The view of teleology sketched in the above remarks seems to me to offer a piece of candy to both the critics and guardians of teleology. The critics want to defend against a number of things: the importation of unverifiable theological or metaphysical doctrines into the sciences; the idea that goals somehow act in favor of their won realization; and the view that biological systems require for their study concepts and patterns of explanation unlike anything employed in the physical sciences. (...) An important part of their defense has been the contention that teleological language can be eliminated without loss from the sciences. I have argued that this is true: any phenomenon that can be described in teleological language can be described otherwise.On the other hand, eliminability does not mean translatability. I have suggested—I do not see how to prove it—that the teleological character of a sentence is so fundamental that it would be preserved under translation. Teleological character is conferred on a sentence by the manner in which it fits into a conceptual scheme designed for the description of certain classes of systems possessing net-like organization. The elimination of teleological language thus involves a conceptual shift, and involves a different method of classifying the elements of a system.The guardians of teleology—myself among them—have insisted that teleological language is perfectly legitimate. This conclusion is plain if my account of “appropriateness” is correct. Indeed, the development of conceptual schemes which render functional ascriptions appropriate is seen to be just a special case of a general scientific procedure: the designing of languages aimed at bringing to light those causal relations which are most interesting to us. (shrink)

Classification of the history of science has a long history, and the essays in this Focus section explore that history and its consequences from several different angles. Two of the papers deal with how classifying schemes in bibliography have evolved. A third looks at the way archival organization has changed over the years. Finally, the last essay explores the intersection of human and machine classifying systems. All four contributions look closely at the ramifications of the digital revolution for the way (...) we organize the knowledge of the discipline. (shrink)

How does Jung model his psychology on Plato's philosophy? The Platonic Jung looks at similarities between the two, particularly in the structure of the cosmos and psyche and in the nature of the self. The book reunites philosophy and psychology and expresses the message these men imparted-the soul is the true self and worth finding.

Strike action in healthcare has been a common global phenomenon. As such action is designed to be disruptive, it creates substantial ethical tension, the most cited of which relates to patient harm, that is, a strike may not only disrupt an employer, but it could also have serious implications for the delivery of care. This article systematically reviewed the literature on strike action in healthcare with the aim of providing an overview of the major justifications for strike action, identifying relative (...) strengths and shortcomings of this literature and providing direction for future discussions, and theoretical and empirical research. Three major themes emerged related to (1) the relationship between healthcare workers, patients and society; (2) the consequences of strike action; and (3) the conduct of strike action. Those who argue against strike action generally cite the harms of such action, particularly as it relates to patients. Many also argue that healthcare workers, because of their skills and position in society, have a special obligation to their patients and society more generally. Those who see this action as not only permissible but also, in some cases, necessary have advanced several points in response, arguing that healthcare workers do not necessarily have any special obligation to their patients or society, and even if so, this obligation is not absolute. Overwhelmingly, when talking about the potential risks of strike action, authors have focused on patient welfare and the impact that a strike could have. Several directions for future work are identified, including greater explorations into how structural and systemic issues impact strike action, the need for greater consideration about the contextual factors that influence the risks and characteristics of strike action and finally the need to tie this literature to existing empirical evidence. (shrink)

I propose to examine what I take to be the point at issue between subjectivist and objectivist theories of ethics and to explain that the controversy between them is unreal. It springs from a misunderstanding of the nature of appraisal sentences. What I hope to show is that if such sentences were really analysable in the way in which the critics and many of the supporters of subjectivist theories suppose, then those theories would indeed, as it is sometimes put “fail (...) to do justice to the facts of moral experience.” But it seems to me that objectivist theories are no better off. They make exactly the same mistake though in a more sophisticated way. I therefore propose to see whether any useful results can be achieved by construing appraisal sentences on rather different lines. By appraisal sentences I mean sentences of the form “I approve of …, I think well of …, I commend …, etc.” I shall call these simple appraisals, sentences of the form “… is good, … is meritorious, … is praiseworthy, etc.” I shall call these moral appraisals. In these terms, subjectivist theories assert that moral appraisals can always be expressed without change of meaning by simple appraisals, though perhaps the addition of an imperative sentence of some kind is required to complete the translation. Objectivist theories deny this possibility and claim that moral appraisals assert truths about the independent world and not psychological facts about the speaker. (shrink)

