With the growth of precision medicine research on health data and biospecimens, research institutions will need to build and maintain long-term, trusting relationships with patient-participants. While trust is important for all research relationships, the longitudinal nature of precision medicine research raises particular challenges for facilitating trust when the specifics of future studies are unknown. Based on focus groups with racially and ethnically diverse patients, we describe several factors that influence patient trust and potential institutional approaches to building trustworthiness. Drawing on (...) these findings, we suggest several considerations for research institutions seeking to cultivate long-term, trusting relationships with patients: Address the role of history and experience on trust, engage concerns about potential group harm, address cultural values and communication barriers, and integrate patient values and expectations into oversight and governance structures. (shrink)

In his book Modal Logic as Metaphysics, Williamson argues that the traditional actualist‐possibilist debate should be abandoned as hopelessly unclear and that we should get on with the clearer contingentism‐necessitism debate. We think that Williamson’s pessimism is not warranted by the brief arguments he gives. In this paper, we explain why and provide a clear formulation of the traditional actualist‐possibilist debate.

Can identity itself be vague? Can there be vague objects? Does a positive answer to either question entail a positive answer to the other? In this paper we answer these questions as follows: No, No, and Yes. First, we discuss Evans’s famous 1978 argument and argue that the main lesson that it imparts is that identity itself cannot be vague. We defend the argument from objections and endorse this conclusion. We acknowledge, however, that the argument does not by itself establish (...) either that there cannot be vague objects or that there cannot be identity statements that are indeterminate for ontic reasons. And we further acknowledge that it does not by itself establish that there cannot be identity statements that are indeterminate in virtue of the existence of vague objects. We then go on to argue that, despite this, one who believes in vague objects cannot endorse Evans’s argument. To establish this we offer supplementary arguments that show that if vague objects exist then identity is vague, and that if identity is vague then vague objects exist. Finally we draw attention to an argument parallel to that of Evans’s, but safer, which can be employed against the putative ontic indeterminacy in identity of vague objects which can be differentiated by identity-free properties. (shrink)

Selections from Hume's and Kant's writings, with commentary.

In lieu of an abstract, here is a brief excerpt of the content:BOOK REVIEWS 117 Undoubtedly Heidegger's detractors will find in this essay the hallmarks of what they abhor: forced interpretations, dubious etymologies, and overblown claims. Heidegger's followers, on the other hand, will maintain that this essay further enhances his already sure reputation as the most profound and original metaphysician of our time. Those less committed one way or the other will at least find Heidegger's latest dialogue with his philosophical (...) forebears provocative and stimulating. PETER Fuss University o/California,Riverside Jeremy Bentham: An Odyssey of Ideas. By Mary P. Mack. (New York: Columbia University Press, 1963. Pp. xiii + 482. $7.50.) Since this is only the first of two projected volumes about Bentham, only an interim report will be possible. The study extends from its subject's birth in 1748 to the death of his father in 1792, when the 44-year-old thinker, on the way to becoming a radical democrat at the height of the French Revolution, found himself endowed with half of the fortune which had supported his father's crusty Toryism. Consequently, it is a story of rebellion and partial escape from the ancestral world of law in the direction of the promises of the new science, culminating in a career devoted to an almost incredible variety of reforms. That Bentham deserves this "first full-scale study of his thought and times in over sixty years" can hardly be doubted in view of the many part-views and caricatures which he brought upon himself by his many elderly eccentricities. This biographer sees him frankly as "one of the most subtle and powerful analytic minds in the history of Western civilization... a great man who has often been misunderstood and therefore undervalued" (pp. xi, 5). She proposes to remedy the situation by the adoption of a fresh perspective that will enable the reader to "see him whole." That admirable resolution faces formidable obstacles, as every student of Bentham knows. It is about like attempting to map a vast, swampy wilderness from an airplane. For Bentham's "odyssey of ideas" was a true wandering among a profusion of them, beginning and abandoning one project after another in a troubled period of change. The dilemma faced by the author is a cruel one: to give an authentic account of Bentham historically she must reproduce the chaotic carelessness of much of his philosophizing ; while to seek to rear a consistent philosophical system from the sketches to be found in the great masses of his wordage, often mingled and mangled by the glosses of disciples, is to lose touch with the man. In Bentham we are dealing with a writer who was always communicating and frequently talking about communication without ever having mastered the art of cumulative philosophical argument. He was more intent upon being fertile than upon being consistent. His mind kept on growing for decades, which meant that he was constantly outgrowing his earlier interests and insights. His eager and all-devouring curiosity became a veritable seed-bed of suggestions from which sprouted an unmatched array of proposals of specific reforms. Yet the story of his many projects resembles that of another seminal contemporary, Henri de Saint-Simon. The perpetual mobility of intellect which marked them both is summed up in Mary Mack's reiterated comment: "Once again Bentham ran from a good thing to a better, and left only fragments behind him" (p. 417). The philosophical underpinning of his doctrines was never quite complete. As Benjamin Franklin once said of himself in the 118 HISTORY OF PHILOSOPHY role of scientist, Bentham was a good "starter of game" for the guns of others to bring down. As portrayed with accuracy in this study, Bentham became in time an intensely pragmatic thinker, passionately desirous not only of showing the directions which reforms ought to take but also of bringing them to pass. He searched incessantly for the right audience, that is, the one with the power to improve the world according to his enlightened ideas. He began by appealing to the elite, and then turned in disgust to the people. His score as a practical reformer amounted to one long series of rebuffs, transformed after his death into... (shrink)

