Earlier in the pages of this journal (p 481), Wendler and Miller offered the "net risks test" as an alternative approach to the ethical analysis of benefits and harms in research. They have been vocal critics of the dominant view of benefit-harm analysis in research ethics, which encompasses core concepts of duty of care, clinical equipoise and component analysis. They had been challenged to come up with a viable alternative to component analysis which meets five criteria. The alternative must (...) (1) protect research subjects; (2) allow clinical research to proceed; (3) explain how physicians may offer trial enrolment to their patients; (4) address the challenges posed by research containing a mixture of interventions and (5) define ethical standards according to which the risks and potential benefits of research may be consistently evaluated. This response argues that the net risks test meets none of these criteria and concludes that it is not a viable alternative to component analysis. (shrink)
[Alan Weir] This paper addresses the problem of how to account for objective content-for the distinction between how we actually apply terms and the conditions in which we ought to apply them-from within a naturalistic framework. Though behaviourist or dispositionalist approaches are generally held to be unsuccessful in naturalising objective content or 'normativity', I attempt to restore the credibility of such approaches by sketching a behaviouristic programme for explicating objective content. /// [Alexander Miller] Paul Boghossian (1989, 1990) has (...) argued, on grounds concerning the holistic nature of belief fixation, that there are principled reasons for thinking that 'optimal conditions' versions of reductive dispositionalism about content cannot hope to satisfy a condition of extensional accuracy. I discern three separable strands of argument in Boghossian's work-the circularity objection, the open-endedness objection, and the certification objection-and argue that each of these objections fails. My conclusion is that for all that Boghossian has shown, 'optimal conditions' versions of reductive dispositionalism have to be assessed on a case-by-case basis. (shrink)
Franklin G. Miller and colleagues have stimulated renewed interest in research ethics through their work criticizing clinical equipoise. Over three years and some twenty articles, they have also worked to articulate a positive alternative view on norms governing the conduct of clinical research. Shared presuppositions underlie the positive and critical dimensions of Miller and colleagues' work. However, recognizing that constructive contributions to the field ought to enjoy priority, we presently scrutinize the constructive dimension of their work. We argue (...) that it is wanting in several respects. (shrink)
This volume is a direct result of a conference held at Princeton University to honor George A. Miller, an extraordinary psychologist. A distinguished panel of speakers from various disciplines -- psychology, philosophy, neuroscience and artificial intelligence -- were challenged to respond to Dr. Miller's query: "What has happened to cognition? In other words, what has the past 30 years contributed to our understanding of the mind? Do we really know anything that wasn't already clear to William James?" Each (...) participant tried to stand back a little from his or her most recent work, but to address the general question from his or her particular standpoint. The chapters in the present volume derive from that occasion. (shrink)
My initial hope when I first saw Miller’s book was that here at least would be a work which satisfies the long standing need for a comprehensive introduction to contemporary metaethics which is accessible enough to be employed in advanced undergraduate courses and introductory graduate seminars. This hope was only partially realized, however, as Miller ends up oscillating between clear presentations of extant debates in the recent literature and his own extended attempts to determine where the truth of (...) the matter lies. The result is an interesting book that likely will appeal both to those looking for a classroom text in metaethics as well as to experts on the relevant issues. (shrink)
: The "therapeutic misconception," described by Paul Appelbaum and colleagues more than 20 years ago, refers to the tendency of participants in clinical trials to confuse the design and conduct of research with personalized medical care. Although the "therapeutic misconception" has become a term of art in research ethics, little systematic attention has been devoted to the ethical significance of this phenomenon. This article examines critically the way in which Appelbaum and colleagues formulate what is at stake in the (...) therapeutic misconception, paying particular attention to assumptions and implications that clinical trial participation disadvantages research participants as compared with receiving standard medical care. After clarifying the ethical significance of the therapeutic misconception with respect to the decision making of patients, we offer policy recommendations for obtaining informed consent to participation in clinical trials. (shrink)
