The author replies to a letter to the editor from Felicitas Sofia Holzer concerning Wenner’s article “The Social Value Requirement in Research: From the Transactional to the Basic Structure Model of Stakeholder Obligations,” in the Hastings Center Report’s January‐February 2019 issue.

Relational autonomy theorists attempt to accommodate social embeddedness within a conception of autonomy. These attempts are conceptually messy, at best, and category errors, at worst. Rejecting the liberal conception of autonomy due to feminist concerns is more helpfully answered by the neorepublican notion of freedom as nondomination. The conception of freedom as nondomination captures the values that motivate the relational turn in moral and political theory and does so in a conceptually neater way than attempting to accommodate those concerns in (...) our accounts of autonomy. (shrink)

It has long been taken for granted that clinical research involving human subjects is ethical only if it holds out the prospect of producing socially valuable knowledge. Recently, this social value requirement has come under scrutiny, with prominent ethicists arguing that the social value requirement cannot be substantiated as an ethical limit on clinical research, and others attempting to offer new support. In this paper, I argue that both criticisms and existing defenses of the social value requirement are predicated on (...) what I call the “transactional model of stakeholder obligations”. I go on to problematize this framework, and to introduce an alternative framework for conceptualizing ethical obligations within clinical research. In defending this framework, which I call the “basic structure model of stakeholder obligations”, I also demonstrate how it provides a stronger grounding for the social value requirement that is not vulnerable to critiques grounded in the transactional model. (shrink)

Ethicists have long recognized that two necessary features of ethical research are scientific validity and social value. Yet despite a significant literature surrounding the validity component of this dictate, until recently there has been little attention paid to unpacking what the social value component might require. This article introduces a framework for assessing the social value of research, and in particular, for determining whether a given research program is likely to have significant social value of the kind necessary to fulfill (...) the social value requirement. The article goes on to illustrate how this framework can provide a clearer account of the responsiveness requirement, an ethical dictum that is oft-repeated but whose content and value as a guideline in international research remains contested. Although I introduce this conception of social value in the context of the responsiveness requirement, the account offered can, and is intended to, stand alone as a tool for the assessment of the social value of research. As such it can be usefully applied to discussions about the value of comparative effectiveness trials, the assessment of the continued proliferation of me-too drugs and the research done to develop them, the demand for public access to study-generated data, and persistent deficits in the publication of negative results. (shrink)

Ethical oversight of clinical research is one of the primary means of ensuring that human subjects are protected from the natural bias of researchers and research institutions in favor of experimentation. At a minimum, effective oversight should ensure that risks are minimized and reasonable in relation to anticipated benefits, protect vulnerable subjects from potential coercion or undue influence, ensure full and informed consent, and promote the equitable distribution of the risks and benefits of research. Because these assessments often involve value (...) judgments for which there are no agreed-upon objective standards, we rely on deliberative procedures thought to have the greatest likelihood of producing the right or best outcomes. Concerns about the potential for improperly functioning IRBs to waste scarce human and institutional resources and impede biomedical progress have motivated a surge in empirical research assessing their procedures and outcomes. Yet within this literature, there has been minimal attention paid to the social scientific evidence regarding how individuals and deliberating groups make decisions, nor how those data might inform IRB practice. This essay seeks to fill that gap, locating recent empirical data on IRB composition and process within the context of data regarding what I call “deliberative pathologies,” or instances when deliberation fails to live up to one or more aspect of the deliberative ideal because of systematic biases in the ways participants interact. The paper goes on to make evidence-based recommendations to reduce the vulnerability of IRB deliberations to the kinds of pathologies discussed and indicate directions for future research. (shrink)

In light of the growth in the conduct of international clinical research in developing populations, this paper seeks to explore what is owed to developing world communities who host international clinical research. Although existing paradigms for assigning and assessing benefits to host communities offer valuable insight, I criticize their failure to distinguish between those benefits which can justify the conduct of research in a developing world setting and those which cannot. I argue that the justification for human subjects research is (...) fundamentally grounded in the social value of knowledge, and that this value is context-dependent in a manner which should inform our ethical evaluation of the conduct of research in specific settings. I propose a new framework for the assessment of research benefits assigned to developing world host communities, a natural implication of which is to limit the types of research projects which may permissibly be conducted in developing world settings. (shrink)

