A large proportion of the total global burden of disease is caused by emergency medical conditions. Emergency care research is essential to improving emergency medicine but this research can raise some distinctive ethical challenges, especially with regard to (1) standard of care and risk–benefit assessment; (2) blurring of the roles of clinician and researcher; (3) enrolment of populations with intersecting vulnerabilities; (4) fair participant selection; (5) quality of consent; and (6) community engagement. Despite the importance of research to improve emergency (...) care in low-income and middle-income countries (LMICs) and the widely acknowledged ethical challenges, very little has been written on the ethics of emergency care research in LMICs. This paper examines the ethical and regulatory challenges to conducting emergency care research with human participants in LMICs. We outline key challenges, present potential solutions or frameworks for addressing these challenges, and identify gaps. Despite the ethical and regulatory challenges, conducting high-quality, ethical emergency care research in LMICs is possible and it is essential for global health. (shrink)

Anthony Giddens’ theory of structuration is a theory of social action, which claims that society should be understood in terms of action and structure; a duality rather than two separate entities. This paper introduces some of the central characteristics of structuration theory, presenting a conceptual framework that helps to explore how people produce the systems and structures that shape their practice. By understanding how people produce and reproduce structures, then there is the potential for changing them. Criticisms that have been (...) raised about the theory are introduced, followed by examples of how the theory might be useful to nursing research. Structuration theory can be employed to explore how nurses produce, reproduce, and transform nursing practice through social interaction across time and space. (shrink)

"An essential overview of an important intellectual movement, Logical Empiricism in North America offers the first significant, sustained, and multidisciplinary attempt to understand the intellectual, cultural, and political dimensions of ...

The author argues that all forms of life are interconnected and that no being, construct, or object can exist independently from the ecological entanglement, nor does "nature" exist as an entity separate from the uglier or more synthetic elements of life. Realizing this interconnectedness is what the author calls the ecological thought. He investigates the philosophical, political, and aesthetic implications of this interconnectedness.

Evolutionary psychologists claim that the mind contains “hundreds or thousands” of “genetically specified” modules, which are evolutionary adaptations for their cognitive functions. We argue that, while the adult human mind/brain typically contains a degree of modularization, its “modules” are neither genetically specified nor evolutionary adaptations. Rather, they result from the brain’s developmental plasticity, which allows environmental task demands a large role in shaping the brain’s information-processing structures. The brain’s developmental plasticity is our fundamental psychological adaptation, and the “modules” that result (...) from it are adaptive responses to local conditions, not past evolutionary environments. If different individuals share common environ- ments, however, they may develop similar “modules,” and this process can mimic the development of genetically specified modules in the evolutionary psychologist’s sense. (shrink)

At any given time, a subject has a multiplicity of conscious experiences. A subject might simultaneously have visual experiences of a red book and a green tree, auditory experiences of birds singing, bodily sensations of a faint hunger and a sharp pain in the shoulder, the emotional experience of a certain melancholy, while having a stream of conscious thoughts about the nature of reality. These experiences are distinct from each other: a subject could experience the red book without the singing (...) birds, and could experience the singing birds without the red book. But at the same time, the experiences seem to be tied together in a deep way. They seem to be unified, by being aspects of a single encompassing state of consciousness. (shrink)

Two opposing tendencies in the philosophy of language go by the names of ‘referentialism’ and ‘inferentialism’ respectively. In the crudest version of the contrast, the referentialist account of meaning gives centre stage to the referential semantics for a language, which is then used to explain the inference rules for the language, perhaps as those which preserve truth on that semantics (since a referential semantics for a language determines the truth-conditions of its sentences). By contrast, the inferentialist account of meaning gives (...) centre stage to the inference rules for the language, which are then used to explain its referential semantics, perhaps as the semantics on which the rules preserve truth. On pain of circularity, we cannot combine both directions of explanation. (shrink)

