Three plausible views—Presentism, Truthmaking, and Independence—form an inconsistent triad. By Presentism, all being is present being. By Truthmaking, all truth supervenes on, and is explained in terms of, being. By Independence, some past truths do not supervene on, or are not explained in terms of, present being. We survey and assess some responses to this.

After witnessing extraordinary scientific and regulatory efforts to speed development of and access to new COVID-19 interventions, patients facing other serious diseases have begun to ask “where’s...

If musical works are abstract objects, which cannot enter into causal relations, then how can we refer to musical works or know anything about them? Worse, how can any of our musical experiences be experiences of musical works? It would be nice to be able to sidestep these questions altogether. One way to do that would be to take musical works to be concrete objects. In this paper, we defend a theory according to which musical works are concrete objects. In (...) particular, the theory that we defend takes musical works to be fusions of performances. We defend this view from a series of objections, the first two of which are raised by Julian Dodd in a recent paper and the last of which is suggested by some comments of his in an earlier paper. (shrink)

This article reflects on the relevance and applicability of the Belmont Report nearly four decades after its original publication. In an exploration of criticisms that have been raised in response to the report and of significant changes that have occurred within the context of biomedical research, five primary themes arise. These themes include the increasingly vague boundary between research and practice, unique harms to communities that are not addressed by the principle of respect for persons, and how growing complexity and (...) commodification in research have shed light on the importance of transparency. The repercussions of Belmont's emphasis on the protection of vulnerable populations is also explored, as is the relationship between the report's ethical principles and their applications. It is concluded that while the Belmont Report was an impressive response to the ethical issues of its day, the field of research ethics involving human subjects may have outgrown it. (shrink)

Can a musical work be created? Some say ‘no’. But, we argue, there is no handbook of universally accepted metaphysical truths that they can use to justify their answer. Others say ‘yes’. They have to find abstract objects that can plausibly be identified with musical works, show that abstract objects of this sort can be created, and show that such abstract objects can persist. But, we argue, none of the standard views about what a musical work is allows musical works (...) both to be created and to persist. (shrink)

Much attention has been focused in recent years on the ethical acceptability of physicians receiving gifts from drug companies. Professional guidelines recognize industry gifts as a conflict of interest and establish thresholds prohibiting the exchange of large gifts while expressly allowing for the exchange of small gifts such as pens, note pads, and coffee. Considerable evidence from the social sciences suggests that gifts of negligible value can influence the behavior of the recipient in ways the recipient does not always realize. (...) Policies and guidelines that rely on arbitrary value limits for gift-giving or receipt should be reevaluated. (shrink)

There are competing ethical concerns when it comes to designing any clinical research study. Clinical trials of possible treatments for Ebola virus are no exception. If anything, the competing ethical concerns are exacerbated in trying to find answers to a deadly, rapidly spreading, infectious disease. The primary goal of current research is to identify experimental therapies that can cure Ebola or cure it with reasonable probability in infected individuals. Pursuit of that goal must be methodologically sound, practical and consistent with (...) prevailing norms governing human subjects research. Some maintain that only randomized controlled trials with a placebo or standard-of-care arm can meet these conditions. We maintain that there are alternative trial designs that can do so as well and that sometimes these are preferable to RCTs. (shrink)

Conceived as a solution to clinical dilemmas, and now required by organizations for hospital accreditation, ethics committees have been subject only to small-scale studies. The wide use of ethics committees and the diverse roles they play compel study. In 1999 the University of Pennsylvania Ethics Committee Research Group (ECRG) completed the first national survey of the presence, composition, and activities of U.S. healthcare ethics committees (HECs). Ethics committees are relatively young, on average seven years in operation. Eighty-six percent of ethics (...) committees report that they play a role in ongoing clinical decision making through clinical ethics consultation. All are engaged in developing institutional clinical policy. Although 4.5% of HECs write policy on managed care, 50% of HEC chairs feel inadequately prepared to address managed care. The power and activity of ethics committees parallels the composition of those committees and the relationship of members to their institutions. The role of ethics committees across the nation in making policies about clinical care is greater than was known, and ethics committees will likely continue to play an important role in the debate and resolution of clinical cases and clinical policies. (shrink)

