Relational autonomy theorists attempt to accommodate social embeddedness within a conception of autonomy. These attempts are conceptually messy, at best, and category errors, at worst. Rejecting the liberal conception of autonomy due to feminist concerns is more helpfully answered by the neorepublican notion of freedom as nondomination. The conception of freedom as nondomination captures the values that motivate the relational turn in moral and political theory and does so in a conceptually neater way than attempting to accommodate those concerns in (...) our accounts of autonomy. (shrink)

It has long been taken for granted that clinical research involving human subjects is ethical only if it holds out the prospect of producing socially valuable knowledge. Recently, this social value requirement has come under scrutiny, with prominent ethicists arguing that the social value requirement cannot be substantiated as an ethical limit on clinical research, and others attempting to offer new support. In this paper, I argue that both criticisms and existing defenses of the social value requirement are predicated on (...) what I call the “transactional model of stakeholder obligations”. I go on to problematize this framework, and to introduce an alternative framework for conceptualizing ethical obligations within clinical research. In defending this framework, which I call the “basic structure model of stakeholder obligations”, I also demonstrate how it provides a stronger grounding for the social value requirement that is not vulnerable to critiques grounded in the transactional model. (shrink)

Ethicists have long recognized that two necessary features of ethical research are scientific validity and social value. Yet despite a significant literature surrounding the validity component of this dictate, until recently there has been little attention paid to unpacking what the social value component might require. This article introduces a framework for assessing the social value of research, and in particular, for determining whether a given research program is likely to have significant social value of the kind necessary to fulfill (...) the social value requirement. The article goes on to illustrate how this framework can provide a clearer account of the responsiveness requirement, an ethical dictum that is oft-repeated but whose content and value as a guideline in international research remains contested. Although I introduce this conception of social value in the context of the responsiveness requirement, the account offered can, and is intended to, stand alone as a tool for the assessment of the social value of research. As such it can be usefully applied to discussions about the value of comparative effectiveness trials, the assessment of the continued proliferation of me-too drugs and the research done to develop them, the demand for public access to study-generated data, and persistent deficits in the publication of negative results. (shrink)

The author replies to a letter to the editor from Felicitas Sofia Holzer concerning Wenner’s article “The Social Value Requirement in Research: From the Transactional to the Basic Structure Model of Stakeholder Obligations,” in the Hastings Center Report’s January‐February 2019 issue.

Ethical oversight of clinical research is one of the primary means of ensuring that human subjects are protected from the natural bias of researchers and research institutions in favor of experimentation. At a minimum, effective oversight should ensure that risks are minimized and reasonable in relation to anticipated benefits, protect vulnerable subjects from potential coercion or undue influence, ensure full and informed consent, and promote the equitable distribution of the risks and benefits of research. Because these assessments often involve value (...) judgments for which there are no agreed-upon objective standards, we rely on deliberative procedures thought to have the greatest likelihood of producing the right or best outcomes. Concerns about the potential for improperly functioning IRBs to waste scarce human and institutional resources and impede biomedical progress have motivated a surge in empirical research assessing their procedures and outcomes. Yet within this literature, there has been minimal attention paid to the social scientific evidence regarding how individuals and deliberating groups make decisions, nor how those data might inform IRB practice. This essay seeks to fill that gap, locating recent empirical data on IRB composition and process within the context of data regarding what I call “deliberative pathologies,” or instances when deliberation fails to live up to one or more aspect of the deliberative ideal because of systematic biases in the ways participants interact. The paper goes on to make evidence-based recommendations to reduce the vulnerability of IRB deliberations to the kinds of pathologies discussed and indicate directions for future research. (shrink)

