Defenders of pragmatic encroachment in epistemology (or what I call practicalism) need to address two main problems. First, the view seems to imply, absurdly, that knowledge can come and go quite easily—in particular, that it might come and go along with our variable practical interests. We can call this the stability problem. Second, there seems to be no fully satisfying way of explaining whose practical interests matter. We can call this the “whose stakes?” problem. I argue (...) that both problems can be addressed in roughly the same terms. More exactly, I argue that by first clarifying the whose stakes? problem an answer to the stability problem naturally falls out. (shrink)

This volume presents a collection of refereed papers reflecting the state of the art in the area of over-constrained systems. Besides 11 revised full papers, selected from the 24 submissions to the OCS workshop held in conjunction with the First International Conference on Principles and Practice of Constraint Programming, CP '95, held in Marseilles in September 1995, the book includes three comprehensive background papers of central importance for the workshop papers and the whole field. Also included is an introduction by (...) one of the volume editors together with a bibliography listing 243 entries. All in all this is a very useful reference book relevant for all researchers and practitioners interested in hierarchical, partial, and over-constrained systems. (shrink)

In defending his interest-relative account of knowledge in Knowledge and Practical Interests (2005), Jason Stanley relies heavily on intuitions about several bank cases. We experimentally test the empirical claims that Stanley seems to make concerning our common-sense intuitions about these bank cases. Additionally, we test the empirical claims that Jonathan Schaffer seems to make in his critique of Stanley. We argue that our data impugn what both Stanley and Schaffer claim our intuitions about such cases are. To account (...) for these results, one must develop a better conception of the connection between a subject's interests and her body of knowledge than those offered by Stanley and Schaffer. (shrink)

Jason Stanley presents a startling and provocative claim about knowledge: that whether or not someone knows a proposition at a given time is in part determined by his or her practical interests, i.e. by how much is at stake for that person at that time. In defending this thesis, Stanley introduces readers to a number of strategies for resolving philosophical paradox, making the book essential not just for specialists in epistemology but for all philosophers interested in philosophical methodology. (...) Since a number of his strategies appeal to linguistic evidence, it will be of great interest to linguists as well. (shrink)

Jason Stanley's "Knowledge and Practical Interests" is a brilliant book, combining insights about knowledge with a careful examination of how recent views in epistemology fit with the best of recent linguistic semantics. Although I am largely convinced by Stanley's objections to epistemic contextualism, I will try in what follows to formulate a version that might have some prospect of escaping his powerful critique.

Recently, some philosophers have defended the idea that knowledge is an interest-relative notion. According to this thesis, whether an agent knows P may depend on the practical costs of her being wrong about P. This perspective marks a radical departure from traditional accounts that take knowledge to be a purely intellectual concept. I think there is much to say on behalf of the interest-relative notion. In this paper, I report on some new evidence which strongly suggests that ordinary people’s (...) attributions of knowledge are in fact sensitive to practical interests. This is noteworthy because recent experiments have been interpreted by many to support the opposite conclusion. I also argue that the new results support an invariantist but interest-relativist account of knowledge, a thesis known as Interest Relative Invariantism (IRI). I do not make the case here that IRI gives us the very best explanation of the results presented here. Any such attempt would require an in-depth survey of the last few decades of work in epistemology. I only want to argue here that IRI gives us a simple and elegant explanation of the new data, and that the same cannot be said about traditional contextualism, a leading competitor to IRI. (shrink)

This paper outlines an account of the ethics of lying, which accommodates two main ideas about lying. The first of these, Anti-Deceptionalism, is the view that lying does not necessarily involve intentions to deceive. The second, Anti-Absolutism, is the view that lying is not always morally wrong. It is argued that lying is not wrong in itself, but rather the wrong in lying is explained by different factors in different cases. In some cases such factors may include deceptive intentions on (...) the part of the liar. In other cases, where such intentions are not found, the wrong in lying may be explained by other factors. Moreover, it is argued that the interaction between considerations against lying and considerations against telling the truth are sensitive to the practical interests of those lied to. When the topic of the lie in question matters little to the victim's rational decision making, the threshold for when considerations against telling the truth can outweigh considerations against lying are lowered. This account is seen to explain why lying to avoid little harm is sometimes permissible, and sometimes not. (shrink)

In this paper we focus mainly on a kind of contextualism theory of vagueness according to which the context dependence has its source in the variation of our practical interests. We largely focus on Fara's version of the theory but our observations work at different levels of generality, some relevant only to the specifics of Fara's theory others relevant to all contextualist theories of a certain type.

