This work has been selected by scholars as being culturally important, and is part of the knowledge base of civilization as we know it. This work was reproduced from the original artifact, and remains as true to the original work as possible. Therefore, you will see the original copyright references, library stamps (as most of these works have been housed in our most important libraries around the world), and other notations in the work. This work is in the public domain (...) in the United States of America, and possibly other nations. Within the United States, you may freely copy and distribute this work, as no entity (individual or corporate) has a copyright on the body of the work.As a reproduction of a historical artifact, this work may contain missing or blurred pages, poor pictures, errant marks, etc. Scholars believe, and we concur, that this work is important enough to be preserved, reproduced, and made generally available to the public. We appreciate your support of the preservation process, and thank you for being an important part of keeping this knowledge alive and relevant. (shrink)

In this article we describe our approach to understanding wrongdoing in medical research and practice, which involves the statistical analysis of coded data from a large set of published cases. We focus on understanding the environmental factors that predict the kind and the severity of wrongdoing in medicine. Through review of empirical and theoretical literature, consultation with experts, the application of criminological theory, and ongoing analysis of our first 60 cases, we hypothesize that 10 contextual features of the medical environment (...) (including financial rewards, oversight failures, and patients belonging to vulnerable groups) may contribute to professional wrongdoing. We define each variable, examine data supporting our hypothesis, and present a brief case synopsis from our study that illustrates the potential influence of the variable. Finally, we discuss limitations of the resulting framework and directions for future research. (shrink)

The importance of _naturalization_—the establishment of species introduced into foreign places—to the early development of Darwin’s theory of evolution deserves historical attention. Introduced and invasive European species presented Darwin with interpretive challenges during his service as naturalist on the HMS _Beagle_. Species naturalization and invasive species strained the geologist Charles Lyell’s creationist view of the organic world, a view which Darwin adopted during the voyage of the _Beagle_ but came to question afterward. I suggest that these phenomena primed Darwin to (...) question the “stability of species.” I then examine the role of introduced and invasive species in Darwin’s early theorizing and negotiation with Lyell’s ideas, recorded in his post-voyage “transmutation notebooks.” Therein, the subject was an inflection point in his contention with Lyell’s views and moreover, his theorizing on invasive species occasioned some of his earliest inklings of natural selection. Finally, I examine how naturalization was crucial to Lyell’s own eventual conversion to evolutionism. I conclude with brief reflections on the implications of this narrative for our understanding of Darwin’s reasoning, his intellectual relationship to Lyell, and the historical context that shaped his theory. (shrink)

This article focuses on mirror self-recognition, the ability to recognize one's own image in a mirror. It presents the result of the first experiment on mirror self-recognition which showed that chimpanzees are able to learn that the chimps they see in the mirror are not other chimps, but themselves, as evidenced by self-directed behaviour. It reviews evidence for neural network for self-recognition and self-other differentiation and cites evidence that frontal cortex and cortical midline structures are implicated in self-recognition tasks. It (...) also suggests that the mirror self-recognition ability correlates to large brain size relative to the animal's body size. (shrink)

Notwithstanding requirements for scientific/social value and risk/benefit proportionality in major research ethics policies, there are no widely accepted standards for these judgments in Phase 1 trials. This paper examines whether the principle of clinical equipoise can be used as a standard for assessing the ratio of risk to direct-benefit presented by drugs administered in one category of Phase 1 study—first-in-human trials involving patients. On the basis of the supporting evidence for, and architecture of, Phase 1 studies, the articles offers two (...) provisional conclusions: (1) the risks of drug administration in such trials cannot generally be justified on therapeutic grounds but by appeal to the social value of the research; and (2) a framework for adjudicating the ratio of risk/social-value must be developed. (shrink)

Does traditional Christianity involve paradoxical doctrines, that is, doctrines that present the appearance (at least) of logical inconsistency? If so, what is the nature of these paradoxes and why do they arise? What is the relationship between "paradox" and "mystery" in theological theorizing? And what are the implications for the rationality, or otherwise, of orthodox Christian beliefs? In Paradox in Christian Theology, James Anderson argues that the doctrines of the Trinity and the incarnation, as derived from Scripture and (...) formulated in the ecumenical creeds, are indeed paradoxical. But this conclusion, he contends, need not imply that Christians who believe these doctrines are irrational in doing so. In support of this claim, Anderson develops and defends a model of understanding paradoxical Christian doctrines according to which the presence of such doctrines is unsurprising and adherence to paradoxical doctrines cannot be considered as a serious intellectual obstacle to belief in Christianity. The case presented in this book has significant implications for the practice of systematic theology, biblical exegesis, and Christian apologetics. (shrink)

