This paper offers a modified version of the certainty equivalence (CE) theory of utility for uncertain prospects and a new set of axioms as its basis. It shows that the CE and the von Neumann-Morgenstern (NM) approaches to uncertainty are opposite in spirit: The CE approach represents a flight from the world of uncertainty to the rules of certainty while the NM approach represents a flight from the world of certainty to one of uncertainty. The two approaches (...) differ even in their treatment of compound prospects and their actuarially identical simple counterparts. (shrink)

Tacking by conjunction is a well-known problem for Bayesian confirmation theory. In the first section, disadvantages of existing Bayesian solution proposals to this problem are pointed out and an alternative solution proposal is presented: that of genuine confirmation. In the second section, the notion of GC is briefly recapitulated and three versions of GC are distinguished: full GC, partial GC and quantitative GC. In the third section, the application of partial GC to pure post-facto speculations is explained. In the fourth (...) section it is demonstrated that full GC is a necessary condition for Bayesian convergence to certainty based on the accumulation of conditionally independent pieces of evidence. It is found that whenever a hypothesis is equivalent to a disjunction of more fine-grained hypotheses conveying different probabilities to the evidence, then conditional independence of the evidence fails. This failure occurs typically for unspecific negations of hypotheses. A refined version of the convergence to certainty theorem that overcomes this difficulty is developed in the final section. (shrink)

Throughout the 19th century and early decades of the 20th century, milk was a dangerous food that required state intervention to make it safe. Throughout this period, the germ theory of contagious disease came to prominence, but could not explicitly determine the causal relationships linking germs, milk, and human illness. Using the notion of an ideational regime, I examine how (1) knowledge claims move from uncertainty to certainty and become privileged claims within ideational regimes that (2) result in an (...) unintended, but necessary deployment of a biopolitical strategy for governance. The argument here is that theoretical uncertainty meant managing populations as a uniform undifferentiated reality using pasteurization technologies. I use two historical moments as evidence of these processes. The first is the 1901 British Congress on Tuberculosis when I argue germ theory came to a theoretical standstill and the second is Ontario’s 1938 amendment to the province’s Public Health Act that permanently institutionalised province-wide compulsory pasteurisation laws organised around the notion of nutritional equivalency. This genealogical exploration should provide some insight into how bacteria became the singular cause of illness and into the conditions that led to targeting milk as the main site of intervention instead of treating individual bodies. (shrink)

In this article, we elicit both individuals’ and couples’ preferences assuming prospect theory (PT) as a general theoretical framework for decision under risk. Our experimental method, based on certainty equivalents, allows to infer measurements of utility and probability weighting at the individual level and at the couple level. Our main results are twofold. First, risk attitude for couples is compatible with PT and incorporates deviations from expected utility similar to those found in individual decision making. Second, couples’ attitudes towards (...) risk are found to be consistent with a mix of individual attitudes, women being more influent on couples’ preferences at low probability levels. (shrink)

One aspect of the utility of gambling may evidence itself in failures of idempotence, i.e., when all chance outcomes give rise to the same consequence the `gamble' may not be indifferent to its common consequence. Under the assumption of segregation, such gambles can be expressed as the joint receipt of the common consequence and what we call `an element of chance', namely, the same gamble with the common consequence replaced by the status quo. Generalizing, any gamble is indifferent to the (...) joint receipt of its element of chance and a certain consequence, which is called the `kernel equivalent' of the gamble. Under idempotence, the kernel equivalent equals the certainty equivalent. Conditions are reported (Theorem 4) that are sufficient for the kernel equivalents to have the kind of utility representation first discussed by Luce and Fishburn (1991), including being idempotent. This utility representation of the kernel equivalents together with the derived form of utility over joint receipts yields a utility representation of the original structure. Possible forms for the utility of an element of chance are developed. (shrink)

This article investigates how subjects determine minimum selling prices for lotteries. We design an experiment where subjects have at every moment an incentive to state their minimum selling price and to adjust the price, if they believe that the price that they stated initially was not optimal. We observe frequent and sizeable price adjustments. We find that random pricing models cannot explain the observed price patterns. We show that earlier prices contain information about future price adjustments. We propose a model (...) of Stochastic Pricing that offers an intuitive explanation for these price adjustment patterns. (shrink)

Elicitation methods in decision-making under risk allow us to infer the utilities of outcomes as well as the probability weights from the observed preferences of an individual. An optimally efficient elicitation method is proposed, which takes the inevitable distortion of preferences by random errors into account and minimizes the effect of such errors on the inferred utility and probability weighting functions. Under mild assumptions, the optimally efficient method for eliciting utilities and probability weights is the following three-stage procedure. First, a (...) probability is elicited whose subjective weight is one half. Second, the utility function is elicited through the midpoint chaining certainty equivalent method using the probability elicited at the first stage. Finally, the probability weighting function is elicited through the probability equivalent method. (shrink)

This chapter introduces the rationalist model of delusions. It begins by presenting John Campbell’s seminal proposal that delusions are caused top-down by pathological Wittgensteinian framework or hinge beliefs. After presenting Campbell’s rationalist account of delusions, the chapter raises and examines prominent objections by Tim Bayne & Elisabeth Pacherie as well as by Tim Thornton. The former make an important distinction between the aetiological top-down cognitive part and the epistemological rationalist framework part of Campbell’s account. The thesis that delusions are caused (...) top-down by pathological beliefs is not equivalent to the thesis that delusions are Wittgensteinian framework certainties. This chapter endorses this distinction. While the arguments against the top-down aspect are found to be more convincing – which motivates popular two-factor theories – the rationalist framework model of delusions is defended as an epistemologically promising account of delusion. Finally, this chapter examines a range of developments that have been made taking Campbell’s rationalism as a starting point. Most prominently the section examines Eilan’s early development of rationalism and Rhodes and Gipps’ proposal that delusions are not framework propositions but a product of their absence. (shrink)

This study investigates performance of portfolios composed of British socially responsible investments (SRI) stocks. Using the ‘Global-100 Most Sustainable Corporations in the World’ list (known also as ‘Global-100’) to select the SRI companies, we found that, in the period 2000–2010, the returns of the SRI portfolios were on average higher compared with the corresponding returns of the market indexes. The annual average difference in returns of the SRI portfolios (with dividends) was 5.26 % and 5.69 % relative to the FTSE100 (...) and FTSE4GOOD indexes (the total return versions), respectively, but the differences in returns in the whole period, in individual years and in other sub-periods were in most cases not statistically significant. Positive performance of SRI stocks in the whole sample is, however, evidenced by risk-adjusted measures such as the modified Sharpe ratio (MSR) and certainty equivalent (CEQ) returns, as well as by incorporating various levels of transaction costs. Furthermore, a simple trading strategy relying on selection of SRI stocks from the Global-100 list would beat the market indexes in the whole period 2000–2010, even after inclusion of various levels of transaction costs. We also estimated the Fama–French and Carhart multi-factor models and found that the returns of the SRI portfolios cannot be consistently explained by conventional factors other than the market factor. (shrink)

In this article, it is shown that a wide range of comparative statics results from expected utility theory can be extended to generalized expected utility models using the tools of supermodularity theory. In particular, a range of concepts of decreasing absolute risk aversion may be formulated in terms of the supermodularity properties of certainty equivalent representations of preferences.

