Economist-philosopher Amartya Sen's writings on social and political issues have attracted wide audiences. Section 2 introduces his contributions on: how people reason as agents within society; social determinants of people's (lack of) access to goods and of the effective freedoms and agency they enjoy or lack; and associated advocacy of self-specification of identity and high expectations for ‘voice’ and reasoning democracy. Section 3 considers his relation to social theory, his tools for theorizing action in society, and his limited degree of (...) attention to work by sociologists and to capitalism and power structures. Section 4 characterizes a style marked by conceptual refinement, emphases on complexity and individuality, including personal individuality, and reformist optimism. Section 5 shows the features from Sections 3 and 4 at work in his conception of personhood that advocates freedom to make a reasoned composition of personal identity. Similarly, Section 6 addresses his conception of public reasoning and neglect of the sociology of democracy. It contrasts the ideal of a reasoning polity with features in many countries. Sen's programmes for critical autonomy in personhood and for reasoned politics play, nevertheless, a normic role, while his analytical formats help investigation of obstacles to more widespread agency, voice, and democratic participation. (shrink)

This study examines the impact of various ethical climate types, dependency factors, and ethical training on ethical optimism of purchasing professionals (n = 151) in India. Instrumental and independence climate types had a significant negative impact on ethical optimism. Other climate types (professional, caring, rules, and efficiency) had no significant impact on ethical optimism. Among the dependency factors, while task uncertainty had a significant positive impact, monitoring had a significant negative impact on (...) ethical optimism. None of the other factors significantly impacted ethical optimism. (shrink)

The number and magnitude of the ethics failures reported on a nearly daily basis in newspapers and on blogs are seemingly unprecedented. The "castle is on fire," to borrow a rabbinic metaphor, and each one of us is faced with the question: Is there anything we can do about it? In this book, Moses Pava explores new and alternative ways of relating to Jewish texts and concepts. In doing so, he invents a nuanced, flexible, and sufficiently sensitive vocabulary to conduct (...) productive ethical dialogues, both within and between communities. (shrink)

SummaryThe author studies the form of philosophical optimism in Slovak Lutheran ethics in the first half of the 19th century in the views of Ján Kollár and Ján Chalupka. Herder’s philosophy of history and his philosophy of historical progress significantly influenced Slovak Lutheran ethics of the given period. In the author’s view, Kollár and Chalupka mainly appreciated human history as progress in all parts of life and refused glorification of the past. However, they did not limit their assessment to (...) a positive evaluation of the present; they used one’s own mistakes and faults to appeal to moral development of man and placed to the forefront the belief in a better future of mankind in the form of humanity. (shrink)

One of the most pressing ethical challenges facing phase I cancer research centres is the process of informed consent. Historically, most scholarship has been devoted to redressing therapeutic misconception, that is, the conflation of the nature and goals of research with those of therapy. While therapeutic misconception continues to be a major ethical concern, recent scholarship has begun to recognise that the informed consent process is more complex than merely a transfer of information and therefore cannot be evaluated (...) only according to how well an individual understands such information. Other components of decision-making operate independently of understanding and yet still may compromise the quality of informed consent. Notable among these components is unrealistic optimism, an event-specific belief that one has a better chance of receiving benefit than others similarly situated. In this article, we consider responses to interviews with parents who had recently completed an informed consent conference for enrolling their child in a phase I cancer clinical trial to examine how this influence manifests and how investigators might address it during informed consent. (shrink)

Greater emphasis on ethical issues is needed in science, technology, engineering, and mathematics (STEM) education. The fiction for specific purposes (FSP) approach, using optimistic science fiction texts, offers a way to focus on ethical reflection that capitalizes on role models rather than negative examples. This article discusses the benefits of using FSP in STEM education more broadly, and then explains how using optimistic fictions in particular encourages students to think in ethically constructive ways. Using examples of science fiction (...) texts with hopeful perspectives, example discussion questions are given to model how to help keep students focused on the ethical issues in a text. Sample writing prompts to elicit ethical reflection are also provided as models of how to guide students to contemplate and analyze ethical issues that are important in their field of study. The article concludes that the use of optimistic fictions, framed through the lens of professional ethics guidelines and reinforced through ethical reflection, can help students to have beneficial ethical models. (shrink)

