In Kidney for Sale by Owner: Human Organs, Transplantation, and the Market, I argued that the market is the most efficient and effective—and morally justified—means of procuring and allocating human organs for transplantation. This special issue of The Journal of Medicine and Philosophy publishes several articles critical of this position and of my arguments mustered in its support. In this essay, I explore the core criticisms these authors raise against my conclusions. I argue that clinging to comfortable, but unfounded, notions (...) that human body parts are not commodities, that the physician-patient relationship transcends commercial practices, and that medicine rises above market-place morality (where “market-place morality” is presented rhetorically as a criticism) leads to a real failure adequately to appreciate the complex reality of modern medicine. Denying the illicit moral intuitions that commodification of body parts is immoral or that it necessarily violates human dignity would benefit donors and recipients alike, while also reinforcing virtuous transplantation practice and policy. Honestly acknowledging the medical marketplace would shed light on what is often a hazy and shrouded policy setting. At stake is not solely the efficiency of procuring human organs for transplantation but also the recognition of the moral authority of persons over themselves. (shrink)

The Geological Society of London was the first learned society to be devoted solely to geology, and its members were responsible for much of the spectacular progress of the science in the nineteenth century. Its distinctive character as a centre of geological discussion and research was established within the first five years from its foundation in 1807. During this period its activities were directed, and its policies largely shaped, by its President, George Bellas Greenough, on whose unpublished papers this account (...) is chiefly based.The Society began as a small scientific dining club in London, but it developed rapidly into a learned society with a nation-wide membership. It became so independent in outlook and so active in research that it was felt to threaten the esteem of the Royal Society; and little more than a year after its foundation it clashed with the Royal Society so violently that its continued existence was for a time uncertain.Its development into a large independent society was the outcome of its ‘Baconian’ view of the importance of collecting geological facts as a surer basis for geological theories. For this purpose it initiated an ambitious scheme for co-operative research, which would unite the efforts of ‘philosophers’ with those of ‘practical men’. Only personal reasons seem to have kept the most prominent of the practical men—William Smith—from co-operating with the Society. (shrink)

As a first comment it should not be taken that we have any argument against the consistency of Mellor’s actualist version of the B-theory. Not only have we no argument; we hold that Mellor’s position is consistent. As far as logic goes we believe that you can translate A into B, and B into A. Mellor takes a quotation from our article as endorsing the policy of doing for time just what you do for modality, and vice versa, and it (...) is true that you can take our sentence that way. It is also true that we are sympathetic to an equal treatment of these two, but it is important to acknowledge that nothing in the logic forces you to do this. In particular, we agree with Mellor that practically no one treats space in an A-theory manner – even though it is logically consistent to do so. Our concern is solely with Mellor’s argument that a certain position in the temporal case is inconsistent where the analogous modal position is not. And our paper is addressed not so much to Mellor’s own position as to an A-theorist who wants to escape the consequences of Mellor’s argument by doing for time what Mellor does for modality. In fact, there is a position against which Mellor’s argument is successful. As far as we can tell the version we shall present is, if not precisely what Mellor has in mind, close to it, or at least sufficiently like it to illustrate his reply in a form in which we are able to comment on it. Mellor’s example is of Jim who …. (shrink)

Africa’s current socio-economic predicament is often solely attributed to political and economic mismanagement. However, such an analysis is far from comprehensive, as it fails to account for the historical, sociological and psychological causes of the current unsatisfactory social conditions in the continent. Consequently, using the critical and prescriptive techniques of philosophic reflection, this paper examines four apparent mental impediments to desirable social transformation in contemporaryAfrica, namely, conservatism, feeble social consciousness, blind acceptance of the white-black dichotomy, and a fixation with foreign (...) paradigms of managing public affairs. The paper calls for an interdisciplinary approach to the verifying, mitigating and/or eliminating of these impediments. (shrink)

Overview -/- Most philosophical explorations of responsibility discuss the topic solely in terms of metaphysics and the "free will" problem. By contrast, these essays by leading philosophers view responsibility from a variety of perspectives—metaphysics, ethics, action theory, and the philosophy of law. After a broad, framing introduction by the volume's editors, the contributors consider such subjects as responsibility as it relates to the "free will" problem; the relation between responsibility and knowledge or ignorance; the relation between causal and moral responsibility; (...) the difference, if any, between responsibility for actions and responsibility for omissions; the metaphysical requirements for making sense of "collective" responsibility; and the relation between moral and legal responsibility. (shrink)