Much attention has been focused in recent years on the ethical acceptability of physicians receiving gifts from drug companies. Professional guidelines recognize industry gifts as a conflict of interest and establish thresholds prohibiting the exchange of large gifts while expressly allowing for the exchange of small gifts such as pens, note pads, and coffee. Considerable evidence from the social sciences suggests that gifts of negligible value can influence the behavior of the recipient in ways the recipient does not always realize. (...) Policies and guidelines that rely on arbitrary value limits for gift-giving or receipt should be reevaluated. (shrink)

This collection of essays examines the ways in which disputes and controversies about the application of scientific knowledge are resolved. Four concrete examples of public controversy are considered in detail: the efficacy of Laetrile, the classification of homosexuality as a disease, the setting of safety standards in the workplace, and the utility of nuclear energy as a source of power. The essays in this volume show that debates about these cases are not confined to matters of empirical fact. Rather, as (...) is seen with most scientific and technical controversies, they focus on and are structured by complex ethical, economic, and political interests. Drs. Engelhardt and Caplan have brought together a distinguished group of scholars from the sciences and humanities, who sketch a theory of scientific controversy and attempt to provide recommendations about the ways in which both scientists and the public ought to seek more informed resolutions of highly contentious issues in science and technology. Scientific Controversies is offered as a contribution to the better understanding of the roles of both science and nonscientific interests in disputes and controversies pertaining to science and technology. (shrink)

In the nineteenth century, astronomers thought that a planet between Mercury and the Sun was causing perturbations in the orbit of Mercury, and they introduced ‘Vulcan’ as a name for such a planet. But they were wrong: there was, and is, no intra-Mercurial planet. Still, these astronomers went around saying things like (2) Vulcan is a planet between Mercury and the Sun. Some philosophers think that, when nineteenth-century astronomers were theorizing about an intra-Mercurial planet, they created a hypothetical planet.

This target article discusses the verbal working memory system used in sentence comprehension. We review the concept of working memory as a short-duration system in which small amounts of information are simultaneously stored and manipulated in the service of accomplishing a task. We summarize the argument that syntactic processing in sentence comprehension requires such a storage and computational system. We then ask whether the working memory system used in syntactic processing is the same as that used in verbally mediated tasks (...) that involve conscious controlled processing. Evidence is brought to bear from various sources: the relationship between individual differences in working memory and individual differences in the efficiency of syntactic processing; the effect of concurrent verbal memory load on syntactic processing; and syntactic processing in patients with poor short-term memory, patients with poor working memory, and patients with aphasia. Experimental results from these normal subjects and patients with various brain lesions converge on the conclusion that there is a specialization in the verbal working memory system for assigning the syntactic structure of a sentence and using that structure in determining sentence meaning that is separate from the working memory system underlying the use of sentence meaning to accomplish other functions. We present a theory of the divisions of the verbal working memory system and suggestions regarding its neural basis. (shrink)

In Parts of Classes and "Mathematics is Megethology" David Lewis shows how the ideology of set membership can be dispensed with in favor of parthood and plural quantification. Lewis's theory has it that singletons are mereologically simple and leaves the relationship between a thing and its singleton unexplained. We show how, by exploiting Kit Fine's mereology, we can resolve Lewis's mysteries about the singleton relation and vindicate the claim that a thing is a part of its singleton.