The Federalist, written by “Publius” (Alexander Hamilton, John Jay, and James Madison) in 1787-1788 in defense of the proposed constitution of the United States, endorses a fundamental principle of political legitimacy: namely, “it is the reason of the public alone, that ought to control and regulate the government.” This essay argues that this principle—the rule of reason—may be traced back to Plato. Part I of the essay seeks to show that Plato's Statesman offers a clearer understanding of the rule of (...) reason than his more famous Republic, and it also indicates how this principle gave rise to the ideal of constitutionalism, which was adopted and reformulated by Aristotle, Polybius, and Cicero, as well as moderns including Locke and Montesquieu. Part II argues that The Federalist agrees with Plato when it argues that popular sovereignty must be tempered by the rule of reason. A proper distance should be maintained between the people and the actual exercise of power in order that political decisions be based on reason rather than passion. The people must therefore act through a federal system divided between national government and state governments, and these governments must themselves possess separated powers which control each other by means of checks and balances. Indeed, federalism itself may be viewed as a modern counterpart of Plato's “art of weaving,” which unites naturally disparate and opposed parts of the city-state into a concordant whole. In declaring, “If men were angels, no government would be necessary,” The Federalist concedes that politics is the art of the possible. But statesmanship is not an exercise in pragmatism devoid of principles. Here “Publius” shares Plato's vision of politics as a “second sailing,” that is, an attempt to approximate the ideal of rational governance as far as possible in ordinary politics. Footnotesa This paper was originally presented at a meeting of the Symposium on Political Thought at Bowling Green State University. I am very grateful to the participants for their helpful suggestions, including Peter Celello, Albert Dzur, Neil Englehart, Jefferson Holcomb, David Jackson, Melissa Miller, Terrence Watson, and Adam White. I also received valuable criticisms from David Keyt, Ellen Frankel Paul, and the other contributors to this volume. (shrink)
Heated debate surrounds the question whether the relationship between physician-researcher and patient-subject is governed by a duty of care. Miller and Weijer argue that fiduciary law provides a strong legal foundation for this duty, and for articulating the terms of the relationship between physician-researcher and patient-subject.
This article assays Paul Ramsey's influential attempt to conceive possible nuclear deterrents within the confines of just war tenets. I look first at Ramsey's construction of just war ideas according to a protection paradigm, one in which agape is deontically defined. I also note a subtle sub-theme in Ramsey's construction of just war ideas, what I call a preservation motif. I then assess Ramsey's discussion of nuclear deterrence, closing with a critique of his treatments of intention and proportionality. I (...) conclude by arguing that Ramsey's argument falters, and that the weaknesses of his argument can be rendered intelligible by noting how the full implications of the protection paradigm are attenuated by the preservation motif. (shrink)
The separation, uniformization, and other properties of the Borel and projective hierarchies over hyperfinite sets are investigated and compared to the corresponding properties in classical descriptive set theory. The techniques used in this investigation also provide some results about countably determined sets and functions, as well as an improvement of an earlier theorem of Kunen and Miller.
: Medical research is widely thought to have a fundamentally therapeutic orientation, in spite of the fact that clinical research is thought to be ethically distinct from medical care. We need an entirely new conception of clinical research ethics—one that looks to science instead of the doctor-patient relationship.
These essays address some of the most intriguing questions raised by natural law theory and its implications for law, morality, and public policy. some of the essays explore the implications that natural law theory has for jurisprudence, asking what natural law suggests about the use of legal devices such as constitutions and precedents. Other essays examine the connections between natural law and various political concepts, such as citizens' rights and the obligation of citizens to obey their government.
