In the USA, there are missed opportunities to diagnose hepatitis C virus in pregnancy because screening is currently risk-stratified and thus primarily limited to individuals who disclose history of injection drug use or sexually transmitted infection risks. Over the past decade, the opioid epidemic has dramatically increased incidence of HCV and a feasible, well-tolerated cure was introduced. Considering these developments, recent evidence suggests universal HCV screening in pregnancy would be cost-effective and several professional organisations have called for updated national policy. (...) Historically, universal screening has been financially disincentivised on the healthcare system level, particularly since new diagnoses may generate an obligation to provide expensive treatments to a population largely reliant on public health resources. Here, we provide ethical arguments supporting universal HCV screening in pregnancy grounded in obligations to respect for persons, beneficence and justice. First, universal prenatal HCV screening respects pregnant women as persons by promoting their long-term health outside of pregnancy. Additionally, universal screening would optimise health outcomes within current treatment guidelines and may support research on treatment during pregnancy. Finally, universal screening would avoid potential harms of risk-stratifying pregnant women by highly stigmatised substance use and sexual behaviours. (shrink)

The number of children with chronic critical illness (CCI) is a growing population in the United States. A defining characteristic of this population is a prolonged hospital stay. Our study assessed the proportion of pediatric patients with chronic critical illness in U.S. hospitals at a specific point in time, and identified a subset of children whose hospital stay lasted for months to years. The potential harms of a prolonged hospitalization for children with CCI, which include over treatment, infection, disruption of (...) family life, and the intensive utilization of resources—combined with the moral distress experienced by the clinicians who care for the children, suggest the need for ethical analysis of this growing issue to identify actions that could be taken at the clinical and health systems levels to reduce the harms associated with prolonged hospital stay.In this article we present three real cases from our study that involved a very long hospital stay. We applied a framework developed by Mackenzie, Rogers, and Dodds to analyze inherent, situational, and pathogenic vulnerabilities to examine the ways that interventions intended to remedy one source of harm for the children in our cohort inadvertently created other harms. We examined the complex ways that children with protracted hospitalization are vulnerable to the choices made by their family and clinicians, as well as by healthcare systems and communities. Finally, we used this analysis to summarize actions and ethical responses to this growing patient population. Such an understanding is essential to making clinical and ethical decisions that arise for children who are at risk for a very long stay in the hospital. (shrink)

En este artículo se reconstruye el vínculo sistemático entre el tratamiento aporético del conocimiento en el diálogo platónico tardío Teetetos y la definición conceptual del conocimiento en parte de la epistemología analítica contemporánea. A través de dicha vinculación se muestra, por una parte, la presencia de los problemas presentados por Platón en la epistemología actual, así como la persistencia de la aporía del dialogo en cuestión. Con ello, se pretende también iluminar desde una clave histórica aspectos esenciales del debate epistemológico (...) en general. (shrink)

En este artículo se abordan las perspectivas de David Hume y Bertrand Rus-sell en tormo dos asuntos estrechamente vinculados, a saber, el problema de la justificación de la inferencia no demostrativa y de la validez del principio de causalidad, ambos configu-ran el así llamado “problema de Hume”. Desde una perspectiva analítica y comparativa, se intenta mostrar que a pesar de la lectura fuertemente crítica que Russell adopta respecto del filósofo escocés, ambos filósofos comparten en cierta medida un programa filosófico común. (...) En este contexto se hacen notar algunas distinciones de importancia pasadas a menudo por alto en la discusión especializada, que permiten concluir que la teoría de Russell del conoci-miento está en realidad alineada con la del empirista moderno, y por tanto, que es también susceptible de las mismas críticas. (shrink)