In this paper we offer a new argument for the existence of God. We contend that the laws of logic are metaphysically dependent on the existence of God, understood as a necessarily existent, personal, spiritual being; thus anyone who grants that there are laws of logic should also accept that there is a God. We argue that if our most natural intuitions about them are correct, and if they are to play the role in our intellectual activities that we take (...) them to play, then the laws of logic are best construed as necessarily existent thoughts -- more specifically, as divine thoughts about divine thoughts. We conclude by highlighting some implications for both theistic arguments and antitheistic arguments. (shrink)

Applied a theory of information integration to decision making with probabilistic events. 10 undergraduates judged the subjective worth of duplex bets that included independent gain and lose components. The worth of each component was assumed to be the product of a subjective weight that reflected the probability of winning or losing, and the subjective worth of the money to be won or lost. The total worth of the bet was the sum of the worths of the 2 components. Thus, each (...) judgment required multiplying and adding operations. The multiplying model worked quite well in 4 experimental conditions. The adding model showed more serious discrepancies, though these were small in magnitude. The theory of functional measurement was applied to scale the subjective values of the probability and money stimuli. Subjective and objective values were nonlinearly related both for probability and for money. (shrink)

One of the most prominent objections to skeptical theism in recent literature is that the skeptical theist is forced to deny our competency in making judgments about the all-things-considered value of any natural event. Some skeptical theists accept that their view has this implication, but argue that it is not problematic. I think that there is reason to question the implication itself. I begin by explaining the objection to skeptical theism and the standard response to it. I then identify an (...) assumption that is prevalent in much of the literature concerning the problem of evil, and show that it is a factor in motivating commitment to the implication I mean to question. I argue that the assumption is false, and that once it is rejected there is room to endorse the skeptical theist's strategy in responding to some arguments from evil without endorsing the putative implication that objectors find unacceptable. (shrink)

The practice of paying research subjects for participating inclinical trials has yet to receive an adequate moral analysis.Dickert and Grady argue for a wage payment model in whichresearch subjects are paid an hourly wage based on that ofunskilled laborers. If we accept this approach, what follows?Norms for just working conditions emerge from workplacelegislation and political theory. All workers, includingpaid research subjects under Dickert and Grady''s analysis,have a right to at least minimum wage, a standard work week,extra pay for overtime hours, (...) a safe workplace, no faultcompensation for work-related injury, and union organization.If we accept that paid research subjects are wage earners likeany other, then the implications for changes to current practiceare substantial. (shrink)

(2011). The Children's Oncology Group Routinely Applies “Lack of Efficacy” Interim Monitoring to Its Randomized Clinical Trials. The American Journal of Bioethics: Vol. 11, No. 3, pp. 18-19.

The principle of clinical equipoise requires that, aside from certain exceptional cases, second generation treatments ought to be tested against standard therapy. In violation of this principle, placebo-controlled trials (PCTs) continue to be used extensively in the development and licensure of second-generation treatments. This practice is typically justified by appeal to methodological arguments that purport to demonstrate that active-controlled trials (ACTs) are methodologically flawed. Foremost among these arguments is the so called assay sensitivity argument. In this paper, I take a (...) closer look at this argument. Following Duhem, I argue that all trials, placebo-controlled or not, rely on external information for their meaningful interpretation. Pending non-circular empirical evidence that we can trust the findings of PCTs to a greater degree than the findings of ACTs, I conclude that the assay sensitivity argument fails to demonstrate that placebo-controlled trials are preferable, methodologically or otherwise, to active-controlled trials. Contrary to the intentions of its authors, the fundamental lesson taught by the assay sensitivity argument is Duhemian: the validity of all clinical trials depends on external information. (shrink)

