Once upon a time, medicine dismissed narrative as unimportant and uninteresting. Then, in the late 1980s, physicians and scholars became interested in how the study of narrative could enhance our understanding of illness and health care, and the field that came to be known as “narrative medicine” developed. Some of this scholarly activity focused on the idea of narrative ethics.After a flurry of activity around the turn of the twenty‐first century, narrative ethics seemed to stall. The general interest in narrative (...) in medicine continued but with few new ideas on how one might use narrative toward ethical ends. In the last few years, however, forward momentum has returned. The timing seems appropriate, therefore, for a “state of the field” report of sorts. (shrink)

The anecdotal and historical literature describing intoxication in elephants from fermented fruit or alcoholic beverages is reviewed. Seven African elephants readily self-administered 7% unflavored alcohol solutions; the results included separation from herd groupings and changes in the frequency and/or duration of several behaviors as scored according to a quantitative observational system. Alcohol decreased feeding, drinking, bathing, and exploration for most animals. Inappropriate behaviors such as lethargy and ataxia increased for all elephants. Results are discussed in terms of stress-induced drinking and (...) intoxication. (shrink)

Computer technology as well as the need to conduct research in primary care settings, has stimulated the creation in the U.S. of information networks linking private physicians' offices and other primary care practice sights. These networks give rise to several problems which have philosophic interest. One is a numerator problem created by the difficulty in primary care of using the more complicated or invasive diagnostic technologies commonly employed in tertiary care research. Another is a denominator problem arising from the difficulties (...) in determining which and how many patients constitute the population from which a practice is drawn. Finally, this mode of research raises questions about the social construction of medical reality and how objective medical truth is actually based on carefully selected patient experience. All these questions combine to challenge the gold standard view on medical research: the idea that some sorts of medical knowledge are epistemologically privileged and can serve as a bench-mark to determine whether new data are valid. (shrink)

Based on the existence of polysemy (e.g., lunch can refer to both food and events), it is argued that central tenets of externalist semantics and Fodorian concept atomism, an externalist theory on which words lack semantic structure, are unsound. We evaluate the premise that these arguments rely on—that polysemous words have separate, finer‐grained senses. We survey the evidence across psychology and linguistics and argue that it shows that polysemy does not exist, at least not in this “sense”. The upshot is (...) that if polysemy does not exist, it cannot pose a problem for atomism or externalism. (shrink)

Restraint as an intervention in the management of acute mental distress has a long history that predates the existence of psychiatry. However, it remains a source of controversy with an ongoing debate as to its role. This article critically explores what to date has seemingly been only implicit in the debate surrounding the role of restraint: how should the concept of validity be interpreted when applied to restraint as an intervention? The practice of restraint in mental health is critically examined (...) using two post-positivist constructions of validity, the pragmatic and the psychopolitical, by means of a critical examination of the literature. The current literature provides only weak support for the pragmatic validity of restraint as an intervention and no support to date for its psychopolitical validity. Judgements regarding the validity of any intervention that is coercive must include reference to the psychopolitical dimensions of both practice and policy. (shrink)

How did one of the greatest Jewish thinkers of the 20th century grapple with the founding of Israel and the Israeli-Palestinian conflict—one of the most significant political conflicts of his time? Samuel Hayim Brody traces the development of Martin Buber's thinking and its implications for the Jewish religion, for the problems posed by Zionism, and for the Zionist-Arab conflict. Beginning in turbulent Weimar Germany, Brody shows how Buber's debates about Biblical meanings had concrete political consequences for anarchists, socialists, Zionists, Nazis, (...) British, and Palestinians alike. Brody further reveals how Buber's passionate commitment to the rule of God absent an intermediary came into conflict in the face of a Zionist movement in danger of repeating ancient mistakes. Brody argues that Buber's support for Israel stemmed from a radically rich and complex understanding of the nature of the Jewish mission on earth that arose from an anarchist reading of the Bible. (shrink)

