BackgroundNusinersen is one of an increasing number of new, expensive orphan drugs to receive authorization. These drugs strain public healthcare budgets and challenge principles for resource allocation. Nusinersen was introduced in the Norwegian public healthcare system in 2018. A national expert group consisting of physicians was formed to oversee the introduction and continuation of treatment in light of specific start and stop criteria.MethodsWe have studied experiences within the expert group with a special emphasis on their application of the start and (...) stop criteria, rationing of treatment, and experienced moral dilemmas. A research interview with six members of the national expert group was performed, then analysed with manifest content analysis. The analysis was supplemented with publically available sources on priority setting and the process leading up to the introduction of nusinersen and the establishment of the expert group.ResultsSixty-six patients have received treatment within the first 25 months since the national expert group’s establishment. Treatment has not been discontinued for any patient. No patients under 18 years of age have been denied treatment, as those who were referred at this age were all deemed to fulfill the start criteria. The expert group has, however, increased geographical treatment equity and facilitated important cooperation at the national level. Furthermore, it has enhanced open and critical discussions of both medical issues and new ethical dilemmas.ConclusionAlthough facilitating equal access to treatment for SMA patients, the national expert group has not discontinued treatment for any patient. It is suggested that in order for clinicians to be able to ration care for individual patients, they require both adequate support and sufficient formal authority. Start and stop criteria need to be re-evaluated as more knowledge and experience are gained regarding the treatment. (shrink)

The Moral Nexus develops and defends a new interpretation of morality—namely, as a set of requirements that connect agents normatively to other persons in a nexus of moral relations. According to this relational interpretation, moral demands are directed to other individuals, who have claims that the agent comply with these demands. Interpersonal morality, so conceived, is the domain of what we owe to each other, insofar as we are each persons with equal moral standing. The book offers an interpretative argument (...) for the relational approach. Specifically, it highlights neglected advantages of this way of understanding the moral domain; explores important theoretical and practical presuppositions of relational moral duties; and considers the normative implications of understanding morality in relational terms. The book features a novel defense of the relational approach to morality, which emphasizes the special significance that moral requirements have, both for agents who are deliberating about what to do and for those who stand to be affected by their actions. The book argues that relational moral requirements can be understood to link us to all individuals whose interests render them vulnerable to our agency, regardless of whether they stand in any prior relationship to us. It also offers fresh accounts of some of the moral phenomena that have seemed to resist treatment in relational terms, showing that the relational interpretation is a viable framework for understanding our specific moral obligations to other people. (shrink)

A lump theorist claims that ordinary objects are spread out across possible worlds, much like many of us think that tables are spread out across space. We are not wholly located in any one particular world, the lump theorist claims, just as we are not wholly spatially located where one’s hand is. We are modally spread out, a trans-world mereological sum of world-bound parts. We are lump sums of modal parts. And so are all other ordinary objects. In this paper, (...) I explore lump theory and investigate five arguments against it. These arguments may be the primary reasons why lump theory has not been widely accepted––or extensively explored––until now. I maintain that these arguments can be answered, and moreover, that accepting lump theory has distinct advantages, making it a competitive view in its own right. (shrink)

I attempt to get as clear as possible on the chain of reasoning by which irreversible macrodynamics is derivable from time-reversible microphysics, and in particular to clarify just what kinds of assumptions about the initial state of the universe, and about the nature of the microdynamics, are needed in these derivations. I conclude that while a “Past Hypothesis” about the early Universe does seem necessary to carry out such derivations, that Hypothesis is not correctly understood as a constraint on the (...) early Universe’s entropy. (shrink)

Most historical accounts of "the West" take it for granted that the guiding principles of the Western tradition—reason, progress, and freedom—have been passed down directly from ancient Greece to modern Europe, evolving in isolation from all non-Western cultures. Today, many political analysts and cultural critics maintain that the Western tradition is fast approaching its end, for better or worse, as it becomes more and more integrated with non-Western cultures in an increasingly globalized world. But what if we are witnessing something (...) else entirely—not the "end" of the West but rather another historical mutation of the idea of the West itself? This groundbreaking work shows that whether the West is hailed as the source of all historical progress or scorned as the root of all cultural imperialism, it remains a deeply problematic concept that is intrinsically connected to an ethnocentric view of the world. In a critical reading of the continental philosophers Husserl, Heidegger, Levinas, and Derrida as well as the postcolonial thinkers Said, Mohanty, Bhabha, and Trinh, Sean Meighoo strikes at the intellectual foundations of Western exceptionalism until its ideological supports show through. Deconstructing the concept of the West in his provocative interpretations of Martin Bernal's controversial publication Black Athena and the Beatles' second film Help!, Meighoo poses a formidable question to philosophers, writers, political analysts, and cultural critics alike: Can we mount an effective critique of Western ethnocentrism without reinforcing the very idea of the West? (shrink)

Graduate-level textbook in general relativity.