Much of the debate about identity in recent decades has been about personal identity, and specifically about personal identity over time, but identity generally, and the identity of things of other kinds, have also attracted attention. Various interrelated problems have been at the centre of discussion, but it is fair to say that recent work has focussed particularly on the following areas: the notion of a criterion of identity; the correct analysis of identity over time, and, in particular, the disagreement (...) between advocates of perdurance and advocates of endurance as analyses of identity over time; the notion of identity across possible worlds and the question of its relevance to the correct analysis of de re modal discourse; the notion of contingent identity; the question of whether the identity relation is, or is similar to, the composition relation; and the notion of vague identity. A radical position, advocated by Peter Geach, is that these debates, as usually conducted, are void for lack of a subject matter: the notion of absolute identity they presuppose has no application; there is only relative identity. Another increasingly popular view is the one advocated by Lewis: although the debates make sense they cannot genuinely be debates about identity, since there are no philosophical problems about identity. Identity is an utterly unproblematic notion. What there are, are genuine problems which can be stated using the language of identity. But since these can be restated without the language of identity they are not problems about identity. (For example, it is a puzzle, an aspect of the so-called “problem of personal identity”, whether the same person can have different bodies at different times. But this is just the puzzle whether a person can have different bodies at different times. So since it can be stated without the language of personal “identity”, it is not a problem about identity, but about personhood.) This article provides an overview of the topics indicated above, some assessment of the debates and suggestions for further reading. (shrink)

Is a phenomenal pain a conscious primitive or composed of more primitive phenomenal states? Are pain experiences necessarily or only contingently unpleasant? Here, I sketch how to answer such questions concerning intra-phenomenal metaphysics using the example of pain and unpleasantness. Arguments for a symmetrical metaphysical independence of phenomenal pain and unpleasant affect are presented, rejecting a composite view like the IASP definition and dimensional views. The motivating intuition of these views is explained by common binding mechanisms in consciousness and characterized (...) as fallacious if generalized. There are, however, underlying commonalities between pain perception and unpleasant affect, e.g. formal content or evolutionary ancestry. (shrink)

From the celebrated author of When Bad Things Happen to Good People , a profound and practical book about doing well by doing good. For decades now, from the pulpit and through his writing, Harold Kushner has been helping people navigate the rough patches of life: loss, guilt, crises of faith. Now, in this compelling new work, he ad-dresses an equally important issue: our craving for significance, the need to know that our lives and our choices mean something. We (...) sometimes do great things, and sometimes terrible things, to reassure ourselves that we matter to the world. We sometimes confuse fame, power, and wealth with true achievement. But finally we need to think of ourselves as good people, and we are troubled when we compromise our integrity in the pursuit of what we think of as success. Harold Kushner tells us that the path to a truly successful and significant life is through friendship, through family, and through acts of generosity and self-sacrifice. He describes how, in affecting the life of even one person in a positive way, we make a difference in the world, and prove that we do in fact matter. Persuasive and sympathetic, anecdotal and commonsensical, Living a Life That Matters inspires and uplifts. (shrink)

Can we find necessary and sufficient conditions for a mental state to be a pain state? That is, does pain have a nature? Or is the term ‘pain’ ambiguous? I argue here that our expression ‘pain’ lacks necessary use conditions if one considers a range of contexts. As use conditions constrain the reference class, I argue that ‘pain’ does not refer to a natural category, but binds together a bunch of loosely resembling phenomena. This leads to problems for scientific and (...) clinical discourse. To solve these, a method of explication is suggested, based on a discursive combination between analysis of first-person reports and theories of natural science. Lastly, I consider the ethical implications of this ambiguity that lead to a reformulation of the goal of pain science: Not alleviation of all pains ought to be our goal, but only manipulation of conscious and negatively emotionally charged pains. (shrink)