One aspect of the utility of gambling may evidence itself in failures of idempotence, i.e., when all chance outcomes give rise to the same consequence the `gamble' may not be indifferent to its common consequence. Under the assumption of segregation, such gambles can be expressed as the joint receipt of the common consequence and what we call `an element of chance', namely, the same gamble with the common consequence replaced by the status quo. Generalizing, any gamble is indifferent to the (...) joint receipt of its element of chance and a certain consequence, which is called the `kernel equivalent' of the gamble. Under idempotence, the kernel equivalent equals the certainty equivalent. Conditions are reported (Theorem 4) that are sufficient for the kernel equivalents to have the kind of utility representation first discussed by Luce and Fishburn (1991), including being idempotent. This utility representation of the kernel equivalents together with the derived form of utility over joint receipts yields a utility representation of the original structure. Possible forms for the utility of an element of chance are developed. (shrink)

The response mode bias, in which subjects exhibit different risk attitudes when assessing certainty equivalents versus indifference probabilities, is a well-known phenomenon in the assessment of utility functions. In this empirical study, we develop and apply a cardinal measure of risk attitudes to analyze not only the existence, but also the strength of this phenomenon. Since probability levels involved in decision problems are already known to have a strong impact on behavior, we use this approach to study the impact (...) of probabilities on the extent of the response mode bias. We find that the direction in which probabilities influence measured risk aversion is the opposite in the certainty equivalence (CE) method versus in the probability equivalence (PE) method. Utilizing the CE elicitation approach leads to an increase of risk seeking for gambles involving high probabilities. For the PE method, subjects tend to behave risk averse with gambles of high probabilities. This behavior is reversed in the gain domain. This “tailwhip” effect is consistently replicated in several experiments, involving both loss and gain domains of lotteries. (shrink)

This note completes the main result of Zimper, by showing that additional conditions are needed in order the law of iterated expectations to hold true for Choquet decision makers. Due to the comonotonic additivity of Choquet expectations, the equation E[f, ν] = E[E[f, ν], ν], is valid only when the act f is comonotonic with its dynamic form, that we name “conditional certainty equivalent act”.

This paper addresses the simultaneous attitude and position tracking of a target spacecraft in the presence of general unknown bounded disturbances in the framework of dual quaternions, which provides a concise and integrated description of the coupled rotational and translational motions. By virtue of the newly introduced dual direction cosine matrix, the dimension of the dual quaternion-based relative motion dynamics written in vector/matrix form can be lowered to six. Treating the disturbances as unknown parameters, a modular adaptive pose tracking control (...) scheme composed of two separately designed parts is then derived. One part is the adaptive disturbance estimator designed based on the immersion and invariance theory. Driven by the disturbance estimation errors, it can realize exponential convergence of the estimations and has the nice “parameter lock” property, which can hardly be expected in the conventional certainty equivalent adaptive controllers. The other part is a proportional-derivative-like pose tracking controller where the estimated disturbances are directly used. The closed-loop stability of the relative motion system under different kinds of disturbances is proven by Lyapunov stability analysis. Simulations and comparisons with two previous dual quaternion-based controllers demonstrate the novel features and performance improvements of the proposed control scheme. (shrink)

When a risk is exchanged, the exact value for the minimum price (positive or negative) that the purchaser (investor, or insurer) is willing to pay is given by the certainty equivalent wealth level, which in turn depends on his specific utility function. When this utility function is unknown, then only a sufficient condition on the price can ever be found. This paper provides methods for calculating such a sufficient condition, when only limited information on the utility function is (...) known. (shrink)

This paper axiomatizes a recursive utility model that captures both intertemporal utility smoothing defined across time and ambiguity aversion defined over states. The resulting representation adapts Wakai model of intertemporal utility smoothing as an aggregator function, where the utility of the certainty equivalent of future uncertainty is computed by Gilboa and Schmeidler multiple-priors utility. The model also permits the separation of intertemporal utility smoothing from ambiguity aversion.

This study focuses on the question of neural differences in the evaluation of hypothetical and real payoffs. Hypothetical payoffs are not incentive compatible and are, therefore, not considered to be reliable. Behavioral differences between the evaluation of hypothetical and real payoffs can be attributed to this incentive effect. Because real payoff mechanisms are not always applicable in the field, it is necessary to know in which way both types of payoffs affect evaluation processes. In order to delineate the cognitive processes (...) related to hypothetical bias, we conducted a within-subject EEG experiment with hypothetical and real payoffs. A certainty equivalent elicitation method for measuring risk attitudes was performed in which subjects had to indicate whether they preferred playing a lottery or receiving a sure payoff instead. At the behavioral level, subjects were more risk averse for real payoff choices, confirming a hypothetical bias. EEG-derived event-related potentials provide evidence that the processes underlying these differences in evaluations differ. A higher N2 component for hypothetical payoffs revealed increased cognitive control for hypothetical decisions. These neuronal underpinnings indicate additional evaluation processes in hypothetical choice paradigms, which can explain the shift in risk attitude toward the expected value of a lottery. (shrink)

This paper presents a novel framework for selecting socially responsible investment (SRI) portfolios. The Hedonic Price Method (HPM) is applied to obtain an evaluation of SRI criteria that is integrated into a multi-objective mathematical programming model. The HPM breaks away from the traditional view that goods are the direct object of utility; on the contrary, it assumes that utility is derived from the properties or characteristics of the goods themselves. As far as the investment decision is concerned, we assume that (...) socially responsible investmentmutual funds (SRI funds) constitute heterogeneous goods. Our approach allows us to obtain a portfolio, the financial performance of which is similar to that which the investor would have reached if he or she had not taken into account social, ethical, and environmental considerations when making his or her investment decisions. This is achieved by designing a two-stage multi-objective mathematical programming procedure. In the first stage, we achieve the maximum level of financial satisfaction that the investor can receive. In the second stage, the portfolio with the best financial–social behavior is built. For the purpose of this second stage, the first stage portfolio is used as a benchmark for the financial performance of a socially responsible portfolio. To apply this methodology, we use portfolios composed of socially responsible and conventional mutual funds domiciled in Spain. (shrink)

