The history of aluminum’s transformation from a precious to a commonplace metal over the course of the late nineteenth and twentieth centuries has frequently been told as a narrative about intrepid western chemists, whose discoveries made it possible for industrialized manufacturers to make the metal global. This paper questions both the singularity of that discovery and the inevitability of aluminum’s global dominance as a ‘modern’ material of manufacture. It does so by considering the history of aluminum in West Africa (...) and the ways in which artisans in that region domesticated the substance to an artisanal mode of production and developed quotidian chemical knowledge of it in the process. Considering aluminum from the perspective of West Africa suggests that aluminum may not have been discovered once, but many times, and that everyday material engagements can inspire forms of chemical knowhow that operate well beyond the bounds of the laboratory and industrial manufacturing plant. (shrink)

The rise of global populism reveals a tension in Western thinking about democracy. Warnings about the "populist threat" to democracy and "authoritarian" populism are now commonplace. However, as Emily B. Finley argues in The Ideology of Democratism, dismissing "populist" as anti-democratic is highly problematic. In effect, such arguments essentially reject the actual popular will in favor of a purely theoretical and abstract "will of the people." She contends that the West has conceptualized democracy--not just its populist doppelgänger--as an (...) ideal that has all of the features of a thoroughgoing political ideology which she labels "democratism." As she shows, this understanding of democracy, which constitutes an entire view of life and politics, has been and remains a powerful influence in America and leading Western European nations. Through a careful analysis of several of history's most vocal champions of democracy, including Jean-Jacques Rousseau, Thomas Jefferson, Woodrow Wilson, John Rawls, and both American neoconservatives and liberal internationalists, Finley identifies an interpretation of democracy that effectively transforms the meaning of "rule by the people" into nearly its opposite. Making use of democratic language and claiming to speak for the people, many politicians, philosophers, academics, and others advocate a more "complete" and "genuine" form of democracy that in practice has little regard for the actual popular will.A heterodox argument that challenges the prevailing consensus of what democracy is and what it is supposed to be, The Ideology of Democratism offers a timely and comprehensive assessment of the features and thrust of this powerful new view of democracy that has enchanted the West. -- Dust jacket. (shrink)

This wise, stirring book argues that the search for meaning can immeasurably deepen our lives and is far more fulfilling than the pursuit of personal happiness. There is a myth in our culture that the search for meaning is some esoteric pursuit--that you have to travel to a distant monastery or page through dusty volumes to figure out life's great secret. The truth is, there are untapped sources of meaning all around us--right here, right now. Drawing on the latest research (...) in positive psychology; on insights from George Eliot, Viktor Frankl, Aristotle, the Buddha, and other great minds; and on interviews with seekers of meaning, Emily Esfahani Smith lays out the four pillars upon which meaning rests. Belonging: We all need to find our tribe and forge relationships in which we feel understood, recognized, and valued--to know we matter to others. Purpose: We all need a far-reaching goal that motivates us, serves as the organizing principle of our lives, and drives us to make a contribution to the world. Storytelling: We are all storytellers, taking our disparate experiences and assembling them into a coherent narrative that allows us to make sense of ourselves and the world. Transcendence: During a transcendent or mystical experience, we feel we have risen above the everyday world and are connected to something vast and meaningful. To bring those concepts to life, Smith visits a tight-knit fishing village on the Chesapeake Bay, stargazes in West Texas, attends a dinner where young people gather to share their experiences of untimely loss, and more. And she explores how we might begin to build a culture of meaning in our schools, our workplaces, and our communities. Inspiring and story-driven, The Power of Meaning will strike a profound chord in anyone seeking a richer, more satisfying life. (shrink)