Although a safe, effective, and licensed coronavirus vaccine does not yet exist, there is already controversy over how it ought to be allocated. Justice is clearly at stake, but it is unclear what justice requires in the international distribution of a scarce vaccine during a pandemic. Many are condemning ‘vaccine nationalism’ as an obstacle to equitable global distribution. We argue that limited national partiality in allocating vaccines will be a component of justice rather than an obstacle to it. For there (...) are role-based and community-embedded responsibilities to take care of one’s own, which constitute legitimate moral reasons for some identity-related prioritisation. Furthermore, a good form of vaccine nationalism prioritises one’s own without denying or ignoring duties derived from a principle of equal worth, according to which all persons, regardless of citizenship or identity, equally deserve vaccine-induced protection from COVID-19. Rather than dismissing nationalism as a tragic obstacle, it is necessary to acknowledge that a limited form of it is valuable and expresses moral commitments. Only then can one understand our world of competing obligations, a world where cosmopolitan duties of benevolence sometimes conflict with special obligations of community membership. Once these competing obligations are recognised as such, we can begin the work of designing sound ethical frameworks for achieving justice in the global distribution of a coronavirus vaccine and developing practical strategies for avoiding, mitigating or resolving conflicts of duty. (shrink)

In this paper, I argue against Millian Descriptivism: that is, the view that, although sentences that contain names express singular propositions, when they use those sentences speakers communicate descriptive propositions. More precisely, I argue that Millian Descriptivism fares no better (or worse) than Fregean Descriptivism: that is, the view that sentences express descriptive propositions. This is bad news for Millian Descriptivists who think that Fregean Descriptivism is dead.

Thanks to David Kaplan (1989a, 1989b), we all know how to handle indexicals like ‘I’. ‘I’ doesn’t refer to an object simpliciter; rather, it refers to an object only relative to a context. In particular, relative to a context C, ‘I’ refers to the agent of C. Since different contexts can have different agents, ‘I’ can refer to different objects relative to different contexts. For example, relative to a context cwhose agent is Gottlob Frege, ‘I’ refers to Frege; relative to (...) a context 0* whose agent is Alexius.. (shrink)

We present a computational evaluation of three hypotheses about sources of deficit in sentence comprehension in aphasia: slowed processing, intermittent deficiency, and resource reduction. The ACT-R based Lewis and Vasishth model is used to implement these three proposals. Slowed processing is implemented as slowed execution time of parse steps; intermittent deficiency as increased random noise in activation of elements in memory; and resource reduction as reduced spreading activation. As data, we considered subject vs. object relative sentences, presented in a self-paced (...) listening modality to 56 individuals with aphasia and 46 matched controls. The participants heard the sentences and carried out a picture verification task to decide on an interpretation of the sentence. These response accuracies are used to identify the best parameters that correspond to the three hypotheses mentioned above. We show that controls have more tightly clustered parameter values than IWA; specifically, compared to controls, among IWA there are more individuals with slow parsing times, high noise, and low spreading activation. We find that individual IWA show differential amounts of deficit along the three dimensions of slowed processing, intermittent deficiency, and resource reduction, overall, there is evidence for all three sources of deficit playing a role, and IWA have a more variable range of parameter values than controls. An important implication is that it may be meaningless to talk about sources of deficit with respect to an abstract verage IWA; the focus should be on the individual's differential degrees of deficit along different dimensions, and on understanding the causes of variability in deficit between participants. (shrink)

The concepts of health and disease play pivotal roles in medicine and the health professions This volume brings together the requisite literature for understanding current discussions and debates these concepts. The selections in the volume attempt to present a wide range of views concerning the nature of the concepts of health and issues using both historical and contemporary sources -- Back cover.

In recent work, Peter Hanks and Scott Soames argue that propositions are types whose tokens are acts, states, or events. Let’s call this view the type view. Hanks and Soames think that one of the virtues of the type view is that it allows them to explain why propositions have semantic properties. But, in this paper, we argue that their explanations aren’t satisfactory. In Section 2, we present the type view. In Section 3, we present one explanation—due to Hanks (2007, (...) 2011) and Soames (2010)—of why propositions have semantic properties. We criticize this first explanation in Section 4. In Section 5, we present another explanation—due to Soames (2104)—of why propositions have semantic properties. We criticize this second explanation in Section 6. (shrink)