When I take off my glasses, the world looks blurred. When I put them back on, it looks sharpedged. I do not think that the world really was blurred; I know that what changed was my relation to the distant physical objects ahead, not those objects themselves. I am more inclined to believe that the world really is and was sharp-edged. Is that belief any more reasonable than the belief that the world really is and was blurred? I see more (...) accurately with my glasses on than off, so visual appearances when they are on have some cognitive priority over visual appearances when they are off. If I must choose which kind of visual appearance to take at face value, I will choose the sharp-edged look. But what should I think when I see a mist, which looks very blurred however well I am seeing? Indeed, why choose to take any of the looks at face value? Why not regard all the choices as illegitimate projections of ways of seeing the world onto the world itself? (shrink)

This paper discusses the nature and the status of inference to the best explanation. We outline the foundational role given IBE by its defenders and the arguments of critics who deny it any place at all ; argue that, on the two main conceptions of explanation, IBE cannot be a foundational inference rule ; sketch an account of IBE that makes it contextual and dependent on substantive empirical assumptions, much as simplicity seems to be ; show how that account avoids (...) the critics ' complaints and leaves IBE an important role ; and sketch how our account can clarify debates over IBE in arguments for scientific realism. (shrink)

In this essay, we present three case studies which suggest that sometimes we are better off supporting a so–called irrational suicide, and that emotional or psychological distress – even if medically controllable – might justify a suicide. We underscore how complicated these decisions are and how murky a physician's moral role can be. We advocate a more individualized route to end–of–life care, eschewing well–meaning, principled, generalizations in favor of a highly contextualized, patient–centered, approach. We conclude that our Western traditions of (...) promoting reasoned behavior and life themselves may at times be counter–productive. (shrink)

Previous research has suggested that bodily signals from internal organs are associated with diverse cortical and subcortical processes involved in sensory-motor functions, beyond homeostatic reflexes. For instance, a recent study demonstrated that the preparation and execution of voluntary actions, as well as its underlying neural activity, are coupled with the breathing cycle. In the current study, we investigated whether such breathing-action coupling is limited to voluntary motor action or whether it is also present for mental actions not involving any overt (...) bodily movement. To answer this question, we recorded electroencephalography (EEG), electromyography (EMG), and respiratory signals while participants were conducting a voluntary action paradigm including self-initiated motor execution (ME), motor imagery (MI), and visual imagery (VI) tasks. We observed that the voluntary initiation of ME, MI, and VI are similarly coupled with the respiration phase. In addition, EEG analysis revealed the existence of readiness potential (RP) waveforms in all three tasks (i.e., ME, MI, VI), as well as a coupling between the RP amplitude and the respiratory phase. Our findings show that the voluntary initiation of both imagined and overt action is coupled with respiration, and further suggest that the breathing system is involved in preparatory processes of voluntary action by contributing to the temporal decision of when to initiate the action plan, regardless of whether this culminates in overt movements. -/- . (shrink)

Gils-Schmidt and Salloch recognise that human and climate health are inextricably linked, and that mitigating healthcare-associated climate harms is essential for protecting human health.1 They argue that physicians have a duty to consider how their own practices contribute to climate change, including during their interactions with patients. Acknowledging the potential for conflicts between this duty and the provision of individual patient care, they propose the application of Korsgaard’s neo-Kantian account of practical identities to help navigate such scenarios. In this commentary, (...) we argue that by focusing attention on this physician–patient level, the authors overlook the complexity of climate change, both within the healthcare sector and beyond. We recognise the importance of individual agency in tackling this issue, and we also recognise that the authors do briefly acknowledge the importance of considering these broader complexities; however, we emphasise the need for climate and health discussions/action to be situated in a wider framework of systemic change. Our concern is that overemphasis on patient-level interactions risks normalising the prioritisation of individual-level approaches to addressing climate change, detracting from such a broader approach. Physician training emphasises the need for trust, confidentiality and shared decision-making in the doctor–patient relationship. …. (shrink)

Disorders of volition are often accompanied by, and may even be caused by, disruptions in the phenomenology of agency. Yet the phenomenology of agency is at present little explored. In this paper we attempt to describe the experience of normal agency, in order to uncover its representational content.

