To what risks may children participating in research be subjected? Institutional review boards can stand surrogate for parents by filtering out studies whose risk is unacceptably high.

In part I of this paper, I argue that #MeToo testimony increases epistemic value for the survivor qua hearer when experiences like hers are represented by others; for society at large when false but dominant narratives about sexual violence and sexual harassment against women are challenged and replaced with true stories; and for the survivor qua teller when her true story is believed. In part II, I argue that the epistemic significance of #MeToo testimony compels us to consider the tremendous (...) and often unappreciated costs to the individual tellers, and the increased credibility they are owed in virtue thereof. (shrink)

Placebo-controlled trials are held by many, including regulators at agencies like the United States Food and Drug Administration, to be the gold standard in the assessment of new medical interventions. Yet the use of placebo controls in clinical trials has been the focus of considerable controversy. In this two-part article, we challenge a number of common beliefs concerning the value of placebo controls. Part I critiques statistical and other scientific justifications for the use of placebo controls in clinical research. The (...) continued use of placebo controls in clinical trials on diseases for which accepted treatment exists raises equally important ethical, legal, and regulatory issues for which various justifications have been given. Defense of this practice relies on normative as well as empirical myths.In their attack on the prevailing use of placebo controls, Kenneth Rothman and Karin Michels emphasize that this practice stands in violation of the World Medical Association's guidelines on the ethics of human experimentation, most commonly known as the Helsinki Declaration. (shrink)

The use of statistics in medical research has been compared to a religion: it has its high priests, supplicants, and orthodoxy. Although the comparison may be more unfair to religion than to research, a useful lesson can nonetheless be drawn: the practice of clinical research may benefit—as does the spirit—from critical self-examination. Arguably, no aspect of the conduct of clinical trials is currently more controversial—and thus in as dire need of critical examination—than the use of placebo controls. The ethical and (...) scientific controversies associated with placebo-controlled trials, never far below the surface, have once again seized public attention. Clearly, concern about these issues within the professional community runs deep and wide, as evidenced by the volume of response generated by Kenneth Rothman and Karin Michels's recent Critique. Criticisms of the use of placebo controls in clinical research are scattered through the literatureo; our objective is to present the case against placebos in a compendious form that takes account of scientific and statistical as well as normative issues. (shrink)

The use of statistics in medical research has been compared to a religion: it has its high priests, supplicants, and orthodoxy. Although the comparison may be more unfair to religion than to research, a useful lesson can nonetheless be drawn: the practice of clinical research may benefit—as does the spirit—from critical self-examination. Arguably, no aspect of the conduct of clinical trials is currently more controversial—and thus in as dire need of critical examination—than the use of placebo controls. The ethical and (...) scientific controversies associated with placebo-controlled trials, never far below the surface, have once again seized public attention. Clearly, concern about these issues within the professional community runs deep and wide, as evidenced by the volume of response generated by Kenneth Rothman and Karin Michels's recent Critique. Criticisms of the use of placebo controls in clinical research are scattered through the literatureo; our objective is to present the case against placebos in a compendious form that takes account of scientific and statistical as well as normative issues. (shrink)

Accumulating evidence for the unique social, behavioral, and physical health benefits of positive emotion and related well-being constructs has led to the development and testing of positive psychological interventions to increase emotional well-being and enhance health promotion and disease prevention. PPIs are specifically aimed at improving emotional well-being and consist of practices such as gratitude, savoring, and acts of kindness. The purpose of this narrative review was to examine the literature on PPIs with a particular focus on positive emotion outcomes. (...) We evaluated the evidence on the effects of PPIs on positive emotion specifically, and discussed the range of evidence regarding the relative responsiveness of emotion measures to PPIs in order to gain a better understanding of the specific emotional pathways through which PPIs influence psychological and physical well-being. We conclude with recommendations for best evaluating effects of PPIs on positive emotion outcomes. (shrink)

Helen Longino argues that the way to ensure scientific knowledge is objective is to have a diversity of scientific investigators. This is the best example of recent feminist arguments which hold that the real value of diversity is epistemic, and not political, but it only partly succeeds. In the end, Longino's objectivity amounts to intersubjective agreement about contextually based standards, and while her account gives us a good reason for wanting diversity in our scientific communities, this reason turns out to (...) be political. (shrink)

Prologue -- Paris, August 1, 1990 -- What happened next -- Live in it -- Africa, 2008 -- Paris, revisited.