: In this paper, I consider some issues concerning Hume’s epistemology of testimony. I’ll particularly focus on the accusation of reductivism and individualism brought by scholars against Hume’s view on testimonial evidence, based on the tenth section of his An enquiry concerning human understanding. I first explain the arguments against Hume’s position, and address some replies in the literature in order to offer an alternative interpretation concerning the way such a defense should go. My strategy is closely connected with Hume’s (...) notion of virtue and the role it plays in his epistemology, mainly as presented in his A treatise of human nature. I address the problem of how the section “Of miracles” in the Enquiry must be properly understood, as several misunderstandings of Hume’s epistemology of testimony emerge partially from the particular character and aim of that section. Resumen: En este artículo, considero algunas cuestiones relacionadas con la epistemología del testimonio de David Hume. El eje central será la acusación de reductivismo e individualismo de los estudiosos en contra de la opinión de Hume sobre la evidencia testimonial. Dicha acusación se basa en su tratamiento de los reportes sobre hechos milagrosos, presente en la sección X de su Investigación sobre el entendimiento humano. En primer lugar, se abordan los argumentos en contra de la posición de Hume y algunas respuestas en la literatura reciente, para luego ofrecer una interpretación alternativa con respecto a la forma en que debería articularse esa defensa. Mi estrategia está estrechamente relacionada con la noción de virtud de Hume y el papel que desempeña en su epistemología, principalmente como se presenta en su Tratado de la naturaleza humana. Finalmente, abordaré el problema relacionado con la forma en que debe entenderse correctamente la sección “Of miracles” de la Investigación, ya que varios malentendidos sobre la epistemología del testimonio de Hume emergen parcialmente del carácter particular y el objetivo de dicho ensayo. (shrink)

In the current research landscape, there are increasing demands for research to be innovative and cutting-edge. At the same time, concerns are voiced that as a consequence of neoliberal regimes of research governance, innovative research becomes impeded. In this paper, I suggest that to gain a better understanding of these dynamics, it is indispensable to scrutinise current demands for innovativeness as a distinct way of ascribing worth to research. Drawing on interviews and focus groups produced in a close collaboration with (...) three research groups from the crop and soil sciences, I develop the notion of a project-innovation regime of valuation that can be traced in the sphere of research. In this evaluative framework, it is considered valuable to constantly re-invent oneself and take ‘first steps’ instead of ‘just’ following up on previous findings. Subsequently, I describe how these demands for innovativeness relate to and often clash with other regimes of valuation that matter for researchers’ practices. I show that valuations of innovativeness are in many ways bound to those of productivity and competitiveness, but that these two regimes are nevertheless sometimes in tension with each other, creating a complicated double bind for researchers. Moreover, I highlight that also the project-innovation regime as such is not always in line with what researchers considered as a valuable progress of knowledge, especially because it entails a de-valuation of certain kinds of long-term epistemic agendas. I show that prevailing pushes for innovativeness seem to be based on a rather short-sighted temporal imaginary of scientific progress that is hardly grounded in the complex realities of research practices, and that they can reshape epistemic practices in potentially problematic ways. (shrink)

Talk of powers is muddled. Building upon Powers and capacities in philosophy: The new aristotelianism, Routledge, London, 2012a, pp 207–227), I disambiguate four senses of the term: powers construed as activity, as capacity/potentiality, as essence and as necessity, respectively, in an attempt to clarify what it is that realists about causal powers take themselves to be realists about.

This volume contains essays which cover a range of aspects in the debate over genetic testing. It looks at both the advantages and disadvantages involved in knowing or not knowing whether one is a carrier of certain genetic traits.

There is an urgent need to understand how private and public organisations can play a role in promoting human values such as fairness, dignity, respect and care. Globalisation, technological advance and climate change are changing work, organisations and systems in ways which foster inequality, alienation and collective risk. Against this backdrop, organisations are being urged to make their contribution to the common good, take account of the interests of multiple stakeholders, and respond ethically as well as efficiently to complex challenges (...) which transcend traditional organisational and state boundaries. Ethics, Meaningfulness, and Mutuality poses critical questions related to organisational design by challenging limits to current thinking, such as the neglect by political philosophers of markets, firms and stakeholders, or by organisational theorists of business ethics. In so doing, the book advances our understanding of the theory and practice of ethical organising. Specifically, meaningfulness and mutuality will be used to yield values and principles for a philosophy of ethical organising which includes an account of human values in morally desirable collective action, and examines the relationship of collective action to the contested concept of shared value creation. Within a philosophy of ethical organising, mutuality permits an examination of the unavoidable relational nature of collective action, whereas meaningfulness addresses fundamental human concerns for significance and leading a life we have reason to value. By addressing our status as relational beings with human needs for meaning, a philosophy of ethical organising brings critical thinking to the creation of morally informed organisational practices which are not only instrumentally beneficial for addressing wicked problems, but are normatively desirable for human flourishing. (shrink)

