Whipple disease is a rare, infectious, disease first described from a single case by Whipple in 1907. As well as characterising the clinical and pathological features of the condition, Whipple made two suggestions regarding its aetiology. These were either than the disease was caused by an infectious agent, or that it was of metabolic origin. As the disease is now thought to be caused by infection with the bacterium Tropheryma whipplei, historical reviews of the history of the disease typically mention (...) only the first of these suggestions. In this paper, we therefore revisit Whipple’s other theory. We argue that a diverse and often successful research programme was developed around this mechanism of disease causation which gave rise to many useful findings on the condition. In the later parts of this article, we then turn to discuss the surprising neglect of this period of Whipple disease research in the current literature, and conclude by offering a brief reconstruction of this early history suitable for use in a technical context. (shrink)

The epistemology of modality has focused on metaphysical modality and, more recently, counterfactual conditionals. Knowledge of kinds of modality that are not metaphysical has so far gone largely unexplored. Yet other theoretically interesting kinds of modality, such as nomic, practical, and ‘easy’ possibility, are no less puzzling epistemologically. Could Clinton easily have won the 2016 presidential election—was it an easy possibility? Given that she didn’t in fact win the election, how, if at all, can we know whether she easily could (...) have? This paper investigates the epistemology of the broad category of ‘objective’ modality, of which metaphysical modality is a special, limiting case. It argues that the same cognitive mechanisms that are capable of producing knowledge of metaphysical modality are also capable of producing knowledge of all other objective modalities. This conclusion can be used to explain the roles of counterfactual reasoning and the imagination in the epistemology of objective modality. (shrink)

Lack of guidance and regulation for authorizing medical cannabis for conditions involving the health and neurodevelopment of children is ethically problematic as it promulgates access inequities, risk-benefit inconsistencies, and inadequate consent mechanisms. In two virtual sessions using participatory action research and consensus-building methods, we obtained perspectives of stakeholders on ethics and medical cannabis for children and youth. The sessions focused on the scientific and regulatory landscape of medical cannabis, surrogate decision-making and assent, and the social and political culture of medical (...) cannabis. We found that evidence-gathering and data dissemination, pressures on clinical relationships, and the lack of integration of culturally diverse perspectives and Indigenous knowledges were key areas of concern. Participants emphasized the importance of utilizing adaptive study designs, highlighted the importance of trust-building between clinicians, patients and caregivers, and discussed barriers including historical and ongoing stigmatization of medical cannabis. We conclude that continued public consultation and strength-based research that integrate diverse perspectives are critical steps forward. (shrink)

Placing the question -- Patristic Precedents -- Moltmann's perichoretic spaces for God and creation -- No place for the spirit? Jean-Luc Marion's placial refusal -- Notes toward a Trinitarian theology of Place.

This article surveys recent developments in the epistemology of modality.

It is widely assumed that sense perception cannot deliver knowledge of nonactual (metaphysical) possibilities. We are not supposed to be able to know that a proposition p is necessary or that p is possible (if p is false) by sense perception. This paper aims to establish that the role of sense perception is not so limited. It argues that we can know lots of modal facts by perception. While the most straightforward examples concern possibility and contingency, others concern necessity and (...) impossibility. The possibility of a perceptual route to some modal knowledge is not as radical as it may at first sound. On the contrary, acknowledging it has benefits. (shrink)

This essay examines the work of Nancy Fraser and Seyla Benhabib, two philosophers who have demonstrated that feminist theorists can usefully draw upon both postmodernism and the critical theory tradition, with which Fraser and Benhabib are more clearly associated. I argue that each theorist claims the universal ideals and normative judgements of modernism, and the contextualism, particularity, and skepticism of postmodernism. I do this by revisiting each of their positions in the now well-known Feminist Contentions exchange, by examining the diverse (...) ways in which they reconcile universalism and difference, and by exploring each theorist's critique of the Habermasian public sphere. (shrink)

