Many clinical ethicists have argued that ethics expertise is impossible. Their skeptical argument usually rests on the assumptions that to be an ethics expert is to know the correct moral conclusions, which can only be arrived at by having the correct ethical theories. In this paper, I argue that this skeptical argument is unsound. To wit, ordinary ethical deliberations do not require the appeal to ethical or meta-ethical theories. Instead, by agreeing to resolve moral differences by appealing to reasons, the (...) participants agree to the Default Principle—a substantive rule that tells us how to adjudicate an ethical disagreement. The Default Principle also entails a commitment to arguments by parity, and together these two methodological approaches allow us to make genuine moral progress without assuming any deep ethical principles. Ethical expertise, in one sense, is thus the ability and knowledge to deploy the Default Principle and arguments by parity. (shrink)

Since its initial publication in 2018, Professor Anya Plutynski’s Explaining Cancer: Finding Order in Disorder has garnered a great deal of accolades.1 In 2021, The London School of Economics and Political Science conferred Professor Plutynski the Lakatos Award, recognizing the book’s significant contribution to the philosophy of science. On the heels of its recent reissuing as a paperback, it is an ideal time to revisit this remarkable work.

ABSTRACT A number of philosophers have argued that alcoholics should receive lower priority for liver transplantations because they are morally responsible for their medical conditions. In this paper, I argue that this conclusion is false. Moral responsibility should not be used as a criterion for the allocation of medical resources. The reason I advance goes further than the technical problem of assessing moral responsibility. The deeper problem is that using moral responsibility as an allocation criterion undermines the functioning of medicine.

Antibiotic-resistant bacteria pose a serious threat to our health. Our ability to destroy deadly bacteria by using antibiotics have not only improved our lives by curing infections, it also allows us to undertake otherwise dangerous treatments from chemotherapies to invasive surgeries. The emergence of antibiotic resistance, I argue, is a consequence of various iterations of prisoner’s dilemmas. To wit, each participant (from patients to nations) has rational self-interest to pursue a course of action that is suboptimal for all of us. (...) The standard solutions to prisoner’s dilemma look to realign cost-benefit such that individuals’ interests match those of the collective. However, the lack of a global organization to enforce an effective carrot-and-stick system makes it unlikely that we can solve the antibiotic resistance problem this way. I argue that our best chance might be an attempt to teach altruism and convince individuals to act not out of their self-interests. (shrink)

Since its introduction in 1964, the World Medical Association’s Declaration of Helsinki—Ethical Principles for Medical Research Involving Human Subjects has enshrined the importance of safeguarding the well-being of human subjects in clinical research. The Declaration has undergone seven revisions, often in response to requests for clarification. I want to argue that the Declaration is in need of another revision in light of recent discoveries in placebo research.

We grant that anthropic reasoning yields the result that we should not expect to be in a small civilization. However, regardless of what civilization one finds oneself in, one can use anthropic reasoning to get the result that one should not expect to be in that sort of civilization. Hence, contra Ken Olum, anthropic reasoning does not conflict with observation.

Students with recent immigrant roots disproportionately choose educational trajectories in STEM. In addition to the perception that STEM represents the "path of least racism," many students assume the responsibility of contributing to their families' financial wellbeing. In this talk, I share my experience teaching at a pre-professional healthcare university with a large percentage of 1st and 2nd-generation Asian immigrant students. Many of them seek advice on how to negotiate the social and familial pressure to pursue STEM against their interests in (...) the humanities. The reply "Follow your heart" might be inappropriate when familial obligations and perceived bigotry are legitimate deterrents. By recognizing the grand tradition of one immigrant generation trying to improve the lot for the next, we strive not merely for financial freedom but freedom in general. As such, we ought to consider how we can spend our lives to best dismantle the barriers that limit our life choices. (shrink)

Nocebo effects occur when an individual experiences undesirable physiological reactions caused by doxastic states that are not a treatment’s core or characteristic features.1 As Scott Gelfand2 points out, there are numerous studies that have shown that the disclosure of a treatment’s side effects to a patient increases the risk of the side effects. From an ethical point of view, nocebo effects caused by the disclosures of side effects present a challenging problem. On the one hand, clinicians’ duty to inform patients (...) of the consequences (including possible side effects) of their treatments is critical in ensuring that patients’ autonomy is respected. Patients cannot act autonomously if relevant information is withheld from them (without their consent, perhaps). On the other hand, clinicians also ought to minimize harm to patients. (shrink)

