This paper responds to the commentaries from Stacy Carter and Alan Cribb. We pick up on two main themes in our response. First, we reflect on how the process of setting standards for empirical bioethics research entails drawing boundaries around what research counts as empirical bioethics research, and we discuss whether the standards agreed in the consensus process draw these boundaries correctly. Second, we expand on the discussion in the original paper of the role and significance of the concept of (...) ‘integrating’ empirical methods and ethical argument as a standard for research practice within empirical bioethics. (shrink)

This book offers a novel critique of public-private partnerships in public health. The author argues these relationships create webs of influence that undermine the integrity of public health agencies, and imperil public health. He makes a compelling case that the paradigm interaction between governments and corporations should be at arm's length: separation, not collaboration.

There is overwhelming evidence that the opioid crisis—which has cost hundreds of thousands of lives and trillions of dollars (and counting)—has been created or exacerbated by webs of influence woven by several pharmaceutical companies. These webs involve health professionals, patient advocacy groups, medical professional societies, research universities, teaching hospitals, public health agencies, policymakers, and legislators. Opioid companies built these webs as part of corporate strategies of influence that were designed to expand the opioid market from cancer patients to larger groups (...) of patients with acute or chronic pain, to increase dosage as well as opioid use, to downplay the risks of addiction and abuse, and to characterize physicians’ concerns about the addiction and abuse risks as “opiophobia.” In the face of these pervasive strategies, conflict of interest policies have proven insufficient for addressing corporate influence in medical practice, medical research, and public health policy. Governments, the academy, and civil society need to develop counterstrategies to insulate themselves from corporate influence and to preserve their integrity and public trust. These strategies require a paradigm shift—from partnerships with the private sector, which are ordinarily vehicles for corporate influence, to a norm of separation. (shrink)

In Perfection and Disharmony in the Thought of Jean-Jacques Rousseau, Jonathan Marks offers an interpretation of the philosopher's thought and its place in the contemporary debate between liberals and communitarians. Against prevailing views, he argues that Rousseau's thought revolves around the natural perfection of a naturally disharmonious being. At the foundation of Rousseau's thought he finds a natural teleology that takes account of and seeks to harmonize conflicting ends. The Rousseau who emerges from this interpretation is a radical (...) critic of liberalism who is nonetheless more cautious about protecting individual freedom than his milder communitarian successors. Marks elaborates on the challenge that Rousseau poses to liberals and communitarians alike by setting up a dialogue between him and Charles Taylor, one of the most distinguished ethical and political theorists at work today. (shrink)

Selecting, applying and reporting on investment screens for socially responsible investing (SRI) presents challenges for companies, investors and fund managers. This article seeks to clarify the nature of these challenges in developing an understanding of the foundations of ethical investment screens. At a conceptual level this work argues that there is a common element to the ethical foundations of SRI, even with very different apparent motivations and investment restrictions. Establishing this commonality assists in explaining the information asymmetry problem inherent in (...) SRI. A market-facilitated solution illustrates how these insights might foster the development of socially responsible investment. (shrink)

Clinical Ethics, Ahead of Print. This paper is a response to a recent BMJ Blog: ‘The duty to treat: where do the limits lie?’ Members of the Surrey Heartlands Integrated Care Service Clinical Ethics Group reflected on arguments in the Blog in relation to resuscitation during the COVID-19 pandemic.Clinicians have had to contend with ever-changing and conflicting guidance from the Resuscitation Council UK and Public Health England regarding personal protective equipment requirements in resuscitation situations. St John Ambulance had different guidance (...) for first responders.The situation regarding resuscitation led the CEG to consider ethical aspects of health care professionals’ responses to the need for resuscitation during COVID-19. Members agreed that professionals should, ideally, have the level of PPE required for an aerosol generating procedure. However, there was no consensus regarding professionals’ duty to care when this is not available. On the one hand, it was agreed that the casualty/patient’s interests regarding resuscitation should be prioritised due to professionals’ contract with the public and professional privilege. On the other hand, risk thresholds were considered relevant to individual decision-making and professionals’ duty to care. All agreed that decision-making should not be influenced by rewards or reprimands. It was agreed also that decisions to resuscitate should not be considered as moral heroism or supererogatory - regardless of PPE availability - but rather as ‘minimally decent’. We agreed that it may be acceptable for professionals, with good reasons, to opt out of resuscitation attempts and these should be reflected on and discussed before the event. (shrink)

