U.S. immigration law has excluded noncitizens likely to become a “public charge” since 1882. When the Trump administration proposed a new Rule expanding the interpretation of that exclusion in 2018, over 55,000 people wrote public comments. These comments, overwhelmingly opposed to the change, are the subject of Rachel Fabi and Lauren Zahn’s insightful article in this issue of The Journal of Law, Medicine, and Ethics. The themes they identify resonate with the history of the public charge exclusion, which has always (...) reflected a tension between two aims of American governance — to provide for those in need of assistance, and to shape the nation’s citizenry according to ideals of self-sufficiency. (shrink)

BackgroundAlthough the peer review process is believed to ensure scientific rigor, enhance research quality, and improve manuscript clarity, many investigators are concerned that the process is too slow, too expensive, too unreliable, and too static. In this feasibility study, we sought to survey corresponding authors of recently published clinical research studies on the speed and efficiency of the publication process.MethodsWeb-based survey of corresponding authors of a 20% random sample of clinical research studies in MEDLINE-indexed journals with Ovid MEDLINE entry dates (...) between December 1 and 15, 2016. Survey addressed perceived manuscript importance before first submission, approximate first submission and final acceptance dates, and total number of journal submissions, external peer reviews, external peer reviewers, and revisions requested, as well as whether authors would have considered publicly sharing their manuscript on an online platform instead of submitting to a peer-reviewed journal.ResultsOf 1780 surveys distributed, 27 corresponding authors opted out or requested that we stop emailing them and 149 emails failed (e.g., emails that bounced n = 64, returned with an away from office message n = 70, or were changed/incorrect n = 15), leaving 1604 respondents, of which 337 completed the survey (21.0%). Respondents and non-respondents were similar with respect to study type and publication journals’ impact factor, although non-respondent authors had more publications (p = 0.03). Among respondents, the median impact factor of the publications’ journal was 2.7 (interquartile range (IQR), 2.0–3.6) and corresponding authors’ median h-index and number of publications was 9 (IQR, 3–20) and 27 (IQR, 10–77), respectively. The median time from first submission to journal acceptance and publication was 5 months (IQR, 3–8) and 7 months (IQR, 5–12), respectively. Most respondents (62.0%, n = 209) rated the importance of their research as a 4 or 5 (5-point scale) prior to submission. Median number of journal submissions was 1 (IQR, 1–2), external peer reviews was 1 (IQR, 1–2), external peer reviewers was 3 (IQR, 2–4), and revisions requested was 1 (IQR, 1–1). Sharing manuscripts to a public online platform, instead of submitting to a peer-reviewed journal, would have been considered by 55.2% (n = 186) of respondents.ConclusionCorresponding authors have high perceptions of their research and reported requiring few manuscript submissions prior to journal acceptance, most commonly by lower impact factor journals. (shrink)

BackgroundThe Freedom of Information Act (FOIA) provides access to unreleased government records that can be used to enhance the transparency and integrity of biomedical research. We characterized FOIA requests to Department of Health and Human Services (HHS) agencies, including request outcomes, processing times, backlogs, and costs.MethodsUsing HHS FOIA annual reports, we extracted data on the number of FOIA requests received and processed by HHS agencies between 2008 and 2017, as well as request outcomes. Processing times were reported in three time (...) increments, < 1–20, 21–60, or 61+ days, and trends in backlog status were also described. Information about costs and fees collected were aggregated.ResultsBetween 2008 and 2017, 69.6% of 530,094 HHS FOIA requests were received by the Centers for Medicare and Medicaid Services (CMS), 18.9% by the Food and Drug Administration (FDA), and 11.6% by all other HHS agencies. During this period, CMS processed 374,728 requests, FDA 114,938, and other HHS agencies 61,890. CMS and FDA reduced backlogged requests by 9396 (89.7%) and 4289 (65.3%), respectively, leaving backlogs of 1081 and 2279 requests at the end of 2017. CMS fully or partially granted 60.3% of requests whereas FDA fully or partially granted 72.4%. Of all requests to CMS, 82.0% were considered simple and 18.0% complex; 82.2% of simple requests and 54.9% of complex requests were processed in 20 days, and 5.6% and 29.9% were processed in 61+ days. In contrast, 60.2% of requests to FDA were considered simple and 39.8% complex; 28.8% of simple requests and 9.0% of complex requests were processed in 20 days, and 58.3% and 81.5% were processed in 61+ days. The costs to HHS associated with FOIA requests totaled $446.4 million ($809 per processed request), increasing from $28.1 million ($423 per request) in 2008 to $53.3 million ($1544 per request) in 2017. In total, HHS collected $8.5 million in fees (1.9% of total costs).ConclusionsFOIA is frequently used to obtain information about HHS and its agencies. With growing costs, minimal fees collected, and lengthy processing times, HHS agencies’ FOIA programs might be made more efficient through greater proactive record disclosure. (shrink)

