Increasing philosophical attention is being directed to the rapidly growing discipline of evidence-based medicine. Philosophical discussions of EBM, however, remain narrowly focused on randomization, mechanisms, and the sociology of EBM. Other aspects of EBM have been all but ignored, including the nature of clinical reasoning and the question of whether it can be standardized; the application of EBM principles to the logic, value, and ethics of diagnosis and prognosis; evidence synthesis ; and the nature and ethics of placebo controls. Philosophical (...) analysis in each of these areas has the potential to enhance the discussion of EBM methodology and practice. (shrink)

The concept of the Anthropocene reflects a particular meaning of the “human” as it exists in society, and a specific understanding of freedom, which only became possible at the close of the twentieth century. Whereas Enlightenment thinkers such as Kant, Rousseau, and Adam Smith attempted to grasp the potential for humanity to be changed through society in a self-conscious process of attaining freedom, the “Age of Man” today appears entirely disconnected from human agency. Indeed, the Anthropocene is associated not with (...) the flourishing of life but with the sixth mass extinction. Drawing insight from classical and contemporary critical theory, this paper seeks to explicate the emancipatory potential within the concept of the Anthropocene, and the ways in which this potential is blocked by material circumstances that masquerade as “freedom.”. (shrink)

Building on recent revisionist trends, this book offers a refreshing new perspective on the Renaissance and presents an invaluable examination of continuities and discontinuities from Petrarch to Machiavelli, from Giotto to Durer, and from Italy to Burgundy, Bohemia and beyond.".

Consideration of the property of action is proposed to provide a more meaningful definition of efficient energy use and sustainable production in ecosystems. Action has physical dimensions similar to angular momentum, its magnitude varying with mass, spatial configuration and relative motion. In this article, the relationship of action to thermodynamic processes such as the spontaneous increase in entropy of the second law is explained and the utility of action for measuring changes in energy and material distribution is promoted. In particular, (...) the view that increases in entropy and action are equivalent to disorder is challenged. Given that the development of action states may be assigned an economic value and the various sources of free energy assigned a price, action theory may provide a novel mechanism for the economic allocation of resources. The importance of the diversity and redundancy of energy resources and work processes to optimize action is highlighted. (shrink)

Since its introduction just over two decades ago, evidence-based medicine (EBM) has come to dominate medical practice, teaching, and policy. There are a growing number of textbooks, journals, and websites dedicated to EBM research, teaching, and evidence dissemination. EBM was most recently defined as a method that integrates best research evidence with clinical expertise and patient values and circumstances in the treatment of patients. There have been debates throughout the early 21st century about what counts as good research evidence between (...) EBM proponents and philosophical critics and even within the EBM community itself. Similar controversy arises about the relative worth of patient values and clinical expertise (and how these can be integrated). EBM has also evolved in ways that have come under scrutiny. Specifically, policymakers have used EBM research methodology to increase the relative importance of clinical guidelines that some clinicians have argued are tyrannical. Philosophers have addressed all of these controversies, and with very few exceptions have been critical of EBM. In addition most philosophical attention has been on the epistemic role of Randomization and evidence hierarchies, with relatively little attention being paid to the role of Diagnosis, expertise, patient values, and Systematic Reviews within EBM. (shrink)

In her article, Pascale Hess raises the issue of whether her proposed model may be extrapolated and applied to clinical research fields other than stem cell-based interventions in the brain (SCBI-B) (Hess 2012). Broadly summarized, Hess’s model suggests prioritizing efficacy over safety in phase 1 trials involving irreversible interventions in the brain, when clinical criteria meet the appropriate population suffering from “degenerative brain diseases” (Hess 2012). Although there is a need to reconsider the traditional phase 1 model, especially with respect (...) to first-in-human clinical trials involving novel technologies, the question arises as to whether it is appropriate to advocate for a new model that prioritizes efficacy over safety across all phase 1 clinical research trials involving irreversible interventions in the brain. -/- . (shrink)

