Employing the National Institute of Mental Health-funded Prevention of Suicide in Primary Care Elderly Collaborative Trial as a case study, we discuss 2 sets of ethical issues: obtaining informed consent for a clinic-based intervention study and using treatment as usual (TAU) as the control condition. We then address these ethical issues in the context of the debate about the quality improvement efforts of health care organizations. Our analysis reveals the tension between ethics and scientific integrity involved with using TAU as (...) a control condition and the difficulty in designing high-quality research in a community-based setting. (shrink)

James I. The Political Works of James I. Reprinted from the Edition of 1616. With an Introduction by Charles Howard McIlwain. Cambridge: Harvard University Press, 1918. cxi, 354 pp. Reprinted 2002 by The Lawbook Exchange, Ltd.

Although sensorimotor contingencies may explain visual perception, it is difficult to extend this concept to speech perception. However, the basic concept of perception as active hypothesis testing using attention does extend well to speech perception. We propose that the concept of sensorimotor contingencies can be broadened to sensory-attentional contingencies, thereby accounting for speech perception as well as vision.

The New Zealand philosopher, Robert Nola (1940-2022), has died. He was a kind man, a good friend, and a fine philosopher. Here is how I remember him.

In I 7 Aristotle lays down criteria for what is to count as human happiness. Happiness for man is self-sufficient, complete without qualification, peculiar to humans, excellent, and best and most complete. Many interpreters agree that in X 6–8 Aristotle uses these along with other criteria to disqualify the life of amusement and rank one happy life above another.

In I 7 Aristotle lays down criteria for what is to count as human happiness. Happiness for man is self-sufficient , complete without qualification , peculiar to humans , excellent , and best and most complete . Many interpreters agree that in X 6–8 Aristotle uses these along with other criteria to disqualify the life of amusement and rank one happy life above another.

Background: Current practice frequently fails to provide care consistent with the preferences of decisionally-incapacitated patients. It also imposes significant emotional burden on their surrogates. Algorithmic-based patient preference predictors (PPPs) have been proposed as a possible way to address these two concerns. While previous research found that patients strongly support the use of PPPs, the views of surrogates are unknown. The present study thus assessed the views of experienced surrogates regarding the possible use of PPPs as a means to help make (...) treatment decisions for decisionally-incapacitated patients. -/- Methods: This qualitative study used semi-structured interviews to determine the views of experienced surrogates [n=26] who were identified from two academic medical centers and two community hospitals. The primary outcomes were respondents’ overall level of support for the idea of using PPPs and the themes related to their views on how a PPP should be used, if at all, in practice. -/- Results: Overall, 21 participants supported the idea of using PPPs. The remaining five indicated that they would not use a PPP because they made decisions based on the patient’s best interests, not based on substituted judgment. Major themes which emerged were that surrogates, not the patient’s preferences, should determine how treatment decisions are made, and concern that PPPs might be used to deny expensive care or be biased against minority groups. -/- Conclusions: Surrogates, like patients, strongly support the idea of using PPPs to help make treatment decisions for decisionally-incapacitated patients. These findings provide support for developing a PPP and assessing it in practice. At the same time, patients and surrogates disagree over whose preferences should determine how treatment decisions are made, including whether to use a PPP. These findings reveal a fundamental disagreement regarding the guiding principles for surrogate decision-making. Future research is needed to assess this disagreement and consider ways to address it. (shrink)

Since the middle of the 20th century, suicidology, as a group of disciplines working to understand and prevent suicide, has reinforced the long-held view that suicide is caused first and foremost b...

I defend the widely-held view that morally worthy action need not be motivated by a desire to promote rightness as such. Some have recently come to reject this view, arguing that desires for rightness as such are necessary for avoiding a certain kind of luck thought incompatible with morally worthy action. I show that those who defend desires for rightness as such on the basis of this argument misunderstand the relationship between moral worth and the kind of luck that their (...) argument employs. Consequently, the argument provides no reason to doubt the popular view that a desire for rightness as such is no part of virtue. I conclude by suggesting that a family of worries about merely accidentally right action presuppose one side of the recent debate about objectivism and perspectivism about moral rightness. (shrink)

