Randomized controlled trial trial designs exist on an explanatory-pragmatic spectrum, depending on the degree to which a study aims to address a question of efficacy or effectiveness. As conceptualized by Schwartz and Lellouch in 1967, an explanatory approach to trial design emphasizes hypothesis testing about the mechanisms of action of treatments under ideal conditions, whereas a pragmatic approach emphasizes testing effectiveness of two or more available treatments in real-world conditions. Interest in, and the number of, pragmatic trials has grown substantially (...) in recent years, with increased recognition by funders and stakeholders worldwide of the need for credible evidence to inform clinical decision-making. This increase has been accompanied by the onset of learning healthcare systems, as well as an increasing focus on patient-oriented research. However, pragmatic trials have ethical challenges that have not yet been identified or adequately characterized. The present study aims to explore the views of key stakeholders with respect to ethical issues raised by the design and conduct of pragmatic trials. It is embedded within a large, four-year project that seeks to develop guidance for the ethical design and conduct of pragmatic trials. As a first step, this study will address important gaps in the current empirical literature with respect to identifying a comprehensive range of ethical issues arising from the design and conduct of pragmatic trials. By opening up a broad range of topics for consideration within our parallel ethical analysis, we will extend the current debate, which has largely emphasized issues of consent, to the range of ethical considerations that may flow from specific design choices. Semi-structured interviews with key stakeholders, across multiple jurisdictions, identified based on their known experience and/or expertise with pragmatic trials. We expect that the study outputs will be of interest to a wide range of knowledge users including trialists, ethicists, research ethics committees, journal editors, regulators, healthcare policymakers, research funders and patient groups. All publications will adhere to the Tri-Agency Open Access Policy on Publications. (shrink)

Abstract:This paper is a preliminary attempt to better understand the concept of legitimacy in stakeholder theory. The normative component of stakeholder theory plays a central role in the concept of legitimacy. Though the elaboration of legitimacy contained herein applies generally to all “normative cores” this paper relies on Phillips’s principle of stakeholder fairness and therefore begins with a brief description of this work. This is followed by a discussion of the importance of legitimacy to stakeholder theory as well as (...) the general ambiguity of the term. A distinction is then drawn between normative and derivative legitimacy. Reference to this distinction helps distinguish between a relationship with the organization based on direct moral obligation and one based on the power to help or harm the organization. It is concluded that stakeholders who retain the ability to affect the organization arelegitimate(derivatively), but that this legitimacy is derived from the moral obligation owed other (normative) stakeholders and that the two sorts of legitimacy are importantly different from one another. An example of the normative/derivative distinction at work in managerial decision making is elaborated upon and managerial and research implications are then suggested. (shrink)

Research on the capacity to understand others' minds has tended to focus on representations ofbeliefs,which are widely taken to be among the most central and basic theory of mind representations. Representations ofknowledge, by contrast, have received comparatively little attention and have often been understood as depending on prior representations of belief. After all, how could one represent someone as knowing something if one does not even represent them as believing it? Drawing on a wide range of methods across cognitive science, (...) we ask whether belief or knowledge is the more basic kind of representation. The evidence indicates that nonhuman primates attribute knowledge but not belief, that knowledge representations arise earlier in human development than belief representations, that the capacity to represent knowledge may remain intact in patient populations even when belief representation is disrupted, that knowledge (but not belief) attributions are likely automatic, and that explicit knowledge attributions are made more quickly than equivalent belief attributions. Critically, the theory of mind representations uncovered by these various methods exhibits a set of signature features clearly indicative of knowledge: they are not modality-specific, they are factive, they are not just true belief, and they allow for representations of egocentric ignorance. We argue that these signature features elucidate the primary function of knowledge representation: facilitating learning from others about the external world. This suggests a new way of understanding theory of mind – one that is focused on understanding others' minds in relation to the actual world, rather than independent from it. (shrink)