In Paradox in Christian Theology I argued that the Christian doctrines of the Trinity and the Incarnation are paradoxical—that is, they appear to involve implicit contradictions—yet Christians can still be rational in affirming and believing those doctrines. Dale Tuggy has characterized my theory of theological paradox as a form of “positive mysterianism” and argues that the theory “faces steep epistemic problems, and is at best a temporarily reasonable but ultimately unsustainable stance.” After summarizing my proposed model for the rational affirmation (...) of theological paradox and considering whether my proposal is indeed a form of “positive mysterianism” as Tuggy defines the term, I address the two main criticisms raised in Tuggy’s paper: first, that the doctrine of divine incomprehensibility cannot bear the weight required by my defense of paradox; and second, that my proposed model is afflicted with epistemic instability. I conclude that Tuggy has failed to show that a mysterian stance with respect to paradoxical Christian doctrines is in principle unreasonable, unnatural, or unsustainable. (shrink)

Institutional Review Board decisions hinge on the availability and interpretation of information. This is demonstrated by the following well-known historical example. In 2001, 24-year-old Ellen Roche died from respiratory distress and organ failure as a result of her participation in a study at Johns Hopkins Asthma and Allergy Center. The non-therapeutic physiological study, “Mechanisms of Deep Inspiration-Induced Airway Relaxation,” was designed to examine airway hyperresponsiveness in healthy individuals in order to better understand the pathophysiology of asthma. Participants inhaled hexamethonium, a (...) chemical ganglionic blocker that was not FDA-approved for use as specified in the experimental protocol. Risks of inhaling hexamethonium, including lung damage, had been reported in the 1950s and ‘60s. An investigation conducted after Roche's death determined that the study's principal investigator had failed to adequately search the medical literature; the protocol submitted for IRB review cited articles indexed in online literature databases that went back only as far as the 1970s. (shrink)

A relatively new and exciting area of collaboration has begun between philosophy of mind and ethics. This paper attempts to explore aspects of this collaboration and how they bear upon traditional ethics. It is the author's contention that much of Western moral philosophy has been guided by largely unrecognized assumptions regarding reason, knowledge and conceptualization, and that when examined against empirical research in cognitive science, these assumptions turn out to be false -- or at the very least, unrealistic for creatures (...) with our cognitive structures. The fundamental tension between the Western idea of morality (as basically rule-following) and the way in which people actually confront and experience moral dilemmas is a result of our failure to take the insights of cognitive psychology seriously. This failure has had a dramatic impact on not only how we teach ethics, but how we attempt to live out lives. (shrink)

Leo Strauss was a political philosopher who died in 1973 but came to prominent attention around the beginning of the war in Iraq. Charges began emerging that architects of the war had studied with, or been influenced by, Strauss' works. This volume explores these works.

The thymus is a unique primary lymphoid organ that supports the production of self‐tolerant T‐cells essential for adaptive immunity. Intrathymic microenvironments are microanatomically compartmentalised, forming defined cortical, and medullary regions each differentially supporting critical aspects of thymus‐dependent T‐cell maturation. Importantly, the specific functional properties of thymic cortical and medullary compartments are defined by highly specialised thymic epithelial cells (TEC). For example, in the medulla heterogenous medullary TEC (mTEC) contribute to the enforcement of central tolerance by supporting deletion of autoreactive T‐cell (...) clones, thereby counterbalancing the potential for random T‐cell receptor generation to contribute to autoimmune disease. Recent advances have further shed light on the pathways and mechanisms that control heterogeneous mTEC development and how differential mTEC functionality contributes to control self‐tolerant T‐cell development. Here we discuss recent findings in relation to mTEC development and highlight examples of how mTEC diversity contribute to thymus medulla function. (shrink)

This essay charts a conceptual history of “planetary health,” which holds that population health and the continuity of human civilization depend on the integrity—the health—of the Earth’s life-support systems. It seeks to identify settler colonial and imperial genealogies of this distinctly ecological approach to human population health and flourishing, an assemblage of systems theory and planetary thinking as well as developments in environmental sciences and theories of sustainable development. Planetary health may be seen as a “third wave” of disease ecology, (...) an emergent resource for more complex, naturalistic, and scaled-up modeling in epidemiology—the latest installment in the search for multifactorial, relational, and integrated explanations of patterns of disease. The approach required a new planetary imaginary—emerging from a series of Earth-encompassing crises, such as global heating—which enlarged and systematized ecological configurations of human health and illness. In tracing and critically situating this conceptual history, the authors offer a partial perspective on what may yet become planetary health, drawing attention to some other conceptual routes that may be taken. (shrink)

The paper discusses various concepts of 'species equality' and 'species superiority' and the assumptions concerning intrinsic value on which they depend. I investigate what philosophers from the traditional deontological (Taylor and Lombardi) and utilitarian (Singer and Attfield) perspectives have meant by their claims for species equality. I attempt to provide a framework of intrinsic values that justifies one sense in which members of a species can be said to be superior to members of another species.