Why does #RepealedThe8th matter for feminist legal studies? The answers seem obvious in one sense. Feminism has long constituted itself through the struggle for sexual and reproductive justice, and Irish feminism has contributed a significant ‘legal win’ with the landslide vote of approval for lifting abortion restrictions in the referendum on the 25th May 2018. That win comes at a global moment when populist legal engagement is doing significant damage in countries that regard themselves as world leaders, and beyond. #RepealedThe8th (...) offers Ireland, and the world, the actuality that the popular vote, and everything that contributes to it, could be something else. Repeal shows how legal tools like the vote may be made into an expression of care for reproductive lives. This expression is important in recognizing pregnant people as knowing agents who are best placed to decide, and in seeking to do justice to those who contribute to everyday reproductive life. But repeal, like the many who brought it into being, has multiple meanings. #RepealedThe8th matters because it is a moving process of socio-legal translation, which draws on a collective energy, ‘repeal energy’, to turn the travesty that was the Eighth Amendment and all it represents into a search for the rest of reproductive life. In opening up the meaning of the vote, much like feminists elsewhere have opened up the meaning of the strike, Irish feminists have turned public mourning over past mistreatment into a series of reproductive connections. This is not a strategy that can be rolled out. Figuring out #RepealedThe8th will take many tellings. Rather we need to give repeal, and repealers, room to breathe and rest. We need to feel our way through repeal’s production of legal change so that this success is not reduced to some generic transferable set of legal instructions. I begin by reflecting on repeal as a process of feminist socio-legal translation, which shows us how legal change comes about through the motivation of collective joy, the mourning of damaged and lost lives, the sharing of legal knowledge, and the claiming of the rest of reproductive life. (shrink)

A large literature has grown up around the proposed use of 'weak measurements' to allegedly provide information about hidden ontological features of quantum systems. This paper attempts to clarify the fact that 'weak measurements' are simply strong measurements on one member of an entangled pair, and that all such measurements thus effect complete disentanglement of the pair. The only thing 'weak' about them is that the correlation established via the entanglement does not correspond to eigenstates of the 'weakly measured observable' (...) for the component system that is subject to the weak measurement. It is observed that complete disentanglement always occurs, whether post-­‐selection is performed before or after the pointer detection. Assertions in the literature that weak measurements leave a system negligibly disturbed are therefore inaccurate, and claims based on those assertions need to be critically reassessed. (shrink)

Tim Maudlin's argument for the inconsistency of Cramer's Transactional Interpretation of quantum theory has been considered in some detail by Joseph Berkovitz, who has provided a possible solution to this challenge at the cost of a significant empirical lacuna on the part of TI. The present paper proposes an alternative solution in which Maudlin's charge of inconsistency is evaded but at no cost of empirical content on the part of TI. However, Maudlin's argument is taken as ruling out Cramer's heuristic (...) "pseudotime" explanation of the realization of one transaction out of many. (shrink)

Pervasive though it is in modern life, the concept of self‐esteem is often viewed with distrust. This paper departs from an idea that was recently aired by Richard Smith: that we might be better off without this concept. The meaning of self‐esteem is explored within four ‘homes’: the self‐help industry, social science, therapy and education. It is suggested that the first two use a ‘simple’ concept of self‐esteem that indeed we are better off without. This concept eliminates the distinction between (...) truthfulness and delusion, and relies on a chimera of quantifiability. The much richer concept of situated self‐esteem is explored, and it is argued that low self‐esteem in children should command the attention of educators. Teachers should address this through education and communication, and reject the idea of boosting self‐esteem through a content‐free curriculum. (shrink)