Moritz Schlick, Rudolf Carnap and Herbert Feig are the most prominent of the positivists to formulate views on the mind-body problem (aside from Hempel’s one-off treatment in 1935). While their views differed from each other and changed over time they were all committed to some form of scientific physicalism, though a linguistic or conceptual rather than ontological form of it. In focus here are their views during the heyday of logical positivism and its immediate aftermath, though some initial scene-setting of (...) Schlick’s and Carnap’s pre-positivist views will help to understand the final opposing positions of Carnap and Feigl. (shrink)

RésuméJe me demande ici si les conceptions pragmatiques de la vérité peuvent être réconciliées avec les intuitions ordinaires quant à la portée de la bivalence. Je soutiens que les pragmatistes sont conduits à accepter une distinction du genre «type / occurrence» entre les formes d'une investigation et ses instanciations particulières, sous peine de banaliser leur vérificationnisme. Néanmoins, même la conception révisée que j'examine échoue à sauver les approches épistémiques de la vérité de certaines conséquences peu plausibles.

I point out a radical indeterminism in potential-based formulations of Newtonian gravity once we drop the condition that the potential vanishes at infinity. This indeterminism, which is well known in theoretical cosmology but has received little attention in foundational discussions, can be removed only by specifying boundary conditions at all instants of time, which undermines the theory's claim to be fully cosmological, i.e., to apply to the Universe as a whole. A recent alternative formulation of Newtonian gravity due to Saunders (...) pp.22-48) provides a conceptually satisfactory cosmology but fails to reproduce the Newtonian limit of general relativity in homogenous but anisotropic universes. I conclude that Newtonian gravity lacks a fully satisfactory cosmological formulation. (shrink)

This book provides an account of the nature of time, especially time's arrow and the role of entropy, at a semi-popular level. Special attention is given to statistical mechanics, the past hypothesis, and possible cosmological explanations thereof.

I discuss "Poetic Naturalism" -- there is only one world, the natural world, but there are many ways of talking about it -- both as a general concept, and how it accounts for our actual world. I talk about emergence, fundamental physics, entropy and complexity, the origins of life and consciousness, and moral constructivism.

I develop an account of how mathematized theories in physics represent physical systems, in response to the frequent claim that any such account must presuppose a non-mathematized, and usually linguistic, description of the system represented. The account I develop contains a circularity, in that representation is a mathematical relation between the models of a theory and the system as represented by some other model --- but I argue that this circularity is not vicious, in any case refers in linguistic accounts (...) of meaning and representation, and is simply a consequence of the fact that we have no unmediated, representation-independent access to the world. (shrink)

I criticise the view that the relativity and equivalence principles are consequences of the small-scale structure of the metric in general relativity, by arguing that these principles also apply to systems with non-trivial self-gravitation and hence non-trivial spacetime curvature (such as black holes). I provide an alternative account, incorporating aspects of the criticised view, which allows both principles to apply to systems with self-gravity.

It is commonplace in discussions of modern cosmology to assert that the early universe began in a special state. Conventionally, cosmologists characterize this fine-tuning in terms of the horizon and flatness problems. I argue that the fine-tuning is real, but these problems aren't the best way to think about it: causal disconnection of separated regions isn't the real problem, and flatness isn't a problem at all. Fine-tuning is better understood in terms of a measure on the space of trajectories: given (...) reasonable conditions in the late universe, the fraction of cosmological histories that were smooth at early times is incredibly tiny. This discussion helps clarify what is required by a complete theory of cosmological initial conditions. (shrink)

The concept of alienation: Hegelian themes in modern social thought -- Creative activity and alienation in Hegel and Marx -- The concept of labour -- The individual and society -- Freedom and the "realm of necessity" -- Alienation as a critical concept -- Private property and communism -- The division of labour and its overcoming -- Marx's concept of communism.