The handicap principle is one of the most influential ideas in evolutionary biology. It asserts that when there is conflict of interest in a signaling interaction signals must be costly in order to be reliable. While in evolutionary biology it is a common practice to distinguish between indexes and fakable signals, we argue this dichotomy is an artifact of existing popular signaling models. Once this distinction is abandoned, we show one cannot adequately understand signaling behavior by focusing solely on cost. (...) Under our reframing, cost becomes one—and probably not the most important—of a collection of factors preventing deception. (shrink)

Health care has become increasingly patient-centred and medical guidelines are considered to be one of the instruments that contribute towards making it so. We reviewed the literature to identify studies on this subject. Both normative and empirical studies were analysed. Many studies recommend active patient participation in the process of guideline development as the instrument to make guidelines more patient-centred. This is done on the assumption that active patient participation will enhance the quality of the guidelines. We found no empirical (...) evidence, however, to support this assumption. Moreover, the studies show that patients experience several difficulties in the participation process, which cannot solely be traced back to flawed practices. Given this poor track record we conclude that the plea to actively involve patients in the guideline development process should be reconsidered. (shrink)

This paper will discuss the origin of the human mind, and the qualitative discontinuity between human and animal cognition. We locate the source of this discontinuity within the language faculty, and thus take the origin of the mind to depend on the origin of the language faculty. We will look at one such proposal put forward by Hauser et al. (Science 298:1569-1579, 2002), which takes the evolution of a Merge trait (recursion) to solely explain the differences between human and animal (...) cognition. We argue that the Merge-only hypothesis fails to account for various aspects of the human mind. Instead we propose that the process of lexicalisation is also unique to humans, and that this process is key to explaining the vast qualitative differences. We will argue that lexicalisation is a process through which concepts are reformatted to be able to take on semantic features and to take part in grammatical relations. These are both necessary conditions for a grammatical mind and the increased ability to express conceptual content. We therefore propose a possible explanans for the discontinuity between humans and animals, namely that merge with lexicalisation (and consequently semantic features and grammatical relations) is a minimal requirement for the human mind. (shrink)

Background Empirical studies of surrogate decision-making tend to assume that surrogates should make only a 'substituted judgement'—that is, judge what the patient would want if they were mentally competent. Objectives To explore what people want in a surrogate decision-maker whom they themselves select and to test the assumption that people want their chosen surrogate to make only a substituted judgement. Methods 30 undergraduate students were recruited. They were presented with a hypothetical scenario about their expected loss of mental capacity in (...) the future and asked to answer some questions about their choice of surrogate. These data were analysed qualitatively using thematic content analysis. Results Most respondents talked about choosing someone who was caring and competent in certain ways, giving interesting evidence for their judgements. Surprisingly few highlighted how well they thought their chosen surrogate knew their preferences and would be able to make a substituted judgement. Moreover, few specified that their chosen surrogate had similar attitudes and values to their own and so would make a similar decision to theirs in the circumstances presented. Some respondents also referred to the social role of their chosen surrogate or the social dynamics of their situation which influenced their choices, as well as to ideas of reciprocity and characteristics of honesty and loyalty. Conclusion In the event that they lose mental capacity, many people will not select a surrogate to decide about medical treatments on their behalf solely on the basis that they expect their surrogate to make a substituted judgement. (shrink)

The Bohr-Heisenberg scheme, which forms the basis of any current version of the standard or Copenhagen interpretation of quantum mechanics, is shown to be internally inconsistent. Although the inconsistencies demonstrated here are directly relatable to Einstein's opinion that it is unsatisfactory to interpret physical theory solely in terms of the knowledge gained from experimental outcomes, it is nevertheless shown that Einstein's view requires important modification. The implications of the Bohr-Heisenberg schem's self-inconsistency are discussed in relation to Bell's theorem and Aspect's (...) experiments. (shrink)

Standard models of cognition are built from abstract, amodal, arbitrary symbols, and the meanings of those symbols are given solely by their interrelations. The target article (Glenberg 1997t) argues that these models must be inadequate because meaning cannot arise from relations among abstract symbols. For cognitive representations to be meaningful they must, at the least, be grounded; but abstract symbols are difficult, if not impossible, to ground. As an alternative, the target article developed a framework in which representations are grounded (...) in perception and action, and hence are embodied. Recent work (Glenberg & Robertson 1999; 2000; Glenberg & Kaschak 2002; Kaschak & Glenberg 2000) extends this framework to language. (shrink)

In the 4 1/2 to 5 days between fertilization and implantation, the mouse conceptus must gain the abilities to implant and produce an embryo. Each of these is the sole developmental responsibility of one of two cell types forming the blastocyst, trophectoderm and inner cell mass (ICM), respectively. Trophectoderm is a polarized transporting epithelium while the ICM is an aggregate of non‐epithelial pluripotent stem cells. These two cell types originate from the division of polar blastomeres when their cleavage furrows (...) parallel their apical surfaces. Blastomeres polarize in response to asymmetric cell–cell contact, and understanding the mechanism of this induction is regarded as the key to understanding the origin of trophectoderm and ICM. Here we propose a model based on transcellular ion current loops for the induction of cell polarity during the development of the first epithelium, trophectoderm. (shrink)

