Environmental health remains a niche topic in bioethics, despite being a prominent social determinant of health. In this paper we argue that if bioethicists are to take the project of health justice as a serious one, then we have to address environmental injustices and the threats they pose to our bioethics principles, health equity, and clinical care. To do this, we lay out three arguments supporting prioritizing environmental health in bioethics based on bioethics principles including a commitment to vulnerable populations (...) and justice. We also highlight and advocate for environmental law efforts that align with these priorities, focusing specifically on the need for a right to a healthy environment. Our intention is to draw attention to the legal and ethical concepts that underlie the importance of a healthy environment, and urge bioethicists to prioritize both legal and ethical advocacy against environmental injustices in their practice. (shrink)

Fabi and Goldberg raised important considerations regarding both research and funding priorities in the field of bioethics and, in particular, the field’s misalignment with social justice. W...

Hastings Center Report, Volume 52, Issue S1, Page S3-S11, March‐April 2022.

There are some long-standing social issues that imperil Black Americans’ relationship with health and healthcare. These issues include racial disparities in health outcomes, provider bi...

An argument in the cognitive enhancement literature is that using stimulants in populations of healthy but socially disadvantaged individuals mistakenly attributes pathology to nonpathological individuals who experience social inequalities. As the argument goes, using stimulants as cognitive-enhancing drugs to solve the social problem of poorly educated students in inadequate schools misattributes the problem as an individual medical problem, when it is really a collective sociopolitical problem. I challenge this argument on the grounds that not all types of enhancement have to (...) be explained in medical terms, but rather at least one conception of enhancement can be explained in social terms—opportunity maintenance. Therefore, I propose that as a moral requirement we ought to explore whether stimulants could be a means of remedying underprivileged children's experiences of social inequalities that are borne from inadequate schools for the sake of increasing their chances for opportunities and well-being. (shrink)

This case is about a study of burn patients that included a request to the IRB for a waiver of consent for perianal specimen collection–a request which ultimately was not approved by a reviewing IR...

In his classic 1936 essay "On the Concept of Logical Consequence", Alfred Tarski used the notion of satisfaction to give a semantic characterization of the logical properties. Tarski is generally credited with introducing the model-theoretic characterization of the logical properties familiar to us today. However, in his book, The Concept of Logical Consequence, Etchemendy argues that Tarski's account is inadequate for quite a number of reasons, and is actually incompatible with the standard model-theoretic account. Many of his criticisms are meant (...) to apply to the model-theoretic account as well. In this paper, I discuss the following four critical charges that Etchemendy makes against Tarski and his account of the logical properties: (1) (a) Tarski's account of logical consequence diverges from the standard model-theoretic account at points where the latter account gets it right. (b) Tarski's account cannot be brought into line with the model-theoretic account, because the two are fundamentally incompatible. (2) There are simple counterexamples (enumerated by Etchemendy) which show that Tarski's account is wrong. (3) Tarski committed a modal fallacy when arguing that his account captures our pre-theoretical concept of logical consequence, and so obscured an essential weakness of the account. (4) Tarski's account depends on there being a distinction between the "logical terms" and the "non-logical terms" of a language, but (according to Etchemendy) there are very simple (even first-order) languages for which no such distinction can be made. Etchemendy's critique raises historical and philosophical questions about important foundational work. However, Etchemendy is mistaken about each of these central criticisms. In the course of justifying that claim, I give a sustained explication and defense of Tarski's account. Moreover, since I will argue that Tarski's account and the model theoretic account really do come to the same thing, my subsequent defense of Tarski's account against Etchemendy's other attacks doubles as a defense against criticisms that would apply equally to the familiar model-theoretic account of the logical properties. (shrink)

In this paper, we outline an approach to giving extensional truth-theoretic semantics for what have traditionally been seen as opaque sentential contexts. We outline an approach to providing a compositional truth-theoretic semantics for opaque contexts which does not require quantifying over intensional entities of any kind, and meets standard objections to such accounts. The account we present aims to meet the following desiderata on a semantic theory T for opaque contexts: (D1) T can be formulated in a first-order extensional language; (...) (D2) T does not require quantification over intensional entities­i.e., meanings, propositions, properties, relations, or the like­in its treatment of opaque contexts; (D3) T captures the entailment relations that hold in virtue of form between sentences in the language for which it is a theory; (D4) T has a finite number of axioms. If the approach outlined here is correct, it resolves a longstanding complex of problems in metaphysics, the philosophy of mind and the philosophy of language. (shrink)

