The rapid adoption and implementation of artificial intelligence in medicine creates an ontologically distinct situation from prior care models. There are both potential advantages and disadvantages with such technology in advancing the interests of patients, with resultant ontological and epistemic concerns for physicians and patients relating to the instatiation of AI as a dependent, semi- or fully-autonomous agent in the encounter. The concept of libertarian paternalism potentially exercised by AI (and those who control it) has created challenges to conventional assessments (...) of patient and physician autonomy. The unclear legal relationship between AI and its users cannot be settled presently, an progress in AI and its implementation in patient care will necessitate an iterative discourse to preserve humanitarian concerns in future models of care. This paper proposes that physicians should neither uncritically accept nor unreasonably resist developments in AI but must actively engage and contribute to the discourse, since AI will affect their roles and the nature of their work. One’s moral imaginative capacity must be engaged in the questions of beneficence, autonomy, and justice of AI and whether its integration in healthcare has the potential to augment or interfere with the ends of medical practice. (shrink)

Volume 20, Issue 3, March 2020, Page 81-83.

To mark the 30th anniversary of Richard Dawkins’s book, OUP is to issue a collection of essays about his work. Here, professor of psychology at Harvard University, wonders if Dawkins’s big idea has not gone far enough..

“Without good brain function, living to age 100 is not an attractive proposition,” said Nir Barzilai, director of the college’s Institute for Ageing Research. “We’ve shown that the same gene variant that helps people live to exceptional ages has the added benefit of helping them think clearly.

I. EXECUTIVE SUMMARY The MRCT Center Post-trial Responsibilities: Continued Access to an Investigational Medicine Framework outlines a case-based, principled, stakeholder approach to evaluate and guide ethical responsibilities to provide continued access to an investigational medicine at the conclusion of a patient’s participation in a clinical trial. The Post-trial Responsibilities (PTR) Framework includes this Guidance Document as well as the accompanying Toolkit. A 41-member international multi-stakeholder Workgroup convened by the Multi-Regional Clinical Trials Center of Brigham and Women’s Hospital and Harvard University (...) (MRCT Center) developed this Guidance and Toolkit. Project Motivation A number of international organizations have discussed the responsibilities stakeholders have to provide continued access to investigational medicines. The World Medical Association, for example, addressed post-trial access to medicines in Paragraph 34 of the Declaration of Helsinki (WMA, 2013): “In advance of a clinical trial, sponsors, researchers and host country governments should make provisions for post-trial access for all participants who still need an intervention identified as beneficial in the trial. This information must also be disclosed to participants during the informed consent process.” This paragraph and other international guidance documents converge on several consensus points: • Post-trial access (hereafter referred to as “continued access” in this Framework [for terminology clarification – see definitions]) is the responsibility of sponsors, researchers, and host country governments; • The plan for continued access should be determined before the trial begins, and before any individual gives their informed consent; • The protocol should delineate continued access plans; and • The plan should be transparent to potential participants and explained during the informed consent process. -/- However, there is no guidance on how to fulfill these responsibilities (i.e., linking specific responsibilities with specific stakeholders, conditions, and duration). To fill this gap, the MRCT Center convened a working group in September of 2014 to develop a framework to guide stakeholders with identified responsibilities. This resultant Framework sets forth applicable principles, approaches, recommendations and ethical rationales for PTR regarding continued access to investigational medicines for research participants. (shrink)

A key philosophical feature of Peter Jackson’s film interpretation of J.R.R. Tolkien’s The Lord of the Rings is its use of fantasy to inspire a “recovery” of the actual or, in other words, a reawakening to the beauty of nature and the many possible ways of living in healthier ecological relation to the world. Though none of these ways is perfectly achieved, this pluralistic view is demonstrated in the various lifeways of Hobbits, Elves, Men, and Ents. All of the positive (...) relationships embodied in the films—to trees, mountains, horses, and vegetable gardens—involve loving care and attention, receiving nourishment and livelihood without instrumentalization, or reducing nature to mere resource. The films also vividly display a variety of ugly and destructive ways of using the land to accrue power and wealth. These noxious ways, specifically because they actively destroy the lands that they use, always need more. They will thus eventually annihilate the beautiful ways of being if they are not actively resisted. Some of those who would rather be tending their own trees, gardens, or horses or even wandering in the wild forests must therefore turn their attention to struggle and resistance instead. This is a struggle full of grief, and at times even verging on despair, but it is marked by the refusal to give up hope. Indeed, what Jackson and Tolkien have to say about hope is as important in responding to the ecological crisis as anything they have to say about nature, inasmuch as they help to remind us that even in our own times, “there is still hope.”. (shrink)

