Importance Informed consent is essential to ethical, rigorous research and is important to recruitment and retention in cancer trials.Objective To examine cancer clinical trial (CCT) participants’ perceptions of informed consent processes and variations in perceptions by cancer type.Design and Setting and Participants Cross-sectional survey from mixed-methods study at National Cancer Institute–designated Northeast comprehensive cancer center. Open-ended and forced-choice items addressed: (1) enrollment and informed consent experiences and (2) decision-making processes, including risk-benefit assessment. Eligibility: CCT participant with gastro-intestinal or genitourinary, hematologic-lymphatic (...) malignancies, lung cancer, and breast or gynecological cancer (N = 334).Main Outcome Measures Percentages satisfied with consent process and information provided; and assessing participation’s perceptions of risks/benefits. Multivariable logistic or ordinal regression examined differences by cancer type.Results Most patient-participants felt well informed by the consent process (more than 90% overall and by cancer type) and. most (87.4%) reported that the consent form provided all the information they wanted, although nearly half (44.8%) reported that they read the form somewhat carefully or less. More than half (57.9%) said that talking to research staff (i.e., the consent process) had a greater impact on participation decisions than reading the consent form (2.1%). A third (31.1%) were very sure of joining in research studies before the informed consent process (almost half of lung cancer patients did—47.1%). Most patients personally assessed the risks and benefits before consenting. However, trust in physicians played an important role in the decision to enroll in CCT.Conclusions and Relevance Cancer patients rely less on written features of the informed consent process than on information obtained from the research staff and their own physicians. Research should focus on information and communication strategies that support informed consent from referring physicians, researchers, and others to improve patient risk-benefit assessment and decision-making. (shrink)

Recent magnetic resonance imaging and pathological studies have indicated that axonal loss is a major contributor to disease progression in multiple sclerosis. 1 H magnetic resonance spectroscopy, through measurement of N -acetyl aspartate, a neuronal marker, provides a unique tool to investigate this. Patients with primary progressive multiple sclerosis have few lesions on conventional MRI, suggesting that changes in normal appearing white matter, such as axonal loss, may be particularly relevant to disease progression in this group. To test this hypothesis (...) NAWM was studied with MRS, measuring the concentration of N -acetyl derived groups. Single-voxel MRS using a water-suppressed PRESS sequence was carried out in 24 patients with primary progressive multiple sclerosis and in 16 age-matched controls. Ratios of metabolite to creatine concentration were calculated in all subjects, and absolute concentrations were measured in 18 patients and all controls. NA/Cr was significantly lower in NAWM in patients than in controls, as was the absolute concentration of NA. There was no significant difference in the absolute concentration of creatine between the groups. This study supports the hypothesis that axonal loss occurs in NAWM in primary progressive multiple sclerosis and may well be a mechanism for disease progression in this group. (shrink)

First published in 2002. Routledge is an imprint of Taylor & Francis, an informa company.

It has been a common assumption that words are substances that instantiate or have properties. In this paper, I question the assumption that our ontology of words requires posting substances by outlining a bundle theory of words, wherein words are bundles of various sorts of properties (such as semantic, phonetic, orthographic, and grammatical properties). I argue that this view can better account for certain phenomena than substance theories, is ontologically more parsimonious, and coheres with claims in linguistics.

Many research ethics guidelines now oblige researchers to offer research participants the results of research in which they participated. This practice is intended to uphold respect for persons and ensure that participants are not treated as mere means to an end. Yet some scholars have begun to question a generalised duty to disclose research results, highlighting the potential harms arising from disclosure and questioning the ethical justification for a duty to disclose, especially with respect to individual results. In support of (...) this view, we argue that current rationales for a duty of disclosure do not form an adequate basis for an ethical imperative. We review policy guidance and scholarly commentary regarding the duty to communicate the results of biomedical, epidemiological and genetic research to research participants and show that there is wide variation in opinion regarding what should be disclosed and under what circumstance. Moreover, we argue that there is fundamental confusion about the notion of “research results,” specifically regarding three core concepts: the distinction between aggregate and individual results, amongst different types of research, and across different degrees of result veracity. Even where policy guidance and scholarly commentary have been most forceful in support of an ethical imperative to disclose research results, ambiguity regarding what is to be disclosed confounds ethical action. (shrink)