A consistent finding reported in the literature is that epistemically suspect beliefs are less frequently endorsed by individuals with a greater tendency to think analytically. However, these results have been observed predominantly in Western participants. In the present work, we explore various individual differences known to predict epistemically suspect beliefs across both Western and Eastern cultures. Across four studies with Japanese and Western individuals, we find that the association between thinking style and beliefs varied as a function of culture. Specifically, (...) while Westerners who scored higher on measures of Type-2 analytic thinking tended to endorse epistemically suspect beliefs less, this association was not observed in Japanese samples, suggesting that the often-observed negative association between analytic thinking and epistemically suspect beliefs may be exclusive to Western individuals. Additionally, we demonstrate that a tendency to think holistically is positively associated with the endorsement of epistemically suspect beliefs within both samples. Overall, we discuss how various individual differences predict the endorsement of epistemically suspect beliefs across cultures. (shrink)

Clinical trials aim to minimise participant risk and generate new clinical knowledge for the wider population. Many military agencies are now investing efforts in pushing towards developing new treatments involving Brain-Computer Interfaces, Gene Therapy and Stem Cells interventions. These trials are targeting smaller disease groups, as such they give rise to novel participant risks of harms that are largely not accommodated by existing practice. This is of most concern with irreversible harms at early trial stages, where participants may forfeit any (...) future therapy, and in personalised medicine, where the individual participant assumes all of the trial risk. Given these new experimental interventions involve high risk of irreversible harms, how much risk should patients be exposed to when participating in experimental testing of innovative technologies? Designing clinical trials which better balance risk/benefit ratios for participants is crucial. The aim of this book chapter is to suggest a new stratified risk framework aimed at minimising the risk-benefit ratio to participants in clinical trials associated with high risk of irrevocable harms. We will argue it demands a higher-level of clinical data capture at earlier trial stages than predicated by current trial doctrine; it also requires publication of all trial data to minimise risk to participants of any future trial. (shrink)

In their article, Sankary et al. (2022) provided important preliminary findings on how research participants exiting from clinical trials engage in decisions related to the removal or post-trial us...

Biological ontologies are used to organize, curate, and interpret the vast quantities of data arising from biological experiments. While this works well when using a single ontology, integrating multiple ontologies can be problematic, as they are developed independently, which can lead to incompatibilities. The Open Biological and Biomedical Ontologies Foundry was created to address this by facilitating the development, harmonization, application, and sharing of ontologies, guided by a set of overarching principles. One challenge in reaching these goals was that the (...) OBO principles were not originally encoded in a precise fashion, and interpretation was subjective. Here we show how we have addressed this by formally encoding the OBO principles as operational rules and implementing a suite of automated validation checks and a dashboard for objectively evaluating each ontology’s compliance with each principle. This entailed a substantial effort to curate metadata across all ontologies and to coordinate with individual stakeholders. We have applied these checks across the full OBO suite of ontologies, revealing areas where individual ontologies require changes to conform to our principles. Our work demonstrates how a sizable federated community can be organized and evaluated on objective criteria that help improve overall quality and interoperability, which is vital for the sustenance of the OBO project and towards the overall goals of making data FAIR. Competing Interest StatementThe authors have declared no competing interest. (shrink)

At the beginning of 2020, COVID-19 became a global problem. Despite all the efforts to emphasize the relevance of preventive measures, not everyone adhered to them. Thus, learning more about the characteristics determining attitudinal and behavioral responses to the pandemic is crucial to improving future interventions. In this study, we applied machine learning on the multi-national data collected by the International Collaboration on the Social and Moral Psychology of COVID-19 (N = 51,404) to test the predictive efficacy of constructs from (...) social, moral, cognitive, and personality psychology, as well as socio-demographic factors, in the attitudinal and behavioral responses to the pandemic. The results point to several valuable insights. Internalized moral identity provided the most consistent predictive contribution—individuals perceiving moral traits as central to their self-concept reported higher adherence to preventive measures. Similar was found for morality as cooperation, symbolized moral identity, self-control, open-mindedness, collective narcissism, while the inverse relationship was evident for the endorsement of conspiracy theories. However, we also found a non-negligible variability in the explained variance and predictive contributions with respect to macro-level factors such as the pandemic stage or cultural region. Overall, the results underscore the importance of morality-related and contextual factors in understanding adherence to public health recommendations during the pandemic. (shrink)