There is little empirical evidence showing a direct link between a capacity for statistical learning (SL) and proficiency with natural language. Moreover, discussion of the role of SL in language acquisition has seldom focused on literacy development. Our study addressed these issues by investigating the relationship between SL and reading ability in typically developing children and healthy adults. We tested SL using visually presented stimuli within a triplet learning paradigm and examined reading ability by administering the Wide Range Achievement Test (...) (WRAT-4; Wilkinson & Robertson, 2006). A total of 38 typically developing children (mean age of 9;5 years, range 6;4–12;5) and 37 healthy adults (mean age of 21 years, range 18–34) were assessed. In children, SL was significantly related to reading ability. Importantly, this relationship was independent of grade and also age. The adult data, too, revealed that SL was significantly related to reading ability. A regression analysis of the combined child and adult data revealed that SL accounted for a unique amount of variance in reading ability, after age and attention had been taken into consideration. For the first time, this study provides empirical evidence that a capacity for more effective SL is related to higher reading ability in the general population. (shrink)

The scope of the issues -- The moral relationship between leaders and followers -- The morality of leaders : motives and deeds -- Puzzles and perils of transformational leadership.

Leading philosopher of religion D. Z. Phillips argues that intellectuals need not see their task as being for or against religion, but as one of understanding it. What stands in the way of this task are certain methodological assumptions about what enquiry into religion must be. Beginning with Bernard Williams on Greek gods, Phillips goes on to examine these assumptions in the work of Hume, Feuerbach, Marx, Frazer, Tylor, Marett, Freud, Durkheim, Le;vy-Bruhl, Berger and Winch. The result exposes (...) confusion, but also gives logical space to religious belief without advocating personal acceptance of that belief, and shows how the academic study of religion may return to the contemplative task of doing conceptual justice to the world. Religion and the Hermeneutics of Contemplation extends in important ways D. Z. Phillips' seminal 1976 book Religion Without Explanation. It will be of interest to scholars and students of philosophy, anthropology, sociology and theology. (shrink)

You want to see the concert, but don’t want to take a long drive (even though the concert is far away). Such *strongly conflicting desire ascriptions* are, I show, wrongly predicted incompatible by standard semantics. I then object to possible solutions, and give my own, based on *some-things-considered desire*. Considering the fun of the concert, but ignoring the drive, you want to see the concert; considering the boredom of the drive, but ignoring the concert, you don’t want to take the (...) drive. (shrink)

Algorithms wield increasing control over our lives—over which jobs we get, whether we're granted loans, what information we're exposed to online, and so on. Algorithms can, and often do, wield their power in a biased way, and much work has been devoted to algorithmic bias. In contrast, algorithmic neutrality has gone largely neglected. I investigate three questions about algorithmic neutrality: What is it? Is it possible? And when we have it in mind, what can we learn about algorithmic bias?

I examine the origins of ordinary racial thinking. In doing so, I argue against the thesis that it is the byproduct of a unique module. Instead, I defend a pluralistic thesis according to which different forms of racial thinking are driven by distinct mechanisms, each with their own etiology. I begin with the belief that visible features are diagnostic of race. I argue that the mechanisms responsible for face recognition have an important, albeit delimited, role to play in sustaining this (...) belief. I then argue that essentialist beliefs about race are driven by some of the mechanisms responsible for “entitativity perception”: the tendency to perceive some aggregates of people as more genuine groups than others. Finally, I argue that coalitional thinking about race is driven by a distinctive form of entitativity perception. However, I suggest that more data is needed to determine the prevalence of this form of racial thinking. (shrink)

Our lives are dominated by technology. We live with and through the achievements of technology. What is true of the rest of life is of course true of medicine. Many of us owe our existence and our continued vigour to some achievement of medical technology. And what is true in a major way of general medicine is to a significant degree true of psychiatry. Prozac has long since arrived, and in its wake an ever-growing armamentarium of new psychotropics; beyond that, (...) neuroscience promises ever more technological advances for the field. -/- However, the effect of technology on the field of psychiatry remains highly ambiguous. On the one hand there are the achievements, both in the science and practice of psychiatry; on the other hand technology's influence on the field threatens its identity as a humanistic practice. In this ambiguity psychiatry is not unique - major thinkers have for a long time been highly ambivalent and concerned about the technological order that now defines modern society. For the future, the danger is that the psychiatrically real becomes that which can be seen, the symptom, and especially that which can be measured. Disorders and treatments might become reduced to what can be defined by diagnostic criteria and what can be mapped out on a scale. -/- This book exams how technology has come to influence and drive psychiatry forward, and considers at just what cost these developments have been made. It includes a range of stimulating and thought-provoking chapters from a range of psychiatrists and philosophers. (shrink)