2020 Gradiva Award Nominee, Best Edited Book Psychoanalytic Perspectives on Women and Their Experience of Desire, Ambition and Leadership considers how these factors can be understood, nurtured, or thwarted and the subsequent impact on women's identity, authority and satisfaction. Psychoanalysis has long struggled with its ideas about women, about who they are, how to work with them, and how to respect and encourage what women want. This book argues that psychoanalytic theory and practice must evolve to maintain its relevance in (...) a volatile landscape. Each section of the book begins with a chapter that reviews contemporary ideas regarding women, as well as psychoanalytic history, gender bias, and societal norms and deficits. Three composite clinical stories allow our distinguished contributors to discuss the contexts within which individual experience can be affected, and the role that clinical work may have to mobilize and advance passion and vitality. In their discussions, the interplay of clinical psychoanalysis, sociopolitical context, and understanding of gender, combine to offer a unique perspective, built on decades of scholarship, personal experience, and clinical expertise. Psychoanalytic Perspectives on Women and Their Experience of Desire, Ambition and Leadership will serve as a reference for all psychoanalysts and psychoanalytic psychotherapists as well as gender studies scholars interested in the progress of psychoanalytic theory regarding women in the 21st century. Contributors to this book include: Rosemary Balsam, Brenda Bauer, Andrea Celenza, Diane Elise, Adrienne Harris, Dorothy Holmes, Nancy Kulish, Vivian Pendar, Dionne Powell, and Arlene Richards. (shrink)

The focus of this paper is the syntax of inverse scope in Hungarian, a language that largely disambiguates quantifier scope at spell-out. Inverse scope is attributed to alternate orderings of potentially large chunks of structure, but with appeal to base-generation, as opposed to nonfeature-driven movement as in Kayne 1998. The proposal is developed within mirror theory and conforms to the assumption that structures are antisymmetrical. The paper also develops a matching notion of scope in terms of featural domination, as opposed (...) to c-command, and applies it to otherwise problematic cases of pied piping. Finally, the interaction of different quantifier types is examined and the patterns are explained invoking morphological considerations on one hand and A-bar reconstruction on the other. (shrink)

section 1. Medical ethics -- section 2. Technology -- section 3. Social and business issues -- section 4. Ritual -- section 5. Women -- section 6. Israel -- section 7. Kashrut -- section 8. Jewish identity and marriage -- section 9. Shabbat and holiday.

Among those who criticize the concept of a common refrain is that we really have no idea what futility means. For example, physicians seem to disagree on whether a treatment being futile means that it has a less than 5% chance of working or a 20% chance of working. If the concept is so unclear, then it seems a thin reed upon which to base a momentous ethical decision—namely, that the physician's judgment should be allowed to override the wishes of (...) the competent patient or the patient's duly appointed surrogate. (shrink)

The human labor and animal inputs required to manufacture meat products are kept physically and symbolically distanced from the consumer. Recently however, meatpacking plants received significant news media attention when they emerged as hotpots for COVID-19 — threatening workers’ health, requiring plants to slow production, and forcing farmers to euthanize livestock. In light of these disruptions, this research asks: how did news media frame the impact of COVID-19 on the meat industry, and to what extent is a process of _defetishization_ (...) observed? Examining a sample of 230 news articles from coverage of US meatpacking plants and COVID-19 in 2020, I find that news media largely attributes the cause for the spread of COVID-19 in meatpacking plants to the history of exploitative working conditions and business practices of the meat industry. By contrast, the solutions offered to address these problems aim at alleviating the immediate obstacles posed by the pandemic and returning to, rather than challenging, the status quo. These short-run solutions for complex issues demonstrate the constraints in imagining alternatives to a problem rooted in capitalism. Furthermore, my analysis shows that animals are only made visible in the production process when their bodies become a waste product. (shrink)