In this paper, I give an answer to the central epistemic question regarding the normative requirements for beliefs based on testimony. My suggestion here is that our best strategy for coming up with the conditions for justification is to look at cases where the adoption of the belief matters to the person considering it. This leads me to develop, in Part One of the paper, an interest-relative theory of justification, according to which our justification for a proposition p depends on (...) our evidence in favour of p in proportion to our interest in p, as signalled by the epistemic risk we take in believing that p is true. In Part Two, I argue that this theory shows that the reductivist view offers a better normative account for the epistemic status of beliefs based on testimony than the credulist one, but it is inaptly named; the view I develop here is better conceived of as The Dependence Account. (shrink)

In their well-known paper, John Gardner and Stephen Shute (2000) propose a pure case of rape, in which a woman is raped while unconscious and the rape, for a variety of stipulated reasons, never comes to light. This makes the pure case a harmless case of rape, or so they argue. In this paper I show that their argument hinges on an outdated conception of trauma, one which conflates evaluative responses that arise in the aftermath of rape with the non-deliberative (...) somatic responses of a central nervous system to a threatening event. In the first part of this paper, I elaborate this objection by drawing on the neurobiological model of trauma. This gives me an opportunity to illustrate the different ways that rape harms its victims, including the central way, what I call ‘threat-circuitry harm.’ This discussion of trauma invites us to rethink the wrong of rape, and sets the groundwork for my argument, in the second part of the paper, that the wrong of rape consists in its central harm. (shrink)

Duty and Healing positions ethical issues commonly encountered in clinical situations within Jewish law. The concept of duty is significant in exploring bioethical issues, and this book presents an authentic and non-parochial Jewish approach to bioethics, while it includes critiques of both current secular and Jewish literatures. Among the issues the book explores are the role of family in medical decision-making, the question of informed consent as a personal religious duty, and the responsibilities of caretakers. The exploration of contemporary ethical (...) problems in healthcare through the lens of traditional sources in Jewish law is an indispensable guide of moral knowledge. (shrink)

There have been many efforts to infer causation from association byusing statistical models. Algorithms for automating this processare a more recent innovation. In Humphreys and Freedman[(1996) British Journal for the Philosophy of Science 47, 113–123] we showed that one such approach, by Spirtes et al., was fatally flawed. Here we put our arguments in a broader context and reply to Korb and Wallace [(1997) British Journal for thePhilosophy of Science 48, 543–553] and to Spirtes et al.[(1997) British Journal for the (...) Philosophy of Science 48, 555–568]. Their arguments leave our position unchanged: claims to have developed a rigorous engine for inferring causation from association are premature at best, the theorems have no implications for samples of any realistic size, and the examples used to illustrate the algorithms are indicative of failure rather than success. The gap between association and causation has yet to be bridged. (shrink)

The target articles in this issue advance our understanding of bioethical considerations in pragmatic trials (Garland, Morain, and Sugarman 2023; Morain and Largent 2023). Both articles appreciate...

A series of studies investigated the capacity of children between the ages of 7 and 12 to give free and informed consent to participation in psychological research. Children were reasonably accurate in describing the purpose of studies, but many did not understand the possible benefits or especially the possible risks of participating. In several studies children's consent was not affected by the knowledge that their parents had given their permission or by the parents saying that they would not be upset (...) if the children refused. In contrast, other studies found that children were much more likely to stop their participation if the experimenter said explicitly that she would not be upset if they stopped. We suggest that experimenters should pay more attention to describing the possible risks and benefits of participation in research, and that they should also make it clearer to children that they are free to stop once they have begun. (shrink)

Foundation models such as GPT-4 are fine-tuned to avoid unsafe or otherwise problematic behavior, so that, for example, they refuse to comply with requests for help with committing crimes or with producing racist text. One approach to fine-tuning, called reinforcement learning from human feedback, learns from humans' expressed preferences over multiple outputs. Another approach is constitutional AI, in which the input from humans is a list of high-level principles. But how do we deal with potentially diverging input from humans? How (...) can we aggregate the input into consistent data about "collective" preferences or otherwise use it to make collective choices about model behavior? In this paper, we argue that the field of social choice is well positioned to address these questions, and we discuss ways forward for this agenda, drawing on discussions in a recent workshop on Social Choice for AI Ethics and Safety held in Berkeley, CA, USA in December 2023. (shrink)

After sketching the conflict between objectivists and subjectivists on the foundations of statistics, this paper discusses an issue facing statisticians of both schools, namely, model validation. Statistical models originate in the study of games of chance, and have been successfully applied in the physical and life sciences. However, there are basic problems in applying the models to social phenomena; some of the difficulties will be pointed out. Hooke's law will be contrasted with regression models for salary discrimination, the latter being (...) a fairly typical application in the social sciences. (shrink)

