Flawed clinical practice guidelines may compromise patient care. Commercial conflicts of interest on panels that write treatment guidelines are particularly problematic, because panelists may have conflicting agendas that influence guideline recommendations. Historically, there has been no legal remedy for conflicts of interest on guidelines panels. However, in May 2008, the Attorney General of Connecticut concluded a ground-breaking antitrust investigation into the development of Lyme disease treatment guidelines by one of the largest medical societies in the United States, the Infectious Diseases (...) Society of America (IDSA). Although the investigation found significant flaws in the IDSA guidelines development process, the subsequent review of the guidelines mandated by the settlement was compromised by a lack of impartiality at various stages of the IDSA review process. This article will examine the interplay between the recent calls for guidelines reform, the ethical canons of medicine, and due process considerations under antitrust laws as they apply to the formulation of the IDSA Lyme disease treatment guidelines. The article will also discuss pitfalls in the implementation of the IDSA antitrust settlement that should be avoided in the future. (shrink)

Images of and references to women are so rare in the vast corpus of his published work that there seems to be no "woman question" for Hans-Georg Gadamer. Yet the authors of the fifteen essays included in this volume show that it is possible to read past Gadamer's silences about women and other Others to find rich resources for feminist theory and practice in his views of science, language, history, knowledge, medicine, and literature. While the essayists find much of value (...) in Gadamer's work, he emerges from their discussion as a controversial figure. Some contributors see him as promoting genuine respect for and engagement with Otherness: others claim that in a Gadamerian conversation the Other has no voice. For some, Gadamer's immersion in tradition is an impediment to feminist inquiry; for others, cognizant of the need to understand tradition well in order to contest its intransigence or benefit from its insights, his way of engaging tradition is especially productive. Some contributors take issue with the separation he maintains between philosophy and politics; others find problems in his relative silence on matters of embodiment; still others maintain that a "fusion of horizons" amounts to a colonizing of difference. But a common aim of each of these controversies is to discern what feminists can learn from Gadamer as well as what limitations feminist reinterpretations of his work must inevitably encounter. Contributors are Linda Martín Alcoff, William Cowling, Gemma Corradi Fiumara, Marie Fleming, Silja Freudenberger, Susan Hekman, Susan-Judith Hoffmann, Grace M. Jantzen, Patricia Altenbernd Johnson, Laura Kaplan, Robin Pappas, Robin May Schott, Meili Steele, Veronica Vasterling, Georgia Warnke, and Kathleen Roberts Wright. (shrink)

In this paper I develop an aesthetic of horror film music based on the film sound theorist Kevin Donnelly's "direct access thesis". This states that horror film scores have the power to provide "direct accesses" to the bodies of an audience; they "produce bodily sensations, excite (mainly negative) emotions and insert in the audience "frames of mind and attitudes...much like a direct injection". I first argue that two dominant theories in the field, namely, the culturalist theory of film music and (...) Peter Kivy's cognitivist theory of music and emotion are inadequate. Then I will show that by aligning the direct access thesis with Jenefer Robinson's theory of music and emotion, Mark Johnson and Steve Larson's contention that musical meaning is primarily embodied, we will be able to reveal a deeper meaning of horror film scores than musical convention. I illustrate my proposal with the shark motif in Jaws and Dies Irae in The Shining. (shrink)

While the origin and development of the just war tradition until the early modern period blended concerns, ideas, and practices from the moral, legal, political, and military spheres, from the mid-seventeenth century until the mid-twentieth it largely disappeared as a conscious source of moral reflection about war and its restraint. Beginning in the 1960s, however, American theologian Paul Ramsey initiated a recovery of just war thinking in a series of writings applying the principles of discrimination and proportionality, ideas he traced (...) both to Augustinian theology and to natural law, to the debate over nuclear weapons and later to the Vietnam War. Ramsey's work directly engaged both theological and policy debate over military force, initiating lines of reflection that have since developed further and become increasingly institutionalized. This brief essay examines the nature of Ramsey's just war thought and its influence over the last 40 years. (shrink)

