Pharmaceutical companies fund the bulk of clinical research that is carried out on medications. Poor outcomes from these studies can have negative effects on sales of medicines. Previous research has shown that company funded research is much more likely to yield positive outcomes than research with any other sponsorship. The aim of this article is to investigate the possible ways in which bias can be introduced into research outcomes by drawing on concrete examples from the published literature. Poorer methodology in (...) industry-funded research is not likely to account for the biases seen. Biases are introduced through a variety of measures including the choice of comparator agents, multiple publication of positive trials and non-publication of negative trials, reinterpreting data submitted to regulatory agencies, discordance between results and conclusions, conflict-of-interest leading to more positive conclusions, ghostwriting and the use of seeding trials. Thus far, efforts to contain bias have largely focused on more stringent rules regarding conflict-of-interest (COI) and clinical trial registries. There is no evidence that any measures that have been taken so far have stopped the biasing of clinical research and it’s not clear that they have even slowed down the process. Economic theory predicts that firms will try to bias the evidence base wherever its benefits exceed its costs. The examples given here confirm what theory predicts. What will be needed to curb and ultimately stop the bias that we have seen is a paradigm change in the way that we treat the relationship between pharmaceutical companies and the conduct and reporting of clinical trials. (shrink)

Vasubandhu is perhaps the most influential figure in the history of Buddhist philosophy, yet the very breadth of his contribution across many schools and traditions has led to a fragmentation of his works, as interpreters have tended to read them through the lens of narrow scholastic perspectives, finding little continuity or coherence. Some modern scholars, doubtful that anyone could have held such varied views, have gone so far as to divide Vasubandhu himself into two distinct philosophers, with two different and (...) irreconcilable views. In his recent book, Paving the Great Way: Vasubandhu’s Unifying Buddhist Philosophy, Jonathan Gold offers for the first time a unified picture of Vasubandhu, extracting the driving... (shrink)

About one third of patients with epilepsy have seizures refractory to the medical treatment. Electrical stimulation mapping is the gold standard for the identification of “eloquent” areas prior to resection of epileptogenic tissue. However, it is time-consuming and may cause undesired side effects. Broadband gamma activity recorded with extraoperative electrocorticography during cognitive tasks may be an alternative to ESM but until now has not proven of definitive clinical value. Considering their role in cognition, the alpha and beta bands could (...) further improve the identification of eloquent cortex. We compared gamma, alpha and beta activity, and their combinations for the identification of eloquent cortical areas defined by ESM. Ten patients with intractable focal epilepsy participated in a delayed-match-to-sample task, where syllable sounds were compared to visually presented letters. We used a generalized linear model approach to find the optimal weighting of each band for predicting ESM-defined categories and estimated the diagnostic ability by calculating the area under the receiver operating characteristic curve. Gamma activity increased more in eloquent than in non-eloquent areas, whereas alpha and beta power decreased more in eloquent areas. Diagnostic ability of each band was close to 0.7 for all bands but depended on multiple factors including the time period of the cognitive task, the location of the electrodes and the patient’s degree of attention to the stimulus. We show that diagnostic ability can be increased by 3–5% by combining gamma and alpha and by 7.5–11% when gamma and beta were combined. We then show how ECoG power modulation from cognitive testing can be used to map the probability of eloquence in individual patients and how this probability map can be used in clinical settings to optimize ESM planning. We conclude that the combination of gamma and beta power modulation during cognitive testing can contribute to the identification of eloquent areas prior to ESM in patients with refractory focal epilepsy. (shrink)

I defend a model of the musically extended mind. I consider how acts of “musicking” grant access to novel emotional experiences otherwise inaccessible. First, I discuss the idea of “musical affordances” and specify both what musical affordances are and how they invite different forms of entrainment. Next, I argue that musical affordances – via soliciting different forms of entrainment – enhance the functionality of various endogenous, emotiongranting regulative processes, drawing novel experiences out of us with an expanded complexity and phenomenal (...) character. I argue that music therefore ought to be thought of as part of the vehicle needed to realize these emotional experiences. I appeal to different sources of empirical work to develop this idea. (shrink)

These four volumes address the question of the kinds of conduct may the state make criminal without infringing on the moral autonomy of individual citizens.

