Patients have received experimental pharmaceuticals outside of clinical trials for decades. There are no industry-wide best practices, and many companies that have granted compassionate use, or ‘preapproval’, access to their investigational products have done so without fanfare and without divulging the process or grounds on which decisions were made. The number of compassionate use requests has increased over time. Driving the demand are new treatments for serious unmet medical needs; patient advocacy groups pressing for access to emerging treatments; internet platforms (...) enabling broad awareness of compelling cases or novel drugs and a lack of trust among some that the pharmaceutical industry and/or the FDA have patients’ best interests in mind. High-profile cases in the media have highlighted the gap between patient expectations for compassionate use and company utilisation of fair processes to adjudicate requests. With many pharmaceutical manufacturers, patient groups, healthcare providers and policy analysts unhappy with the inequities of the status quo, fairer and more ethical management of compassionate use requests was needed. This paper reports on a novel collaboration between a pharmaceutical company and an academic medical ethics department that led to the formation of the Compassionate Use Advisory Committee. Comprising medical experts, bioethicists and patient representatives, CompAC established an ethical framework for the allocation of a scarce investigational oncology agent to single patients requesting non-trial access. This is the first account of how the committee was formed and how it built an ethical framework and put it into practice. (shrink)

Traditional pharmacy education emphasizes the biological processes of diseases and their pharmacological treatments. While the intense focus on biomedical aspects of disease is vital to educating pharmacy students, this focus is often insufficient in conveying what patients experience. The humanities, however, offer powerful characterizations of the disease experience for individuals as well as its impact on the human condition more generally. In this essay, I describe how using literary texts with pharmacy students provides them with a fuller appreciation of what (...) patients face with their diseases. The goal of this endeavor is to make students more effective as pharmacists in detecting and responding to their patients’ problems and needs by connecting their biomedical knowledge to depictions and meanings of illness experiences. (shrink)

Health care costs have been rising steadily in most industrialized countries. These increases are driven primarily by technological advances and, to a lesser degree, by aging of the population. Many factors make it unlikely that market forces alone will limit increases in the costs of health care. These unremitting increases make health care rationing appear both necessary and inevitable.One of the least controversial mechanisms for rationing could be to allow patients to make their own choices as to which kinds of (...) care they would be willing to forgo. This is appealing because it preserves individual freedom of choice regarding health care in a way that other rationing mechanisms often do not. Rationing by patient choice, however, can only happen if patients recognize that resources are limited and need to be conserved, and are willing to forgo marginal benefits. (shrink)

The present study was designed to explore the relationship between self-reported dissociative experiences and performance in tasks eliciting right-hemisphere processing load. Thirty-four participants performed a vigilance task in two conditions: with task-irrelevant negative-arousing pictures and task-irrelevant neutral pictures. Dissociation was assessed with the Dissociative Experience Scale. Consistent with theories positing right-hemisphere deregulation in high non-clinical dissociators, dissociative experiences correlated with greater vigilance decrement only in the negative picture condition. As both the vigilance task and negative picture processing are right lateralized, (...) this result provides support for a right-hemisphere dysfunction in high dissociators, at least in negative conditions. (shrink)

Cognitive Science, Volume 46, Issue 5, May 2022.

This paper argues that human psychological resilience is a central virtue in sport and in human life generally. Despite its importance, it is an overlooked virtue in philosophy of sport and classical and contemporary virtue theory. The phenomenon of human resilience has received a great deal of attention recently in other quarters, however. There is a large and instructive empirical psychological literature on resilience, but connections to virtue theory are rarely drawn and there is no agreement about what the concept (...) refers to. This paper attempts to clarify the concept of resilience and explain how it fits into and supports a traditional Aristotelian conception of virtue. It shows how resilience figures centrally in sport and can extend and enrich our understanding of virtue and success in sport and of sport's internal values. The investigations into the nature of resilience in sport can also help us to understand better sport's contributions to human culture and well-being. (shrink)

In this paper we examine how the use of robots in caring for elders can impact the meaningfulness of elders’ lives. We present a framework for understanding ‘meaningfulness in life’, and then apply that framework in discussing ways in which the use of robots to assist in activities of daily living can preserve, enhance or undermine the meaningfulness of elders’ lives. We conclude with a discussion of if and how having false beliefs about companion robots can affect meaningfulness in the (...) life of the person having those false beliefs. (shrink)

This essay argues that defences of strategic fouling in sport are enriched and supported by better recognizing the role of play in sport. A common characteristic of play is its disengagement from the everyday, in particular its moral disengagement. If sport in its best manifestations is a species of play, then we should expect to find some moral disengagement there. And indeed we do in a variety of ways. Strategic fouling affords a useful example to illustrate and support this claim (...) and to examine the limits of that sort of disengagement. It is argued that while strategic fouling is morally problematic, it can be a sort of playful ‘competitive shenanigan’ that should be tolerated at times for the way it adds to the challenge and drama of sport. This allows us to better recognize the complexity and depth of sport and the way it reflects fundamental human values. Like everyday life, sport challenges us to weigh morality, perfection, and play against each other in ways that give each sphere of value its due and that contribute to rewarding and meaningful activities and lives. (shrink)