Our intuitions about whether someone knows that p vary even fixing the intuitively epistemic features of that person’s situation. Sometimes they vary with features of our own situation, and sometimes they vary with features of the putative knower’s situation. If the putative knower is in a risky situation and her belief that p is pivotal in achieving a positive outcome of one of the actions available to her, or avoiding a negative one, we often feel she must be in a (...) particularly good epistemic position to know that p. If however she is not in a risky situation, we tend to be considerably more permissive in our attributions of knowledge. Our intuitions about when someone knows that p and when she doesn’t also fluctuate with what is salient, either to the putative knower or ourselves. If someone claims to know where their car is, and I raise the possibility that it has been stolen, she may retract her claim to know. Which of these tendencies, if any, reveal something about the nature of our epistemic terms or concepts? (shrink)

Savulescu J. Is current practice around late termination of pregnancy eugenic and discriminatory? Maternal interests and abortion. J Med Ethics 2001;27:165–71. Lachlan de Crespigny contributed in a major way to the conceptualisation, design, administration of surveys, ….

A clinical scenario is described where an anaesthetist is concerned about the seemingly high risk/benefit ratio relating to laparoscopic versus standard inguinal hernia operations. Some options for further action by the anaesthetist are introduced. The remainder of the paper explores the question of who can legitimately assess the acceptability of risk/benefit ratios, and defends the use of practice guidelines at the expense of so called clinical freedom. It is argued that respect for persons is not breached by limiting the treatment (...) options offered to patients to those therapies which have a ‘reasonable’ risk/benefit ratio. This ‘reasonableness’ is context dependent, and should be properly decided by those with expertise in the field. (shrink)

A clinical scenario is described where an anaesthetist is concerned about the seemingly high risk/benefit ratio relating to laparoscopic versus standard inguinal hernia operations. Some options for further action by the anaesthetist are introduced. The remainder of the paper explores the question of who can legitimately assess the acceptability of risk/benefit ratios, and defends the use of practice guidelines at the expense of so called clinical freedom. It is argued that respect for persons is not breached by limiting the treatment (...) options offered to patients to those therapies which have a ‘reasonable’ risk/benefit ratio. This ‘reasonableness’ is context dependent, and should be properly decided by those with expertise in the field. (shrink)

A clinical scenario is described where an anaesthetist is concerned about the seemingly high risk/benefit ratio relating to laparoscopic versus standard inguinal hernia operations. Some options for further action by the anaesthetist are introduced. The remainder of the paper explores the question of who can legitimately assess the acceptability of risk/benefit ratios, and defends the use of practice guidelines at the expense of so called clinical freedom. It is argued that respect for persons is not breached by limiting the treatment (...) options offered to patients to those therapies which have a ‘reasonable’ risk/benefit ratio. This ‘reasonableness’ is context dependent, and should be properly decided by those with expertise in the field. (shrink)

This study examines the extent to which scientific and biomedical journals have adopted conflict of interest (COI) policies for authors, and whether the adoption and content of such policies leads to the publishing of authors’ financial interest disclosure statements by such journals. In particular, it reports the results of a survey of journal editors about their practices regarding COI disclosures. About 16 percent of 1396 highly ranked scientific and biomedical journals had COI policies in effect during 1997. Less than 1 (...) percent of the articles published during that year in the journals with COI policies contained any disclosures of author personal financial interests while nearly 66 percent of the journals had zero disclosures of author personal financial interests. Nearly three fourths of journal editors surveyed usually publish author disclosure statements suggesting that low rates of personal financial disclosures are either a result of low rates of author financial interest in the subject matter of their publications or poor compliance by authors to the journals’ COI policies. (shrink)

IT IS CHARACTERISTIC OF KANT that he interprets pure practical reason as will. He thereby revolutionizes the notions of both reason and the will. Reason is conceived as interest, a motivating power, even a self-sufficient telos. Moreover, the will is understood as a rational power, that is, as initially structured by the form of law, and striving for universality in both its inner operation and the way it ought to shape the outside world. For such a will, being rational (...) also means being self-constituting, or autonomous, and self-willing, that is, seeking rationality as end-in-itself. (shrink)

Our society has long sanctioned, at least tacitly, a degree of conflict of interest in medical practice and clinical research as an unavoidable consequence of the different interests of the physician or clinical investigator, the patient or clinical research subject, third party payers or research sponsors, the government, and society as a whole, to name a few. In the past, resolution of these conflicts has been left to the conscience of the individual physician or clinical investigator and to professional (...) organizations. The public is no longer willing to allow health care providers to wholly govern their own conflicts of interest for several reasons. These include: new forms of health care financing and delivery that provide innovative and lucrative opportunities for physician or insurer enrichment at patient expense; the increased importance of commercial research support as peer-reviewed governmental research support has decreased; evidence that physicians and clinical investigators too frequently resolve conflicts of interest in their own favor; and a general societal mistrust of authority. This volume represents a multidisciplinary effort, drawing from philosophy, medicine, law, economics and public policy to identify and categorize conflicts of interest in medical practice and clinical research, and, where possible, to offer a mechanism for resolving them. Part I addresses conflicts of interest from a theoretical perspective, offering basic concepts and analytical frameworks. The second part discusses two topics prominent in current health care policy debates--self-referral and financial incentives to limit care. Part III examines conflicts of interest generated by pharmaceutical industry involvement in clinical practice and research. The final section deals with conflicts of interest in clinical research in several contexts, including institutional reviews boards, clinical trials, Cooperative Research and Development Agreements between government and private researchers, brokerage of research subjects by Contract Research Organizations, and cost-effectiveness studies. (shrink)