BackgroundResponsive neurostimulation has been utilized as a treatment for intractable epilepsy. The RNS System delivers stimulation in response to detected abnormal activity, via leads covering the seizure foci, in response to detections of predefined epileptiform activity with the goal of decreasing seizure frequency and severity. While thalamic leads are often implanted in combination with cortical strip leads, implantation and stimulation with bilateral thalamic leads alone is less common, and the ability to detect electrographic seizures using RNS System thalamic leads is (...) uncertain.ObjectiveThe present study retrospectively evaluated fourteen patients with RNS System depth leads implanted in the thalamus, with or without concomitant implantation of cortical strip leads, to determine the ability to detect electrographic seizures in the thalamus. Detailed patient presentations and lead trajectories were reviewed alongside electroencephalographic analyses.ResultsAnterior nucleus thalamic leads, whether bilateral or unilateral and combined with a cortical strip lead, successfully detected and terminated epileptiform activity, as demonstrated by Cases 2 and 3. Similarly, bilateral centromedian thalamic leads or a combination of one centromedian thalamic alongside a cortical strip lead also demonstrated the ability to detect electrographic seizures as seen in Cases 6 and 9. Bilateral pulvinar leads likewise produced reliable seizure detection in Patient 14. Detections of electrographic seizures in thalamic nuclei did not appear to be affected by whether the patient was pediatric or adult at the time of RNS System implantation. Sole thalamic leads paralleled the combination of thalamic and cortical strip leads in terms of preventing the propagation of electrographic seizures.ConclusionThalamic nuclei present a promising target for detection and stimulation via the RNS System for seizures with multifocal or generalized onsets. These areas provide a modifiable, reversible therapeutic option for patients who are not candidates for surgical resection or ablation. (shrink)

Technology transfer is a multi-level process of communication involving a variety of senders and receivers of ideas and materials. As a response to market failure, or as an effort to accelerate market-driven social change, technology transfer may combine public and private aparatus or rely solely on public institutional mechanisms to identify, develop, and deliver innovations and information. Technology transfer institutions include universities, government ministries, research institutes, and what may be termed the ‘project sector’. Four farm- and village-level change models are (...) considered: traditional community development, adoption-diffusion, training and Visit Extension, and Farming Systems Research. The challenges to technology transfer efforts center on developing indigenous capacity to generate and adapt agricultural technology to local conditions. This is the primary objective of technology transfer in agriculture and the basis for advancing rural development. (shrink)

Advance care directives for health care have been promoted as a way to improve end-of-life decision making. These documents allow a patient to state, in advance of incapacity, the types of medical treatments they would like to receive, to name a surrogate to make those decisions, or to do both. Although studies have shown that both physicians and patients generally have positive attitudes about the use of these documents, relatively few individuals have actually completed one.What underlies this discrepancy between attitudes (...) and behavior with regard to advance care directives? One obvious explanation is lack of access. Emanuel et al. estimated that approximately 90 percent of the population desire an advance care directive, and they pointed to access as the major barrier. Yet interventions that increase accessibility have typically failed to yield more than a 20 percent completion rate. Thus, it appears that access is not the sole determinant of advance care directive completion. (shrink)

This article discusses common ethical and practical considerations in psychosocial and behavioral research in healthcare. Issues such as appropriate objectives and intent, risk-benefit ratios, research design, and human subject protection are explored. The burden of ethical research design and implementation is placed on the investigator, rather than relying solely on institutional review boards to judge individual projects. The benefit of acquisition of knowledge must be balanced against the burdens of the research on society in general and human subjects specifically. Scientific (...) replication of research is encouraged, unnecessary duplication defined and discouraged, and benefits of true collaboration outlined. Investigators are advised to consider the context, intent, purpose, implementation, and use of information when developing research. The concept of “researcher myopia” is defined as a common stumbling block. It is suggested that academic researchers also look to other disciplines, such as industry, for examples of research that is concise, cost-effective, and reliable. (shrink)

This long-awaited book replaces Hughes and Cresswell's two classic studies of modal logic: _An Introduction to Modal Logic_ and _A Companion to Modal Logic_. _A New Introduction to Modal Logic_ is an entirely new work, completely re-written by the authors. They have incorporated all the new developments that have taken place since 1968 in both modal propositional logic and modal predicate logic, without sacrificing tha clarity of exposition and approachability that were essential features of their earlier works. The book takes (...) readers from the most basic systems of modal propositional logic right up to systems of modal predicate with identity. It covers both technical developments such as completeness and incompleteness, and finite and infinite models, and their philosophical applications, especially in the area of modal predicate logic. (shrink)

Expressions in a language, whether words, phrases, or sentences, have meanings. So it seems reasonable to suppose that there are meanings that expressions have. Of course, it is fashionable in some philosophical circles to deny this.