I aim to show that (i) there are good ways to argue about what has intrinsic value; and (ii) good ethical arguments needn't make ethical assumptions. I support (i) and(ii) by rebutting direct attacks, by discussing nine plausible ways to argue about intrinsic value, and by arguing for pains intrinsic badness without making ethical assumptions. If (i) and (ii) are correct, then ethical theory has more resources than many philosophers have thought: empirical evidence, and evidence bearing (...) on intrinsic value. With more resources, we can hope to base all of our moral beliefs on evidence rather than on, say, emotion or mere intuition. (shrink)

Neopragmatist epistemology rejects any significant distinction between ethics and the sciences. The idea is that in ethics, we acquire knowledge in similar ways as in the natural sciences. Quine/duhem holism applies to both fields, which explains why the aim of reaching reflective equilibrium is prominent in many meta-ethical accounts: As in the sciences, our ethical system of belief is constrained by logic, observation, coherence, simplicity and parsimony. Whereas considerations of beauty (an important ingredient of scientific methodology) are irrelevant (...) in ethical epistemology, emotions play an essential role; these, in turn, do not matter in the sciences. (shrink)

Does optimism lead to success? Friends of optimism argue that positive beliefs about ourselves and our future contribute to fitness and mental health, and are correlated with good functioning, productivity, resilience, and pro-social behaviour. Sceptics, instead, claim that when we are optimistic we fail to react constructively to negative feedback, and put ourselves at risk because we underestimate threats. Thus, it is controversial whether optimistic beliefs are conducive to success, intended as the fulfilment of our goals in a (...) given domain. According to the traditional view, optimistic beliefs lead to success when they do not involve any distortion of reality, and according to the trade-off view, they lead to success when they involve a distortion of reality, but a small one. Based on the literature about positive illusions in the perception of romantic partners and in the assessment of future health prospects, I suggest that optimistic beliefs lead to goal attainment when they support agency by contributing to the sense that we are competent and efficacious agents and that our goals are both desirable and attainable. (shrink)

Deep brain stimulation (DBS) is optimistically portrayed in contemporary media. This already happened with psychosurgery during the first half of the twentieth century. The tendency of popular media to hype the benefits of DBS therapies, without equally highlighting risks, fosters public expectations also due to the lack of ethical analysis in the scientific literature. Media are not expected (and often not prepared) to raise the ethical issues which remain unaddressed by the scientific community. To obtain a more objective (...) portrayal of DBS in the media, a deeper collaboration between the science community and journalists, and particularly specialized ones, must be promoted. Access to databases and articles, directly or through science media centers, has also been proven effective in increasing the quality of reporting. This article has three main objectives. Firstly, to explore the past media coverage of leukotomy, and to examine its widespread acceptance and the neglect of ethical issues in its depiction. Secondly, to describe how current enthusiastic coverage of DBS causes excessive optimism and neglect of ethical issues in patients. Thirdly, to discuss communication models and strategies to enhance media and science responsibility. (shrink)

Unrealistic optimism is a bias that leads people to believe, with respect to a specific event or hazard, that they are more likely to experience positive outcomes and/or less likely to experience negative outcomes than similar others. The phenomenon has been seen in a range of health-related contexts—including when prospective participants are presented with the risks and benefits of participating in a clinical trial. In order to test for the prevalence of unrealistic optimism among participants of early-phase oncology (...) trials, we conducted a survey with patients over 18 years of age who were enrolled in a phase I, phase I/II, or phase II clinical cancer trial in the New York City area between August 2008 and October 2009. Participants in our study were asked to compare their own chances of experiencing a range of risks and benefits related to the trial they were enrolled in with the chances of the other trial participants. We found a significant optimistic bias in their responses. Respondents tended to overestimate the benefits of the trial they were enrolled in and underestimate its risks. In addition, we found no significant relationship between respondents’ understanding of the trial’s purpose and how susceptible they were to unrealistic optimism. Our findings suggest that improving the consent process for oncology studies requires more than addressing deficits in understanding. (shrink)