Antimicrobial resistance (AMR) is an urgent threat to global public health and development. Mitigating this threat requires substantial short-term action on key AMR priorities. While international legal agreements are the strongest mechanism for ensuring collaboration among countries, negotiating new international agreements can be a slow process. In the second article in this special issue, we consider whether harnessing existing international legal agreements offers an opportunity to increase collective action on AMR goals in the short-term. We highlight ten AMR priorities and (...) several strategies for achieving these goals using existing “legal hooks” that draw on elements of international environmental, trade and health laws governing related matters that could be used as they exist or revised to include AMR. We also consider the institutional mandates of international authorities to highlight areas where additional steps could be taken on AMR without constitutional changes. Overall, we identify 37 possible mechanisms to strengthen AMR governance using the International Health Regulations, the Agreement on the Application of Sanitary and Phytosanitary Measures, the Agreement on Trade-Related Aspects of Intellectual Property Rights, the Agreement on Technical Barriers to Trade, the International Convention on the Harmonized Commodity Description and Coding System, and the Basel, Rotterdam, and Stockholm conventions. Although we identify many shorter-term opportunities for addressing AMR using existing legal hooks, none of these options are capable of comprehensively addressing all global governance challenges related to AMR, such that they should be pursued simultaneously with longer-term approaches including a dedicated international legal agreement on AMR. (shrink)

Biobanks that are run on an opt-in basis depend on people having the motivation to give and to trust in those who control their samples. Yet in the UK trust in the healthcare system has been in decline and there have been a number of health-related scandals that have received widespread media and public attention. Given this background, and the previous public consultations on UK Biobank, the paper explores the way people express their trust and mistrust in the area of (...) medical and genetic information through discussions in six focus groups held in different areas of Britain. The themes that emerged in the discussion were the special character of genetic data; the ease with which information spreads; the public/private divide in genetic research; the potential of genetic information to harm people; choice, consent and lack of control; and the difficulty of establishing trustworthy governing arrangements. The expert agenda of policy-makers and medical ethics does not address the broader concerns expressed by participants. It seems that public consultation and the language of openness and transparency may not be sufficient to establish trust in the governance of genetic databases. Donors will be asked to give freely without any return but the participants' perception of those using the samples is that they are motivated by success and profit rather than healthcare priorities. In this context altruism seems naive and even dangerous. In order to place their trust well people need evidence of a relationship with obligations and expectations on both sides. (shrink)

© JNCCN-Journal of the National Comprehensive Cancer Network.Background: Next-generation tumor sequencing panels, which include multiple established and novel targets across cancers, are emerging in oncology practice, but lack formal positive coverage by US payers. Lack of coverage may impact access and adoption. This study identified challenges of NGTS coverage by private payers.Methods: We conducted semi-structured interviews with 14 NGTS experts on potential NGTS benefits, and with 10 major payers, representing more than 125,000,000 enrollees, on NGTS coverage considerations. We used the (...) framework approach of qualitative research for study design and thematic analyses and simple frequencies to further describe findings.Results: All interviewed payers see potential NGTS benefits, but all noted challenges to formal coverage: 80% state that inherent features of NGTS do not fit the medical necessity definition required for coverage, 70% view NGTS as a bundle of targets versus comprehensive tumor characterization and may evaluate each target individually, and 70% express skepticism regarding new evidence methods proposed for NGTS. Fifty percent of payers expressed sufficient concerns about NGTS adoption and implementation that will preclude their ability to issue positive coverage policies.Conclusions: Payers perceive that NGTS holds significant promise but, in its current form, poses disruptive challenges to coverage policy frameworks. Proactive multidisciplinary efforts to define the direction for NGTS development, evidence generation, and incorporation into coverage policy are necessary to realize its promise and provide patient access. This study contributes to current literature, as possibly the first study to directly interview US payers on NGTS coverage and reimbursement. (shrink)

