"Written by a well-known and respected author, this book reflects careful scholarship by someone who has extensive experience in the field and creative insights.

As Shavelson et al. (2023) demonstrate with their example of Imani, the lines drawn between permissible and impermissible aid in dying can seem arbitrary, discriminatory, and inconsistent with the...

: When a patient could be offered one of multiple established treatments, doctors should be able to offer treatment only if the patient agrees to participate in research aimed at determining which of the treatments is most effective. Making treatment conditional on research participation will help researchers complete badly needed studies.

Should surgeons offer uterus transplants to women who want to become pregnant but do not have a functioning uterus? The debate reminds us that society often neglects the interests of the infertile. Only a handful of uterus transplants have been reported worldwide—including two this past September—but advances in technique may make the transplants available more widely. Some women are born without a functioning uterus; others have hysterectomies for cancer, postpartum hemorrhage, or other reasons. Many of these women want to become (...) mothers and carry their own pregnancies. However, the prospect of uterus transplantation has elicited sharp criticism. According to ethics professor Rebecca Kukla, the surgery is not, “in any traditional sense, therapeutic.”. (shrink)

When a patient could be offered one of multiple established treatments, doctors should be able to offer treatment only if the patient agrees to participate in research aimed at determining which of the treatments is most effective. Making treatment conditional on research participation will help researchers complete badly needed studies.

The medicalization model of poverty leads us to devote considerable resources to treating the healthcare problems caused by poverty while neglecting the root cause of those problems — the poverty itself. Treating symptoms rather than causes is far less effective than treating causes. When correctly understood, poverty is a major public health problem that needs to be addressed directly with effective anti-poverty programs. Only then can we properly serve the healthcare needs of the poor.

As the medical profession becomes more and more of a commercial enterprise, commentators are subjecting conflicts of interest in medicine to increasing scrutiny. However, one critical area of conflict has largely escaped discussion—the conflicts of interest raised by the advertising policies of medical journals. Moreover, when these conflicts are discussed, they are examined almost exclusively in terms of the concerns that they pose for journal editors. Yet, there is a second critical concern with journal advertising policies. The policies also create (...) serious conflicts of interest for the professional societies that own medical journals.In this article, we will discuss the conflicts of interest that are raised for journal editors and professional societies by journal advertising policies, and we will conclude that the policies are exactly backward. Currently, medical journals rely on advertisements from pharmaceutical companies and other health-related businesses and avoid—indeed exclude—advertisements from consumer-oriented companies, like producers of automobiles, golf equipment, or jewelry. We submit that the medical journals, the medical profession, and the public would be better served if consumeroriented advertisement were preferred over health-related advertising. (shrink)

As the medical profession becomes more and more of a commercial enterprise, commentators are subjecting conflicts of interest in medicine to increasing scrutiny. However, one critical area of conflict has largely escaped discussion—the conflicts of interest raised by the advertising policies of medical journals. Moreover, when these conflicts are discussed, they are examined almost exclusively in terms of the concerns that they pose for journal editors. Yet, there is a second critical concern with journal advertising policies. The policies also create (...) serious conflicts of interest for the professional societies that own medical journals.In this article, we will discuss the conflicts of interest that are raised for journal editors and professional societies by journal advertising policies, and we will conclude that the policies are exactly backward. Currently, medical journals rely on advertisements from pharmaceutical companies and other health-related businesses and avoid—indeed exclude—advertisements from consumer-oriented companies, like producers of automobiles, golf equipment, or jewelry. We submit that the medical journals, the medical profession, and the public would be better served if consumeroriented advertisement were preferred over health-related advertising. (shrink)

As the medical profession becomes more and more of a commercial enterprise, commentators are subjecting conflicts of interest in medicine to increasing scrutiny. However, one critical area of conflict has largely escaped discussion—the conflicts of interest raised by the advertising policies of medical journals. Moreover, when these conflicts are discussed, they are examined almost exclusively in terms of the concerns that they pose for journal editors. Yet, there is a second critical concern with journal advertising policies. The policies also create (...) serious conflicts of interest for the professional societies that own medical journals.In this article, we will discuss the conflicts of interest that are raised for journal editors and professional societies by journal advertising policies, and we will conclude that the policies are exactly backward. Currently, medical journals rely on advertisements from pharmaceutical companies and other health-related businesses and avoid—indeed exclude—advertisements from consumer-oriented companies, like producers of automobiles, golf equipment, or jewelry. We submit that the medical journals, the medical profession, and the public would be better served if consumeroriented advertisement were preferred over health-related advertising. (shrink)

