellenistic Philosophy provides accessible yet rigorous introductions to the theories of knowledge, ethics, and physics belonging to each of the three schools. It explores the fascinating ways in which interschool rivalries shaped the philosophies of the era, and offers (...) unique insight into the relevance of Hellenistic views to issues today, such as environmental ethics, consumerism, and bioethics. Eleven countries are represented among the Handbook's thirty-five authors, whose chapters were written specifically for this volume and are organized thematically into six sections: I. The people, history, and methods of Epicureanism, Stoicism, and Skepticism. II. Earlier philosophical influences on Hellenistic thought, such as Aristotle, Socrates, and Presocratics. III. The soul, perception, and knowledge. IV. God, fate, and the primary principles of nature and the universe. V. Ethics, political theory, society, and community. VI. Hellenistic philosophy's relevance to contemporary life. Spanning from the ancient past to the present, this Handbook aims to show that Hellenistic philosophy has much to offer all thinking people of the twenty-first century. (shrink)

Often neglected as an influence on phenomenology, Bergson's thought has resurfaced and brought challenges to phenomenology. In a series of original essays and translations, leading scholars of contemporary continental philosophy seek to redress this oversight and inaugurate a long over due dialogue and yet pertinent to the future of continental philosophy. This thematically focused collection reintroduces Bergson to the dominant discourse in continental philosophy (phenomenology), reevaluates phenomenologists' readings of Bergson (e.g., Heidegger, Sartre, Merleau-Ponty, Levinas, and Henry), and examines Bergsonian challenges (...) to phenomenological methods and issues. What emerges is not only a revitalized Bergson read on his own terms, but also a view of the vibrance of Bergson's thought and its central contributions to perennial issues in phenomenology and contemporary continental philosophy: including dualism, intentionality, subjectivity and selfhood, science, time, ethics, freedom, life and affectivity. -- Product Description. (shrink)

In these original readings of Albert Camus' novels, short stories, and political essays, David Carroll concentrates on Camus' conflicted relationship with his Algerian background and finds important critical insights into questions of justice, the effects of colonial oppression, and the deadly cycle of terrorism and counterterrorism that characterized the Algerian War and continues to surface in the devastation of postcolonial wars today. During France's "dirty war" in Algeria, Camus called for an end to the violence perpetrated against civilians by (...) both France and the Algerian National Liberation Front and supported the creation of a postcolonial, multicultural, and democratic Algeria. His position was rejected by most of his contemporaries on the Left and has, ironically, earned him the title of colonialist sympathizer as well as the scorn of important postcolonial critics. Carroll rescues Camus' work from such criticism by emphasizing the Algerian dimensions of his literary and philosophical texts and by highlighting in his novels and short stories his understanding of both the injustice of colonialism and the tragic nature of Algeria's struggle for independence. By refusing to accept that the sacrifice of innocent human lives can ever be justified, even in the pursuit of noble political goals, and by rejecting simple, ideological binaries, Camus' work offers an alternative to the stark choices that characterized his troubled times and continue to define our own. "What they didn't like, was the Algerian, in him," Camus wrote of his fictional double in _The First Man_. Not only should "the Algerian" in Camus be "liked," Carroll argues, but the Algerian dimensions of his literary and political texts constitute a crucial part of their continuing interest. Carroll's reading also shows why Camus' critical perspective has much to contribute to contemporary debates stemming from the global "war on terror.". (shrink)

In these original readings of Albert Camus' novels, short stories, and political essays, David Carroll concentrates on Camus' conflicted relationship with his Algerian background and finds important critical insights into questions of justice, the effects of colonial oppression, and the deadly cycle of terrorism and counterterrorism that characterized the Algerian War and continues to surface in the devastation of postcolonial wars today. During France's "dirty war" in Algeria, Camus called for an end to the violence perpetrated against civilians by (...) both France and the Algerian National Liberation Front and supported the creation of a postcolonial, multicultural, and democratic Algeria. His position was rejected by most of his contemporaries on the Left and has, ironically, earned him the title of colonialist sympathizer as well as the scorn of important postcolonial critics. Carroll rescues Camus' work from such criticism by emphasizing the Algerian dimensions of his literary and philosophical texts and by highlighting in his novels and short stories his understanding of both the injustice of colonialism and the tragic nature of Algeria's struggle for independence. By refusing to accept that the sacrifice of innocent human lives can ever be justified, even in the pursuit of noble political goals, and by rejecting simple, ideological binaries, Camus' work offers an alternative to the stark choices that characterized his troubled times and continue to define our own. "What they didn't like, was the Algerian, in him," Camus wrote of his fictional double in _The First Man_. Not only should "the Algerian" in Camus be "liked," Carroll argues, but the Algerian dimensions of his literary and political texts constitute a crucial part of their continuing interest. Carroll's reading also shows why Camus' critical perspective has much to contribute to contemporary debates stemming from the global "war on terror.". (shrink)

Thinking about business ethics and corporate citizenship -- Compliance, companies, and corporate governance -- Ethical leadership -- the heart of moral direction -- Ethics issues and guidelines for decision making -- Spirituality and business ethics -- Ethics, organizations, and management -- Stakeholders, environment and sustainability -- Employee stakeholders -- Consumer stakeholders -- Global topics in business ethics.