For decisions whose consequences accrue over time, there are several possible techniques to compute total utility. One is to discount utilities of future consequences at some appropriate rate. The second is to discount per-period certainty equivalents. And the third is to compute net present values (NPVs) of various possible streams and to then apply the utility function to these net present values. We find that the best approach is to first compute NPVs of various possible income streams and then (...) take the utility of such NPVs. We show the drawbacks of other alternative models of evaluating income streams. The article discusses the advantages of the power and logarithmic forms in the modeling of time preference. These are the only forms for which utility of income and utility of consumption are strategically equivalent. Further, these forms permit the flexibility in the choice of a time period (e.g., monthly or quarterly) without modifying the utility function, thus simplifying analysis. (shrink)

The Expected Shortfall or Conditional Value-at-Risk (CVaR) has been playing the role of main risk measure in the recent years and paving the way for an enormous number of applications in risk management due to its very intuitive form and important coherence properties. This work aims to explore this measure as a probability-dependent utility functional, introducing an alternative view point for its Choquet Expected Utility representation. Within this point of view, its main preference properties will be characterized and its utility (...) representation provided through local utilities with an explicit dependence on the assessed revenue’s distribution (quantile) function. Then, an intuitive interpretation for the related probability dependence and the piecewise form of such utility will be introduced on an investment pricing context, in which a CVaR maximizer agent will behave in a relativistic way based on his previous estimates of the probability function. Finally, such functional will be extended to incorporate a larger range of risk-averse attitudes and its main properties and implications will be illustrated through examples, such as the so-called Allais Paradox. (shrink)

Isn't probability 1 certainty? If the probability is objective, so is the certainty: whatever has chance 1 of occurring is certain to occur. Equivalently, whatever has chance 0 of occurring is certain not to occur. If the probability is subjective, so is the certainty: if you give credence 1 to an event, you are certain that it will occur. Equivalently, if you give credence 0 to an event, you are certain that it will not occur. And so (...) on for other kinds of probability, such as evidential probability. The formal analogue of this picture is the regularity constraint: a probability distribution over sets of possibilities is regular just in case it assigns probability 0 only to the null set, and therefore probability 1 only to the set of all possibilities. (shrink)

Isn't probability 1 certainty? If the probability is objective, so is the certainty: whatever has chance 1 of occurring is certain to occur. Equivalently, whatever has chance 0 of occurring is certain not to occur. If the probability is subjective, so is the certainty: if you give credence 1 to an event, you are certain that it will occur. Equivalently, if you give credence 0 to an event, you are certain that it will not occur. And so (...) on for other kinds of probability, such as evidential probability. The formal analogue of this picture is the regularity constraint: a probability distribution over sets of possibilities is regular just in case it assigns probability 0 only to the null set, and therefore probability 1 only to the set of all possibilities. (shrink)

BackgroundSocio-cultural perceptions surrounding death have profoundly changed since the 1950s with development of modern intensive care and progress in solid organ transplantation. Despite broad support for organ transplantation, many fundamental concepts and practices including brain death, organ donation after circulatory death, and some antemortem interventions to prepare for transplantation continue to be challenged. Attitudes toward the ethical issues surrounding death and organ donation may influence support for and participation in organ donation but differences between and among diverse populations have not (...) been studied.ObjectivesIn order to clarify attitudes toward brain death, organ donation after circulatory death and antemortem interventions in the context of organ donation, we conducted a scoping review of international English-language quantitative surveys in various populations.Study appraisalA search of literature up to October 2020 was performed, using multiple databases. After screening, 45 studies were found to meet pre-specified inclusion criteria.Results32 studies examined attitudes to brain death, predominantly in healthcare professionals. In most, around 75% of respondents accepted brain death as equivalent to death of the person. Less common perspectives included equating death with irreversible coma and willingness to undertake organ donation even if it caused death. 14 studies examined attitudes to organ donation following circulatory death. Around half of respondents in most studies accepted that death could be confidently diagnosed after only 5 min of cardiorespiratory arrest. The predominant reason was lack of confidence in doctors or diagnostic procedures. Only 6 studies examined attitudes towards antemortem interventions in prospective organ donors. Most respondents supported minimally invasive procedures and only where specific consent was obtained.ConclusionsOur review suggests a considerable proportion of people, including healthcare professionals, have doubts about the medical and ethical validity of modern determinations of death. The prognosis of brain injury was a more common concern in the context of organ donation decision-making than certainty of death. (shrink)

Cover -- Half Title Page -- Title Page -- Copyright Page -- Original Title Page -- Original Copyright Page -- Contents -- Preface -- 1 Introduction -- 2 Probability And Possibility For Choice -- 1 Introductory -- 2 A Theory About Personal Power -- 3 A Criticism Of Keynes -- 4 Some More Theories About Personal Power -- 5 An Analogy Between Two Kinds Of Possibility -- 3 Probability And Natural Powers -- 1 Introductory -- 2 The Relation Between Epistemic (...) And Natural Possibility -- 3 A Criticism Of The Doctrine That 'Probable' Is Ambiguous -- 4 A Comparison Of Possibility With Probability -- 4 Some Unobservable Properties -- 1 Introductory -- 2 Certainty, Necessity And Hume -- 3 Epistemology And Determinism -- 4 An Analysis Proposed And Defended -- 5 Power And Law -- 5 Some Puzzles About Potentiality -- 1 Introductory -- 2 The idea of a 'circumstance' -- 3 The Distinction Between Intrinsic And Extrinsic Properties -- 4 The Refutation Of Actualism -- 5 The Refutation Of The Theory That 'All Power Is Conditional' -- 6 The Powers Of People Andthe Powers Of Things -- 1 Introductory -- 2 The Distinction Between Natural And Personal Power -- 3 The Refutation Of Ryle's Dispositionalist Account Of Human Capacities -- 7 IFS And Cans -- 1 Introductory -- 2 The Refutation Of The Theory That All Personal Power is Conditional -- 3 A Refutation Of The Orthodox Account Of 'I Can', As Equivalent To A Conditional Statement -- 4 A Contradiction In Dispositionalism -- 5 Further Objections To The Orthodox View -- 6 The Verification Of 'I Can': More About Trying -- 8 Deliberation, Freedom And Meaning -- 1 Introductory -- 2 More About Possibility And The Context Of Deliberation -- And About The Relation Between Power And Will -- 3 On Not Being Able To Help It: A: Discussion Of The Relationship Between Power And Responsibility -- 4 On The Meaning Of Words Like 'Can'. (shrink)

