Prior to their announcement of the birth of gene-edited twins in China, Dr. He Jiankui and colleagues published a set of draft ethical principles for discussing the legal, social, and ethical aspects of heritable genome interventions. Within this document, He and colleagues made it clear that their goal with these principles was to “clarify for the public the clinical future of early-in-life genetic surgeries” or heritable genome editing. In light of He’s widely criticized gene editing experiments it is of interest (...) to place these draft principles in the larger ethical debate surrounding heritable genome editing. Here we examine the principles proposed by He and colleagues through the lens of Beauchamp and Childress’ Principles of Biomedical Ethics. We also analyze the stated goal that the “clinical future” of heritable genome editing was clarified by He and colleagues’ proposed principles. Finally, we highlight what might be done to help prevent individual actors from pushing forward ahead of broad societal consensus on heritable genome editing. (shrink)

We examine topological dynamical systems on the Cantor set from the point of view of the continuous model theory of commutative C*-algebras. After some general remarks, we focus our attention on the generic homeomorphism of the Cantor set, as constructed by Akin, Glasner, and Weiss. We show that this homeomorphism is the prime model of its theory. We also show that the notion of “generic” used by Akin, Glasner, and Weiss is distinct from the notion of “generic” encountered in Fraïssé (...) theory. (shrink)

Objectives: To report the attitudes and opinions of subjects in US clinical trials about whether or not, and why, they should receive post-trial access (PTA) to the trial drug, care and information. Design: Focus groups, short self-administered questionnaires. Setting: Boston, Dallas, Detroit, Oklahoma City. Participants: Current and recent subjects in clinical trials, primarily for chronic diseases. Results: 93 individuals participated in 10 focus groups. Many thought researchers, sponsors, health insurers and others share obligations to facilitate PTA to the trial drug, (...) if it benefited the subject, or to a therapeutic equivalent. Some thought PTA obligations include providing transition care (referrals to non-trial physicians or other trials, limited follow-up, short-term drug supply) or care for long-term adverse events. Others held, in contrast, that there are no PTA obligations regarding drugs or care. However, there was agreement that former subjects should receive information (drug name, dosage received, market approval date, long-term adverse effects, trial results). Participants frequently appealed to health need, cost, relationships, reciprocity, free choice and sponsor self-interest to support their views. Many of their reasons overlapped with those commonly discussed by bioethicists. Conclusion: Many participants in US trials for chronic conditions thought there are obligations to facilitate PTA to the trial drug at a “fair” price; these views were less demanding than those of non-US subjects in other studies. However, our participants’ views about informational obligations were broader than those of other subjects and many bioethicists. Our results suggest that the PTA debate should expand beyond the trial drug and aggregate results. (shrink)

Global debates in approaches to HIV/AIDS control have recently moved away from a uniformly strong human rights-based focus. Public health utilitarianism has become increasingly important in shaping national and international policies. However, potentially contradictory imperatives may require reconciliation of individual reproductive and other human rights with public health objectives. Current reproductive health guidelines remain largely nonprescriptive on the advisability of pregnancy amongst HIV-positive couples, mainly relying on effective counselling to enable autonomous decision-making by clients. Yet, health care provider values and (...) attitudes may substantially impact on the effectiveness of nonprescriptive guidelines, particularly where social norms and stereotypes regarding childbearing are powerful, and where providers are subjected to dual loyalty pressures, with potentially adverse impacts on rights of service users. Data from a study of user experiences and perceptions of reproductive and HIV/AIDS services are used to illustrate a rights analysis of how reproductive health policy should integrate a rights perspective into the way services engage with HIV-positive persons and their reproductive choices. The analysis draws on recognised tools developed to evaluate health policies for their human rights impacts and on a model developed for health equity research in South Africa to argue for greater recognition of agency on the part of persons affected by HIV/AIDS in the development and content of policies on reproductive choices. We conclude by proposing strategies that are based upon a synergy between human rights and public health approaches to policy on reproductive health choices for persons with HIV/AIDS. (shrink)