Jonathan Vogel has recently argued that counterfactual reliabilism cannot account for higher‐level knowledge that one's belief is true, or not false. His particular argument for this claim is straightforward and valid. Interestingly, there is a parallel argument, based on an alternative but plausible reinterpretation of the main premise in Vogel's argument, which squares CR with higher‐level knowledge both that one's belief is true and that one's belief is not false. I argue that, while Vogel's argument reveals the incompatibility of CR (...) and knowledge of certain higher‐level propositions, it does not establish the general claim that CR is incompatible with knowledge that any of one's beliefs is true, or not false. (shrink)

Characterization of a form of explanation involving grounding on the model of mechanistic causal explanation.

Recent years have seen an increasing amount of studies of the history of the term “religion” and how it figures in conceptions of “the secular” and of cultural differences generally. A recurrent theme in these studies is that “religion” carries associations with Protestant Christianity and thus is not as universal a category as it might appear. The aim of this paper is to explore some resources in Wittgenstein’s philosophy to obtain greater clarity about the contexts of ascription of religion-status to (...) various phenomena and thus to gain perspective on claims made by scholars who investigate the genealogy of the term. While there is good reason to be circumspect about uncritical use of the term “religion” (no less in philosophizing about religions or conducting interreligious dialogue), I argue that instead of abandoning the term or proffering a critical theory of religion, investigation of ascriptions of religion will help philosophers to perceive more clearly the social dynamics that have led to some- one or thing being called religious and thus avoid equivocations that could obstruct the ends of philosophical inquiry or dialogue. (shrink)

Ever since Eve tempted Adam with her apple, women have been regarded as a corrupting and destructive force. The very idea that women can be used as interrogation tools, as evidenced in the infamous Abu Ghraib torture photos, plays on age-old fears of women as sexually threatening weapons, and therefore the literal explosion of women onto the war scene should come as no surprise. From the female soldiers involved in Abu Ghraib to Palestinian women suicide bombers, women and their bodies (...) have become powerful weapons in the Afghanistan and Iraq wars. In _Women as Weapons of War_, Kelly Oliver reveals how the media and the administration frequently use metaphors of weaponry to describe women and female sexuality and forge a deliberate link between notions of vulnerability and images of violence. Focusing specifically on the U.S. campaigns in Afghanistan and Iraq, Oliver analyzes contemporary discourse surrounding women, sex, and gender and the use of women to justify America's decision to go to war. For example, the administration's call to liberate "women of cover," suggesting a woman's right to _bare_ arms is a sign of freedom and progress. Oliver also considers what forms of cultural meaning, or lack of meaning, could cause both the guiltlessness demonstrated by female soldiers at Abu Ghraib and the profound commitment to death made by suicide bombers. She examines the pleasure taken in violence and the passion for death exhibited by these women and what kind of contexts created them. In conclusion, Oliver diagnoses our cultural fascination with sex, violence, and death and its relationship with live news coverage and embedded reporting, which naturalizes horrific events and stymies critical reflection. This process, she argues, further compromises the borders between fantasy and reality, fueling a kind of paranoid patriotism that results in extreme forms of violence. (shrink)

This book makes a case for the permissibility of reactive blame – the angry, harmful variety. Blame is a thorny philosophical problem, as it is notoriously difficult to specify the conditions under which an agent is deserving of blame, is deserving of blame in the basic sense, and furthermore why this is so. Kelly McCormick argues that sharpening the focus to reactive, angry blame can both show us how best to characterize the problem itself, and suggest a possible solution (...) to it, because even reactive blame is both valuable and deserved in the basic sense. Finally, McCormick shows how, despite the many facets of the dark side of blame, adopting an explicitly victim-centered approach highlights a powerful argument from empathy for retaining reactive blame and its attendant attitudes and practices. (shrink)

As a linguist, Julia Kristeva has pioneered a revolutionary theory of the sign in its relation to social and political emancipation; as a practicing psychoanalyst, she has produced work on the nature of the human subject and sexuality, and on the "new maladies" of today's neurotic. _The Portable Kristeva_ is the only fully comprehensive compilation of Kristeva's key writings. The second edition includes added material from Kristeva's most important works of the past five years, including _The Sense and Non-Sense of (...) Revolt_, _Intimate Revolt_, and _Hannah Arendt_. Editor Kelly Oliver has also added new material to the introduction, summarizing Kristeva's latest intellectual endeavors and updating the bibliography. (shrink)