The essays in this volume examine the nature of human flourishing and its relationship to a variety of other key concepts in moral theory. Some of them trace the link between flourishing and human nature, asking whether a theory of human nature can allow us to develop an objective list of goods that are of value to all agents, regardless of their individual purposes or aims. Some essays look at the role of friendships or parent-child relationships in a good life, (...) or seek to determine whether an ethical theory based on human flourishing can accommodate concern for others for their own sake. Other essays analyze the function of families or other social-political institutions in promoting the flourishing of individuals. Still others explore the implications of flourishing for political theory, asking whether considerations of human flourishing can help us to derive principles of social justice. (shrink)
This collection of essays is dedicated to the memory of the late Harvard philosopher Robert Nozick, who died in 2002. The publication of Nozick's Anarchy, State, and Utopia in 1974 revived serious interest in natural rights liberalism, which, beginning in the latter half of the eighteenth century, had been eclipsed by a succession of antithetical political theories including utilitarianism, progressivism, and various egalitarian and collectivist ideologies. Some of our contributors critique Nozick's political philosophy. Other contributors examine earlier figures in the (...) liberal tradition, most notably John Locke, whose Second Treatise of Government, published in the late seventeenth century, profoundly influenced the American founders. The remaining authors analyze natural rights liberalism's central doctrines. (shrink)
A central idea in moral and political philosophy, 'autonomy' is generally understood as some form of self-governance or self-direction. Certain Stoics, modern philosophers such as Spinoza, and most importantly, Immanuel Kant, are among the great philosophers who have offered important insights on the concept. Some theorists analyze autonomy in terms of the self being moved by its higher-order desires. Others argue that autonomy must be understood in terms of acting from reason or from a sense of moral duty independent of (...) the passions. Autonomy seems closely related to the notion of freedom, but in what sense: freedom from coercion, freedom from psychological constraints, or freedom from material necessity? Various approaches to these and similar questions yield different implications for public policy. Is capitalism, social democracy or socialism more favorable to autonomy? The essays in this volume address these important questions. (shrink)
Since the end of the Cold War, there has been increasing interest in the global dimensions of a host of public policy issues - issues involving war and peace, terrorism, international law, regulation of commerce, environmental protection, and disparities of wealth, income, and access to medical care. Especially pressing is the question of whether it is possible to formulate principles of justice that are valid not merely within a single society but across national borders. The thirteen essays in this volume (...) explore a range of issues that are central to contemporary discussions of global politics. Written by prominent philosophers, political scientists, economists, and legal theorists, they offer valuable contributions to current debates over the nature of justice and its implications for the development of international law and international institutions. (shrink)
Divisions abound as to whether politics should be held responsible to a higher moral standard or whether pragmatic considerations, or realpolitik, should prevail. The two poles are represented most conspicuously by Aristotle (for whom the proper aim of politics is moral virtue) and Machiavelli (whose prince exalted political pragmatism over morality). The fourteen contributions to this volume address perennial concerns in political and moral theory. They underscore the rekindled yearning of many to hold the political realm to a higher standard (...) despite the skepticism of dissenters who question the likelihood, or even the desirability, of success. (shrink)
Philosophers since ancient times have pondered how we can know whether moral claims are true or false. The first half of the twentieth century witnessed widespread skepticism concerning the possibility of moral knowledge. Indeed, some argued that moral statements lacked cognitive content altogether, because they were not susceptible to empirical verification. The British philosopher A. J. Ayer contends that 'They are pure expressions of feeling and as such do not come under the category of truth and falsehood. They are unverifiable (...) ... because they do not express genuine propositions.' The second half of the twentieth century brought a revival of interest among philosophers in moral and political questions. Whether or not ethics can be founded upon a rational basis continues to preoccupy the philosophical community even now. (shrink)