How does talk work, and can we engage the public in a dialogue about the scientific study of talk? This article presents a history, critical evaluation and empirical illustration of the public science of talk. We chart the public ethos of conversation analysis that treats talk as an inherently public phenomenon and its transcribed recordings as public data. We examine the inherent contradictions that conversation analysis is simultaneously obscure yet highly cited; it studies an object that people understand intuitively, yet (...) routinely produces counter-intuitive findings about talk. We describe a novel methodology for engaging the public in a science exhibition event and show how our ‘conversational rollercoaster’ used live recording, transcription and public-led analysis to address the challenge of demonstrating how talk can become an informative object of scientific research. We conclude by encouraging researchers not only to engage in a public dialogue but also to find ways to actively engage people in taking a scientific approach to talk as a pervasive, structural feature of their everyday lives. (shrink)

Since the seventeenth century, when Descartes divided the universe into two realms, the distinctive character of one of which being its spatiality or extendedness, philosophers have been increasingly concerned with the analysis of the category of Space. Scientists, too, have been interested in the concepts of Space and Time, especially since the promulgation of the theory of relativity.

In lieu of an abstract, here is a brief excerpt of the content:Kennedy Institute of Ethics Journal 13.1 (2003) 51-52 [Access article in PDF] Congress Considers Incentives for Organ Procurement Alexander S. Curtis [Tables]During the 108th Congressional session, several bills pertaining to ethical incentives for organ donation likely will be introduced. In some cases, they will be similar to bills before the 107th Congress (see Table 1). Bills in both the House of Representatives and the Senate address the (...) establishment and maintenance of donor registries, financial reimbursements for medical and nonmedical expenses incurred by qualifying donors, the presentation of commemorative medals, and tax credits.A bill entitled "Gift of Life Congressional Medal Act" (introduced last year by Senate majority leader Bill Frist (R-TN) as Senate Bill 325), and its corresponding bill of the same title (passed in the House of Representatives last year as H.R. 708), would establish a congressional commemorative medal honoring "any organ donor, or the family or family member of any organ donor." The medal is to be designed and struck with "suitable emblems, devices, and inscriptions" by the Secretary of the Treasury. The eligible donor or donor's family member would be presented with the medal by the Secretary of Health and Human Services. This bill would establish qualifying donations as those of human kidneys, livers, hearts, lungs, pancreases, or any other organ, but excludes corneas and eyes.Another bill, introduced by Representative Michael Bilirakis (R-FL) entitled "Organ Donation Improvement Act" (H.R. 624), would award grants or contracts to states, transplant centers, and qualified organ procurement organizations for the purpose of providing travel, subsistence, and incidental nonmedical expenses to individuals who make living donations. In order to receive reimbursement, the donating individuals must reside in states other than the states in which the intended recipients reside and the annual income of those receiving the organs cannot exceed $35,000. The bill also would appropriate $15,000,000 to make grants to states and public and nonprofit entities for the purpose of carrying out studies, public education demonstrations, and outreach activities "designed to increase the number of organ donors within the state." The bill would be effective from time of enactment through 2005. [End Page 51]Two other bills proposed within the House of Representatives in 2002 called for amendment to the Internal Revenue Code. The "Gift of Life Tax Credit Act (introduced as H.R. 1872 by Representative James Hansen (R-UT)) and the "Help Organ Procurement Expand Act" (introduced as H.R. 2090 by Representative Chris Smith (R-NJ)) present a refundable credit to individuals or to the estates of those who agree either to be living donors or to donate their organs upon death. The "Gift of Life Tax Credit Act" refunds $10,000 to the estates of eligible individuals "for the taxable year which includes the date of the individual's death." The "Help Organ Procurement Expand Act" offers a refund of $2,500 to qualified persons. Donations of kidneys, livers, pancreases, islet cells, lungs, and intestines are accepted, however several conditions restrict permissible donors. The "Gift of Life Tax Credit Act" requires that the legally competent individual's death not be due to a suicide and that the intention to donate was clearly declared. The "Help Organ Procurement Expand Act" prohibits donations from individuals who were killed with physician assistance, died as a result of a suicide, have been indicted or convicted of a felony or a misdemeanor offense, or are actively under criminal investigation for a possible felony offense. The "Help Organ Procurement Expand Act" also restricts procuring organs from unborn children or human fetuses and under circumstances in which the living donor would be subject to "unacceptable levels of medical risk of death or permanent debilitation." Alexander S. Curtis is a research assistant at the Kennedy Institute of Ethics, Georgetown University, Washington, DC. He received his bachelor's degree from Miami University.... (shrink)