This paper articulates and responds to a challenge to contemporary compatibilist views of free will. Despite the popularity and appeal of compatibilist theories, many are left with lingering doubts about compatibilism. This paper explains this doubt in terms of the absurdity challenge: because a compatibilist accepts that they do not have causal access to all the actual sufficient causal sources of their own agency, the compatibilist can find their own agency absurd. By taking a cue from political philosophy, this paper (...) argues that a non-ideal construction of the problem of free will allows compatibilists to overcome this existential-metaphysical challenge, and by doing so, perhaps adopt a metaphysically progressive picture of human agency. (shrink)

There is uneasy tension between our ordinary talk about beliefs and desires and the ontological facts supported by neuroscience. Arguments for eliminative materialism are persuasive, yet error theory about folk psychological discourse seems unacceptable. One solution is to accept mental fictionalism: the view that we are (or should be) fictionalists about mentality. My aim in this paper is to explore mental fictionalism as a viable theoretical option, and to show that it has advantages over other fictionalist views in the literature, (...) as well as advantages over other theories of mind. However, mental fictionalism faces objections that do not plague other fictionalist accounts, nor other theories of the mind. These objections may provide some explanation as to why mental fictionalism has not (until recently) gained much traction in the literature. I end with some suggestions on how the mental fictionalist can address these objections, hopefully paving the way for further development of mental fictionalism as a live philosophical position in philosophy of mind. (shrink)

Philosophy of Physics: A Very Short Introduction explores the core topics of philosophy of physics through three key themes: the nature of space and time; the origin of irreversibility and probability in the physics of large systems; how we can make sense of quantum mechanics. Central issues discussed include: the scientific method as it applies in modern physics; the distinction between absolute and relative motion; the way that distinction changes between Newton's physics and special relativity; what spacetime is and how (...) it relates to the laws of physics; how fundamental physics can make no distinction between past and future and yet a clear distinction exists in the world we see around us; why it is so difficult to understand quantum mechanics, and why doing so might push us to change our fundamental physics, to rethink the nature of science, or even to accept the existence of parallel universes. (shrink)

Normativity and the Will collects fourteen important papers on moral psychology and practical reason by R. Jay Wallace, one of the leading philosophers currently working in these areas.The papers explore the interpenetration of normative and psychological issues in a series of debates that lie at the heart of moral philosophy. Part I, Reason, Desire, and the Will, discusses the nexus linking normativity to motivation, including the relations between desire and reasons, the role of normative considerations in explanations of action, (...) and the normative commitments involved in willing an end. Part II, Responsibility, Identification, and Emotion, looks at questions about the rational capacities presupposed by accountable agency and the psychic factors that both inhibit and enable identification with what we do. It includes an interpretation of the Nietzschean claim that ressentiment is among the sources of modern moral consciousness. Part III, Morality and Other Normative Domains, addresses the structure of moral reasons and moral motivation, and the relations between moral demands and other normative domains. Wallace's treatments of these topics are at once sophisticated and engaging. Taken together, they constitute an advertisement for a distinctive way of pursuing issues in moral psychology and the theory of practical reason. The book articulates and defends a unified framework for thinking about those issues, while offering sustained critical discussions of other influential approaches. It should be of interest to every serious student of moral philosophy. (shrink)

This is my second entry in Mental Fictionalism: Philosophical Explorations. It examines three meta-ontological deflationary approaches - frameworks, verbal disputes, and metalinguistic negotiation - and applies them to ontological debates in philosophy of mind. An intriguing consequence of this application is that it reveals a deep, systematic problem for mental deflationism – specifically, a problem of cognitive collapse. This is surprising. Cognitive collapse problems are usually reserved for serious ontological views such as eliminative materialism and mental fictionalism, not deflationism. This (...) paper investigates why deflationism about the mental is particularly problematic and provides an explanation as to why mental fictionalism is in principle better equipped to address collapsing problems than deflationism is. (shrink)

Abstract According to Russellianism, the content of a Russellian thought, in which a person ascribes a monadic property to an object, can be represented as an ordered couple of the object and the property. A consequence of this is that it is not possible for a person to believe that a is F and not to believe b is F, when a=b. Many critics of Russellianism suppose that this is possible and thus that Russellianism is false. Several arguments for this (...) claim are criticized and it is argued that Russellians need not appeal to representational notions in order to defeat them. Contrary to popular opinion, the prospects for a pure Russellianism, a Russellianism without representations, are in fact very good. (shrink)

This is both a book about ourselves, our world, and education. What made an education successful is too often left behind when we focus too closely on what we think should be in the spotlight. Re-looking at how these things interact and intersect will be pertinent to their and our success.

