Background: In prevalence studies of sexually transmitted infections (STIs), investigators often provide syndromic management for symptomatic participants, but may not provide specific treatment for asymptomatic individuals with positive laboratory test results due to the delays between sample collection and availability of results as well as logistical constraints in recontacting study participants. Methods: To characterize the extent of this issue, 80 prevalence studies from the World Health Organization’s Report on global sexually transmitted infection surveillance, 2018, were reviewed. Studies were classified as (...) to whether clinically relevant positive results were returned or if this was not specified. Results: More than half (56%) of the cited studies did not specify if participants were notified of clinically relevant positive STI test results. The percentages were similar for low- and middle-income country populations (57%) and high-income country populations (53%). Conclusions: The absence of documentation of the provision of test results raises the possibility that in some instances, results may not have been communicated, with potential negative effects for participants, their sexual partners, and newborns. From an ethical perspective, clinically relevant results should be returned to study participants and treating clinicians in a timely fashion to ensure appropriate management of identified infections. Study authors should document if they returned test results to study participants and report on numbers lost to follow-up. (shrink)

In this paper, we move toward offering psychological benchmarks to measure success in building increasingly humanlike robots. By psychological benchmarks we mean categories of interaction that capture conceptually fundamental aspects of human life, specified abstractly enough to resist their identity as a mere psychological instrument, but capable of being translated into testable empirical propositions. Nine possible benchmarks are considered: autonomy, imitation, intrinsic moral value, moral accountability, privacy, reciprocity, conventionality, creativity, and authenticity of relation. Finally, we discuss how getting the right (...) group of benchmarks in human–robot interaction will, in future years, help inform on the foundational question of what constitutes essential features of being human. (shrink)

This paperback edition reproduces the complete text of the Essay as prepared by professor Nidditch for The Clarendon Edition of the Works of John Locke. The Register of Formal Variants and the Glossary are omitted and Professor Nidditch has written a new foreword.

Accounts of the concepts of function and dysfunction have not adequately explained what factors determine the line between low‐normal function and dysfunction. I call the challenge of doing so the line‐drawing problem. Previous approaches emphasize facts involving the action of natural selection (Wakefield 1992a, 1999a, 1999b) or the statistical distribution of levels of functioning in the current population (Boorse 1977, 1997). I point out limitations of these two approaches and present a solution to the line‐drawing problem that builds on the (...) second one. (shrink)

In a series of recent papers, I have made three arguments about how to define “disease” and evaluate and apply possible definitions. First, I have argued that definitions should not be seen as traditional conceptual analyses, but instead as proposals about how to define and use the term “disease” in the future. Second, I have pointed out and attempted to address a challenge for dysfunction-requiring accounts of disease that I call the “line-drawing” problem: distinguishing between low-normal functioning and dysfunctioning. Finally, (...) I have used a dysfunction-requiring approach to argue that some extremely prevalent conditions, such as high blood pressure, high cholesterol, and ductal carcinoma in situ, are not diseases, but instead are risk factors. Four of the papers in this issue directly engage my previous work. In this commentary, I applaud the advances these authors make, address points of disagreement, and make suggestions about where the discussion should go next. (shrink)

A scholarly edition of Essay Concerning Human Understanding by P. H. Nidditch. The edition presents an authoritative text, together with an introduction, commentary notes, and scholarly apparatus.

Our inability to feel what others feel makes it difficult to understand how they think. Because moral intuitions organize political attitudes, moral empathy gaps can exacerbate political conflict (and other kinds of conflict as well) by contributing to the perception that people who do not share our moral opinions are unintelligent and/or have malevolent intentions.