Precarious employment is commonplace within the University-as-business model. Neoliberal and New Public Management agendas have influenced widespread insecurity, and limited career progression pathways within academic work. Qualitative multi-case data inform this investigation of how young academic workers cope with, and justify, their precarious situations in a large Australian university. This article introduces the notion of cruel optimism to analyse the unethical exploitation of desires of precariously employed academics. This analytical engagement extends empathetic engagement with the lived experiences and rationalisations (...) of precariously employed academic workers, paying homage to their desires and negotiations. Findings demonstrate that participants were heavily invested in working towards achieving their good life fantasy which encompassed secure employment and the recognition this provided. Cruel optimism operated as participants developed coping mechanisms to deal with the ongoingness of their troubling situation as precarious workers uncertain how to change their precarious circumstances. Participants experienced cruel optimism as they navigated through issues of identity, control, and desire, related to their present and future lives as academic workers experiencing an impasse of crisis ordinariness. Optimism directed towards the academic scene of desire motivated participants’ daily actions and informed their understandings. Ethical elements of the impasse of precarious employment are presented in relation to the neoliberal and New Public Management-oriented University context. This article provides a novel conceptualisation of how precarious employment contributes to a relation of cruel optimism among workers by highlighting how organisations exploit the desires of insecure employees for extended periods of time, contributing to an impasse of crisis ordinariness. (shrink)

While animal sentience research has flourished in the last decade, scepticism about our ability to accurately measure animal feelings has unfortunately remained fairly common. Here, we argue that evolutionary considerations about the functions of feelings will give us more reason for optimism and outline a method for how this might be achieved.

In this study, we explore the sincerity of the rhetorical tone of 664 annual letters to shareholders (CEO letters). Prior studies adopt Impression Management theory to predict that firms obfuscate failures and emphasize successes to unfairly enhance their image and maintain organizational legitimacy. Yuthas et al. (J Bus Ethics 41:141–157, 2002) challenged such a view, showing that firms reporting earnings surprises engage in ethical discourse with shareholders. We adopt the methodology of Yuthas et al. (J Bus Ethics 41:141–157, 2002) (...) to explore the association between firm performance and the rhetorical features of CEO letters in a large sample of Fortune 500 firms in the wake of the global economic crisis. In contrast to most prior research, we find that optimistic tone is congruent with both past and future performance. We conclude that under tough macroeconomic conditions, incentives to distort public information strategically are low. Rather, firms tend to engage in communicative action aimed at dialoguing with shareholders through sincere disclosure. However, in our conclusions, we warn about the impact of accounting and rhetorical manipulation on the congruence between optimistic tone and financial performance. (shrink)

Joining the dialogue on the relationship between the law and business ethics, Jeffrey Nesteruk and Eric W. Orts have offeredconceptions of the law as a positive influence rather than a negative curb on corporate behavior. While these “legal optimists” pursue anoble end in promoting higher ethical standards for corporations through the law, they may be overly optimistic in their suggestion that these more skillfully wielded legal models will influence corporate behavior for the better. Reviewing the basic tenets of their (...) two approaches, this paper uses corporate responses to environmental statutes to suggest that while legal optimism may offer hope for promoting corporate ethics, it has definite limitations in its current stage of development. (shrink)

Abstract‘Cruel optimism’ is a term coined by Lauren Berlant. In conceptualizing this term, Berlant draws on the resources of critical theory to interrogate people’s desires for things they think may improve their lot, but actually act as obstacles to flourishing. This notion may be useful for analysing the current state of education in Australia, and the desire to believe that My School, and the associated data it provides, will enable schools to address social inequalities. For Berlant, the promise of (...) such technologies is problematic because it diverts our attention from important ethical, social and political questions, some of which are highlighted in the contributions to this special issue. Using ‘cruel optimism’ as a point of departure, I interrogate how the notion of critical theory has been conceptualized in educational research by briefly looking at scholarship within and outside education relating to critical theory. Following on from this, I consider how what I am terming critical theory is put to work in each of the articles that make up this special issue on My School. (shrink)