Alfred Tarski’s work on truth has played such a central role in the discourse on truth that most coming to it for the first time have probably already heard a great deal about what is said there. Unfortunately, since the work is largely technical and Tarski was only tan- gentially philosophical, a certain incautious assimilation dominates many philosophical discussions of Tarski’s ideas, and so, examining Tarski on the concept of truth is in many ways an act of unlearning. -/- In (...) this paper I focus on those key ideas in Tarski’s work that have made a lasting impact on the philosophical discourse. These are the notions of T-sentence, Convention T, Tarskian truth definition, and Tarski’s general limiting theses on the expressibility and definability of truth. Though these ideas are in name familiar, we will seek in this essay to uncover and remove certain widespread misunderstandings of each. Tarski’s name also features prominently in discussions of the liar paradox, so we will take time out to explain Tarski’s connection to this ancient puzzle. (shrink)

This comprehensive analysis dives deep into the intricate interplay between artificial intelligence (AI) and human agency, examining the remarkable capabilities and inherent limitations of large language models (LLMs) such as GPT-3 and ChatGPT. The paper traces the complex trajectory of AI's evolution, highlighting its operation based on statistical pattern recognition, devoid of self-consciousness or innate comprehension. As AI permeates multiple spheres of human life, it raises substantial ethical, legal, and societal concerns that demand immediate attention and deliberation. The metaphorical illustration (...) of humans as “shepherds” of AI, coupled with a thought-provoking examination of “agency without intelligence,” engenders deep reflections on the future of human-AI interplay and the associated philosophical, ethical, and practical ramifications. The paper further elucidates critical challenges associated with AI, such as ethical dilemmas, “agency without intelligence,” the role of human oversight, and the environmental impact of AI technologies. In the pursuit of solutions, the paper maps prospective directions, emphasizing the need for robust AI policies, improved AI literacy, sustainable AI practices, and a continued dialogue on the multifaceted issues surrounding AI. Through a holistic exploration of AI, this paper underlines the necessity for a multidisciplinary, collaborative approach to chart an ethical, beneficial, and sustainable AI future, enabling society to harness the potential of AI responsibly while mitigating the associated risks. (shrink)

This chapter argues that while quotation marks are polysemous, the thread that runs through all uses of quotation marks that involve reference to expressions is pure quotation, in which an expression formed by enclosing another expression in quotation marks refers to that enclosed expression. We defend a version of the so-called disquotational theory of pure quotation and show how this device is used in direct discourse and attitude attributions, in exposition in scholarly contexts, and in so-called mixed quotation in indirect (...) discourse and attitude attributions. We argue that uses of quotation marks that extend beyond pure quotation have two features in common. First, the expressions appearing in quotation marks are intended to be understood, and that they are intended to be understood is essential to the function that such quotations play in communication, though this does not always involve the expressions contributing their extensional properties to fixing truth conditions for the sentences in which they appear. Second, they appeal to a relation to the expression appearing in quotation marks that plays a role in determining the truth conditions of the sentences in which they appear. (shrink)