Technology corporations and the emerging digital health market are exerting increasing influence over the public healthcare agendas forming around the application of mobile medical devices. By promising quick and cost-effective technological solutions to complex healthcare problems, they are attracting the interest of funders, researchers, and policymakers. They are also shaping the public facing discourse, advancing an overwhelmingly positive narrative predicting the benefits of wearable medical devices to include personalised medicine, improved efficiency and quality of care, the empowering of under-resourced communities, (...) and delivery of health services previously unavailable to the citizens of developing countries. Typically techno-optimist in their description, the key barriers to this impending inflection point in healthcare are identified as technical issues such as short battery life and a lack of data protection. However, this tech innovation narrative is consistent with problematic ethical, social, and political assumptions that have practical and normative effects, and risk, one, undermining the real clinical potential of wearable devices and, two, designing social inequality and injustice into our mobile health interventions in global healthcare. I argue that the foundational assumptions dealing with the just distribution of healthcare ‘goods’, the individual as part of society, and the political framing of future healthcare policy devalue equity and despite what they promise cannot meet the distinctive needs of individuals and groups that do not conform to a standardised concept of care-receiver. (shrink)

This paper is about how epistemic and practical reasons for belief can be compared against one another when they conflict. It provides a model for determining what one ought to believe, all-things-considered, when there are conflicting epistemic and practical reasons. The model is meant to supplement a form of pluralism about doxastic normativity that I call ‘Inclusivism’. According to Inclusivism, both epistemic and practical considerations can provide genuine normative reasons for belief, and both types of consideration can contribute to metaphysically (...) determining what beliefs one ought, all-things-considered, to have. (shrink)

This paper addresses a recent puzzle in the ethics of emotions concerning the fitting duration of emotions. On the one hand, many of our emotions tend to fade with time and can seem to do so fittingly. Think of attitudes like anger, grief, and regret. On the other hand, it's difficult to see how it could be fitting for these feelings to fade since the facts that make them fitting can seem to persist. This is the puzzle in brief; that (...) of explaining how certain feelings can fittingly fade with time. This paper argues that this puzzle has no general solution: in a wide range of true‐to‐life cases our fitting feelings remain fitting forever, until the day that we die. I conclude by exploring the normative significance of this result and its implications for the ethics of attitudes more generally. (shrink)

We often find ourselves in situations where it is up to us to make decisions on behalf of others. How can we determine whether such decisions are morally justified, especially if those decisions may change who it is these others end up becoming? In this paper, I will evaluate one plausible kind of justification that may tempt us: we may want to justify our decision by appealing to the likelihood that the other person will be glad we made that specific (...) choice down the line. Although it is tempting, I ultimately argue that we should reject this sort of appeal as a plausible justification for the moral permissibility of our vicarious decisions. This is because the decisions that we make on behalf of another may affect the interests and values that that person will hold in the future. As I will show, this complicates the justificatory relationship between present decisions and future attitudes, since the latter can depend on the former. This is not to say that the predicted future attitudes of others can play no significant role in justifying our decisions on others’ behalf. Rather, appealing to the future attitudes in our moral justifications may play an important role in our practical thinking but only when we consider the future attitudes of all relevant possible futures. (shrink)

Faith in God conflicts with reason—or so we’re told. We focus on two arguments for this conclusion. After evaluating three criticisms of them, we identify an assumption they share, namely that faith in God requires belief that God exists. Whether the assumption is true depends on what faith is. We sketch a theory of faith that allows for both faith in God without belief that God exists, and faith in God while in belief-cancelling doubt God’s existence. We then argue that (...) our theory, unlike the theory of Thomas Aquinas, makes sense of four central items of faith-data: (i) pístis in the Synoptics, (ii) ʾemunāh in the Hebrew scriptures, (iii) exemplars of faith in God, including Abraham, Jesus, and Mother Teresa, and (iv) the widespread experience of people of faith today. We close by assessing revisions of the two arguments we began with, revisions that align with our theory of faith, and find them dubious, at best. (shrink)

Many contemporary act consequentialists define facts about what we should do in terms of facts about what we should prefer. They claim that we should perform an action if and only if we should prefer its outcome to the outcome of any available alternative. Some of these theorists claim they can accommodate deontic constraints, such as a constraint against killing the innocent. I argue that they can’t. If there’s a constraint against killing, then when we can prevent five killings only (...) by killing one, we shouldn’t kill—but we should prefer the outcome where we do. (shrink)