This book sheds light on important philosophical assumptions made by professionals working in clinical and research medicine. In doing so, it aims to make explicit how active philosophy is in medicine and shows how this awareness can result in better and more informed medical research and practice. -/- It examines: what features make something a scientific discipline; the inherent tensions between understanding medicine as a research science and as a healing practice; how the “replication crisis” in medical research asks us (...) to rethink the structure of knowledge production in our modern world; whether explanations have any real scientific values; the uncertainties about probabilistic claims; and whether it is possible for evidence-based medicine to truly be value free. The final chapter argues that the most important question we can ask is not, “How can we separate values from science?” but, “In a democratic society, how can we decide in a politically and morally acceptable way what values should drive science?”. (shrink)

The ubiquitous presence of pharmaceuticals in our lives is underappreciated. In the United States between 2009 and 2012, almost half the population used at least one prescription drug and more than one in ten Americans used five or more prescription drugs within a 30-day period. The use of pharmaceuticals is so widespread that runoffs from incorrect disposal of drugs have become a pollutant in our drinking water. In 2009, researchers found 51 different pharmaceuticals from beta-blockers to antianxiety medications to anticonvulsants (...) in 19 water treatment plants. Environmental impacts are worrisome for sure, but the effects of drugs on us raise far deeper concerns. (shrink)

This anthology provides a collection of new essays on ethical and philosophical issues that concern the development, dispensing, and use of pharmaceuticals. It brings together critical ethical issues in pharmaceutics that have not been included in any collection (e.g., the ethics of patients as researchers). In addition, it includes philosophical issues that are not within the traditional domain of applied ethics. For example, a game-theoretic approach to combating the emergence of antibiotic-resistent pathogens by spreading altruism. A tripartite distinction provides an (...) organized series of discussions that shows the interrelatedness of philosophical issues from the creation of pharmaceuticals, the creation of demand for them, through their delivery to their ultimate consumption. (shrink)

Theorizing the World argues that explanations play a central role in our theoretical understanding of the world. Explanations explain in virtue of subsuming what is to be explained under the appropriate projectable regularities. My epistemological account of explanation differs from traditional views in understanding subsumption as a far more complex relation. When a projectable regularity explains, it both confirms its corresponding background theories and draws explanatory strength from them at the same time. The failure of the standard models of explanation, (...) I claim, has to do with their inability to consider explanations as a part of a broader enterprise of theory-formation. In this sense, we account for the essentially epistemic nature of explanation by noting the intimate connection between explanations and theoretical reasoning. ;The dissertation proceeds in four chapters. In the first chapter, I argue that the object of an explanation always contains a reference to the epistemic conditions of the inquirer. The need for an explanation arises out of a detachment between what the inquirer believes and some observation at hand. To explain is to eliminate the detachment in the appropriate manner. The second chapter examines a host of standard models of explanation. I show that the failure of these models is largely due to their inability to explicate the explanation relation in sufficiently strong metaphysical notions. In the third chapter, I propose that in explaining, we connect the epistemic corpus of the inquirer to the observation via an appropriate projectable regularity. Finally, in chapter four, I examine issues of unification, the role of explanation in science and explanations in ethics as further evidence for my view. (shrink)

In his "Let the drugs lead the way! On the unfolding of a research program in psychiatry," Shai Mulinari nicely lays out the evolution of theories of depression since the late 1950s; that is, understanding depression as ultimately a brain disorder centering on the functioning of monoamine neurotransmitters. Moreover, the emergence of various psychotropic drug treatments have provided researchers with a "pharmacological bridge" to gain a more precise understanding of depression by observing the effects of these drugs on patients' monoamines (...) and mood. This evolution, Mulinari argues, fits Imre Lakatos's concept of a research program. Mulinari's narrative is clear, compelling, and informative and it generates some... (shrink)

Placebo effects raise some fundamental questions concerning the nature of clinical and medical research. This Element begins with an overview of the different roles placebos play, followed by a survey of significant studies and dominant views about placebo mechanisms. It then critically examines the concept of placebo and offers a new definition that avoids the pitfalls of other attempts. The main philosophical lesson is that background medical theories provide the ontology for clinical and medical research. Because these theories often contain (...) incoherent and arbitrary classifications, the concept of placebo inherits the same messiness. The Element concludes by highlighting some impending challenges for placebo studies. (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)

An accessible and illuminating exploration of the conceptual basisof scientific and statistical inference and the practical impact this has on conducting psychological research. The book encourages a critical discussion of the different approaches and looks at some of the most important thinkers and their influence.

