Mill's discussion of ‘the internal sanction’ in chapter III of Utilitarianism does not do justice to his understanding of internal sanctions; it omits some important points and obscures others. I offer an account of this portion of his moral psychology of motivation which brings out its subtleties and complexities. I show that he recognizes the importance of internal sanctions as sources of motives to develop and perfect our characters, as well as of motives to do our duty, and I examine (...) in some detail the various ways in which these sanctions give rise to motivating desires and aversions. (shrink)

In a well-known passage in chapter V of On Liberty, J. S. Mill notes that while economic competition is generally socially beneficial and should be permitted, this “Free Trade” doctrine does not follow from the liberty or harm principle because “trade is a social act.” In a largely overlooked passage in chapter IV of the same essay, however, Mill contends that for society to coercively prohibit the practice of piecework – paying workers by the unit rather than by the hour (...) or day – does violate this principle. In this short note, I demonstrate that Mill's reasoning in these two passages is contradictory. (shrink)

In the fourteenth paragraph of the fifth chapter of Utilitarianism, J. S. Mill writes that ‘We do not call anything wrong, unless we mean to imply that a person ought to be punished in some way or other for doing it; if not by law, by the opinion of his fellow-creatures; if not by opinion, by the reproaches of his own conscience.’ I criticize the attempts of three commentators who have recently presented act-utilitarian readings of Mill – Roger Crisp, David (...) Brink, and Piers Norris Turner – to accommodate this passage. (shrink)

Background: In 2014, companies began covering the costs of egg freezing for their employees. The adoption of this benefit was highly contentious. Some argued that it offered women more reproductive...

Purpose Prescription stimulant use as “cognitive enhancers” has been described among undergraduate college students. However, the use of prescription stimulants among future health care professionals is not well characterized. This study was designed to determine the prevalence of prescription stimulant misuse among students at an academic health sciences center. -/- Method Electronic surveys were e-mailed to 621 medical, pharmacy, and respiratory therapy students at East Tennessee State University for four consecutive weeks in fall 2011. Completing the survey was voluntary and (...) anonymous. Surveys asked about reasons for, frequency of, and side effects of nonprescription misuse of prescription stimulants. Given the sensitive material, an opportunity to win one of ten $50 gift cards was used as an incentive. -/- Results Three hundred seventy-two (59.9%) students completed the survey from three disciplines (47.6% medical, 70.5% pharmacy, and 57.6% respiratory therapy). Overall, 11.3% of responders admitted to misusing prescription stimulants. There was more misuse by respiratory therapy students, although this was not statistically significant (10.9% medicine, 9.7% pharmacy, 26.3% respiratory therapy; P = .087). Reasons for prescription stimulant misuse included to enhance alertness/ energy (65.9%), to improve academic performance (56.7%), to experiment (18.2%), and to use recreationally/get high (4.5%). -/- Conclusions Prescription stimulant misuse was prevalent among participating students, but further research is needed to describe prevalence among future health care workers more generally. The implications and consequences of such misuse require further study across professions with emphasis on investigating issues of academic dishonesty (e.g., “cognitive enhancement”), educational quality, and patient safety or health care quality. (shrink)

