Overdiagnosis refers to diagnosis that does not benefit patients because the diagnosed condition is not a harmful disease in those individuals. Overdiagnosis has been identified as a problem in cancer screening, diseases such as chronic kidney disease and diabetes, and a range of mental illnesses including depression and attention deficit hyperactivity disorder. In this paper, we describe overdiagnosis, investigate reasons why it occurs, and propose two different types. Misclassification overdiagnosis arises because the diagnostic threshold for the disease in question has (...) been set at a level where many people without harmful disease are nonetheless diagnosed. We illustrate misclassification overdiagnosis using the example of chronic kidney disease. Misclassification occurs in diseases diagnosed using biomarkers or based on patient reported phenomena. Maldetection overdiagnosis arises because, at the time the diagnosis is made and despite the presence of a 'gold standard' diagnostic test, it is not possible to discriminate between harmful and non-harmful cases of the index disease. We illustrate maldetection overdiagnosis using the example of thyroid cancer. While there is some overlap between misclassification and maldetection overdiagnosis, this conceptual analysis helps to clarify the phenomenon of overdiagnosis and is a necessary first step in developing strategies to address the problem. (shrink)

Wes Morriston contends that William Lane Craig's argument for the impossibility of a beginningless past results in an equally good argument for the impossibility of an endless future. Craig disagrees. I show that Craig's reply reveals a commitment to an unmotivated position concerning the relationship between actuality and the actual infinite. I then assess alternative routes to the impossibility of a beginningless past that have been offered in the literature, and show that, contrary to initial appearances, these routes similarly seem (...) to support the impossibility of an endless future. (shrink)

In the early 1760s, the entry dedicated to the term “social” in Diderot's Encyclopédie claimed that it was “un mot nouvellement introduit dans la langue.” Strictly speaking, this description was inaccurate: “social” had already appeared (though very sporadically) in seventeenth-century French texts. But the essence of the Encyclopédie's argument was correct: “social” had been so marginal in French up until the mid-eighteenth century that its wide deployment in enlightened discourse from the 1740s onward could be treated as a new appearance. (...) The article main argument is that “social's” new appearance in the mid-1740s was of considerable intellectual importance. To support this argument, the article is divided into three parts. The first outlines the general premises of the research into the word “social” and its significance. By placing this research within the ongoing investigation of the semantic field around “société” in enlightened philosophy, the article claims that such an investigation is much more than an etymological exercise. The special epistemological status of “social” in enlightened philosophy makes an understanding of the reasons for its rapid domination of French philosophical discourse a most rewarding project from the perspective of intellectual history. The second part of the article provides empirical evidence for the argument that “social” had been all but completely absent from French intellectual discourse before the mid-eighteenth century. It is of course harder to ascertain the absence of a word before a given point in time than to confirm its presence, but many different indications substantiate the essence of the Encyclopédie's claim. These indications also allow one to follow “social's” discursive rise after about 1745 and to speculate about the identity of the author(s) responsible for it. All evidence lead to two philosophes, the article claims: Diderot and Rousseau. Finally, the third part of the article presents an argument about the reasons for “social's” rapid naturalization in French enlightened thought and discusses what the philosophes tried so intensively to do, achieve, or express with “social.” Possible answers to this question lead to a reevaluation of mid-eighteenth century enlightened thought in general and contemporary philosophes in particular. Most importantly, such answers allow us to reflect on how we write and think about the intellectual achievements of the mid-eighteenth century, and in what way we, too, still inhabit the mental universe the philosophes helped to create. ☆ I would like to thank Keith Michael Baker for his encouragement and helpful criticism of a previous draft of this article. (shrink)