This paper examines "moderate modal skepticism", a form of skepticism about metaphysical modality defended by Peter van Inwagen in order to blunt the force of certain modal arguments in the philosophy of religion. Van Inwagen’s argument for moderate modal skepticism assumes Yablo's (1993) influential world-based epistemology of possibility. We raise two problems for this epistemology of possibility, which undermine van Inwagen's argument. We then consider how one might motivate moderate modal skepticism by relying on a different epistemology of possibility, which (...) does not face these problems: Williamson’s (2007: ch. 5) counterfactual-based epistemology. Two ways of motivating moderate modal skepticism within that framework are found unpromising. Nevertheless, we also find a way of vindicating an epistemological thesis that, while weaker than moderate modal skepticism, is strong enough to support the methodological moral van Inwagen wishes to draw. (shrink)

Developing a simple test to identify swiftly neonates with sepsis who carry the genetic variant which means that one dose of the recommended antibiotic, gentamicin, will cause the child to become profoundly deaf looks like an admirable objective. The baby needs antibiotics and needs them within 1 hour of admission to the neonatal intensive care unit. Conventional genetic tests take much longer to yield results. The test being trialled produces results in 25 min; a baby who carries the variant can (...) be treated with a different antibiotic. All the test requires is a gentle swab of the baby’s inner cheek. Babies can be treated for potentially fatal sepsis without the risk that the drugs designed to save their lives will cost them their hearing. Parents and healthcare staff are relieved of worry—a great idea? PALOH is not a trial of the safety or efficacy of the test, only to assess how feasible it will be to carry out this test in a busy NICU, without disrupting the care of the baby. A tiny painless ‘scrape’ will take a sample of DNA—what’s the fuss about? Several other invasive and painful procedures will be carried out without a fuss.1 The problem is DNA. Genetic information must be safeguarded from falling into the wrong hands. In section 45 of Human Tissue Act 2004, Parliament legislated to prohibit non-consensual DNA testing.1 It fits uncomfortably in a statute designed to regulate retention and uses of human material, after revelations that organs and tissue from the …. (shrink)

Over the past decade, we have witnessed some early signs of progress in the battle against international bribery and corruption, a problem that throughout the history of commerce had previously been ignored. We present a model that we then use to assess progress in reducing bribery. The model components include both hard law and soft law legislation components and enforcement and compliance components. We begin by summarizing the literature that convincingly argues that bribery is an immoral and unethical practice and (...) that the economic harm it causes falls most heavily on those least able to absorb it. The next section summarizes the main provisions of anti-bribery legislation including the Foreign Corrupt Practices Act (FCPA), the Organization for Eco nomic Development's Convention on Combating Bribery of Foreign Officials in International Business Transactions, the United Nations Convention Against Corruption and the laws of selected countries. We conclude this section with a discussion of the "moral imperialism" argument for not imposing Western laws and values on other cultures. The next section focuses on the roles played by NGOs including Transparency International (TI), the World Economic Forum (WEF), and the International Chamber of Commerce. We review trends in enforcement and prosecution, including a review of the United States' enforcement processes, mechanisms for cross-border legal assistance, a discussion of the distinctive nature of FCPA cases, and an assessment of what the future holds for enforcement. The final section focuses on compliance processes for corporations aimed at reducing the risk of FCPA and related violations. This section also addresses the ethics of gift giving and "grease" payments. The article concludes with a summary and suggestions for further research. Throughout the article, we reference important bribery cases and include comments from several authorities who are on the front lines of the battle against international bribery. (shrink)

The COVID-19 pandemic put a large burden on many healthcare systems, causing fears about resource scarcity and triage. Several COVID-19 guidelines included age as an explicit factor and practices of both triage and ‘anticipatory triage’ likely limited access to hospital care for elderly patients, especially those in care homes. To ensure the legitimacy of triage guidelines, which affect the public, it is important to engage the public’s moral intuitions. Our study aimed to explore general public views in the UK on (...) the role of age, and related factors like frailty and quality of life, in triage during the COVID-19 pandemic. We held online deliberative workshops with members of the general public. Participants were guided through a deliberative process to maximise eliciting informed and considered preferences. Participants generally accepted the need for triage but strongly rejected ‘fair innings’ and ‘life projects’ principles as justifications for age-based allocation. They were also wary of the ‘maximise life-years’ principle, preferring to maximise the number of lives rather than life years saved. Although they did not arrive at a unified recommendation of one principle, a concern for three core principles and values eventually emerged: equality, efficiency and vulnerability. While these remain difficult to fully respect at once, they captured a considered, multifaceted consensus: utilitarian considerations of efficiency should be tempered with a concern for equality and vulnerability. This ‘triad’ of ethical principles may be a useful structure to guide ethical deliberation as societies negotiate the conflicting ethical demands of triage. (shrink)

