Because idealizations frequently advance scientific understanding, many claim that falsehoods play an epistemic role. In this paper, we argue that these positions greatly overstate idealiza...

Under what conditions does machine learning (ML) model opacity inhibit the possibility of explaining and understanding phenomena? In this article, I argue that nonepistemic values give shape to the ML opacity problem even if we keep researcher interests fixed. Treating ML models as an instance of doing model-based science to explain and understand phenomena reveals that there is (i) an external opacity problem, where the presence of inductive risk imposes higher standards on externally validating models, and (ii) an internal opacity (...) problem, where greater inductive risk demands a higher level of transparency regarding the inferences the model makes. (shrink)

There is a long tradition, in the history and philosophy of science, of studying Kant’s philosophy of mathematics, but recently philosophers have begun to examine the way in which Kant’s reflections on mathematics play a role in his philosophy more generally, and in its development. For example, in the Critique of Pure Reason , Kant outlines the method of philosophy in general by contrasting it with the method of mathematics; in the Critique of Practical Reason , Kant compares the Formula (...) of Universal Law, central to his theory of moral judgement, to a mathematical postulate; in the Critique of Judgement , where he considers aesthetic judgment, Kant distinguishes the mathematical sublime from the dynamical sublime. This last point rests on the distinction that shapes the Transcendental Analytic of Concepts at the heart of Kant’s Critical philosophy, that between the mathematical and the dynamical categories. These examples make it clear that Kant's transcendental philosophy is strongly influenced by the importance and special status of mathematics. The contributions to this book explore this theme of the centrality of mathematics to Kant’s philosophy as a whole. This book was originally published as a special issue of the Canadian Journal of Philosophy. (shrink)

Belief polarization occurs when subjects who disagree about some matter of fact are exposed to a mixed body of evidence that bears on that dispute. While we might expect mutual exposure to common evidence to mitigate disagreement, since the evidence available to subjects comes to consist increasingly of items they have in common, this is not what happens. The subjects’ initial disagreement becomes more pronounced because each person increases confidence in her antecedent belief. Kelly aims to identify the mechanisms that (...) underlie this phenomenon and assess whether these processes undermine the justification of polarized beliefs. He concludes that given evidentialism, justification is not undermined by the polarizing mechanisms. I take on board Kelly’s description of the polarizing mechanisms, but challenge his conclusion. I argue that on plausible versions of evidentialism, the beliefs that result from these routes to polarization are not justified. (shrink)

Are there epistemic duties to inquire? The idea enjoys intuitive support. However, prominent evidentialists argue that our only epistemic duty is to believe well (i.e., to have doxastically justified beliefs), and doing so does not require inquiry. Against this, I argue that evidentialists are plausibly committed to the idea that if we have epistemic duties to believe well, then we have epistemic duties to inquire. This is because on plausible evidentialist views of evidence possession (i.e., views that result in plausible (...) theories of evidentialist justification), inquiry is sometimes a necessary constitutive means of forming doxastically justified beliefs—beliefs that are proportioned to and based on one's evidence. So, either evidentialist views of evidence possession commit them to epistemic duties to inquire or they lead to independently implausible theories of evidentialist justification. My discussion also has important implications for the zetetic turn in epistemology, since I argue that evidentialists who are staunchly opposed to epistemic norms on inquiry have reason to reconsider. (shrink)

Some people oppose abortion on the grounds that fetuses have full moral status and thus a right to not be killed. We argue that special obligations that hold between mother and fetus also hold between parents and their children. We argue that if these special obligations necessitate the sacrifice of bodily autonomy in the case of abortion, then they also necessitate the sacrifice of bodily autonomy in the case of organ donation. If we accept the argument that it is obligatory (...) to override a woman’s bodily autonomy for the sake of an unborn child’s survival, we must continue to override the bodily autonomy of parents to ensure the survival of their living children, until the parent no longer has a special obligation to their child to the same degree as their special obligation to the fetus. And if the life of a child is truly more important than the bodily autonomy of its parents, as must be the case to force women to carry unwanted pregnancies to term, this should remain true until such a time that their children are no longer considered their responsibility. Thus, parity of reasoning suggests that policies compelling the gestation of a fetus should be accompanied by policies compelling organ donation. (shrink)