This paper explores the question whether utilitarianism is compatible with the autonomy of the moral agent. The paper begins by considering Bernard Williams' famous complaint that utilitarianism cannot do justice to the personal projects and commitments constitutive of character. Recent work (by Peter Railton among others) has established that a utilitarian agent need not be free of such personal projects and commitments, and could even affirm them morally at the level of second"order reflection. But a different and more subtle problem (...) confronts this approach: the use of utilitarian principles to justify the cultivation of personal projects and attachments undermines the autonomy to support this objection, according to which autonomy is a matter of acting in a way one can reflectively endorse. (shrink)

A non-technical introduction to quantum mechanics, the Everett interpretation, and the emergence of spacetime.

How do we establish the relevance of a moral consideration when doing so is problematic? How are conflicts among relevant considerations properly resolved? James D. Wallace maintains that a successful ethical theory should be able to answer these important questions. Nevertheless, he argues, the leading contemporary moral theories do not satisfactorily address them. In this book, Wallace criticizes the standard philosophical accounts of how we should resolve problems of moral relevance and moral conflict. He proceeds by looking at (...) such accounts as utilitarianism, Kantian moral theory, and intuitionism, and by providing an extended evaluation of Henry Sidgwick's moral epistemology. According to Wallace, these approaches pose difficulties because they all assume that there exist fixed, unchanging standards, rules, or methods that give us explicit directions for the solution of such problems. He then goes on to develop his own, "contextualist," approach, which combines elements of both Aristotelian and pragmatic views. To solve new problems, he asserts, we must adapt what we have learned from past problems to novel circumstances, sometimes appreciably changing our ways of dealing with certain kinds of issues. In adapting our ways of dealing with these issues to unprecedented problems, and in dealing with the conflicts that arise from unprecedented juxtapositions of considerations, we alter and even reform morality. (shrink)

This chapter offers a general outline of Schopenhauer’s peculiarly named concept of the 'acquired character’ and explains its basic function in his ethical thought. For Schopenhauer, a person of acquired character is someone who knows the ways of acting (Handlungsweise) that are most expressive of their individuality and who allows that self-knowledge to structure their practical and emotional life. In keeping with certain elements of his psychological determinism, acquired character is not the acquisition of a ‘new’ character; rather, it is (...) the acquisition of self-knowledge of one’s essentially fixed empirical character. It is part of the argument of this chapter that by introducing the acquired character into his reflections on human action and agency Schopenhauer weaves a certain view of individual flourishing (eudaimonia) into his ethics. There are two central ingredients of Schopenhauer’s conception of eudaimonia, and both are linked to the acquired character. The first is self-knowledge; the second is a sense of personal autonomy that follows in the wake of the first. The chapter ends with a brief attempt to connect Schopenhauer’s concept of acquired character to contemporary debates in ethics concerning autonomy, practical identity, and what some call the ‘normative significance of self’. (shrink)

In The Logic of Sense, Deleuze effectively argues that two types of relation between events govern their ‘evental’ or ‘ideal play’, and ultimately underlie determined substances, that is, worldly individuals and persons. Leibniz calls these relations ‘compossibility’ and ‘incompossibility’. Deleuze calls them ‘convergence’ and ‘divergence’. This paper explores how Deleuze appropriates and extends a number of Leibnizian concepts in order to ground the idea that events have ontological priority over substances ‘all the way down’.

What responsibility does an author bear for his legacy? Do 'catastrophic' misreadings of authors, as we have seen with totaliatarian readings of Plato and fascist interpretations of Nietzsche, testify to authorial recklessness? These and other questions are the starting point for a new theory of authorial ethics. Continuing the mission of the 'returned author' begun in his pioneering book The Death and Return of the Author, Burke recommends the 'law of genre' as a contract drawn up between author and reader (...) to establish ethical responsibility. Criticism, under this contract, becomes an ethical realm and realm of the ethical. -- Back cover. (shrink)

Archaeological theory -- Philosophy and archaeology -- Critical realism as critique of Western philosophy -- Critical realism as philosophical underlabourer -- Diversity and impasse in current archaeological theorising -- The contradictions of archaeological theory -- The material in archaeological theory -- Critical realism, the material, and absence -- Time, scale, and the ontology of the material -- Conclusions, implications, and further research.