This article argues against the long-enduring practice of Josephan scholarship to treat the termsτύραννος(‘tyrant’) andλῃστής(‘brigand’) as a collocation, or as undistinguished terms of invective employed by Josephus against various Jewish antagonists in hisBellum Judaicum(=BJ). Towards this aim, the article first examines the frequency in which these two terms appear together throughout the text of theBJ, before turning to a critical examination of particular passages that feature the terms, in order to prove that they are, in fact, not used as undistinguished (...) terms of invective but as terms pertaining to two distinct classes of people: renegade aristocrats vying with their peers for absolute power (the ‘tyrants’) and their gangs of foot soldiers comprising men from the lower classes (the ‘brigands’). The article concludes that Josephus used these terms in this manner in order to convey to his readership, which largely consisted of Roman aristocrats, that the ringleaders of the Judaean revolt which raged betweena.d.66–73 were akin to renegades who periodically wreaked havoc on Rome's own aristocracy, often with devastating consequences for class and country alike. (shrink)

The Article argues that, contrary to its state-centered conception, citizenship is determined, managed and controlled in three distinct yet intertwined territorial spheres: the local, the national and the global. Without claiming that the national sphere is vanishing or becoming irrelevant for the determination of rights, duties, group belonging and participation in public life, I argue that sub-national territorial units as well as supranational political organizations are increasingly impacting citizenship. All three spheres take part in deciding who shall be entitled to (...) various rights, what shall be the exact content of those rights, and who shall have the power to make such determinations. Yet each sphere bases its citizenship on a distinct logic and on a different set of assumptions and justifications: the local on residency; the national on lineage or place of birth; and the global on belonging to humanity. The Article demonstrates the ways in which citizenship is impacted by the three spheres and the different forms of legitimation that each sphere enjoys. The realization that our citizenship is a product of developments and activities in all three levels has theoretical, analytical and practical implications. (shrink)

The Middle Persian literature from the early Islamic centuries frequently deals with practical theological issues faced by the Zoroastrian communities under foreign domination. Here, we present a number of questions regarding a Zoroastrian’s conversion to Islam and his subsequent repentance and desire to return to Zoroastrianism and answers given by ninth- and tenth-century Zoroastrian priestly authorities. It is shown how the priests cite ancient traditions found in the Pahlavi versions of Avestan texts to justify their answers, and then apply them (...) to the contemporary social reality. (shrink)

I draw upon Helen Steward's concept of agential settling to argue that freedom requires an ability to change the truth‐value of tenseless future contingents over time from false to true and that this ability requires a metaphysically open future.

According to actualism, an agent ought to φ just in case what would happen if she were to φ is better than what would happen if she were to ~φ. We argue that actualism makes a morally irrelevant distinction between certain counterfactuals, given that an agent sometimes has the same kind of control over their truth-value. We then offer a substantive revision to actualism that avoids this morally irrelevant distinction by focusing on a certain kind of control that is available (...) to an agent. Finally, we show how this revised view has two additional advantages over actualism. (shrink)

Recent experimental studies dispute the position that commonsense morality accepts ‘Ought’ Implies ‘Can’, the view that, necessarily, if an agent ought to perform some action, then she can perform that action. This paper considers and supports explanations for the results of these studies on the hypothesis that OIC is intuitive and true.

According to deliberation compatibilism, rational deliberation is compatible with the belief that one’s actions are causally determined by factors beyond one’s control. This paper offers a counterexample to recent accounts of rational deliberation that entail deliberation compatibilism. The counterexample involves a deliberator who believes that whichever action she performs will be the result of deterministic manipulation. It is further argued that there is no relevant difference between the purported counterexample and ordinary doxastic circumstances in which a determinist deliberates.

Perszyk has argued that Molinists cannot consistently endorse the consequence argument because of a structurally similar argument for the incompatibility of true Molinist counterfactuals of freedom and the ability to do otherwise. Wierenga has argued that on the proper understanding of CCFs, there is a relevant difference between the consequence argument and the anti-Molinist argument. I argue that, even on Wierenga’s understanding of CCFs, there is in fact no relevant difference between the two arguments. Moreover, I strengthen Perszyk’s challenge by (...) highlighting further relevant similarities between CCFs and facts about the laws. (shrink)