While there is a steadily growing literature on epistemic injustice in healthcare, there are few discussions of the role that biomedical technologies play in harming patients in their capacity as knowers. Through an analysis of newborn and pediatric genetic and genomic sequencing technologies (GSTs), I argue that biomedical technologies can lead to epistemic injustice through two primary pathways: epistemic capture and value partitioning. I close by discussing the larger ethical and political context of critical analyses of GSTs and their broader (...) implications for just and equitable healthcare delivery. (shrink)

Sometimes we make a decision about an action we will undertake later and form an intention, but our judgment of what it is best to do undergoes a temporary shift when the time for action comes round. What makes it rational not to give in to temptation? Many contemporary solutions privilege diachronic rationality; in some “rational non-reconsideration” (RNR) accounts once the agent forms an intention, it is rational not to reconsider. This leads to other puzzles: how can someone be motivated (...) to follow a plan that is contrary to their current judgment? How can it be rational to form a plan to resist if we can predict that our judgment will shift? I show how these puzzles can be solved in a framework where there are multiple units of agency, distinguishing between the judgments of the timeslice and those of the person over time, and allowing that the timeslice can “self identify”, taking the person over time as the relevant unit of agency and doing intrapersonal team reasoning (with a different causal role for intentions than RNR accounts). On my account, resisting temptation is compatible with synchronic rationality, so synchronic and diachronic rationality are aligned. However, either resisting or succumbing to temptation can be instrumentally rational, depending on the unit of agency that is identified with. In order to show why we ought to resist temptation, we need to draw on a non-instrumental rationale. I sketch possible routes for doing this. (shrink)

One of liberalism’s core commitments is to safeguarding individuals’ autonomy. And a central aspect of liberal social justice is the commitment to protecting the vulnerable. Taken together, and combined with an understanding of autonomy as an acquired set of capacities to lead one’s own life, these commitments suggest that liberal societies should be especially concerned to address vulnerabilities of individuals regarding the development and maintenance of their autonomy. In this chapter, we develop an account of what it would mean for (...) a society to take seriously the obligation to reduce individuals’ autonomy-related vulnerabilities to an acceptable minimum. In particular, we argue that standard liberal accounts underestimate the scope of this obligation because they fail to appreciate various threats to autonomy. (shrink)

Willard V. Quine’s 1951 article, “Two Dogmas of Empiricism” (Two Dogmas) was taken to be revolutionary because it rejects the analytic-synthetic distinction and the thesis that empirical statements are confirmed individually rather than holistically. The present chapter, however, argues that the overcoming of modern philosophy already included the overcoming of these theses by Hegelians, pragmatists and two critics of Hegelianism and pragmatism, Grace and Theodore de Laguna. From this perspective, Two Dogmas offers a Hegelian epistemology that was already superseded in (...) 1910. The perspective is largely based on the de Lagunas’ 1910 book Dogmatism and Evolution: Studies in Modern Philosophy. The de Lagunas’ book also helps to make clear that the real revolution Two Dogmas participated in was the marginalisation of their work and that of other speculative philosophers. Grace de Laguna surely recognised much of this when she stood opposite Quine as he first presented Two Dogmas. (shrink)

This chapter provides the background to the American women philosophers’ works that are introduced and collected in Knowledge, Mind and Reality: An Introduction by Early Twentieth-Century American Women Philosophers. We describe the institutional context which made these works possible and their methodological and theoretical background. We also provide biographies for their authors.

Politicians, preachers, and ordinary people speak often of character; psychologists study `personality', used as a term of art with meanings close to `character'. Most ethical philosophers in the last two hundred years, on the other hand, have not had much to say about character. This book attempts to understand character and to refocus ethical philosophy so that character is central.