This study examined preschool children’s reasoning about and behavioral interactions with one of the most advanced robotic pets currently on the retail market, Sony’s robotic dog AIBO. Eighty children, equally divided between two age groups, 34–50 months and 58–74 months, participated in individual sessions with two artifacts: AIBO and a stuffed dog. Evaluation and justification results showed similarities in children’s reasoning across artifacts. In contrast, children engaged more often in apprehensive behavior and attempts at reciprocity with AIBO, and more often (...) mistreated the stuffed dog and endowed it with animation. Discussion focuses on how robotic pets, as representative of an emerging technological genre, may be blurring foundational ontological categories, and impacting children’s social and moral development. (shrink)

Can original philosophy be done while simultaneously engaging in the history of philosophy? Such a possibility is questioned by analytic philosophers who contend that history contaminates good philosophy, and by historians of philosophy who insist that theoretical predecessors cannot be ignored. Believing that both camps are misguided, the contributors to this book present a case for historical philosophy as a valuable enterprise. The contributors include: Todd L. Adams, Lilli Alanen, Jos? Bernardete, Jonathan Bennett, John I. Biro, Phillip Cummins, Georges Dicker, (...) Daniel A. Dombrowski, Daniel Garber, Josiah Gould, Jorge J.E. Gracie, Daniel Graham, Charles Griswold, James Lawler, Rudolf Luthe, Edward H. Madden, George Mavrodes, Gerald E. Myers, Jonathan R?e, Frithjof Rodi, Kenneth L. Schmitz, Vladimir Shtinov, David G. Stern, Robert Turnbull, James Van Cleve, Frederick Van De Pitte, Henry Beatch, and Richard Watson. (shrink)

Similarly to other accounts of disease, Christopher Boorse’s Biostatistical Theory (BST) is generally presented and considered as conceptual analysis, that is, as making claims about the meaning of currently used concepts. But conceptual analysis has been convincingly critiqued as relying on problematic assumptions about the existence, meaning, and use of concepts. Because of these problems, accounts of disease and health should be evaluated not as claims about current meaning, I argue, but instead as proposals about how to define and use (...) these terms in the future, a methodology suggested by Quine and Carnap. I begin this article by describing problems with conceptual analysis and advantages of “philosophical explication,” my favored approach. I then describe two attacks on the BST that also question the entire project of defining “disease.” Finally, I defend the BST as a philosophical explication by showing how it could define useful terms for medical science and ethics. (shrink)

Studies of patient decision‐making use many different measures to evaluate the quality of decisions and the decision‐making process, partly to determine whether the ethical goals of informed consent, patient autonomy, and shared decision‐making have been achieved. We describe these measures, grouped under three main approaches, and review their limitations, leading to three conclusions. First, no measure or combination of measures can provide a complete assessment of decision quality. Second, the quality of a decision is best characterized vaguely, for instance as (...) “good,” “satisfactory,” or “poor,” and these categorizations depend on qualitative judgments that go beyond quantitative measures. Third, bioethicists should focus on identifying and addressing poor or problematic decisions, rather than trying to incrementally increase decision quality, quantified by a measure. Decision‐quality measures can be useful in research and in advancing important goals of bioethics, as long as the challenges of defining and measuring decision quality are recognized. (shrink)

"Modern History" versions of the etiological theory claim that in order for a trait X to have the proper function F, individuals with X must have been recently favored by natural selection for doing F (Godfrey-Smith 1994; Griffiths 1992, 1993). For many traits with prototypical proper functions, however, such recent selection may not have occurred: traits may have been maintained due to lack of variation or due to selection for other effects. I examine this flaw in Modern History accounts and (...) offer an alternative etiological theory, the Continuing Usefulness account, which appears to avoid such problems. (shrink)

Blumenthal-Barby (2024) presents strong arguments that bioethicists should stop using the concept “personhood.” She points out that “person,” meaning an entity with full moral rights, is defined in...