Research on ethical issues within food systems is often human-centric. As a consequence, animal-centric policy debates where regulatory decisions about food are being made tend to be overlooked by food scholars and activists. This absence was notable in the recent debates around Australia’s animal live export industry. Using Foucault’s tools, we explore how ‘food security’ is conceptualised and governed within animal cruelty policy debates about the live export trade. The problem of food security produced in these debates shaped Indonesians as (...) ‘victims’ of food insecurity due to the nation’s inability to produce sufficient quantities of protein. This understanding of the problem reproduced the dominant framing of food security as a problem for developing countries addressed by increasing global food production. The underlying premise uncritically accepted in Australia’s debates on live export trade was that intensive animal agriculture, and Australia’s live export trade specifically, were essential to alleviating global food insecurity. Drawing on our findings, we show how dominant representations of ‘food security’, and related regulatory and technological trajectories, flourish where alliances between animal and food activists, scholarship, and movements are weak. Accordingly, we argue for agri-food scholars to take up opportunities to contribute to the policy discussions about the treatment of animals to effectively expand the kinds of problems, solutions, and strategies of resistance produced in the discourses surrounding food system issues. (shrink)

All treatments, even those labeled as supportive, have burdens as well as benefits. Patients and their surrogates have the right to finally decide whether the offered treatment's cost-benefit calculation is acceptable.

In recent years, bioethics has increasingly become an international area of inquiry with major contributions being made not only in North America but also in Europe and in the Pacific Rim countries. This general observation is particularly true for research ethics. Little attention has been paid, however, to this internationalization of bioethics in general and research ethics in particular, and there are few studies comparing what has emerged in the different countries.

An individual's health, genetic, or environmental-exposure data, placed in an online repository, creates a valuable shared resource that can accelerate biomedical research and even open opportunities for crowd-sourcing discoveries by members of the public. But these data become “immortalized” in ways that may create lasting risk as well as benefit. Once shared on the Internet, the data are difficult or impossible to redact, and identities may be revealed by a process called data linkage, in which online data sets are matched (...) to each other. Reidentification, the process of associating an individual's name with data that were considered deidentified, poses risks such as insurance or employment discrimination, social stigma, and breach of the promises often made in informed-consent documents. At the same time, re-ID poses risks to researchers and indeed to the future of science, should re-ID end up undermining the trust and participation of potential research participants. The ethical challenges of online data sharing are heightened as so-called big data becomes an increasingly important research tool and driver of new research structures. Big data is shifting research to include large numbers of researchers and institutions as well as large numbers of participants providing diverse types of data, so the participants’ consent relationship is no longer with a person or even a research institution. In addition, consent is further transformed because big data analysis often begins with descriptive inquiry and generation of a hypothesis, and the research questions cannot be clearly defined at the outset and may be unforeseeable over the long term. In this article, we consider how expanded data sharing poses new challenges, illustrated by genomics and the transition to new models of consent. We draw on the experiences of participants in an open data platform—the Personal Genome Project—to allow study participants to contribute their voices to inform ethical consent practices and protocol reviews for big-data research. (shrink)

A social study of "An essay concerning human understanding." Includes bibliographical references and index.

This chapter contains sections titled: Of Greek Gods, the Judaeo‐Christian God, and the Sea A Ship Bound for India Beyond the Pillars of Hercules.

Smith, Glass, and Miller have reported a meta-analysis of over 500 studies comparing some form of psychological therapy with a control condition. They report that when averaged over all dependent measures of outcome, psychological therapy is. 85 standard deviations better than the control treatment. We examined the subset of studies included in the Smith et al. metaanalysis that contained a psychotherapy and a placebo treatment. The median of the mean effect sizes for these 32 studies was. 15. There was a (...) nonsignificant inverse relationship between mean outcome and the following: sample size, duration of therapy, use of measures of outcome other than undisguised self-report, measurement of outcome at follow-up, and use of real patients rather than subjects solicited for the purposes of participation in a research study. A qualitative analysis of the studies in terms of the type of patient involved indicates that those using psychiatric outpatients had essentially zero effect sizes and that none using psychiatric inpaticnts provide convincing evidence for psychotherapeutic effectiveness. The onty studies clearly demonstrating significant effects of psychotherapy were the ones that did not use real patients. For the most part, these studies involved small samples of subjects and brief treatments, occasionally described in quasibeliavioristic language. It was concluded that for real patients there is no evidence that the benefits of psychotherapy are greater than those of placebo treatment. (shrink)

I am grateful to Drs. Richard Bukata and Jerome Hoffman and the staff of Primary Care Medicals for retrieving and analyzing some of the references used in this paper.