Philosophers disagree, with some rare exceptions. One of those exceptions is the broadest-brush account of what language is. Language is a system of signs used for the communication of --well, and here the agreement begins to break down--thoughts, ideas, messages, propositions or propositional contents, intentions, and a host of technical terms offer themselves to chink the cracks. A list of philosophers subscribing would be impossible to complete. Locke, Carnap, Augustine, Hobbes, Fodor, Katz, Chomsky, Derrida, --well, and on and on. Easier (...) would be to list those who dissent. Heraclitus, Wittgenstein, maybe J.L. Austin, Frank Ebersole, and NOT on and on. The first chapter lays out the view that language is a system of signs in sympathetic terms. The second provides a selection of what are usually called “ordinary language” arguments against the view--reminders about how the view requires us to think in terms which are not consistent with how we think about language and signs when we are not doing philosophy. Those arguments have been unpersuasive among philosophers, and Chapter Three begins the work of investigating separate pieces of the view in detail. Chapter Three takes up an argument for the view which is familiar among philosophers, using Jerry Fodor’s formulation: we cannot be thinking in a public, natural language, because animals and preverbal infants think with no such language. I show this argument is not an argument at all but is rather an expression of the view in question. Chapter Four takes up the argument that the relations between particular words and their meanings is arbitrary or conventional rather than natural or necessary, otherwise there would be only one language among mankind. I argue that the alternatives (conventional vs. natural or necessary) are both generated by taking the division between words and their meanings to be the division between signs and signified--in other words, the question is a result of adopting the view of language as signs. Attempts to argue for the legitimacy of the question without taking the view for granted only serve to call it into question more. In Chapter Five I investigate whether we talk in order to communicate something which is otherwise hidden and invisible. We are tempted to think that you and I talk because I cannot read your mind or you mine. Though Wittgenstein has a famous set of comments on the notion of a private language, it remains a strong temptation to think that language gives public form to something (thoughts, ideas, intentions, feelings, content, meaning) which without language would be unknowable to all but the person whose something it is. Examples help point to the incoherence of this view and show that even if it were not incoherent, remedying the invisibility of those internal whatnots would still leave us with a need for language. Chapter Six takes up a hoary question about boundaries of effability--the possibility that there are limits to what can be said which are more restrictive than what can be thought or felt. The account of language as signs provides one easy way to make sense of this idea, but investigation into examples shows the problem is not one that makes sense unless we just grant that account. Chapter Seven investigates how to make sense of the notion that there are things which are in language and other things which are not. I spell out how the view of language as signs gives us a way to think this, and then show how one reaction to finding problems with the notion resonates with Wittgenstein’s early work and with some work of Jacques Derrida, who bite similar bullets and agree that everything is language, that the limits of language are the limits of our world. I then subject that reaction to critical investigation using examples, which reveals their reaction as a rear-guard attempt to save the view of language as signs. Chapter Eight uses examples as guides toward alternative views of language, feeling our way toward what language might be if it is not a system of signs. Finally, the appendix takes up what I take to be the serious arguments against the methods I use in this work, the first two articulated by John Searle (“the assertion fallacy”) and H. P. Grice (“conversational implicature”), and another the generally unspoken belief that philosophical work is like scientific work. (shrink)

To address the complex challenge of global antimicrobial resistance (AMR), a pandemic treaty should include mechanisms that 1) equitably address the access gap for antimicrobials, diagnostic technologies, and alternative therapies; 2) equitably conserve antimicrobials to sustain effectiveness and access across time and space; 3) equitably finance the investment, discovery, development, and distribution of new technologies; and 4) equitably finance and establish greater upstream and midstream infection prevention measures globally. Biodiversity, climate, and nuclear governance offer lessons for addressing these challenges.