In this chapter, we turn our attention to the effects of the attention economy on our ability to act autonomously as a group. We begin by clarifying which sorts of groups we are concerned with, which are structured groups (groups sufficiently organized that it makes sense to attribute agency to the group itself). Drawing on recent work by Purves and Davis (2022), we describe the essential roles of trust (i.e., depending on groups to fulfill their commitments) and trustworthiness (i.e., the (...) property of a group that makes trusting them fitting) in autonomous group action, with particular emphasis on democratic institutions (which we view as group agents) and democratic legitimacy (which depends on trust and trustworthiness). We then explain how engagement maximization promotes polarization, which is detrimental to trust and trustworthiness and, in turn, democratic legitimacy and democratic institutions. We close by considering what groups might do to protect themselves from the threat posed to them by the attention economy. (shrink)

In Sisyphus's Boulder, Eric Dietrich and Valerie Hardcastle argue that we will never get such a theory because consciousness has an essential property that..

Medical practice is ideally based on robust, relevant research. However, the lack of disease-modifying treatments for Alzheimer’s disease has motivated “innovative practice” to improve patients’ well-being despite insufficient evidence for the regular use of such interventions in health systems treating millions of patients. Innovative or new non-validated practice poses at least three distinct ethical questions: first, about the responsible application of new non-validated practice to individual patients ; second, about the way in which data from new non-validated practice are communicated (...) via the scientific and lay press ; and third, about the prospect of making new non-validated interventions widely available before more definitive testing. We argue that the authors of metabolic enhancement protocols for Alzheimer’s disease have overstated the evidence in favor of these interventions within the scientific and lay press, failing to communicate weaknesses in their data and uncertainty about their conclusions. Such unmeasured language may create false hope, cause financial harm, undermine informed consent, and frustrate the production of generalizable knowledge necessary to face the societal problems posed by this devastating disease. We therefore offer more stringent guidelines for responsible innovation in the treatment of Alzheimer’s disease. (shrink)

To desire something is a condition familiar to everyone. It is uncontroversial that desiring has something to do with motivation, something to do with pleasure, and something to do with reward. Call these "the three faces of desire." The standard philosophical theory at present holds that the motivational face of desire presents its unique essence--to desire a state of affairs is to be disposed to act so as to bring it about. A familiar but less standard account holds the hedonic (...) face of desire to reveal to true nature of desire. In this view, to desire something is to tend to pleasure if it seems that the desired state of affairs has been achieved, or displeasure if it seems otherwise, thus tying desire to feelings instead of actions. In Three Faces of Desire, Schroeder goes beyond actions and feelings to advance a novel and controversial theory of desire that puts the focus on desire's neglected face, reward. Informed by contemporary science as much as by the philosophical tradition, Three Faces of Desire discusses recent scientific discoveries that tell us much about the way that actions and feelings are produced in the brain. In particular, recent experiments reveal that a distinctive system is responsible for promoting action, on the one hand, and causing feelings of pleasure and displeasure, on the other. This system, the brain's reward system, is the causal origin of both action and feeling, and is the key to understanding the nature of desire. (shrink)

In this paper we defend the doxastic conception of delusions against the metacognitive account developed by Greg Currie and collaborators. According to the metacognitive model, delusions are imaginings that are misidentified by their subjects as beliefs: the Capgras patient, for instance, does not believe that his wife has been replaced by a robot, instead, he merely imagines that she has, and mistakes this imagining for a belief. We argue that the metacognitive account is untenable, and that the traditional conception of (...) delusions as beliefs should be retained. (shrink)

The most promising contemporary form of epistemic scientific realism is based on the following intuition: Belief should be directed, not toward theories as wholes, but toward particular theoretical constituents that are responsible for, or deployed in, key successes. While the debate on deployment realism is quite fresh, a significant degree of confusion has already entered into it. Here I identify five criteria that have sidetracked that debate. Setting these distractions aside, I endeavor to redirect the attention of both realists and (...) non-realists to the fundamental intuition above. In more detail: I show that Stathis Psillos (1999) has offered an explicit criterion for picking out particular constituents, which, contrary to Kyle Stanford’s (2006a) criticisms, neither assumes the truth of theories nor requires hindsight. I contend, however, that, in Psillos’s case studies, Psillos has not successfully applied his explicit criterion. After clarifying the various alternative criteria at work (in those case studies and in a second line of criticism offered by Stanford), I argue that, irrespective of Stanford’s criticisms, the explicit criterion Psillos does offer is not an acceptable one. Nonetheless, the deployment realist’s fundamental intuition withstands all of these challenges. In closing, I point in a direction toward which I’ve elsewhere focused, suggesting that, despite the legitimacy and applicability of the deployment realist’s intuition, the historical threat that prompted it remains. (shrink)