We argue that the interaction of biased media coverage and widespread employment of the recognition heuristic can produce epistemic injustices. First, we explain the recognition heuristic as studied by Gerd Gigerenzer and colleagues, highlighting how some of its components are largely external to, and outside the control of, the cognitive agent. We then connect the recognition heuristic with recent work on the hypotheses of embedded, extended, and scaffolded cognition, arguing that the recognition heuristic is best understood as an instance of (...) scaffolded cognition. In section three, we consider the double-edged sword of cognitive scaffolding. On the one hand, scaffolds can reduce the internal processing demands on cognitive agents while increasing their access to information. On the other hand, the use of scaffolding leaves cognitive agents increasingly vulnerable to forming false beliefs or failing to form beliefs at all about particular topics. With respect to the recognition heuristic, agents rely on third parties (such as the media) to report not just what’s true but also what’s important or valuable. This makes cognitive agents relying on these third parties vulnerable to two erroneous influences: 1) because they don’t recognize something, it isn’t important or valuable, and 2) because they do recognize something, it is important or valuable. Call the latter the Kardashian Inference and the former the Darfur Inference. In section four, we use Fricker’s (2007) concept of epistemic injustice to characterize the nature and harm of these false inferences, with special emphasis on the Darfur Inference. In section five, we use data-mining and an empirical study to show how Gigerenzer’s population estimation task is liable to produce Darfur Inferences. We conclude with some speculative remarks on more important Darfur Inferences, and how to avoid them by scaffolding better. One primary way to accomplish this it to shift the burden of embodying the virtue of epistemic justice from the hearer or consumer of media to the media themselves. (shrink)

Cosmetic surgery is a fast-growing medical practice. In 1997 surgeons in the United States performed the four most common cosmetic procedures443,728 times, an increase of 150% over the comparable total for 1992. Estimated total expenditures for cosmetic surgery range from $1 to $2 billion. As managed care cuts into physicians' income and autonomy, cosmetic surgery, which is not covered by health insurance, offers a financially attractive medical specialty.

This book offers a systematic framework for thinking about the relationship between language and technology and an argument for interweaving thinking about technology with thinking about language. The main claim of philosophy of technology—that technologies are not mere tools and artefacts not mere things, but crucially and significantly shape what we perceive, do, and are—is re-thought in a way that accounts for the role of language in human technological experiences and practices. Engaging with work by Wittgenstein, Heidegger, McLuhan, Searle, Ihde, (...) Latour, Ricoeur, and many others, the author critically responds to, and constructs a synthesis of, three "extreme", idealtype, untenable positions: only humans speak and neither language nor technologies speak, only language speaks and neither humans nor technologies speak, and only technology speaks and neither humans nor language speak. The construction of this synthesis goes hand in hand with a narrative about subjects and objects that become entangled and constitute one another. Using Words and Things thus draws in central discussions from other subdisciplines in philosophy, such as philosophy of language, epistemology, and metaphysics, to offer an original theory of the relationship between language and technology centered on use, performance, and narrative, and taking a transcendental turn. (shrink)

The timing of this special issue of AJOB probing whether public engagement (PE)1 might help achieve equity in genomics is no coincidence. While many issues discussed by the authors are not entirely...