In a presidential speech to philosophers, J. R. Jones addressed the question, 'How do I know who I am?' But how do we know who he was? Different audiences will give different answers. Those who know only his philosophical writings in English will give one kind answer, while those who knew him as an inspirational speaker and leader in the fight to preserve and sustain the Welsh language and its culture, and as a troubler of theological waters, will give a (...) very different answer. As someone who knew him in both contexts, Dewi Z. Phillips argues that there are deep connections between J. R. Jones's major preoccupations with the identity of the self the identity of a nation, and the identity of God. This book will introduce new readers to J. R. Jones's work, and will also introduce his different audiences to each other. (shrink)

Aristotle claims that in some extenuating circumstances, the correct response to the wrongdoer is sungnōmē rather than blame. Sungnōmē has a wide spectrum of meanings that include aspects of sympathy, pity, fellow-feeling, pardon, and excuse, but the dominant interpretation among scholars takes Aristotle’s meaning to correspond most closely to forgiveness. Thus, it is commonly held that the virtuous Aristotelian agent ought to forgive wrongdoers in specific extenuating circumstances. Against the more popular forgiveness interpretation, I begin by defending a positive account (...) of sungnōmē as the correct judgment that a wrongdoer deserves excuse since she was not blameworthy. I then argue that since sungnōmē is merited on the grounds of fairness, this shows that both the forgiveness interpretation and a third, alternative interpretation of sungnōmē as sympathy mischaracterize both the justification for sungnōmē and its nature. Moreover, I argue that Aristotle not only lacks an account of forgiveness but in fact, that his account of blame is incompatible with forgiveness altogether. (shrink)

Eavesdropping judgments (judgments about truth, retraction, and consistency across contexts) about epistemic modals have been used in recent years to argue for a radical thesis: that truth is assessment-relative. We argue that judgments for 'I think that p' pattern in strikingly similar ways to judgments for 'Might p' and 'Probably p'. We argue for this by replicating three major experiments involving the latter and adding a condition with the form 'I think that p', showing that subjects respond in the same (...) way to 'thinks' as to modals. This poses a serious challenge to relativist treatments of the modal judgments, since a relativist treatment of the corresponding 'thinks' judgments is totally implausible, so if a unified account of the phenomena is to be found, it cannot be a relativist one. We briefly sketch how a unified account might look. (shrink)

This chapter pursues an understanding of what Cicero thought 'Italic' philosophy to be, and proceeds to develop a broader account of how Cicero's version compares with the surviving textual evidence and testimonia from the Hellenistic period of the philosophy of the 'Italic' philosophers, including the Lucanians 'Ocellus', 'Eccelus', and 'Aresas/Aesara', and the Rudian Ennius. Special focus is placed on their theories of cosmology, psychology, and law. Collocation of 'Italic' with 'Pythagorean' philosophy of this era aids in building a more comprehensive (...) view of what Hellenistic Pythagoreanism may have looked like. Uploaded here is the pre-publication version; please email me for the printed version. (shrink)

For serious yoga practitioners curious to know the ancient origins of the art, Stephen Phillips, a professional philosopher and sanskritist with a long-standing personal practice, lays out the philosophies of action, knowledge, and devotion as well as the processes of meditation, reasoning, and self-analysis that formed the basis of yoga in ancient and classical India and continue to shape it today. In discussing yoga's fundamental commitments, Phillips explores traditional teachings of hatha yoga, karma yoga, _bhakti_ yoga, and tantra, (...) and shows how such core concepts as self-monitoring consciousness, karma, nonharmfulness, reincarnation, and the powers of consciousness relate to modern practice. He outlines values implicit in _bhakti_ yoga and the tantric yoga of beauty and art and explains the occult psychologies of _koshas_, _skandhas_, and _chakras_. His book incorporates original translations from the early Upanishads, the _Bhagavad Gita_, the _Yoga Sutra_, the _Hatha Yoga Pradipika_, and seminal tantric writings of the tenth-century Kashmiri Shaivite, Abhinava Gupta. A glossary defining more than three hundred technical terms and an extensive bibliography offer further help to nonscholars. A remarkable exploration of yoga's conceptual legacy, _Yoga, Karma, and Rebirth_ crystallizes ideas about self and reality that unite the many incarnations of yoga. (shrink)