During times of crisis, institutions tend to focus on maintaining or restoring public trust, as well as on measures to insulate themselves (and their leadership) from potential legal liability. This is because institutions reflexively turn to lawyers, risk managers, crisis consultants, and public relations firms that focus on what they euphemistically call the “optics.” In this essay, I highlight the vital importance of addressing underlying reasons for an institution's loss of public trust—in particular, the loss (or erosion) of its integrity (...) and trustworthiness. Loss of public trust generates one kind of crisis—which I term “opsis.” But there is another kind of institutional crisis that so often remains unrecognized. Just as medical sepsis in the human body is a critical condition that endangers life, the loss of an institution's integrity and trustworthiness constitutes a type of sepsis—ethical sepsis—that poses an existential threat to the institution if unaddressed. (shrink)

The decision to initiate invasive, first-in-human trials involving Parkinson’s disease presents a vexing ethical challenge. Such studies present significant surgical risks, and high degrees of uncertainty about intervention risks and biological effects. We argue that maintaining a favorable riskbenefit balance in such circumstances requires a higher than usual degree of confidence that protocols will lead to significant direct and/or social benefits. One critical way of promoting such confidence is through the application of stringent evidentiary standards for preclinical studies. We close (...) with a series of recommendations for strengthening the internal and external validity of preclinical studies, reducing their tendency toward optimism and publication biases, and improving the knowledge base used to design and evaluate preclinical studies. (shrink)

Let M be a structure for a language L on a set M of urelements. HYP(M) is the least admissible set above M. In § 1 we show that pp(HYP(M)) [ = the collection of pure sets in HYP(M] is determined in a simple way by the ordinal α = ⚬(HYP(M)) and the $\mathscr{L}_{\propto\omega}$ theory of M up to quantifier rank α. In § 2 we consider the question of which pure countable admissible sets are of the form pp(HYP(M)) for (...) some M and show that all sets L α (α admissible) are of this form. Other positive and negative results on this question are obtained. (shrink)

Volume 19, Issue 5, May 2019, Page 70-72.

“What’s the big deal?”The meaning of this interrogative depends on the inflection. From the mouths of proponents of public–private partnerships (PPPs) related to food and health, it asks—perhaps with some skepticism or bewilderment—what objections there could possibly be to public–private partnerships intended to address some of our most pressing public health challenges. This is due, in no small part, to the way such partnerships are often characterized by participants and proponents alike: they are a “win–win–win,” for the public sector actor, (...) for the private sector actor, and for the general public or relevant publics (often characterized as consumers).1 Posed by critics of PPPs, the question cynically .. (shrink)

Drawing on role theory and socio?constructivist ideas about learning, this study explores how peer?tutoring can support tutors? learning. The sample comprised ten 16?17?year?old biology tutors, working with twenty?one 14?15?year?old students from a science class over eight weeks. Data were collected through an online wiki, tutor interviews, paired tutor discussions and video recordings. Tutors? perceptions of their role motivated them to learn the material, and their learning was supported by discussion and explanation, revisiting fundamentals, making links between conceptual areas, testing and (...) clarifying their understanding, and reorganising and building ideas, rehearsing them, and working through them repeatedly, to secure their understanding. When tutors employed long answer questions, there was evidence of reflection on their learning and links made between conceptual areas. When preparing to tutor, tutors could focus on key points and engage with basic ideas from alternative perspectives. Mental rehearsal of peer?tutoring episodes helped them appreciate weaknesses in their own subject knowledge. (shrink)

Volume 20, Issue 7, July 2020, Page 103-106.