I defend a new argument for causal finitism, the view that nothing can have an infinite causal history. I begin by defending a number of plausible metaphysical principles, after which I explore a host of novel variants of the Littlewood-Ross and Thomson’s Lamp paradoxes that violate such principles. I argue that causal finitism is the best solution to the paradoxes.

The paper reviews a number of approaches for handling restricted quantification in relevant logic, and proposes a novel one. This proceeds by introducing a novel kind of enthymematic conditional.

To Live Until We Say Good‐bye. By Elisabeth Kübler‐Ross.

To Live Until We Say Good‐bye. By Elisabeth Kübler‐Ross.

Is helping those whose subsistence needs are not meet a matter of charity or an obligation? What role should ordinary citizens of developed nations play? In a globalized world, the causes, connections, and responsibilities become complicated. Agriculture subsidies that keep food prices low for many in relatively rich countries may, for example, negatively impact poor farmers in developing countries. Students in Ethics/Philosophy 352 report on their project examining whether, and to what extent, a true obligation to aid exists.

Background: The American Medical Association, the British Medical Association and the Canadian Medical Association have guidelines that specifically discourage physicians from self-prescribing or prescribing to family members, but only the BMA addresses informal prescription requests between colleagues. Objective: To examine the practices of paediatric providers regarding self-prescribing, curbsiding colleagues, and prescribing and refusing to prescribe to friends and family. Methods: 1086 paediatricians listed from the American Academy of Paediatrics 2007 web-based directory were surveyed. Results: 44% of eligible survey respondents returned (...) usable surveys. Almost half of respondents had prescribed for themselves. An equal number had informally requested a prescription from a colleague. Three-quarters stated they had been asked to prescribe a prescription drug for a first-degree or second-degree relative, and 51% had been asked by their spouse. Eighty-six per cent stated that they had refused to write a prescription on at least one occasion for a friend or family member. The following reasons “strongly influenced” their decision to refuse a prescription request: outside of provider’s expertise ; patient’s need for his or her own physician ; not medically indicated ; need for a physical examination. Conclusion: These data confirm that most physicians have engaged in self-prescribing or curbside requests for prescriptions. It can be argued that curbsiding is more morally problematic than self-prescribing because it implicates a third party, and should be discouraged regardless of whether the requester is a colleague, family member or friend. (shrink)

The case of clinical trials for convalescent plasma during COVID-19 illustrates important lessons for realizing public sector approaches to biomedical research and development. These lessons, centering on mission, transparency, and spillover effects, can be translated to wider efforts to develop a “public option” for clinical trials.

Benardete paradoxes involve a beginningless set each member of which satisfies some predicate just in case no earlier member satisfies it. Such paradoxes have been wielded on behalf of arguments for the impossibility of an infinite past. These arguments often deploy patchwork principles in support of their key linking premise. Here I argue that patchwork principles fail to justify this key premise.

We argue that there is a conflict among classical theism's commitments to divine simplicity, divine creative freedom, and omniscience. We start by defining key terms for the debate related to classical theism. Then we articulate a new argument, the Aloneness Argument, aiming to establish a conflict among these attributes. In broad outline, the argument proceeds as follows. Under classical theism, it's possible that God exists without anything apart from Him. Any knowledge God has in such a world would be wholly (...) intrinsic. But there are contingent truths in every world, including the world in which God exists alone. So, it's possible that God contingently has wholly intrinsic knowledge. But whatever is contingent and wholly intrinsic is an accident. So, God possibly has an accident. This is incompatible with classical theism. Finally, we consider and rebut several objections. (shrink)