Challenges to the exercise of the basic socio-economic rights of half the global population give rise to some of the most pressing issues today. This timely book focuses on world poverty, providing a systematic exposition of the evolving legal responsibility of the international community of states to cooperate in addressing the structural obstacles that contribute to this injustice. This book analyzes the approach, contribution, and current limitations of the international law of human rights to the manifestations of world poverty, inviting (...) the reader to rethink human rights, and, in particular, the framing of responsibilities that are essential to their contemporary protection. (shrink)

Debates regarding clinical ethicists’ scope of practice are not novel and will continue to evolve. Rapid changes in healthcare delivery, outcomes, and expectations have necessitated flexibility in clinical ethicists’ roles whereby hospital-based clinical ethicists are expected to be woven into the institutional fabric in a way that did not exist in more traditional relationships. In this article we discuss three emerging roles: the ethicist embedded in the interdisciplinary team, the ethicist with an expanded educational mandate, and the ethicist as a (...) therapeutic presence in the patient care space. Such expanded capacities offer more robust, positive contributions to institutional culture, stakeholders’ relationships, and patient-centered care. (shrink)

Rousseau avait tout lieu, dans la controverse qui oppose au xviii e siècle partisans et pourfendeurs des voyages d’éducation, de prendre position contre ces voyages, suivant en cela les déclarations de Béat de Muralt, qu’il approuvait dans une large mesure. Nous constatons pourtant qu’en abordant « la question des voyages », l’auteur de l’Émile se voit obligé, tout en condamnant cette « mode », à la manière de Muralt, d’opérer un glissement théorique et de conférer à l’expérience du voyage, comme (...) expérience critique de la pluralité et de la liberté, une place essentielle dans son système, place rendue nécessaire par sa théorie des affects politiques. (shrink)

Emerging from the intersection of the virtual world with the real."--BOOK JACKET.

Miller synthesizes Karen Horney's model of submission, aggression and withdrawal, Jean Baker Miller's concept of relational being, Julia Kristeva's idea of psychic space, and Kelly Oliver's notions on social support to advance a penetrating analysis of the fiction of Paule Constant.

For healing the land and human relationships to land are a step toward healing a troubled relationship, borne of a history, which is painful for native people and shameful for settlers. Protection...

This exploratory study investigates the divergent ways that people make sense of their own charisma. Through in-depth, semi-structured qualitative interviews with people who self-identified as charismatic (_n_ = 11), findings reveal that self-identified charismatic people hold divergent views regarding (1) who they believe benefits from their charisma (self or others), (2) how they believe they came to be charismatic (developed or innate), (3) how they experience self-confidence (self-conscious or self-assured), and (4) how they manage rejection (preparation or resilience). Taken together, (...) these divergent views reflect at least two charisma profiles—what we term _opportunistic charisma_ (i.e., charisma employed for personal gain) and _humanistic charisma_ (i.e., charisma employed to empower others)—with implications for humanistic management theory and practice. (shrink)

Prisoners are legally categorized as a vulnerable group for the purposes of medical research, but their vulnerability is not limited to the research context. Prisoner-patients may experience lower standards of care, fewer options for treatment, violations of privacy, and the use of inappropriate surrogates as a result of their status. This case study highlights some of the ways in which a prisoner-patient’s vulnerable status impacted the care he received. The article argues the following: (1) Prisoner-patients are entitled to the same (...) quality of care as all other patients, and healthcare providers should be vigilant to ensure that the stigma of incarceration does not influence care decisions. (2) Options for treatment should reflect what is most medically appropriate in the hospital or other healthcare setting, even when not all treatments would be available in the correctional setting. (3) The presence of guards at the bedside requires that additional measures be taken to protect the privacy and confidentiality of prisoner-patients. (4) When endof-life decisions must be made for an incapacitated patient, prison physicians are not well placed to act as surrogate decision makers, which heightens the obligations of the healthcare professionals in the hospital to ensure an ethically supportable process and outcome. Therefore, healthcare professionals should provide extra protection for those prisoner-patients who do not have decision-making capacity, by utilizing a robust process for decision making such as those used for incapacitated patients without surrogates, rather than relying solely on prison physicians as surrogates. (shrink)