Phillip Cary argues that Augustine invented or created the concept of self as an inner space--as space into which one can enter and in which one can find God. This concept of inwardness, says Cary, has worked its way deeply into the intellectual heritage of the West and many Western individuals have experienced themselves as inner selves. After surveying the idea of inwardness in Augustine's predecessors, Cary offers a re-examination of Augustine's own writings, making the controversial point that in his (...) early writings Augustine appears to hold that the human soul is quite literally divine. Cary goes on to contend that the crucial Book 7 of the Confessions is not a historical report of Augustine's "conversion" experience, but rather an explanation of his intellectual development over time. (shrink)

Five reasons are given for why Wittgensteinianism, though a major movement in philosophy of religion, has never been a dominant one. The remainder of the chapter is divided as follows: - I: The influence of Descartes’ Legacy. - II: Philosophy of Religion’s epistemological inheritance as seen in Reformed epistemology and the influence of Thomas Reid, and in neo-Kantianism. - III: The return from metaphysical reality in Wittgenstein. - IV: Difficulties in the metaphysical notion of God: as being itself or pure (...) consciousness. - V: The importance of ordinary certitudes in Wittgenstein’s On Certainty. - VI: The sense of God’s “otherness” from the world. - VII: Religion and contemplative philosophy. (shrink)

It follows from Humean principles of plenitude, I argue, that island universes are possible: physical reality might have 'absolutely isolated' parts. This makes trouble for Lewis's modal realism; but the realist has a way out. First, accept absolute actuality, which is defensible, I argue, on independent grounds. Second, revise the standard analysis of modality: modal operators are 'plural', not 'individual', quantifiers over possible worlds. This solves the problem of island universes and confers three additional benefits: an 'unqualified' principle of compossibility (...) can be accepted; the possibility of nothing can be accommodated; and the identity of indiscernible worlds can be decisively refuted. (shrink)

This volume contains eighteen papers, three with new postscripts, that were written over the past 35 years. Five of the papers have not been previously published. Together they provide a comprehensive account of modal reality—the realm of possible worlds—from a Humean perspective, with excursions into neighboring topics in metaphysics. Part 1 sketches an account of reality as a whole, both the mathematical and the modal, defending a form of plenitudinous realism: every consistent proposition is true of some portion of reality. (...) Part 2 presents and defends a realist theory of concrete possible worlds with an absolute ontological distinction between the actual and the merely possible. Part 3 presents and defends a Humean account of modal plenitude, formulating and endorsing principles of recombination, of plenitude of possible structures, and of plenitude of alien contents. Part 4 applies the Humean account to truthmaking, mereology, spacetime, and quantities. I argue that holding fast to Humean strictures leads to views that differ in radical ways from those put forth by contemporary metaphysicians. (shrink)

Understanding the nature of science has long been a desired outcome of science education, despite ongoing disagreements about the content, structure, and focus of NOS expectations. Addressing the concern that teachers likely focus only on student learning expectations appearing in standards documents, this study examines the current state of NOS in science education standards documents from nine diverse countries to determine the overt NOS learning expectations that appeared, NOS statements provided near those learning expectations, but not identified as learning outcomes, (...) and NOS statements found in ancillary text. Findings indicate that NOS ideas rarely occur as expectations for student learning and are far more commonly found in ancillary material. Moreover, consensus was not apparent in the overt learning outcomes for students. Given the well-documented poor state of NOS instruction and the consistent lack of NOS appearing in published curriculum materials, the NOS standards appearing in nearly all documents analyzed are unlikely to provide sufficient conceptual or pedagogical support for NOS to be accurately interpreted or translated into meaningful experiences for students. (shrink)