' I heartily recommend it to any philosopher of language interested in the issues. [] Logicians, of course, will want to savour the whole thing.' Australian Journal of Philosophy, 71:3 (1993).

Semantic Indexicality shows how a simple syntax can be combined with a propositional language at the level of logical analysis. It is the adoption of such a base language which has not been attempted before, and it is this which constitutes the originality of the book. Cresswell's simple and direct style makes this book accessible to a wider audience than the somewhat specialized subject matter might initially suggest.

Adverbial modification is probably one of the least understood areas of linguistics. The essays in this volume all address the problem of how to give an analysis of adverbial modifiers within truth-conditional semantics. Chapters I-VI provide analyses of particular modifiers within a possible worlds framework, and were written between 1974 and 1981. Original publication details of these chapters may be found on p. vi. Of these, all but Chapter I make essential use of the idea that the time reference involved (...) in tensed sentences should be a time interval rather than a single instant. The final chapter (Chapter VII) was written especially for this volume and investigates the question of how the 'situation semantics' recently devised by Jon Barwise and John Perry, as a rival to possible-worlds semantics, might deal with adverbs. In addition I have included an appendix to Chapter III and an introduction which links all the chapters together. (shrink)

Over a longer period than I sometimes care to contemplate I have worked on possible-worlds semantics. The earliest work was in modal logic, to which I keep returning, but a sabbatical in 1970 took me to UCLA, there to discover the work of Richard Montague in applying possible-worlds semantics to natural lan guage. My own version of this appeared in Cresswell (1973) and was followed up in a number of articles, most of which were collected in Cresswell (1985b). A central (...) problem for possible worlds semantics is how to accommodate propositional attitudes. This problem was addressed in Cresswell (1985a), and the three books mentioned so far represent a reasonably complete picture of my positive views on formal semantics. I have regarded the presentation of a positive view as more important than the criticism of alternatives, although the works referred to do contain many passages in which I have tried to defend my own views against those of others. But such criticism is important in that a crucial element in establishing the content of a theory is that we be able to evaluate it in relation to its com petitors. It is for that reason that I have collected in this volume a number of articles in which I attempt to defend the positive semantical picture I favour against objections and competing theories. (shrink)

The paper considers the question of when the operator L of necessity in modal logic can be expressed in terms of the operator meaning it is non-contingent that.

First published in 2002. Routledge is an imprint of Taylor & Francis, an informa company.

In this paper, I offer a view beyond that which would narrowly reduce the role of parents in medical decision making to acting as custodians of the best interests of children and toward an account of family authority and family autonomy. As a fundamental social unit, the good of the family is usually appreciated, at least in part, in terms of its ability successfully to instantiate its core moral and cultural understandings as well as to pass on such commitments to (...) future generations. The putative rights of children to expression, information, freedom of thought, conscience, religion, and to freedom of association with others are, in this essay, assessed from the perspective of those conditions necessary for the family to function as a moral community. In so doing, I respond to the move to liberate children from parental authority and to effect the transformation of the family as implied by the United Nations’ "Convention on the Rights of the Child" and the pediatric bioethics it supports. (shrink)

I distinguish between sentences like(1) Last Thursday we drove from Wellington to Waikanae and (2) Last Thursday my copy of Aspects of the Theory of Syntax remained on my bookshelf. Sentence (2) has the subinterval property. If it is true at an interval t it is true at every subinterval of t. (1) lacks this property. (1) reports an event. (2) reports a state. Events do not have the subinterval property but states do have it, and so do objects. If (...) something is a linguist at an interval t then that person is a linguist at all subintervals of t. I argue that exists applies to things which have the subdinterval property, and occurs applies to things which lack it. (shrink)

Two of the most fundamental questions about language are these: what are languages?; and, what is it to know a given language? Many philosophers who have reflected on these questions have presented answers that attribute a central role to conventions. In one of its boldest forms such a view runs as follows. Languages are either social entities constituted by networks of social conventions or abstract objects where when a particular community speaks a given language they do so in virtue of (...) the conventions operative within that community. Consequently, for an individual to know a given language is for them to be party to the relevant conventions. Call this view conventionalism. In this article my aim is to evaluate conventionalism. I will argue that although there are linguistic conventions and that they do play an important role in language development and communication conventionalism should be rejected in favour of a more psychologistically orientated position. (shrink)