Exploring both the political and intellectual contexts within which Machiavelli's political vision was formed, Mikael Hornqvist stresses the classical and rhetorical character of Machiavelli's thought. He analyzes his preoccupation with glory and liberality in relation to the revival of Roman ideas of triumphalism. The result is a revealing account of the formation of Machiavelli's characteristic preoccupations.

This article synthesizes the current theoretical attempts to understand human-machine interactions and introduces seven premises to understand our emerging dynamics with increasingly competent, pervasive, and instantly accessible algorithms. The hope that these seven premises can build toward a social theory of human-AI cocreation. The focus on human-AI cocreation is intended to emphasize two factors. First, is the fact that our machine learning systems are socialized. Second, is the coevolving nature of human mind and AI systems as smart devices form an (...) indispensable part of our cognitive scaffolds, thus, shaping how we perceive the world and ourselves. The seven premises include: primacy of social structures; human’s desire for freedom and autonomy; AI systems will form inseparable parts of our cognitive/affective scaffolds and can change our self-understanding; philosophy and humanistic foundations on human flourishing as a guide to human-AI interaction; mindsponge information-filtering process; acculturative process of how values change and emerge from human-AI interaction; overlapping Venn diagram of the human-human, human-nature, and human-machine interactions. This article concludes with a discussion on human agency in our entanglements with socialized machines and the illusoriness of the Cartesian agent view of the mind. (shrink)

We examined two potential correlates of hypnotic suggestibility: dissociation and cognitive inhibition. Dissociation is the foundation of two of the major theories of hypnosis and other theories commonly postulate that hypnotic responding is a result of attentional abilities . Participants were administered the Waterloo-Stanford Group Scale of Hypnotic Susceptibility, Form C. Under the guise of an unrelated study, 180 of these participants also completed: a version of the Dissociative Experiences Scale that is normally distributed in non-clinical populations; a latent inhibition (...) task, a spatial negative priming task, and a memory task designed to measure negative priming. The data ruled out even moderate correlations between hypnotic suggestibility and all the measures of dissociation and cognitive inhibition overall, though they also indicated gender differences. The results are a challenge for existing theories of hypnosis. (shrink)

Like most Africans, particularly those from Western Africa, I come from an oral tradition where the Word has a central place. Whether it is spiritual or educational, transmission takes place primarily through spoken exchange. Our traditions are passed on to children in the evening, after dinner and around bedtime, by their parents, grandparents, uncles and elders. Then the talk touches on basic matters, which are put across in a teaching style that uses images: this is the time for stories through (...) which children discover their ancestors, their family history and the traditional religions. During these evening hours a number of ceremonies and artistic and religious activities also occur. Circumcised boys join together with the whole community for musical festivities that have a religious dimension, for in the traditional world circumcision is the important rite of passage through which a boy learns to master pain: it should never be visible. This is not a purely medical or surgical act. It is ritualized to the highest degree. It is the first marker of a concept that the West does not have, that of generation. (shrink)

This book presents an overview of these studies and attempts to clarify apparently disparate results by placing them in a coherent theoretical framework.

It is shown that any hidden variable model that reproduces quantum mechanics for a single particle must either be nonlocal or violate conservation of momentum. This is established by deriving an inequality which must hold in any local, momentum-conserving hidden variable model for a modified form of the double-slit experiment. It is then shown that any hidden variable model that reproduces quantum mechanics must violate the inequality. The inconsistency between the classical and quantum views of the world is therefore demonstrated (...) in a new way. (shrink)