Studies in several developing countries for treatmen to prevent HIV-transmission from mother to child generated considerable controversy in 1997. Critics of the studies argued that basic principles of research ethics were violated. According to the critics, researchers subjected women in developing countries to studies that would have been unethical in the United States and that the researchers were therefore engaged in unethical exploitation ofcitizens of the developing countries in which the studies were conducted.While the critics agreed that unethical exploitation had (...) occurred, they differed on the exact nature of the exploitation. Some observers condemned the researchers for employing a double standard — because the researchers were applying a standard of care that would have been unacceptable in their own country. In the view of these critics, researchers should have been comparing the experimental treatment to established therapy rather than to placebo, as would have been required in the United States or other developed countries. (shrink)

Studies in several developing countries for treatmen to prevent HIV-transmission from mother to child generated considerable controversy in 1997. Critics of the studies argued that basic principles of research ethics were violated. According to the critics, researchers subjected women in developing countries to studies that would have been unethical in the United States and that the researchers were therefore engaged in unethical exploitation ofcitizens of the developing countries in which the studies were conducted.While the critics agreed that unethical exploitation had (...) occurred, they differed on the exact nature of the exploitation. Some observers condemned the researchers for employing a double standard — because the researchers were applying a standard of care that would have been unacceptable in their own country. In the view of these critics, researchers should have been comparing the experimental treatment to established therapy rather than to placebo, as would have been required in the United States or other developed countries. (shrink)

Informed consent mandates for abortion providers may infringe the First Amendment's freedom of speech. On the other hand, they may reinforce the physician's duty to obtain informed consent. Courts can promote both doctrines by ensuring that compelled physician speech pertains to medical facts about abortion rather than abortion ideology and that compelled speech is truthful and not misleading.

Daryl Pullman (2023) highlights a striking statistic—while aid in dying constitutes less than one percent of deaths in the U.S. states that have legalized the practice,1 around three percent of dea...

When the Supreme Court of Canada recognized a constitutional right to “medical assistance in dying” last year—and the nation's Parliament enacted legislation to implement the right earlier this year—Canadian lawmakers could look to two different models for guidance. The Netherlands and Belgium recognize a broad right to assistance in dying, while Oregon and elsewhere in the United States have a narrow right. In some ways, assistance in dying in Canada follows the Dutch-Belgian approach, while, in other ways, it seems more (...) American. Two societal factors seem relevant to the different approaches: the role that religion plays in people's lives and the trust that people place in their governments and health care systems. As other governments consider legalizing assistance in dying, an important question is whether some restrictions on the right are particularly critical. The experience to date suggests that requiring patients to be terminally ill has provided the best protection against misuse. (shrink)

Pharmaceutical companies have exploited health information technology to “mine” data from drug prescriptions and use the data to better target their sales pitches to physicians. This article considers the policy arguments and first amendment implications regarding state regulation of data mining. It concludes that the legislative provisions are desirable and should withstand constitutional challenge.

Pharmaceutical companies have long relied on direct marketing of their drugs to physicians through one-on-one meetings with sales representatives. This practice of “detailing” is substantial in its costs and its number of participants. Every year, pharmaceutical companies spend billions of dollars on millions of visits to physicians by tens of thousands of sales representatives.Critics have argued that drug detailing results in sub-optimal prescribing decisions by physicians, compromising patient health and driving up spending on medical care. In this view, physicians often (...) are unduly influenced both by marketing presentations that do not accurately reflect evidence from the medical literature and by the gifts that sales representatives deliver in conjunction with their presentations. (shrink)

In the wake of Republican gains in November 2010, anti-abortion bills were common and aggressive during the 2011 legislative sessions.1 State general assemblies passed statutes that include provisions to (a) block abortions after twenty weeks of gestation, (b) require doctors to tell pregnant women that fetuses feel pain at or before twenty weeks of gestation, (c) prevent state or federal health care dollars from reaching clinics and physician groups that provide abortions as part of their services,2 and (d) require doctors (...) to describe the ultrasound images of the fetus and offer women the option to view the ultrasound and listen to the fetal heartbeat before an abortion.3 These statutes are troubling .. (shrink)

"These essays make a splendid book. Ignatieff's lectures are engaging and vigorous; they also combine some rather striking ideas with savvy perceptions about actual domestic and international politics.