Recent work on the interpretation of counterfactual conditionals has paid much attention to the role of causal independencies. One influential idea from the theory of Causal Bayesian Networks is that counterfactual assumptions are made by intervention on variables, leaving all of their causal non-descendants unaffected. But intervention is not applicable across the board. For instance, backtracking counterfactuals, which involve reasoning from effects to causes, cannot proceed by intervention in the strict sense, for otherwise they would be equivalent to their (...) consequents. We discuss these and similar cases, focusing on two factors which play a role in determining whether and which causal parents of the manipulated variable are affected: Speakers' need for an explanation of the hypothesized state of affairs, and differences in the ‘resilience’ of beliefs that are independent of degrees of certainty. We describe the relevant theoretical notions in some detail and provide experimental evidence that these factors do indeed affect speakers' interpretation of counterfactuals. (shrink)

Orthodox Bayesianism endorses revising by conditionalization. This paper investigates the zero-raising problem, or equivalently the certainty-dropping problem of orthodox Bayesianism: previously neglected possibilities remain neglected, although the new evidence might suggest otherwise. Yet, one may want to model open-minded agents, that is, agents capable of raising previously neglected possibilities. Different reasons can be given for open-mindedness, one of which is fallibilism. The paper proposes a family of open-minded propositional revisions depending on a parameter ϵ. The basic idea is this: (...) first extend the prior to the newly suggested possibilities by mixing the prior with the uniform probability on these possibilities, then conditionalize. This may put the agent back on the right track when her beliefs or evidence happen to be false. The paper justifies this family of equivocal epsilon-conditionalizations as minimal non-biased open-minded modifications of conditionalization. Several variations are discussed, such as mixing with an ad hoc or silent prior instead of the uniform prior, and a generalization to probabilistic information is given. The approach is compared to other accounts, such as Jeffrey’s Bayesianism, Gärdenfors’s probabilistic revision, maximizing entropy, and minimal revision. _1_ Introduction _2_ Downsides of Certainty Conservation _3_ Why Raise Zeros? _3.1_ Accuracy defects _3.2_ Fallibilism and dissolutions _3.3_ Weak fallibilism and partial solutions _4_ Epsilon-Conditionalization _4.1_ Definitions _4.2_ Revision types and information assumptions _4.3_ Epsilon interpretation and flavours _5_ Justifications _5.1_ Open-minded orthodox Bayesianism _5.2_ Minimal revision _5.3_ Transitivity _6_ Conclusion Appendix. (shrink)

An assertion of high conditional probability or, more briefly, an HCP assertion is a statement of the type: The conditional probability of B given A is close to one. The goal of this paper is to construct logics of HCP assertions whose conclusions are highly likely to be correct rather than certain to be correct. Such logics would allow useful conclusions to be drawn when the premises are not strong enough to allow conclusions to be reached with certainty. This (...) goal is achieved by taking Adams' (1966) logic, changing its intended application from conditionals to HCP assertions, and then weakening its criterion for entailment. According to the weakened entailment criterion, called the Criterion of Near Surety and which may be loosely interpreted as a Bayesian criterion, a conclusion is entailed if and only if nearly every model of the premises is a model of the conclusion. The resulting logic, called NSL, is nonmonotonic. Entailment in this logic, although not as strict as entailment in Adams' logic, is more strict than entailment in the propositional logic of material conditionals. Next, NSL was modified by requiring that each HCP assertion be scaled; this means that to each HCP assertion was associated a bound on the deviation from 1 of the conditional probability that is the subject of the assertion. Scaling of HCP assertions is useful for breaking entailment deadlocks. For example, it it is known that the conditional probabilities of C given A and of - C given B are both close to one but the bound on the former's deviation from 1 is much smaller than the latter's, then it may be concluded that in all likelihood the conditional probability of C given A ∧ B is close to one. The resulting logic, called NSL-S, is also nonmonotonic. Despite great differences in their definitions of entailment, entailment in NSL is equivalent to Lehmann and Magidor's rational closure and, disregarding minor differences concerning which premise sets are considered consistent, entailment in NSL-S is equivalent to entailment in Goldszmidt and Pearl's System-Z⁺. Bacchus, Grove, Halpern, and Koller proposed two methods of developing a predicate calculus based on the Criterion of Near Surety. In their randomstructures method, which assumed a prior distribution similar to that of NSL, it appears possible to define an entailment relation equivalent to that of NSL. In their random-worlds method, which assumed a prior distribution dramatically different from that of NSL, it is known that the entailment relation is different from that of NSL. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:IntroductionCynthia B. CohenThe explosion of genetic information in recent years raises a fundamental question for us as individuals and as members of various communities: Have we an obligation to know as much as possible about our genes—or should we bypass genetic information, leaving it hidden? A terrible ambivalence grips us when it comes to our genes. We want to respond to the Socratic call to know ourselves by learning (...) what lies on the minute threads of the chromosomes spun into the nuclei of our cells. At the same time, we fear obtaining that information, for it seems functionally equivalent to the oracle at Delphi, revealing a distinct and dangerous knowledge we would rather not have.What is it about genetic knowledge that creates such ambivalence in us? Genetic knowledge is empowering. It offers us the freedom to shape the contours of our lives and those of our families. At the same time, genetic knowledge is disempowering. It bears a peculiar mark of inevitability, telling us that we have no control over our present or future in important respects. Better to hide from such overbearing information than to suffer the assaults on our freedom it seems to create.We can see this ambivalence about genetic knowledge appearing again and again as the field of genetics has grown. Initially, genetics emerged as a tool for understanding how traits and diseases are passed from generation to generation. We used genetic testing mostly to enhance our personal decision making about reproductive matters. It was at this time that our hesitancy about pursuing such testing first arose, for we feared being put into a position of asking such painful questions as, “Knowing what we do about our genes, should we have children?” As the scope of genetic information expanded, we learned to test for genes that could signal the development of such terrible conditions as Huntington’s disease. The possibility of gaining access to such disturbing information exacerbated our fear of genetic knowledge—to some, the certainty of knowing seemed worse than the uncertainty of not knowing. As genetic research has disclosed genes associated with conditions that might, but not necessarily will occur, the uncertainty of knowing, to some, seems worse than that of not knowing. Further, questions focused on individuals, although still pertinent, are being supplanted by broader questions about families and [End Page vii] social groups. When added to the personal agony that genetic information can engender, the specter of egregious discrimination seems to some to outweigh the value of knowing. As the net is cast further and further from the initial genetic inquiries, the call to halt or control certain kinds of genetic testing is growing increasingly loud.Ambivalence about whether to obtain genetic information hovers over the pages of this issue of the Kennedy Institute of Ethics Journal. The authors address both the promise and the threat of the information to be derived from genetic tests. Each examines a different facet of the problem of knowing that vexes the terrain of genetic technology and proposes blueprints for resolving it.Cynthia B. Cohen opens by examining whether genetic testing should be used to unearth information about conditions children might develop later in life. She challenges the current trend within the professional genetics community to keep such information hidden, claiming that the putative psychosocial burdens of receiving that information are outweighed by the psychosocial benefits. Moreover, Cohen maintains that having such information can enhance, rather than impair, the adult autonomy of children. She offers a framework for assessing whether to test in individual cases and maintains that it is the responsibility of parents to make the final decision for their children.A similar response to our ambivalence about obtaining genetic knowledge is given by Robert Wachbroit. In discussing the dilemma caused by pleiotropic genetic tests—those in which a single gene mutation is involved in several apparently unrelated diseases—he favors fully disclosing their dual nature to patients before testing. Wachbroit’s emphasis on openness extends beyond informed consent recommendations, for he maintains that patients have an obligation to know as much about their genetic proclivities as possible. He goes on to confute the common wisdom that genetic information is... (shrink)