The semantic paradoxes are often associated with self-reference or referential circularity. Yablo (Analysis 53(4):251–252, 1993), however, has shown that there are infinitary versions of the paradoxes that do not involve this form of circularity. It remains an open question what relations of reference between collections of sentences afford the structure necessary for paradoxicality. In this essay, we lay the groundwork for a general investigation into the nature of reference structures that support the semantic paradoxes and the semantic hypodoxes. We develop (...) a functionally complete infinitary propositional language endowed with a denotation assignment and extract the reference structural information in terms of graph-theoretic properties. We introduce the new concepts of dangerous and precarious reference graphs, which allows us to rigorously define the task: classify the dangerous and precarious directed graphs purely in terms of their graph-theoretic properties. Ungroundedness will be shown to fully characterize the precarious reference graphs and fully characterize the dangerous finite graphs. We prove that an undirected graph has a dangerous orientation if and only if it contains a cycle, providing some support for the traditional idea that cyclic structure is required for paradoxicality. This leaves the task of classifying danger for infinite acyclic reference graphs. We provide some compactness results, which give further necessary conditions on danger in infinite graphs, which in conjunction with a notion of self-containment allows us to prove that dangerous acyclic graphs must have infinitely many vertices with infinite out-degree. But a full characterization of danger remains an open question. In the appendices we relate our results to the results given in Cook (J Symb Log 69(3):767–774, 2004) and Yablo (2006) with respect to more restricted sentences systems, which we call $\mathcal{F}$ -systems. (shrink)

Background Despite the growth of biomedical research in South Africa, there are few insights into the operation of Research Ethics Committees (RECs) in this setting. We investigated the composition, operations and training needs of health RECs in South Africa against the backdrop of national and international guidelines. Methods The 12 major health RECs in South Africa were surveyed using semi-structured questionnaires that investigated the composition and functions of each REC as well as the operational issues facing committees. Results Health RECs (...) in SA have an average of 16 members and REC members are predominantly male and white. Overall, there was a large discrepancy in findings between under-resourced RECs and well resourced RECs. The majority of members (56%) are scientists or clinicians who are typically affiliated to the same institution as the health REC. Community representatives account for only 8% of membership. Training needs for health REC members varied widely. Conclusion Most major health RECs in South Africa are well organized given the resource constraints that exist in relation to research ethics in developing countries. However, the gender, racial and occupational diversity of most of these RECs is suboptimal, and most RECs are not constituted in accordance with South African guidelines. Variability in the operations and training needs of RECs is a reflection of apartheid-entrenched influences in tertiary education in SA. While legislation now exists to enforce standardization of research ethics review systems, no provision has been made for resources or capacity development, especially to support historically-disadvantaged institutions. Perpetuation of this legacy of apartheid represents a violation of the principles of justice and equity. (shrink)

The notion that something can exist a se is central to Descartes’s overall metaphysics of causation. In the Meditations, divine aseity plays the role of explaining not only God’s existence but ultimately the existence of everything else apart from God. Yet in the Meditations proper, as well as in the early Replies, Descartes does little to clarify exactly what his view of divine aseity is and how it might differ from the sort of aseity commonly posited by the Scholastics. Despite (...) Descartes’s later attempts to assuage this worry and clarify his position, the positive aseity charge has not gone away. Here I shall argue that the charge is unjustified on all counts. Baldly stated, Descartes’s notion of aseity is no different than the negative sense of aseity endorsed by his Scholastic predecessors - especially Aquinas. Understanding this not only helps in clarifying the overall picture of Cartesian causality but also aids in seeing how commentaries on the Meditations, old and new, have obscured it. (shrink)

William Lane Craig's defence of the kalam cosmological argument rests heavily on two philosophical arguments against a past-eternal universe. In this article I take issue with one of these arguments, what I call the – namely, that the metaphysical absurdity of an actually infinite number of things existing precludes the possibility of a beginningless past. After explaining this argument, I proceed to raise some initial doubts. After setting those aside, I show that the argument is ineffective against proponents of presentism. (...) The remainder of the article considers and rejects possible replies on Craig's behalf. (shrink)