Abstract:Joining the dialogue on the relationship between the law and business ethics, Jeffrey Nesteruk and Eric W. Orts have offered conceptions of the law as a positive influence rather than a negative curb on corporate behavior. While these “legal optimists” pursue a noble end in promoting higher ethical standards for corporations through the law, they may be overly optimistic in their suggestion that these more skillfully wielded legal models will influence corporate behavior for the better. Reviewing the basic tenets (...) of their two approaches, this paper uses corporate responses to environmental statutes to suggest that while legal optimism may offer hope for promoting corporate ethics, it has definite limitations in its current stage of development. (shrink)

Joining the dialogue on the relationship between the law and business ethics, Jeffrey Nesteruk and Eric W. Orts have offeredconceptions of the law as a positive influence rather than a negative curb on corporate behavior. While these “legal optimists” pursue anoble end in promoting higher ethical standards for corporations through the law, they may be overly optimistic in their suggestion that these more skillfully wielded legal models will influence corporate behavior for the better. Reviewing the basic tenets of their (...) two approaches, this paper uses corporate responses to environmental statutes to suggest that while legal optimism may offer hope for promoting corporate ethics, it has definite limitations in its current stage of development. (shrink)

Complete collection of Schwarzschild’s essays on the neo-Kantian Jewish philosopher Hermann Cohen. Steven S. Schwarzschild (1924–1989) was arguably the leading expositor of German-Jewish philosopher Hermann Cohen (1842–1918), undertaking a lifelong effort to reintroduce Cohen’s thought into contemporary philosophical discourse. In The Tragedy of Optimism, George Y. Kohler brings together all of Schwarzschild’s work on Cohen for the first time. Schwarzschild’s readings of Cohen are unique and profound; he was conversant with both worlds that shaped Cohen’s thought, neo-Kantian German idealism (...) and Jewish theology. The collection covers a wide range of subjects, from ethics, socialism, the concept of human selfhood, and the mathematics of the infinite to more explicitly Jewish themes. This volume includes two of Schwarzschild’s previously unpublished manuscripts and a scholarly introduction by Kohler. Schwarzschild shows that despite its seeming defeat by events of the twentieth century, Cohen’s optimism about human progress is a rational, indeed necessary, path to peace. George Y. Kohler is Director of the Joseph Carlebach Institute and Senior Lecturer of Jewish Philosophy at Bar Ilan University, Israel. He is the author of Reading Maimonides’ Philosophy in 19th Century Germany: The Guide to Religious Reform. (shrink)

Recently there has arisen a new wave of optimism in the discussions about the environment. According to Gregg Easterbrook, one of the most prominent of the environmental optimists, we are presently witnessing fundamental and far-reaching changes for the better: “the Western world today is on the verge of the greatest ecological renewal that humankind has known; perhaps the greatest that the Earth has known” .The optimism of these new environmental optimists is not simply strategic, a mere psychological stimulant (...) to maintain the struggle against environmental destruction. They believe there are good reasons for being optimistic: they claim that a sober and scientific analysis of the environmental problematic shows that the prospects for the Earth and for our own kind are actually much better than the eco-alarmists would have us think. Nature is not on the brink of collapse. The real existing problems can be controlled and solved, at least if we are prepared to adopt a less dogmatic, more rational, pragmatic and flexible approach. The environmental movement, and environmental protesters are locked into ideas, analyses and attitudes that are no longer in touch, or never were in touch, with reality. So the time is ripe, according to the American environmental optimist Ronald Bailey, for a second wave of environmental activism. It is time for “a modern, smart environmentalism” .In what follows, I shall look at environmental optimism primarily as it is presented in Gregg Easterbrook’s voluminous book. His book contains a comprehensive and well-documented argument in favour of a new approach and a new attitude toward the whole environmental problematic. Of particular interest is his attempt to ground environmental optimism in an image of nature that has clearly been influenced by dynamic or evolutionary ecology — a new paradigm in ecology. Easterbrook considers himself a ‘liberal’, which might be translated as a ‘social democrat’ in the European political spectrum. He is not at all opposed to the environmental movement, environmental protest or environmental politics. Indeed, he regards the environmental movement as one of the most positive social developments of the 20th century. The politics of the environment and environmental protection legislation are, in his opinion, among the greatest success stories of the post-war social-democratic welfare state. “Americans and Europeans today live in a world where effective environmental influence is assured at nearly every level of government and business. This is a wonderful development for society”. (shrink)