Many states offer generous provision of fertility treatment, but this article asks whether and how such state funding can be justified. I argue that, at most, there is limited justification for state funding of fertility treatment as one good among many that could enable citizens to pursue valuable life projects, but not one that should have the privileged access to funding it is currently given. I then consider and reject reasons one might think that fertility treatment has a special claim (...) to funding, over the other goods that might enable life projects. First, I deny that fertility treatment has a special claim to funding on the grounds that infertility is a disease or disability. Second, I argue that individuals do not have a right to assistance with the project of having a child of their own. Third, I deny that providing fertility treatment is a special case on the grounds that having children is good for society. However, there may be one exception: states have a reason to fund fertility treatment for same sex couples that does not apply to heterosexual couples. (shrink)

Philosophical discussions of climate change have mainly conceived of it as a moral or ethical problem, but climate change also raises new challenges for aesthetics. In this paper I show that, in particular, climate change (1) raises difficult questions about the status of aesthetic judgments about the future, or 'future aesthetics'; and (2) puts into relief some challenging issues at the intersection of aesthetics and ethics. I maintain that we can rely on aesthetic predictions to enable us to grasp, in (...) some sense, aesthetic value in environments affected by climate change and, through a discussion of three hypothetical cases, I argue that, although moral considerations will press on aesthetic judgments, aesthetic value will not necessarily be trumped by them. (shrink)

Payment to recruit research subjects is a common practice but raises ethical concerns relating to the potential for coercion or undue influence. We conducted the first national study of IRB members and human subjects protection professionals to explore attitudes as to whether and why payment of research participants constitutes coercion or undue influence. Upon critical evaluation of the cogency of ethical concerns regarding payment, as reflected in our survey results, we found expansive or inconsistent views about coercion and undue influence (...) that may interfere with valuable research. In particular, respondents appear to believe that coercion and undue influence lie on a continuum; by contrast, we argue that they are wholly distinct: whereas undue influence is a cognitive distortion relating to assessment of risks and benefits, coercion is a threat of harm. Because payment is an offer, rather than a threat, payment is never coercive. (shrink)

Political philosophy offers a range of utopian proposals, from open borders to global egalitarianism. Some object that these proposals ought to be constrained by what is feasible, while others insist that what justice demands does not depend on what we can bring about. Currently, this debate is mired in disputes over the fundamental nature of justice and the ultimate purpose of political philosophy. I take a different approach, proposing that we should consider which facts could fill out a feasibility requirement. (...) This search for the facts requires requires looking to the social sciences, but I argue that it turns out that the social sciences will not provide us with findings that rule out, nor even count against, the kinds of proposals that political philosophers actually make, whether ideal or non-ideal. At the least, to deny this requires adopting deeply controversial commitments within the philosophy of social science. Thus, I conclude that a feasibility requirement has little practical use for political philosophers. Disputes over that requirement ought to be replaced by other, more fruitful ways for political philosophers to address both the findings of social science and the debates over non-ideal theory or political realism. (shrink)

In Cohen’s vision of the just society, there would be no need for unequalizing incentives so as to benefit the least well-off; instead, people would be motivated by an egalitarian ethos to work hard and in the most socially productive jobs. As such, Cohen appears to offer a way to mitigate the trade-off of equality for efficiency that often characterizes theorizing about distributive justice. This article presents an egalitarian challenge to Cohen’s vision of the just society. I argue that a (...) society where all internalized the egalitarian ethos would be one lacking equal respect among its members, in which certain groups lacked the grounds of self-respect. Section 1 defends equal respect and a form of equality of self-respect as values with broad-based appeal to egalitarians, and argues that a particular form of hierarchy would undermine both equal respect and the grounds of self-respect. Sections 2 and 3 reveal that just such a hierarchy would emerge in a society in which all had internalized the egalitarian ethos, in the case of both carers and the untalented. Thus, Cohen’s proposed society is shown to fail to unite equality and efficiency. Instead, Cohen’s society would be characterized by a lack of equality. (shrink)