The natural name theory, recently discussed by Johnson (2018), is proposed as an explanation of pure quotation where the quoted term(s) refers to a linguistic object such as in the sentence ‘In the above, ‘bank’ is ambiguous’. After outlining the theory, I raise a problem for the natural name theory. I argue that positing a resemblance relation between the name and the linguistic object it names does not allow us to rule out cases where the natural name fails to resemble (...) the linguistic object it names. I argue that to avoid this problem, we can combine the natural name theory with a type-realist metaphysics of language, and hold that the name is natural because the name is an instance of the kind that it names. I conclude by reflecting on the importance of the metaphysics of language for questions in the philosophy of language. (shrink)

In this paper we examine the case of Tay, the Microsoft AI chatbot that was launched in March, 2016. After less than 24 hours, Microsoft shut down the experiment because the chatbot was generating tweets that were judged to be inappropriate since they included racist, sexist, and anti-Semitic language. We contend that the case of Tay illustrates a problem with the very nature of learning software that interacts directly with the public, and the developer's role and responsibility associated with it. (...) We make the case that when LS interacts directly with people or indirectly via social media, the developer has additional ethical responsibilities beyond those of standard software. There is an additional burden of care. (shrink)

To many who develop and use free software, the GNU General Public License represents an embodiment of the meaning of free software. In this paper we examine the definition and meaning of free software in the context of three events surrounding the GNU General Public License. We use a case involving the GPU software project to establish the importance of Freedom 0 in the meaning of free software. We analyze version 3 of the GNU General Public License and conclude that (...) although a credible case can be made that the added restrictions are consistent with the definition of free software, the case requires subtle arguments. Strong arguments against the added restrictions are less subtle, and may therefore be more convincing to many users and developers. We also analyze the Affero General Public License and conclude that it is inconsistent with the definition of free software. (shrink)

What are words? What makes two token words tokens of the same word-type? Are words abstract entities, or are they (merely) collections of tokens? The ontology of words tries to provide answers to these, and related questions. This article provides an overview of some of the most prominent views proposed in the literature, with a particular focus on the debate between type-realist, nominalist, and eliminativist ontologies of words.

ABSTRACT The idea that two words can be instances of the same word is a central intuition in our conception of language. This fact underlies many of the claims that we make about how we communicate, and how we understand each other. Given this, irrespective of what we think words are, it is common to think that any putative ontology of words, must be able to explain this feature of language. That is, we need to provide criteria of identity for (...) word-types which allow us to individuate words such that it can be the case that two particular word-instances are instances of the same word-type. One solution, recently further developed by Irmak, holds that words are individuated by their history. In this paper, I argue that this view either fails to account for our intuitions about word identity, or is too vague to be a plausible answer to the problem of word individuation. (shrink)

It has been widely argued that words are analogous to species such that words, like species, are natural kinds. In this paper, I consider the metaphysics of word-kinds. After arguing against an essentialist approach, I argue that word-kinds are homeostatic property clusters, in line with the dominant approach to other biological and psychological kinds.

Minimally, metaphysical realists hold that there exist some mind-independent entities. Metaphysical realists also hold that we can speak meaningfully or truthfully about mind-independent entities. Those who reject metaphysical realism deny one or more of these commitments. This Element aims to introduce the reader to the core commitments of metaphysical realism and to illustrate how these commitments have changed over time by surveying some of the main families of views that realism has been contrasted with: such as scepticism, idealism, and anti-realism.

Although the metaphysics of words remains a relatively understudied domain, one of the more discussed topics has been the question of how to account for the apparent sameness of words. Put one way, the question concerns what it is that makes two word- instances (or tokens) instances of the same word. In this paper, I argue that the existing solutions to the problems all fail as they take the problem of sameness of word to be a problem about how one (...) object relates to another. I propose an alternative solution to the problem of sameness of word which is instead focused on the intrinsic nature of the properties possessed by words. The result is a more thoroughgoing version of nominalism than is currently defended in the literature. (shrink)

Investigation of neural and cognitive processes underlying individual variation in moral preferences is underway, with notable similarities emerging between moral- and risk-based decision-making. Here we specifically assessed moral distributive justice preferences and non-moral financial gambling preferences in the same individuals, and report an association between these seemingly disparate forms of decision-making. Moreover, we find this association between distributive justice and risky decision-making exists primarily when the latter is assessed with the Iowa Gambling Task. These findings are consistent with neuroimaging studies (...) of brain function during moral and risky decision-making. This research also constitutes the first replication of a novel experimental measure of distributive justice decision-making, for which individual variation in performance was found. Further examination of decision-making processes across different contexts may lead to an improved understanding of the factors affecting moral behaviour. (shrink)