Background: “Therapeutic misconception” arises when human subjects interpret a clinical trial as aimed primarily at therapy rather than producing knowledge. Therapeutic misconceptions may be more prevalent in trials enrolling gravely ill subjects or involving novel and well publicised investigational agents.Objective: To examine the extent to which investigators express therapeutic optimism in phase 1 human gene transfer consent documents, whether highly active gene transfer researchers are more prone to expressing therapeutic optimism, and whether consent forms have grown more optimistic (...) in their descriptions of personal benefit over the last decade.Design: Content analysis was performed on 277 consent documents to measure the number of sentences describing possibility of benefit, terminology used for experimental agents, the proportion of statements describing personal versus societal benefits, and whether investigators attempted to thwart therapeutic misconceptions.Results: Consent forms generally used therapeutic terminology to describe study agents, devoted more sentences to describing possible personal benefits than to describing benefits to society, and infrequently explained that a particular benefit was unlikely. Consent documents used by highly active gene transfer researchers tended to portray significantly greater optimism about personal benefit than less active investigators, though they were also significantly more cautious with agent terminology. Finally, therapeutic optimism expressed in consent forms has declined over the past decade.Conclusions: Consent documents used in phase 1 gene transfer trials, although increasingly attentive to possible therapeutic misconceptions, are inappropriately optimistic about direct benefits of trial participation. Such optimism is expressed more emphatically in trials involving highly active gene transfer researchers as principal investigators. (shrink)

From Optimism to Tenacious Hope: Communication Ethics and the Scottish Enlightenment works with the Scottish Enlightenment as the intellectual and performative background for the illustration of the differentiation between optimism and tenacious hope.

Researchers and ethicists have long been concerned about the expectations for direct medical benefit expressed by participants in early phase clinical trials. Early work on the issue considered the possibility that participants misunderstand the purpose of clinical research or that they are misinformed about the prospects for medical benefit from these trials. Recently, however, attention has turned to the possibility that research participants are simply expressing optimism or hope about their participation in these trials. The ethical significance of (...) this therapeutic optimism remains unclear. This paper argues that there are two distinct phenomena that can be associated with the term ‘therapeutic optimism’—one is ethically benign and the other is potentially worrisome. Distinguishing these two phenomena is crucial for understanding the nature and ethical significance of therapeutic optimism. The failure to draw a distinction between these phenomena also helps to explain why different writers on the topic often speak past one another. (shrink)

The introduction of new medical treatments based on invasive technologies has often been surrounded by both hopes and fears. Hope, since a new intervention can create new opportunities either in terms of providing a cure for the disease or impairment at hand; or as alleviation of symptoms. Fear, since an invasive treatment involving implanting a medical device can result in unknown complications such as hardware failure and undesirable medical consequences. However, hopes and fears may also arise due to the cultural (...) embeddedness of technology, where a therapy due to ethical, social, political and religious concerns could be perceived as either a blessing or a threat. While Deep Brain Stimulation (DBS) for treatment resistant depression (TRD) is still in its cradle, it is important to be proactive and try to scrutinize both surfacing hopes and fears. Patients will not benefit if a promising treatment is banned or avoided due to unfounded fears, nor will they benefit if DBS is used without scrutinizing the arguments which call for caution. Hence blind optimism is equally troublesome. We suggest that specificity, both in terms of a detailed account of relevant scientific concerns as well as ethical considerations, could be a way to analyse expressed concerns regarding DBS for TRD. This approach is particularly fruitful when applied to hopes and fears evoked by DBS for TRD, since it can reveal if our comprehension of DBS for TRD suffer from various biases which may remain unnoticed at first glance. We suggest that such biases exist, albeit a further analysis is needed to explore this issue in full. (shrink)