This paper examines the moral force of exploitation in developing world research agreements. Taking for granted that some clinical research which is conducted in the developing world but funded by developed world sponsors is exploitative, it asks whether a third party would be morally justified in enforcing limits on research agreements in order to ensure more fair and less exploitative outcomes. This question is particularly relevant when such exploitative transactions are entered into voluntarily by all relevant parties, and both research (...) sponsors and host communities benefit from the resulting agreements. I show that defenders of the claim that exploitation ought to be permitted rely on a mischaracterization of certain forms of interference as unjustly paternalistic and two dubious empirical assumptions about the results of regulation. The view I put forward is that by evaluating a system of constraints on international research agreements, rather than individual transaction-level interference, we can better assess the alternatives to permitting exploitative research agreements. (shrink)

Patient-funded trials are gaining traction as a means of accelerating clinical translation. However, such trials sidestep mechanisms that promote rigor, relevance, efficiency, and fairness. We recommend that funding bodies or research institutions establish mechanisms for merit review of patient-funded trials, and we offer some basic criteria for evaluating PFT protocols.

Within bioethics as well as in broader clinical practice, support for transgender and gender‐questioning adolescent access to pubertal suppression has often relied heavily on the desire to prevent risky, self‐destructive, and suicidal behavior. We argue that framing justifications for access to puberty suppression in this way can actually be harmful to both individual patients as well as to the broader trans population. This justification for access to care makes such access precarious, limits its scope, and introduces perverse incentives to the (...) patient population that is being served. We go on to offer an alternative, positive defense of access to puberty‐blocking treatment for transgender youth grounded in the child's right to an open future. We argue that decisions related to pubertal suppression are both importantly weighty and potentially irreversible, and show why this justification is preferable to so‐called “informed consent” approaches. (shrink)

Volume 19, Issue 9, September 2019, Page 60-62.

Pratt, Zion, and Loff (2012) correctly point out that most international clinical research (ICR) is not intended to address the vast inequities in access to health care between developed and develo...

A growing proportion of clinical research funded by pharmaceutical companies, high-income country research agencies, and not-for-profit funders is conducted in low- and middle-income settings. Disparities in wealth and access to healthcare between the populations where new interventions are often tested and those where many of them are ultimately marketed raise concerns about exploitation. This chapter examines several ethical requirements frequently advanced as mechanisms for protecting research subjects in underserved communities from exploitation and evaluates the effectiveness of those mechanisms as responses (...) to exploitation worries. It goes on to highlight where the conceptual frameworks relied upon by research ethicists must be improved if we are to fully understand the nature of the moral claims and obligations that arise in research conducted in underserved communities. (shrink)

The global impact of Dobbs v. Jackson Women’s Health Organization and the backlash towards reproductive justice that it represents warrant a global feminist response informed by broad theoretical and geopolitical lenses. We consider how a solidaristic, transnational feminist movement might learn from Latin American feminist movements that have been successful in uniting broad coalitions in the fight for reproductive justice as situated within far-reaching political goals. The success of such a global movement must be decolonial and must contend with the (...) fact that overlapping realities of global inequality, severe poverty, extractivism, and western-backed violence are fundamentally implicated in reproductive justice. (shrink)

There has been a growing concern over establishing norms that ensure the ethically acceptable and scientifically sound conduct of clinical trials. Among the leading norms internationally are the World Medical Association's Declaration of Helsinki, guidelines by the Council for International Organizations of Medical Sciences, the International Conference on Harmonization's standards for industry, and the CONSORT group's reporting norms, in addition to the influential U.S. Federal Common Rule, Food and Drug Administration's body of regulations, and information sheets by the Department of (...) Health and Human Services. There are also many norms published at more local levels by official agencies and professional groups.Any account of international standards should cover both scientific and ethical norms at once – the two are conceptually intertwined. Recent sources recognize that “[s]cientifically unsound research on human subjects is unethical in that it exposes research subjects to risks without possible benefit.”. (shrink)