Between 2013 and 2016, West Africa experienced the largest ever outbreak of Ebola Virus Disease. In the absence of registered treatments or vaccines to control this lethal disease, the World Health Organization coordinated and supported research to expedite identification of interventions that could control the outbreak and improve future control efforts. Consequently, the World Health Organization Research Ethics Review Committee was heavily involved in reviews and ethics discussions. It reviewed 24 new and 22 amended protocols for research studies including (...) interventional and observational studies. WHO-ERC provided the reviews within on average 6 working days. The WHO-ERC often could not provide immediate approval of protocols for reasons which were not Ebola Virus Disease specific but related to protocol inconsistencies, missing information and complex informed consents. WHO-ERC considerations on Ebola Virus Disease specific issues are presented. To accelerate study approval in future public health emergencies, we recommend: internally consistent and complete submissions with information documents in language participants are likely to understand, close collaboration between local and international researchers from research inception, generation of template agreements for data and sample sharing and use during the ongoing global consultations on bio-banks, formation of Joint Scientific Advisory and Data Safety Review Committees for all studies linked to a particular intervention or group of interventions, formation of a Joint Ethics Review Committee with representatives of the Ethics Committees of all institutions and countries involved to strengthen reviews through the different perspectives provided without the ‘opportunity costs’ for time to final approval of multiple, independent reviews, direct information exchange between the chairs of advisory, safety review and ethics committees, more Ethics Committee support for investigators than is standard and a global consultation on criteria for inclusion of pregnant women and children in interventional studies for conditions which put them at particularly high risk of mortality or other irreversible adverse outcomes under standard-of-care. (shrink)

Offered here is an interpretation of the ancient Confucian philosopher Mengzi's (372–289 B.C.E.) method of cultivating moral feelings, which he calls "extension." It is argued that this method is both psychologically plausible and an important, but often overlooked, part of moral life. In this interpretation, extending our moral feelings is not a project in logical consistency, analogical reasoning, or emotional intuition. Rather, Mengzi's method of extension is a project in realigning the human heart that harnesses our rational, reflective, and emotional (...) capacities in order to extend the feelings we already have to the appropriate objects for these feelings. It is argued that there are three main features of Mengzi's account that make it an attractive explanation of the cultivation of moral feelings. The first is the way Mengzi sees reasoning and philosophical reflection as an aid to, rather than the foundation for, moral development. The second is Mengzi's precision regarding the relationship between the basic moral feelings we start with (the "sprouts") and their corresponding virtues. The method of extension acts as a well-designed bridge between feelings and virtues. Third, Mengzi's account, unlike that of the Mohist Yi Zhi, whom he criticizes, pays special attention to the complexities and limitations of human psychology. In conclusion it is shown how a Mengzian understanding of the relationship between feelings and morality can answer some traditional challenges, especially Kantian ones, regarding the proper role of emotion in moral life. (shrink)

Background Between 2013 and 2016, West Africa experienced the largest ever outbreak of Ebola Virus Disease. In the absence of registered treatments or vaccines to control this lethal disease, the World Health Organization coordinated and supported research to expedite identification of interventions that could control the outbreak and improve future control efforts. Consequently, the World Health Organization Research Ethics Review Committee was heavily involved in reviews and ethics discussions. It reviewed 24 new and 22 amended protocols for research studies (...) including interventional and observational studies. WHO-ERC reviews WHO-ERC provided the reviews within on average 6 working days. The WHO-ERC often could not provide immediate approval of protocols for reasons which were not Ebola Virus Disease specific but related to protocol inconsistencies, missing information and complex informed consents. WHO-ERC considerations on Ebola Virus Disease specific issues are presented. Conclusions To accelerate study approval in future public health emergencies, we recommend: internally consistent and complete submissions with information documents in language participants are likely to understand, close collaboration between local and international researchers from research inception, generation of template agreements for data and sample sharing and use during the ongoing global consultations on bio-banks, formation of Joint Scientific Advisory and Data Safety Review Committees for all studies linked to a particular intervention or group of interventions, formation of a Joint Ethics Review Committee with representatives of the Ethics Committees of all institutions and countries involved to strengthen reviews through the different perspectives provided without the ‘opportunity costs’ for time to final approval of multiple, independent reviews, direct information exchange between the chairs of advisory, safety review and ethics committees, more Ethics Committee support for investigators than is standard and a global consultation on criteria for inclusion of pregnant women and children in interventional studies for conditions which put them at particularly high risk of mortality or other irreversible adverse outcomes under standard-of-care. (shrink)