Bernard Williams is widely recognized as belonging among the greatest and most influential moral philosophers of the twentieth-century – and arguably the greatest British moral philosopher of the late twentieth-century. His various contributions over a period of nearly half a century changed the course of the subject and challenged many of its deepest assumptions and prejudices. There are, nevertheless, a number of respects in which the interpretation of his work is neither easy nor straightforward. One reason for this is that (...) both his views and his methods evolved and shifted in significant ways, especially around the time that he wrote and published Ethics and the Limits of Philosophy (i.e. the early 1980s). One way of gauging and assessing these changes in Williams’ views and outlook is to consider his relationship and attitude to other philosophers during this period. Of particular interest is his changing attitude to the moral philosophy of David Hume. This relationship is of considerable importance, not only because it serves as a useful tool for the interpretation of Williams’ views but also because it provides us with some critical insight into the respective strengths and weaknesses of both Hume’s and Williams’ contributions. -/- . (shrink)

The process of making ethical judgments is much more complex than studying only personal moral philosophy variables (idealism and relativism). The renewed interest in epistemic values (virtue and vice epistemology) in contemporary philosophy has shown significant relevance to understanding ethical behavior and such values may be better predictors than studying only idealism and relativism. The purpose of this exploratory study is to examine employees’ personal moral philosophies, optimism, epistemic values, and various organizational unethical practices as compared to (...) their managers. We used Rawwas’ items of epistemology in this study. The sample consisted of 262 managers and employees. The results revealed that managers were more sensitive to organizational unethical practices, scored less on epistemic vices, less on absolutism, and more on exceptionalism than employees were. However, there was no difference between managers and employees related to moderate and minor unethical organizational practices, situationism, subjectivism, optimism, and epistemic virtues. We provided discussion of the results and implications. (shrink)

A widespread complaint about humanism is that it is ‘too optimistic’. It is a nice and open attitude towards life but as a philosophy it cannot be taken seriously. This chapter shows that although people pay lip service to religion as the foundation of morals, in fact it is morals that are increasingly seen as the basis of religion. There is a strange psychological process at work: on the one hand people repeatedly state that morals are in need of a (...) religious foundation and in particular that our moral culture is deeply rooted in Christianity but on the other hand religion is increasingly interpreted according to moral standards. Many people who are de facto following autonomous or non‐religious ethics proclaim to derive ‘inspiration’ from religion or be following the dictates of religion. Contemporary morals are much less theologically driven or religiously founded than many people proclaim. (shrink)

IntroductionDeep brain stimulation (DBS) is utilized to treat pediatric refractory dystonia and its use in pediatric patients is expected to grow. One important question concerns the impact of hope and unrealistic optimism on decision-making, especially in “last resort” intervention scenarios such as DBS for refractory conditions.ObjectiveThis study examined stakeholder experiences and perspectives on hope and unrealistic optimism in the context of decision-making about DBS for childhood dystonia and provides insights for clinicians seeking to implement effective communication strategies.Materials and (...) MethodsSemi-structured interviews with clinicians (n = 29) and caregivers (n = 44) were conducted, transcribed, and coded.ResultsUsing thematic content analysis, four major themes from clinician interviews and five major themes from caregiver interviews related to hopes and expectations were identified. Clinicians expressed concerns about caregiver false hopes (86%, 25/29) and desperation (68.9%, 20/29) in light of DBS being a last resort. As a result, 68.9% of clinicians (20/29) expressed that they intentionally tried to lower caregiver expectations about DBS outcomes. Clinicians also expressed concern that, on the flip side, unrealistic pessimism drives away some patients who might otherwise benefit from DBS (34.5%, 10/29). Caregivers viewed DBS as the last option that they had to try (61.3%, 27/44), and 73% of caregivers (32/44) viewed themselves as having high hopes but reasonable expectations. Fewer than half (43%, 19/44) expressed that they struggled setting outcome expectations due to the uncertainty of DBS, and 50% of post-DBS caregivers (14/28) expressed some negative feelings post treatment due to unmet expectations. 43% of caregivers (19/44) had experiences with clinicians who tried to set low expectations about the potential benefits of DBS.ConclusionThoughtful clinician-stakeholder discussion is needed to ensure realistic outcome expectations. (shrink)