Anti-vascular endothelial growth factor therapy has revolutionised the treatment of a variety of ophthalmic conditions and has become the first-line therapy for a range of retinal diseases. Bevacizumab, a VEGF inhibitor first approved for the treatment of colorectal cancer, has been shown to be nearly or virtually as effective and safe as other anti-VEGF therapies in the treatment of certain retinal diseases but is not approved or registered by the Food and Drug Administration or European Medicines Agency. While other anti-VEGF (...) options are approved and registered, they are generally more expensive and less accessible. Accordingly, despite its off-label status, bevacizumab is frequently used for a variety of disabling retinal diseases. Indeed, bevacizumab is included on the World Health Organization’s list of essential medicines. However, its use in some parts of the world remains restricted due to its off-label status. How, then, should healthcare authorities approach this situation? What are the ethical and societal implications of adhering to a standard and generally effective evaluation and approval system while restricting access to a potentially cost-saving therapy? In countries where its use is not restricted, how should providers approach off-label treatment with bevacizumab? By examining the evidence behind bevacizumab’s efficacy and safety and evaluating the individual and societal implications of off-label use and restriction, this paper illustrates the ethical factors providers and policy makers must consider in the off-label use of bevacizumab and ultimately argues for increased access to bevacizumab in the treatment of retinal disease. (shrink)

Agrifood scholars have long investigated the relationship between farm size and a wide variety of social and ecological outcomes. Yet neither this scholarship nor the extensive research on farmworkers has addressed the relationship between farm size and job quality for hired workers. Moreover, although this question has not been systematically investigated, many advocates, popular food writers, and documentaries appear to have the answer—portraying precarious work as common on large farms and nonexistent on small farms. In this paper, we take on (...) this question by describing and explaining the relationship between farm size and job quality for hired farm workers. To do so, we draw on data from two independently conducted, mixed-methods case studies—organic fruit and vegetable production in California, and dairy farming in Wisconsin—each of which offers a different set of insights into the farm size-job quality relationship. In both cases, larger farms fared better than or no worse than their smaller-scale counterparts for most job quality metrics investigated, though many of the advantages of working on large farms accrue disproportionately to white, U.S.-born workers. We explain that these patterns stem from economies of scale, industrialization, firm size itself, the dominant class identities and aspirations of farmers and their peers, as well as farmers’ and immigrant workers’ fears of immigration enforcement. (shrink)

The use of the symbol ∨for disjunction in formal logic is ubiquitous. Where did it come from? The paper details the evolution of the symbol ∨ in its historical and logical context. Some sources say that disjunction in its use as connecting propositions or formulas was introduced by Peano; others suggest that it originated as an abbreviation of the Latin word for “or,” vel. We show that the origin of the symbol ∨ for disjunction can be traced to Whitehead and (...) Russell’s pre-Principia work in formal logic. Because of Principia’s influence, its notation was widely adopted by philosophers working in logic (the logical empiricists in the 1920s and 1930s, especially Carnap and early Quine). Hilbert’s adoption of ∨ in his Grundzüge der theoretischen Logik guaranteed its widespread use by mathematical logicians. The origins of other logical symbols are also discussed. (shrink)

As interest in Owen Barfield grows, we aim to meet the need for a scholarly introduction to his thought. Our primary purpose is to present an overview, analysis, and synthesis of Barfield's most salient ideas in a manner that will be of interest to neophytes and initiates alike. Barfield's work can, at time, be difficult to understand; C. S. Lewis put it well when he described Barfield's style of argument as 'dark, labyrinthine,' and 'pertinacious.' But Lewis ardently promoted Barfield's work (...) because he knew that people who willingly walk in those dim and winding corridors are, in time, richly rewarded by the bright light at their end. We offer the present work in service to those who wish to undertake this adventure. While the present book will help those readers who wish to engage Barfield for the sake of achieving a greater understanding of and appreciation for other writers who have been associated with or influenced by him, we aim first and foremost to present Barfield as a profound and original thinker in his own right. (shrink)