For ten years, between 1903 and 1913, Gertrude Stein saw human relationships as painful mathematical puzzles in need of solutions. Again and again, she converted the predicaments of her personal life into literary material, the better to solve and to exorcise them. The revelation that relationships had a structural quality came to her during the composition of Q.E.D. , when she grasped the almost mathematical nature of her characters' emotional impasse. Stein's persona in the novel comments on their triangular affair, (...) "Why it's like a piece of mathematics. Suddenly it does itself and you begin to see."1 The theory encouraged her to examine such situations as if they were case histories: she continued to study the same piece of mathematics from different angles in Fernhurst , Three Lives , and The Making of Americans . But whatever the sexual arrangements in these triangles, the powerful generally managed to impose their wills upon the less powerful, and the triangles resolved themselves into oppositional structures, pitting two against one. Gradually, when the couple began to replace the triangle as her structural model, Stein composed numerous verbal portraits of couples and their relationships. In two of these, "Ada" and "Two Women," Stein applied her general theory of relationships to the particular puzzle of female friendships because, I think, she felt that women's characters were most intensely molded in same-sex involvements. Although she attempted to "prove" these theories in distanced, deliberately depersonalized prose, we as readers must examine "the complex interplay of self-discovery and writing" from which her portraits emerged.2Stein's portraits of women entangled in familial and erotic bonds seem to invite us into "the process whereby the self creates itself in the experience of creating art"; to read them, we must "join the narrator in reconstructing the other woman by whom we know ourselves."3 This task of reconstruction implies that we must also rethink the place of biography—generally dismissed by New Criticism and its subsequent post-structuralist permutations as "mere" biography—in feminist critical projects. If it is true that "in reading as in writing, it is ourselves that we remake," then feminist critics have a special stake in understanding the biographical, and autobiographical, impulses at work in these activities.4 Stein's portraits, which hover between fiction and biography, raise important questions about the ways in which biographical information can justify our suspicion that female writers may be "closer to their fictional creations than male writers are."5 Recently, feminist critics have adapted psychoanalytic theory to examine the particular closeness of female characters in women's writing or to suggest a related closeness between the female author and her characters. We find it useful to speak of the pre-Oedipal structures and permeable ego boundaries that seem to shape women's relationships. Although Stein used very different psychological paradigms, she approached these same issues in her own studies of female friendships. Realizing that she preferred to write about women, she observed, "It is clearer…I know it better, a little, not very much better."6 In spite of her qualifications, she knew that she could see the structuring principles of relationships with greater clarity when writing from her own perspective.1. Stein, "Fernhurst," "Q.E.D.," and Other Early Writings, ed. Leon Katz , p. 67.2. Elizabeth Abel, "Reply to Gardiner," Signs 6 : 444. For a very useful critical discussion of this complex issue, see Abel, "Merging Identities: The Dynamics of Female Friendship in Contemporary Fiction by Women," and Judith Kegan Gardiner, "The es of dentity: a Response to Abel on 'Merging Identities,'" in the same issue of Signs .3. Gardiner, "The es of dentity," p. 442.4. Jonathan Morse, "Memory, Desire, and the Need for Biography: The Case of Emily Dickinson," The Georgia Review 35 : 271. See also J. Gerald Kennedy's suggestive remarks on the "tension between personal confession and implacable theory" in Barthes' later work .5. Abel, "Reply to Gardiner," p. 444.6. Stein, The Making of Americans, cited in Richard Bridgeman, Gertrude Stein in Pieces , p. 78.Carolyn Burke, an Affiliated Scholar at the Center for Research on Women, Stanford University, has published articles on French feminist writing and on Mina Loy, whose biography she is now completing. The theoretical implications of this essay will be explored in her related study in progress on feminist biography. (shrink)