This experiment investigated the effect of format (line vs. bar), viewers’ familiarity with variables, and viewers’ graphicacy (graphical literacy) skills on the comprehension of multivariate (three variable) data presented in graphs. Fifty-five undergraduates provided written descriptions of data for a set of 14 line or bar graphs, half of which depicted variables familiar to the population and half of which depicted variables unfamiliar to the population. Participants then took a test of graphicacy skills. As predicted, the format influenced viewers’ interpretations (...) of data. Specifically, viewers were more likely to describe x–y interactions when viewing line graphs than when viewing bar graphs, and they were more likely to describe main effects and “z–y” (the variable in the legend) interactions when viewing bar graphs than when viewing line graphs. Familiarity of data presented and individuals’ graphicacy skills interacted with the influence of graph format. Specifically, viewers were most likely to generate inferences only when they had high graphicacy skills, the data were familiar and thus the information inferred was expected, and the format supported those inferences. Implications for multivariate data display are discussed. (shrink)

Akrasia is a classical Greek term that is typically translated as “incontinence,” although it is sometimes translated as “weakness of the will”. Someone who displays practical akrasia exhibits a failure of control, but not an absence of control. In the practical case, the akratic individual intentionally and voluntarily acts in a way that is contrary to what she judges she ought to do. I tuck into a large piece of cheesecake even though I know I ought not to, or I (...) light up a cigarette although I have avowed to quit. In cases of akrasia, practical judgments go in different directions; the agent acts against her best... (shrink)

There is the world of ideas and the world of practice; the French are often for sup pressing the one and the English the other; but neither is to be suppressed. -Matthew Arnold The Function of Criticism at the Present Time From its inception, bioethics has confronted the need to reconcile theory and practice. At first the confrontation was purely intellectual, as writers on ethical theory (within phi losophy, theology, or other humanistic disciplines) turned their attention to topics from the (...) world of medical practice. Recently the confrontation has grown more intense. The ap pointment of clinical ethicists in hospitals and other health care settings is an accelerating trend in North America. Concomitantly, those institutions involved in training peo ple in clinical ethics have added organized exposure to the world of practice, in the form of placement requirements, to the normal academic course load. In common with other dis ciplines, bioethics has begun to see clinical training as a con dition of didactic theory and apprenticeship. (shrink)

The American Academy of Pediatrics Task Force on Circumcision published its policy statement and technical report on newborn circumcision in September 2012.1 ,2 Since that time, some individuals and groups have voiced objections to the work of the Task Force, while others have conveyed their support. The AAP task force is pleased that the policy statement and technical reports on circumcision have stimulated debate on this topic and welcomes respectful discussion and dialogue about the scientific and ethical issues that surround (...) neonatal circumcision. We believe this is a complex issue that does not lend itself to simplistic solutions. The Task Force encourages those of all viewpoints to contribute to a vibrant, thoughtful and respectful evidence-based dialogue. We appreciate that the free exchange of competing ideas is a necessary component of scientific discovery. We also recognise that all clinical decisions carry ethical dimensions and that a respectful and thoughtful dialogue about these issues is important. However, the Task Force also feels strongly that this debate and the academic literature are demeaned when those with an ideological agenda disseminate inaccurate information, misapply scientific principles, make accusations that are unsupported, communicate in a vitriolic tone, and attempt to discredit and mischaracterise alternative views and those who hold them. Healthy debate and …. (shrink)

This essay explores the epistemological significance of the kinds of beliefs that grow out of traumatic experiences, such as the rape survivor's belief that she is never safe. On current theories of justification, beliefs like this one are generally dismissed due to either insufficient evidence or insufficient propositional content. Here, Freedman distinguishes two discrete sides of the aftermath of psychic trauma, the shattered self and the shattered worldview. This move enables us to see these beliefs as beliefs; in other words, (...) as having cognitive content. Freedman argues that what we then need is a theory of justification that allows us to handpick reliable sources of information on sexual violence, and give credibility where deemed appropriate. She advances a mix of reliabilism and coherentism that privileges feminism. On this account, the evidence for the class of beliefs in question will depend on an act of sexual violence (or testimony, or statistics) to the extent that the act is a reliable indication of the prevalence of sexual violence against women. (shrink)