Suppose you can save only one of two groups of people from harm, with one person in one group, and five persons in the other group. Are you obligated to save the greater number? While common sense seems to say ‘yes’, the numbers skeptic says ‘no’. Numbers Skepticism has been partly motivated by the anti-consequentialist thought that the goods, harms and well-being of individual people do not aggregate in any morally significant way. However, even many non-consequentialists think that Numbers Skepticism (...) goes too far in rejecting the claim that you ought to save the greater number. Besides the prima facie implausibility of Numbers Skepticism, Michael Otsuka has developed an intriguing argument against this position. Otsuka argues that Numbers Skepticism, in conjunction with an independently plausible moral principle, leads to inconsistent choices regarding what ought to be done in certain circumstances. This inconsistency in turn provides us with a good reason to reject Numbers Skepticism. Kirsten Meyer offers a notable challenge to Otsuka’s argument. I argue that Meyer’s challenge can be met, and then offer my own reasons for rejecting Otsuka’s argument. In light of these criticisms, I then develop an improved, yet structurally similar argument to Otsuka’s argument. I argue for the slightly different conclusion that the view proposed by John Taurek that ‘the numbers don’t count’ leads to inconsistent choices, which in turn provides us with a good reason to reject Taurek’s position. (shrink)

The actualism/possibilism debate in ethics is about whether counterfactuals of freedom concerning what an agent would freely do if they were in certain circumstances even partly determines that agent’s obligations. This debate arose from an argument against the coherence of utilitarianism in the deontic logic literature. In this chapter, we first trace the historical origins of this debate and then examine actualism, possibilism, and securitism through the lens of consequentialism. After examining their respective benefits and drawbacks, we argue that, contrary (...) to what has been assumed, actualism and securitism both succumb to the so-called nonratifiability problem. In making this argument, we develop this problem in detail and argue that it’s a much more serious problem than has been appreciated. We conclude by arguing that an alternative view, hybridism, is independently the most plausible position and best fits with the nature of consequentialism, partly in light of avoiding the nonratifiability problem. (shrink)

Do facts about what an agent would freely do in certain circumstances at least partly determine any of her moral obligations? Actualists answer ‘yes’, while possibilists answer ‘no’. We defend two novel hybrid accounts that are alternatives to actualism and possibilism: Dual Obligations Hybridism and Single Obligation Hybridism. By positing two moral ‘oughts’, each account retains the benefits of actualism and possibilism, yet is immune from the prima facie problems that face actualism and possibilism. We conclude by highlighting one substantive (...) difference between our two hybrid accounts. (shrink)

The new dispositionalists defend the position that an agent in a deterministic Frankfurt-style case has the ability to do otherwise, where that ability is the one at issue in the principle of alternative possibilities. Focusing specifically on Kadri Vihvelin's proposal, I argue against this position by showing that it is incompatible with the existence of structurally similar cases to FSCs in which a preemptive intervener bestows an agent with an ability.

The actualism/possibilism debate in ethics is traditionally formulated in terms of whether true counterfactuals of freedom about the future (true subjunctive conditionals concerning what someone would freely do in the future if they were in certain circumstances) even partly determine an agent's present moral obligations. But the very assumption that there are true counterfactuals of freedom about the future conflicts with the idea that freedom requires a metaphysically open future. We develop probabilism as a solution to the actualism/possibilism debate, a (...) solution that accommodates an open future requirement for freedom. We argue that probabilism resolves the conflicting intuitions that arise between actualists and possibilists and maintains certain distinct advantages over actualism and possibilism. (shrink)

The compatibility of determinism and the ability to do otherwise has been implicitly assumed by many to be irrelevant to the viability of compatibilist responses to the manipulation argument for incompatibilism. I argue that this assumption is mistaken. The manipulation argument may be unsound. But even so, the manipulation argument, at the very least, undermines classical compatibilism, the view that free will requires the ability to do otherwise, and having that ability is compatible with determinism. This is because classical compatibilism, (...) in conjunction with any type of reply to the manipulation argument, has counterintuitive implications. In order to avoid such implications, we need not hold that determinism is incompatible with moral responsibility. But we must hold that determinism is incompatible with the ability to do otherwise. (shrink)