BackgroundIn the Canadian Alliance for Healthy Hearts and Minds (CAHHM) cohort, participants underwent magnetic resonance imaging (MRI) of the brain, heart, and abdomen, that generated incidental findings (IFs). The approach to managing these unexpected results remain a complex issue. Our objectives were to describe the CAHHM policy for the management of IFs, to understand the impact of disclosing IFs to healthy research participants, and to reflect on the ethical obligations of researchers in future MRI studies.MethodsBetween 2013 and 2019, 8252 participants (...) (mean age 58 ± 9 years, 54% women) were recruited with a follow-up questionnaire administered to 909 participants (40% response rate) at 1-year. The CAHHM policy followed a restricted approach, whereby routine feedback on IFs was not provided. Only IFs of severe structural abnormalities were reported.ResultsSevere structural abnormalities occurred in 8.3% (95% confidence interval 7.7–8.9%) of participants, with the highest proportions found in the brain (4.2%) and abdomen (3.1%). The majority of participants (97%) informed of an IF reported no change in quality of life, with 3% of participants reporting that the knowledge of an IF negatively impacted their quality of life. Furthermore, 50% reported increased stress in learning about an IF, and in 95%, the discovery of an IF did not adversely impact his/her life insurance policy. Most participants (90%) would enrol in the study again and perceived the MRI scan to be beneficial, regardless of whether they were informed of IFs. While the implications of a restricted approach to IF management was perceived to be mostly positive, a degree of diagnostic misconception was present amongst participants, indicating the importance of a more thorough consent process to support participant autonomy.ConclusionThe management of IFs from research MRI scans remain a challenging issue, as participants may experience stress and a reduced quality of life when IFs are disclosed. The restricted approach to IF management in CAHHM demonstrated a fair fulfillment of the overarching ethical principles of respect for autonomy, concern for wellbeing, and justice. The approach outlined in the CAHHM policy may serve as a framework for future research studies.Clinical trial registrationhttps://clinicaltrials.gov/ct2/show/nct02220582. (shrink)

This Companion offers a state-of-the-art survey of the work of John Stuart Mill – one which covers the historical influences on Mill, his theoretical, moral and social philosophy, as well as his relation to contemporary movements. Its contributors include both senior scholars with established expertise in Mill’s thought and new emerging interpreters. Each essay acts as a ‘go-to’ resource for those seeking to understand an aspect of Mill’s thought or to familiarise themselves with the contours of a debate within the (...) scholarship. The Companion is a key reference on Mill’s theory of liberty and utilitarianism, but also provides a valuable resource on lesser-known aspects of his work, including his epistemology, metaphysics, and philosophy of language. The volume is divided into six sections. Part I covers Mill’s life, his immediate posthumous reputation, and his own telling of his life-story. Part II brings together an accessible and comprehensive summary of the various influences on Mill’s thought. Part III offers an account of the foundations of Mill’s philosophy and his thought on key philosophic topics. Parts IV and V tackle issues from Mill’s moral and social philosophy. Part VI concludes with a treatment of the broader aspects of Mill’s thought, tracing his relation to major movements in philosophy. (shrink)

[The Catcher in the Rye's] catalogue of characters, incidents, expressions could be extended indefinitely, all of them suggesting that Holden's sickness of soul is something deeper than economic or political, that his revulsion at life is not limited to social and monetary inequities, but at something in the nature of life itself - the decrepitude of the aged, the physical repulsiveness of the pimpled, the disappearance and dissolution of the dead, the terrors of sex, the hauntedness of human aloneness, the (...) panic of individual isolation. Headlines about Korea, Dean Acheson, and the cold war seem, if not irrelevant, essentially wide of the mark - if we define the mark as the heart and soul of Catcher. James E. Miller, Jr., author of "Henry James in Reality" and numerous books and articles on American literature, responds in this essay to Carol and Richard Ohmann's "Reviewers, Critics, and The Catcher in the Rye. The Ohmann's answer will appear in our summer issue. (shrink)

In working his way through his complex conception of the relation of fiction and reality, [Henry] James thus found the unconscious moral dimension inextricably embedded within "realism" itself. In following the threads of realism back to consciousness itself, James invariably found there intertwined with its roots those aspects and elements that other theorists kept carefully separate. By exploring experience to its source, he found imagination. By following objective life from "out there" to conception, he found individual vision. By following the (...) seeming oneness of the passing show back to perception, he found infinite variation and multiplicity. By following the uncolored flux and flow of events to their embodiment in the fictional medium, he found coloration of personality. And by following the "felt life" back to the artist's "prime sensibility", James found there the "moral sense" and the "enveloping air of the artist's humanity"—that which gives "the last touch to the worth of a work." James E. Miller, Jr., professor of English at the University of Chicago, is the author of A Critical Guide to Leaves of Grass; Walt Whitman; F. Scott Fitzgerald: His Art and His Technique; J.D. Salinger; Theory of Fiction: Henry James; and numerous articles on American literature and education. He contributed "Catcher In and Out of History" to Critical Inquiry, Spring 1977. (shrink)