Reprinted in Philosophy of Religion: An Anthology, Wadsworth 2015, 6th edition, eds Michael Rea and Louis Pojman. What is propositional faith? At a first approximation, we might answer that it is the psychological attitude picked out by standard uses of the English locution “S has faith that p,” where p takes declarative sentences as instances, as in “He has faith that they’ll win”. Although correct, this answer is not nearly as informative as we might like. Many people say that there (...) is a more informative answer. They say that, at the very least, propositional faith requires propositional belief. More precisely, they say that faith that p requires belief that p or that it must be partly constituted by belief that p. This view is common enough; call it the Common View. I have two main aims in this paper: (i) to exhibit the falsity of the Common View and the paucity of reasons for it, and (ii) to sketch a more accurate and comprehensive account of what propositional faith is. (shrink)

I argue that Davidson's conception of motivating reasons as belief-desire pairs suggests a model of normative reasons for action that is superior to the orthodox conception according to which normative reasons are propositions, facts, or the truth-makers of such facts.

It is a standard feature of modern philosophy, at least from Locke, to tie together the questions of how we perceive the world and what we have reason to think the world is like in itself. This is a natural connection, because the questions of how we perceive it, and what kind of conception of it we can best form on the basis of that mode of perception, are obviously intimately linked. Part I of this volume defends the sense-datum theory (...) of perception against its opponents, and argues that the sense-datum theory is much closer to a form of direct realism than is normally thought: we directly perceive the world in the form that it naturally manifests itself to creatures like us. This leaves open the question of what it is like in itself, and Part II tries to show that a Berkeleian interpretation—that the world is a nomological structure in the mind of God—is the most plausible option. Arguments with roots in Berkeley, in modern philosophers such as John Foster, and in modern science, are drawn on to support this conclusion. (shrink)

Summary Using the neurological syndrome kuru as a frame, Warwick Anderson examines the social dynamics and material culture of its medical investigation among the Fore people conducted by D. Carleton Gajdusek beginning at midcentury. The Collectors of Lost Souls: Turning Kuru Scientists into White Men uses a postcolonial framework to complicate dominant/subordinate binaries and diffusionist accounts of indigenous contacts with medical science. Anderson proposes that colonies are specific sites of production of medical knowledge. He draws a distinction between traditional and (...) advanced economies in regard to individual rights to make an argument in support of context-specific ethical regulation for medical research and suggests a role for historians of science in interrogating the process of globalisation. (shrink)

Some have attempted to explain why it appears that action based on deferential moral belief lacks moral worth by appealing to claims about an attitude that is difficult to acquire through testimony, which theorists have called “moral understanding”. I argue that this state is at least partly non-cognitive. I begin by employing case-driven judgments to undermine the assumption that I argue is responsible for the strangeness of deferential moral belief: the assumption that if an agent knows that some fact gives (...) them a moral reason to act in some way, then they’re in a position to act that way for the moral reason given by that fact. I then argue that cases from non-moral epistemology concerning properly-based belief give us independent reason to reject this assumption and conclude by sketching a Davidson-inspired account of normative reasons that explains why acting for moral reasons requires the right non-cognitive state, which is worth calling a kind of moral understanding. (shrink)

The relationship between mission and spirituality for sincere disciples of Jesus involves dimensions that include the biblical, the theological, the historical, the missiological, the spiritual, and the practical. This article will offer a contribution to the biblical discussion, specifically from the Fourth Gospel and through the lens of the motif of agency. This motif can inform what Jesus meant when he said, “Just as the Father has sent me, so I send you”.1 As a result, conclusions can be drawn in (...) regard to the place of mission in Johannine spirituality and discipleship. (shrink)

The influence of Kant's philosophy has been, and continues to be, so profound and so widespread as to have become imperceptible. Philosophical inquiry within both the ‘analytic’ and the ‘continental’ traditions is unthinkable without the lexical and conceptual resources bequeathed by Kant. Even outside philosophy, in the humanities, social sciences and natural sciences, Kantian concepts and structures of argument are ubiquitous. Anyone practicing literary or social criticism is contributing to the Kantian tradition; anyone reflecting on the epistemological implications of their (...) work will find themselves doing so within parameters established by Kant. Indeed, many contemporary debates, whether in aesthetics, literary or political theory, show a peculiar tendency to mutate into disputes in Kant exegesis. All in all, in the less than 200 years since the death of its author, Kantian philosophy has established itself as an indispensable point of intellectual orientation. (shrink)