This paper will discuss the origin of the human mind, and the qualitative discontinuity between human and animal cognition. We locate the source of this discontinuity within the language faculty, and thus take the origin of the mind to depend on the origin of the language faculty. We will look at one such proposal put forward by Hauser et al. (Science 298:1569-1579, 2002), which takes the evolution of a Merge trait (recursion) to solely explain the differences between human and animal (...) cognition. We argue that the Merge-only hypothesis fails to account for various aspects of the human mind. Instead we propose that the process of lexicalisation is also unique to humans, and that this process is key to explaining the vast qualitative differences. We will argue that lexicalisation is a process through which concepts are reformatted to be able to take on semantic features and to take part in grammatical relations. These are both necessary conditions for a grammatical mind and the increased ability to express conceptual content. We therefore propose a possible explanans for the discontinuity between humans and animals, namely that merge with lexicalisation (and consequently semantic features and grammatical relations) is a minimal requirement for the human mind. (shrink)

This paper addresses the ontological status of the ontological categories as defended within E.J. Lowe’s four-category ontology (kinds, objects, properties/relations, and modes). I consider the arguments in Griffith (2015. “Do Ontological Categories Exist?” Metaphysica 16 (1):25–35) against Lowe’s claim that ontological categories do not exist, and argue that Griffith’s objections to Lowe do not work once we fully take advantage of ontological resources available within Lowe’s four-category ontology. I then argue that the claim that ontological categories do not exist has (...) no undesirable consequences for Lowe’s brand of realism. (shrink)

University human research ethics application procedures can be complicated and daunting, especially for international students unfamiliar with the process and the language. We conducted focus groups and interviews with four research higher degree and 21 Master’s coursework international students at an Australian university to gain their views on the human ethics application process. We found the most important influences on their experience were: the time it took to do an application; support from supervisors, peers and others; their own language skills; (...) and their lack of familiarity with research ethics procedures. To improve the experience of international students undertaking research involving human research ethics applications, we recommend universities provide guidance on institutional ethics review processes, concepts and terminology, with translations in a range of languages, together with guidance on how to conduct research ethically within and outside the students’ own countries. We also recommend curricula be developed to further students’ understanding of the importance of ethical research practice, and that these curricula be embedded in undergraduate and postgraduate degree programs and reflected in course learning outcomes. (shrink)

This article examines whether it is possible to uphold one form of deflationism towards metaphysics, ontological pluralism, whilst maintaining metaphysical realism. The focus therefore is on one prominent deflationist who fits the definition of an ontological pluralist, Eli Hirsch, and his self-ascription as a realist. The article argues that ontological pluralism is not amenable to the ascription of realism under some basic intuitions as to what a “realist” position is committed to. These basic intuitions include a commitment to more than (...) a stuff-ontology, and a view that realism carries with it more than a rejection of idealism. This issue is more than merely terminological. The ascription of realism is an important classification in order to understand what sorts of entities can be the truthmakers within a given theory. “Realism” is thus an important term to understand the nature of the entities that a given theory accepts into its ontology. (shrink)

Primitives are both important and unavoidable, and which set of primitives we endorse will greatly shape our theories and how those theories provide solutions to the problems that we take to be important. After introducing the notion of a primitive posit, I discuss the different kinds of primitives that we might posit. Following Cowling (2013), I distinguish between ontological and ideological primitives, and, following Benovsky (2013) between functional and content views of primitives. I then propose that these two distinctions cut (...) across each other leading to four types of primitive posits. I then argue that theoretical virtues should be taken to be meta-theoretical ideological primitives. I close with some reflections on the global nature of comparing sets of primitives. (shrink)