This report describes the rationale, approaches, organization, and resource development leading to a large-scale deletion bin map of the hexaploid wheat genome. Accompanying reports in this issue detail results from chromosome bin-mapping of expressed sequence tags representing genes onto the seven homoeologous chromosome groups and a global analysis of the entire mapped wheat EST data set. Among the resources developed were the first extensive public wheat EST collection. Described are protocols for sequencing, sequence processing, EST nomenclature, and the assembly of (...) ESTs into contigs. These contigs plus singletons were used for selection of distinct sequence motif unigenes. Selected ESTs were rearrayed, validated by 5′ and 3′ sequencing, and amplified for probing a series of wheat aneuploid and deletion stocks. Images and data for all Southern hybridizations were deposited in databases and were used by the coordinators for each of the seven homoeologous chromosome groups to validate the mapping results. Results from this project have established the foundation for future developments in wheat genomics. (shrink)

Recruiting research participants based on genetic information generated about them in a prior study is a potentially powerful way to study the functional significance of human genetic variation, but it also presents ethical challenges. To inform policy development on this issue, we conducted a survey of U.S. institutional review board chairs concerning the acceptability of recontacting genetic research participants about additional research and their views on the disclosure of individual genetic results as part of recruitment. Our findings suggest there is (...) unlikely to be a “one-size-fits-all” solution, but rather several ethically acceptable approaches to genotype-driven recruitment, depending on context. Disclosures made during the consent process for the original study and the clinical validity of the results are key considerations. Researchers must be prepared to communicate and answer questions in clear lay language about what is known and not known regarding the role of genetics in their proposed area of research. (shrink)

BackgroundThe U.S. Food and Drug Administration traditionally has kept confidential significant amounts of information relevant to the approval or non-approval of specific drugs, devices, and biologics and about the regulatory status of such medical products in FDA’s pipeline.ObjectiveTo develop practical recommendations for FDA to improve its transparency to the public that FDA could implement by rulemaking or other regulatory processes without further congressional authorization. These recommendations would build on the work of FDA’s Transparency Task Force in 2010.MethodsIn 2016-2017, we convened (...) a team of academic faculty from Harvard Medical School, Brigham and Women’s Hospital, Yale Medical School, Yale Law School, and Johns Hopkins Bloomberg School of Public Health to develop recommendations through an iterative process of reviewing FDA’s practices, considering the legal and policy constraints on FDA in expanding transparency, and obtaining insights from independent observers of FDA.ResultsThe team developed 18 specific recommendations for improving FDA’s transparency to the public. FDA could adopt all these recommendations without further congressional action.FundingThe development of the Blueprint for Transparency at the U.S. Food and Drug Administration was funded by the Laura and John Arnold Foundation. (shrink)

This article presents a process account of some typicality effects and related similarity-dependent accuracy and response time phenomena that arise in the context of supervised concept acquisition. We describe Symbolic Concept Acquisition (SCA), a computational system that acquires and activates category prediction rules. In contrast to gradient representations, SCA performs by probing for prediction rules in a series of discrete steps. For learning new rules, it acquires general rules but then incrementally learns more specific ones. In describing SCA, we emphasize (...) its functionality in terms of accuracy and efficiency and motivate its design within the set of symbolic mechanisms and memory structures defined by the Soar architecture (Laird, Newell & Rosenbloom, 1987). For replicating human behavior, we first show how SCA exhibits some typicality effects in the course of learning responding faster and more accurately to more typical test examples. Then, using data from human experiments, we evaluate SCA's qualitative predictions on accuracy and response time on individual dataset instances. We show how SCA's predictions correlate with human data across three experimental conditions concerning the effect of instruction on learning strategy. (shrink)

What determines whether an action is right or wrong? Morality, Rules, and Consequences: A Critical Reader explores for students and researchers the relationship between consequentialist theory and moral rules. Most of the chapters focus on rule consequentialism or on the distinction between act and rule versions of consequentialism. Contributors, among them the leading philosophers in the discipline, suggest ways of assessing whether rule consequentialism could be a satisfactory moral theory. These essays, all of which are previously unpublished, provide students in (...) moral philosophy with essential material and ask key questions on just what the criteria for an adequate moral theory might be. (shrink)