Investigation of neural and cognitive processes underlying individual variation in moral preferences is underway, with notable similarities emerging between moral- and risk-based decision-making. Here we specifically assessed moral distributive justice preferences and non-moral financial gambling preferences in the same individuals, and report an association between these seemingly disparate forms of decision-making. Moreover, we find this association between distributive justice and risky decision-making exists primarily when the latter is assessed with the Iowa Gambling Task. These findings are consistent with neuroimaging studies (...) of brain function during moral and risky decision-making. This research also constitutes the first replication of a novel experimental measure of distributive justice decision-making, for which individual variation in performance was found. Further examination of decision-making processes across different contexts may lead to an improved understanding of the factors affecting moral behaviour. (shrink)
The essays in this volume address questions about responsibility that arise in moral philosophy and legal theory. Some analyse different theories of causality, asking which theory offers the best account of human agency and the most satisfactory resolution of troubling controversies about free will and determinism. Some essays look at responsibility in the legal realm, seeking to determine how the law should assign liability for negligence, or whether the courts should allow defendants to offer excuses for their wrongdoing or to (...) claim some form of 'diminished responsibility'. Other essays explore libertarian views about political freedom and accountability, asking whether libertarian positions on consent, contract law, and responsibility are consistent, or whether restitution is superior to retribution or deterrence as a basis for a theory of corrective justice. Still others examine the notion of partial or divided responsibility, or the relationship between responsibility and the emotions. (shrink)
A vision of a living code of ethics is proposed to counter the emphasis on negative phenomena in the study of organizational ethics. The living code results from the harmonious interaction of authentic leadership, five key organizational processes (attraction–selection–attrition, socialization, reward systems, decision-making and organizational learning), and an ethical organizational culture (characterized by heightened levels of ethical awareness and a positive climate regarding ethics). The living code is the cognitive, affective, and behavioral manifestation of an ethical organizational identity. We draw (...) on business ethics literature, positive organizational scholarship, and management literature to outline the elements of positive ethical organizations as those exemplary organizations consistently practicing the highest levels of organizational ethics. In a positive ethical organization, the right thing to do is the only thing to do. (shrink)
The article is an attempt to better understand the objections to the doctrine of 'reliabilism' made by prominent epistemologists. The view argued for here is that while one extreme case of anti-reliabilism seems to be the paradigm case against the entire concept, this very case points out some additional, and implicit, problems with the standard account of epistemic justification. The most notable is that the standard view attacks reliabilism on the grounds that it lacks a means of giving adequate reasons (...) or evidence for its claims. We argue that the standard view, while correct on its paradigm case against reliabilism, is itself weakened by its lack of recognition of the central role theories of evidence must play in its basic account. Since theories of evidence are themselves divergent and problematic in terms of explaining how claims are justified, the standard account needs to address the issues of which account of evidence is 'adequate' and why it is. It is finally suggested that traditional epistemology might be more accurately described as a branch of confirmation theory. (shrink)
What is a person? What makes me the same person today that I was yesterday or will be tomorrow? Philosophers have long pondered these questions. In Plato's Symposium, Socrates observed that all of us are constantly undergoing change: we experience physical changes to our bodies, as well as changes in our 'manners, customs, opinions, desires, pleasures, pains, [and] fears'. Aristotle theorized that there must be some underlying 'substratum' that remains the same even as we undergo these changes. John Locke rejected (...) Aristotle's view and reformulated the problem of personal identity in his own way: is a person a physical organism that persists through time, or is a person identified by the persistence of psychological states, by memory? These essays - written by prominent philosophers and legal and economic theorists - offer valuable insights into the nature of personal identity and its implications for morality and public policy. (shrink)
This chapter attempts to derive, define, and specify norms governing the relationship between physician-researcher and patient-subject, and to explore their interconnection. It argues that rooting the relationship between physician-researcher and patient-subject in a normative theory of trust is promising. It enables the derivation, definition, and specification of norms governing the relationship and appreciation of their interconnection.
The scientific, ethical, and policy issues raised by research involving the engraftment of human neural stem cells into the brains of nonhuman primates are explored by an interdisciplinary working group in this Policy Forum. The authors consider the possibility that this research might alter the cognitive capacities of recipient great apes and monkeys, with potential significance for their moral status.