This book critically assesses arguments for the existence of the God of classical theism, develops an innovative account of objects’ persistence, and defends new arguments against classical theism. The authors engage the following classical theistic proofs: Aquinas’s First Way, Aquinas’s De Ente argument, and Feser’s Aristotelian, Neo-Platonic, Augustinian, Thomistic, and Rationalist proofs. The authors also provide the first systematic treatment of the ‘existential inertia thesis’. By connecting the thesis to relativity theory and recent developments in the philosophy of physics, and (...) by developing a variety of novel existential-inertia-friendly explanations of persistence, they mount a formidable new case against classical theistic proofs. Finally, they defend new arguments against classical theism based on abstract objects and changing divine knowledge. The text appeals to students, researchers, and others interested in classical theistic proofs, the existence and nature of God, and the ultimate explanations of persistence, change, and contingency. (shrink)

James Henry Collin recently developed a new symmetry breaker favouring the ontological argument’s possibility premiss over that of the reverse ontological argument. The symmetry breaker amounts to an undercutting defeater for the reverse possibility premiss based on Kripkean cases of a posteriori necessity. I argue, however, that symmetry re-arises in two forms. First, I challenge the purported asymmetry in epistemic entitlements to the original and reverse possibility premisses. Second, relevantly similar Kripkean cases equally undercut the original possibility premiss.

Modal collapse arguments are all the rage in certain philosophical circles as of late. The arguments purport to show that classical theism entails the absurdly fatalistic conclusion that everything exists necessarily. My first aim in this paper is bold: to put an end to action-based modal collapse arguments against classical theism. To accomplish this, I first articulate the ‘Simple Modal Collapse Argument’ and then characterize and defend Tomaszewski’s criticism thereof. Second, I critically examine Mullins’ new modal collapse argument formulated in (...) response to the aforementioned criticism. I argue that Mullins’ new argument does not succeed. Third, I critically examine a powers-based modal collapse argument against classical theism that has received much less attention in the literature. Fourth, I show why God’s being purely actual, as well God’s being identical to each of God’s acts, simply cannot entail modal collapse given indeterministic causation. This, I take it, signals the death of modal collapse arguments. But not all hope is lost for proponents of modal collapse arguments—for the death is a fruitful one insofar as it paves the way for new inquiry into at least two new potential problems for classical theism. Showing this is my paper’s second aim. (shrink)

We draw out significant consequences of a relatively popular theory of metaphysical modality—branching actualism—for cosmological arguments for God’s existence. According to branching actualism, every possible world shares an initial history with the actual world and diverges only because causal powers (or dispositions, or some such) are differentially exercised. We argue that branching actualism undergirds successful responses to two recent cosmological arguments: the Grim Reaper Kalam argument and a modal argument from contingency. We also argue that branching actualism affords a response (...) to one popular defense of the classic contingency argument. What results are new difficulties for several cosmological arguments arising from the metaphysics of modality. (shrink)

Almaatouq et al. propose a novel integrative approach to experiments. We provide three examples of how unaddressed measurement issues threaten the feasibility of the approach and its promise of promoting commensurability and knowledge integration.

The question of the nature of Hegel’s metaphysics is a continuing one. In the last few decades the idea that Hegel even has a metaphysics has been challenged. Recently Stephen Houlgate has responded to this latter idea and tried to show not only that Hegel has a metaphysics, but of what sort it is. In my view Houlgate is right about Hegel having a metaphysics and also right generally about what sort of metaphysics it is. However, it seems to me (...) that he has made too weak a case for the metaphysics in his presentation of what he takes to be Hegel’s arguments, and as a consequence cannot escape a charge that Hegel might still be either a Kantian or some sort of subjective idealist. What I mean by this is that, to the extent that we are simply limited in our metaphysics to what we can think being to be, there may still be an absolute other which we simply cannot know. Houlgate has made things very clear concerning the conclusion to which we should come about the nature of Hegel’s metaphysics, but has not, in my view, made his argument leading to his conclusions quite strong enough. (shrink)

The global coronavirus disease 2019 (COVID-19) pandemic has caused significant uncertainty for students and teachers. During this time, teacher and student creative beliefs and affect play a supportive role in adaptively managing stress, finding joy, and bouncing back from inevitable setbacks with resilience. Developing an adaptive orientation to creativity is a critically important step in helping teachers deal with the challenges and stress of reaching their students through distance learning, especially the most marginalized. This study aims to understand how teacher (...) creativity linked to well-being in the face of COVID-19-related school shutdowns and how teachers planned to adapt creatively to distance learning through the guidance of a summer creative teaching training institute. Results from this sequential mixed method study demonstrated important relationships. Creative self-efficacy in teaching related to teacher buoyancy in the face of setbacks. Creative growth mindset related to teachers’ general positive affect in teaching. Lowered creative anxiety related to reduced effects of secondary traumatic stress and general negative affect in teaching. Environmental support and encouragement for creativity in schools may be foundational for teacher well-being by enhancing teachers’ dispositional joy, general positive affect, and reducing general negative affect. Results suggested additional stress and loss of creativity for most teachers due to the COVID-19 pandemic alongside substantial capacity for creative adaptations with the support of training for creativity in teaching and learning. (shrink)