A sorites argument is a symptom of the vagueness of the predicate with which it is constructed. A vague predicate admits of at least one dimension of variation (and typically more than one) in its intended range along which we are at a loss when to say the predicate ceases to apply, though we start out confident that it does. It is this feature of them that the sorites arguments exploit. Exactly how is part of the subject of this paper. (...) The majority of philosophers writing on vagueness take it to be a kind of semantic phenomenon. If we are right, they are correct in this assumption, which is surely the default position, but they have not so far provided a satisfactory account of the implications of this or a satisfactory diagnosis of the sorites arguments. Other philosophers have urged more exotic responses, which range from the view that the fault lies not in our language, but in the world, which they propose to be populated with vague objects which our semantics precisely reflects, to the view that the world and language are both perfectly in order, but that the fault lies with our knowledge of the properties of the words we use (epistemicism). In contrast to the exotica to which some philosophers have found themselves driven in an attempt to respond to the sorites puzzles, we undertake a defense of the commonsense view that vague terms are semantically vague. Our strategy is to take fresh look at the phenomenon of vagueness. Rather than attempting to adjudicate between different extant theories, we begin with certain pre-theoretic intuitions about vague terms, and a default position on classical logic. The aim is to see whether (i) a natural story can be told which will explain the vagueness phenomenon and the puzzling nature of soritical arguments, and, in the course of this, to see whether (ii) there arises any compelling pressure to give up the natural stance. We conclude that there is a simple and natural story to be told, and we tell it, and that there is no good reason to abandon our intuitively compelling starting point. The importance of the strategy lies in its dialectical structure. Not all positions on vagueness are on a par. Some are so incredible that even their defenders think of them as positions of last resort, positions to which we must be driven by the power of philosophical argument. We aim to show that there is no pressure to adopt these incredible positions, obviating the need to respond to them directly. If we are right, semantic vagueness is neither surprising, nor threatening. It provides no reason to suppose that the logic of natural languages is not classical or to give up any independently plausible principle of bivalence. Properly understood, it provides us with a satisfying diagnosis of the sorites argumentation. It would be rash to claim to have any completely novel view about a topic so well worked as vagueness. But we believe that the subject, though ancient, still retains its power to inform and challenge us. In particular, we will argue that taking seriously the central phenomenon of predicate vagueness—the “boundarylessness” of vague predicates—on the commonsense assumption that vagueness is semantic, leads ineluctably to the view that no sentences containing vague expressions (henceforth ‘vague sentences’) are truth-evaluable. This runs counter to much of the literature on vagueness, which commonly assumes that, though some applications of vague predicates to objects fail to be truth-evaluable, in clear positive and negative cases vague sentences are unproblematically true or false. It is clarity on this, and related points, that removes the puzzles associated with vagueness, and helps us to a satisfying diagnosis of why the sorites arguments both seem compelling and yet so obviously a bit of trickery. We give a proof that semantically vague predicates neither apply nor fail-to-apply to anything, and that consequently it is a mistake to diagnose sorites arguments, as is commonly done, by attempting to locate in them a false premise. Sorites arguments are not sound, but not unsound either. We offer an explanation of their appeal, and defend our position against a variety of worries that might arise about it. The plan of the paper is as follows. We first introduce an important distinction in terms of which we characterize what has gone wrong with vague predicates. We characterize what we believe to be our natural starting point in thinking about the phenomenon of vagueness, from which only a powerful argument should move us, and then trace out the consequences of accepting this starting point. We consider the charge that among the consequences of semantic vagueness are that we must give up classical logic and the principle of bivalence, which has figured prominently in arguments for epistemicism. We argue there are no such consequences of our view: neither the view that the logic of natural languages is classical, nor any plausible principle of bivalence, need be given up. Next, we offer a diagnosis of what has gone wrong in sorites arguments on the basis of our account. We then present an argument to show that our account must be accepted on pain of embracing (in one way or another) the epistemic view of “vagueness”, i.e., of denying that there are any semantically vague terms at all. Next, we discuss some worries that may arise about the intelligibility of our linguistic practices if our account is correct. We argue none of these worries should force us from our intuitive starting point. Finally, we cast a quick glance at other forms of semantic incompleteness. (shrink)

Berger and Miller offer a strong argument for how cultural competence in medical education reinforces the racial structures that it purports to address. As social scientists with expertise i...

When health professions learners’ primary pedagogical experience of Black people and how they become patients is through statistics, it becomes very easy for learners to think of Black people as data points rather than as individuals whose health is often at the mercy of racist institutions. When the human dimension of Black people’s health is ignored, specifically the ways that poor health affects individual wellbeing, one of the barriers to proper health for Black patients is how to be seen and (...) considered as a part of a larger problem of systemic racism and institutional injustices as well as individuals whose personal lives are affected by such larger problems. I propose an approach to health professions pedagogy—the experiential race testimonies approach—that can change the way health professions learners understand and treat Black patients, thus changing the future of Black health. The ERT approach pairs population data analysis with analysis of personal testimonies and the experiences they convey. (shrink)

Facilities that emit hazardous toxins, such as toxic landfills, oil refineries, and chemical plants, are disproportionately located in predominantly Black, Latinx, and Indigenous neighborhoods. Environmental injustices like these threaten just distribution of health itself, including access to health that is not dependent on having the right skin color, living in the right neighborhood, or making the right amount of money. Facilities that emit environmental toxins wrongly make people's race, ethnicity, income, and neighborhood essential to who is allowed to breathe clean (...) air and drink clean water, and thus, who is allowed to be healthy. This can be seen in the environmental crises in Louisiana; Mississippi; Houston, Texas; and Flint, Michigan. Since bioethics purports to concern itself with the principle of justice as applied to individuals and increasingly to populations, the field ought to concern itself more with environmental injustice. (shrink)