This article contributes to a growing conversation about the role of numbers in promoting gendered agendas in potentially contradictory ways. Drawing from interviews with gender advisors—the professionals tasked with mainstreaming gender in development projects—in an East African country, I begin from the paradox that gender advisors articulate a strong preference for qualitative data to best capture the lives of the women they aim to assist while voicing a need for quantitative metrics. I demonstrate that gender advisors come to imagine metrics (...) as expeditious bureaucratic tools able to inspire cooperation from otherwise reluctant coworkers. I argue that development organizations are gendered in ways—acutely seen in how advisors struggle, are sidelined, and attempt to advance their goals with numbers—that lead to the utility of valuing quantitative metrics over qualitative ones. I establish two theoretical contributions: Gendered organizations theory is essential to understanding the adoption and globalization of performance metrics, and in an age of evidence-based decision making, the utility of quantified data to garner resources is heightened, rewarding those who adopt quantified knowledge production. I coin the term “the paradox of quantified utility” to describe how these material advantages encourage even skeptics to value quantitative metrics. (shrink)

Exploring the intimate tie between body movement and space and time, Lee begins with the position that body movement generates space and time and explores the ethical implications of this responsibility for the situations one’s body movements generate. Whiteness theory has come to recognize the ethical responsibility for situations not of one’s own making and hence accountability for the results of more than one’s immediate personal conscious decisions. Because of our specific history, whites have developed a particular embodiment and body (...) movement that generates places that can only be characterized as more comfortable and more enabling to whites. (shrink)

Daniel Sennert , a prominent physician and a prolific and influential writer, was both an atomist and an Aristotelian. He was influenced by a distinctive and now little known Aristotelian approach to matter and form, and this promoted his development over time of a hierarchical account of atoms, with elementary atoms and grades of molecules. The first section provides a study of Sennert's Aristotelian foundation. The final two sections consider, in turn, Sennert's development over time of an atomistic theory, and (...) the nature and significance for him of substantial forms. (shrink)

To ensure that the information resulting from research is relevant to patients, the Patient‐Centered Outcomes Research Institute eschews the “traditional health research” paradigm, in which investigators drive all aspects of research, in favor of one in which patients assume the role of research partner. If we accept the premise that patient engagement can offer fresh perspectives that shape research in valuable ways, then at least two important sets of questions present themselves. First, how are patients being engaged—and how should they (...) be engaged? Second, which patients are being engaged—and which patients should be? This set has received relatively less attention, and the neglect is surprising, given that the “who” question is conceptually prior to the question of “how.”This article focuses attention on the “who” of patient engagement in research. First, we provide background on the rationale for patient engagement, underscoring the importance of ensuring the representativeness of engaged patients. Second, we present what little is known about patients engaged in PCORI‐funded research. Third, we identify and discuss the ethical implications of ways in which current practices of patient identification and recruitment may lead to a lack of representativeness. These practices include reliance on the well‐connected and well‐informed, reliance on patients who are not well trained or well‐informed, and reliance on patient advocacy organizations. Finally, we consider several strategies for addressing these pitfalls in order to maximize the positive goals of patient engagement. Patient engagement is intended to address the inability of researchers, funders, and others to fully represent patient views and priorities, but without sufficient attention, the patients selected for this role may still leave important gaps. (shrink)