Recently the relevance of the philosophy of Martin Heidegger has been critiqued in nursing literature. However, this critique is based primarily upon an appropriation of Heidegger that does not reflect an understanding of meaning as grounded in temporality. Therefore, this paper aims to (1) explicate Heidegger's grounding of meaning, (2) briefly contrast Heidegger's and Husserl's notions of the origin of meaning, (3) describe how Heidegger was first introduced to nursing, and (4) illustrate through examples from a research study how the (...) philosophy of Heidegger might inform the phenomenological researcher. (shrink)

Following Aristotle (who himself was following Parmenides), philosophers have appealed to the distributional reflexes of expressions in determining their semantic status, and ultimately, the nature of the extra-linguistic world. This methodology has been practiced throughout the history of philosophy; it was clarified and made popular by the likes of Zeno Vendler and J.L. Austin, and is realized today in the toolbox of linguistically minded philosophers. Studying the syntax of natural language was fueled by the belief that there is a conceptually (...) tight connection between the syntax of our language and its semantics, and the belief that there is a similarly tight connection between the semantics of our language and metaphysical facts about the world. We are less confident than our colleagues about the relation syntax has to semantics and metaphysics. In particular, we do not believe that the current status of theoretical syntax (or semantics or metaphysics) provides much support for either of the above two beliefs. We will illustrate our view with a case study regarding the status of complex demonstratives. We will show that a recent and particularly subtle syntactically based argument for the semantic/metaphysical status of complex demonstratives does not in fact show what semantic category complex demonstratives are.. (shrink)

Contrary to what many philosophers believe, Calvinism neither makes the problem of evil worse nor is it obviously refuted by the presence of evil and suffering in our world. Or so most of the authors in this book claim. While Calvinism has enjoyed a resurgence in recent years amongst theologians and laypersons, many philosophers have yet to follow suit. The reason seems fairly clear: Calvinism, many think, cannot handle the problem of evil with the same kind of plausibility as other (...) more popular views of the nature of God and the nature of God's relationship with His creation. This book seeks to challenge that untested assumption. With clarity and rigor, this collection of essays seeks to fill a significant hole in the literature on the problem of evil. (shrink)

One hundred and three participants solved conflict and non-conflict versions of four reasoning tasks using a two-response procedure: a base rate task, a causal reasoning task, a denominator neglect task, and a categorical syllogisms task. Participants were asked to give their first, intuitive answer, to make a Feeling of Rightness judgment, and then were given as much time as needed to rethink their answer. They also completed a standardized measure of IQ and the actively open-minded thinking questionnaire. The FORs of (...) both high- and low-capacity reasoners were responsive to conflict, such that FORs were lower for conflict relative to non-conflict problems. Consistent with the quantity hypothesis, high-capacity reasoners made a greater distinction between conflict and non-conflict items on measures of Type 2 thinking, namely, rethinking time and probability of changing answers. In contrast to the quality hypothesis, however, this rethinking time did not advantage the ability of the high-capacity group to produce normative answers, except for the base rate task. Indeed, we observed that the correlation between capacity and the probability of normative answers emerged at the initial response, rather than after rethinking. (shrink)