California has focused on health equity in the state’s COVID-19 reopening plan. The Blueprint for a Safer Economy assigns each of California’s 58 counties into 1 of 4 tiers based on 2 metrics: test positivity rate and adjusted case rate. To advance to the next less-restrictive tier, counties must meet that tier’s test positivity and adjusted case rate thresholds. In addition, counties must have a plan for targeted investments within disadvantaged communities, and counties with more than 106 000 residents must (...) meet an equity metric. California's explicit incorporation of health equity into its reopening plan underscores the interrelated fate of its residents during the COVID-19 pandemic and creates incentives for action. This article evaluates the benefits and challenges of this novel health equity focus, and outlines recommendations for other US states to address disparities in their reopening plans. (shrink)

Danielle Wenner has crafted novel arguments in defense of republican accounts of freedom. I learned a lot from her discussion of how Philip Pettit's neorepublican account of freedom as nondomination does a better job than standard accounts of freedom as noninterference of explaining how power over an agent can restrict their freedom to act autonomously. The real crux of Wenner's argument, however, is that freedom as nondomination can do this work in a way that those who defend (...) an account of relational autonomy cannot. I will start with Wenner's defense of freedom as nondomination and of what it can do as the background for assessing her critique of relational autonomy. The upshot of my comments will be that Wenner... (shrink)

Three studies test eight hypotheses about (1) how judgment differs between people who ascribe greater vs. less moral relevance to choices, (2) how moral judgment is subject to task constraints that shift evaluative focus (to moral rules vs. to consequences), and (3) how differences in the propensity to rely on intuitive reactions affect judgment. In Study 1, judgments were affected by rated agreement with moral rules proscribing harm, whether the dilemma under consideration made moral rules versus consequences of choice salient, (...) and by thinking styles (intuitive vs. deliberative). In Studies 2 and 3, participants evaluated policy decisions to knowingly do harm to a resource to mitigate greater harm or to merely allow the greater harm to happen. When evaluated in isolation, approval for decisions to harm was affected by endorsement of moral rules and by thinking style. When both choices were evaluated simultaneously, total harm -- but not the do/allow distinction -- influenced rated approval. These studies suggest that moral rules play an important, but context-sensitive role in moral cognition, and offer an account of when emotional reactions to perceived moral violations receive less weight than consideration of costs and benefits in moral judgment and decision making. (shrink)

This book philosophically explores a wide range of subjects relating to evil and human wickedness, including the nature of evil, explaining evil, evil and moral responsibility, and responding to evil.

In this book Daniel Wegner offers a novel understanding of the relation of consciousness, the will, and our intentional and voluntary actions. Wegner claims that our experience and common sense view according to which we can influence our behavior roughly the way we experience that we do it is an illusion.

Dan Haybron presents an illuminating examination of well-being, drawing on important recent work in the science of happiness. He shows that we are remarkably prone to error in judgements of our own personal welfare, and suggests that we should rethink traditional assumptions about the good life and the good society.

In this 1970 introduction to philosophy Mr Taylor concentrates on two central topics - explanation and meaning. He takes the argument far enough to acquaint the reader first-hand with the methods and approach of analytical philosophy, and yet because of the scope of these two topics he is able to introduce many of the traditional philosophical problems in epistemology, metaphysics, ethics, aesthetics, and logic. By this approach he avoids the dangers both of superficiality and of undue technicality. Philosophers are concerned (...) to analyse and describe certain concepts and modes of argument, not to establish facts or conclusions of any sort that can be tested by formal demonstration or controlled observation; their findings cannot be conveniently categorized or graded into a comprehensive and progressive course of studies. Mr Taylor meets this difficulty with his extended discussions of specific topics and questions which have implications over the whole subject. (shrink)