Kennedy (Linguist Philos 30:1–45, 2007) forcefully proposes what is now a widely assumed semantics for absolute gradable adjectives. On this semantics, maximum standard adjectives like “straight” and “dry” ascribe a maximal degree of the underlying quantity. Meanwhile, minimum standard adjectives like “bent” and “wet” merely ascribe a non-zero, non-minimal degree of the underlying quantity. This theory clashes with the ordinary intuition that sentences like “The stick is straight” are frequently true while sentences like “The stick is bent” are frequently (...) informative, and fans of the indicated theory of absolute gradable adjectives appeal to loose talk in response. One goal of this paper is to show that all extant theories of loose talk are inconsistent with this response strategy. Another goal is to offer a revised version of Hoek’s (Philos Rev 127:151–196, 2018, in: Proceedings of the 22nd Amsterdam Colloquium, 2019) recent theory of loose talk that accommodates absolute gradable adjectives after all, while being defensible against a range of important concerns. (shrink)

The concept of interactional expertise – characterized by sociologists Harry Collins and Robert Evans as the ability to speak the language of a discipline without the corresponding ability to practice – can serve as a powerful way of breaking down expert/non-expert dichotomies and providing a role for new voices in specialist communities. However, in spite of the vast uptake of this concept and its potential to fruitfully address many important issues related to scientific expertise, there has been surprisingly little (...) critical analysis of it. We seek to remedy this situation by considering potential benefits of interactional expertise and the ways in which the current conception can – and cannot – realize those benefits. In particular, we argue that interactional expertise hasn’t reached its full potential for addressing who ought to be involved in scientific research and decision-making, largely owing to an unnecessarily restrictive way of operationalizing the concept. In its place, we offer a broader, more pluralistic account of interactional expertise – one that is in line with the original spirit of the concept, but also captures the diversity that we see as being an important aspect of interactional experts and the value they can bring to the table. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Richard H. Popkin 1923-2005Harry M. Bracken and Richard A. WatsonRichard H. Popkin, founding editor of the journal of the History of Philosophy, died on April 14, 2005. He was 81 years old and had continued his research and writing to the last moment before he entered the hospital on march 21st with extreme respiratory difficulties.Popkin's The History of Scepticism from Erasmus to Descartes (1960) revolutionized the study and understanding (...) of early modern philosophy. Popkin entered the minds and world of thinkers from Erasmus to Descartes in a way few other scholars had done, and he showed how the development of philosophy and science was far from an easy series of steps from success to success. Instead, philosophers and scientists pursued a dozen lines from the scepticism of Sextus Empiricus through religious belief, atheism, numerology, astrology, alchemy, eschatology, magic, and millenarianism—a maelstrom of ideas out of which emerged the major figures and ideas of Modern philosophy and science. Dick once explained that actually he lived in the 17th century, and certainly he knew as many of those thinkers and their thoughts as did many people who actually lived at that time. Of course Popkin did not originate the notion of exploring the history of philosophy in the context of its times, but he made that approach central today. It led him not only through the Early Modern period, but also from medieval jewish philosophy to a critical analysis of the Kennedy assassination.Popkin received his PhD at Columbia University, and in his career he taught at the universities of Connecticut, Iowa, California (San Diego and Los Angeles), Washington University in St. Louis, and Harvey Mudd College. He served as the first editor of the Journal of the History of Philosophy, and as president of JHP, Inc. For many years, and was active in its operation for over four decades, having attended the annual meeting of the Board of Directors a little over a month before he died. After retirement, he lived in close association with the Clark Library in Los Angeles. He was well known to scholars and librarians throughout the world. Whatever library he visited, he was likely to find some obscure or hidden document that would either clear up some mystery, or give rise to a new problem. His memory was extraordinary. During his final years when he was virtually blind, he would sift through his mind, send assistants off to look for something that had to be in this or that library and write papers in his head for later dictation. Besides his memory, indispensable throughout his lifetime he had Julie, his co-worker and wife of 60 years, without whom, the Popkin we knew could not have existed.These few paragraphs are meant to be neither an obituary nor an adequate memorial. We were Dick's first two PhDs, and we were barely five years his junior. He treated us from the beginning as colleagues and he became a lifelong friend. He changed our lives, as he did the lives of many other aspiring scholars. We miss him.Copyright © 2005 Journal of the History of Philosophy, Inc.... (shrink)