To be an effective teacher, a combination of specific professional skills and psychological attributes are required. With increasingly fluid employment conditions, particularly in the international context, recruiters and schools are under considerable pressure to quickly differentiate candidates and make successful placements, which involves more than just determining if a candidate holds an appropriate qualification. Therefore, the aim of this cross-sectional study was to measure theoretically and empirically valuable psychological attributes in an international sample of schoolteachers to determine the most valuable (...) correlates of satisfaction and position duration. An international sample (N= 335) of elementary, middle and high school teachers completed an online survey to capture their workplace satisfaction, position duration and measure 15 psychological attributes using validated instruments. Linear associations were estimated using hierarchical regression with this analysis complemented and compared with follow-up non-linear neural network models. Using regression, lower agreeableness (less people-oriented) emerged as the strongest correlate of longer position duration throughout the cohort. In elementary school teachers, lower impulsivity and higher organizational commitment emerged as the strongest correlates of longer position duration. In high school teachers, better stress tolerance and higher organizational commitment emerged as the strongest correlates of longer position duration. Using neural networks to suggest predictive models, low levels of neuroticism and impulsivity were the strongest predictors of longer position duration in elementary school teachers. High stress tolerance also predicted high work satisfaction in elementary teachers, whereas it was lower impulsivity that most strongly predicted higher work satisfaction in high school teachers. Innovation tendencies, perhaps surprisingly, appeared as a consistent predictor of lower levels of workplace satisfaction across teaching levels. Honesty-humility also emerged as a predictor of shorter position duration, particularly for primary/elementary teachers scoring above the mean. Taken together the results suggest an interesting balancing act that needs to be struck between hiring people-oriented and innovative teachers who may be more effective and adaptable but also at greater risk of changing position, possibly due to an increased interest and ability to transition into new social environments. (shrink)

We examine two competing solutions to Benardete paradoxes: causal finitism, according to which nothing can have infinitely many causes, and the unsatisfiable pair diagnosis (UPD), according to which such paradoxes are logically impossible and no metaphysical thesis need be adopted to avoid them. We argue that the UPD enjoys notable theoretical advantages over causal finitism. Causal finitists, however, have levelled two main objections to the UPD. First, they urge that the UPD requires positing a ‘mysterious force’ that prevents paradoxes from (...) arising. Since such a force is implausible, the UPD is in trouble. Second, they employ recombination or patchwork principles to argue that paradoxical situations would be possible if causal finitism were false. Since such situations are not possible, causal finitism is true, and so a substantive metaphysical thesis is needed to avoid the paradoxes. We argue that the UPD proponent can successfully respond to these objections. (shrink)

Edward Feser defends the ‘Aristotelian proof’ for the existence of God, which reasons that the only adequate explanation of the existence of change is in terms of an unchangeable, purely actual being. His argument, however, relies on the falsity of the Existential Inertia Thesis, according to which concrete objects tend to persist in existence without requiring an existential sustaining cause. In this article, I first characterize the dialectical context of Feser’s Aristotelian proof, paying special attention to EIT and its rival (...) thesis—the Existential Expiration Thesis. Next, I provide a more precise characterization of EIT, after which I outline two metaphysical accounts of existential inertia. I then develop new lines of reasoning in favor of EIT that appeal to the theoretical virtues of explanatory power and simplicity. Finally, I address the predominant criticisms of EIT in the literature. (shrink)

José Benardete developed a famous paradox involving a beginningless set of items each member of which satisfies some predicate just in case no earlier member satisfies it. The Grim Reaper version of this paradox has recently been employed in favor of various finitist metaphysical theses, ranging from temporal finitism to causal finitism to the discrete nature of time. Here, I examine a new challenge to these finitist arguments—namely, the challenge of implying that the future cannot be endless. In particular, I (...) develop future-oriented Benardete paradoxes and examine their epistemic symmetry with past-oriented paradoxes. (shrink)