In the debate on climate change commentators often express pessimistic or optimistic views. We see this mainly in the media and popular literature, but also in various academic fields. The aim of this paper is to investigate different kinds of pessimistic and optimistic views put forward in this debate and suggest explanations of the diversity of views. The paper concludes that pessimism and optimism may concern, for example, climate change as an unmitigated or poorly mitigated process, mitigation of climate (...) change or specific measures of mitigation. These aspects are important to distinguish, because a person can be pessimist concerning climate change as an unmitigated or poorly mitigated process and optimist concerning mitigation of climate change, and be pessimist concerning one specific mitigation measure and optimist concerning another. It is suggested that the diversity of pessimistic and optimistic views is due to the uncertainty of scientific climate models and the influence of evaluative and ideological assumptions. (shrink)

Applied mathematics often operates by way of shakily rationalizedexpedients that can neither be understood in a deductive-nomological nor in an anti-realist setting.Rather do these complexities, so a recent paper of Mark Wilson argues, indicate some element in ourmathematical descriptions that is alien to the physical world. In this vein the mathematical opportunistopenly seeks or engineers appropriate conditions for mathematics to get hold on a given problem.Honest mathematical optimists, instead, try to liberalize mathematical ontology so as to include all physicalsolutions. Following (...) John von Neumann, the present paper argues that the axiomatization of a scientifictheory can be performed in a rather opportunistic fashion, such that optimism and opportunism appear as twomodes of a single strategy whose relative weight is determined by the status of the field to beinvestigated. Wilson's promising approach may thus be reformulated so as to avoid precarious talk about a physicalworld that is void of mathematical structure. This also makes the appraisal of the axiomatic method inapplied matthematics less dependent upon foundationalist issues. (shrink)

BackgroundResearchers worry that patients in early-phase research experience unrealistic optimism about benefits and risks of participation. The standard measure of unrealistic optimism is the Comparative Risk/Benefit Assessment questionnaire, which asks people to estimate their chances of an outcome relative to others in similar situations. Such a comparative framework may not be a natural way for research participants to think about their chances.ObjectiveTo examine how people interpret questions measuring unrealistic optimism and how their interpretations are associated with their (...) responses.MethodsUsing an early-phase cancer trial vignette, we administered the CRBA to 297 adults from the general public. They estimated their comparative chances of risk and benefit, then provided rationales for their estimates.ResultsFor both CRBA benefit and risk questions, about 50% of respondents chose 0, and 50% chose a non-0 response. Respondents’ rationales for their estimates showed that overall only about 40%–44% gave comparative rationales, indicating that they interpreted the CRBA as intended. 68.7% of respondents who gave the ‘correct’ 0 rating gave comparative rationales, whereas only 11.6% of respondents who gave non-0 ratings did so. A similar trend was seen for chances of risk.ConclusionResearch participants may not understand comparative benefit and risk questions as intended; attributions of unrealistic optimism may require additional evidence that the respondents’ estimates are intended to be comparative. (shrink)

If you’re thinking ethically you ought to try to take the point of view from which you consider whether you could prescribe the action if you were in the position of all of those affected by it. I think that if you consider the situation of poverty and affluence, if you were really to put yourself in the position of the poor person and the affluent person, and ask yourself whether you could support the view that the affluent person doesn’t (...) give anything to the poor, you couldn’t. (shrink)

If you’re thinking ethically you ought to try to take the point of view from which you consider whether you could prescribe the action if you were in the position of all of those affected by it. I think that if you consider the situation of poverty and affluence, if you were really to put yourself in the position of the poor person and the affluent person, and ask yourself whether you could support the view that the affluent person doesn’t (...) give anything to the poor, you couldn’t. (shrink)