Testing is an effective learning method, and it is the basis of mobile quiz apps. Quiz apps have the potential to facilitate remote and self-regulated learning. In this context, automatized feedback plays a crucial role. In two experimental studies, we examined the effects of two feedback types of quiz apps on performance, namely, the standard corrective feedback of quiz apps and a feedback that incorporates additional information related to the correct response option. We realized a controlled lab setting (n= 68, (...) Study 1) and an unsupervised mobile setting (n= 150, Study 2). In the learning phase, participants used the quiz app and received feedback. They also completed a subsequent test as well as a follow-up test 1 week later by using the same quiz app. Irrespective of feedback type and setting, cognitive outcomes (quiz scores) and metacognitive outcomes (response certainty) increased similarly in the short term and long term. Feedback effects were not moderated by participants' overall response certainty during learning, their prior knowledge, and the difficulty of quiz items. Moreover, we found that participants perceived the quiz app to be similarly attractive, interesting, and enjoyable in both feedback conditions and that they spent slightly more time to process quiz items in the lab setting. We discuss these results in detail, including the role of moderating and mediating factors and prospects for further research and practice. Overall, our results underline that quiz apps are useful and effective tools that can support the acquisition and retention of semantic knowledge in different learning settings. (shrink)

Notions of recognition and difference do not inform the mainstream debate about welfare reform, which is, instead, dominated by a dichotomous discourse of active modernization vs passive ‘welfare dependency’. The article challenges this dichotomy within the context of New Labour’s welfare reform agenda in the UK. It argues, first, that welfare reform should treat improvements in social security benefits not as promoting ‘passive’ welfare but as complementary to labour market activation policies. Second, it redefines active welfare to incorporate notions of (...) active citizenship, which construct welfare subjects as actors in the political process of welfare policy-making and delivery. As a framework for this position, the article discusses three ‘R’s of welfare reform, risk protection, redistribution and recognition, together with the further two ‘R’s of rights and responsibilities. It concludes by emphasizing the importance of a rights agenda both to tackling poverty and exclusion and to recognition politics. (shrink)

By whatever general principles and mechanisms animal behavior is governed, human behavior control rides piggyback on top of the same or very similar mechanisms. We have reflexes. We can be conditioned. The movements that make up our smaller actions are mostly caught up in perception-action cycles following perceived Gibsonian affordances. Still, without doubt there are levels of behavior control that are peculiar to humans. Following Aristotle, tradition has it that what is added in humans is rationality ("rational soul"). Rationality, however, (...) can be and has been characterized in many different ways. I am going to speculate about two different kinds of cognitive capacities that we humans seem to have, each of which is at least akin to rationality as Aristotle described it. The first I believe we share with many other animals, the second perhaps with none. Since this session of the conference on rational animals has been designated a "brainstorming" session, I will take philosopher's license, presenting no more than the softest sort of intuitive evidence for these ideas. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Philosophy, Psychiatry, & Psychology 11.4 (2004) 299-301 [Access article in PDF] The Right Not to Know: A Challenge for Accurate Self-Assessment Ruth F. Chadwick Anderson and Lux present a very interesting and thought-provoking argument for the view that accurate self-assessment is a requirement for personal autonomy. What I want to suggest is that although this may be helpful in the context with which these authors are primarily concerned, (...) namely psychiatry and brain dysfunction, it is of less value to an account of autonomy more widely construed. I want to look at a possible counterexample, taken from another area of medicine, namely genetics.Toward the end of their article Anderson and Lux consider three objections to their position. I shall not discuss them all. My concern is with the third, that inaccurate self-assessment sometimes promotes autonomy, because knowing the truth about one's weaknesses is sometimes very debilitating. It is commonly argued that "you can if you think you can" and vice versa. As they point out, there are some complex issues involved here, in that if the result of the positive thinking is the ability to do the thing in question, then how can the self-assessment be deemed to have been inaccurate in the first place? They go on, however, to say that "it is unclear that inflated self-assessments yield benefits in contexts where what is required is not just effort but competence" (290).Now it has been argued, by some, in the context of genetics, that the proper understanding of autonomy may imply a "right not to know" facts about oneself. In other words, this is not just a matter of accurate or inaccurate assessment of the relevant facts about oneself; rather, what may be involved is a deliberate decision not to have access to facts that may be relevant to that assessment. There are clearly cases in which genetic information appears to be pertinent to an accurate self-assessment, as the following example suggests. Suppose there is information "available", through genetic testing, that would affect one's chances of having children, or of having children without a particular genetic disorder, and, knowing that such information is available, a couple decides not to avail themselves of this. This is clearly an inaccurate self-assessment, but is their autonomy compromised?It might be thought that the reasons for this decision not to know could be relevant. If they have no family history of any particular genetic disorder, it could be regarded as subjectively reasonable to decline such testing as might be offered. Anderson and Lux, however, argue that whether or not a self-assessment is accurate depends on externalities. In other words, A's self-assessment is not to be assessed as accurate, or [End Page 299] not, according to what it is subjectively reasonable to believe; it has to be measured against the facts. The more that the possibilities of genetic testing increase, the more that "facts" of this nature will be available, including in the context of psychiatry.It might be objected that genetic information is not the type of information that is relevant in this context. In so far as it is predictive and probabilistic it is, arguably, different from the type of diagnostic information involved in the cases discussed by Anderson and Lux. It is not the place here, however, to discuss in general terms the thesis of "genetic exceptionalism" with regard to medical information. The important point is refusal of access to information that may be relevant to an accurate self-assessment. Historically, people have been mistaken in their self-assessment because of lack of information—for example, lack of understanding of facts about the reproduction process has led individuals automatically to blame the woman partner of a couple for infertility. And, as Anderson and Lux rightly point out, being autonomous is compatible with making mistakes, and indeed requires the freedom to make mistakes, it would look rather different if a person continued to hold this without any attempt to avail himself of the relevant—and now available—information... (shrink)