Researches over many years have examined whether levonorgestrel emergency contraception has a postfertilization effect. In a recent article in the Catholic Health Association’s journal Health Progress, Sandra Reznik, MD, asserts that “levonorgestrel acts to prevent pregnancy before, and only before, fertilization occurs.” A companion article by Ron Hamel, PhD, argues for the moral certainty that Plan B is not an abortifacient. Reznik fails to address the principal model supporting a potential postfertil­ization mechanism of action, specifically, that preovulatory administration of (...) levonorgestrel disrupts the delicate ratio of estrogen and progesterone essential to healthy endometrial development and induces the equivalent of luteal phase insufficiency, thereby jeopardizing implantation. Hamel’s argument for moral certitude is similarly inadequate. This article critically reviews both articles and the sources on which they rely. National Catholic Bioethics Quarterly 10.4 : 741–772. (shrink)

I advance a novel argument for an infallibilist theory of knowledge, according to which we know all and only those propositions that are certain for us. I argue that this theory lets us reconcile major extant theories of knowledge, in the following sense: for any of these theories, if we require that its central condition (evidential support, reliability, safety, etc.) obtains to a maximal degree, we get a theory of knowledge extensionally equivalent to infallibilism. As such, the infallibilist can (...) affirm that, when their conditions are suitably interpreted, most post-Gettier theories of knowledge offer necessary and sufficient conditions for knowledge. The infallibilist can thus reconcile major theories of knowledge, and is in a better position to explain the intuitive appeal of these theories than the fallibilist who only accepts one of them, and rejects the rest. (shrink)

JOHN CORCORAN AND WILIAM FRANK. Surprises in logic. Bulletin of Symbolic Logic. 19 253. Some people, not just beginning students, are at first surprised to learn that the proposition “If zero is odd, then zero is not odd” is not self-contradictory. Some people are surprised to find out that there are logically equivalent false universal propositions that have no counterexamples in common, i. e., that no counterexample for one is a counterexample for the other. Some people would be surprised (...) to find out that in normal first-order logic existential import is quite common: some universals “Everything that is S is P” —actually quite a few—imply their corresponding existentials “Something that is S is P”. Anyway, perhaps contrary to its title, this paper is not a cataloging of surprises in logic but rather about the mistakes that did or might have or might still lead people to think that there are no surprises in logic. The paper cataloging of surprises in logic is on our “to-do” list. -/- ► JOHN CORCORAN AND WILIAM FRANK, Surprises in logic. Philosophy, University at Buffalo, Buffalo, NY 14260-4150, USA E-mail: [email protected] There are many surprises in logic. Peirce gave us a few. Russell gave Frege one. Löwenheim gave Zermelo one. Gödel gave some to Hilbert. Tarski gave us several. When we get a surprise, we are often delighted, puzzled, or skeptical. Sometimes we feel or say “Nice!”, “Wow, I didn’t know that!”, “Is that so?”, or the like. Every surprise belongs to someone. There are no disembodied surprises. Saying there are surprises in logic means that logicians experience surprises doing logic—not that among logical propositions some are intrinsically or objectively “surprising”. The expression “That isn’t surprising” often denigrates logical results. Logicians often aim for surprises. In fact, [1] argues that logic’s potential for surprises helps motivate its study and, indeed, helps justify logic’s existence as a discipline. Besides big surprises that change logicians’ perspectives, the logician’s daily life brings little surprises, e.g. that Gödel’s induction axiom alone implies Robinson’s axiom. Sometimes wild guesses succeed. Sometimes promising ideas fail. Perhaps one of the least surprising things about logic is that it is full of surprises. Against the above is Wittgenstein’s surprising conclusion : “Hence there can never be surprises in logic”. This paper unearths basic mistakes in [2] that might help to explain how Wittgenstein arrived at his false conclusion and why he never caught it. The mistakes include: unawareness that surprise is personal, confusing logicians having certainty with propositions having logical necessity, confusing definitions with criteria, and thinking that facts demonstrate truths. People demonstrate truths using their deductive know-how and their knowledge of facts: facts per se are epistemically inert. [1] JOHN CORCORAN, Hidden consequence and hidden independence. This Bulletin, vol.16, p. 443. [2] LUDWIG WITTGENSTEIN, Tractatus Logico-Philosophicus, Kegan Paul, London, 1921. -/-. (shrink)