Background: Expanded newborn screening generates incidental results, notably carrier results. Yet newborn screening programmes typically restrict parental choice regarding receipt of this non-health serving genetic information. Healthcare providers play a key role in educating families or caring for screened infants and have strong beliefs about the management of incidental results. Methods: To inform policy on disclosure of infant sickle cell disorder (SCD) carrier results, a mixed-methods study of healthcare providers was conducted in Ontario, Canada, to understand attitudes regarding result management (...) using a cross-sectional survey (N = 1615) and semistructured interviews (N = 42). Results: Agreement to reasons favouring disclosure of SCD carrier results was high (65.1%–92.7%) and to reasons opposing disclosure was low (4.1%–18.1%). Genetics professionals expressed less support for arguments favouring disclosure (35.3%–78.8%), and more agreement with arguments opposing disclosure (15.7%–51.9%). A slim majority of genetics professionals (51.9%) agreed that a reason to avoid disclosure was the importance of allowing the child to decide to receive results. Qualitatively, there was a perceived “duty” to disclose, that if the clinician possessed the information, the clinician could not withhold it. Discussion: While a majority of respondents perceived a duty to disclose the incidental results of newborn screening, the policy implications of these attitudes are not obvious. In particular, policy must balance descriptive ethics (ie, what providers believe) and normative ethics (ie, what duty-based principles oblige), address dissenting opinion and consider the relevance of moral principles grounded in clinical obligations for public health initiatives. (shrink)

In this essay we argue that the current social and ethical structure in the Open Source Software Community stem from its roots in academia. The individual developers experience a level of autonomy similar to that of a faculty member. Furthermore, we assert that the Open Source Software Community’s social structure demands benevolent leadership. We argue that it is difficult to pass off low quality open source software as high quality software and that the Open Source development model offers strong accountability. (...) Finally, we argue that Open Source Software introduces ethical challenges for universities and the software development community. (shrink)

The objectively best language is intended to refer to some metaphysically privileged language that ‘carves reality at its joints’ perfectly. That is, it is the kind of language that various ‘metaphysical deflationists’ have argued is impossible. One common line of argument amongst deflationists is that we have no means to compare languages that all express true facts about the world in such a way to decide which is ‘better’. For example, the language is physics is not objectively better than the (...) language of economics, as each language has the semantic purpose of expressing some domain of truths about the world inexpressible in the other language, and therefore neither could be ‘objectively best’. In this paper, I argue that metaphysical deflationists have failed to recognise a distinction between fine- and coarse-grained semantic purposes of languages, and that a recognition of that distinction provides us grounds to compare languages to see which is objectively best. I argue that once we recognise the distinction between fine- and coarse-grained semantic purposes, then we can see that it is relative to the coarse-grained purpose that we must compare putative objectively best ontological languages. (shrink)

An overview of the concept of Strong Emergence, and a summary of the papers within the special issue.

Providing empirically supportable instances of ontological emergence is notoriously difficult. Typically, the literature has focused on two possible sources. The first is the mind and consciousness; the second is within physics, and more specifically certain quantum effects. In this paper, I wish to suggest that the literature has overlooked a further possible instance of emergence, taken from the special science of linguistics. In particular, I will focus on the property of truth-evaluability, taken to be a property of sentences as created (...) by the language faculty within human minds (or brains). The claim will not be as strong as to suggest that the linguistic data and theories prove emergence. Rather the dialectical aim here is to say that we have some good reasons (even if not conclusive reasons) to think that the property is emergent. (shrink)

"The Rules" are found in a collaborative document that states principles for responsibility when a computer artifact is designed, developed and deployed into a sociotechnical system. At this writing, over 50 people from nine countries have signed onto The Rules. Unlike codes of ethics, The Rules are not tied to any organization, and computer users as well as computing professionals are invited to sign onto The Rules. The emphasis in The Rules is that both users and professionals have responsibilities in (...) the production and use of computing artifacts. In this paper, we use The Rules to examine issues of trust. (shrink)

We contend that software developers have an ethical responsibility to strive for reliable software. We base that obligation on long standing engineering traditions that place the public good as a central tenant and on the professional relationship between a software developer and the users of the software developed.

Holistic Learning is designed as a practical guide for teachers on how to integrate curriculum around human processes and human themes. Specifically, problem solving (human process) and mythology (human theme) have been selected as vehicles for curriculum integration. Along with a number of specific strategies for classroom use, the book includes a rationale and framework for integrated studies, teaching approaches in problem solving and mythology, guidelines for writing units in integrated studies, and implementation strategies for integrated studies. The primary audience (...) is teachers at the intermediate and senior levels, although muc of the material is applicable to teachers at all levels of the curriculum. Individuals in curriculum leadership positions (e.g., principals, co-ordinators, and superintendents) should also find the work of interest. Holistic Learning is a practical guide for teachers seeking approaches to integrate diverse subject matter. (shrink)