The shortage of organs for transplantation by its nature prompts ethical dilemmas. For example, although there is an imperative to save human life and reduce suffering by maximising the supply of vital organs, there is an equally important obligation to ensure that the process by which we increase the supply respects the rights of all stakeholders. In a relatively unexamined practice in the USA, organs are procured from unrepresented decedents without their express consent. Unrepresented decedents have no known healthcare wishes (...) or advance care planning document; they also lack a surrogate. The Revised Uniform Anatomical Gift Act of 2006 sends a mixed message about the procurement of organs from this patient population and there are hospitals that authorise donation. In addition, in adopting the RUAGA, some states included provisions that clearly allow organ procurement from unrepresented decedents. An important unanswered question is whether this practice meets the canons of ethical permissibility. The current Brief Report presents two principled approaches to the topic as a way of highlighting some of the complexities involved. Concluding remarks offer suggestions for future research and discussion. (shrink)

David Hume's Enquiry concerning Human Understanding is the definitive statement of the greatest philosopher in the English language. His arguments in support of reasoning from experience, and against the "sophistry and illusion"of religiously inspired philosophical fantasies, caused controversy in the eighteenth century and are strikingly relevant today, when faith and science continue to clash. The Enquiry considers the origin and processes of human thought, reaching the stark conclusion that we can have no ultimate understanding of the physical world, or (...) indeed our own minds. In either sphere we must depend on instinctive learning from experience, recognizing our animal nature and the limits of reason. Hume's calm and open-minded skepticism thus aims to provide a new basis for science, liberating us from the "superstition" of false metaphysics and religion. His Enquiry remains one of the best introductions to the study of philosophy, and his edition places it in its historical and philosophical context. (shrink)

A leading political theorist’s groundbreaking defense of ideal conceptions of justice in political philosophy Throughout the history of political philosophy and politics, there has been continual debate about the roles of idealism versus realism. For contemporary political philosophy, this debate manifests in notions of ideal theory versus nonideal theory. Nonideal thinkers shift their focus from theorizing about full social justice, asking instead which feasible institutional and political changes would make a society more just. Ideal thinkers, on the other hand, question (...) whether full justice is a standard that any society is likely ever to satisfy. And, if social justice is unrealistic, are attempts to understand it without value or importance, and merely utopian? Utopophobia argues against thinking that justice must be realistic, or that understanding justice is only valuable if it can be realized. David Estlund does not offer a particular theory of justice, nor does he assert that justice is indeed unrealizable—only that it could be, and this possibility upsets common ways of proceeding in political thought. Estlund engages critically with important strands in traditional and contemporary political philosophy that assume a sound theory of justice has the overriding, defining task of contributing practical guidance toward greater social justice. Along the way, he counters several tempting perspectives, including the view that inquiry in political philosophy could have significant value only as a guide to practical political action, and that understanding true justice would necessarily have practical value, at least as an ideal arrangement to be approximated. Demonstrating that unrealistic standards of justice can be both sound and valuable to understand, Utopophobia stands as a trenchant defense of ideal theory in political philosophy. (shrink)

The zetetic turn in epistemology raises three questions about epistemic and zetetic norms. First, there is the relationship question: what is the relationship between epistemic and zetetic norms? Are some epistemic norms zetetic norms, or are epistemic and zetetic norms distinct? Second, there is the tension question: are traditional epistemic norms in tension with plausible zetetic norms? Third, there is the reaction question: how should theorists react to a tension between epistemic and zetetic norms? Drawing on an analogy to practical (...) philosophy, I develop a focal point view to resolve these motivating questions. On the focal point view, traditional epistemic norms and zetetic norms answer different types of normative questions. There is nevertheless a familiar type of evaluative tension between traditional epistemic norms and zetetic norms, but this tension is an unavoidable feature of the normative landscape and not a sign that traditional epistemic norms need revision. But if traditional epistemic norms are not zetetic norms, then in what sense is zetetic epistemology a project for epistemologists? I conclude by articulating a sense in which some nontraditional epistemic norms are zetetic norms, and in which zetetic epistemology is an important part of the study of theoretical rationality. (shrink)