John Fleming , later professor in Aberdeen and Edinburgh, made his combative contribution to natural history between 1812 and 1832. As an Edinburgh student he had followed Robert Jameson's ‘Wernerian’ lead. His earliest publications, from 1813, expressed what was to be a lifelong hostility to the work of James Hutton. Yet his own thinking moved increasingly towards a ‘uniformitarian’ as opposed to a ‘catastrophist’ view of earth history. His Philosophy of Zoology embodied criticism of Cuvier. More dramatically, he became (...) embroiled in controversy with Buckland and later with Conybeare. By then the ‘uniformitarian’ hypothesis had been adopted by Lyell, with whom Fleming was in close touch from the mid-1820s. Fleming may have had some grounds for feeling that his priority in advocating uniformitarianism was later overlooked. His History of British Animals included a preface in which he elaborated his earlier hypothesis as to ‘revolutions … in the animal kingdom’ correlated with six geological epochs. Tension had then developed in Fleming's relationship with Jameson, and the early 1830s found him in a mood of increasing frustration. Reconciliation with Buckland and approval by Sedgwick still left ‘the Zoological Ishmael’ feeling that his advancement in the scientific world was blocked, perhaps permanently. In historical perspective Fleming may be seen as a minor but not insubstantial figure in the scientific landscape of the early nineteenth century. (shrink)

The application of artificial intelligence and machine learning technologies in healthcare have immense potential to improve the care of patients. While there are some emerging practices surro...

Since its introduction in 1987, Benjamin Freedman’s principle of clinical equipoise has enjoyed widespread uptake in bioethics discourse. Recent years, however, have witnessed a growing consensus that the principle is fundamentally flawed. One of the most vocal critics has undoubtedly been Franklin Miller. In a 2008 paper, Steven Joffe and Miller build on this critical work, offering a new conception of clinical research ethics based on science, taking what they call a “scientific orientation” toward the ethics of clinical research. Though (...) there is much to recommend Joffe and Miller’s scientifically oriented conception of clinical research ethics, I believe that both the critical and constructive projects suffer from the same basic mistake: inattention to context. The internal norms of science cannot be fully specified, let alone satisfied, independently of contextual (external) factors that only come into view when we are attentive to the particular context of that form of inquiry. (shrink)

Despite their crucial role in the translation of pre-clinical research into new clinical applications, phase 1 trials involving patients continue to prompt ethical debate. At the heart of the controversy is the question of whether risks of administering experimental drugs are therapeutically justified. We suggest that prior attempts to address this question have been muddled, in part because it cannot be answered adequately without first attending to the way labor is divided in managing risk in clinical trials. In what follows, (...) we approach the question of therapeutic justification for phase 1 trials from the viewpoint of five different stakeholders: the drug regulatory authority, the IRB, the clinical investigator, the referring physician, and the patient. Our analysis shows that the question of therapeutic justification actually raises multiple questions corresponding to the roles and responsibilities of the different stakeholders involved. By attending to these contextual differences, we provide more coherent guidance for the ethical negotiation of risk in phase 1 trials involving patients. We close by discussing the implications of our argument for various perennial controversies in phase 1 trial practice. (shrink)

Much philosophical effort has been exerted over problems having to do with the correct analysis and application of the concept of epistemic justification. While I do not wish to dispute the central place of this problem in contemporary epistemology, it seems to me that there is a general neglect of the belief condition for knowledge. In this paper I offer an analysis of 'degrees of belief' in terms of a quality I label 'conviction', go on to argue that one requires (...) more conviction in a proposition in order to know it than to merely believe it, and conclude by suggesting that some current epistemological issues admit of new insight when we begin taking conviction seriously. (shrink)