The Bavarian and the Indian constitutions were developed in almost the same period of time. Because of historic experiences the prospect of legal certainty was the determining factor for the representatives of the people in India and Bavaria. They elaborated functioning constitutions and integrated their fundamental ideological principles quite naturally. The Indian and the Bavarian constitution are characterized by their aspirations to balance social injustice, particularly by striking a balance between individual liberty and social need.The history of political economy (...) demonstrates a broad variety of interpretations regarding the meaning and function of value concepts. When we review all these value concepts we identify two poles of the value-concept that still lack compatibility with each other in economical and philosophical schools to this day. Value systems have to be applied situation-sensitive and are in need of a frequent critical reflection; they need to be refused or changed if necessary.Examining some examples of the Bavarian Constitution, we indicate some concordances with regard to contents of the Indian Constitutional Law. The equivalences in the Bavarian and the Indian Constitution incorporate entitlements which should protect citizens against an unjustified economical assault upon their existence. The social value conflicts that occur more and more because of the hiatus to the constitutionally warranted values, and that cannot be solved simply by law or political adjustment, are therefore up for discussion. We then examine the disparity between entitlements and reality and discuss the hierarchy of our values. (shrink)

Psychological research has shown that cognitive illusions, of which visual illusions are just a special case, are systematic and pervasive, raising epistemological questions about how error in all forms of research can be identified and eliminated. The quantitative sciences make use of statistical techniques for this purpose, but it is not clear what the qualitative equivalent is, particularly in view of widespread scepticism about validity and objectivity. I argue that, in the light of cognitive psychology, the ‘error question’ cannot (...) be dismissed as a positivist obsession, and that the concepts of truth and objectivity are unavoidable. However, they constitute only a ‘minimal realism’, which does not necessarily bring a commitment to ‘absolute’ truth, certainty, correspondence, causation, reductionism, or universal laws in its wake. The assumption that it does reflects a misreading of positivism and, ironically, precipitates a ‘crisis of legitimation and representation’, as described by constructivist authors. (shrink)

Psychological research has shown that cognitive illusions, of which visual illusions are just a special case, are systematic and pervasive, raising epistemological questions about how error in all forms of research can be identified and eliminated. The quantitative sciences make use of statistical techniques for this purpose, but it is not clear what the qualitative equivalent is, particularly in view of widespread scepticism about validity and objectivity. I argue that, in the light of cognitive psychology, the ‘error question’ cannot (...) be dismissed as a positivist obsession, and that the concepts of truth and objectivity are unavoidable. However, they constitute only a ‘minimal realism’, which does not necessarily bring a commitment to ‘absolute’ truth, certainty, correspondence, causation, reductionism, or universal laws in its wake. The assumption that it does reflects a misreading of positivism and, ironically, precipitates a ‘crisis of legitimation and representation’, as described by constructivist authors. (shrink)

In their article, Sahan and colleagues have presented ethical dilemmas faced by clinical scientists working in genomics.1 This is a welcome development since thus far little has been published on the ethical issues faced by clinical scientists in general. In their article, the authors present the three themes which emerged from discussions with clinical scientists in respect to three case studies: ‘(1) the redistribution of labour and responsibilities resulting from the practice of genomic medicine; (2) the interpretation and certainty (...) of results and (3) the proposal that better standardisation and consistency of ethical approaches (for example, more guidelines and policy) could resolve some of the challenges arising’.1 One theme which appeared not to emerge is that of ethics education received by clinical scientists during their training, and this is the theme on which this commentary will focus. As noted elsewhere, ‘Clinical Scientists receive some lectures on clinical and research ethics as part of their training, but it amounts to only to a couple of hours of lectures (references omitted)’.2 The usual route to becoming a clinical scientist involves undertaking the 3-year postgraduate Scientist Training Programme (STP), though the ‘equivalence’ route is quite commonly taken by clinical scientists working in …. (shrink)

Contrary to the traditional claim that needs for unambiguous communication about animal and plant species are best served by a single set of names ruled by international Codes, I suggest that a more diversified system is required, especially to cope with problems emerging from aggregation of biodiversity data in large databases. Departures from Linnaean nomenclature are sometimes intentional, but there are also other, less obvious but widespread forms of not Code-compliant grey nomenclature. A first problem is due to the circumstance (...) that the Codes are intended to rule over the way names are applied to species and other taxonomic units, whereas users of taxonomy need names to be applied to specimens. For different reasons, it is often impossible to refer a specimen with certainty to a named species, and in those cases an open nomenclature is employed. Second, molecular taxonomy leads to the discovery of clusters of gene sequence diversity not necessarily equivalent to the species recognized and named by taxonomists. Those clusters are mostly indicated with informal names or formulas that challenge comparison between different publications or databases. In several instances, it is not even clear if a formula refers to an individual voucher specimen, or is a provisional species name. The use of non-Linnaean names and formulas must be revised and strengthened by fixing standard formats for the different kinds of objects or hypotheses and providing permanent association of ‘grey names’ with standardized source information such as author and year. In the context of a broad-scope revisitation of aims and scope of scientific nomenclature, it may be worth rethinking if natural objects like plant galls and lichens, although other than the ‘single-entity’ objects traditionally covered by biological classifications, may nevertheless deserve taxonomic names. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:70 HUME'S LETTER TO STEWART A Note on a Paper by D. C. Stove In a recent paper, D. C. Stove raises an historical problem. There exists a letter, written in 1754 by Hume to John Stewart, then Professor of Natural Philosophy at Edinburgh, in which the following words occur:. „. J never asserted so absurd a Proposition, as that any thing might arise without a Cause: I only (...) maintained, that our Certainty of the Falsehood of that Proposition proceeded neither from Intuition nor Demonstration; but from another Source. Some commentators, most notably Norman Kemp-Smith, take this as telling strongly in favour of a non-sceptical reading of Hume. Stove undertakes to show beyond reasonable doubt that the claim made in the letter is in blatant contradiction with central theses of Hume's published philosophy, so that it has to be regarded as useless as evidence for the interpretation of the latter. There is a mystery as to how Hume came to say something so clearly false about what he himself had written; Stove offers certain conjectures, none of which he finds wholly satisfactory. As the conclusion of the first, exegetical, part of his article, Stove advances the thesis that Hume held the falsity of the Causal Principle to be possible in at least three senses of "possible". These senses he specifies accurately, but doesn't wish to rest anything on the detail of his specification of the third; it is important only that it be stronger than either of the preceding two. This done, he takes a look at the letter to Stewart, and says, with reference to the first part of the 71 passage quoted above: That something might begin to exist without a cause, is evidently equivalent to the proposition that it is possib Ie for something to begin to exist without a cause. That, in turn, is evidently equivalent to the proposition that the falsity of the Causal Principle is possible. (Stove's o underlining). It follows that what Hume says in the letter is simply false. It could be true only if the "might" referred to some sense of possibility even weaker than the weakest of Stove's three senses. But since that is mere self-consistency, there is no such sense. Now the argument to the contradiction relies on reading "might" as "it is possible", in some sense of those words. Stove says, as we have seen, that they are "evidently equivalent", but the equivalence is certainly not evident, and it may well be asked whether it exists at all. After all, there are English constructions with "might" which don't have modal force: "Do you think something might have happened to them without our knowing about it?" The hearer is not, of course, being asked whether it- is possible that something should have happened without their knowledge; he is being asked for his opinion on whether something actually has so happened. "Most unlikely", would be a perfectly natural and acceptable response. Again : "ïou stay here, to take care of any problem that might arise before we get back". Obviously it is not intended that the hearer should start taking precautions against all possibilities, only that he should cope with whatever actually arises, if anything. 72 This is quite normal modern usage, and I know no reason to think that it wasn't also norT.il usage in the 18th Century. Admittedly, it isn't modern philocophers ' usage - we would be very careful, in writing or; logical matters, not to use the word "might" unless it was definitely the modal proposition that we had in mind, but earlier times haven't always been so professional about their vocabulary. Certainly, if Hume, in the letter to Stewart, was denying that he had ever asserted the possibility of the falsehood of the Causal Principle it would be, as Stove shows, extremely hard to see what he could have been thinking of. But if what he meant could have been as well expressed by "I never asserted... that anything arises without a cause" then most of Stove's problems are over, for there is no 3 conflict with any of the theses (1) - (3) which he... (shrink)