In light of the growth in the conduct of international clinical research in developing populations, this paper seeks to explore what is owed to developing world communities who host international clinical research. Although existing paradigms for assigning and assessing benefits to host communities offer valuable insight, I criticize their failure to distinguish between those benefits which can justify the conduct of research in a developing world setting and those which cannot. I argue that the justification for human subjects research is (...) fundamentally grounded in the social value of knowledge, and that this value is context-dependent in a manner which should inform our ethical evaluation of the conduct of research in specific settings. I propose a new framework for the assessment of research benefits assigned to developing world host communities, a natural implication of which is to limit the types of research projects which may permissibly be conducted in developing world settings. (shrink)

This paper examines the moral force of exploitation in developing world research agreements. Taking for granted that some clinical research which is conducted in the developing world but funded by developed world sponsors is exploitative, it asks whether a third party would be morally justified in enforcing limits on research agreements in order to ensure more fair and less exploitative outcomes. This question is particularly relevant when such exploitative transactions are entered into voluntarily by all relevant parties, and both research (...) sponsors and host communities benefit from the resulting agreements. I show that defenders of the claim that exploitation ought to be permitted rely on a mischaracterization of certain forms of interference as unjustly paternalistic and two dubious empirical assumptions about the results of regulation. The view I put forward is that by evaluating a system of constraints on international research agreements, rather than individual transaction-level interference, we can better assess the alternatives to permitting exploitative research agreements. (shrink)

Patient-funded trials are gaining traction as a means of accelerating clinical translation. However, such trials sidestep mechanisms that promote rigor, relevance, efficiency, and fairness. We recommend that funding bodies or research institutions establish mechanisms for merit review of patient-funded trials, and we offer some basic criteria for evaluating PFT protocols.

Within bioethics as well as in broader clinical practice, support for transgender and gender‐questioning adolescent access to pubertal suppression has often relied heavily on the desire to prevent risky, self‐destructive, and suicidal behavior. We argue that framing justifications for access to puberty suppression in this way can actually be harmful to both individual patients as well as to the broader trans population. This justification for access to care makes such access precarious, limits its scope, and introduces perverse incentives to the (...) patient population that is being served. We go on to offer an alternative, positive defense of access to puberty‐blocking treatment for transgender youth grounded in the child's right to an open future. We argue that decisions related to pubertal suppression are both importantly weighty and potentially irreversible, and show why this justification is preferable to so‐called “informed consent” approaches. (shrink)

Volume 19, Issue 9, September 2019, Page 60-62.

Pratt, Zion, and Loff (2012) correctly point out that most international clinical research (ICR) is not intended to address the vast inequities in access to health care between developed and develo...

A growing proportion of clinical research funded by pharmaceutical companies, high-income country research agencies, and not-for-profit funders is conducted in low- and middle-income settings. Disparities in wealth and access to healthcare between the populations where new interventions are often tested and those where many of them are ultimately marketed raise concerns about exploitation. This chapter examines several ethical requirements frequently advanced as mechanisms for protecting research subjects in underserved communities from exploitation and evaluates the effectiveness of those mechanisms as responses (...) to exploitation worries. It goes on to highlight where the conceptual frameworks relied upon by research ethicists must be improved if we are to fully understand the nature of the moral claims and obligations that arise in research conducted in underserved communities. (shrink)

The global impact of Dobbs v. Jackson Women’s Health Organization and the backlash towards reproductive justice that it represents warrant a global feminist response informed by broad theoretical and geopolitical lenses. We consider how a solidaristic, transnational feminist movement might learn from Latin American feminist movements that have been successful in uniting broad coalitions in the fight for reproductive justice as situated within far-reaching political goals. The success of such a global movement must be decolonial and must contend with the (...) fact that overlapping realities of global inequality, severe poverty, extractivism, and western-backed violence are fundamentally implicated in reproductive justice. (shrink)

There has been a growing concern over establishing norms that ensure the ethically acceptable and scientifically sound conduct of clinical trials. Among the leading norms internationally are the World Medical Association's Declaration of Helsinki, guidelines by the Council for International Organizations of Medical Sciences, the International Conference on Harmonization's standards for industry, and the CONSORT group's reporting norms, in addition to the influential U.S. Federal Common Rule, Food and Drug Administration's body of regulations, and information sheets by the Department of (...) Health and Human Services. There are also many norms published at more local levels by official agencies and professional groups.Any account of international standards should cover both scientific and ethical norms at once – the two are conceptually intertwined. Recent sources recognize that “[s]cientifically unsound research on human subjects is unethical in that it exposes research subjects to risks without possible benefit.”. (shrink)