Peter Spader has written a magisterial study on Max Scheler, one of phenomenology’s earliest and greatest figures, whose theory of ethical personalism has become a major voice in the formulation of phenomenological ethics today. Spader follows Scheler’s use of the classic phenomenological approach, by means of which he presented a fresh view of values, feelings, and the person, and thereby staked out a new approach in ethics. Spader recreates the logic of Scheler’s quest, revealing the basis of his thought (...) and the reasons for his dramatic changes of direction. This remarkable study provides a framework that allows us to understand Scheler’s insights in the context of their dynamic evolution of his thought. It corrects imbalances in the presentation of his ideas and defends Scheler against key misunderstandings and criticisms. In short, Spader’s work continues the process of developing Scheler’s pioneering theory of ethical personalism. (shrink)

Philosophical interest in the biological concept of function stems largely from concerns about its teleological associations. Assigning something a function seems akin to assigning it a purpose, and discussion of the purpose of items has long been off-limits to science. Analytic philosophers have attempted to defend ‘function’ by showing that claims about functions do not involve any reference to a problematic notion of purpose. To do this, philosophers offer short lists of necessary and sufficient conditions for the application of the (...) concept—where the conditions involve only acceptable physical or biological notions—and claim that the set of conditions captures the import of function statements. (shrink)

In this paper, we move toward offering psychological benchmarks to measure success in building increasingly humanlike robots. By psychological benchmarks we mean categories of interaction that capture conceptually fundamental aspects of human life, specified abstractly enough to resist their identity as a mere psychological instrument, but capable of being translated into testable empirical propositions. Nine possible benchmarks are considered: autonomy, imitation, intrinsic moral value, moral accountability, privacy, reciprocity, conventionality, creativity, and authenticity of relation. Finally, we discuss how getting the right (...) group of benchmarks in human–robot interaction will, in future years, help inform on the foundational question of what constitutes essential features of being human. (shrink)

In this account of his mature thinking, Peter Marshall develops a dynamic and organic philosophy for the coming millennium which he calls liberation ecology. Liberation ecology is holistic in viewing the world as a harmonious whole and all beings and things as interwoven threads in nature's web. It is intuitive in recognizing intuition as the main source of knowledge and the imagination as the great organ of morality. It is ecological in seeing human beings as fellow voyagers with other (...) species in the magnificent odyssey of evolution. Above all, it is libertarian in seeking to release humanity, society and nature from their existing burdens so that they can unfurl and realize together their full potential. Exploring our strengths and possibilities, this book presents the ideas and values needed to ride the winds of change at this crucial stage in our development and in the history of the world. It provides a new philosophy for a new era, an uplifting and inspired vision which combines ancient wisdom and modern insights, reason and feeling, science and poetry, myth and the marvellous. It offers a guide for the future on how to rive in the most fulfilling way and how to create a genuinely free and sustainable society in harmony with nature. (shrink)

'Modern History' views claim that in order for a trait X to have the proper function F, X must have been recently favored by natural selection for doing F (Griffiths 1992, 1993; Godfrey-Smith 1994). For many traits with prototypical proper functions, however, such recent selection may not have occurred, since traits may have been maintained owing to lack of variation or selection for other effects. I explore this flaw in Modern History accounts and offer an alternative etiological theory, which I (...) call the 'Continuing Usefulness' account. According to my view, a trait has the proper function F if and only if, first, the trait was favored by selection for doing F at some point (perhaps far in the past), and, secondly, the trait has recently contributed to survival and reproduction by doing F. This separates the requirement involving natural selection from the one involving the recent past, two issues that the Modern History account conflates. The clear separation allows a detailed analysis of the causal judgments and form of adaptationism that ground the etiological approach to function. (shrink)

Patients should not always receive hard data about the risks and benefits of a medical intervention. That information should always be available to patients who expressly ask for it, but it should be part of standard disclosure only sometimes, and only for some patients. And even then, we need to think about how to offer it.