Much recent discussion of love concerns ‘the reasons for love’: whether we love for reasons and, if so, what sorts of things those reasons are. This chapter seeks to call into question some of the assumptions that have shaped this debate, in particular the assumption that love might be ‘responsive’ to reasons in something like the way that actions, beliefs, intentions and ordinary emotions are. I begin by drawing out some tensions in the existing literature on reasons for love, suggesting (...) that these arise in part because different interests expressed in the language of ‘reasons’ – the interests of explanation, justification and interpersonal understanding – pull us towards different kinds of account of reasons for love. This seems to count in favor of treating these interests separately, with different conceptions of the reasons that answer to them. This suggestion, as I explain, runs up against a certain conception of ‘responsiveness to reasons’, which I argue is implicitly assumed in many discussions of reasons for love. However, I argue that we should be skeptical about the application of this conception to love in light of the ontological differences between love and paradigm ‘reasons-responsive’ phenomena, potentially making room for the suggested methodological separation. (shrink)

In this chapter, I survey what I call Lewisian approaches to modality: approaches that analyze modality in terms of concrete possible worlds and their parts. I take the following four theses to be characteristic of Lewisian approaches to modality. (1) There is no primitive modality. (2) There exists a plurality of concrete possible worlds. (3) Actuality is an indexical concept. (4) Modality de re is to be analyzed in terms of counterparts, not transworld identity. After an introductory section in which (...) I motivate analyzing modality in terms of possible worlds, I devote one section to each of these four theses. For each thesis, I take Lewis’s interpretation and defense as my starting point. I then consider and endorse alternative ways of accepting the thesis, some of which disagree substantially with Lewis’s interpretation or defense. There is more than one way to be a Lewisian about modality. (shrink)

Business ethics is a topic receiving much attention in the literature. However, the term 'business ethics' is not adequately defined. Typical definitions refer to the rightness or wrongness of behavior, but not everyone agrees on what is morally right or wrong, good or bad, ethical or unethical. To complicate the problem, nearly all available definitions exist at highly abstract levels. This article focuses on contemporary definitions of business ethics by business writers and professionals and on possible areas of agreement among (...) the available definitions. Then a definition is synthesized that is broad enough to cover the field of management in a sense as full as most managers might conceive of it. (shrink)

The frontispiece of Hobbes's Leviathan is justly renowned as a powerful visual advertisement for his political philosophy. Consequently, its rich imagery has been the subject of extensive scholarly commentary. Surprisingly, then, its gendered dimensions have received relatively limited attention. This essay explores this neglected facet of the frontispiece. I argue that the image initially appears to present a hypermasculine sovereign. However, upon closer inspection, and considered alongside Hobbes's economic theory, it yields to a reading of the sovereign as an ambiguously (...) gendered figure. Reading the frontispiece through the prism of gender and the economy reveals not a static image of unwavering male power but rather one of an equivocally-sexed creature teeming with life, contradictions, and complexities worthy of continued examination. (shrink)

The business and human rights movement shares several goals with the Benefit Corporation movement: corporations respecting human rights; maintaining a “wide aperture” so that all impacts of a company on people and communities are addressed; and creating rigorous standards of conduct and means of accountability. This paper argues that nonetheless the movements are traveling along parallel tracks and thus missing an opportunity for mutual learning that can improve their effectiveness. The BHR movement can look to B Corps for concrete examples (...) of viable companies that value human rights intrinsically and not just where there is a “business case” to do so. The B Impact Assessment, the B Corp certification tool, can better ensure that B Corps are in fact respecting human rights by adopting BHR standards. And both movements must give greater consideration to the potential contradiction between unlimited scaling—a key goal of B Corps—and the ability of large multinational corporations to respect human rights. (shrink)