One of the enduring concerns of moral philosophy is deciding who or what is deserving of ethical consideration. Much recent attention has been devoted to the "animal question" -- consideration of the moral status of nonhuman animals. In this book, David Gunkel takes up the "machine question": whether and to what extent intelligent and autonomous machines of our own making can be considered to have legitimate moral responsibilities and any legitimate claim to moral consideration. The machine question poses a (...) fundamental challenge to moral thinking, questioning the traditional philosophical conceptualization of technology as a tool or instrument to be used by human agents. Gunkel begins by addressing the question of machine moral agency: whether a machine might be considered a legitimate moral agent that could be held responsible for decisions and actions. He then approaches the machine question from the other side, considering whether a machine might be a moral patient due legitimate moral consideration. Finally, Gunkel considers some recent innovations in moral philosophy and critical theory that complicate the machine question, deconstructing the binary agent--patient opposition itself. Technological advances may prompt us to wonder if the science fiction of computers and robots whose actions affect their human companions could become science fact. Gunkel's argument promises to influence future considerations of ethics, ourselves, and the other entities who inhabit this world. (shrink)

This book is an attempt to get to the bottom of an acute and perennial tension between our best scientific pictures of the fundamental physical structure of the world and our everyday empirical experience of it. The trouble is about the direction of time. The situation (very briefly) is that it is a consequence of almost every one of those fundamental scientific pictures--and that it is at the same time radically at odds with our common sense--that whatever can happen can (...) just as naturally happen backwards. Albert provides an unprecedentedly clear, lively, and systematic new account--in the context of a Newtonian-Mechanical picture of the world--of the ultimate origins of the statistical regularities we see around us, of the temporal irreversibility of the Second Law of Thermodynamics, of the asymmetries in our epistemic access to the past and the future, and of our conviction that by acting now we can affect the future but not the past. Then, in the final section of the book, he generalizes the Newtonian picture to the quantum-mechanical case and (most interestingly) suggests a very deep potential connection between the problem of the direction of time and the quantum-mechanical measurement problem. The book aims to be both an original contribution to the present scientific and philosophical understanding of these matters at the most advanced level, and something in the nature of an elementary textbook on the subject accessible to interested high-school students. Table of Contents: Preface 1. Time-Reversal Invariance 2. Thermodynamics 3. Statistical Mechanics 4. The Reversibility Objections and the Past-Hypothesis 5. The Scope of Thermodynamics 6. The Asymmetries of Knowledge and Intervention 7. Quantum Mechanics Appendix: Gedankenexperiments with Heat Engines Index Reviews of this book: The foundations of statistical mechanisms are often presented in physics textbooks in a rather obscure and confused way. By challenging common ways of thinking about this subject, Time and Chance can do quite a lot to improve this situation. --Jean Bricmont, Science Albert is perfecting a style of foundational analysis that is uniquely his own...It has a surgical precision...and it is ruthless with pretensions. The foundations of thermodynamics is a topic that has accumulated a good deal of dead wood; this is a fire that will burn and burn. --Simon W. Saunders, Oxford University As usual with Albert's work, the exposition is brisk and to the point, and exceptionally clear...The book will be an extremely valuable contribution to the literature on the subject of philosophical issues in thermodynamics and statistical mechanics, a literature which has been thin on the ground but is now growing as it deserves to. --Lawrence Sklar, University of Michigan. (shrink)

By means of an example, shows the possibility of beliefs that are separately rational whilst together inconsistent.