In 2005, Ethiopia changed its abortion law to curb its high maternal mortality. This has led to a considerable reduction in deaths from unsafe abortions. Abortion is now legal if the woman’s pregnancy is a result of rape or incest, if her health is endangered, if the fetus has a serious deformity, if she suffers from a physical or mental deficiency, or if she is under 18 years of age. The word of the woman, if in compliance with the law, (...) is sufficient to qualify for an abortion. In this context, where the law makes the door slightly open, health workers become important in deciding who gets access to safe services and who doesn’t, thus creating considerable ethical dilemmas. The objective of this study was to explore abortion service providers’ personal experiences and reflections, perceptions of the abortion law, and ethical and dilemmas that arise. Data collection took place from March to May 2016 in Addis Ababa, at different health clinics providing abortion services. Thirty in-depth interviews and three focus group discussions were conducted with 41 abortion service providers at governmental and non-governmental clinics. Content analysis was drawn upon in the interpretation of the findings. When working in a context where the law has slightly opened the door for abortion seeking women, the health workers describe conflicting concerns, burdensome responsibilities, and ambiguity concerning how to interpret and implement the law. They describe efforts to balance their religious faith and values against their professional obligations and concern for women’s health and well-being. This negotiation is particularly evident in the care of women who fall outside the law’s indications. They usually handle ethical dilemmas and decision-making alone without guidance. Moreover, many health workers face a stigma from fellow colleagues not performing abortions and therefore keep their job a secret from family and friends. Health workers in Ethiopia experience ethical dilemmas trying to maneuver between the abortion law, their personal values, and their genuine concern for the health of women. More research is needed to further explore this. (shrink)

This book provides a systematic, philosophical account of the main issues that pertain to the aesthetics of modified environments, as well as new insights concerning the generation and appreciation of landscapes and environments that fall between nature and culture, including gardens and ecologically restored landscapes.

This essay explores how the distinctively anthropological concept of culture provides uniquely valuable insights into the workings of science in its cultural context. Recent efforts by anthropologists to dislodge the traditional notion of culture as a homogenous, stable whole have opened up a variety of ways of imagining culture that place power differentials, flux, and contradiction at its center. Including attention to a wide variety of social domains outside the laboratory, attending to the ways nonscientists actively engage with scientific knowledge, (...) and focusing on the complex interactions that flow both into and out of research laboratories are ways the activities of both scientists and nonscientists can be situated in the heterogeneous matrtx of culture. Three images—the citadel, the rhizome, and the string figure—allow us to picture the discontinuous ways science both permeates and is permeated by cultural life. (shrink)

Healthcare workers experience moral injury (MI), a violation of their moral code due to circumstances beyond their control. MI threatens the healthcare workforce in all settings and leads to medical errors, depression/anxiety, and personal and occupational dysfunction, significantly affecting job satisfaction and retention. This article aims to differentiate concepts and define causes surrounding MI in healthcare. A narrative literature review was performed using SCOPUS, CINAHL, and PubMed for peer-reviewed journal articles published in English between 2017 and 2023. Search terms included (...) “moral injury” and “moral distress,” identifying 249 records. While individual risk factors predispose healthcare workers to MI, root causes stem from healthcare systems. Accumulation of moral stressors and potentially morally injurious events (PMIEs) (from administrative burden, institutional betrayal, lack of autonomy, corporatization of healthcare, and inadequate resources) result in MI. Individuals with MI develop moral resilience or residue, leading to burnout, job abandonment, and post-traumatic stress. Healthcare institutions should focus on administrative and climate interventions to prevent and address MI. Management should ensure autonomy, provide tangible support, reduce administrative burden, advocate for diversity of clinical healthcare roles in positions of interdisciplinary leadership, and communicate effectively. Strategies also exist for individuals to increase moral resilience, reducing the impact of moral stressors and PMIEs. (shrink)

This paper suggests that the contemporary feminist debate on relational autonomy is best understood as an attempt at ameliorative inquiry—the concept of autonomy is defined in order to secure political and theoretical advantages. Most theorists adopt some sort of constructionist, or relational, account precisely because of the political and theoretical advantages relational accounts are meant to offer. But there are also significant drawbacks to this approach. I argue that there are reasons to be skeptical of ameliorative inquiries into the concept (...) of autonomy: first, the goals of inquiry have not been made explicit and may not be shared; second, because ameliorative inquiries are guided by unclear and unshared goals, the debate will continue to pull feminists in conflicting directions; and finally, the normative and aspirational nature of ameliorative inquiry unacceptably threatens the exclusion of some women from the category of autonomous agents. (shrink)