A key philosophical feature of Peter Jackson’s film interpretation of J.R.R. Tolkien’s _The Lord of the Rings_ is its use of fantasy to inspire a “recovery” of the actual or, in other words, a reawakening to the beauty of nature and the many possible ways of living in healthier ecological relation to the world. Though none of these ways is perfectly achieved, this pluralistic view is demonstrated in the various lifeways of Hobbits, Elves, Men, and Ents. All of the positive (...) relationships embodied in the films—to trees, mountains, horses, and vegetable gardens—involve loving care and attention, receiving nourishment and livelihood without instrumentalization, or reducing nature to mere resource. The films also vividly display a variety of ugly and destructive ways of using the land to accrue power and wealth. These noxious ways, specifically because they actively destroy the lands that they use, always need more. They will thus eventually annihilate the beautiful ways of being if they are not actively resisted. Some of those who would rather be tending their own trees, gardens, or horses or even wandering in the wild forests must therefore turn their attention to struggle and resistance instead. This is a struggle full of grief, and at times even verging on despair, but it is marked by the refusal to give up hope. Indeed, what Jackson and Tolkien have to say about hope is as important in responding to the ecological crisis as anything they have to say about nature, inasmuch as they help to remind us that even in our own times, “there is still hope.”. (shrink)

The ability to extract patterns from sensory input across time and space is thought to underlie the development and acquisition of language and literacy skills, particularly the subdomains marked by the learning of probabilistic knowledge. Thus, impairments in procedural learning are hypothesized to underlie neurodevelopmental disorders, such as dyslexia and developmental language disorder. In the present meta‐analysis, comprising 2396 participants from 39 independent studies, the continuous relationship between language, literacy, and procedural learning on the Serial Reaction Time task (SRTT) was (...) assessed across children and adults with typical development (TD), dyslexia, and Developmental Language Disorder (DLD). Despite a significant, but very small, relationship between procedural learning and overall language and literacy measures, this pattern was not observed at the group‐level when examining TD, dyslexic, and DLD groups separately. Based on the procedural/declarative model, a positive relationship was expected between procedural learning and language and literacy measures for the typically developing group; however, no such relationship was observed. This was also the case for the disordered groups (ps >.05). Also counter to expectations, the magnitude of the relationship between procedural learning and grammar and phonology did not differ between TD and DLD (ps >.05), nor between the TD and dyslexic group on reading, spelling, and phonology (ps >.05). While lending little support to the procedural/declarative model, we consider that these results may be the consequence of poor psychometric properties of the SRTT as a measure of procedural learning. (shrink)

This paper focuses on examining the dynamic nature of community supported agriculture (CSA) and the real-world experiences which mark its contours, often making it distinct from the early idealized CSA “model.” Specifically, our study examines the narratives of the farmers of Devon Acres CSA over its duration, in tandem with a survey of recent shareholders in order to understand and explain its evolution. The framework we develop here shows that this CSA is largely characterized by instrumental and functional beliefs (...) and practices, with some elements in the collaborative mode. A key contribution of this research is the development of a framework which helps to highlight the relative fluidity and patchwork quality of CSA participant positions over time. At Devon Acres, the real-world factors and issues influencing CSA evolution are seen to be products of both the local and larger contexts, evident in such areas as shifts in farmer learning and adaptation, differences between beliefs and practices in member volunteer efforts, and changes in farm and resource conditions. With respect to CSA more broadly, we argue that the reality of dominant food system context and site-specific influences on CSA development compels us to rework our attachment to early idealized “model” traits. Expansion in CSA numbers, evidence of adaptation and situated learning, and retention of the local and organic as core traits, speak to the pragmatic yet transformative potential of CSA contribution to food system change. (shrink)

Debates over how to conceptualize the nursing role were prominent in the nursing literature during the latter part of the twentieth century. There were, broadly, two schools of thought. Writers like Henderson and Orem used the idea of a self‐care deficit to understand the nurse as doing for the patient what he or she could not do alone. Later writers found this paternalistic and emphasized the importance of the patient's free will. This essay uses the ideas of positive and (...) negative freedom to explore the differing conceptions of autonomy which are implicit in this debate. The notion of positive freedom has often been criticized as paternalistic, and the criticisms of self‐care in the nursing literature echo criticisms from political philosophy. Recent work on relational autonomy and on the relationship between autonomy and identity are used to address these objections. This essay argues for a more nuanced conception of the obligation to support autonomy that includes both positive (freedom to) and negative (freedom from) dimensions. This conception of autonomy provides a moral foundation for conceptualizing nursing in something like Henderson's terms: as involving the duty to expand the patient's capacities. The essay concludes by generalizing the lesson. Respect for autonomy on the part of any health care provider requires both respect for the patient's choices and a commitment to expand the patient's ability to actualize their choices. (shrink)