In response to Amy Olberding's fascinating and thoughtful book—a book that I wholeheartedly recommend to anyone—I will explore a specific kind of problem regarding manners and morality. It is a question that arises at the intersection of good manners, moral self-cultivation, and oppressive social systems: how do we practice good manners in non-ideal, unjust contexts as members of socially disadvantaged groups? Before I begin to address this question, I want to note that I am convinced by Amy's arguments for the (...) significance of civility and mannerliness in moral and social life (her main argument being, roughly, that civility shows our commitment to the big values of shared life together, the regular expression of... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Grand Manner Aesthetics in LandscapeFrom Canvas to CelluloidEmily E. Auger (bio)Popular films about the environment and related human and material resource issues, particularly colonialism, tend to enhance the appeal of their subject matter by aesthetically transforming it according to audience preferences and tastes. Such mediating strategies are perhaps too familiar to contemporary artists of all types who would prefer to work beyond the limits of what their readers or (...) viewers are prepared to tolerate as entertainment, but the particular emphases and accommodations made by film artists to convey messages about the environment are little changed from those strategies used by painters over the past three centuries to a similar end. The methods by which environmental issues are aestheticized in late-twentieth-century film is directly and historically related to those established for grand manner painters by Nicholas Poussin (1594-1665) and taught at the French academy from the seventeenth through the nineteenth centuries. That these fundamentals were part of the training of artists who would be willing and able to enhance the glory of Louis XIV's absolutist monarchy seems not to have undermined the popular enthusiasm their association with the "classical" past generated outside of France. Thus, the grand manner ideal was repeated, elaborated, and adapted by subsequent British and American artists, teachers, and aestheticians, both amateur and professional, including Joshua Reynolds (1723-92), president of the British academy; theoretician Edmund Burke (1729-97); and such American painters as Benjamin West (1738-1820), Thomas Cole (1801-48), Frederic Church (1826-1900), and Albert Bierstadt (1830-1902).Examples of filmic adaptations of grand manner aesthetics considered here include English director John Boorman's The Emerald Forest (1985) and Anglo-French director Roland Joffé's The Mission (1986), both British productions; Kevin Costner's Dances with Wolves (1990) and John McTiernan's [End Page 96] Medicine Man (1992), both American productions with American directors; and Australian director Bruce Beresford's Black Robe (1991), a Canadian/Australian production based on Irish-born, Canadian novelist Brian Moore's best-selling novel of the same title (1985). While it might be argued that these films merely show the adaptation of academy-based grand manner ideals and principles to new imperialist interests, this article demonstrates how they educate and draw public sympathy to global environmental concerns, albeit with reference to a recognizably Western aesthetic tradition. Thus, the interest of this study to educators and students of the visual arts is twofold: first, it demonstrates the continued adaptation and application of aesthetic principles originally developed in the seventeenth century to a technology-based medium; and second, it shows how those aesthetic principles are currently applied in film to direct and modulate public opinion on matters well beyond the domain of pure or theoretical aesthetics.The grand manner aesthetic, first defined with reference to seventeenth-century painting and still apparent in twentieth-century film, is largely attributable to Poussin since he was an artist who wrote—and wrote well—about his understanding of artistic quality and priorities. He was deeply committed to classicism; he thought the elements of a painting should be idealized rather than realistic and particularized, that those elements should be clearly delineated in a linear manner, that exotic subjects and excessive color should be avoided as both appeal too much to the senses and not enough to the mind, and that figures should always predominate over landscape. Poussin's ideals became the model for students training at the French Academy, an institution officially formed in 1648 under the direct control of the government. Aspiring academicians were exhorted to produce images that were usually composites of the better, and sometimes imagined, aspects of the appearance, character, and deeds of the fictional and historical people, events, and locations that were their subjects. They were never allowed to forgot the hierarchy of value that placed genre painting forever below history painting, yet it cannot have escaped their notice that a certain number of well-executed examples of the lowly still life, domestic interior, and picturesque landscape on the exhibition walls made the "grandness" of more ambitious works more apparent by contrast.The French Academy soon became the envy of foreign upper-level bureaucrats cognizant... (shrink)