BackgroundCommentators believe that the ethical decision-making climate is instrumental in enhancing interprofessional collaboration in intensive care units. Our aim was twofold: to determine the perception of the ethical climate, levels of moral distress, and intention to leave one's job among nurses and physicians, and between the different ICU types and determine the association between the ethical climate, moral distress, and intention to leave.MethodsWe performed a cross-sectional questionnaire study between May 2021 and August 2021 involving 206 nurses and physicians in a (...) large urban academic hospital. We used the validated Ethical Decision-Making Climate Questionnaire and the Measure of Moral Distress for Healthcare Professionals tools and asked respondents their intention to leave their jobs. We also made comparisons between the different ICU types. We used Pearson's correlation coefficient to identify statistically significant associations between the Ethical Climate, Moral Distress, and Intention to Leave.ResultsNurses perceived the ethical climate for decision-making as less favorable than physicians. They also had significantly greater levels of moral distress and higher intention to leave their job rates than physicians. Regarding the ICU types, the Neonatal/pediatric unit had a significantly higher overall ethical climate score than the Medical and Surgical units and also demonstrated lower moral distress scores and lower “intention to leave” scores compared with both the Medical and Surgical units. The ethical climate and moral distress scores were negatively correlated ; moral distress and "intention to leave" was positively correlated ; and ethical climate and “intention to leave” were negatively correlated.ConclusionsSignificant differences exist in the perception of the ethical climate, levels of moral distress, and intention to leave between nurses and physicians and between the different ICU types. Inspecting the individual factors of the ethical climate and moral distress tools can help hospital leadership target organizational factors that improve interprofessional collaboration, lessening moral distress, decreasing turnover, and improved patient care. (shrink)

This paper will set out in plain language the basic ontology of “Deleuze’s Spinoza”; it will then critically examine whether such a Spinoza has, or indeed could have, ever truly existed. In this, it will be shown that Deleuze’s reading of Spinoza involves the imposition of three interlocking, formal principles. These are (1) Necessitarianism, (2) Immanence, and (3) Univocity. The uncovering of Deleuze’s use of these three principles, how they relate to one another, and what they jointly imply in terms (...) of ontology, will occupy Part 1 of this paper. The critique of these principles from a Spinozist perspective, i.e. that their use by Deleuze is incompatible with Spinoza’s own metaphysics, will occupy Part 2 of this paper. (shrink)

At the level of the individual, current research suggests that most of our daily actions are done out of habit. At the same time, individuals are part of larger social units, and their behavior gives rise to customs and institutions. Hume recognized the indispensable role of custom and habit in human life in his science of the mind, a science which aims to form the most general principles possible. Custom and habit are singled out by Hume as particularly potent general (...) principles of human nature, describing them as the “great guide of life” and essential to human affairs. The aim of this paper is to explore the role custom and habit play in Hume’s work, especially as it concerns his political philosophy and experimental method, while considering intersections with contemporary discussions in political science. (shrink)

Though the interaction of philosophy with pop culture has so far mostly taken the form of books for nonphilosophers that use various shows and movies as sources of examples to illustrate “traditional” philosophical issues, this article contends that serious engagement with the informal philosophical discussions expressed in popular entertainments constitutes a kind of “ethnophilosophy” and should be considered an important part of the discipline. Our disciplinary responsibility for maintaining and considering the history of philosophy ought to include even the philosophical (...) conversations that occur outside the academy; however unlike “proper” philosophy this material may be, it nonetheless represents engagement—sometimes substantial engagement—with the same issues that concern those of us who are considered “professional” philosophers, and thus is legitimately of interest to us. (shrink)

Bribery in international business has become a priority concern among business, government, and community leaders. While discussions among philosophers often emphasize the ethical justification for banning bribery, policy-makers around the world are challenging it on the basis of its effects for economic development. In this paper we define bribery, trace recent efforts by the public, private, and civil society sectors to curb it, and attempt to answer the question: Will bribery become less common?

We examine the influence of word choices on mathematical practice, i.e. in developing definitions, theorems, and proofs. As a case study, we consider Euclid’s and Euler’s word choices in their influential developments of geometry and, in particular, their use of the term ‘polyhedron’. Then, jumping to the twentieth century, we look at word choices surrounding the use of the term ‘polyhedron’ in the work of Coxeter and of Grünbaum. We also consider a recent and explicit conflict of approach between Grünbaum (...) and Shephard on the one hand and that of Hilton and Pedersen on the other, elucidating that the conflict was engendered by disagreement over the proper conceptualization, and so also the appropriate word choices, in the study of polyhedra. (shrink)

Beginning from an analysis of what factors disqualify a person from complaining about a given moral breach, I show that the prima facie presumption that a complaint is justified in the face of non-moral offense in the context of a business transaction must be balanced against the potential consequences to the object of the complaint, especially given the particular realities of popular employment practices. In particular, I will identify three cases in which complamts are justified, presuming unjust employment arrangements, as (...) a way of showing that complaints in other situations should be, contrary to naive intuition, considered inappropriate. (shrink)