This book offers a comprehensive overview of the structure, strategy and methods of assessment of orthodox theoretical economics. In Part I Professor Hausman explains how economists theorise, emphasising the essential underlying commitment of economists to a vision of economics as a separate science. In Part II he defends the view that the basic axioms of economics are 'inexact' since they deal only with the 'major' causes; unlike most writers on economic methodology, the author argues that it is the rules that (...) economists espouse rather than their practice that is at fault. Part III links the conception of economics as a separate science to the fact that economic theories offer reasons and justifications for human actions, not just their causes. With its lengthy appendix introducing relevant issues in philosophy of science, this book is a major addition to philosophy of economics and of social science. (shrink)

Understanding moral philosophy can help one to do economics better, and philosophers can learn by drawing on economic insights and analytical tools. This book argues that standard views of rationality lead economists to espouse questionable moral principles, and discusses methods of economic evaluation in terms of welfare and other moral criteria. It also contains a brief discussion of the relevance of social choice and game theory to philosophy. There is a glossary and at the end of each chapter are suggestions (...) for further reading. (shrink)

This book is about preferences, principally as they figure in economics. It also explores their uses in everyday language and action, how they are understood in psychology and how they figure in philosophical reflection on action and morality. The book clarifies and for the most part defends the way in which economists invoke preferences to explain, predict and assess behavior and outcomes. Hausman argues, however, that the predictions and explanations economists offer rely on theories of preference formation that are in (...) need of further development, and he criticizes attempts to define welfare in terms of preferences and to define preferences in terms of choices or self-interest. The analysis clarifies the relations between rational choice theory and philosophical accounts of human action. The book also assembles the materials out of which models of preference formation and modification can be constructed, and it comments on how reason and emotion shape preferences. (shrink)

This book, by one of the pre-eminent philosophers of science writing today, offers the most comprehensive account available of causal asymmetries. Causation is asymmetrical in many different ways. Causes precede effects; explanations cite causes not effects. Agents use causes to manipulate their effects; they don't use effects to manipulate their causes. Effects of a common cause are correlated; causes of a common effect are not. This book explains why a relationship that is asymmetrical in one of these regards is asymmetrical (...) in the others. Hausman discovers surprising hidden connections between theories of causation and traces them all to an asymmetry of independence. This is a major book for philosophers of science that will also prove insightful to economists and statisticians. (shrink)

In this addition to the award-winning Church and Postmodern Culture series, respected theologian Daniel Bell compares and contrasts capitalism and Christianity, showing how Christianity provides resources for faithfully navigating the postmodern global economy. Bell approaches capitalism and Christianity as alternative visions of humanity, God, and the good life. Considering faith and economics in terms of how desire is shaped, he casts the conflict as one between different disciplines of desire. He engages the work of two important postmodern philosophers, Deleuze and (...) Foucault, to illuminate the nature of the postmodern world that the church currently inhabits. Bell then considers how the global economy deforms desire in a manner that distorts human relations with God and one another. In contrast, he presents Christianity and the tradition of the works of mercy as a way beyond capitalism and socialism, beyond philanthropy and welfare. Christianity heals desire, renewing human relations and enabling communion with God. (shrink)

Hooking up is a term commonly used in contemporary American society to refer to sexual activity between two people who are not in a committed romantic relationship. Data show that although many college students are engaging in hookups, there is no consensus on how to define a hookup. The author uses the concept of “strategic ambiguity” to explore the intentionality and usefulness of the vagueness of this term. Specific to hookups, strategic ambiguity is when individuals use the term “hookup” to (...) describe their sexual activities rather than give details about their sexual activities as an impression management strategy to protect their sexual and social identities. Analyzing data gathered through interviews with heterosexual students at a mid-sized public university in the South, this article addresses the normative character and the myriad definitions of hookups; addresses the underlying heterosexist bias in the definitions of hookups; and analyzes how the ambiguity of the term “hookup” serves women and men in different ways and both reinforces and challenges the current gender order, allowing men to conform to and preserve components of hegemonic masculinity and women to conform to and preserve components of emphasized femininity. (shrink)

This essay explains what the Causal Markov Condition says and defends the condition from the many criticisms that have been launched against it. Although we are skeptical about some of the applications of the Causal Markov Condition, we argue that it is implicit in the view that causes can be used to manipulate their effects and that it cannot be surrendered without surrendering this view of causation.