California has focused on health equity in the state’s COVID-19 reopening plan. The Blueprint for a Safer Economy assigns each of California’s 58 counties into 1 of 4 tiers based on 2 metrics: test positivity rate and adjusted case rate. To advance to the next less-restrictive tier, counties must meet that tier’s test positivity and adjusted case rate thresholds. In addition, counties must have a plan for targeted investments within disadvantaged communities, and counties with more than 106 000 residents must (...) meet an equity metric. California's explicit incorporation of health equity into its reopening plan underscores the interrelated fate of its residents during the COVID-19 pandemic and creates incentives for action. This article evaluates the benefits and challenges of this novel health equity focus, and outlines recommendations for other US states to address disparities in their reopening plans. (shrink)

Danielle Wenner has crafted novel arguments in defense of republican accounts of freedom. I learned a lot from her discussion of how Philip Pettit's neorepublican account of freedom as nondomination does a better job than standard accounts of freedom as noninterference of explaining how power over an agent can restrict their freedom to act autonomously. The real crux of Wenner's argument, however, is that freedom as nondomination can do this work in a way that those who defend (...) an account of relational autonomy cannot. I will start with Wenner's defense of freedom as nondomination and of what it can do as the background for assessing her critique of relational autonomy. The upshot of my comments will be that Wenner... (shrink)

In "Nondomination and the Limits of Relational Autonomy," Danielle Wenner aims to achieve the political goals of relational theorists through a more effective means. This is a worthy aspiration. She believes the neorepublican conception of freedom as nondomination "can best promote the aims embodied in the political project of feminist theorists", including reducing conditions of oppression, and do it in a way that avoids the conceptual problems inherent in relational autonomy. While I appreciate the pragmatism and clarity of (...) her argument, in this commentary I raise a challenge to the freedom as nondomination approach, specifically Wenner's claim that it can avoid making substantive value judgments. I... (shrink)

There is much to learn from and admire in Danielle Wenner's "Nondomination and the Limits of Relational Autonomy." The core claim Wenner advances is that the very concerns that have motivated feminist relational autonomy theorists would be better pursued by foregoing their concern with autonomy and pursuing instead the political aim of promoting a neorepublican conception of freedom as nondomination. While leaving open the possibility that "autonomy speak may remain valuable in some contexts", Wenner nevertheless claims (...) that "for the purposes of understanding and combating relations of oppression and subjection, freedom as nondomination provides a more useful conceptual apparatus than the ideal of... (shrink)

It is common to hear talk of the aim of belief and to find philosophers appealing to that aim for numerous explanatory purposes. What belief 's aim explains depends, of course, on what that aim is. Many hold that it is somehow related to truth, but there are various ways in which one might specify belief 's aim using the notion of truth. In this article, by considering whether they can account for belief 's standard of correctness and the epistemic (...) norms governing belief, I argue against certain prominent specifications of belief 's aim given in terms of truth, and advance a neglected alternative. (shrink)

The _Physics_ is a foundational work of western philosophy, and the crucial one for understanding Aristotle's views on matter, form, essence, causation, movement, space, and time. This richly annotated, scrupulously accurate, and consistent translation makes it available to a contemporary English reader as no other does—in part because it fits together seamlessly with other closely associated works in the New Hackett Aristotle series, such as the _Metaphysics_, _De Anima_, and forthcoming _De Caelo_ and _On Coming to Be and Passing Away_. (...) Eventually the series will include all of Aristotle's works. Sequentially numbered endnotes provide the information most needed at each juncture, while a detailed Index of Terms indicates places where focused discussion of key notions occurs. An illuminating general Introduction describes the book that lies ahead, explaining what sort of work it is and what sorts of evidence it relies on. (shrink)