In this paper we develop a general theory of algorithmic fairness. Drawing on Johnson King and Babic’s work on moral encroachment, on Gary Becker’s work on labor market discrimination, and on Strawson’s idea of resentment and indignation as responses to violations of the demand for goodwill toward oneself and others, we locate attitudes to fairness in an agent’s utility function. In particular, we first argue that fairness is a matter of a decision-maker’s relative concern for the plight of people (...) from different groups, rather than of the outcomes produced for different groups. We then show how an agent’s preferences, including in particular their attitudes to error, give rise to their decision thresholds. Tying these points together, we argue that the agent’s relative degrees of concern for different groups manifest in a difference in decision thresholds applied to these groups. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Philosophy and Literature 26.2 (2002) 432-442 [Access article in PDF] The Legacy of the Enlightenment James Schmidt What's Left of Enlightenment? A Postmodern Question, edited by Keith Michael Baker and Peter Hanns Reill; ix & 203 pp. Stanford, California: Stanford University Press, $45.00 cloth, $19.95 paper. Postmodernism and the Enlightenment: New Perspectives in Eighteenth-Century French Intellectual History, edited by Daniel Gordon; vi & 227 pp. New York: Routledge, 2001, (...) $80.00 cloth, $22.95 paper. IF THE ENLIGHTENMENT did not exist, postmodernists would have had to invent it. It performs the same function, Daniel Gordon argues in his introduction to Postmodernism and the Enlightenment, that the Ancien Regime did for the French revolutionaries: as the "other of postmodernism," it represents "the modern that postmodernism revolts against" (P&E, p. 1). Indeed, the image of the Enlightenment that emerges from the postmodern critique does seem, in large part, to be an invention. As Keith Michael Baker and Peter Hanns Reill suggest in the introduction to their collection What's Left of Enlightenment? the various strands of thought commonly grouped under the label postmodernism "have at least one thing in common": "they all depend upon a stereotyped, even caricatural, account of the Enlightenment" which sees the Enlightenment as the point of origin for the "rationalism, instrumentalism, scientism, logocentrism, universalism, abstract rights, eurocentrism, individualism, humanism, masculinism, etc." that [End Page 432] defines the modernity which postmodernity hopes to supersede (WLE? p. 1).One consequence of the inclination to trace the origin of the various failings of modernity to the Enlightenment is that arguments about the "legacy of the Enlightenment" tend to get out of hand. In a particularly sharp-sighted contribution to the Baker and Reill collection David Hollinger notes that it is all too easy for a critic of Enlightenment to argue that "I'm hot stuff because I'm not only refuting you, my puny opponent, but... every great thinker from Descartes to Popper," and, conversely, all too enticing for those who have been criticized to counter, "watch out, you think you are arguing only against me, but the implications of your reasoning are to deny the common sense of every humane and rational mind since the seventeenth century" (WLE? p. 9). Historians of the eighteenth century have been curiously reluctant to join this battle and have, for the most part, left the field to philosophers, literary scholars, and political theorists (WLE? pp. 17-18; P&E, p. 3). The intent of the two collections reviewed here is to remedy this situation by setting a group of historians to work scrutinizing differing aspects of the postmodernist critique of the Enlightenment. More often than not, the results are quite rewarding, though the question of the relationship between postmodernism and the Enlightenment remains, in the end, somewhat ambiguous.The scope of these two volumes is quite impressive. Baker and Reill's collection opens with essays by David Hollinger and Richard Rorty (one of the two nonhistorians invited to the festivities) offering contrasting characterizations of the relationship of postmodernism and the Enlightenment. It continues with a discussion of a few important interpretations of the Enlightenment (including articles by Jonathan Knudsen on German historicism, Hans Sluga on Heidegger, Johnson Kent Wright on Cassirer, and Michael Meranze on Foucault) and concludes with essays by Lorraine Daston ("Enlightenment Fears, Fears of Enlightenment"), Dena Goodman (on gender difference in the Enlightenment), and Lawrence Klein (on the idea of "conversation" in the Enlightenment) that seek, in differing ways, to reveal "the existence within the Enlightenment of elements frequently seen as characteristic of Postmodernity itself" (WLE? p. 3).Gordon's volume offers a counterpoint to the final part of Baker and Reill's collection: each of its nine essays is intended as confrontation between a postmodernist characterization of a particular aspect of the Enlightenment and an account of "how the theme really operates in [End Page 433] Enlightenment thought" (P&E, p. 5). Thus Malick W. Ghachem examines how Montesquieu's account of law was applied to French colonies in the Caribbean, Arthur Goldhammer discusses Diderot's view of language, Daniel Rosenberg... (shrink)

In the Platonic work Alcibiades I, a divinely guided Socrates adopts the guise of a lover in order to divert Alcibiades from an unthinking political career. The contributors to this carefully focussed volume cover aspects of the background to the work; its arguments and the philosophical issues it raises; its relationship to other Platonic texts, and its subsequent history up to the time of the Neoplatonists. Despite its ancient prominence, the authorship of Alcibiades I is still unsettled; the essays and (...) two appendices, one historical and one stylometric, come together to suggest answers to this tantalising question. (shrink)