In their excellent new volume, Asian and Feminist Philosophies in Dialogue: Liberating Traditions, editors Jennifer McWeeny and Ashby Butnor offer a vision for philosophy that begins with the insight that philosophy is an activity: it is something that we do rather than simply learn about. As an activity—or even, at times, a performance—philosophy both shapes and is shaped by the social world, a world of power hierarchies, economic realities, and political strategies. Conceiving of philosophy as a socially situated activity highlights (...) its liberatory potential. The activity of philosophy can liberate or constrain; it can empower a person or diminish her. This volume seizes on this insight by employing what Butnor... (shrink)

Le livre d’Emily L. Osborn propose une histoire politique de la vallée du Milo en Guinée, sous l’angle des rapports de genre. Couvrant une longue période, de la fondation du royaume de Baté au milieu du xviie siècle au début du xxe siècle, cette étude fait ressortir la présence et l’influence, variable selon les époques, des femmes dans le jeu politique. Plus précisément, l’ambition de l’ouvrage est d’articuler la formation des unités familiales (household-making) et celle de l’État (state-ma...

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)

Viewed this way, the texts yield striking examples of language and notation that are irreducibly ambiguous and productive because they are ambiguous.

In 1919 Emily James Putnam gave twelve lectures at the New School under the title of “Habit and History.” The course description is as follows:The long predominance of habitual conduct over individual initiative in primitive society and in the early empires; the biological and social limitations which tend to foster habit and develop it beyond its proper sphere; the technique of habitbreaking inaugurated by the Greeks and becoming a characteristic of western society; an effort to appraise the amount of (...) excessive and undesirable habit in thought and action generally connected with such concepts as nationalism, religion, the status of women, etc.It is an interesting challenge, eighty-two years later, to try to understand what Mrs. James meant by that description and how to think about those issues today. Mrs. James contrasts the term `habitual conduct' to the term `individual initiative,' and finds the former more characteristic of primitive society and the early empires whereas the latter, beginning with the habit-breaking Greeks, is more characteristic of Western society. She does not reject habit altogether, indicating that it has a `proper sphere,' but only `excessive and undesirable habit,' and she suggests that nationalism, religion and the status of women are spheres where such excessive and undesirable habits are to be found.Without being able to peruse her lectures in detail, I cannot be sure of all that she is implying. One might note that in her contrast between habit and individual initiative she privileges, as until recently we have been wont to do, the West as against the rest. This contrast, with its whiff of Orientalism, might serve to warn us that, although the contrast at the heart of her lecture series is still part of our common sense today, it, like the contrast between the West and the non-West, ought not be affirmed until subjected to a degree of critical suspicion. (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)

We argued in a recent issue of this journal that if abortion is restricted,1 then there are parallel obligations for parents to donate body parts to their children. The strength of this obligation to donate is proportional to the strength of the abortion restrictions. If abortion is never permissible, then a parent must always donate any organ if they are a match. If abortion is sometimes permissible and sometimes not, then organ donation is sometimes obligatory and sometimes not. Our argument (...) was based on the following ideas: (a) that a fetus has full moral status, (b) that parents have special obligations to their offspring, fetus or not, and (c) that this special obligation is to protect them. The result is the conclusion that abortion restrictivists cannot also consistently deny that organ donation should be compulsory. (shrink)