Alexis de Tocqueville asserted that America had no truly great literature, and that American writers merely mimicked the British and European traditions of the eighteenth and nineteenth centuries. This new edited collection masterfully refutes Tocqueville's monocultural myopia and reveals the distinctive role American poetry and prose have played in reflecting and passing judgment upon the core values of American democracy. The essays, profiling the work of Mark Twain, F. Scott Fitzgerald, John Updike, Edith Wharton, Walt Whitman, Henry James, Willa (...) Cather, Walker Percy, and Tom Wolfe, reveal how America's greatest writers have acted as society's most ardent cheerleaders and its most penetrating critics. Christine Dunn Henderson's exciting new work offers literature as a portal through which to view the philosophical principles that animate America's political order and the mores which either reinforce or undermine them. (shrink)

After characterizing the general outlines of Davidson's criticism of the idea of conceptual schemes, the specifics of his argument are examined and evaluated. It is argued that his argument against radically different conceptual schemes does mark out plausible limits to what might be thought of as differences against conceptual schemes, but it is doubtful that those he mentioned as proponents of the idea envisions such differences. It is argued that the stylized character of Davidson's arguments against the less radical (...) variants of the idea fail to foreclose the possibility of differences that many would find interesting. (shrink)

David Henderson and Terry Horgan offer a detailed account of the structure of conceptual analysis that is embedded within a more general account of a priori justification. Their account highlights an important feature of conceptual analysis that has been overlooked in the recent debate. Although it is generally recognized that conceptual analysis involves an inference from premises to the effect that some concept does (or does not) apply to a range of particular cases to a general conclusion about the (...) nature of the concept itself, the details of that inference have not been fully articulated. Henderson and Horgan offer an articulation of the inferential connection which, taken in conjunction with their account of a priori justification, yields a startling conclusion about the epistemic status of the results of conceptual analysis. My view is that their account of a priori justification misses the mark and, as a consequence, they arrive at a conclusion about the epistemic status of the results of conceptual analysis that many will find implausible. Moreover, I fear that because many will find their overall conclusion implausible, they will either overlook or dismiss the important feature of the inferential connection that Henderson and Horgan correctly highlight. Hence, I have two goals. First, I want to track down the source of their mischaracterization of the a priori and to show why it is a mischaracterization. Second, I want to highlight the important feature of the inferential connection involved in conceptual analysis that they identify, articulate its bearing on the debate over the existence of a priori knowledge and assess its implications. (shrink)

This paper explores a position that combines contextualism regarding knowledge with the idea that the central point or purpose of the concept of knowledge is to feature in attributions that keep epistemic gate for contextually salient communities. After highlighting the main outlines and virtues of the suggested gate-keeping contextualism, two issues are pursued. First, the motivation for the view is clarified in a discussion of the relation between evaluative concepts and the purposes they serve. This clarifies why one's sense for (...) the point of an evaluative concept ought to constrain and inform one's understanding of the concept. Second, the paper explores ways of avoiding a problem in the author's earlier development of gate-keeping contextualism. The initial development of the view opened the door to a form of skepticism that would hobble an important facet of our social-epistemic lives. (shrink)

What makes for a good explanation of a person’s actions? Their reasons, or soa natural reply goes. But how do reasons function as part of explanations, that is, within an account of the causes of action? Here philosophers divide concerning the logical relation in which reasons stand to actions. For, tradition holds, reasons evaluatively characterized must be causally inert, inasmuch as the normative features cannot be found in any account of the empirical/descriptive. To countenance reasons as causes thus seems to (...) imply some degree of normative involvement in causal explanation. Mark Risjord opts for full normative involvement while David Henderson insistently denies a role to norms in explanation. Stueber occupies an intermediate position here. I question just whether there exists some "special" problem regarding norms, at least in the form which, I take it, all three of the authors I discuss assume there to be one. Key Words: reasons • causes • norms • rules • explanation. (shrink)

This chapter examines how epistemic norms could be social norms, with a reliance on work on the philosophy and social science of social norms from Bicchieri (on the one hand) and Brennan, Eriksson, Goodin and Southwood (on the other hand). We explain how the social ontology of social norms can help explain the rationality of epistemic cooperation, and how one might begin to model epistemic games.

John Henderson focuses on three key Letters visiting three Roman villas, and reveals their meaning as designs for contrasting lives. Seneca brings the philosophical epistle to Latin literature, creating models for moralizing which feature self-criticism, parody, and animated revision of myth. The Stoic moralist wrests writing away from Greek gurus and texts, and recasts it into critical thinking in Latin terms, within a Roman context. The Letters embody critical thinking on metaphor and translation, self-transformation and cultural tradition.