SummaryThe Gainj of highland Papua New Guinea do not use contraception but have a total fertility rate of only 4·3 live births per woman, one of the lowest ever recorded in a natural fertility setting. From an analysis of cross-sectional demographic and endocrinological data, the causes of low reproductive output have been identified in women of this population as: late menarche and marriage, a long interval between marriage and first birth, a high probability of widowhood at later reproductive ages, low (...) effective fecundability and prolonged lactational amenorrhoea. These are combined with near-universal marriage, a low prevalence of primary sterility and a pattern of onset of secondary sterility similar to that found in other populations. Of all the factors limiting fertility, by far the most important are those involved in birth spacing, especially lactational amenorrhoea. (shrink)

[Open access] In this book symposium the author takes up questions from phenomenology, hermeneutics, ethical theory, and intellectual history raised by a group of scholarly interlocutors from a range of backgrounds. In the course of engaging with these issues, he discusses, inter alia, McDowell’s realism, Jonathon Lear’s work on the end of a world, Michael Oakeshott’s view of selfhood, Heidegger’s conception of Jemeinigkeit, Uexküll’s notion of Umwelt, and Gadamer’s hermeneutic conception of truth.

The communicative theory of emotions postulates that emotions are communications both within the brain and between individuals. Basic emotions owe their evolutionary origins to social mammals, and they enable human beings to use repertoires of mental resources appropriate to recurring and distinctive kinds of events. These emotions also enable them to cooperate with other individuals, to compete with them, and to disengage from them. The human system of emotions has also grafted onto basic emotions propositional contents about the cause of (...) the emotion, the self, and other matters. Complex emotions always contain such contents, whereas basic emotions can be experienced without them. This article explains the role of basic emotions in social relationships, their effects on reasoning, and their pathology in psychological illness, such as depression and obsessive-compulsive disorder. (shrink)

The prevailing “segregated model” for understanding clinical research sharply separates it from clinical care and subjects it to extensive regulations and guidelines. This approach is based on the fact that clinical research relies on procedures and methods—research biopsies, blinding, randomization, fixed treatment protocols, placebos—that pose risks and burdens to participants in order to collect data that might benefit all patients. Reliance on these methods raises the potential for exploitation and unfairness, and thus points to the need for independent ethical review (...) and more extensive informed consent. In contrast, it is widely assumed that clinical care does not raise these ethical concerns because it is designed to promote the best interests of individual patients. The segregation of clinical research from clinical care has been largely effective at protecting research participants. At the same time, this approach ignores the fact that several aspects of standard clinical care, such as clinician training and scheduling, also pose some risks and burdens to present patients for the benefit of all patients. We argue that recently proposed learning health care systems offer a way to address this concern, and better protect patients, by developing integrated review and consent procedures. Specifically, current approaches base the need for independent ethical review and more extensive informed consent on whether an activity is categorized as clinical research or clinical care. An ethically sounder approach, which could be incorporated into learning health care systems, would be to base the need for independent ethical review and more extensive informed consent on the extent to which an activity poses risks to present patients for the benefit of all patients. (shrink)

This paper responds to Philipona & O’Regan (2006), which attempts to account for certain color phenomena by appeal to singularities in the space of “accessible information” in the light striking the retina. Three points are discussed. First, it is unclear what the empirical significance/import is of the mathematical analysis of the data regarding the accessible information in the light. Second, the singularity index employed in the study is both mathematically and empirically faulty. Third, the connection drawn between their findings and (...) some data from the World Color Survey is lacking in quantitative analysis in places where it is needed. The difficulties raised prevent Philipona & O’Regan’s conclusions from being accepted. (shrink)

In this paper, we will explore one way in which understanding can—and, we will argue, should—be valuable. We will do this by drawing on what has been said about the different ways knowledge can be valuable. Our main contribution will be to identify one heretofore undiscussed way knowledge could be valuable, but isn’t—specifically, having value to someone other than the understander. We suggest that it is a desideratum on an account of understanding that understanding have the specified type of value; (...) our basis for this claim will come from recent work in cognitive psychology. This desideratum can then be used to measure the success of various accounts of understanding. We argue that accounts of understanding that have a particular structure will predict why understanding has that sort of value. For good measure, we then engage in a bit of a literature review, investigating which extant accounts of understanding satisfy this desideratum. (shrink)

The American Journal of Bioethics, Volume 11, Issue 12, Page 1, December 2011.

The American Journal of Bioethics, Volume 11, Issue 8, Page 2-5, August 2011.