Displays of eye movements may convey information about cognitive processes but require interpretation. We investigated whether participants were able to interpret displays of their own or others' eye movements. In Experiments 1 and 2, participants observed an image under three different viewing instructions. Then they were shown static or dynamic gaze displays and had to judge whether it was their own or someone else's eye movements and what instruction was reflected. Participants were capable of recognizing the instruction reflected in their (...) own and someone else's gaze display. Instruction recognition was better for dynamic displays, and only this condition yielded above chance performance in recognizing the display as one's own or another person's. Experiment 3 revealed that order information in the gaze displays facilitated instruction recognition when transitions between fixated regions distinguish one viewing instruction from another. Implications of these findings are discussed. (shrink)

Thought experiments provide a conspicuous case study for epistemologists of the imagination. Galileo’s famous thought experiment about falling stones is a central example in the debate about how thought experiments in science work. According to a standard interpretation, the thought experiment poses a challenge to an Aristotelian principle about falling bodies that conceives of bodies in an extremely liberal way. This chapter argues that this interpretation is implausible and then shows how the thought experiment might present a challenge to a (...) principle that conceives of bodies in a less permissive, more plausible way. The new interpretation of the thought experiment relies on a distinction between two ways of imagining Galileo’s experiment, one of which requires Aristotelians to temporarily ignore their belief in the principle under challenge. It is suggested that the distinction tracks an increasingly familiar distinction among dual-process theories in psychology: ‘intuitive’ and ‘reflective’ imagination. In order for Aristotelians to appreciate the thought experiment’s challenge to their theory, they are expected to use their intuitive imagination and not just their reflective imagination. (shrink)

An increasing number of scientists and doctors are concerned that new laws are inhibiting ethical research. This paper argues that this is not the case. Laws do not inhibit medical progress. Misunderstanding the law may do so.

The basis for ‘sound’ medical opinion has moved from clinical opinion to evidence based research. This article will comment on the basis on which evidence in clinical medicine is collected and, indeed, what actually constitutes evidence. It is suggested that the definition of guidelines arising from evidence-based medicine may lead to false conclusion and, as noted by Sir Douglas Black, whilst ‘guidelines can of course be helpful in clear-cut situations; [but] these are the minority in actual practice’.

Sider (2011, 2013) proposes a reductive analysis of metaphysical modality—‘(modal) Humeanism’—and goes on to argue that it has interesting epistemological and methodological implications. In particular, Humeanism is supposed to undermine a class of ‘arguments from possibility’, which includes Sider's (1993) own argument against mereological nihilism and Chalmers's (1996) argument against physicalism. I argue that Sider's arguments do not go through, and moreover that we should instead expect Humeanism to be compatible with the practice of arguing from possibility in philosophy.

Editor's suggested further reading in BioEssaysA new paradigm in cell therapy for diabetes: Turning pancreatic α‐cells into β‐cells Abstract.

Assertions about metaphysical modality play central roles in philosophical theorizing. For example, when philosophers propose hypothetical counterexamples, they often are making a claim to the effect that some state of affairs is possible. Getting the epistemology of modality right is thus important. Debates have been preoccupied with assessing whether imaginability—or conceivability, insofar as it’s different—is a guide to possibility, or whether it is rather intuitions of possibility—and modal intuitions more generally—that are evidence for possibility claims. The dissertation argues that the (...) imagination plays a subtler role than the first view recognizes, and a more central one than the second view does. In particular, it defends an epistemology of metaphysical modality on which someone can acquire modal knowledge in virtue of having performed certain complex imaginative exercises. (shrink)

Scientific societies can play an important role in promoting ethical research practices among their members, and over the past two decades several studies have addressed how societies perform this role. This survey continues this research by examining current efforts by scientific societies to promote research integrity among their members. The data indicate that although many of the societies are working to promote research integrity through ethics codes and activities, they lack rigorous assessment methods to determine the effectiveness of their efforts.