Affordances are action-possibilities, ways of relating to and acting on our world. A theory of affordances helps us understand how we have bodily access to our world and what it means to enjoy such access. But what happens to bodies when this access is somehow ruptured or impeded? This question is relevant to psychopathology. People with psychiatric disorders often describe feeling as though they’ve lost access to affordances that others take for granted. Focusing on schizophrenia, depression, and autistic spectrum disorder, (...) I argue that thinking about the bodily consequences of losing access to everyday affordances can help us better understand these reports. An affordance-based approach to psychopathology can illuminate some of the causes, as well as the experiential character and content, of affective disorders in psychopathology. It can also draw our attention to some under-explored ethical and political dimensions of these issues needing further consideration. (shrink)

In an attempt to bridge the vast divide between classical Asian thought and contemporary Western philosophy, Joel J. Kupperman finds that the two traditions do not, by and large, supply different answers to the same questions. Rather, each tradition is searching for answers to their own set of questions--mapping out distinct philosophical investigations. In this groundbreaking book, Kupperman argues that the foundational Indian and Chinese texts include lines of thought that can enrich current philosophical practice, and in some cases (...) provide uniquely sophisticated insights. Special attention is given to the ethical issues of formation and fluidity of self, the nature and possibilities of choice, the compartmentalization of life implicit in some ethical systems, the variations of ethical demands from person to person, and the nature of philosophy itself as a communicative activity. This study will provide a wealth of information for philosophers seeking a closer knowledge of Asian philosophy and general readers with an interest in Eastern thought. (shrink)

Dutch Book Arguments (DBAs) have been invoked to support various requirements of rationality. Some are plausible: probabilism and conditionalization. Others are less so: credal transparency and reflection. Anna Mahtani has argued for a new understanding of DBAs which, she claims, allow us to keep the DBAs for probabilism (and perhaps conditionalization) and reject the DBAs for credal transparency and reflection. I argue that Mahtani’s new account fails as (a) it does not support highly plausible requirements of rational coherence and (b) (...) it does not, even setting aside the first objection, succeed in undermining the DBAs for credal transparency or reflection. (shrink)

The Indian Buddhist philosopher Vasubandhu is known for his critical contribution to Buddhist Abhidharma thought, his turn to the Mahayana tradition, and his concise, influential Yogacara-Vijñanavada texts. _Paving the Great Way_ reveals another dimension of his legacy: his integration of several seemingly incompatible intellectual and scriptural traditions, with far-ranging consequences for the development of Buddhist epistemology and the theorization of tantra. Most scholars read Vasubandhu's texts in isolation and separate his intellectual development into distinct phases. Featuring close studies of Vasubandhu's (...) _Abhidharmakosabhasya_, _Vyakhyayukti_, _Vimsatika_, and _Trisvabhavanirdesa_, among other works, this book identifies recurrent treatments of causality and scriptural interpretation that unify distinct strands of thought under a single, coherent Buddhist philosophy. In Vasubandhu's hands, the Buddha's rejection of the self as a false construction provides a framework through which to clarify problematic philosophical issues, such as the nature of moral agency and subjectivity under a broadly causal worldview. Recognizing this continuity of purpose across Vasubandhu's diverse corpus recasts the interests of the philosopher and his truly innovative vision, which influenced Buddhist thought for a millennium and continues to resonate with today's philosophical issues. An appendix includes extensive English-language translations of the major texts discussed. (shrink)