IT IS CHARACTERISTIC OF KANT that he interprets pure practical reason as will. He thereby revolutionizes the notions of both reason and the will. Reason is conceived as interest, a motivating power, even a self-sufficient telos. Moreover, the will is understood as a rational power, that is, as initially structured by the form of law, and striving for universality in both its inner operation and the way it ought to shape the outside world. For such a will, being rational (...) also means being self-constituting, or autonomous, and self-willing, that is, seeking rationality as end-in-itself. (shrink)

The analysis of a dispute can focus on either interests, rights, or power. Commentators often frame the conflict over conscience in clinical practice as a dispute between a patient’s right to legally available medical treatment and a clinician’s right to refuse to provide interventions the clinician finds morally objectionable. Multiple sources of unresolvable moral disagreement make resolution in these terms unlikely. One should instead focus on the parties’ interests and the different ways in which the health care delivery (...) system can accommodate them. In the specific case of pharmacists refusing to dispense emergency contraception, alternative systems such as advanced prescription, pharmacist provision, and over-the-counter sales may better reconcile the client’s interest in preventing unintended pregnancy and the pharmacist’s interest in not contravening his or her conscience. Within such an analysis, the ethicist’s role becomes identifying and clarifying the parties’ morally relevant interests. (shrink)

Conflicts of interest are common and exist in academia, government, and many industries, including pharmaceutical development. Medical journal editors and others have recently criticized “the pharmaceutical industry,” citing concerns over investigator access to data, approaches to analysis of clinical trial data, and publication practices. Merck & Co., Inc. is a global, research-driven pharmaceutical company that discovers, develops, manufactures, and markets a broad range of human and animal health products, directly and through its joint ventures. Although part of its mission is (...) to provide a superior rate of return to its investors, Merck does not believe this creates an irreconcilable conflict of interest, particularly in activities concerning clinical drug development. We employ rigorous scientific methods to design, conduct, analyze, and report results of clinical trials in the development of innovative drugs and vaccines, with a focus on meeting unmet medical needs and with an ethic that puts the interests of the patient first. This article describes Merck’s approaches to potential conflicts of interest in drug development, particularly with regard to clinical trials. We believe that proprietary interests of the Company can be respected while observing objectivity and transparency in communicating clinical research results. The standards for the review of manuscripts reporting such trials for peer-reviewed publication should be the same, whether they are from Merck or elsewhere. (shrink)

: In this article it is assumed that human goodness is to be judged with respect to how well one does at practical reasoning. It is acknowledged that there is a difference between moral practical reasoning and prudential practical reasoning and what these would recommend sometimes conflict. A distinction is then made between absolute PPR and relative PPR and it is argued that doing well at absolute PPR is always consistent with MPR. It is also argued that (...) since it is more reasonable to assess prudential practical rationality in terms of the absolute standard than the relative standard, there is no conflict between the demands of MPR and PPR. (shrink)

Community-based healthcare organisations manage competing, and often conflicting, priorities. These conflicts can arise from the multiple roles these organisations take up, and from the diverse range of stakeholders to whom they must be responsive. Often such conflicts may be titled conflicts of interest; however, what precisely constitutes such conflicts and what should be done about them is not always clear. Clarity about the duties owed by organisations and the roles they assume can help identify and manage some of these conflicts. (...) Taking divisions of general practice in Australia as an example, this paper sets out to distinguish two main types of conflicts of interest, so that they may be more clearly identified and more effectively managed. (shrink)

It is often challenging for mental health‐care providers and health organizations to perform their various roles and to meet their varied obligations. In complex mental health‐care circumstances the concurrent application of relevant ethical principles and values often leads to the emergence of completing obligations that need to be carefully weighed and balanced in the making of care‐related decisions. Although some clinical circumstances, such as those potentially triggering the duty to warn, are adequately guided by existing rules based on legal precedents, (...) there is a gap in decision‐making support in other mental health‐care domains. This article proposes that a set of targeted, decision‐making approaches be developed to assist in the handling of specific, challenging circumstances. By way of illustration, two novel approaches are introduced; that is, choosing to work within a moral relational space of optimal therapeutic engagement (at the micro level of clinical practice), and the use of a health policy development approach that instantiates deliberative engagement (at the meso and macro levels of health organization). (shrink)