Communism is not a reaction against the failure of the nineteenth century to organize optimal economic output. It is a reaction against its comparative success. It is a protest against the emptiness of economic welfare, an appeal to the ascetic in us all... The idealistic youth play with Communism because it is the only spiritual appeal which feels to them contemporary.

Let $\mathscr{M}$ be a structure for a language $\mathscr{L}$ on a set $M$ of urelements. $\mathrm{HYP}(\mathscr{M})$ is the least admissible set above $\mathscr{M}$. In $\S 1$ we show that $pp(\mathrm{HYP}(\mathscr{M})) \lbrack = \text{the collection of pure sets in} \mathrm{HYP}(\mathscr{M}\rbrack$ is determined in a simple way by the ordinal $\alpha = \circ(\mathrm{HYP}(\mathscr{M}))$ and the $\mathscr{L}_{\propto\omega}$ theory of $\mathscr{M}$ up to quantifier rank $\alpha$. In $\S 2$ we consider the question of which pure countable admissible sets are of the form $pp(\mathrm{HYP}(\mathscr{M}))$ for (...) some $\mathscr{M}$ and show that all sets $L_\alpha (\alpha$ admissible) are of this form. Other positive and negative results on this question are obtained. (shrink)

"Central Themes in Early Modern Philosophy is a selection of some of the best work being done in early modern philosophy by Anglo-American philosophers today.... The essays in this collection are historically informed and philosophically challenging. The book is a fitting tribute to Jonathan Bennett." -- Daniel Garber, University of Chicago.

Ideas about biology, race, and theology were bound up together in nineteenth‐century scholarship, although they are rarely, if ever, considered together today. Nevertheless, the new genealogical way of thinking about the history of life arose alongside a new way of thinking about the Bible, and a new way of thinking about people. They connected with one another in subtle ways, and modern scholarly boundaries do not map well on to nineteenth‐century scholarship.

These are not the words of a harsh critic of the Food and Drug Administration. They were penned by the agency’s deputy commissioner for food. That this is an insider’s view makes it all the more troubling. Recent studies suggest that roughly half the products on supermarket shelves proclaim their purported health benefits.2 But a trip to the supermarket suggests that this is a conservative estimate. The FDA is not powerless to regulate these claims, but it operates in a regulatory (...) framework that is the product of piecemeal reform and compromise, not intelligent design. And its limited staff resources and budget further constrain what it can do. The food industry is required to seek prior .. (shrink)

Our knowledge of the evolution of human thought is limited not only by the nature of the evidence, but also by the values we bring to the authoritative scientific study of our ancestors. The tendency to see human thought as linear progress in rational capacities has been popular since the Enlightenment, and in the wake of Darwinism has been extended to other species as well. Human communication can be used to transmit useful information, but is rooted in symbolic processes that (...) are nonrational—that is, they involve choosing among functionally equivalent alternatives, any of which is as good an option as any other. The evolution of human thought cannot be realistically isolated from the evolution of human society or human communication, neither of which is rooted in obvious rationality. (shrink)