The modal ontological argument (MOA) proceeds from God’s possible existence to God’s actual existence. A prominent objection to the MOA is that it suffers from a symmetry problem: an exactly parallel modal ontological argument can be given for God's non-existence. Several attempts have been made to break the symmetry between the arguments. This draft is a mostly comprehensive survey of those attempts. -/- The draft was initially written as a supplement to the 2024 Summer edition of the SEP entry on (...) Ontological Arguments. However, the draft is not included in the SEP entry. (shrink)

What explains change? Edward Feser argues in his ‘Aristotelian proof’ that the only adequate answer to these questions is ultimately in terms of an unchangeable, purely actual being. In this paper, I target the cogency of Feser’s reasoning to such an answer. In particular, I present novel paths of criticism—both undercutting and rebutting—against one of Feser’s central premises. I then argue that Feser’s inference that the unactualized actualizer lacks any potentialities contains a number of non-sequiturs.

What do appeals to case studies accomplish? Consider the dilemma: On the one hand, if the case is selected because it exemplifies the philosophical point, then it is not clear that the historical data hasn't been manipulated to fit the point. On the other hand, if one starts with a case study, it is not clear where to go from there—for it is unreasonable to generalize from one case or even two or three.

Surrogate endpoints are a common application of biomarkers to estimate clinical benefit in clinical trials, despite questions about reliability. This article discusses ongoing opportunities for their validation, in the context of a regulatory environment in which they are increasingly championed.

Since the publication of Carl Hempel and Paul Oppenheim's ground-breaking work "Studies in the Logic of Explanation," the theory of explanation has remained a major topic in the philosophy of science. This valuable collection provides readers with the opportunity to study some of the classic essays on the theory of explanation along with the best examples of the most recent work being done on the topic. In addition to the original Hempel and Oppenheim paper, the volume includes Scriven's critical reaction (...) to it, Wilfrid Sellars's discussion of the problem of theoretical explanation, and pieces by Salmon, Railton, van Fraassen, Friedman, Kitcher, and Achinstein in which they demonstrate the vitality of the subject by extending the scope of the inquiry. (shrink)

Surely God, as a perfectly rational being, created the universe for some _reason_. But is God’s creating the universe for a reason compatible with divine impassibility? That is the question I investigate in this article. The _prima facie_ tension between impassibility and God’s creating for a reason arises from impassibility’s commitment to God being uninfluenced by anything _ad extra_. If God is uninfluenced in this way, asks the detractor, how could he be moved to create anything at all? This _prima (...) facie_ tension has recently been formalized and dubbed the ‘Problem of Arbitrary Creation’. In this article, I defend a new extension of this problem. I begin by characterizing classical theism, divine simplicity, and divine impassibility. I then spell out the Problem of Arbitrary Creation as developed by R. T. Mullins. I next raise a worry for Mullins’ version of the argument. Finally, I extend the argument and show how my extension avoids the aforementioned worry. (shrink)

The modal collapse objection to classical theism has received significant attention among philosophers as of late. My aim in this paper is to advance this blossoming debate. First, I briefly survey the modal collapse literature and argue that classical theists avoid modal collapse if and only if they embrace an indeterministic link between God and his effects. Second, I argue that this indeterminism poses two challenges to classical theism. The first challenge is that it collapses God’s status as an intentional (...) agent who knows and intends what he is bringing about in advance. The second challenge is that it collapses God’s providential control over which creation obtains. (shrink)

Over 40 years of research have shown that traumatic brain injury affects brain volume. However, technical and practical limitations made it difficult to detect brain volume abnormalities in patients suffering from chronic effects of mild or moderate traumatic brain injury. This situation improved in 2006 with the FDA clearance of NeuroQuant®, a commercially available, computer-automated software program for measuring MRI brain volume in human subjects. More recent strides were made with the introduction of NeuroGage®, commercially available software that is based (...) on NeuroQuant® and extends its utility in several ways. Studies using these and similar methods have found that most patients with chronic mild or moderate traumatic brain injury have brain volume abnormalities, and several of these studies found—surprisingly—more abnormal enlargement than atrophy. More generally, 102 peer-reviewed studies have supported the reliability and validity of NeuroQuant® and NeuroGage®. Furthermore, this updated version of a previous review addresses whether NeuroQuant® and NeuroGage® meet the Daubert standard for admissibility in court. It concludes that NeuroQuant® and NeuroGage® meet the Daubert standard based on their reliability, validity, and objectivity. Due to the improvements in technology over the years, these brain volumetric techniques are practical and readily available for clinical or forensic use, and thus they are important tools for detecting signs of brain injury. (shrink)