The normative notion of fittingness figures saliently in the work of a number of ethical theorists writing in the late nineteenth and mid-twentieth centuries and has in recent years regained prominence, occupying an important place in the theoretical tool kits of a range of contemporary writers. Yet the notion remains strikingly undertheorized. This article offers a (partial) remedy. I proceed by canvassing a number of attempts to analyze the fittingness relation in other terms, arguing that none is fully adequate. In (...) explaining why various analyses of fittingness fail, I draw into relief certain of the relation’s constitutive features and spotlight some of its interesting and important connections to various other properties. Along the way, I highlight the relation’s relevance to a number of ongoing debates in normative and metanormative philosophy. I conclude by indicating some directions for further research. (shrink)

Many authors, including Derek Parfit, T.M. Scanlon, and Mark Schroeder, favor a “reasons-first” ontology of normativity, which treats reasons as normatively fundamental. Others, most famously G.E. Moore, favor a “value-first” ontology, which treats value or goodness as normatively fundamental. I argue that both the reasons-first and value-first ontologies should be rejected because neither can account for all of the normative reasons that, intuitively, there are. I advance an ontology of normativity, originally suggested by Franz Brentano and A.C. Ewing, according to (...) which fittingness is normatively fundamental. The normative relation of fittingness is the relation in which a response stands to an object when the object merits—or is worthy of—that response. I argue that my “fittingness-first” ontology is no less parsimonious than either the reasons- or the value-first ontology, but it can plausibly accommodate the existence of all the normative reasons there are. It therefore provides a superior ontology of normativity. (shrink)

While it is tempting to suppose that an act has moral worth just when and because it is motivated by sufficient moral reasons, philosophers have, largely, come to doubt this analysis. Doubt is rooted in two claims. The first is that some facts can motivate a given act in multiple ways, not all of which are consistent with moral worth. The second is the orthodox view that normative reasons are facts. I defend the tempting analysis by proposing and defending a (...) heterodox account of both normative and motivating reasons that is inspired by Donald Davidson’s primary reasons. We should adopt the heterodox view, I argue, because it addresses an overlooked but fatal defect in the orthodox conception of reasons, of which challenges to the tempting analysis are a special case. (shrink)

John Rawls, among others, has argued that one of aims political philosophy is that it provides reasonable hope in the possibility of justice in the future. But what makes hope reasonable? What sorts of theories of justice are best suited to foster reasonable hope in us? To answer these questions, this paper investigates Rawls’s conception of reasonable hope and the kinds of unreasonableness Rawls sought to guard against with his account of a realistic utopia. Rawls's idea of reasonable hope goes (...) beyond the weaker kind of “reconciliation” put forward by Rousseau’s account of a conjectural history that sketches a picture of how we could have developed into the kind of people and the kind of society where justice is possible. It is one thing to believe, with Rousseau, that our deep natures are not incompatible with the possibility of a just society. It is something further to harbor any hope for this in the future. I argue that this temporal aspect, which is built into what Kant and Rawls mean by reasonable hope, is useful approach to the practice of political philosophy. An approach that takes the need for reasonable hope seriously is one that moves political theorizing from a more passive framework of theoretical imagination toward a more active one that entails political anticipation. (shrink)

We develop a logical modelling approach to describe evolvable computational systems. In this account, evolvable systems are built hierarchically from components where each component may have an associated supervisory process. The supervisor's purpose is to monitor and possibly change its associated component. Evolutionary change may be determined purely internally from observations made by the supervisor or may be in response to external change. Supervisory processes may be present at any level in the component hierarchy allowing us to use evolutionary behaviour (...) as an integral part of system design. We model such systems in a revision-based first-order logical framework in which supervisors are modelled as theories which are at a logical meta-level to the theories of their components. This enables evolutionary change of the component to be induced by revision-based changes of the supervisor at the meta-level. In this way, the intervention required in evolutionary change is modelled purely logically. The hierarchical component-based structure is fairly intricate so we present the basic ideas firstly in a simple setting, the well-known blocks world, before introducing tree-based structures to represent component hierarchies. We also introduce some techniques for establishing the behaviour of evolvable systems specified in this logical framework. The ideas and concepts are driven by example throughout. We conclude with a more substantial example, that of a simple model of an evolvable system of automated bank teller machines. (shrink)