We are developing the Neurological Disease Ontology (ND) to provide a framework to enable representation of aspects of neurological diseases that are relevant to their treatment and study. ND is a representational tool that addresses the need for unambiguous annotation, storage, and retrieval of data associated with the treatment and study of neurological diseases. ND is being developed in compliance with the Open Biomedical Ontology Foundry principles and builds upon the paradigm established by the Ontology for General Medical Science (OGMS) (...) for the representation of entities in the domain of disease and medical practice. Initial applications of ND will include the annotation and analysis of large data sets and patient records for Alzheimer’s disease, multiple sclerosis, and stroke. (shrink)

This paper concerns a key point of decision in Donald Davidson's early work in philosophy of language — a fateful decision that set him and the discourse in the area on the path of truth-theoretic semantics. The decision of moment is the one Davidson makes when, in the face of a certain barrier, he gives up on the idea of constructing an explicit meaning theory that would parallel Tarski's recursive way with truth theory. For Davidson there was little choice: he (...) tells us he does not see how to deal with the difficulty except in the radical way he proposes. But there is a way to give such a meaning theory — a meaning theory proper which, using classical logic only, meets a meaning-theoretic analogue of Convention T, satisfies Davidson’s three key desiderata for a theory of meaning, reflects linguistic competence, and avoids quantifying over meanings. The meaning theory sketched here uses Tarskian strategies, as Davidson proposed, but differs from Davidson's approach in not going by way of a truth theory for the target language. (shrink)

Bioethics, Volume 36, Issue 3, Page 233-234, March 2022.

Some proponents of moral bioenhancement propose that people should utilize biomedical practices to enhance the faculties and traits that are associated with moral agency, such as empathy and a sense of justice. The hope is that doing so will improve our ability to meet the moral challenges that have emerged in our contemporary, globalized world. In this paper, we caution against this view by arguing that biomedically inducing more empathy may, in fact, diminish moral agency. We argue that this type (...) of increase in empathy would not be effective for addressing empathy’s vulnerability to the biases that can undermine moral judgment. Furthermore, doing so may undermine the important capacity to regulate empathy. We determine that if the moral enhancement project is to be a serious one, it must address these challenges. (shrink)

Alfred Tarski (1944) wrote that "the condition of the 'essential richness' of the metalanguage proves to be, not only necessary, but also sufficient for the construction of a satisfactory definition of truth." But it has remained unclear what Tarski meant by an 'essentially richer' metalanguage. Moreover, DeVidi and Solomon (1999) have argued in this Journal that there is nothing that Tarski could have meant by that phrase which would make his pronouncement true. We develop an answer to the historical question (...) of what Tarski meant by 'essentially richer' and pinpoint the general result that stands behind his essential richness claim. In defense of Tarski, we then show that each of the several arguments of DeVidi and Solomon are either moot or mistaken. One of the fruits of our investigation is the reclamation of what Tarski took to be his central result on truth. This is a reclamation since: (i) if one does not understand 'essential richness', one does not know what that result is, and (ii) we must unearth a heretofore unrecognized change that occurs in Tarski's view - an alteration of his main thesis in light of a failing he discovered in it. (shrink)

The purpose of this article is to discuss an external whistleblowing event that occurred after all internal whistleblowing through the hierarchy of the organization had failed. It is argued that an organization that does not support those that whistle blow because of violation of professional standards is indicative of a failure of organizational ethics. Several ways to build an ethics infrastructure that could reduce the need to resort to external whistleblowing are discussed. A relational ethics approach is presented as a (...) way to eliminate the negative consequences of whistleblowing by fostering an interdependent moral community to address ethical concerns. (shrink)

Hastings Center Report, Volume 52, Issue S1, Page S46-S49, March‐April 2022.