Despite the burgeoning literature on professionalism in other health professions, psychology lags behind in the level of attention given to this core competency. In this article, we review definitions from other health professions and how they address professionalism. Next, we review how this competency evolved within health service psychology (HSP), and we propose a definition. We offer an approach for assessing professionalism within HSP. Consideration is given to strategies and methods for providing effective education and training in this multifaceted competency. (...) Finally, recommendations are made for creating a culture of professionalism within HSP and honoring psychology’s social contract with multiple publics. (shrink)

Using payment to recruit research subjects is a common practice, but it raises ethical concerns that coercion or undue inducement could potentially compromise participants’ informed consent. This is the first national study to explore the attitudes of IRB members and other human subjects protection professionals concerning whether payment of research participants constitutes coercion or undue influence, and if so, why. The majority of respondents expressed concern that payment of any amount might influence a participant’s decisions or behaviors regarding research participation. (...) Respondents expressed greater acceptance of payment as reimbursement or compensation than as an incentive to participate in research, and most agreed that subjects are coerced if the offer of payment makes them participate when they otherwise would not or when the offer of payment causes them to feel that they have no reasonable alternative but to participate . Views about undue influence were similar. We conclude that human subjects protection professionals hold expansive and inconsistent views about coercion and undue influence that may interfere with the recruitment of research participants and impede valuable research. (shrink)

Late in 1990, the Center for the Study of Ethics in the Professions at Illinois Institute of Technology (lIT) received a grant of more than $200,000 from the National Science Foundation to try a campus-wide approach to integrating professional ethics into its technical curriculum.! Enough has now been accomplished to draw some tentative conclusions. I am the grant's principal investigator. In this paper, I shall describe what we at lIT did, what we learned, and what others, especially philosophers, can learn (...) from us. We set out to develop an approach that others could profitably adopt. I believe that we succeeded. (shrink)

Electronic media present tremendous opportunities for improving the nature of society. I will address how discourse affects society, and how changes in media may improve societal discourse.

Primary progressive aphasia is a clinical syndrome in which patients progressively lose speech and language abilities. Three variants are recognized: logopenic, associated with phonology and/or short-term verbal memory deficits accompanied by left temporo-parietal atrophy; semantic, associated with semantic deficits and anterior temporal lobe atrophy; non-fluent associated with grammar and/or speech-motor deficits and inferior frontal gyrus atrophy. Here, we set out to investigate whether the three variants of PPA can be dissociated based on error patterns in a single language task. We (...) recruited 21 lvPPA, 28 svPPA, and 24 nfvPPA patients, together with 31 healthy controls, and analyzed their performance on an auditory noun-to-verb generation task, which requires auditory analysis of the input, access to and selection of relevant lexical and semantic knowledge, as well as preparation and execution of speech. Task accuracy differed across the three variants and controls, with lvPPA and nfvPPA having the lowest and highest accuracy, respectively. Critically, machine learning analysis of the different error types yielded above-chance classification of patients into their corresponding group. An analysis of the error types revealed clear variant-specific effects: lvPPA patients produced the highest percentage of “not-a-verb” responses and the highest number of semantically related nouns ; in contrast, svPPA patients produced the highest percentage of “unrelated verb” responses and the highest number of light verbs. Taken together, our findings indicate that error patterns in an auditory verb generation task are associated with the breakdown of different neurocognitive mechanisms across PPA variants. Specifically, they corroborate the link between temporo-parietal regions with lexical processing, as well as ATL with semantic processes. These findings illustrate how the analysis of pattern of responses can help PPA phenotyping and heighten diagnostic sensitivity, while providing insights on the neural correlates of different components of language. (shrink)

In 'Axiological Actualism' Josh Parsons argues that 'axiological actualism', which is 'the doctrine that ethical theory should refrain from assigning levels of welfare, or preference orderings, or anything of the sort to merely possible people', lends plausibility to 'the converse intuition'. This is the proposition that 'the welfare a person would have, were they actual, can give us a reason not to bring that person into existence'. I show that Parsons's argument delivers less than he promises. It could be convincing (...) only to actualists who hold certain views about normative ethics, and could at most convince them to heed the converse intuition only under certain circumstances. (shrink)