Kit Fine and Gideon Rosen propose to define constitutive essence in terms of ground-theoretic notions and some form of consequential essence. But we think that the Fine–Rosen proposal is a mistake. On the Fine–Rosen proposal, constitutive essence ends up including properties that, on the central notion of essence, are necessary but not essential. This is because consequential essence is closed under logical consequence, and the ability of logical consequence to add properties to an object’s consequential essence outstrips the ability of (...) ground-theoretic notions, as used in the Fine–Rosen proposal, to take those properties out. The necessary-but-not-essential properties that, on the Fine–Rosen proposal, end up in constitutive essence include the sorts of necessary-but-not-essential properties that, others have noted, end up in consequential essence. (shrink)

Researchers are developing a fertility preservation technique?testicular tissue cryopreservation (TTCP)?for prepubescent boys who may become infertile as a result of their cancer treatment. Although this technique is still in development, some researchers are calling for its widespread use. They argue that if boys do not bank their tissue now, they will be unable to benefit from any therapies that might be developed in the future. There are, however, risks involved with increasing access to an investigational procedure. This article examines four (...) methods of expanding access to TTCP: (1) expansion of institutional review board (IRB)-approved research trials; (2) offering TTCP as an innovative procedure in hospitals; (3) offering TTCP as a standard practice in hospitals; and (4) commercialization of TTCP. The ethical and practical implications of each are evaluated through a comparison with umbilical cord blood banking (UCBB), a technology that has achieved widespread use based on similar claims of future benefit. (shrink)

In 1992, the Joint Commission on the Accreditation of Healthcare Organizations (JCAHO) passed a mandate that all its approved hospitals put in place a means for addressing ethical concerns.Although the particular process the hospital uses to address such concernsmay vary, the hospital or healthcare ethics committee (HEC) is used most often. In a companion study to that reported here, we found that in 1998 over 90% of U.S. hospitals had ethics committees, compared to just 1% in 1983, and that many (...) have some and a few have sweeping clinical powers in hospitals. (shrink)

Anthony Everett has argued that fictional realism entails that some fictional characters are indeterminately identical. Benjamin Schnieder and Tatjana von Solodkoff deny that fictional realism has that entailment. But, we argue in this paper, their view is arbitrary, since there is no reason to prefer their principles to alternative ones. We don’t take this to show that fictional realism should be rejected. But we do take this to show that fictional realists who deny that some fictional characters are indeterminately identical (...) need another response to Everett’s argument. (shrink)

By any reasonable reckoning, Gottlob Frege's ‘On Sense and Reference’ is one of the more important philosophical papers of all time. Although Frege briefly discusses the sense-reference distinction in an earlier work, it is through ‘Sense and Reference’ that most philosophers have become familiar with it. And the distinction so thoroughly permeates contemporary philosophy of language and mind that it is almost impossible to imagine these subjects without it.The distinction between the sense and the referent of a name is introduced (...) in the second paragraph of ‘Sense and Reference.’. (shrink)

Clinical bioethics is big business. There are now hundreds of people who bioethics in community and university hospitals, nursing homes, rehabilitation and home care settings, and some who play the role of clinical ethics consultant to transplant teams, managed care companies, and genetic testing firms. Still, there is as much speculation about what clinically active bioethicists actually do as there was ten years ago. Various commentators have pondered the need for training standards, credentials, exams, and malpractice insurance for ethicists engaged (...) in clinical consultation. Much of the discussion seems to accept an implicit presumption that all clinical ethics consultation practices look pretty much alike. But is this accurate? What do clinical ethicists do, how and where do they do it, and what kind of clinical ethics is useful in the hospital and in other settings? (shrink)