It's well-known that Kant believed that intuition was central to an account of mathematical knowledge. What that role is and how Kant argues for it are, however, still open to debate. There are, broadly speaking, two tendencies in interpreting Kant's account of intuition in mathematics, each emphasizing different aspects of Kant's general doctrine of intuition. On one view, most recently put forward by Michael Friedman, this central role for intuition is a direct result of the limitations of the syllogistic logic (...) available to Kant. On this view, Kant's reasons for introducing intuition are taken to be logical or mathematical, rather than philosophical. The other tendency, which I shall try to develop here, emphasizes an epistemological or phenomenological role for intuition in mathematics arising out of what may loosely be called Kant's ‘antiformalism.’This paper, which focuses specifically on the case of geometry, falls into two parts. First, I consider Kant's discussion of intuition in the Metaphysical Exposition of the concept of space. (shrink)

In this chapter, we address the roles that exemplars might play in a comprehensive response to epistemic injustice. Fricker defines epistemic injustices as harms people suffer specifically in their capacity as (potential) knowers. We focus on testimonial epistemic injustice, which occurs when someone’s assertoric speech acts are systematically met with either too little or too much credence by a biased audience. Fricker recommends a virtue­theoretic response: people who do not suffer from biases should try to maintain their disposition towards naive (...) testimonial justice, and those who find themselves already biased should cultivate corrective testimonial justice by systematically adjusting their credence in testimony up or down depending on whether they are hearing from someone whom they may be biased against or in favor of. We doubt that the prominent admiration­emulation model of exemplarism will be much use in this connection, so we propose two ways of learning from negative exemplars to better conduct one’s epistemic affairs. In the admiration­emulation model, both the identification of what a virtue is and the cultivation of virtues identified thusly proceed through the admiration of virtuous exemplars. We show that this model has serious flaws and argue for two alternatives: the envy­agonism model and the ambivalence­avoidance model. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Kant on the Method of MathematicsEmily Carson1. INTRODUCTIONThis paper will touch on three very general but closely related questions about Kant’s philosophy. First, on the role of mathematics as a paradigm of knowledge in the development of Kant’s Critical philosophy; second, on the nature of Kant’s opposition to his Leibnizean predecessors and its role in the development of the Critical philosophy; and finally, on the specific role of intuition (...) in Kant’s philosophy of mathematics. One of the points that I want to make is that recognizing the importance of these first two issues is essential to giving an adequate account of the third. That is, only by appreciating how Kant uses the example of mathematical knowledge, and in particular the objections he had to previous accounts of such knowledge, can we understand the philosophical role that he ascribes to intuition in his own account of mathematics.I don’t propose to explain the details of Kant’s philosophy of mathematics, but rather to compare his views on mathematics in the pre-Critical Prize Essay of 1764 to those of the Critique of Pure Reason, with the aim of showing how Kant’s doctrine of construction in pure intuition arises out of a combination of two factors: first, his attempt to ground the distinction between the respective methods of mathematics and philosophy, and second, his concern to defend the reality of mathematical knowledge against the views of those he called ‘the metaphysicians.’ The first factor demands an account of the certainty of mathematics, the second requires an account of its content. I shall argue that there is a possible conflict between Kant’s accounts of these features in the Prize Essay, a possibility which is finally ruled out only by means of the Critical doctrine of pure intuition. So I hope to show that there is a significant philosophical role for intuition in Kant’s account of mathematical knowledge (over and above the more logical role attributed to it on readings [End Page 629] such as those of Friedman, Beth, and Hintikka1) in reconciling the content of mathematics and its certainty.2. THE MATHEMATICIANS VS. THE METAPHYSICIANSThroughout his early writings, Kant appealed to the evidence and certainty of mathematics; his attitude towards metaphysics, however, underwent a dramatic shift. In the Physical Monadology of 1756, Kant asked how metaphysics and geometry can be united,[f] or the former peremptorily denies that space is infinitely divisible, while the latter, with its usual certainty, asserts that it is infinitely divisible. Geometry contends that empty space is necessary for free motion, while metaphysics hisses the idea off the stage. Geometry holds universal attraction or gravitation to be hardly explicable by mechanical causes but shows that it derives from the forces which are inherent in bodies at rest and which act at a distance, whereas metaphysics dismisses the notion as an empty delusion of the imagination [1:475–6].2He attempted in this work to reconcile the respective positions of metaphysics and geometry regarding infinite divisibility, thereby demonstrating that “it is neither the case that the geometer is mistaken nor that the opinion to be found among metaphysicians deviates from the truth” [1:480]. But in a series of works from 1762–3, Kant reveals a markedly different attitude towards metaphysics. For example, in “The only possible argument in support of a demonstration of the existence of God,” Kant says:the mania for method and the imitation of the mathematician, who advances with a sure step along a well-surfaced road, have occasioned a large number of such mishaps on the slippery ground of metaphysics. These mishaps are constantly before one’s eyes, but there is little hope that people will be warned by them, or that they will learn to be more circumspect as a result [2:71].In contrast, Kant describes the geometer as uncovering “with the greatest certainty” the most secret properties of that which is extended [2:70]. But the less conciliatory attitude to metaphysics comes out most clearly in Kant’s actual procedure in “The only possible argument.” In the Seventh Reflection, he presents an attempt to explain the origin of... (shrink)