We study two logics of knowledge and belief stemming from the work of Stalnaker, omitting positive introspection for knowledge. The two systems are equivalent with positive introspection, but not without. We show that while the logic of beliefs remains unaffected by omitting introspection for knowledge in one system, it brings significant changes to the other. The resulting logic of belief is non-normal, and its complete axiomatization uses an infinite hierarchy of coherence constraints. We conclude by returning to the philosophical (...) interpretation underlying both models of belief, showing that neither is strong enough to support a probabilistic interpretation, nor an interpretation in terms of certainty or the “mental component” of knowledge. (shrink)

We study two logics of knowledge and belief stemming from the work of Stalnaker, omitting positive introspection for knowledge. The two systems are equivalent with positive introspection, but not without. We show that while the logic of beliefs remains unaffected by omitting introspection for knowledge in one system, it brings significant changes to the other. The resulting logic of belief is non-normal, and its complete axiomatization uses an infinite hierarchy of coherence constraints. We conclude by returning to the philosophical (...) interpretation underlying both models of belief, showing that neither is strong enough to support a probabilistic interpretation, nor an interpretation in terms of certainty or the “mental component” of knowledge. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:Everyday Poetics: Logic, Love, and Ethics by Brett BourbonKatie PelkeyEveryday Poetics: Logic, Love, and Ethics by Brett Bourbon; 200 pp. London: Bloomsbury Publishing, 2022.In Everyday Poetics: Logic, Love, and Ethics, Brett Bourbon probes the nature of poetry and its centrality in our everyday lives, working from the ordinary-language philosophical framework associated with Ludwig Wittgenstein, J. L. Austin, W. V. O. Quine, and Stanley Cavell. Bourbon's ideas contribute new (...) dimensions to the elusive concept of poetry and pivots the reader's attention inward: how can we recognize poetry in our day-to-day and why should we? At sentence level, his claims are clear and compelling to readers across disciplines with varying knowledge of philosophy and poetry. This book is thus addressed to "poets, literary scholars, philosophers, and students of religion, and anyone who cares about the ethics of everyday life, about the surprises that punctuate and give our lives form" (p. ix).Poems themselves are such "events of form," Bourbon emphasizes, which live among us and need not be constituted by words. Wordless poems can be uncovered and embraced through the development of a "poetic vulnerability" to ordinary experiences that are not necessarily wedded to one's aesthetic reaction. Bourbon designates the alphabet as one such example of what he calls a "primal everyday poem"; the alphabet is wordless and consists of a patterned order whose mere form does not encompass its meaning. The ordinary expression "I love you" also falls under this classification; the phrase is a performative poem whose intricate connotation is simplified by common language, yet is not the equivalent of its mere words. Bourbon asserts that, like the phrase "I love you," poems of the everyday cannot be reduced to mere language, conditions, or creative modes.Of the ineffable nature of poetry, Bourbon claims, "Poetry, like death, is that which we can only know by analogy—by examples—but it has a scope beyond all our examples" (p. 108). In terms of examples, he draws from poignant personal experiences to reinforce his arguments and provide insight into his keen sensibility. In chapter 1 ("Poems of the Everyday"), Bourbon recounts his own dismissal as a young boy of poetry's worthiness until one day while watching an old film, he in fact was struck by the phrase "I love you." This ordinary phrase allowed him to reconsider the parameters of what constitutes poetry and acknowledge the dichotomy of the phrase's formal power constituted by trivial symbols.Chapter 4 ("Epithalamion") is also rooted in personal experience. Bourbon opens with the flat assertion, "I have never liked weddings" (p. 43), but he notes a difference between a "marriage of forms" and "marriage of intimacy and stability": his distaste is for the former. He believes that a successful marriage can become a poem of the everyday—an event of power and "linguistic surrogacy"—where the event itself fosters more meaning than the words alone [End Page 475] can carry. Marriage can be a poem of discovery that arises from the action of learning what it means to love. But in the objects of the wedding and all its trite, heart-shaped symbols, Bourbon remarks, no poems are to be found.Bourbon dedicates chapter 5 ("Is a Poem the Same as Its Words?") to his claim that what a poem is cannot be bound by its words entirely or by meaning alone. If one finds each line of a poem intelligible, that does not indicate that the poem's meaning is consequentially understood. Conversely, a reader may not know a poem's meaning with complete certainty; what is said may not illuminate what is meant. In Bourbon's explanation of the sentence as a model for how particular words construct a poem, he says that one must determine how such a sentence-poem would be meaningful through our own reading. He claims that a poem is more than its words and cannot be simplified into sets of sentences or phrases. "A poem, if it is a sentence, is always more than that sentence; otherwise, a poem would not be a poem but a sentence" (p. 67).Bourbon's latest publication challenges traditional, long... (shrink)