This paper attempts to clarify the meaning and significance of "qualitative confirmation". The need to do so is related to the fact that, without such a conceptualization, a large portion of the human sciences are relegated to a less than scientific status. Accordingly, "qualitative confirmation" is viewed as a proper subset of traditional confirmation theory. To establish such a case, a general Hempelian framework is utilized, but it is supplemented with two additional levels of confirmation. It is concluded that the (...) final test for adequacy of such confirmation must rest on a subjective probability notion. (shrink)
: When may a physician legitimately offer enrollment in a randomized clinical trial (RCT) to her patient? Two answers to this question have had a profound impact on the research ethics literature. Equipoise, as originated by Charles Fried, which we term Fried's equipoise (FE), stipulates that a physician may offer trial enrollment to her patient only when the physician is genuinely uncertain as to the preferred treatment. Clinical equipoise (CE), originated by Benjamin Freedman, requires that there exist a state of (...) honest, professional disagreement in the community of expert practitioners as to the preferred treatment. FE and CE are widely understood as competing concepts. We argue that FE and CE offer separable and, in themselves, incomplete justifications for the conduct of clinical trials. FE articulates conditions under which the fiduciary duties of physician to patient may be upheld in the conduct of research. CE sets out a standard for the social approval of research by institutional review boards. Viewed in this way, FE and CE are not necessarily competing notions, but rather address complementary moral concerns. (shrink)
This paper is an attempt to extend the meaning of the concept of indeterminacy for the human sciences. The authors do this by coining the term methodological indeterminacy and arguing that indeterminacy is better understood when linked to specific methodological techniques. Paradoxically, while specific research techniques demonstrate that the issue of indeterminacy is complex, yielding the possibility of types and degrees, it does not eliminate the problem of translation first raised by Quine. However, the authors go on to argue that, (...) from a research perspective, indeterminacy can and must be approached in such a way that it is possible to reduce cases of it, even though never completely eliminating it in the human sciences. (shrink)
When may a physician enroll a patient in clinical research? An adequate answer to this question requires clarification of trust-based obligations of the state and the physician-researcher respectively to the patient-subject. The state relies on the voluntarism of patient-subjects to advance the public interest in science. Accordingly, it is obligated to protect the agent-neutral interests of patient-subjects through promulgating standards that secure these interests. Component analysis is the only comprehensive and systematic specification of regulatory standards for benefit-harm evaluation by research (...) ethics committees (RECs). Clinical equipoise, a standard in component analysis, ensures the treatment arms of a randomised control trial are consistent with competent medical care. It thus serves to protect agent-neutral welfare interests of the patient-subject. But REC review occurs prior to enrolment, highlighting the independent responsibility of the physician-researcher to protect the agent-relative welfare interests of the patient-subject. In a novel interpretation of the duty of care, we argue for a “clinical judgment principle” which requires the physician-researcher to exercise judgment in the interests of the patient-subject taking into account evidence on treatments and the patient-subject‘s circumstances. (shrink)
: In response to the preceding commentary by Jerry Menikoff in this issue of the Journal , the authors argue that Fried's central concern is not that randomized clinical trials (RCTs) are conducted without consent, but rather that various aspects of the design and conduct of RCTs are in tension with physicians' duties of personal care to their patients. Although Fried does argue that the existence of equipoise cannot justify failure to obtain consent from research subjects, informed consent by itself (...) does not supplant ill subjects' rights to personalized judgment and care embodied in Fried's equipoise. (shrink)
The question "When are research risks reasonable in relation to anticipated benefits?" is at the heart of disputes in the ethics of clinical research. Institutional review boards are often criticized for inconsistent decision-making, a problem that is compounded by a number of contemporary controversies, including the ethics of research involving placebo controls, developing countries, incapable adults and emergency rooms. If this pressing ethical question is to be addressed in a principled way, then a systematic approach to the ethics of risk (...) in research is required. Component analysis provides such a systematic approach. (shrink)
The article argues for the possibility of translation manuals having an implicit internal structure. This structure is composed of specific methodological assumptions and techniques. Using the (N)-type and (G)-type distinction developed by Fuller for the study of scientific behavior, it is shown that these are incomplete characterizations of translation manuals. A more complete characterization must involve an analysis of how the presence or absence of methodological rules influences the interpretation of specific research questions. It is further argued that while Quine's (...) original indeterminacy thesis cannot be completely rejected, in some cases it can be modified to reflect the importance of the methodological constraints. Finally, it is suggested that the more critical analysis of translation manuals will benefit the on-going debates in the study of scientific behavior. (shrink)
IÂ’m only talking about commercial big time music in the United States. Of course music is gloriously seething in odd corners of the planet as it should. I can team up with some compatible friends and we can go find or make our own music in any of a number of accommodating environments- on the net, in the forest, or in some dank club late at night.