Democracy in the 21st century is exhibiting some radical discontinuities in terms of its forms and institutions and needs to be rethought, if we wish to have a sustainable future. Democracy increasingly will be shaped by three realities: the demise of the nation state; the failure of representational liberal democracy; and the radical impacts of resource insufficiency and climate change. Yet if no government, however tyrannical, survives for long except by consent of the people, then that consent can serve as (...) the starting point for rethinking what is meant by “democracy.” Three terms are offered as functional categories that allow for an assessment of democratic forms and institutions: subsistence, operational and systemic. Each describes how and why the population acquiesces to governance and under what conditions. (shrink)

Some experts have argued that patients should routinely be told the specific magnitude and absolute probability of potential risks and benefits of screening tests. This position is motivated by the idea that framing risk information in ways that are less precise violates the ethical principle of respect for autonomy and its application in informed consent or shared decisionmaking. In this Perspective, we consider a number of problems with this view that have not been adequately addressed. The most important challenges stem (...) from the danger that patients will misunderstand the information or have irrational responses to it. Any initiative in this area should take such factors into account and should consider carefully how to apply the ethical principles of respect for autonomy and beneficence. (shrink)

There is nothing so difficult to understand as the obvious, because the assumptions underlying it are rarely examined or challenged. Technology has become just such an obvious facet of our existence at the start of the twenty-first century. Our daily lives are shaped and directed by technology; it dominates our work and our leisure, constructs our home and work and our means of traveling between them, in ways so obvious it remains, for the most part, unexamined.Technology has the Janus-like character (...) of being both benefactor and threat. Unfortunately, neither aspect of technology is well understood by most of the participants in our current global culture. Until we understand the nature of technology, however, we will not recognize the assumptions and choices inherent in the technology that, at the moment, holds as much peril as promise for our future. Without that critical understanding, we will accept as inescapable what is in fact open to choice. We may make poor choices without recognizing that we are even choosing, and we may miss the opportunities to choose wisely for ourselves and for future generations.To better understand technology, therefore, we need to unpack the obvious and examine technology more closely, both to identify some prevalent assumptions about it, and to provide the conceptual tools we need to make wise choices about the technology we develop and use.These twelve statements about the nature of technology are a starting point for such an examination, a framework for conversation among the choosers and users of technology. (shrink)

Democracy in the 21st century is exhibiting some radical discontinuities in terms of its forms and institutions and needs to be rethought, if we wish to have a sustainable future. Democracy increasingly will be shaped by three realities: the demise of the nation state; the failure of representational liberal democracy; and the radical impacts of resource insufficiency and climate change. Yet if no government, however tyrannical, survives for long except by consent of the people, then that consent can serve as (...) the starting point for rethinking what is meant by “democracy.” Three terms are offered as functional categories that allow for an assessment of democratic forms and institutions: subsistence, operational and systemic. Each describes how and why the population acquiesces to governance and under what conditions. (shrink)