Descriptivists say that every name is synonymous with some definite description, and Descriptivists who are Widescopers say that the definite description that a name is synonymous with must take wide scope with respect to modal adverbs such as “necessarily”. In this paper, I argue against Widescopism. Widescopers should be Super Widescopers: that is, they should say that the definite description that a name is synonymous with must take wide scope with respect to complementizers such as “that”. Super Widescopers should be (...) Super Duper Widescopers: that is, they should say that the definite description that a name is synonymous with must take wide scope with respect to quotation marks. And Super Duper Widescopers should be Ultra Super Duper Widescopers: that is, they should say that, when the definite description that a name is synonymous with itself contains a name, the definite description that that name is synonymous with must take wide scope with respect to modal adverbs, complementizers, and quotation marks. But Descriptivists should not be Ultra Super Duper Widescopers. So Descriptivists should not be Widescopers either. (shrink)

In a series of recent publications, Jeffrey King (The nature and structure of content, 2007; Proc Aristot Soc 109(3):257–277, 2009; Philos Stud, 2012) argues for a view on which propositions are facts. He also argues against views on which propositions are set-theoretical objects, in part because such views face Benacerraf problems. In this paper, we argue that, when it comes to Benacerraf problems, King’s view doesn’t fare any better than its set-theoretical rivals do. Finally, we argue that his view faces (...) a further Benacerraf problem, one that threatens to undercut his explanation of why propositions have truth-conditions. If correct, our arguments undercut King’s main motivation for accepting his view over its rivals. (shrink)

Patients have received experimental pharmaceuticals outside of clinical trials for decades. There are no industry-wide best practices, and many companies that have granted compassionate use, or ‘preapproval’, access to their investigational products have done so without fanfare and without divulging the process or grounds on which decisions were made. The number of compassionate use requests has increased over time. Driving the demand are new treatments for serious unmet medical needs; patient advocacy groups pressing for access to emerging treatments; internet platforms (...) enabling broad awareness of compelling cases or novel drugs and a lack of trust among some that the pharmaceutical industry and/or the FDA have patients’ best interests in mind. High-profile cases in the media have highlighted the gap between patient expectations for compassionate use and company utilisation of fair processes to adjudicate requests. With many pharmaceutical manufacturers, patient groups, healthcare providers and policy analysts unhappy with the inequities of the status quo, fairer and more ethical management of compassionate use requests was needed. This paper reports on a novel collaboration between a pharmaceutical company and an academic medical ethics department that led to the formation of the Compassionate Use Advisory Committee. Comprising medical experts, bioethicists and patient representatives, CompAC established an ethical framework for the allocation of a scarce investigational oncology agent to single patients requesting non-trial access. This is the first account of how the committee was formed and how it built an ethical framework and put it into practice. (shrink)

The movement to try to close the ever-widening gap between demand and supply of organs has recently arrived at the prison gate. While there is enthusiasm for using executed prisoners as sources of organs, there are both practical barriers and moral concerns that make it unlikely that proposals to use prisoners will or should gain traction. Prisoners are generally not healthy enough to be a safe source of organs, execution makes the procurement of viable organs difficult, and organ donation post-execution (...) ties the medical profession too closely to the act of execution. (shrink)

Can sentence comprehension impairments in aphasia be explained by difficulties arising from dependency completion processes in parsing? Two distinct models of dependency completion difficulty are investigated, the Lewis and Vasishth (2005) activation-based model and the direct-access model (DA; McElree, 2000). These models' predictive performance is compared using data from individuals with aphasia (IWAs) and control participants. The data are from a self-paced listening task involving subject and object relative clauses. The relative predictive performance of the models is evaluated using k-fold (...) cross-validation. For both IWAs and controls, the activation-based model furnishes a somewhat better quantitative fit to the data than the DA. Model comparisons using Bayes factors show that, assuming an activation-based model, intermittent deficiencies may be the best explanation for the cause of impairments in IWAs, although slowed syntax and lexical delayed access may also play a role. This is the first computational evaluation of different models of dependency completion using data from impaired and unimpaired individuals. This evaluation develops a systematic approach that can be used to quantitatively compare the predictions of competing models of language processing. (shrink)