How people learn chunks or associations between adjacent items in sequences was modelled. Two previously successful models of how people learn artificial grammars were contrasted: the CCN, a network version of the competitive chunker of Servan‐Schreiber and Anderson [J. Exp. Psychol.: Learn. Mem. Cogn. 16 (1990) 592], which produces local and compositionally‐structured chunk representations acquired incrementally; and the simple recurrent network (SRN) of Elman [Cogn. Sci. 14 (1990) 179], which acquires distributed representations through error correction. The models' susceptibility to two (...) types of interference was determined: prediction conflicts, in which a given letter can predict two other letters that appear next with an unequal frequency; and retroactive interference, in which the prediction made by a letter changes in the second half of training. The predictions of the models were determined by exploring parameter space and seeing howdensely different regions of the space of possible experimental outcomes were populated by model outcomes. For both types of interference, human data fell squarely in regions characteristic of CCN performance but not characteristic of SRN performance. (shrink)

The implicit-explicit distinction is applied to knowledge representations. Knowledge is taken to be an attitude towards a proposition which is true. The proposition itself predicates a property to some entity. A number of ways in which knowledge can be implicit or explicit emerge. If a higher aspect is known explicitly then each lower one must also be known explicitly. This partial hierarchy reduces the number of ways in which knowledge can be explicit. In the most important type of implicit knowledge, (...) representations merely reflect the property of objects or events without predicating them of any particular entity The dearest cases of explicit knowledge of a fact are representations of one's own attitude of knowing that fact. These distinctions are discussed in their relationship to similar distinctions such as procedural-declarative, conscious unconscious, verbalizable-nonverbalizable, direct-indirect tests, and automatic voluntary control. This is followed by an outline of how these distinctions can be used to integrate and relate the often divergent uses of the implicit-explicit distinction in different research areas. We illustrate this for visual perception, memory, cognitive development, and artificial grammar learning. (shrink)

Especially over the past twenty years, a number of analytic philosophers have embraced the idea that the world itself is vague or indeterminate in one or more respects. The issue then arises as to whether it can be the case that the world itself is indeterminate in all respects. Using as a basis Chinese Madhyamaka Buddhist thought, I offer two reasons for the coherence and intelligibility of the thesis that all concrete things are themselves indeterminate with respect to the ways (...) they are. The first reason draws on a notion reminiscent of the picture of reality as an amorphous lump, while the second reason makes use of the relativity of conceptual perspectives and determinations. Assuming that the world is the mere totality of all concrete things, I show that there is a genuine metaphysical possibility of the world’s being indeterminate in all respects. (shrink)

The volume _The Many Faces of Beauty_ joins the rich debate on beauty and aesthetic theory by presenting an ambitious, interdisciplinary examination of various facets of beauty in nature and human society. The contributors ask such questions as, Is there beauty in mathematical theories? What is the function of arts in the economy of cultures? What are the main steps in the historical evolution of aesthetic theories from ancient civilizations to the present? What is the function of the ugly in (...) enhancing the expressivity of art? and What constitutes beauty in film? The sixteen essays, by eminent scientists, critics, scholars, and artists, are divided into five parts. In the first, a mathematician, physicist, and two philosophers address beauty in mathematics and nature. In the second, an anthropologist, psychologist, historian of law, and economist address the place of beauty in the human mind and in society. Explicit philosophical reflections on notoriously vexing issues, such as the historicity of aesthetics itself, interculturality, and the place of the ugly, are themes of the third part. In the fourth, practicing artists discuss beauty in painting, music, poetry, and film. The final essay, by a theologian, reflects on the relation between beauty and God. (shrink)

To explain why we should be structurally rational – or mentally coherent – is notoriously difficult. Some philosophers argue that the normativity of structural rationality can be explained in terms of substantive rationality, which is a matter of correct response to reason. I argue that the psychological phenomena – positive illusions – are counterexamples to the substantivist approach. Substantivists dismiss the relevance of positive illusions because they accept evidentialism that reason for belief must be evidence. I argue that their evidentialist (...) stance would imply that we are caught in unsolvable dilemmas arising from positive illusions. (shrink)

We explore three methods for measuring the conscious status of knowledge using the artificial grammar learning paradigm. We show wagering is no more sensitive to conscious knowledge than simple verbal confidence reports but is affected by risk aversion. When people wager rather than give verbal confidence they are less ready to indicate high confidence. We introduce a “no-loss gambling” method which is insensitive to risk aversion. We show that when people are just as ready to bet on a genuine random (...) process as their own classification decisions, their classifications are still above baseline, indicating knowledge participants are not aware of having. Our results have methodological implications for any study investigating whether people are aware of knowing. (shrink)