Before committing suicide, Othello says, "Speak of me as I am; . . . speak of one who loved not wisely, but too well." Thinking of his love for Desdemona, we are not likely to agree with his assessment that he loved her "too well," especially if loving well is supposed to require some kind of dependability or concern for her well-being; we would be loath even to grant that he loved her "too much." Othello's love for his wife seems, (...) rather, to have been firmly subordinated to his love for his honor. Perhaps, then, his statement could be saved by saying that it was his honor that he loved too well, and that in devoting himself so completely to it, he did not love wisely. He needed a better way of coordinating his two concerns, one that wouldn't give him cause for regret—a way of loving well that was also wise. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:An Egg Takes Flight: The Once and Future Life of the National Bioethics Advisory Commission*Alexander Morgan Capron (bio)Attempting to describe the National Bioethics Advisory Commission (NBAC) is comparable to the surreal feat performed by the artist in a famous painting by René Magritte. The artist (Magritte himself) sits with his back to the viewer, a palette in his left hand. The brush in his right hand is raised (...) to a canvas, blank except for a bird in flight that he is in the process of painting. The artist is looking to his left at a tabletop, bare except for a single, plain egg.Having held its second formal meeting in mid-January, NBAC is certainly still embryonic, its future mysterious within its shell. Yet answers to four major questions that will determine not just what kind of bird the Commission turns out to be but the heights to which it will fly should be evident by April or May 1997. First, will the White House take the sort of interest in NBAC that is needed if it is to succeed? Second, will the Commission’s term be extended beyond October 1997—and will the decision come early enough to allow it to start soon on projects that will take more than a single year to complete? Third, will the Commission take a broad view of the issues it addresses, reexamining widely accepted assumptions and going back to basic premises, or will it respond primarily in bureaucratic terms, guided by its charter’s focus on improving the policies and practices of federal departments and agencies? Fourth, will the Commission move beyond its initially mandated topics—the rights and welfare of human research subjects and the management and use of genetic information—and become what its name promises, the nation’s advisory body on the full range of bioethical issues that arise in the organization and management of health services and research?The Origins of the Egg: NBAC’s PredecessorsThe creation of a national bioethics commission has been demanded for years, at the least since its most recent predecessor, the Biomedical Ethics [End Page 63] Advisory Committee (BEAC) finally expired in 1990. BEAC’s statutory authority lapsed after the hapless committee had spent several years itself like an in vitro embryo in a vat of liquid nitrogen. BEAC’s opponents in Congress froze its appropriation and forbad it to meet until the Biomedical Ethics Board of six senators and six representatives to which it was supposed to report resolved the chaos resulting from the Board members’ ideological differences and personal distrust; this never occurred, and the Board proved unable even to choose its chairman. 1 BEAC, which met only twice, had laid preliminary plans to study the issues raised by the new genetics, but the politics of abortion—which had greatly complicated and slowed the Board’s naming of the BEAC members—was strong enough to interfere even with the topic of genetics, on which the difference among committee members actually gave no sign of dividing on pro-life/pro-choice grounds.The disappearance of BEAC left the nation without a mechanism for “public bioethics,” and several efforts were undertaken in the early 1990s to generate a new commission that could carry on in the tradition of the two previous, successful bioethics commissions. (The National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research operated under a Congressional mandate in the Department of Health, Education, and Welfare from 1974 to 1978, and the President’s Commission for the Study of Ethical Problems in Medicine and Biomedical and Behavioral Research, which had been authorized by Congress in 1978, actually operated as an independent body with government-wide purview from January 1980 to March 1983.) The Institute of Medicine established a committee to assess the mechanisms available not only to the federal government but also to states, professional bodies, and the public for deliberating about and resolving ethical issues stemming from developments in biomedicine (Bulger, Bobby, and Fineberg 1995). In September 1992, Senators Mark O. Hatfield (R-OR), Edward M. Kennedy (D-MA), and Dennis DeConcini (D-AZ) requested that the Office of Technology Assessment (OTA) evaluate the... (shrink)

American Journal of Bioethics, Bioethics, Cambridge Quarterly of Healthcare Ethics, Journal of Medical Ethics, Kennedy Institute of Ethics Journal, Nursing Ethics, Theoretical Medicine and Bioethics.