The attitudes of Australian practitioners working in clinical genetics and obstetrical ultrasound were surveyed on whether termination of pregnancy (TOP) should be available for conditions ranging from mild to severe fetal abnormality and for non-medical reasons.These were compared for terminations at 13 weeks and 24 weeks. It was found that some practitioners would not facilitate TOP at 24 weeks even for lethal or major abnormalities, fewer practitioners support TOP at 24 weeks compared with 13 weeks for any condition, and the (...) difference in attitudes to TOP between 13 weeks and 24 weeks is most marked for pregnancies which are normal or involve a mild disorder. It is argued that a fetal abnormality criterion for late TOP is inconsistently applied, discriminatory and eugenic. Four possible moral justifications for current practice are examined, each of which would require significant changes to current practice. I argue in favour of a maternal interests criterion for any TOP. (shrink)

Conflicts of interest affect recommendations in clinical guidelines and disclosure of such conflicts is important. However, not all conflicts of interest are disclosed. Using a public available disclosure list we determined the prevalence and underreporting of conflicts of interest among authors of clinical guidelines on drug treatments.

In the public interest: autonomy and resistance to methods of standardising nurses’ advice and practices from a health call centre in Perth, Western Australia The history of nursing is replete with examples of nurses battling for autonomy over their education, knowledge and work practices. The latest battleground is HealthDirect, Australia's first medial call centre, where nurses are required to meet externally imposed clinical standards while satisfying legal and financial obligations. These objectives are arguably achieved when nurses assess callers’ health problems (...) via computerised algorithms that determine an appropriate plan of action. That way, nurses’ subjective responses to callers are ruled out. To ensure nurses comply with the standard processes, calls are monitored randomly and surreptitiously in formal and informal ways. This paper explores how nurses respond to standard procedures and surveillance, in order to argue that nurses’ input partially drives reform processes. Nurses continue to seek autonomy over the advice they give and how their work is evaluated but are constrained by structural power relations. (shrink)

This article explores the enterprising act of socially constructing fatness, or overweight and obesity, as an individual and collective problem. We argue that this process is complex and hence draw liberally on and extend an eclectic range of scholarship (e.g. the sociology of the body, moral panic theory, critical weight studies) when presenting a typology of obesity epidemic entrepreneurs, that is, those who actively make fatness into a correctable health problem. Using a variety of data, we consider six main ideal (...) typical entrepreneurs: creators, amplifiers/moralizers, legitimators, supporters, enforcers/administrators and the entrepreneurial self. We conclude with a critique of obesity epidemic entrepreneurship and underscore the broader salience of our work for the sociology of the body/embodiment. The relevance of social studies of the body for the obesity debate and critical weight studies is also highlighted. (shrink)

Through the continuous investigation of humans in organizations, we have learned much about motivation, attitudes, and performance. For example, Yukl and others have helped increase our understanding of influence tactics and the effect they have on the performance of subordinates, supervisors, and peers. Some tactics (and combinations of tactics) lead to resistance, some lead to compliance, and some lead to commitment. In this study, we raise the question of whether or not we incorporate our knowledge of these research findings into (...) the design, implementation, and interpretation of our own research studies that require the participation of human subjects. In a survey of 134 subjects from a previous social science study, we found that performance varied across the sample, consistent with the concepts of resistance, compliance, and commitment. In addition, the variance in performance could be explained, in part, by task interest and perceived task demands. Implications are discussed. (shrink)

There are 4 main arguments for euthanasia: (1) arguments appealing to consistency (e.g., from passive to active euthanasia); (2) the argument from respect for autonomy; (3) appeals to justice; and (4) the argument from interests (mercy or relief of suffering). I will argue that only the last is directly relevant to active euthanasia as a medical intervention, though arguments together from autonomy and justice can in practice (through the backdoor) provide a ground for voluntary active medical euthanasia (AME).

The power of skepticism depends on the apparent possibility of rationally asking, for virtually any kind of proposition commonly thought to be known,howit is known or what justifies believing it. Moral claims are among those commonly subjected to skeptical challenges and doubts, even on the part of some people who are not skeptical about ordinary claims regarding the external world. There may be even more skepticism about the possibility of justifying moralactions,particularly if they are against the agent's self-interest. Both problems-how (...) to justify moral claims and how to justify moral action - come within the scope of the troubling question “Why be moral?” Even a brief response to moral skepticism should consider both kinds of targets of justification, cognitive and behavioural, and should indicate some important relations between the two types of skeptical challenge. I will begin with the cognitive case- with skepticism about the scope of theoretical reason in ethics - proceed to practical skepticism, which concerns the scope of practical reason, and then show how an adequate account of rationality may enable us to respond to moral skepticism. (shrink)