In this article, we want to show the relevance and importance of melancholy as an aesthetic emotion. Melancholy often plays a role in our encounters with art works, and it is also present in some of our aesthetic responses to the natural environment. Melancholy invites aesthetic considerations to come into play not only in well-defined aesthetic contexts but also in everyday situations that give reason for melancholy to arise. But the complexity of melancholy, the fact that it is fascinating in (...) itself, suggests the further thought that it may be considered as an aesthetic emotion per se. To this end, we argue that it is the distinctive character of melancholy, its dual character and its differences from sadness and depression, which distinguishes it as an aesthetic emotion. (shrink)

Over the last several decades there has been an increase in the amount of research conducted concerning academically dishonest behaviors at the undergraduate level. However, this research and subsequent interventions are based on the assumptions that there exists a clear understanding of what constitutes academic dishonesty. In an attempt to address this gap in the current literature, a concept synthesis of students’ perceptions of academic behavior was completed. The end result was 18 categories of potentially dishonest academic behaviors. Definitions and (...) examples are explored. Inter-rater reliability was completed and Kappa values are reported as well as implications for teaching and future research. (shrink)

The concept of self-gaslighting has recently become prevalent in popular discourse but has yet to be subjected to detailed philosophical analysis. In this paper, I examine one context in which self-gaslighting is often discussed: situations in which someone has experienced trauma. I argue that the phenomenon currently described as self-gaslighting fails to display core features of manipulative gaslighting and that therefore we should seek other conceptual resources for understanding such cases. I suggest that self-gaslighting, at least in some paradigmatic cases, (...) amounts to either extremely successful interpersonal gaslighting or to internalized oppression. Utilizing these concepts instead of self-gaslighting avoids conceptual difficulties and also has a significant practical payoff. By moving away from the language of self-gaslighting we can move away from feelings of self-blame that so often accompany trauma. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:158 Feminist Studies 46, no. 1. © 2020 by Feminist Studies, Inc. María Fernanda Olarte-Sierra and Tania Pérez-Bustos Careful Speculations: Toward a Caring Science of Forensic Genetics in Colombia Feminist Science and Technology Studies (STS) has recently opened up the question of care as a set of practices related to the sustainability of life.1 The field of feminist studies more broadly has extensively 1. This literature mostly comes from (...) Northern contexts and started to flourish with the seminal work of María Puig de la Bellacasa, “Matters of Care in Technoscience: Assembling Neglected Things,” Social Studies of Science 41, no. 1 (2010): 85–106. This essay gathers scattered feminist STS reflections on these issues and looks at them through the lens of care, including authors such as Susan Leigh Star, Donna Haraway, Isabelle Stengers, Hilary Rose, and Annemarie Mol. The concept of care orienting this exercise of rereading these authors is proposed by Berenice Fisher and Joan Tronto, “Toward a Feminist Theory of Caring,” in Circles of Care: Work and Identity in Women’s Lives, ed. Emily K. Abel and Margaret K. Nelson (Albany: State University of New York Press, 1990), 35–62. Before and after that essay came out, Puig de la Bellacasa published several other papers related to this issue, including “Touching Technologies, Touching Visions. The Reclaiming of Sensorial Experience and the Politics of Speculative Thinking,” Subjectivity 28, no. 1 (2009): 297–315; “‘Nothing Comes without Its World’: Thinking with Care,” The Sociological Review 60, no. 2 (2012): 197– 216; “Ethical Doings in Naturecultures,” Ethics, Place & Environment 13, no. 2 (2010): 151–69; “Making Time for Soil: Technoscientific Futurity and the Pace of Care,” Social Studies of Science 45, no. 5 (2015): 691–716; and Matters of Care: Speculative Ethics in More than Human Worlds (Minneapolis: University of Minnesota Press, 2017). All these publications have been widely cited by other authors, particularly in a special issue of Social Studies of Science on the politics of care published in 2015 (volume 45, issue 5). Other examples María Fernanda Olarte-Sierra and Tania Pérez-Bustos 159 studied how care, and associated practices such as transnational care chains, are feminized and precarious—involving an ethos embodied by those who actively work to maintain or preserve another’s life. Feminists have focused on the politics of care embedded in invisible jobs related to aesthetics, domestic work, child and elder care, and sexual activities and see all these tasks as related to the reproduction of life and culture.2 Central to this conceptualization of care is the understanding that these jobs are typically women’s work. There is a common association between this care and notions of “motherhood” as it relates to values such as compassion, love, and respect, which have been constructed as universally feminine. However, the main goal of feminist studies of care has been to deconstruct this association, particularly because it is imbued with the white, wealthy, heteronormative ideal of femininity that underlies a gendered division of labor. The reality is that class, race, nation, and gender determine who cares for whom, whether or not labor is paid, and to what extent care is exploitative. One strand of recent research problematizes both valorizing and criticizing care practices on the grounds that they are based on a rather homogeneous understanding of the feminine. Instead, these scholars seek to resurrect valuable feminist work without relying on essentialism of authors contributing to this discussion on care as an ethos for science include Ruth Müller and Martha Kenney, “Agential Conversations: Interviewing Postdoctoral Life Scientists and the Politics of Mundane Research Practices,” Science as Culture 24, no. 4 (2014): 537–59; Charis Thompson, Good Science: The Ethical Choreography of Stem Cell Research (Cambridge, MA: MIT Press, 2013); and Carrie Friese, “Realizing Potential in Translational Medicine: The Uncanny Emergence of Care as Science,” Current Anthropology 54 (S7): S129-S138. 2. From Latin America, see, for example, Luz Gabriela Arango Gaviria, Adira Amaya Urquijo, Tania Pérez-Bustos, and Javier Pineda Duque, eds., Género y cuidado: teorías, escenarios y políticas (Bogotá: Universidad Nacional de Colombia, 2018); Pascale Molinier and Luz Grabriela Arango Gaviria, eds., El trabajo y... (shrink)