Trust makes cooperation possible. It enables us to learn from others and at a distance. It makes democratic deliberation possible. But it also makes us vulnerable: when we place our trust in another’s word, we are liable to be deceived—sometimes intentionally, sometimes unintentionally. Our evolved mechanisms for deciding whom to trust and whom to distrust mostly rely on face-to-face interactions with people whose reputation we can both access and influence. Online, these mechanisms are largely useless, and the institutions that might (...) supplant them need to have their own trustworthiness verified. Currently, those institutions are mostly corporations such as Facebook and Twitter, which have checkered track records at best. To make matters worse, the social media sector is a natural monopoly, and companies like Facebook have shown that they are willing to use their market power unscrupulously. For these reasons, we argue that social media should be treated like other natural monopolies: it should either be nationalized, highly regulated, or broken up through antitrust legal actions. (shrink)

This book draws its inspiration from Hilbert, Wittgenstein, Cavaillès and Lakatos and is designed to reconfigure contemporary philosophy of mathematics by making the growth of knowledge rather than its foundations central to the study of mathematical rationality, and by analyzing the notion of growth in historical as well as logical terms. Not a mere compendium of opinions, it is organised in dialogical forms, with each philosophical thesis answered by one or more historical case studies designed to support, complicate or question (...) it. The first part of the book examines the role of scientific theory and empirical fact in the growth of mathematical knowledge. The second examines the role of abstraction, analysis and axiomatization. The third raises the question of whether the growth of mathematical knowledge constitutes progress, and how progress may be understood. Readership: Students and scholars concerned with the history and philosophy of mathematics and the formal sciences. (shrink)

Demystifying Legal Reasoning defends the proposition that there are no special forms of reasoning peculiar to law. Legal decision makers engage in the same modes of reasoning that all actors use in deciding what to do: open-ended moral reasoning, empirical reasoning, and deduction from authoritative rules. This book addresses common law reasoning when prior judicial decisions determine the law, and interpretation of texts. In both areas, the popular view that legal decision makers practise special forms of reasoning is false.

What do humility, intellectual humility, and open-mindedness mean in the context of inter-group conflict? We spend most of our time with ingroup members, such as family, friends, and colleagues. Yet our biggest disagreements —— about practical, moral, and epistemic matters —— are likely to be with those who do not belong to our ingroup. An attitude of humility towards the former might be difficult to integrate with a corresponding attitude of humility towards the latter, leading to smug tribalism that masquerades (...) as genuine virtue. These potentially conflicting priorities have recently come to the fore because “tribal epistemology” has so thoroughly infected political and social discourse. Most research on these dispositions focuses on individual traits and dyadic peer-disagreement, with little attention to group membership or inter-group conflict. In this chapter, we dilate the social scale to address this pressing philosophical and social problem. (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)

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)

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)

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 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)