Sometimes, learning about the origins of a belief can make it irrational to continue to hold that belief—a phenomenon we call ‘genealogical defeat’. According to explanationist accounts, genealogical defeat occurs when one learns that there is no appropriate explanatory connection between one’s belief and the truth. Flatfooted versions of explanationism have been widely and rightly rejected on the grounds that they would disallow beliefs about the future and other inductively-formed beliefs. After motivating the need for some explanationist account, we raise (...) some problems for recent versions of explanationism. Learning from their failures, we then produce and defend a more resilient explanationism. (shrink)

Examines the lived experience of social encounters drawing on phenomenological insights.

Infallibilism is the view that a belief cannot be at once warranted and false. In this essay we assess three nonpartisan arguments for infallibilism, arguments that do not depend on a prior commitment to some substantive theory of warrant. Three premises, one from each argument, are most significant: if a belief can be at once warranted and false, then the Gettier Problem cannot be solved; if a belief can be at once warranted and false, then its warrant can be transferred (...) to an accidentally true belief; if a belief can be at once warranted and false, then it can be warranted and accidentally true. We argue that each of these is either false or no more plausible than its denial. Along the way, we offer a solution to the Gettier Problem that is compatible with fallibilism. (shrink)

Supererogatory acts—good deeds “beyond the call of duty”—are a part of moral common sense, but conceptually puzzling. I propose a unified solution to three of the most infamous puzzles: the classic Paradox of Supererogation (if it’s so good, why isn’t it just obligatory?), Horton’s All or Nothing Problem, and Kamm’s Intransitivity Paradox. I conclude that supererogation makes sense if, and only if, the grounds of rightness are multi-dimensional and comparative.

In Lukács: Praxis and the Absolute, Daniel Andrés López reassembles Lukács’s philosophy of praxis on a Hegelian basis, as a conceptual-historical totality, both defending him and proposing an unprecedented, immanent critique that raises problems for Marxian philosophy as a whole.

" Qualia " is an unfamiliar term for something that could not be more familiar to each of us: the ways things seem to us. As is so often the case with philosophical jargon, it is easier to give examples than to give a definition of the term. Look at a glass of milk at sunset; the way it looks to you--the particular, personal, subjective visual quality of the glass of milk is the quale of your visual experience at the (...) moment. The way the milk tastes to you then is another, gustatory quale, and how it sounds to you as you swallow is an auditory quale; These various "properties of conscious experience" are prime examples of qualia. Nothing, it seems, could you know more intimately than your own qualia ; let the entire universe be some vast illusion, some mere figment of Descartes' evil demon, and yet what the figment is made of will be the qualia of your hallucinatory experiences. Descartes claimed to doubt everything that could be doubted, but he never doubted that his conscious experiences had qualia, the properties by which he knew or apprehended them. (shrink)

The social sciences playa variety of multifaceted roles in the policymaking process. So varied are these roles, indeed, that it is futile to talk in the singular about the use of social science in policymaking, as if there were one constant relationship between two fixed and stable entities. Instead, to address this issue sensibly one must talk in the plural about uses of dif ferent modes of social scientific inquiry for different kinds of policies under various circumstances. In some cases, (...) the influence of social scientific research is direct and tangible, and the connection between the find ings and the policy is easy to see. In other cases, perhaps most, its influence is indirect-one small piece in a larger mosaic of politics, bargaining, and compromise. Occasionally the findings of social scientific studies are explicitly drawn upon by policymakers in the formation, implementation, or evaluation of particular policies. More often, the categories and theoretical models of social science provide a general background orientation within which policymakers concep tualize problems and frame policy options. At times, the in fluence of social scientific work is cognitive and informational in nature; in other instances, policymakers use social science primarily for symbolic and political purposes in order to le gitimate preestablished goals and strategies. Nonetheless, amid this diversity and variety, troubling general questions persistently arise. (shrink)

Supererogatory acts are those that lie “beyond the call of duty.” There are two standard ways to define this idea more precisely. Although the definitions are often seen as equivalent, I argue that they can diverge when options are infinite, or when there are cycles of better options; moreover, each definition is acceptable in only one case. I consider two ways out of this dilemma.