This chapter contains sections titled: Notes.

Some modern cosmological models predict the appearance of Boltzmann Brains: observers who randomly fluctuate out of a thermal bath rather than naturally evolving from a low-entropy Big Bang. A theory in which most observers are of the Boltzmann Brain type is generally thought to be unacceptable, although opinions differ. I argue that such theories are indeed unacceptable: the real problem is with fluctuations into observers who are locally identical to ordinary observers, and their existence cannot be swept under the rug (...) by a choice of probability distributions over observers. The issue is not that the existence of such observers is ruled out by data, but that the theories that predict them are cognitively unstable: they cannot simultaneously be true and justifiably believed. (shrink)

This article consists of a close reading and explication of several of the central philosophical concepts to be found in Simondon's L’individu et sa genèse physico-biologique. It then proceeds to show how not only these concepts, but also Simondon's method for constructing these concepts, are taken up by Gilles Deleuze in Chapter 5 of his Difference and Repetition. In particular, the article shows how Deleuze's characterization of ‘intensive processes of individuation’ is thoroughly Simondonian. The article will also provide the English (...) speaking reader with an introduction to the French language commentary on Simondon and Deleuze. (shrink)

A provocative close reading revealing a radical, proto-phenomenological Socrates.

This Is A New Release Of The Original 1898 Edition.

We have a much better understanding of physics than we do of consciousness. I consider ways in which intrinsically mental aspects of fundamental ontology might induce modifications of the known laws of physics, or whether they could be relevant to accounting for consciousness if no such modifications exist. I suggest that our current knowledge of physics should make us skeptical of hypothetical modifications of the known rules, and that without such modifications it’s hard to imagine how intrinsically mental aspects could (...) play a useful explanatory role. Draft version of a paper submitted to Journal of Consciousness Studies, special issue responding to Philip Goff’s Galileo’s Error: Foundations for a New Science of Consciousness. (shrink)

This book examines Cornelius Castoriadis's elucidation of the social imaginary within human societies, assessing how strict dichotomisation between autonomous and heternomous modes of institution hinders further insights into the creative capacities of social imaginary, while also imposing limits on Castoriadis's own assessment of the "partially" autonomous situation of modern societies.

Teacher Education and the Pursuit of Wisdom takes its readers into the deep waters of investigating teaching not simply as a profession but as a precious "way of life." The author begins by investigating the nature of teaching as both an "active" and a "contemplative" endeavor and inquires into the resonance between the nature of teaching on the one hand and what has been said classically about genuine philosophizing on the other hand. Having laid the groundwork for students to be (...) able to recognize this intimate connection, readers are next challenged to take up the notion of teaching as a "way of life" in the pursuit of wisdom experimentally and to record their observations in a personalized journal format. Thorough explanations are provided concerning the value of journaling for self-knowledge, and exemplar texts by master journal writers are discussed. This book is designed for use as a primary textbook in philosophy of education courses. Instructors will find it helpful as a means to organize engaging classes at both the undergraduate and graduate levels for genuine philosophic practices and inquiry. It contains a well-defined program of work that is modelled upon the latest research concerning "authentic task design." Its rich experimental approach is replete with a broad array of learning tasks, assessment tools, and practices that are aligned with the competencies-based approach taken in most professional certification and BEd Programs. (shrink)

This work has been selected by scholars as being culturally important, and is part of the knowledge base of civilization as we know it. This work was reproduced from the original artifact, and remains as true to the original work as possible. Therefore, you will see the original copyright references, library stamps (as most of these works have been housed in our most important libraries around the world), and other notations in the work. This work is in the public domain (...) in the United States of America, and possibly other nations. Within the United States, you may freely copy and distribute this work, as no entity (individual or corporate) has a copyright on the body of the work. As a reproduction of a historical artifact, this work may contain missing or blurred pages, poor pictures, errant marks, etc. Scholars believe, and we concur, that this work is important enough to be preserved, reproduced, and made generally available to the public. We appreciate your support of the preservation process, and thank you for being an important part of keeping this knowledge alive and relevant. (shrink)

I defend the extremist position that the fundamental ontology of the world consists of a vector in Hilbert space evolving according to the Schrödinger equation. The laws of physics are determined solely by the energy eigenspectrum of the Hamiltonian. The structure of our observed world, including space and fields living within it, should arise as a higher-level emergent description. I sketch how this might come about, although much work remains to be done.