Many models of evolution are implicitly causal processes. Features such as causal feedback between evolutionary variables and evolutionary processes acting at multiple levels, though, mean that conventional causal models miss important phenomena. We develop here a general theoretical framework for analyzing evolutionary processes drawing on recent approaches to causal modeling developed in the machine-learning literature, which have extended Pearls do-calculus to incorporate cyclic causal interactions and multilevel causation. We also develop information-theoretic notions necessary to analyze causal information dynamics in our (...) framework, introducing a causal generalization of the Partial Information Decomposition framework. We show how our causal framework helps to clarify conceptual issues in the contexts of complex trait analysis and cancer genetics, including assigning variation in an observed trait to genetic, epigenetic and environmental sources in the presence of epigenetic and environmental feedback processes, and variation in fitness to mutation processes in cancer using a multilevel causal model respectively, as well as relating causally-induced to observed variation in these variables via information theoretic bounds. In the process, we introduce a general class of multilevel causal evolutionary processes which connect evolutionary processes at multiple levels via coarse-graining relationships. Further, we show how a range of fitness models can be formulated in our framework, as well as a causal analog of Prices equation, clarifying the relationships between realized/probabilistic fitness and direct/indirect selection. Finally, we consider the potential relevance of our framework to foundational issues in biology and evolution, including supervenience, multilevel selection and individuality. Particularly, we argue that our class of multilevel causal evolutionary processes, in conjunction with a minimum description length principle, provides a conceptual framework in which identification of multiple levels of selection may be reduced to a model selection problem. (shrink)

We tend to think of conflict as bad and compromise as good. But how should we view conflict that exposes potential threats to the environment and health? And what about a compromise between litigants that may adversely affect the interests of third parties or undermine public health? There can be few places in the country where this issue has become more pressing than in my home state, Pennsylvania. The hydraulic fracturing of natural gas in the Marcellus Shale has transformed lives (...) and landscapes here, mainly in rural communities with low‐income populations. The Hallowich family is a case in point. (shrink)

Nell Toussaint is not well. In recent years, she has been diagnosed with uterine fibroids, uncontrolled hypertension, nephrotic syndrome, poorly controlled diabetes, hyperlipidemia, and a pulmonary embolism. She also suffers from decreased mobility, shortness of breath, and‐perhaps not surprisingly, given her other ailments‐anxiety. Toussaint is an indigent undocumented immigrant living in Canada who has been trying to secure medical coverage in the federal courts. In the process, she has sacrificed the medical confidentiality that most of us ordinarily enjoy. Toussaint first (...) came to Canada from Grenada as a visitor in 1999 and remained after the term of her visa expired. At first, she earned enough to sustain a living, but in 2006, her health began to deteriorate, and she was no longer able to work. Although she has received some medical care since then, it has been sporadic, on an emergency basis, and at great expense. When Toussaint applied for medical health coverage under Canada's Interim Medical Health Program, which covers the cost of emergency medical care for legally admitted indigents, her application was rejected. She challenged the decision in federal court on the grounds that her right to life and security of the person under the Canadian Charter had been violated and that the denial of coverage was discriminatory. (shrink)

My invitation to respond to Lepora and Goodin may be the result of my work on complicity—in particular, the participation of health professionals in torture and aggressive interrogation in the so-called ‘war on terror’.1,2 However, instead of responding to the précis, I intend to address the section of the authors' book dealing with compromise and to explore the implications of their approach for some pressing public health issues.3,4 In their chapter entitled ‘Compromise as a Template’, Lepora and Goodin contend that (...) ‘[i]t is only when the intra-personal conflict forces an agent to choose among items of principled concern … to her that a compromise is genuinely involved’ (p. 19). The authors are right to emphasise the ethical significance of setting aside, forsaking or violating one's principles to reach an agreement. There may be serious implications for the integrity of an individual or an institution that makes such a compromise. But we should ensure that the intrapersonal focus does not lead to the neglect of other important ethical dimensions. A compromise may be problematic because of its impact on others who are affected by, but are not …. (shrink)

Patient and public involvement (PPI) has gained widespread support in health research and health policy circles, but there is little consensus on the precise meaning or justifications of PPI. We argue that an important step towards clarifying the meaning and justification for PPI is to split apart the familiar acronym and draw a distinction between patient and public involvement. Specifically, we argue that patient involvement should refer to the practice of involving individuals in health research or policy on the basis (...) of their experience with a particular condition, while public involvement should refer to the practice of involving individuals in health policy or research based on their status as members of a relevant population. Analyzing cases from the UK, Australia, and the USA, we show how our proposed distinction can deliver much needed clarity to conversations on PPI, while guiding the development and evaluation of future PPI‐based policies. (shrink)