Madison Kilbride recently argued that insurance ) should cover in vitro fertilisation with preimplantation genetic testing services for couples at high risk of having a child affected with a genetic condition. She argues that IVF-PGT meets CMS’s definition of ‘medically necessary care’, where such care includes ‘services or supplies needed to diagnose or treat an illness, injury, condition, disease or its symptoms’. Kilbride argues that IVF-PGT satisfies this definition in two ways: as a diagnostic tool and as a treatment. Contradicting (...) Kilbride, however, I argue that IVF-PGT provides neither diagnosis nor treatment under CMS’s definition. Thus, as long as we accept CMS’s definition of medically necessary care—which Kilbride does, explicitly—it follows that IVF-PGT does not count as medically necessary care. Still, there may be other reasons to conclude that IVF-Preimplantation genetic testing should be covered, and so, it would be a mistake to reject Kilbride’s conclusion altogether. The problem is simply that Kilbride’s argument—that the procedure should be covered because it is medically necessary per CMS’s definition—is not sound. I conclude by discussing a number of other genetic services that are not currently being covered despite the fact that they do seem to satisfy CMS’s definition of ‘medically necessary diagnosis or treatment’. These services, I argue, should be provided under CMS before we consider expanding coverage to include elective procedures such as IVF-PGT. (shrink)

The Cartesian method, construed as a way of organizing domains of knowledge according to the "order of reasons," was a powerful reductive tool. Descartes made significant strides in mathematics, physics, and metaphysics by relating certain complex items and problems back to more simple elements that served as starting points for his inquiries. But his reductive method also impoverished these domains in important ways, for it tended to restrict geometry to the study of straight line segments, physics to the study of (...) ambiguously constituted bits of matter in motion, and metaphysics to the study of the isolated, incorporeal knower. This book examines in detail the negative and positive impact of Descartes's method on his scientific and philosophical enterprises, exemplified by the Geometry, the Principles, the Treatise of Man, and the Meditations. (shrink)