This paper reviews the development of socially responsible investment (SRI) over recent years and highlights the prospects for an increasingly strong connection with the practice of corporate social responsibility. The paper argues that not only has SRI grown significantly, it has also matured. In particular, it has become an investment philosophy adopted by a growing proportion of large investment institutions. This shift in SRI from margin to mainstream and the position in which institutional investors find themselves is leading to a (...) new form of SRI shareholder pressure. Although this bears some resemblance to lobbying campaigns which might take advantage of shareholder rights, we seek to distinguish it as an important phenomenon in its own right — one to which corporate executives are likely to be paying increasing attention in the years to come. We further argue that this approach potentially meets some of the earlier ethical criticisms of certain forms of SRI but, ironically, probably owes its existence to those pioneering approaches. We conclude with some suggestions for further research to inform discussion of the issues highlighted in the paper. (shrink)

This paper argues that striving is a cardinal virtue in sport and life. It is an overlooked virtue that is an important component of human happiness and a source of a sense of dignity. The human ps...

ABSTRACT This paper argues that striving is a cardinal virtue in sport and life. It is an overlooked virtue that is an important component of human happiness and a source of a sense of dignity. The human psychological capacity for striving emerged as a trait for addressing the entropic features of our existence, but it can be engaged and used for other purposes. Sport is one such example. Sport appears exceptional in being designed specifically to test and display our capacities (...) to strive. Although striving is connected to pursuit of excellence in sport, it supports a more democratic conception of the value of sport than achievement-oriented perfectionist accounts. (shrink)

This collection of research papers explores the implications of quantum cosmology and the status of the laws of nature for theological and philosophical issues regarding God's action in the world. The main goal is to contribute to constructive theology as it engages current research in the natural sciences, and to investigate the philosophical and theological elements in ongoing theoretical research in the natural sciences.

This paper is a response to Nicholas Dixon's defence of the moderate partisan as the ideal fan of team sports. For Dixon, the moderate partisan is someone who combines a partisan fan's loyalty for a particular team with a purist fan's desire to see fair and skilful play by all participants. My aim is to argue that there is no ideal fan of team sports. In particular, there is nothing specially commendable about the moderate partisan's loyalty that justifies the claim (...) to be the ideal fan. There are many other ways of being a fan than being a purist or a partisan as described by Dixon. None of them is morally superior to the other, assuming that they meet basic requirements of respect for others and for fair play. I argue that the commitment of partisan fans to particular teams is better explained by other values than the moral virtue of loyalty. A better explanation and justification of partisanship, and indeed of fan interest in sport generally, is found in the human attachment to narrative as a way of creating meaning in our lives. (shrink)

Economic models are founded in the idea of taking individuals' preferences as both known and given. This article explores the evolution of personal preferences, within a context of both entrepreneurial discovery and Objectivist philosophy. It begins by formalizing Ayn Rand's theory of Objectivism applied to human values, and continues by modeling preference changes similar to Schumpeter's theory of creative destruction—a process of self-discovery. Next the role of societal factors is examined in forming shared preference sets. Finally, the article describes how (...) the strength of human preferences is used to narrow choice sets in the presence of greater consumption options. (shrink)

Two types of conception of a Way of Life are important for a consideration of the question of the forming and testing of ideals of conduct, and consequently for a consideration of our questions regarding the relation of ideals to practice. The one type is more, the other type less general. The one has reference to man as man, the other to particular classes of man, with relation to their specific function in society. The former issues in the idea of (...) a universal ethic, the latter in the idea of a professional code. Thus the former has a wider generality, the latter has a greater concreteness. Ethical progress seems to me to require that both types should be kept in view, and used to guide man's efforts. (shrink)

A well-known term in eighteenth-century literature and philosophy, the “beautiful soul” (die schöne Seele) has resurfaced in recent years. Deleuze refers to the beautiful soul’s “religiosity” and argues that aggressive “selection” is necessary as its antidote. However, in volatile contexts of social destabilization, such selection risks recoiling into reactionary violence. After first developing in more detail the beautiful soul’s background as a discursive figure, I argue that understanding Deleuze’s selection within a context of spiritual experience is necessary to mitigate this (...) worry. Exploration of this experience is pursued through juxtaposition of Deleuze’s thought with Nishida Kitarō’s investigation of the ontological structure of religious consciousness. The comparative resonances I develop suggest an ontological objectivity to the problems and structuring of the logos of religious consciousness and show how a more explicitly spiritual rendering of “selection,” developed through the Deleuze/Nishida encounter, intervenes into the broader beautiful soul problematic. (shrink)