Social scientists agree that women are generally more religious than men, but disagree about whether the differences are universal or contingent on social context. This study uses General Social Survey data to explore differences in religiosity between, as well as among, women and men by level of individual earned income. Extending previous research, I focus on high earners with other groups included for comparison. Predicted probabilities based upon fully interacted models provide four key findings: There are no significant gender differences (...) among high earners; high-earning women are less religious than low-earning women; high-earning men are more religious than low-earning men; and differences among women and among men at different earnings levels are just as large as average differences between women and men. Further analyses demonstrate that the relationship between gender, earnings, and religiosity varies by race. The findings demonstrate the utility of intersectional approaches for understanding gender differences in religiosity. Beyond the implications specific to the gender differences in religiosity literature, this study also indicates that religion is an important, yet often underemphasized, aspect of our intersectional selves. (shrink)

In this dissertation, I argue that aesthetic experience is a kind of valuing experience that has certain, objective features not dependent on the psychological state of the subject. Accounts of aesthetic experience can generally be divided into two categories: internalist and externalist. The former pick out aesthetic experience as a being a certain kind of psychological state on the part of the subject, whereas the latter specify it based on features external to the experience itself, usually by reference to the (...) object. My account is neither strictly internalist nor externalist, but combines features of both. Like an internalist account, it requires that the subject be in a certain mental state – the subject must be having a valuational experience. Like an externalist account, it insists that there are features of aesthetic experience that are not part of the phenomenal character of the experience – that is, the type of value assigned is in fact subjective, regardless of how the subject perceives it. It is my contention that such a hybrid account is broadly explanatory while avoiding the problems that plague other accounts. (shrink)

Don didn’t grasp what would eventually come to be one of the most successful ad campaigns ever because he didn’t recognise the person presenting the evidence as being appropriately trustworthy. He failed to know because Dr Guttman’s say-so was not enough to provide justification for a belief. But why would he think that? To get to the bottom of this, we need the help of an analytical approach known as standpoint theory.

Don didn’t grasp what would eventually come to be one of the most successful ad campaigns ever because he didn’t recognise the person presenting the evidence as being appropriately trustworthy. He failed to know because Dr Guttman’s say-so was not enough to provide justification for a belief. But why would he think that? To get to the bottom of this, we need the help of an analytical approach known as standpoint theory.

In his 1918 logical atomism lectures, Russell argued that there are no molecular facts. But he posed a problem for anyone wanting to avoid molecular facts: we need truth-makers for generalizations of molecular formulas, but such truth-makers seem to be both unavoidable and to have an abominably molecular character. Call this the problem of generalized molecular formulas. I clarify the problem here by distinguishing two kinds of generalized molecular formula: incompletely generalized molecular formulas and completely generalized molecular formulas. I next (...) argue that, if empty worlds are logically possible, then the model-theoretic and truth-functional considerations that are usually given address the problem posed by the first kind of formula, but not the problem posed by the second kind. I then show that Russell’s commitments in 1918 provide an answer to the problem of completely generalized molecular formulas: some truth-makers will be non-atomic facts that have no constituents. This shows that the neo-logical atomist goal of defending the principle of atomicity—the principle that only atomic facts are truth-makers—is not realizable. (shrink)

This book offers a comprehensive critical survey of issues of historical interpretation and evaluation in Bertrand Russell's 1918 logical atomism lectures and logical atomism itself. These lectures record the culmination of Russell's thought in response to discussions with Wittgenstein on the nature of judgement and philosophy of logic and with Moore and other philosophical realists about epistemology and ontological atomism, and to Whitehead and Russell’s novel extension of revolutionary nineteenth-century work in mathematics and logic. Russell's logical atomism lectures have had (...) a lasting impact on analytic philosophy and on Russell's contemporaries including Carnap, Ramsey, Stebbing, and Wittgenstein. Comprised of 14 original essays, this book will demonstrate how the direct and indirect influence of these lectures thus runs deep and wide. (shrink)

Curren and Metzger’s work makes a bold, normative claim: The moral goal of sustainability is human flourishing. Their eudaimonic theory has as its summum bonum ‘living well’ according to the fundam...