According to the Dilemma Defense, it is question-begging against the incompatibilist defender of the principle of alternative possibilities (PAP) to assume that the agent in a deterministic Frankfurt-style case (FSC) cannot do otherwise in light of causal determinism, but is nevertheless morally responsible. As a result, Fischer (Philos Rev 119:315–336, 2010; Analysis 73:489–496, 2013) attempts to undermine PAP in a different manner via a deterministic FSC. More specifically, Fischer attempts to show that if causal determinism rules out an agent’s moral (...) responsibility, it is not in virtue of its eliminating the agent’s alternative possibilities. I contend that, once we focus upon the distinction between entailment and explanation, the incompatibilist defender of PAP can successfully rebut Fischer’s argument. I argue for this claim while granting Fischer a number of assumptions that only render a defense of PAP more difficult. Additionally, I cast doubt upon Palmer’s (Synthese 191:3847–3864, 2014) critique of Fischer’s argument, which in turn renders my defense of PAP all the more critical. (shrink)

Contrary to the commonly held position of Luis de Molina, Thomas Flint and others, I argue that counterfactuals of divine freedom are pre-volitional for God within the Molinist framework. That is, CDFs are not true even partly in virtue of some act of God’s will. As a result, I argue that the Molinist God fails to satisfy an epistemic openness requirement for rational deliberation, and thus she cannot rationally deliberate about which world to actualize.

I argue that the theory of moral responsibility defended by John Martin Fischer and Mark Ravizza is incompatible with the metaphysical possibility of time travel.

Virtue ethics is often understood as a rival to existing consequentialist, deontological, and contractualist views. But some have disputed the position that virtue ethics is a genuine normative ethical rival. This chapter aims to crystallize the nature of this dispute by providing criteria that determine the degree to which a normative ethical theory is complete, and then investigating virtue ethics through the lens of these criteria. In doing so, it’s argued that no existing account of virtue ethics is a complete (...) normative ethical view that rivals existing consequentialist, deontological, and contractualist views. Moreover, it is argued that one of the most significant challenges facing virtue ethics consists in offering an account of the right-making features of actions, while remaining a distinctively virtue ethical view. (shrink)

In this paper I articulate and defend a new anti-theodicy challenge to Skeptical Theism. More specifically, I defend the Threshold Problem according to which there is a threshold to the kinds of evils that are in principle justifiable for God to permit, and certain instances of evil are beyond that threshold. I further argue that Skeptical Theism does not have the resources to adequately rebut the Threshold Problem. I argue for this claim by drawing a distinction between a weak and (...) strong version of Skeptical Theism, such that the strong version must be defended in order to rebut the Threshold Problem. However, the skeptical theist’s appeal to our limited cognitive faculties only supports the weak version. (shrink)

According to the Felix Culpa Theodicy, worlds containing atonement and incarnation are of such great value that God is justified in actualizing such a world, despite all of the moral evil that has accompanied it. Focusing upon Alvin Plantinga’s articulation of this theodicy, I argue against FCT on the basis of normative ethical considerations. On the one hand, the deontic status of at least some actions depends upon the consequences of those actions. On the other hand, the existence of atonement (...) depends upon the deontic status of at least one action. Under certain circumstances, this two-way dependence yields a contradiction if atonement has the kind of value conferred upon it by FCT. I conclude by discussing some implications for Molinism and evidential arguments from moral evil. (shrink)

Helen Steward holds that an agent’s settling something does not require a conscious, full-fledged intention. Rather, sub-intentional acts can be instances of settling by the agent if that act is subordinated to the agent’s personal-level conscious systems. I argue that this position is mistaken, and that agential settling does in fact require a conscious intention. I argue for this claim by offering a case which on Steward’s position has counterintuitive implications. I consider a variety of ways in which Steward might (...) respond, and show how each response incurs serious dialectical burdens. I then propose my preferred view of agential settling which does not share the aforementioned counterintuitive claims. (shrink)