Moderate rationalism is the view a person's having a rational intuition that p prima facie justifies them in believing that p. It has recently been argued that moderate rationalism requires empirical support and, furthermore, that suitable empirical support would suffice to convince empiricists to abandon their opposition to rationalism. According to one argument, the causal requirement argument, empirical evidence is necessary in order to justify the claim that any actual token belief is based on rational intuition and moderate rationalism requires (...) such a claim for its justification. According to a second argument, the reliability argument, empirical evidence is necessary in order to justify the claim that a putative source of evidence is reliable and moderate rationalism requires such a claim for its justification. According to a third argument, the empirical case argument, certain sorts of empirical evidence would be dialectically sufficient to resolve the traditional dispute between empiricists and rationalists in the rationalists' favor. Against the causal requirement argument, I maintain that the core doctrines of moderate rationalism are not hostage to causal claims and that such causal claims as may be plausibly part of other recognizably rationalist doctrines can be justified on broadly non-empirical grounds. Against the reliability argument, I show that no empirical evidence is required to justify belief in the reliability of rational intuition. Against the empirical case argument, I argue that the envisioned empirical support for moderate rationalism should not convince any traditional empiricist. (shrink)

This paper follows directly from an earlier paper where we discussed the requirements for an artifact to be a moral agent and concluded that the artifactual question is ultimately a red herring. As...

The book's clear organization structures selections so that readings complement each other guiding you through contrasting positions on key concepts in ...

This book is concerned with the role of intuitions in the justification of philosophical theory. The author begins by demonstrating how contemporary philosophers, whether engaged in case-driven analysis or seeking reflective equilibrium, rely on intuitions as evidence for their theories. The author then provides an account of the nature of philosophical intuitions and distinguishes them from other psychological states. Finally, the author defends the use of intuitions as evidence by demonstrating that arguments for skepticism about their evidential value are either (...) self-defeating or guilty of arbitrary and unjustified partiality towards non-intuitive modes of knowledge. (shrink)

In _A Question of Time_, Joel Pearl offers a new reading of the foundations of psychoanalytic thought, indicating the presence of an essential lacuna that has been integral to psychoanalysis since its inception. Pearl returns to the moment in which psychoanalysis was born, demonstrating how Freud had overlooked one of the most principal issues pertinent to his method: the question of time. The book shows that it is no coincidence that Freud had never methodically and thoroughly discussed time and (...) that the metaphysical assumption of linear time lies at the very heart of Freudian psychoanalysis. Pearl’s critical reading of Freud develops through an original dialogue that he creates with the philosophy of Martin Heidegger and, specifically, with the German philosopher’s notion of temporality. Pearl traces the encounter between Freud and Heidegger by observing the common inspiration shaping their thinking: philosopher Franz Brentano, who taught both Freud and Edmund Husserl, Heidegger’s mentor. The book travels down an alternate path, one overlooked by Freudian thought – a path leading from Brentano, through Husserl and onto Heidegger’s notion of time, which is founded on the ecstatic’ interrelation of past, present and future. (shrink)

This entry addresses the nature and epistemological role of intuition by considering the following questions: (1) What are intuitions?, (2) What roles do they serve in philosophical (and other “armchair”) inquiry?, (3) Ought they serve such roles?, (4) What are the implications of the empirical investigation of intuitions for their proper roles?, and (5) What is the content of intuitions prompted by the consideration of hypothetical cases?

This is a second, revised edition of Kupperman's introduction to Asian philosophy via its canonical texts. Kupperman ranges from the Upanishads to the Bhagavad Gita through Confucius to Zen Buddhism, walking students through the texts, conveying the vitality and appeal of the works, and explaining their philosophical roots. Kupperman has made revisions throughout the text, clarifying where necessary, and added a new chapter on al-Arabi's The Bezels of Wisdom, a classic of Islamic Sufism.