A profoundly inspiring yet practical guide to well-being from one of modern Judaism's most beloved sages.As a congregational rabbi for half a century and the bestselling author of When Bad Things Happen to Good People and twelve other books on faith, ethics, and how to translate the timeless wisdom of religious thought into dealing with everyday challenges, Harold Kushner knows a thing or two about living a good life. In this compassionate new work, Kushner distills nine essential lessons from (...) the sum of his teaching, study and experience, offering a lifetime's worth of spiritual food for thought, pragmatic advice, inspiration for better living, and strength for trying times. With vital, original insights into everything from belief ("there is no commandment in Judaism to believe in God"), to conscience (the Garden of Eden story as you've never heard it), to mercy ("forgiveness is a favor you do yourself, not a favor to the person who offended you"), grounded in Kushner's brilliant readings of Scripture, history and popular culture, Nine Essential Things I've Learned About Life is a capstone addition to Kushner's oeuvre. (shrink)

I argue that the understanding of "pain" as presented in the official medical definition by the IASP is ambiguous and likely a cluster concept.

In this article, I focus on what is we know when we know pain or that someone is in pain. I argue that claims of knowledge about pains are problematic because of the complex nature of the phenomenon and because of "pain" is a cluster concept.

What am I? And what is my relationship to the thing I call ‘my body’? Thus each of us can pose for himself the philosophical problems of the nature of the self and the relationship between a person and his body. One answer to the question about the relationship between a person and the thing he calls ‘his body’ is that they are two things composed of the same matter at the same time (like a clay statue and the piece (...) of clay which presently constitutes it). This is the ‘constitution view’. In this paper we give a novel overview of the literature on personal identity, the constitution view, and surrounding topics. (shrink)

In this consensus report by a diverse group of academics who conduct and/or are concerned about social and behavioral genomics (SBG) research, the authors recount the often‐ugly history of scientific attempts to understand the genetic contributions to human behaviors and social outcomes. They then describe what the current science—including genomewide association studies and polygenic indexes—can and cannot tell us, as well as its risks and potential benefits. They conclude with a discussion of responsible behavior in the context of SBG research. (...) SBG research that compares individuals within a group according to a “sensitive” phenotype requires extra attention to responsible conduct and to responsible communication about the research and its findings. SBG research (1) on sensitive phenotypes that (2) compares two or more groups defined by (a) race, (b) ethnicity, or (c) genetic ancestry (where genetic ancestry could easily be misunderstood as race or ethnicity) requires a compelling justification to be conducted, funded, or published. All authors agree that this justification at least requires a convincing argument that a study's design could yield scientifically valid results; some authors would additionally require the study to have a socially favorable risk‐benefit profile. (shrink)

While Hume has often been held to have been an agnostic or atheist, several contemporary scholars have argued that Hume was a theist. These interpretations depend chiefly on several passages in which Hume allegedly confesses to theism. In this paper, I argue against this position by giving a threshold characterization of theism and using it to show that Hume does not confess. His most important confession does not cross this threshold and the ones that do are often expressive rather than (...) assertive. I then argue that Hume is best interpreted as an atheist. Instead of interpreting Hume as a proto-logical positivist and arguing on the basis of Hume’s theories of meaning and method, I show that textually he appears to align himself with atheism, that his arguments in the Dialogues on Natural Religion support atheism, and that this position is most consistent with Hume’s naturalism. But, I hold that his atheism is soft and therefore distinct from that of his peers like Baron d’Holbach—while Hume really does reject theism, he neither embraces a dogmatically materialist position nor takes up a purely polemical stance towards theism. I conclude by suggesting several ways in which Hume’s atheistic philosophy of religion is relevant to contemporary discussions. (shrink)

This paper argues that Immanuel Kant’s practical philosophy contains a coherent, albeit implicit, defense of the legitimacy of capital punishment, one that refutes the most important objections leveled against it. I first show that Kant is consistent in his application of the ius talionis. I then explain how Kant can respond to the claim that death penalty violates the inviolable right to life. To address the most significant objection – the claim that execution violates human dignity – I argue that (...) motives of honor, as Kant conceives it, require a rational person to will her own execution, were she to commit murder. (shrink)

The study of anarchism as a philosophical, political, and social movement has burgeoned both in the academy and in the global activist community in recent years. Taking advantage of this boom in anarchist scholarship, Nathan J. Jun and Shane Wahl have compiled twenty-six cutting-edge essays on this timely topic in New Perspectives on Anarchism.

In this paper I argue that Poston and Dougherty's attempt to undermine the problem of divine hiddenness by using the notion of belief de re is problematic at best. They hold that individuals who appear to be unbelievers (because they are de dicto unbelievers) may actually be de re believers. I construct a set of conditions on ascribing belief de re to show that it is prima facie implausible to claim that seemingly inculpable and apparent unbelievers are really de re (...) believers. Thus, while it is indeed possible that a de dicto unbeliever is a de re believer, it is unlikely that this has sufficiently general application to actual individuals to alleviate the problem of divine hiddenness. (shrink)