1. Happiness, then and now -- Happiness, eudaimonia, and practical reasoning -- Happiness as eudaimonia -- Happiness and virtuous activity -- New directions from old debates -- 2. Happiness then: the sufficiency debate -- Aristotle's case against the sufficiency thesis -- 3. Happiness now: rethinking the self -- Socrates' case for the sufficiency thesis -- Epictetus and the stoic self -- The Stoics' case for the sufficiency thesis -- The embodied conception of the self -- The embodied conception and psychological (...) well-being -- The Stoics' case against the embodied conception. (shrink)

Public discussions of political and social issues are often characterized by deep and persistent polarization. In social psychology, it’s standard to treat belief polarization as the product of epistemic irrationality. In contrast, we argue that the persistent disagreement that grounds political and social polarization can be produced by epistemically rational agents, when those agents have limited cognitive resources. Using an agent-based model of group deliberation, we show that groups of deliberating agents using coherence-based strategies for managing their limited resources tend (...) to polarize into different subgroups. We argue that using that strategy is epistemically rational for limited agents. So even though group polarization looks like it must be the product of human irrationality, polarization can be the result of fully rational deliberation with natural human limitations. (shrink)

From an early age, humans know a surprising amount about basic physical principles, such as gravity, force, mass, and shape. We can see this in the way that young children play, and manipulate objects around them. The same behaviour has long been observed in primates - chimpanzees have been shown to possess a remarkable ability to make and use simple tools. But what does this tell us about their inner mental state - do they therefore share the same understanding to (...) that of a young child? Do they understand the simple, underlying physical principles involved? Though some people would say that they do, this book reports groundbreaking research that questions whether this really is the case. -/- Folk Physics for Apes challenges the assumptions so often made about apes. It offers us a rare glimpse into the workings of another mind, examining how apes perceive and understand the physical world - an understanding that appears to be both similar to, and yet profoundly different from our own. The book will have broad appeal to evolutionary psychologists, developmental psychologists, and those interested in the sub-disciplines of cognitive science (philosophy, anthropology). The book additionally offers for developmental psychologists some valuable new non-verbal techniques for assessing causal understanding in young children. (shrink)

Sometimes it takes years of debate for philosophers to discover what it is they really disagree about. Sometimes they talk past each other in long series of books and articles, never guessing at the root disagreement that divides them. But occasionally a day comes when something happens to coax the cat out of the bag. "Aha!" one philosopher exclaims to another, "so that's why you've been disagreeing with me, misunderstanding me, resisting my conclusions, puzzling me all these years!".

A remarkable number of Nietzsche's substantive moral psychological views have been borne out by evidence from the empirical sciences. Moral judgments are products of affects on Nietzsche's view, but the latter are in turn causally dependent upon more fundamental features of the individual. Nietzsche accepts a doctrine of types. The path is short from the acceptance of the Doctrine of Types to the acceptance of epiphenomenalism, as Leiter, and more recently, Riccardi argue. This chapter explains Nietzsche's phenomenological account of willing, (...) which serves as independent motivation for the view that Nietzsche denies the causal efficacy of conscious acts of willing. It also explores that in spite of an absence of volitional freedom, self‐control can be usefully understood on a strength‐model of motivational resources. The chapter concludes with a brief discussion of how Nietzsche, without employing the contemporary methods of empirical psychology, could nonetheless be such a prescient moral psychologist. (shrink)

Philosophers have found postulating possible worlds to be very useful in a number of areas, including philosophy of language and mind, logic, and metaphysics. Impossible worlds are a natural extension to this use of possible worlds, and can help resolve a number of difficulties thrown up by possible‐worlds frameworks.