I introduce the key ideas of foundationalist, coherentist and pragmatist theories of knowledge. I then use these ideas as background for presenting the work on knowledge and perception in this part, work by Grace Andrus de Laguna and Marie Collins Swabey. We will see that these authors critique the idea of sense data that was central to the foundationalist theories of knowledge of Bertrand Russel and other early analytic thinkers, though de Laguna’s critique leads to perspectivism about perception and knowledge (...) while Swabey rejects perspectivism. So too, we will see that de Laguna and Swabey develop epistemologies with strong coherentist elements, much as did their idealist teacher James Edwin Creighton. De Laguna’s, developed jointly with her husband, Theodore de Laguna, is a sophisticated form of naturalism that is built on a critique of pragmatist naturalism and is similar to the one made famous later by Willard V. Quine. Swabey rejects all forms of naturalism, arguing that knowledge requires an a priori foundation in reason. (shrink)

This chapter uses the distinction between speculative and analytic philosophy as a background against which to present the summaries of the articles on the nature of philosophy by Mary Whiton Calkins, Dorothy Walsh and Marjorie Glicksman. Calkins and Walsh (in her first contribution) examine the relationship between philosophy and metaphysics: Calkins identifies philosophy with speculative metaphysics while Walsh argues that any ethical theory requires some underlying speculative metaphysics. In Walsh’s second contribution, she further argues that philosophical language rightly is characteristically (...) different from the languages of science, logic and poetry. Glicksman, finally, addresses the question how to deal with the multiplicity of views concerning the nature of philosophy. (shrink)

In this paper, we develop an analysis of the structure and content of loneliness. We argue that this is an emotion of absence-an affective state in which certain social goods are regarded as out of reach for the subject of experience. By surveying the range of social goods that appear to be missing from the lonely person's perspective, we see what it is that can make this emotional condition so subjectively awful for those who undergo it, including the profound sense (...) of being unable to realise oneself, in collaboration with others. (shrink)

We offer a particularist defense of conspiratorial thinking. We explore the possibility that the presence of a certain kind of evidence—what we call "fortuitous data"—lends rational credence to conspiratorial thinking. In developing our argument, we introduce conspiracy theories and motivate our particularist approach (§1). We then introduce and define fortuitous data (§2). Lastly, we locate an instance of fortuitous data in one real world conspiracy, the Watergate scandal (§3).

This chapter introduces the articles by Marie C. Swabey, Thelma Z. Lavine, Grace A. de Laguna and Dorothy Walsh on the objectivity of scientific knowledge. We will see Swabey placing herself outside the historicist traditions of (later) authors (e.g., Thomas Kuhn), and arguing that the rationality and objectivity of science are grounded in synthetic a priori justified logical principles. Lavine and de Laguna, by contrast, embrace socio-historical approaches to the study of science, thus anticipating later developments in philosophy of science. (...) Still, whereas Lavine embraces a relativist notion of objectivity, de Laguna argues that science, at least in some respects, actually is universally valid. Walsh, finally, like Swabey, believes in context-independent objectivity that is grounded in metaphysics, but like de Laguna and Lavine, contends that such objectivity is discipline-specific. (shrink)

This volume brings together a collection of essays that explore in a new way how unacknowledged moral concerns are integral to debates in the philosophy of mind.The radical suggestion of the book is that we can make sense of the internal dynamics and cultural significance of these debates only when we understand the moral forces that shape them. Drawing inspiration from a variety of traditions including Wittgenstein, Lacan, phenomenology and analytic philosophy, the authors address a wide range of topics including (...) the mind/body-problem, the problem of other minds, subjectivity and objectivity, the debates on mindreading, naturalism, reductive physicalism, representationalism and the ‘E-turn’; Dennett’s heterophenomenology, McDowell’s neo-Kantianism, Wittgenstein’s ‘private language’ considerations and his notion of an ‘attitude towards a soul’; repression, love, conscience, the difficulties of self-understanding, and the methods and aims of philosophy. Through a combination of detailed, immanent criticism and bold constructive work, the authors move the discussion to a new level, beyond humanistic or conservative critiques of naturalism and scientism. (shrink)