In Physics 2.4–6, Aristotle offers an account of things that happen “by luck” and “spontaneously”. Many of these things are what we might think of as “lucky breaks”: cases where things go well for us, even though we don’t expect them to. In Physics 2.5, Aristotle illustrates this idea with the case of a man who goes to the market for some reason unrelated to collecting a debt he is owed. While he is there, this man just so happens to (...) run into his debtor and get his money back—which is what he “wanted” all along. This case has a number of features that have proved puzzling. Most notably, Aristotle seems to think that while “it happened accidentally to him to come and to do this for the sake of getting the money”, nevertheless the man “did not come for the sake of this”—though he “would have”. What must such a proceeding be like to be described in these ways? Physics 2.4–6 makes several important moves towards answering this question. One of them—among the earliest and seemingly a foundational one—is the claim that “for the sake of something are as many things as could be done by thought and by nature”. The aim of this paper is to identify the role that this claim plays in Aristotle’s account of spontaneous proceedings. It defends two main claims. First, Aristotle’s suggestion that spontaneous proceedings could be done by nature and by thought is the product of a more general strategy. His approach is to sketch an intuitive pattern of explanation for proceedings that happen for the sake of something in the ordinary—non-spontaneous—way, and then to try to extend that model to the case of things that do so spontaneously, preserving as much of it as possible. Applying this strategy reveals that whereas nature and thought in fact function as efficient causes of ordinary proceedings that are for the sake of something, this cannot be the case in spontaneous ones. Instead, nature and thought could function as their causes. Second, I argue that Aristotle’s implementation of this strategy is rooted in his account of causation and especially Physics 2.3’s list of “modes” of causes. When he claims that spontaneous proceedings “could” be done by nature and by thought, he is saying that nature and thought are their efficient causes in capacity. In the practical case, spontaneous proceedings are caused by agents who have certain capacities, connected with their desires and abilities. In the right circumstances, these agents would actively exercise those capacities in acting for the sake of a given end. (shrink)

In this paper, I discuss the recent discovery of alleged arsenic bacteria in Mono Lake, California, and the ensuing debate in the scientific community about the validity and significance of these results. By situating this case in the broader context of projects that search for anomalous life forms, I examine the methodology and upshots of challenging biochemical constraints on living things. I distinguish between a narrower and a broader sense in which we might challenge or change our knowledge of life (...) as the result of such a project, and discuss two different kinds of projects that differ in their potential to overhaul our knowledge of life. I argue that the arsenic bacteria case, while potentially illuminating, is the kind of constraint-challenging project that could not—in spite of what was said when it was presented to the public—change our knowledge of life in the deeper sense. (shrink)

In this issue of the Hastings Center Report, James Sabin and his colleagues ask what responsibility investigators in a learning health organization have to patients when research—particularly research of which patients might be unaware—illuminates problematic aspects of the patients' care. Sabin and his colleagues were confronted by this question in the midst of designing a randomized controlled trial that sought to determine if an educational intervention targeted at patients with atrial fibrillation and their clinicians reduces underuse of oral anticoagulants. Worried (...) about harm that might befall patients in the control group and fearing that they would be negligent bystanders if they knew these patients were at risk and did nothing, the investigators adopted a “workaround.” But the “workaround,” I suggest, was not a solution to the negligent bystander problem. Nor was it a solution to the problem as I would alternatively frame it—how to address instances of suboptimal patient care identified through research within learning health organizations. (shrink)

The equality provision in section 15 of the Canadian Charter of Rights and Freedoms 1982 was drafted with a vision of promoting substantive equality. Following challenges to this vision during the 1990s by a group of conservative Supreme Court judges, the recent judgment of Iacobucci J in Law v Canada (1999) has been welcomed for reasserting section 15's substantive ideal. But despite the effective manner in which the provision was drafted, and despite the recent guidelines set out in Law, interpretations (...) of section 15 must continue to explore the complexities of intersectional inequalities and clarify any reliance on the ambiguous call to ‘human dignity’ if they are to maintain Canada's position near the forefront of progressive approaches to equality law. (shrink)