If you’re thinking ethically you ought to try to take the point of view from which you consider whether you could prescribe the action if you were in the position of all of those affected by it. I think that if you consider the situation of poverty and affluence, if you were really to put yourself in the position of the poor person and the affluent person, and ask yourself whether you could support the view that the affluent person doesn’t (...) give anything to the poor, you couldn’t. (shrink)

Bioethicists have long been concerned that seriously ill patients entering early phase (‘phase I’) treatment trials are motivated by therapeutic benefit even though the likelihood of benefit is low. In spite of these concerns, consent forms for phase I studies involving seriously ill patients generally employ indeterminate benefit statements rather than unambiguous statements of unlikely benefit. This seeming mismatch between attitudes and actions suggests a need to better understand research ethics committee members’ attitudes toward communication of potential benefits and risks (...) of early phase studies to potential subjects. We surveyed the members of two U.S. research ethics committees using a phase I gene transfer study scenario, and compared the results to a previous survey of potential subjects’ perceptions and attitudes toward benefit and risk for the same protocol. The results show that there is indeed a gap between the subjects’ perceptions and the committee members’ views on what is appropriate to be communicated to research subjects. This discrepancy is the product of both the commonly assumed optimism of the subjects and to a “protective pessimism” of the research ethics committee members. We discuss this discrepancy using “frameworks of trust” and demonstrate the need to incorporate these frameworks into the existing model of informed consent. (shrink)

Kai Nielsen is one of Canada’s most distinguished political philosophers. In a career spanning over 40 years, he has published more than 400 papers in political philosophy, ethics, meta-philosophy, and philosophy of religion. He has engaged much of the best work in Anglophone political philosophy, shedding light on many of the central debates and controversies of our time but throughout has remained a unique voice on the political left. _ Pessimism of the Intellect _presents a thoughtful collection of Nielsen’s essays (...) complemented by an extended reflective interview with Nielsen. This collection allows the reader to grasp the systematic scope of his thought and methodology. (shrink)

Unrealistic therapeutic beliefs are very common—the majority of patient-subjects enrol in phase 1 trials seeking and expecting significant medical benefit, even though the likelihood of such benefit has historically proven very low. The high prevalence of therapeutic misestimation and unrealistic optimism in particular has stimulated debate about whether unrealistic therapeutic beliefs in early-phase clinical trials preclude adequate informed consent. We seek here to help resolve this controversy by showing that a crucial determination of when such therapeutic beliefs are ethically (...) problematic turns on whether they are causally linked and instrumental to the motivation to participate in the trial. Thus, in practice, it is ethically incumbent on researchers to determine which understanding and beliefs lead to the participant’s primary motivation for enrolling, not to simply assess understanding, beliefs and motivations independently. We further contend that assessing patient-subjects’ appreciation as a component of informed consent—it is already an established component of decision-making capacity assessments—can help elucidate the link between understanding-beliefs and motivation; appreciation refers to an individual’s understanding of the personal significance of both the medical facts and the experience of trial participation. Therefore, we recommend that: in addition to the usual question, ‘Why do you want to participate in this trial?’, all potential participants should be asked the question: ‘What are you giving up by participating in this trial?’ and researchers should consider the settings in which it may be possible and practical to obtain ‘two-point consent’. (shrink)

Extra-corporeal membrane oxygenation has been introduced to clinical practice for several decades. It is unclear how internet and newspapers portray the use of extra-corporeal membrane oxygenation. This study were: (1) to quantify the coverage of extra-corporeal membrane oxygenation use in newspapers and on the Internet; (2) to describe the characteristics of extra-corporeal membrane oxygenation users presented in newspaper articles and the Internet web pages in comparison with those shown in extra-corporeal membrane oxygenation studies in Taiwan; and (3) to examine the (...) survival rates of extra-corporeal membrane oxygenation users presented in newspaper articles and the Internet web pages in comparison with those in Taiwan and in the Extracorporeal Life Support Registry Report International Summary for January 2014. (shrink)