Building on influential work in virtue ethics, this collection of essays examines the categories of self, person, and anthropology as foci for comparative analysis. The papers unite reflections on theory and method with descriptive work that addresses thinkers from the modern West, Christian and Jewish Late Antiquity, early China, and other settings. The introduction sets out central methodological issues that are subsequently taken up in each essay, including the origin of the categories through which comparison proceeds, the status of these (...) categories in the process of comparison, and the goals of comparison. In considering the question of goals, the introduction draws connections between comparative study and historical study within one tradition. Both types of analysis can bridge the gap between historical and normative work by attending to the ways in which the questions a scholar asks - not just the answers found - vary from one context to another. (shrink)

Reflections on principle and prudence in the thoughts and actions of great thinkers and statesmen. Discussions of the place of moral principle in political practice are haunted by the abstract and misleading distinction between realism and its various principled or “idealist” alternatives. This volume argues that such discussions must be recast in terms of the relationship between principle and prudence: as Nathan Tarcov maintains, that relationship is “not dichotomous but complementary.” In a substantive introduction, the editors investigate Leo Strauss’s attack (...) on contemporary political thought for its failure to account for both principle and prudence in politics. Leading commentators then reflect on principle and prudence in the writings of great thinkers such as Homer, Machiavelli, and Hegel, and in the thoughts and actions of great statesmen such as Pericles, Jefferson, and Lincoln. In a concluding section, contributors reassess Strauss’s own approach to principle and prudence in the history of political philosophy. “Principle and Prudence in Western Political Thought contains a series of first-rate essays on a—if not the—central problem of political thought: how should and can abstract and general principles inform contingent, particularistic political life.” — Catherine H. Zuckert, coauthor of Leo Strauss and the Problem of Political Philosophy. (shrink)

To model behavioral and neural correlates of language comprehension in naturalistic environments, researchers have turned to broad‐coverage tools from natural‐language processing and machine learning. Where syntactic structure is explicitly modeled, prior work has relied predominantly on context‐free grammars (CFGs), yet such formalisms are not sufficiently expressive for human languages. Combinatory categorial grammars (CCGs) are sufficiently expressive directly compositional models of grammar with flexible constituency that affords incremental interpretation. In this work, we evaluate whether a more expressive CCG provides a better (...) model than a CFG for human neural signals collected with functional magnetic resonance imaging (fMRI) while participants listen to an audiobook story. We further test between variants of CCG that differ in how they handle optional adjuncts. These evaluations are carried out against a baseline that includes estimates of next‐word predictability from a transformer neural network language model. Such a comparison reveals unique contributions of CCG structure‐building predominantly in the left posterior temporal lobe: CCG‐derived measures offer a superior fit to neural signals compared to those derived from a CFG. These effects are spatially distinct from bilateral superior temporal effects that are unique to predictability. Neural effects for structure‐building are thus separable from predictability during naturalistic listening, and those effects are best characterized by a grammar whose expressive power is motivated on independent linguistic grounds. (shrink)

Lack of supportive workplaces may be depriving babies and mothers of the health advantages of breastfeeding. This citizen science pilot project set out to engage women in photographing and sharing information on the available facilities for breastfeeding and expressing and storing breastmilk in Australian workplaces. While some useful insights were gained, the project failed in the sense that 234 people ‘liked’ the project Facebook page set up to recruit participants, but only nine photographs were submitted. The heaviest loss of participation (...) occurred after the ethics committee requirements were explained, in particular, the requirement for employer consent to take a photograph, or alternatively, for a participant to agree to bear the risk of taking a photo without permission. The ethics committee also made stipulations about the formality of language to be used. Thus, the project’s potential role as an enabler for health action was neutered. We argue that the ethics requirements worked contrary to our purpose and possibly acted to reinforce the powerlessness some women experience at work. (shrink)