Between the 1930s and the mid 1970s, it was commonly believed that in 1880 Karl Marx had proposed to dedicate to Charles Darwin a volume or translation of Capital but that Darwin had refused. The detail was often interpreted by scholars as having larger significance for the question of the relationship between Darwinian evolutionary biology and Marxist political economy. In 1973–4, two scholars working independently—Lewis Feuer, professor of sociology at Toronto, and Margaret Fay, a graduate student at Berkeley—determined simultaneously that (...) the traditional story of the proposed dedication was untrue, being based on a long-standing misinterpretation of the relevant correspondence. Between the two, and among several other scholars who became their respective allies, there developed a contest of authority and priority over the discovery. From 1975 to 1982, the controversy generated a considerable volume of spilled ink in both scholarly and popular publications. Drawing on previously unexamined archival resources, this article revisits the ‘case’ of the so-called ‘Darwin–Marx correspondence’ as an instance of the phenomenon of ‘multiple discovery’. A familiar occurrence in the natural sciences, multiple discovery is rarer in the humanities and social sciences. The present case of a priority dispute in the history of ideas followed patterns familiar from such disputes in the natural sciences, while also diverging from them in ways that shed light on the significance of disciplinary norms and research infrastructures. (shrink)

We provide self-contained proof of a theorem relating probabilistic coherence of forecasts to their non-domination by rival forecasts with respect to any proper scoring rule. The theorem recapitulates insights achieved by other investigators, and clarifi es the connection of coherence and proper scoring rules to Bregman divergence.

Externalist theories hold that a comprehensive understanding of mental disorder cannot be achieved unless we attend to factors that lie outside of the head: neural explanations alone will not fully capture the complex dependencies that exist between an individual’s psychiatric condition and her social, cultural, and material environment. Here, we firstly offer a taxonomy of ways in which the externalist viewpoint can be understood, and unpack its commitments concerning the nature and physical realization of mental disorder. Secondly, we apply a (...) strongly externalist approach to the case of Autistic Spectrum Disorder, and argue that this condition can be illuminated by appeal to the hypothesis of extended cognition. We conclude by briefly considering the significance this strongly externalist approach may have for psychiatric practice and pedagogy. (shrink)

The concept of the receptive field, first articulated by Hartline, is central to visual neuroscience. The receptive field of a neuron encompasses the spatial and temporal properties of stimuli that activate the neuron, and, as Hubel and Wiesel conceived of it, a neuron’s receptive field is static. This makes it possible to build models of neural circuits and to build up more complex receptive fields out of simpler ones. Recent work in visual neurophysiology is providing evidence that the classical receptive (...) field is an inaccurate picture. The receptive field seems to be a dynamic feature of the neuron. In particular, the receptive field of neurons in V1 seems to be dependent on the properties of the stimulus. In this paper, we review the history of the concept of the receptive field and the problematic data. We then consider a number of possible theoretical responses to these data. (shrink)

We add texture to the conclusion of Duchon and Drake (Journal of Business Ethics, 85, 2009, 301) that extreme narcissism is associated with unethical conduct. We argue that the special features possessed by financial accounting facilitate extreme narcissism in susceptible CEOs. In particular, we propose that extremely narcissistic CEOs are key players in a recurring discourse cycle facilitated by financial accounting language and measures. Such CEOs project themselves as the corporation they lead, construct a narrative about the corporation and themselves (...) using financial accounting measures, and then reflect on how their accounting-constructed performance is perceived by stakeholders. We do not present empirical evidence about whether the use of accounting language and measures leads to unethical behaviour by extreme narcissistic CEOs — although the conclusions of Duchon and Drake (2009) suggest empirical support is probable. Rather, we focus on developing alertness to the potential for accounting, when engaged by an extremely narcissistic CEO, to be a precursor or implement of unethical behaviour. (shrink)