Can sentence comprehension impairments in aphasia be explained by difficulties arising from dependency completion processes in parsing? Two distinct models of dependency completion difficulty are investigated, the Lewis and Vasishth (2005) activation‐based model and the direct‐access model (DA; McElree, 2000). These models' predictive performance is compared using data from individuals with aphasia (IWAs) and control participants. The data are from a self‐paced listening task involving subject and object relative clauses. The relative predictive performance of the models is evaluated using k‐fold (...) cross‐validation. For both IWAs and controls, the activation‐based model furnishes a somewhat better quantitative fit to the data than the DA. Model comparisons using Bayes factors show that, assuming an activation‐based model, intermittent deficiencies may be the best explanation for the cause of impairments in IWAs, although slowed syntax and lexical delayed access may also play a role. This is the first computational evaluation of different models of dependency completion using data from impaired and unimpaired individuals. This evaluation develops a systematic approach that can be used to quantitatively compare the predictions of competing models of language processing. (shrink)

Over 90% of the organs transplanted in China before 2010 were procured from prisoners. Although Chinese officials announced in December 2014 that the country would completely cease using organs harvested from prisoners, no regulatory adjustments or changes in China’s organ donation laws followed. As a result, the use of prisoner organs remains legal in China if consent is obtained. We have collected and analysed available evidence on human rights violations in the organ procurement practice in China. We demonstrate that the (...) practice not only violates international ethics standards, it is also associated with a large scale neglect of fundamental human rights. This includes organ procurement without consent from prisoners or their families as well as procurement of organs from incompletely executed, still-living prisoners. The human rights critique of these practices will also address the specific situatedness of prisoners, often conditioned and traumatized by a cascade of human rights abuses in judicial structures. To end the unethical practice and the abuse associated with it, we suggest to inextricably bind the use of human organs procured in the Chinese transplant system to enacting Chinese legislation prohibiting the use of organs from executed prisoners and making explicit rules for law enforcement. Other than that, the international community must cease to abet the continuation of the present system by demanding an authoritative ban on the use of organs from executed Chinese prisoners. (shrink)

British Journal of Aesthetics (forthcoming Jan. 2008).

Richard Thaler and Cass Sunstein (2008) contend that mandated choice is the most practical nudge for increasing organ donation. We argue that they are wrong, and their mistake results from failing to appreciate how perceptions of meaning can influence people's responses to nudges. We favor a policy of default to donation that is subject to immediate family veto power, includes options for people to opt out (and be educated on how to do so), and emphasizes the role of organ procurement (...) organizations and in-house transplant donation coordinators creating better environments for increasing the supply of organs and tissues obtained from cadavers. This policy will provide better opportunities for offering nudges in contexts where in-house coordinators work with families. We conclude by arguing that nudges can be introduced ethically and effectively into these contexts only if nudge designers collaborate with in-house coordinators and stakeholders. (shrink)

Thanks to David Kaplan, we all know how to handle indexicals like ‘I’. ‘I’ doesn’t refer to an object simpliciter; rather, it refers to an object only relative to a context. In particular, relative to a context C, ‘I’ refers to the agent of C. Since different contexts can have different agents, ‘I’ can refer to different objects relative to different contexts. For example, relative to a context c whose agent is Gottlob Frege, ‘I’ refers to Frege; relative to a (...) context c* whose agent is Alexius Meinong, ‘I’ refers to Meinong. (shrink)

In ‘Truth, Relativism, and Serial Fiction’, Andrew McGonigal presents new data that a theory of truth in fiction should account for, and argues that the data is best accounted for by his relativist view. I argue against McGonigal’s relativist view and in favour of a more metaphysical view. The key feature of this view is that it is one on which the content of a work of fiction can change over time. Along the way I also argue against Ross Cameron’s (...) contextualist view. (shrink)

In 1968, the definition of death in the United States was expanded to include not just death by cardiopulmonary criteria, but also death by neurologic criteria. We explore the way the definition has been modified by the medical and legal communities over the past 50 years and address the medical, legal and ethical controversies associated with the definition at present, with a particular highlight on the Supreme Court of Nevada Case of Aden Hailu.