In summary, the usual elements of a typical health care ethics consultation note might reasonably accommodate the needs and expectations of relevant parties, and would therefore include: 1. identification of the relevant ethical issues, questions, or dilemmas; 2. reference to any relevant facts--medical, nursing, social, psychological, spiritual, legal, political, etc.; 3. a prioritized list of recommendations to improve coordinated care; 4. a clear and concise articulation of relevant arguments, wtih specific reference to the list of recommendations as well as to (...) the institution's overall ethos; 5. a contextual statement, identifying the perceived degree of consensus or support for the recommendations and conclusions, as well as any inherent agendas. (shrink)

RÉSUMÉ: L’observation de populations spécifiques d’agents épistémiques révèle que la présomption d’identité au sein de communautés épistémiques peut mener à certaines omissions cognitives. Les victimes de violence sexuelle en sont un bon exemple. Cette étude de cas offre selon nous une nouvelle perspective sur le débat entre les internalistes et les externalistes en épistémologie en proposant une nouvelle perspective sur les dimensions psychologiques complexes dans la formation des croyances et sur leur implication dans une épistémologie qui nécessite que les raisons (...) soient accessibles à la première personne. (shrink)

Journalism faces a series of ethics crises, particularly in Central Asia because journalism is marked by wide ethical misbehavior including lack of balance and impartiality, using multiple fake nam...

In this paper I respond to Rebecca Kukla's (2014) "Commentary on Karyn Freedman, "Testimony and Epistemic Risk: The Dependence Account."".

In lieu of an abstract, here is a brief excerpt of the content:The Morality of Huck FinnCarol FreedmanA familiar refrain is that emotions threaten our capacity for moral judgment because they infringe on our ability to be impartial. Some hold that emotions lead us to serve personal rather than impersonal ends. And most Kantians argue that even when emotions influence us to pursue impartial ends, they still fail to be moral motives. Barbara Herman argues, however, that emotions can play an (...) important role in a Kantian model of moral judgment. 1 But her description of the moral role of emotions ultimately falls short. 2The problems with Herman’s argument are illustrated by a passage from Huckleberry Finn. The passage challenges a common Kantian assumption that any decision motivated by compassion or love is not a case of moral judgment. I contend that there is good reason to interpret Huck’s decision to help his friend Jim as an instance of moral judgment, even though it is also a case of acting from compassion and love. And though Herman’s theory offers a Kantian way of supporting my reading of Huck, her model fails to do justice to Huck’s case. But there is much that we can learn from the way it fails.IHuckleberry Finn is a story “which details some passages in the life of an ignorant village boy... [who has] run away from his persecuting father, and from a persecuting, good widow, who wishes to make a nice, truth-telling, respectable boy of him....” 3 The journey that follows, in which Huck is accompanied by the widow’s runaway slave, Jim, becomes a symbol of a boy’s attempt to grow up, discover his own identity, make his own decisions. In the part of the journey that has come to be known [End Page 102] as Huck’s “crisis of conscience,” we find him trying to decide whether he should help Jim escape from a slaveholder who has just captured him, or whether he should write to Miss Watson to tell her the where-abouts of her slave (pp. 168–69). On the face of it, Huck seems torn between the voices of conscience and temptation. Writing to Miss Watson, as he describes it, is “the right thing and the clean thing.” To do otherwise would just confirm his “wickedness”: “stealing a poor old woman’s nigger,” he says, “who hadn’t ever done me no harm.” But Huck also loves Jim. He says: “I couldn’t seem to strike no places to harden me against him, but only the other kind.” So Huck seems torn between his sense of what’s right and his compassion. When, in exas-peration, he finally decides not to write the letter, but chooses instead “to go to hell,” it sounds like compassion triumphs over conscience. 4But is it necessarily the case that just because Huck acts from compassion that he does not conceive of what he’s doing as right—that he does not engage in moral judgment? I think it is most plausible to say that when Huck finally decides not to turn Jim in, he comes to a more heart-felt conception of what’s right, not that he does what he believes is wrong.Even though Huck describes helping Jim as “stealing,” and sinful, and the sort of thing for which he will “go to hell,” it is not clear that he thinks it is the wrong thing to do. Huck’s deliberation is tied up with thoughts of social condemnation and eternal punishment. He is obsessed with the pain he will endure if he does not write to Miss Watson. His thoughts begin with the pain of social condemnation (“And then think of me! It would get all around, that Huck Finn helped a nigger to get his freedom”); but they quickly turn to the pain of eternal punishment (“And at last, when it hit me all of a sudden that here was the plain hand of Providence slapping me in the face and letting me know my wickedness was being watched all the time from up there in heaven... I most dropped in my tracks I was so scared”). But Huck describes the... (shrink)