The principle of informed consent obligates physicians to explain possible side effects when prescribing medications. This disclosure may itself induce adverse effects through expectancy mechanisms known as nocebo effects, contradicting the principle of nonmaleficence. Rigorous research suggests that providing patients with a detailed enumeration of every possible adverse event—especially subjective self-appraised symptoms—can actually increase side effects. Describing one version of what might happen (clinical “facts”) may actually create outcomes that are different from what would have happened without this information (another (...) version of “facts”). This essay argues that the perceived tension between balancing informed consent with nonmaleficence might be resolved by recognizing that adverse effects have no clear black or white “truth.” This essay suggests a pragmatic approach for providers to minimize nocebo responses while still maintaining patient autonomy through “contextualized informed consent,” which takes into account possible side effects, the patient being treated, and the particular diagnosis involved. (shrink)

It is Frege's third contribution that makes the point of departure for the present paper. Not merely did Frege show how to manipulate symbols more exactly; he also gave a searching account of what these symbols mean. Consider a philosophical problem that arises out of the simplest arithmetic. When we say that 5 = 2 + 3, what do we mean? Do we mean that 5 is identical with 2 + 3? But in some ways 5 and 2 + 3 (...) are obviously different. Or do we mean that 5 and 2 + 3 are equal but not identical, equality being a relation that falls short of complete identity? But in that case, some ordinary ways of speaking in mathematics must be false. Suppose a pupil is asked for the positive square root of 25. The phrasing of the question implies that there is one and only one. No doubt he may answer, '5'. But then it follows that the answer '2 + 3' is not allowable, since ex hypothesi 5 and 2 + 3, though equal, are not identical. Yet ordinarily the answer '2 + 3' would be regarded as strange but not as wrong. (shrink)

To the Editor: Daniel Callahan is correct when, in “Rationing: Theory, Politics, and Passions”, he tells us that the combination of ever-rising medical costs and ever-increasing demand for expensive resources by physicians and their patients will—in the absence of any workable, generally acceptable mode of official rationing—lead to covert rationing. Or, more precisely, it will encourage us to extend the covert rationing that already exists, where those with more get more. As things stand now, this is unavoidable. However..

If necessity is a generic notion, then, like any generic notion, it becomes specified not by a criterion as such but by a differentia. The differentia of logical necessity is that the denial of a logically necessary proposition is self-contradictory; one of our best criteria of logical necessity is that after careful consideration we see that the denial of the proposition is self-contradictory.

Rachel Wells turns to the examination of three recent artistic practices, which integrate facts in their work not as an antagonistic other but as a constitutive element to their efficacy and ethics. She argues, that in introducing news, factual actions, or objects with traces of factual events, Alfredo Jaar, Jeremy Deller and Martin Creed use facts in order to retract from the position of art as an expression of artistic freedom and subjectivity and thus as the opposite of fact. Instead, (...) she states that by introducing the factual the artists underline each in their own way the instability of given eptistemological and ethical frameworks. Far from being a mere relativist pose, Wells understands this denial of a stable subjectivist position as a reconfigured sense of “decision”—perhaps in the sense of Nancy’s articulation of a “decision of existence—that lets the factual take precedence over the control in and of the artwork as a heightened form of responsiveness and responsibility. Whereas Jaar uses the factual to engage overt political action, Deller presents facts that avoid taking an overtly critical perspective forcing the viewer to think about political events. Creed in contrast seeks for the interpretation of the past altogether, would avoid to take over the responsibility of taking a position. Whereas David Hume stated famously, that reasoning concerning matter of fact is founded in causality and Immanuel Kant concludes, that responsibility and freedom begins where causality ends, Wells understands the positions of Jaar, Deller and Creed as an attempt to reconcile the realm of the factual and the realm of the moral. Responsibility would then arise exactly out of the insight in the impossibility to ground moral stances in rationality and causality and in an attempt to use causality to demonstrate this impossibility. (shrink)

The interest in Leibniz's early writings was not spurred on by any doctrinaire motive; for instance, there was no temptation, as there has been in the case of some other thinkers, to hypothesize a youthful view which was subsequently rejected in some dramatic way comparable to Aristotle's break with the Academy or to Kant's being awakened from his dogmatic slumber. So if scholars should come to conclude that there is no essential or major difference between Leibniz's earliest and his latest (...) doctrines, the conclusion would not shock us; and neither would the opposite conclusion. We are uncommitted. (shrink)

The past decade has been Hellenistic rather than Hellenic, a Silver rather than a Golden Age. But if it has not been a midday, it has been no twilight either.

A commentary on “Why It's Not Time for Health Care Rationing,” by Peter A. Ubel, in the March‐April 2015 issue.

Such a thesis is counter to prevailing trends among contemporary philosophers. All that is about to be maintained is that facts may be regarded as entities, i.e. that it is legitimate and tenable so to regard them; this is much less than saying that they must be so regarded, and that anyone who declined to make use of the category of facts would be mistaken. Yet even so weak a thesis will be viewed askance by many; those who concede its (...) meaningfulness and logical possibility will still, a large proportion of them, dismiss it on other grounds-particularly on the ground of superfluity. And precisely one of the reasons why we have selected this particular thesis for defense, is as an occasion to examine the weight and force of Ockham's Razor. (shrink)

Is language a social art by some necessity, or merely in point of fact? Is society indispensable in principle, or merely very useful in practice? Is language a social art in its origin only, or also in its definitive nature?

(2008). A Review of: “Schools or Markets? Commercialism, Privatization, and School-Business Partnerships”. Educational Studies: Vol. 43, No. 2, pp. 158-162.

The expectation is fulfilled, but in an unexpected way. 'The first studies toward this book were addressed to topics in the field of ethics' ; but our author, like Wagner composing 'Der Ring des Nibelungen', found himself becoming preoccupied with prolegomena. To these the present volume is wholly devoted. In order to establish its fundamental thesis that valuation is a form of empirical knowledge, two preparatory discussions are called for. An analysis of empirical knowledge in general is one of these; (...) but there is an inquiry properly prior even to this, an examination of the topic of meaning. The articulation of the book is accordingly tripartite; and Book I Meaning and Analytic Truth, Book II Empirical Knowledge, and Book III Valuation are of roughly equal length. (shrink)