In trying to make sense out of our behavior, we reach a point at which we stop talking about what we did and start talking about what we wish we had done, about what we mean to do next. But we think we are still talking about our motives and intentions in what we did. How do we know when we cross the line between finding out what actually happened and ascribing to a situation what we think ought to have (...) happened?This is a serious question, precisely because we usually do not know the difference between what we do and what we imagine that we do. For since all action is governed by our conception of “how we would have it” and “what we would bring about,” we can always honestly claim to have meant what we did for the best. We frequently find ourselves in the situation in which we don't know why we did what we did, but by casting about, we can always turn up a purpose for which our action must have been meant - a purpose which we now perceive.The reasons we ascribe to our actions, like our excuses, are governed by the demands made on us now, rather than by the factual content of what we did. Thus the behavior of reason-giving or excusing is meant to satisfy the social situation in which we presently find ourselves: the demand for explanation, the need to be “in the right,” the need to reinforce our convictions. The verbal account of what we did is thus literally about (as representing and serving) where we are now rather than what we did then.Our verbal account is about the context of social obligation in which we have to explain ourselves, not about the behavior we claim to interpret. This is why, proverbially, we will give any excuse which will satisfy the accuser and why “understanding” i.e. inventing reasons for our conduct, is no corrective. The addict, alcoholic, neurotic and criminal recidivist are frequently rational and even persuasive in giving reasons for what they do. And we wonder why if they understand their problems so well they can't do something about them. The problem is that the habitué doesn't understand his behavior at all. He is simply trained to give a certain after the fact explanation as a conditioned response to his habitual behavior. What he “understands” is not what makes him go back to the pill, the bottle or to crime, but what to tell people each time after he does. Naturally, when the habit-triggering occasion arises, it is never that reason - the stated one - which leads to repetition, but some new, special crisis, difficulty or impulse.Bluntly stated, our reasons and justifications have little or nothing to do with our actual behavior. We continue to suppose that we intend to do this or that immediately before we do it. But insofar as this intention is expressed it is a separate verbal act having its own conditions and consequences; insofar as it is unexpressed (and in general) intention is disclosed only through conduct. It is only the powerful social convention of justification that supports the illusion that verbal expressions are causal antecedents of acts.Two conclusions follow. First, the “sense” of our activity is either evident in the activity or else it is nonexistent, since not yet discovered meaning is meaning not yet achieved. Second, our verbal justifications are acts having a peculiar sense of their own. They express the relation of our convictions and objectives to the convictions and objectives of those to whom our explanations are addressed. Here is where, in the process of making sense of our activity, the crossover from discovery to invention occurs. This is why we may never discover the extent to which our justifications are inventions superimposed on the conduct they are supposed to represent. Insofar as our justification satisfies those to whom it is addressed, (including ourselves) it is right. But we take this rightness, which is actually the the compatibility of our values and objectives, to be the rightness of the act in question. The reasons we give for our actions make great sense, but despite our invincible “rightness” our actions, taken in themselves, make no more sense.What are our options? They are either to put ourselves in the power of those to whom we explain ourselves, or to take responsibility for our own nonsense. Take our conduct out of the medium of talk - of habitual justification - in which it is suspended and sustained, and what is it? Whatever has become of the “importance” of our appointments, our meetings, our appearances, our obligations, our consistency? Experience, not persuasion and reasoning, is the corrective. Only the direct experience of futility is powerful enough to break our addiction to justification. (shrink)

This is the first of three volumes which will contain all of Locke's extant philosophical writings relating to An Essay Concerning Human Understanding, not included in other Clarendon editions like the Correspondence. It contains the earliest known drafts of the Essay, Drafts A and B, both written in 1671, and provides for the first time an accurate version of Locke's text. Virtually all his changes are recorded in footnotes on each page. Peter Nidditch, whose highly acclaimed edition of An (...) Essay Concerning Human Understanding was published in this series in 1975, used pioneering editorial techniques in his compilation of Volume 1. Most of the work was completed before his tragically early death in 1983. Volumes 2 and 3, almost wholly the work of G. A. J. Rogers will contain the third extant draft of the Essay, the Epitome and the Conduct of the Understanding. They will also include a History of the Writing of the Essay, together with other shorter writings by Locke. (shrink)

The biochemical mechanism by which the phytochrome family of plant sensory photoreceptors transmit perceived informational light signals downstream to transduction pathway components is undetermined. The recent sequencing of the entire genome of the cyanobacterium Synechocystis, however, has revealed a protein that has an NH2‐terminal domain with striking sequence similarity to the photosensory NH2‐terminal domain of the phytochromes, and a COOH‐terminal domain strongly related to the transmitter histidine kinase module of bacterial two‐component sensors. The Synechocystis protein is capable of autocatalytic chromophore (...) ligation and exhibits photoreversible light‐absorption changes analogous to the phytochromes, indicating its capacity to function as an informational photoreceptor. Together with earlier observations that the COOH‐terminal domains of the plant phytochromes also have sequence similarity to the histidine kinases, these data suggest that the cyanobacteria utilize photoregulated histidine kinases as a sensory system and that the plant phytochromes may be evolutionary descendants of these photoreceptors. (shrink)