Cosmological ideas influenced every aspect of traditional Chinese culture, from science and medicine to art, philosophy, and religion. Although other premodern societies developed similar conceptions, in no other major civilization were such ideas so pervasive or powerful. In The Development and Decline of Chinese Cosmology, John Henderson traces the evolution of Chinese thought on cosmic order from the classical era to the nineteenth century. Unlike many standard studies of premodern cosmologies, this book analyzes the origins, development, and rejection of (...) these models, not just their structure. Moreover, while historians often limit their studies of cosmic order to specialized fields like the history of science, Henderson examines how the cosmological ideas formulated in late classical times permeated various facets of Chinese life, from high philosophy to popular culture. (shrink)

Hume's Reception in Early America: Expanded Edition brings together the original American responses to one of Britain's greatest men of letters, David Hume. Now available as a single volume paperback, this new edition includes updated further readings suggestions and dozens of additional primary sources gathered together in a completely new concluding section. From complete pamphlets and booklets, to poems, reviews, and letters, to extracts from newspapers, religious magazines and literary and political journals, this book's contents come from a wide variety (...) of sources published in colonial America and the early United States between 1758 and 1850. As well as classics by Thomas Jefferson, John Adams and Alexander Hamilton, it contains scores of unknown and hard-to-locate items, many of which have not been reprinted since their original publication. These responses are divided into four parts covering Hume's Essays; his Philosophical Writings; his History of England; and his Character and Death. Each of those parts has a separate introductory essay, and every selection is introduced by a short headnote that sets the piece in its historical context and provides bibliographical references. Packed with new insights into Hume and American thought and culture, Hume's Reception in Early America reveals the relevance and impact of Hume on American political, philosophical, historical, religious, and aesthetic debates. (shrink)

Prologue, invitation to thinking about God In the Hebrew Bible? -- Part I, questions about God? -- Why does God in the Bible have a body? -- What do God's body parts in the Bible mean? -- Why is God angry in the Bible? -- Does God in the Bible have gender or sexuality? -- Part II, questions about God in the world? -- What can creation tell us about God? -- Who-or what-is the Satan? -- Why do people suffer (...) according to the Hebrew Bible? -- Epilogue, God in the Bible and beyond. (shrink)

Whatever else a theory of impeccability assumes about the moral life of heavenly agents, it seems to imply something about the type of actions possible for such agents, along with the quality of their moral characters. Regarding these characters, there are many that have argued impeccable and heavenly agents must also be perfectly virtuous agents. Michael Slote has recently argued, however, that perfect virtue is impossible. Assuming Slote’s argument is successful, a theory of impeccability that relies on the possibility of (...) perfect virtue would be greatly harmed, even to the point of incoherence. My intent here is to defend the coherence of the doctrine of impeccability, at least as it applies to the moral life of heavenly agents. (shrink)

The intent of this essay is to examine what most would call an essential component to the theistic notion of a perfected agent in heaven: impeccability. In Part 1 I will attempt to softly defend the Christian dependence on the doctrine of impeccability, followed by an examination of what I believe to be the two basic moral conditions for impeccability: the deontic condition and the virtue condition. In Parts 2 and 3, I will examine the coherence of each of these (...) conditions by proposing recently raised objections to both. Ultimately, my hope for this essay is to further the discussion concerning the theistic notions of a perfected agent, and the coherence of a heavenly afterlife for that perfected agent. (shrink)

This paper offers a new way to make sense of disagreement expansion from a polylogical perspective by incorporating various places in addition to players and positions into the analysis. The concepts build on prior implicit ideas about disagreement space by suggesting how to more fully account for argumentative context, and its construction, in large-scale complex controversies. As a basis for our polylogical analysis, we use a New York Times news story reporting on an oil train explosion—a significant point in the (...) broader controversy over producing oil and gas via hydraulic fracturing. (shrink)

This paper advances and defends a new solution to the so-called fundamental problem in christology (the problem being the apparent contradiction entailed by the christian doctrine of divine incarnation).

A specific issue for argumentation theory is whether information and communication technologies play any role in governing argument — that is, as parties engage in practical activities across space and time via ICTs, does technology matter for the interplay of argumentative content and process in managing disagreement? The case made here is that technologies do matter because they are not merely conduits of communication but have a role in the pragmatics of communication and argumentation. In particular, ICTs should be recognized (...) as communication-information services that are delegated degrees of responsibility for managing disagreements arising from practical activities. These services are organized around practical theories for designing disagreement space. However, recognizing this relationship between argument and technology requires accounting for procedures, techniques, or rules and speech acts that are not argumentative propositions in any strict sense but that are consequential for what becomes argumentation in any setting. An account about designing disagreement space, grounded in Jackson and Jacobs’s theory of Disagreement Management, is put forward to address these issues while more generally contributing to understanding argument in context. (shrink)

It is time to bring the rich resources of these traditions into the contemporary debate about the nature of self. This volume is the first of its kind.