I am a realist of a metaphysical stripe. I believe in an immense realm of "modal" and "abstract" entities, of entities that are neither part of, nor stand in any causal relation to, the actual, concrete world. For starters: I believe in possible worlds and individuals; in propositions, properties, and relations (both abundantly and sparsely conceived); in mathematical objects and structures; and in sets (or classes) of whatever I believe in. Call these sorts of entity, and the reality they comprise, (...) metaphysical. In contrast, call the actual, concrete entities, and the reality they comprise, physical. Physical and metaphysical reality together comprise all that there is. In this paper, it is not my aim to defend realism about any particular metaphysical sort of entity. Rather, I ask quite generally whether and how any brand of realism about metaphysical sorts of entity could be justified? (shrink)

Many commentators have contrasted the way that sociability is theorized in the writings of Mary Astell and Damaris Masham, emphasizing the extent to which Masham is more interested in embodied, worldly existence. I argue, by contrast, that Astell's own interest in imagining a constitutively relational individual emerges once we pay attention to her use of religious texts and tropes. To explore the relevance of Astell's Christianity, I emphasize both how Astell's Christianity shapes her view of the individual's relation to society (...) and how Masham's contrasting views can be analyzed through the lens of her charge that Astell is an “enthusiast.” In late seventeenth-century England, “enthusiasm” was a term of abuse that, commentators have recently argued, could function polemically to dismiss those deemed either excessively social or antisocial. By accusing Astell of enthusiasm, I claim, Masham seeks to marginalize the relational self that Astell imagines and to promote a more instrumental view of social ties. I suggest some aspects of Astell's thought that may have struck contemporaries as “enthusiastic” and contrast her vision of the self with Masham's more hedonistic subject. I conclude that, although each woman differently configures the relation between self and society, they share a desire to imagine autonomy within a relational framework. (shrink)

For the successful achievement of evidence-based practice, clinicians, managers and purchasers need evidence on whether a particular intervention works and ways to judge the appropriateness of the outcome criteria and measures used. Guidance is needed on what outcome measure to use, especially within routine clinical care settings. Beginning with a re-clarification of the difference between a health status and an outcome measure, the paper presents an evaluative checklist for use by clinical audit and research staff to review outcome measures for (...) use in routine care settings. Central features include the user-centredness of the measure, its psychometric properties, feasibility of use and utility. The applicability of the checklist is illustrated for outcome measurement in diabetes and stroke care. A modified form of the checklist is proposed for use by the busy clinician as an aid to the critical review of research papers within the context of evidence-based practice and to aid health care practitioners' choice of which outcome measure(s) to use within routine clinical care. (shrink)

In this paper I argue that a greater understanding of the part of ethics in leadership will improve leadership studies. Debates over thedefinition of leadership are really debates over what researchers think constitutes good leadership. The ultimate question is not “What is leadership?” but “What is good leadership?” The word good is refers to both ethics and competence. Research into leadership ethics would explore the ethical issues of current leadership research, serve as a critical study of the field, analyze and (...) expand normative theories of leadership, and develop new theories, research questions and ways of thinking about leadership. (shrink)

I argue that we can visually perceive others as seeing agents. I start by characterizing perceptual processes as those that are causally controlled by proximal stimuli. I then distinguish between various forms of visual perspective-taking, before presenting evidence that most of them come in perceptual varieties. In doing so, I clarify and defend the view that some forms of visual perspective-taking are “automatic”—a view that has been marshalled in support of dual-process accounts of mindreading.

Darwin's art collection : the prints, drawings, and photographs Darwin collected in the 1860s and 70s -- Illustrations and illusion : strategies Darwin used in illustrating his books -- Art, experience, and observation : Darwin's knowledge of art history and use of illustration in his books -- Darwin and the passions : how passion manuals informed Darwin's research -- Photography and evolution meet : connections between photography and biology in the 1860s -- Method to their madness : how photography in (...) mental hospitals influenced Darwin -- Laughing and crying : Darwin's quest for pictures of expressive babies -- Darwin's eyes and ears : the artists who guided Darwin's search for pictures -- Darwin's art photographer : Oscar Rejlander, Darwin's favorite photographer -- Rejlander's performances : posing for Darwin's pictures -- Alice, eugenics, and the spirit world : the aftermath of Darwin's experiments. (shrink)