Colburn (computer science, U. of Minnesota-Duluth) has a doctorate in philosophy and an advanced degree in computer science; he's worked as a philosophy professor, a computer programmer, and a research scientist in artificial intelligence. Here he discusses the philosophical foundations of artificial intelligence; the new encounter of science and philosophy (logic, models of the mind and of reasoning, epistemology); and the philosophy of computer science (touching on math, abstraction, software, and ontology).

The harms associated with wireless mobile devices (e.g. smartphones) are well documented. They have been linked to anxiety, depression, diminished attention span, sleep disturbance, and decreased relationship satisfaction. Perhaps what is most worrying from a moral perspective, however, is the effect these devices can have on our autonomy. In this article, we argue that there is an obligation to foster and safeguard autonomy in ourselves, and we suggest that wireless mobile devices pose a serious threat to our capacity to fulfill (...) this obligation. We defend the existence of an imperfect duty to be a ‘digital minimalist’. That is, we have a moral obligation to be intentional about how and to what extent we use these devices. The empirical findings already justify prudential reasons in favor of digital minimalism, but the moral duty is distinct from and independent of prudential considerations. (shrink)

It is a tale of two Pfizers. In 2018 they abandoned research into the leading cause of dementia, Alzheimer’s Disease (AD) (Hawkes 2018). In 2021, they developed the first vaccine for Covid-19 to re...

Volume 19, Issue 12, December 2019, Page 66-68.

What is belief? "Beliefs aim at truth" is the commonly accepted starting point for philosophers who want to give an adequate account of this fundamental state of mind, but it raises as many questions as it answers. For example, in what sense can beliefs be said to have an aim of their own? If belief aims at truth, does it mean that reasons to believe must also be based on truth? Must beliefs be formed on the basis of evidence alone? (...) Is truth the constitutive norm of belief? Does aiming at truth bring in a normative dimension to the nature of belief? How can the aim of truth guide the formation of our beliefs? In what ways do partial beliefs aim at truth? Is truth the aim of epistemic justification? Last but not least, is it knowledge rather than truth which is the fundamental aim of belief? In recent years, pursuing these questions has proved extremely fertile for our understanding of a wide range of current issues in philosophy of mind and action, epistemology, and meta-ethics. The Aim of Belief is the first book to be devoted to this fast-growing topic. It brings together eleven newly commissioned essays by leading authors on the aim of belief. Contributors: Jonathan Adler, Krister Bykvist, Timothy Chan, Pascal Engel, Kathrin Glüer, Anandi Hattiangadi, Michael Hicks, Paul Horwich, David Papineau, Andrew Reisner, Asbjørn Steglich-Petersen, Ralph Wedgwood, Åsa Wikforss, Daniel Whiting. (shrink)

Critics of persuasive advertising argue that it undermines the autonomy of consumers by manipulating their desires in morally problematic ways. My aim is this paper is to refine that argument by employing a conception of autonomy that is not at odds with certain forms of manipulation. I argue that the charge of manipulation is not sufficient for condemning persuasive advertising. On my view, manipulation of an agent’s desires through advertising is justifiable in cases where the agent accepts the process through (...) which the desires were developed. I show how the standard manipulation objection proves too much as it would also condemn cases of that kind. I argue that this distinction is especially important when we consider the implications of “new media.” In addition to increasing vulnerability to manipulation, new media have considerable impacts on well-being. By siding with the traditional autonomy argument, we would be compelled to take an implausible stand against all forms of manipulation through advertising, but I suggest that only a proper subset of those cases are morally problematic. This conclusion opens up a space for persuasive advertising that is permissible while nevertheless condemning cases that violate consumers’ autonomy. (shrink)

Carruthers argues that knowledge of our own propositional attitudes is achieved by the same mechanism used to attain knowledge of other people's minds. This seems incompatible with "privileged access"---the idea that we have more reliable beliefs about our own mental states, regardless of the mechanism. At one point Carruthers seems to suggest he may be able to maintain privileged access, because we have additional sensory information in our own case. We raise a number of worries for this suggestion, concluding that (...) Carruthers's new theory cannot clearly preserve the superior reliability of our beliefs about our own attitudes. (shrink)