In this paper I articulate and defend a new anti-theodicy challenge to Skeptical Theism. More specifically, I defend the Threshold Problem according to which there is a threshold to the kinds of evils that are in principle justifiable for God to permit, and certain instances of evil are beyond that threshold. I further argue that Skeptical Theism does not have the resources to adequately rebut the Threshold Problem. I argue for this claim by drawing a distinction between a weak and (...) strong version of Skeptical Theism, such that the strong version must be defended in order to rebut the Threshold Problem. However, the skeptical theist’s appeal to our limited cognitive faculties only supports the weak version. (shrink)

Regionalism is experiencing a global resurgence as countries grapple with issues such as coordination problems, economic inequality, racial tensions, and environmental degradation. Nations are exploring various regional entities as potential solutions to these challenges. However, despite the growing prominence of regions, they remain undertheorized. While extensive research has been conducted on national and local governments, regions have often been treated as either state-like or locality-like, or as ad-hoc remedies for the limitations of both. This article seeks to complicate this perspective (...) and present the initial stages of a theory of regions. By examining the case study of the Cities’ Union in Israel and tracing its historical origins and legal evolution into multipurpose regional clusters, the article uncovers valuable theoretical insights about regions. First, it argues that just as “the local” and “the national” mutually shape one another, “the local” and “the regional” too are interdependent concepts, each definition relying on the other. The existence of a third concept—the regional—is crucial, making this a conceptual triad rather than a dyad. Second, the article highlights that legal institutions such as interlocal cooperations and special-purpose governments (SPGs) are not inherently local or regional but can be perceived as either depending on historical and political contingencies. The conceptualization and concrete manifestations of local and regional forms are subject to political concerns and ideological commitments, extending beyond mere technical or functional considerations. Lastly, the article reflects on the unique characteristics of regional forms that make them legally, socially, geographically, and economically nimbler and more adaptable than their national and local counterparts. (shrink)

New modes of environmental regulation are said to have transcended the public/private divide. These new regulatory schemes - referred to as non-coercive orderings, self-regulation, co-regulation, metaregulation and social regulation - set aside the formal nature of the regulating entity, the regulated entity, and the tools of regulation. Instead of asking whether the means, objects and formulators of the regulation are public or private, the focus lies on the substance and effectiveness of the regulation in mitigating environmental harms. In this Article (...) we argue that despite these claims, often advanced by new governance proponents, the public/private divide in in fact alive and well, informing and impacting the ways in which various regulatory schemes are justified and legitimated. We exemplify this argument through an analysis of the role of three entities in international environmental regulation: the state, local governments, and civil society entities. This Article then suggests three consequences of the persistence of the public/private dichotomy and its denial: it produces a “tilt” towards the private; it tends to hide conflicts and disagreements, projecting an image of a frictionless world; and it prevents an imagination of a different world that transcends the structure of social life embedded in it. (shrink)

This paper explores what the metaphysics of time travel might teach us about moral responsibility. We take our cue from a recent paper by Yishai Cohen, who argues that if time travel is metaphysically possible, then one of the most influential theories of moral responsibility (i.e., Fischer and Ravizza’s) is false. We argue that Cohen’s argument is unsound but that Cohen’s argument can serve as a lens to bring reasons-responsive theories of moral responsibility into sharper focus, helping us to (...) better understand actual-sequence theories of moral responsibility more generally and showing how actual-sequence theorists should respond to a recent criticism. (shrink)

This paper aims to defend deliberation-compatibilism against several objections, including a recent counterexample by Yishai Cohen that involves a deliberator who believes that whichever action she performs will be the result of deterministic manipulation. It begins by offering a Moorean-style proof of deliberation-compatibilism. It then turns to the leading argument for deliberation-incompatibilism, which is based on the presumed incompatibility of causal determinism and the ‘openness’ required for rational deliberation. The paper explains why this argument fails and develops a coherent (...) account of how one can rationally deliberate and believe in causal determinism without inconsistency. The second half of the paper then takes up Cohen's proposed counterexample and his Four-Case Deliberation Argument against deliberation-compatibilism, which is meant to mirror Derk Pereboom's famous Four-Case Manipulation Argument. In response, the author defends a hard-line reply to FCDA but also argues that the notion of ‘sourcehood’ relevant to rational deliberation differs from that involved in free will. (shrink)