We often consciously will our own actions. This experience is so profound that it tempts us to believe that our actions are caused by consciousness. It could also be a trick, however – the mind’s way of estimating its own apparent authorship by drawing causal inferences about relationships between thoughts and actions. Cognitive, social, and neuropsychological studies of apparent mental causation suggest that experiences of conscious will frequently depart from actual causal processes and so might not reflect direct perceptions of (...) conscious thought causing action. (shrink)

Drawing on theories of William James, Freud, and Dewey, as well as on studies in mood control, cognitive therapy, and artificial intelligence, this...

ABSTRACT:This paper examines the norms that should guide policies aimed at promoting happiness or, more broadly, well-being. In particular, we take up the question of which conception of well-being should govern well-being policy, assuming some such policies to be legitimate. In answer, we lay out a case for ‘pragmatic subjectivism’: given widely accepted principles of respect for persons, well-being policy may not assume any view of well-being, subjectivist or objectivist. Rather, it should promote what its intended beneficiaries see as good (...) for them: pleasure for hedonists, excellence for Aristotelians, etc. Specifically, well-being policy should promote citizens’ ‘personal welfare values’: those values—and not mere preferences—that individuals see as bearing on their well-being. Finally, we briefly consider how pragmatic subjectivism works in practice. While our discussion takes for granted the legitimacy of well-being policy, we suggest that pragmatic subjectivism strengthens the case for such policy. (shrink)

Participants watched themselves in a mirror while another person behind them, hidden from view, extended hands forward on each side where participants’ hands would normally appear. The hands performed a series of movements. When participants could hear instructions previewing each movement, they reported an enhanced feeling of controlling the hands. Hearing instructions for the movements also enhanced skin conductance responses when a rubber band was snapped on the other’s wrist after the movements. Such vicarious agency was not felt when the (...) instructions followed the movements, and participants’ own covert movement mimicry was not essential to the influence of previews on reported control. (shrink)

ABSTRACT Recent writings by philosophers such as David Miller and Yael Tamir have undertaken to provide nationalism with a normative foundation, a task which has been all but ignored by post‐War English‐language political philosophy. I identify and criticise three lines of argument which have been deployed in their writings. First, it is argued by Miller that the universalism and abstraction of rationalist moral theories have made them suspicious of ‘particularisms’ such as nationalism, but that they stem from a faulty metaethics. (...) Against this I argue that abstraction and universality need not be grounded in a universalist metaethics, but can be derived pragmatically from the ethical needs of multicultural societies. Second, it is argued that liberal policies such as taxation and material redistribution, restrictions on immigration, as well as liberal concepts such as political obligation, presuppose the validity of the nationalist point of view. Against this I hold that nationalism never provides the strongest moral grounds for these policies and concepts, and that, in the specific case of distributive justice, it can even undermine them. And third, I examine the argument that the historical excesses of which nationalists have been guilty are actually the product of a narrow, ‘ethnic’nationalism, in contrast to which we can articulate a categorically distinct, open, ‘civic’nationalism, which would be broadly compatible with liberal political morality. I argue that the concept of civic nationalism is unstable, and that under fairly plausible and widespread empirical conditions, it either collapses back into a form of ethnic nationalism, or else becomes devoid of any recognisably nationalist content. (shrink)

Three experiments examined whether the mere priming of potential action effects enhances people’s feeling of causing these effects when they occur. In a computer task, participants and the computer independently moved a rapidly moving square on a display. Participants had to press a key, thereby stopping the movement. However, the participant or the computer could have caused the square to stop on the observed position, and accordingly, the stopped position of the square could be conceived of as the potential effect (...) resulting from participants’ action of pressing the stop key. The location of this position was primed or not just before participants had to stop the movement. Results showed that priming of the position enhanced experienced authorship of stopping the square. Additional experimentation demonstrated that this priming of agency was not mediated by the goal or intention to produce the effect. (shrink)