In 'Axiological Actualism' Josh Parsons argues that 'axiological actualism', which is 'the doctrine that ethical theory should refrain from assigning levels of welfare, or preference orderings, or anything of the sort to merely possible people', lends plausibility to 'the converse intuition'. This is the proposition that 'the welfare a person would have, were they actual, can give us a reason not to bring that person into existence'. I show that Parsons's argument delivers less than he promises. It could be convincing (...) only to actualists who hold certain views about normative ethics, and could at most convince them to heed the converse intuition only under certain circumstances. (shrink)

No one doubts that Kierkegaard's Concluding Unscientific Postscript is one of the most important, one of the most artistically contrived, and certainly one of the wittiest works in the history of philosophy. Further, the Postscript has often been accorded a kind of centrality in the Kierkegaardian corpus. Kierkegaard himself seems to have assigned it some such role. He informs the reader in the ‘First and Last Declaration’ that he originally intended the Postscript to be his last word before retiring from (...) his authorship . In The Point of View for My Work as an Author he himself calls it both ‘the turning-point’ and ‘the middle point’ in the sense that ‘this work concerns itself with and sets “the Problem”, which is the problem of the whole authorship: how to become a Christian’. Aside from the way in which Kierkegaard may have conceived the Postscript as being central or pivotal to his whole enterprise, certainly scholars have sometimes treated the Postscript as, at least in some ways, his magnum opus and summum verbum – as I would also. But our concern here is not with the centrality of the Postscript but with the centrality within the Postscript. Most everyone would, I think, acknowledge that a central section of the Postscript may be identified, though I would go farther and claim that within this a central, pivotal, solitary statement may be identified. (shrink)

Amie Thomasson’s work provides numerous ways to rethink and improve our approach to metaphysics. This chapter is my attempt to begin to sketch why I still think the easy approach leaves room for substantive metaphysical work, and why I do not think that metaphysics need rely on any ‘epistemically metaphysical’ knowledge. After distinguishing two possible forms of deflationism, I argue that the easy ontologist needs to accept (implicitly or explicitly) that there are worldly constraints on what sorts of entities could (...) exist, and could co-exist. I argue this leaves room for a substantive role for metaphysics if (following the work of E.J. Lowe) we take metaphysics to be concerned with the possible ways that reality could be. I explain how this conception does not need to appeal to any ‘epistemically metaphysical’ knowledge, and need only make use of conceptual and/or empirical means to arrive at views on what could exist (and co-exist). Thus, the answer I propose to the question posed in the title, at least in my view, is no-one. Or, at least, no-one should be afraid of conceptual analysis. Not even metaphysicians. (shrink)

After critiquing some earlier attempts (including those of Marcus Singer and Frances Howard–Snyder) to ground objections to actual–consequence act utilitarianism (ACAU) on human cognitive limitations, I present two new objections with this same foundation. Both start with the observation that, because human cognitive abilities are not up to the task of reliably recognizing utility–maximizing actions, any agents who are recognizably human – including the best possible humans, morally speaking – are certain to perform many actions every day that ACAU says (...) are immoral, and to perform some actions over the course of their lives that it says are highly immoral. The first objection is that, if Mill's analysis of what it means to call an action wrong is accurate, then ACAU entails a conclusion that no one will accept, viz., that the morally–best humans possible ought to undergo constant punishment. The second objection is that ACAU entails that even the morally–best humans possible are bad moral agents in some respect. This conclusion, while unpalatable, is not so obviously unacceptable as the first. However, I do briefly consider some ways in which it might be possible to demonstrate that it is false and thereby complete a reductio of ACAU. (shrink)

The introduction (about 6,000 words) to _The Cambridge Companion to Utilitarianism_, in three sections: utilitarianism’s place in recent and contemporary moral philosophy (including the opinions of critics such as Rawls and Scanlon), a brief history of the view (again, including the opinions of critics, such as Marx and Nietzsche), and an overview of the chapters of the book.