: The authors respond to objections Fred Gifford has raised against their paper "Rehabilitating Equipoise." They situate this exchange in the wider context of recent debate over equipoise, highlighting substantial points of agreement between themselves and Gifford. The authors offer a brief restatement of "Rehabilitating Equipoise" in which they amplify some of its core arguments. They then assess Gifford's objections. Finding each to be unfounded, they argue that there is no justification for "pulling the plug" on clinical equipoise.
The purpose of this article is to examine the applicability of the theory of projection for Anthropological hypotheses. The claim is made that Goodman's classic statement of the problem does not apply in its entirety to actual Anthropological hypotheses. The recent Freeman-Mead debate is employed as a framework for the discussion, illustrating that the issue of projectibility, while central for the social sciences, is best used as a backdrop to illustrate several important methodological problems. For Anthropology, and other related social (...) sciences, the central methodological problem, which is directly related to the projectibility one, is the development and justification of evidence-rules that can be used for a theory of confirmation. A preliminary attempt is then made to articulate the nature of these rules within the general Hempelian framework of qualitative confirmation. (shrink)
Technological innovations and social developments have led to dramatic changes in the practice of medicine and in the way that scientists conduct medical research. Change has brought beneficial consequences, yet these gains have come at a cost, for many modern medical practices raise troubling ethical questions: Should life be sustained mechanically when the brain's functions have ceased? Should potential parents be permitted to manipulate the genetic characteristics of their embryos? Should society ration medical care to control costs? Should fetal stem (...) cells be experimented upon in an effort to eventually palliate or cure debilitating diseases? Bioethicists analyze and assess moral dilemmas raised by medical research and innovative treatments; they also counsel healthcare practitioners, patients, and their families. In this anthology, fifteen philosophers, social scientists, and academic lawyers assess various aspects of this field. (shrink)
Roth's analysis of the Rationalitätstreit (i.e., the debate(s) about rationality) stands as one of the major works on how the debate affects a wide range of issues in the philosophy of science and the social sciences. His principal thesis is that the debate may be seen as a series of Quine-type "translation manuals," exhibiting characteristics of paradigms (following Kuhn 1970) that can be treated as testable scientific theories by adequate empirical tests. The author argues that Roth's notion of empirically testing (...) translation manuals is not possible given his criteria. He suggests a clearer definition of "methods" and develops a case whereby translation manuals can be adequately tested within an inductive model-but with rather severe restrictions. Implications are indicated. (shrink)
This article discusses the development and application of various types of corporate social monitoring systems. Boycotts are a relatively simple form of social monitoring system which aim to produce changes in corporate social behavior. Boycotts may be organized by a single group, or by a number of groups simultaneously. Rating systems may be organized around a single issue, such as the Sullivan Principles rating scheme, or may include multiple companies and multiple issues, such as shopping guides or ethical investment systems.Monitoring (...) systems may be unidimensional or multidimensional, qualitative or quantitative, and absolute or relative. Consumers and investors appear to be the groups most likely to be targeted in these schemes. The importance of these monitoring systems appears to be increasing as both consumers and investors become more interested in using social criteria in decision-making. (shrink)
These essays represent the latest research of a number of prominent political theorists. The essays explore the role of government, the nature of public discourse and the obligations of citizens. Some examine the sources of our need for government, asking what form of government we should establish and whether a single form can be suitable for all societies. Some seek to discover the proper aims of government - asking, for example, whether government should promote equality among its citizens or whether (...) it should allow inequalities in the hope of raising everyone's level of well-being. Others explore government's role in ensuring citizens' autonomy and in protecting their rights to pursue their own interests and projects. Still others examine the processes through which policies are formulated and debated, asking what forms of public deliberation are likely to produce the best results. (shrink)
Introduction: "Know yourself" -- The revelation of God's wisdom -- Credo ut intellegam -- Intellego ut credam -- The relationship between faith and reason -- The interventions of the Magisterium in philosophical matters -- The interaction between philosophy and theology -- Current requirements and tasks -- Conclusion.