The neurotransmitters GABA and glutamate have been suggested to play a role in Major Depressive Disorder (MDD) through an imbalance between cortical inhibition and excitation. This effect has been highlighted in higher brain areas, such as the prefrontal cortex, but has also been posited in basic sensory cortices. Based on this, magnetic resonance spectroscopy (MRS) was used to investigate potential changes to GABA+ and glutamate+glutamine (Glx) concentrations within the occipital cortex in MDD patients (n = 25) and healthy controls (n (...) = 25). No difference in occipital GABA+ or Glx concentrations, nor in the GABA+/Glx ratio, was found between groups. An analysis of an extended MDD patient and unmatched control dataset (n = 90) found no correlation between metabolite concentrations and depressive symptoms. These results were integrated with prior studies through metabolite-specific meta-analyses, revealing no difference in occipital GABA and Glx concentrations between patients and controls. An effect of publication year on GABA group differences was found, suggesting that previously reported results may have been artifacts of measurement accuracy. Taken together, our results suggest that, contrary to some prior reports, MRS measurements of occipital GABA and Glx do not differ between MDD patients and controls. (shrink)

This article adapts John Rawls’s writings, arguing that past injustice can change what we ought to publicly affirm as the standard of justice today. My approach differs from forward-looking approaches based on alleviating prospective disadvantage and backward-looking historical entitlement approaches. In different contexts, Rawls’s own concern for the ‘social bases of self-respect’ and equal citizenship may require public endorsement of different principles or specifications of the standard of justice. Rawls’s difference principle focuses on the least advantaged socioeconomic group. I argue (...) that a historicized difference principle considers the relative standing of racial, gender, and other historically stigmatized groups; provides their members assurance by weakening incentives to manipulate justice to another group’s advantage; and may result in policies resembling reparations, though justified by forward-looking considerations of self-respect and public assurance. I then examine how disrespectful justifications were historically used to forcibly include indigenous peoples as citizens. While Rawls thinks providing citizens one package of basic liberties signals respect, indigenous self-government could better support self-respect. I invoke Rawlsian international justice, which calls for mutual respect between peoples. Indigenous peoples’ status should reflect their past and persisting peoplehood, providing assurance by weakening incentives to unjustly transform international into domestic contexts. (shrink)

This is the first single volume to offer a comprehensive and systematic account of British and American aesthetics from the early eighteenth century to the late twentieth century.

The following article explores the use of creative writing techniques to teach research ethics, breathe life into case study preparation, and train students to think of their settings as complex organizational environments with multiple actors and stakeholders.

The influential public health ethics framework proposed by Childress et al. includes five “justificatory conditions,” two of which are “necessity” and “least infringement.” While the framework points to important moral values, we argue it is redundant for it to list both necessity and least infringement because they are logically equivalent. However, it is ambiguous whether Childress et al. would endorse this view, or hold the two conditions distinct. This ambiguity has resulted in confusion in public health ethics discussions citing the (...) Childress et al. framework, as demonstrated by debate between Resnik and Wilson and Dawson. We analyse this debate to resolve these ambiguities. Finally, we argue that the necessity/least infringement principle of the Childress et al. framework applies only in cases in which only one intervention is to be implemented to achieve one specific goal. In other cases, it is not essential to require that only the least infringing intervention be implemented. (shrink)

What we call “the evidential argument from evil” is not one argument but a family of them, originating (perhaps) in the 1979 formulation of William Rowe. Wykstra’s early versions of skeptical theism emerged in response to Rowe’s evidential arguments. But what sufficed as a response to Rowe may not suffice against later more sophisticated versions of the problem of evil—in particular, those along the lines pioneered by Paul Draper. Our chief aim here is to make an earlier version of skeptical (...) theism more responsive to the type abductive atheology pioneered by Draper. In particular, we suggest a moderate form of skeptical theism may be able to resist Draper’s abductive atheology. (shrink)

This book aims to give a coherent interpretation of the whole dialogue, paying particular attention to these etymologies.The book discusses the rival theories ...