Responsible conduct of research courses are widely taught, but little is known about the purposes or effectiveness of such courses. As one way to assess the purposes of these courses, students were surveyed about their perspectives after recent completion of one of eleven different research ethics courses at ten different institutions. Participants enrolled in RCR courses in spring and fall of 2003 received a voluntary, anonymous survey from their instructors at the completion of the course. Responses were received from 268 (...) participants. Seventy-seven percent of open-ended responses listed specific kinds of information learned; only a few respondents talked about changes in skills or attitudes. The perception that courses did more to provide information than to foster skills or attitudes was verified in quantitative responses. Over 75% of the respondents specifically noted that courses were useful in preparing them to recognize, avoid, and respond to research misconduct. The two principal findings of this multi-institutional study are that respondents reported: a wide variety of positive outcomes for research ethics courses, but that the impact on knowledge was greater than that for changes in skills or attitudes. (shrink)

In this paper, I describe some of what I take to be the more interesting features of friendship, then explore the extent to which other virtues can be reconstructed as sharing those features. I use trustworthiness as my example throughout, but I think that other virtues such as generosity & gratitude, pride & respect, and the producer’s & consumer’s sense of humor can also be analyzed with this model. The aim of the paper is not to demonstrate that all moral (...) virtues are exactly like friendship in all important respects, but rather to articulate a fruitful model in which to explore the virtues. Section 2 explores the relational nature of friendship, drawing on Aristotle’s discussion of friendship in the Nicomachean Ethics. Section 3 catalogues four motivations for taking seriously the friendship model of virtue. Section 4 applies the friendship model in depth to the virtue of trustworthiness. (shrink)

During multiple testing, researchers often adjust their alpha level to control the familywise error rate for a statistical inference about a joint union alternative hypothesis (e.g., “H1,1 or H1,2”). However, in some cases, they do not make this inference. Instead, they make separate inferences about each of the individual hypotheses that comprise the joint hypothesis (e.g., H1,1 and H1,2). For example, a researcher might use a Bonferroni correction to adjust their alpha level from the conventional level of 0.050 to 0.025 (...) when testing H1,1 and H1,2, find a significant result for H1,1 (p < 0.025) and not for H1,2 (p > .0.025), and so claim support for H1,1 and not for H1,2. However, these separate individual inferences do not require an alpha adjustment. Only a statistical inference about the union alternative hypothesis “H1,1 or H1,2” requires an alpha adjustment because it is based on “at least one” significant result among the two tests, and so it refers to the familywise error rate. Hence, an inconsistent correction occurs when a researcher corrects their alpha level during multiple testing but does not make an inference about a union alternative hypothesis. In the present article, I discuss this inconsistent correction problem, including its reduction in statistical power for tests of individual hypotheses and its potential causes vis-à-vis error rate confusions and the alpha adjustment ritual. I also provide three illustrations of inconsistent corrections from recent psychology studies. I conclude that inconsistent corrections represent a symptom of statisticism, and I call for a more nuanced inference-based approach to multiple testing corrections. (shrink)

A predominant ethical view holds that physician‐investigators should conduct their research with therapeutic intent. And since a physician offering a therapy wouldn't prescribe second‐rate treatments, the experimental intervention and the best proven therapy should appear equally effective. "Clinical equipoise" is necessary. But this perspective is flawed. The ethics of research and of therapy are fundamentally different, and clinical equipoise should be abandoned.

Particularists in ethics emphasize that the normative is holistic, and invite us to infer with them that it therefore defies generalization. This has been supposed to present an obstacle to traditional moral theorizing, to have striking implications for moral epistemology and moral deliberation, and to rule out reductive theories of the normative, making it a bold and important thesis across the areas of normative theory, moral epistemology, moral psychology, and normative metaphysics. Though particularists emphasize the importance of the holism of (...) the normative, however, it is not something that they have been able to explain. In this paper I’ll show how to use a small number of simple and, I’ll argue, independently compelling assumptions in order to both predict and explain the holistic features of the normative with respect to the non-normative. The basic idea of the paper is simple. It is that normative claims are holistic because they are general, rather than because they defy generalization. (shrink)

From his earliest work on personal identity to his last on the value of truthfulness, the ideas and arguments of Bernard Williams - in the metaphysics of personhood, in the history of philosophy, but especially in ethics and moral psychology - have proved sometimes controversial, often influential, and always worth studying. This book provides a comprehensive account of Williams's many significant contributions to contemporary philosophy. Topics include personal identity, various critiques of moral theory, practical reasoning and moral motivation, truth and (...) objectivity, and the relevance of ancient Greece to modern life. It not only positions Williams among these important philosophical topics, but also with regard to the views of other philosophers, including prominent forerunners such as Hume and Nietzsche and contemporary thinkers such as, Nagel, McDowell, MacIntyre and Taylor. The fragmentary nature of Williams's work is addressed and recurring themes and connections within his work are brought to light. (shrink)

If politics is about the state, can a stateless people be political? The field of Jewish political thought examines how Jewish individuals and communal organizations have behaved politically both within and beyond statehood. The study of Jewish political thought promises to expand received conceptions of what counts as "political.".