We argue that claims of racial progress rest upon untenable teleological assumptions founded in Enlightenment discourse. We examine the theoretical and methodological focus on progress and its historical roots. We argue research should examine the concrete mechanisms that produce racial stability and change, and we offer three alternative frameworks for interpreting longitudinal racial data and phenomena. The first sees racism as a “fundamental cause,” arguing that race remains a “master category” of social differentiation. The second builds on Glenn’s “settler colonialism (...) as structure” framework to describe race relations as a mutually constituted and place-based system of resource allocation. The third framework draws attention to racialized agency. (shrink)

Famously, Saul Kripke proposes that there are contingent a priori truths, and has offered a number of examples to illustrate his claim. The most well-known example involves the standard meter bar in Paris. Purportedly, a certain agent knows a priori that the bar is one meter long. However, in response to a long-standing objection to such examples - the "existential complaint" - generally only modified examples having a conditional form are now considered candidates for the contingent a priori. Gareth Evans (...) argues that these conditionals must be understood free-logically, and on this basis argues against Keith Donnellan's analysis of the contingent a priori. I show Evans' argument mistaken. I also take issue with the existential complaint, and suggest a way of understanding Kripke's original examples that is not subject to it. My approach focuses the debate in its right place, and allows us to take Kripke's original examples seriously. (shrink)

This paper examines the role that linguistic and cognitive prominence play in the resolution of anaphor–antecedent relationships. In two experiments, we found that pronouns are immediately sensitive to the cognitive prominence of potential antecedents when other antecedent selection cues are uninformative. In experiment 1, results suggest that despite their theoretical dissimilarities, topic and contrastive focus both serve to enhance cognitive prominence. Results from experiment 2 suggest that the contrastive prosody appropriate for focus constructions may also play an important role in (...) enhancing cognitive prominence. Thus different types of linguistic prominence (topic, contrastive focus) appear to have the common effect of increasing the cognitive prominence of the discourse referent. For pronouns with two possible antecedents, the cognitive prominence of an antecedent aids in anaphor resolution, immediately biasing selection towards the more prominent (and ultimately preferred) antecedent. (shrink)

Over 100 million Americans suffer from chronic pain, which causes more disability than any other medical condition in the United States at a cost of $560–$635 billion per year. Opioid analgesics are frequently used to treat CP. However, long term use of opioids can cause brain changes such as opioid-induced hyperalgesia that, over time, increase pain sensation. Also, opioids fail to treat complex psychological factors that worsen pain-related disability, including beliefs about and emotional responses to pain. Cognitive behavioral therapy can (...) be efficacious for CP. However, CBT generally does not focus on important factors needed for long-term functional improvement, including attainment of personal goals and the psychological flexibility to choose responses to pain. Acceptance and Commitment Therapy has been recognized as an effective, non-pharmacologic treatment for a variety of CP conditions. However, little is known about the neurologic mechanisms underlying ACT. We conducted an ACT intervention in women with chronic musculoskeletal pain. Functional magnetic resonance imaging data were collected pre- and post-ACT, and changes in functional connectivity were measured using Network-Based Statistics. Behavioral outcomes were measured using validated assessments such as the Acceptance and Action Questionnaire, the Chronic Pain Acceptance Questionnaire, the Center for Epidemiologic Studies Depression Scale, and the NIH Toolbox Neuro-QoLTM scales. Results suggest that, following the 4-week ACT intervention, participants exhibited reductions in brain activation within and between key networks including self-reflection, emotion, and cognitive control. These changes in connectivity strength were correlated with changes in behavioral outcomes including decreased depression and pain interference, and increased participation in social roles. This study is one of the first to demonstrate that improved function across the DMN, SN, and FPN may drive the positive outcomes associated with ACT. This study contributes to the emerging evidence supporting the use of neurophysiological indices to characterize treatment effects of alternative and complementary mind-body therapies. (shrink)

After giving the name “burnout” to the experience of being overworked and undervalued and the physician and patient suffering that comes from it, many clinicians have sought to elucidate further wh...

I offer an interpretation of a familiar, but poorly understood portion of Tarskis work on truth – bringing to light a number of unnoticed aspects of Tarskis work. A serious misreading of this part of Tarski to be found in Scott Soames Understanding Truth is treated in detail. Soamesreading vies with the textual evidence, and would make Tarskis position inconsistent in an unsubtle way. I show that Soames does not finally have a coherent interpretation of Tarski. This is unfortunate, since (...) Soames ultimately arrogates to himself a key position that he has denied to Tarski and which is rightfully Tarskis own. (shrink)

Contribution of emotional valence and arousal to attentional processing over time is not fully understood. We employed a rapid serial visual paradigm in three experiments to investigate the...