This quotation from the London Review of Books is an example of a turn—a different way of looking at things that involves a redefinition of the kind of thing higher education is and how it should be provided. It is a turn away from a public good perspective—the opposite, it might be said, of the kind of turn addressed in this article.

In this paper I argue that Care theory has the resources to offer an insightful and original theoretical perspective on issues in medical ethics. The paper begins with a discussion of the sort of theory Care is, and argues that it closely resembles virtue theory. After a discussion of cammon features of Care theories, I respond to a few of the criticisme that have been levied against the theory. The final section of the paper is a discussion of the question (...) of neutrality in public moral discourse. Care theory is not a neutral theory with regard to questions of the nature of the good life for humans, but I argue that this should not preclude Care from playing a part in the public debate over policy decisions. (shrink)

We empirically tested Hemelrijk's agent-based model, in which dyadic agonistic interaction between primate-group subjects determines their spatial distribution and whether or not the dominant subject has a central position with respect to the other subjects. We studied a group of captive red-capped mangabeys that met the optimal conditions for testing this model. We analyzed the spatial distribution of the subjects in relation to their rank in the dominance hierarchy and the results confirmed the validity of this model. In accordance with (...) Hemelrijk's model, the group studied showed an ambiguity-reducing strategy that led to non-central spatial positioning on the part of the dominant subject, thus confirming the model indirectly. Nevertheless, for the model to be confirmed directly, the group has to adopt a risk-sensitive strategy so that observers can study whether dominant subjects develop spatial centrality. Our study also demonstrated that agent-based models are a good tool for the study of certain complex behaviors observed in primates because these explanatory models can help formulate suggestive hypotheses for exploring new lines of research in primatology. Keywords: Dominance-hierarchy rank; spatial distribution; Cercocebus torquatus ; agent-based models. (shrink)

The goal of this article is to explore how a social justice framework can help illuminate the role that consent should play in health and science policy. In the first section, we set the stage for our inquiry with the important case of Henrietta Lacks. Without her knowledge or consent, or that of her family, Mrs. Lacks’s cells gave rise to an enormous advance in biomedical science—the first immortal human cell line, or HeLa cells.

This dynamic collection provides an overview of the relationship between linguistic form and interpretation as exemplified by the most influential of these ...

Though active in the arts herself, Dr. Richards (psychology, Saybrook Graduate School, San Francisco; psychiatry, Harvard Medical School; McLean Hospital, Belmont, Massachusetts) views creativity more broadly and as essential to survival. As someone who helped break new ground in the assessment of creativity in the general population, she introduces 13 chapters in which interdisciplinary thinkers probe the "originality of everyday life" in individual and societal contexts. Perspectives range from Piaget's developmental stages and the more positive aspects of television viewing to (...) chaos theory and Zen Buddhism. In integrating these views, the editor enumerates the benefits of living creatively. (shrink)

Response to Emily A. Largent, Franklin G. Miller and Steven Joffe, A Prescription for Ethical Learning, Hastings Center Report, 43, s1, (S28-S29), (2013).

This chapter contains sections titled: Introduction Values Democracy.