I modify Grice's theory of conversational implicature so as to accommodate acts of implicating propositions by asking questions, acts of implicating questions by asserting propositions, and acts of implicating questions by asking questions. I describe the relations between a declarative sentence's semantic content (the proposition it semantically expresses), on the one hand, and the propositions that a speaker locutes, asserts, and implicates by uttering that sentence, on the other. I discuss analogous relations between an interrogative sentence's semantic content (the question (...) it semantically expresses), and the questions that a speaker locutes, asks, and implicates by uttering that sentence. (shrink)

How should one react when one has a belief, but knows that other people—who have roughly the same evidence as one has, and seem roughly as likely to react to it correctly—disagree? This paper argues that the disagreement of other competent inquirers often requires one to be much less confident in one’s opinions than one would otherwise be.

Consider the following two (hypothetical) generic causal claims: “Living in a neighborhood with many families with children increases purchases of bicycles” and “living in an affluent neighborhood with many families with children increases purchases of bicycles.” These claims not only differ in what they suggest about how bicycle ownership is distributed across different neighborhoods (i.e., “the data”), but also have the potential to communicate something about the speakers’ values: namely, the prominence they accord to affluence in representing and making decisions (...) about the social world. Here, we examine the relationship between the level of granularity with which a cause is described in a generic causal claim (e.g., neighborhood vs. affluent neighborhood) and the value of the information contained in the causal model that generates that claim. We argue that listeners who know any two of the following can make reliable inferences about the third: 1) the level of granularity at which a speaker makes a generic causal claim, 2) the speaker’s values, and 3) the data available to the speaker. We present results of four experiments (N=1,323) in the domain of social categories that provide evidence in keeping with these predictions. (shrink)

I attempt to get as clear as possible on the chain of reasoning by which irreversible macrodynamics is derivable from time-reversible microphysics, and in particular to clarify just what kinds of assumptions about the initial state of the universe, and about the nature of the microdynamics, are needed in these derivations. I conclude that while a “Past Hypothesis” about the early Universe does seem necessary to carry out such derivations, that Hypothesis is not correctly understood as a constraint on the (...) early Universe’s entropy. (shrink)

Understanding Animal Welfare, 2nd Edition is revised and expanded to incorporate new research and developments in animal welfare. Updated with greater accessibility in mind, the reader is guided through animal welfare in its cultural and historical context, methods of study, and applications in practice and policy. Drawing examples from farm, companion, laboratory and zoo animals, the text provides an up-to-date overview of research and its applications, while also tracing how concepts and methods have evolved over time. Originally intended for scientists (...) and professionals, Understanding Animal Welfare has also found a home in undergraduate classrooms. It is now the essential text for students, practitioners, veterinarians, and researchers in animal welfare and related fields. (shrink)

We start by presenting three different views that jointly imply that every person has many conscious beings in their immediate vicinity, and that the number greatly varies from person to person. We then present and assess an argument to the conclusion that how confident someone should be in these views should sensitively depend on how massive they happen to be. According to the argument, sometimes irreducibly de se observations can be powerful evidence for or against believing in metaphysical theories.

Worries about mental causation are prominent in contemporary discussions of the mind and human agency. Originally, the problem of mental causation was that of understanding how a mental substance (thought to be immaterial) could interact with a material substance, a body. Most philosophers nowadays repudiate immaterial minds, but the problem of mental causation has not gone away. Instead, focus has shifted to mental properties. How could mental properties be causally relevant to bodily behavior? How could something mental qua mental cause (...) what it does? After looking at the traditional Problem of Interaction, we survey various versions of the property-based problem and look at proposed solutions to them. (shrink)

In this paper we show that axiomatic extensions of H. Wansing’s connexive logic $$\textsf{C}$$ ( $$\textsf{C}^{\perp }$$ ) are algebraizable (in the sense of J.W. Blok and D. Pigozzi) with respect to sub-varieties of $$\textsf{C}$$ ( $$\textsf{C}^{\perp }$$ )-algebras. We develop the structure theory of $$\textsf{C}$$ ( $$\textsf{C}^{\perp }$$ )-algebras, and we prove their representability in terms of twist-like constructions over implicative lattices (Heyting algebras). As a consequence, we further clarify the relationship between the aforementioned classes. Finally, taking advantage of (...) the above machinery, we provide some preliminary remarks on the lattice of axiomatic extensions of $$\textsf{C}$$ ( $$\textsf{C}^{\perp }$$ ) as well as on some properties of their equivalent algebraic semantics. (shrink)