Many philosophers think there is a luck problem confronting libertarian models of free will. If free actions are undetermined, then it seems to be a matter of chance or luck that they occur—so the objection goes. Agent-causal libertarians have responded to this objection by asserting that free actions, in their essence, involve a direct causal relation between agents and the events they cause. So, free actions are not lucky after all. Not everyone, however, is convinced by this response. Al Mele (...) and Peter van Inwagen, for instance, argue that luckiness remains even if agent-causation exists. One way to answer their arguments, I suggest, is by appealing to considerations in metaphysical grounding and the associated idea of explanatory priority. Mele’s argument loses force if facts about which possible world is actual are partly grounded in facts about free choices themselves. And van Inwagen’s challenge can be met if facts about free actions are explanatorily prior to any objective probabilities associated with those actions. (shrink)

Civility is an essential feature of health care, as it is in so many other areas of human interaction. The article examines the meaning of civility, reviews its origins, and provides reasons for its moral significance in health care. It describes common types of uncivil behavior by health care professionals, patients, and visitors in hospitals and other health care settings, and it suggests strategies to prevent and respond to uncivil behavior, including institutional codes of conduct and disciplinary procedures. The article (...) concludes that uncivil behavior toward health care professionals, patients, and others subverts the moral goals of health care and is therefore unacceptable. Civility is a basic professional duty that health care professionals should embrace, model, and teach. (shrink)

This book traces how such a seemingly immutable idea as measurement proved so malleable when it collided with the subject matter of psychology. It locates philosophical and social influences reshaping the concept and, at the core of this reshaping, identifies a fundamental problem: the issue of whether psychological attributes really are quantitative. It argues that the idea of measurement now endorsed within psychology actually subverts attempts to establish a genuinely quantitative science and it urges a new direction. It relates views (...) on measurement by thinkers such as Holder, Russell, Campbell and Nagel to earlier views, like those of Euclid and Oresme. Within the history of psychology, it considers contributions by Fechner, Cattell, Thorndike, Stevens and Suppes, among others. It also contains a non-technical exposition of conjoint measurement theory and recent foundational work by leading measurement theorist R. Duncan Luce. (shrink)

In this paper, I examine two versions of the so-called “hierarchical” approach to personal autonomy, based on the notion of “second-order desires”. My primary concern will be with the question of whether these approaches provide an adequate basis for understanding the dynamics of autonomy-ascription. I begin by distinguishing two versions of the hierarchical approach, each representing a different response to the oft-discussed “regress” objection. I then argue that both “structural hierarchicalism” (e.g., Frankfurt, Bratman) and “procedural hierarchicalism” (e.g., Dworkin, Christman, Mele) (...) have difficulties accommodating the dynamics of how the attribution of autonomy to persons is claimed, disputed, and resolved. Although they differ in details, both shortcomings can be traced to viewing autonomy as a metaphysical rather than a normative, practical matter. I conclude by suggesting that these difficulties underscore the advantages of a more constructivist and pragmatist. (shrink)

Should society intervene to prevent the risky behavior of precocious teenagers even if it would be impermissible to intervene with adults who engage in the same risky behavior? The problem is well illustrated by the legal case of the 13-year-old Dutch girl Laura Dekker, who set out in 2009 to become the youngest person ever to sail around the world alone, succeeding in January 2012. In this paper we use her case as a point of entry for discussing the fundamental (...) question of how to demarcate childhood from adulthood. After summarizing the case, we identify a ‘demarcation dilemma’ that frames much of the public and expert debate. On the one hand, it seems morally imperative ‘to treat like alike’, which means that both children and adults should be allowed to undertake all actions for which they have the relevant competences. On the other hand, requiring proportional treatment of children and adults seems to neglect the special nature of childhood as a distinct stage in life that ends at a specific age. We introduce the notion of a ‘regime of childhood’ to deal with this problem. This regime includes several dimensions, including the limited liability for children, the supervisory responsibilities of parents, the role of age-based thresholds, and the overarching purpose of childhood as a context for developing autonomy. We argue that, all things considered, there are good reasons not to shift to a regime that offers individual children the option of qualifying for adulthood on the basis of age-neutral criteria. (shrink)