In this paper, I argue that there is a picture of how law works that most legal theorists are implicitly committed to and take to be common ground. This Standard Picture (SP, for short) is generally unacknowledged and unargued for. SP leads to a characteristic set of concerns and problems and yields a distinctive way of thinking about how law is supposed to operate. I suggest that the issue of whether SP is correct is a fundamental one for the philosophy (...) of law, more basic, for example, than the issue that divides legal positivists and anti-positivists, at least as the latter issue is ordinarily understood. The goals of the paper are fourfold: 1) to identify and articulate in some detail the Standard Picture; 2) to show that SP is widely held and has important consequences for other debates in the philosophy of law; 3) to show that SP leads to a serious theoretical problem; 4) to sketch an alternative picture that promises to avoid this problem. I emphasize the modesty of these goals in one respect. I make no claim to refute SP or to fully develop and defend an alternative picture. (shrink)

This essay is composed of five stories written by practicing physicians about their patients. Each clinical story describes a challenging ethical condition–potential abuse of medical power, gravely ill and probably over-treated newborns, iatrogenic narcotic addiction, deceived dying people. Rather than singling out one ethical conflict to resolve or adjudicate, the authors attempt, through literary methods, to grasp the singular experiences of their patients and to act according to the deep structures of their patients' lives. Examining these five stories with simple (...) literary tools–attention to narrative frames, time, plot, and desire–reveals the mechanisms through which acts of writing and reading contribute to clinical clarity and ethical actions. (shrink)

The Clarke/Rowe version of the Cosmological Argument is sound only if the Principle of Sufficient Reason is true, but many philosophers, including Rowe, think that there is not adequate evidence for the principle of sufficient reason. I argue that there may be indirect evidence for PSR on the grounds that if we do not accept it, we lose our best justification for an important principle of metaethics, namely, the Principle of Universalizability. To show this, I argue that all the other (...) justifications of the Principle of Universalizability on offer, including Richard Hare's, are inadequate. (shrink)

Quietist Moral Realists accept that there are moral facts and properties, while aiming to avoid many of the explanatory burdens thought to fall on traditional moral realists. This chapter examines the forms that Quietist Moral Realism has taken and the challenges it has faced, in order to better assess its prospects. The best hope, this chapter argues, lies in a pragmatist approach that distinguishes the different functions of diverse areas of discourse. This paves the way for a form of Quietism (...) that does not simply remain quiet about the explanatory demands of metaethics, but rather is able to diagnose where they go wrong. By combining a neopragmatic analysis of the discourse with an easy approach to ontology, , we can develop a form of Quietist Moral Realism that is far stronger than critics of quietism have appreciated. (shrink)

The leading ethical position on placebo-controlled clinical trials is that whenever proven effective treatment exists for a given condition, it is unethical to test a new treatment for that condition against placebo. Invoking the principle of clinical equipoise, opponents of placebo-controlled trials in the face of proven effective treatment argue that they (1) violate the therapeutic obligation of physicians to offer optimal medical care and (2) lack both scientific and clinical merit. We contend that both of these arguments are mistaken. (...) Clinical equipoise provides erroneous ethical guidance in the case of placebo-controlled trials, because it ignores the ethically relevant distinction between clinical trials and treatment in the context of clinical medicine and the methodological limitations of active-controlled trials. Placebo controls are ethically justifiable when they are supported by sound methodological considerations and their use does not expose research participants to excessive risks of harm. (shrink)