. The brain evolved not to think but to act, and ideology is an act of social affiliation which can be compared to kin affiliation, both satisfyingly emotional and expressing a perception about the nature of the real world central to the nature of being human. Males may affiliate to macrosocial ideologies more enthusiastically than females because of their relative lack of certainty of kin relationships. Exogamy was the necessary solution to kin‐related strife in prehistory. Perhaps what the world (...) needs is not only a moral equivalent to war but an ideological equivalent to exogamy to resolve social differences on a much larger scale. (shrink)

Einstein’s special theory of relativity has had a wide influence on fields far removed from physics. It has given the impression that physics has shown that there are now no absolute truths, that all beliefs are relative to the observer, and that traditional stable landmarks have been washed away. We each have our own frame of reference that is as good as any other frame, so that there are no absolute standards by which our actions may be judged. The predictions (...) of relativity theory, such as the elimination of simultaneity, the variation of mass with velocity, and the equivalence of mass and energy, are all highly counterintuitive and yet are precisely confirmed by detailed measurements. The clear rocklike mechanical physics of Newton seems to have dissolved into a swirling mist of unintelligible concepts, and familiar certainties seem to have disappeared. A detailed analysis of relativity theory shows, however, a completely different picture. Properly understood, it is a logical extension of Newtonian physics that expresses the relations of space and time in a more exact and elegant way and in the process shows forth more clearly the invariant features of the world. The apparently counterintuitive features appear as natural consequences that extend and refine our classical concepts. The traditional landmarks remain, but God’s world is more subtle than we had previously imagined. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Philosophy, Psychiatry, & Psychology 11.1 (2004) 95-99 [Access article in PDF] Delusional Content and the Public Nature of Meaning:Reply to the Other Contributors Robert Klee The contribution by professors Bayne and Pacherie (2004) is an earnest attempt to defend a popular model of monothematic delusions against criticisms launched by John Campbell (2001). This model of monothematic delusions holds that such delusions are rational attempts by the sufferer to explain (...) to herself specific kinds of anomalous sensory/affective experiences. Bayne, Pacherie, Campbell, and for that matter Sass, Harper, and Georgaca, write as if semantic meaning accrued to words in a language term by term, as if meaning is "private" to the deluded person, and that she might therefore mean almost anything by her own idiosyncratic use of the public language she otherwise speaks. This is a notorious mistake. As Hilary Putnam famously put it in his classic 1975 paper "The meaning of 'meaning,'" "Cut the pie any way you like, 'meanings' just ain't in the head" (1975, 227). That is, meanings are not ethereal interior mental objects, private to the speaker—they are not private inner episodes that take place in some mental center stage of consciousness. The deluded person does not and cannot succeed in changing the meaning of a term in a public language like English merely by an individual act of imaginative will involving the making of a bizarre assertion—not even if she repeats it a thousand times. The public nature of meaning, if I can coin a phrase for it, is the central theme in the work of the later Wittgenstein. Even before Putnam, Wittgenstein had made the same point in his Philosophical Investigations via a famous footnote in which he writes, Can I say 'bububu' and mean "If it doesn't rain I shall go for a walk"?—it is only in a language that I can mean something by something. This shows clearly that the grammar of 'to mean' is not like that of the expression 'to imagine' and the like." (2001, 18e) Wittgenstein argues that the answer to the rhetorical question in the footnote is an emphatic No. To mean something by the use of words in a public language is not equivalent to an act of individual free imagination. The languages we each speak, including the unfortunately deluded among us, are public not private, and insofar as the notion of meaning has an understandable sense, the meaning of a term is fixed by its actual public use, across large time intervals, in many different contexts, by the many millions of speakers of the language in question. It is time that segments of the intellectual map beyond the borders [End Page 95] of philosophy got the news about this, for I think an appreciation of this point would forestall certain objections and argumentative moves that otherwise take up space in the psychological literature.Bayne and Pacherie (2004) describe Campbell's model of monothematic delusions as proposing that "delusions can be usefully regarded as Wittgensteinian framework propositions" (p. 7). I have discussed this notion in my main paper, although I do not use the terms framework propositions; I stick to Wittgenstein's own words. Wittgenstein called them, literally in the German, propositions that "stand fast for us" (feststehen). This description strikes me as less misleading than calling them framework propositions, for the latter expression suggests that they could in some sense be replaceable by a different framework of framework propositions, something that Wittgenstein in no way ever meant to suggest. Wittgenstein did not think of these propositions as individualized or privately owned—as beliefs that might vary considerably across the population of speakers of the language in which they are expressed. That is why he explicitly wrote that they stand fast for us. Note the plural pronoun. There is something irreducibly collective, something publicly owned, about the epistemology of these propositions. These propositions represent the accumulated certainties that precipitate out of what is commonly shared in human experience over long time intervals. Precisely because what stands fast for us is... (shrink)

If, as is universally acknowledged, the proper goal of the mathematical sciences is the discovery of the least possible number of principles from which the universal laws of empirically given facts emerge with mathematical necessity, and thus the discovery of principles equivalent to those empirical facts, then it must appear as a duty of indubitable importance to reflect carefully on the principles that have already surfaced with some certainty in one area of the natural sciences and present them (...) in a form that really fulfills the equivalence requirement. (shrink)

BackgroundWithholding and withdrawing treatment are deemed ethically equivalent by most Bioethicists, but intensivists often find withdrawing more difficult in practice. This can lead to futile treatment being prolonged. Time-limited trials have been proposed as a way of promoting timely treatment withdrawal whilst giving the patient the greatest chance of recovery. Despite being in UK guidelines, time-limited trials have been infrequently implemented on Intensive Care Units. We will explore the role of time in Intensive Care Unit decision-making and provide a (...) UK perspective on debates surrounding time-limited trials.MethodsThis qualitative study recruited 18 participants (nine doctors, nine nurses) from two Intensive Care Units in North West England for in-depth, one-to-one semi-structured interviews. A thematic analysis was performed of the data.ResultsOur findings show time is utilised by Intensive Care Unit staff in a variety of ways including managing uncertainty when making decisions about a patient’s prognosis or the reversibility of a disease, constructing relationships with patients’ relatives, communicating difficult messages to patients’ relatives, justifying resource allocation decisions to colleagues, and demonstrating compassion towards patients and their families.ConclusionsTime shifts the balance towards greater certainty in Intensive Care Unit decision-making, by demonstrating futility, and can ease the difficult transition for staff and families from active treatment to palliation. However, this requires clear and open communication, both within the Intensive Care Unit team and with the family, being prioritised when time is used in decision-making. (shrink)