ABSTRACT In his contribution to the second part of this special issue, Storrs McCall criticizes the solution to his puzzle that we put forward in the first part of the issue. In this paper, we expand on our solution and defend it from his objections.

Kathleen Stock’s engaging and careful book demonstrates that ‘extreme intentionalism’ – the view that a fiction’s content is determined by what its author actually intended – has for too long been held back by a set of familiar objections.1 1 It is often thought to have implausible consequences involving disregarding conventional meaning, permitting undetectable fictional content, denying that authorial intentions can be unsuccessful, or giving too much importance to extraneous indications of intention and too little to the work itself. All (...) these objections, Stock argues, are overplayed, all are answerable, and several ultimately favour extreme intentionalism over its rivals. Stock’s defence of extreme intentionalism grounds a view of imaginative resistance, an account of the fiction/non-fiction distinction and of what an individual fiction is, and a characterization of propositional imagining and of the nature of supposition. (shrink)

Is there any difference between playing video games in which the player’s character commits murder and video games in which the player’s character commits pedophilic acts? Morgan Luck’s “Gamer’s Dilemma” has established this question as a puzzle concerning notions of permissibility and harm. We propose that a fruitful alternative way to approach the question is through an account of aesthetic engagement. We develop an alternative to the dominant account of the relationship between players and the actions of their characters, and (...) argue that the ethical difference between so-called “virtual murder” and “virtual pedophilia” is to be understood in terms of the fiction-making resources available to players. We propose that the relevant considerations for potential players to navigate concern (1) attempting to make certain characters intelligible, and (2) using aspects of oneself as resources for homomorphic representation. (shrink)

Event summary: The conference focuses on metafiction, taken to cover any fiction which represents itself as a fiction. Because metafictions acknowledge their own status as fictions, they are sometimes known as ‘reflexive’ or ‘self-conscious’ fictions, and sometimes generate apparently paradoxical results. The conference will explore what this reflexivity amounts to, how it distinguishes the metafictional from the non-metafictional works, and what impact this has on questions about the nature of fiction in general. Metafiction amounts to a significant – but not (...) uncommon – distortion of the standard relationship between a fiction and what it represents. This two-day interdisciplinary conference will explore how metafictional representation works by bringing together research on the nature of fiction within philosophy and research on metafiction in literary criticism, film studies and art theory. Questions to Explore Understanding how metafiction works is important to understanding how fiction works. For it raises interesting questions about what fictional representation is, what distinguishes it from non-fictional representation, how fictions represent, how we engage with fiction, and what relations the representation bears to its contents. How should we accommodate metafictions within an account of truth in fiction? Are there any peculiarities of audience engagement with metafictions – do our emotional reactions to a scenario change if we are told by the work that it is ‘just fictional’? What are the different metafictional narrative techniques, and do they all have the same impact on the content of the fiction? What constraints, if any, do metafictions place on the ontology of fiction and the nature of fictional objects? (shrink)

Event synopsis: -What does it mean to claim that the future is open? -Are future contingent statements like "There will be a sea battle tomorrow" now true or false? -Is the claim that future contingents are now true or false compatible with the claim that the future is open? -What is the relation between future contingents and future ontology? -What metaphysical picture is required in order to make sense of the claim that the future is open? Multiple, branching futures? A (...) ‘thin red line’? Metaphysical indeterminacy? Presentism? (shrink)

Some fictions seem to involve branching time, where one time series ‘splits’ into two or two time series ‘fuse’ into one. We provide a new framework for thinking about these fictional representations: not as representations of branching time series but rather as branching representations of linear time series. We explain how branching at the level of the representation creates a false impression that the story describes a branching of the time series in the fictional world itself. This involves explaining away (...) the illusion of various causal connections which may at first appear essential to understanding the story as a unified whole. This provides a more accurate account of the relationship between the representation and what is represented, which in turn reveals the extent to which it is legitimate to draw conclusions about actual time from fictional representations. (shrink)

Personification has received little philosophical attention, but Daniel Nolan has recently argued that it has important ramifications for the relationship between fictional representation and possibility. Nolan argues that personification involves the representation of metaphysically impossible identities, which is problematic for anyone who denies that fictions can have impossible content. We develop an account of personification which illuminates how personification enhances engagement with fiction, without need of impossible content. Rather than representing an identity, personification is something that is done with representations—a (...) matter of use rather than content—and involves only a comparison of possibilities. We illustrate our account using the personification of death in the film Meet Joe Black, and show that there are no grounds for taking it to be fictionally true that there is a metaphysically impossible identity between Death and death. (shrink)

What can we learn about the world from engaging with fictional time-series--stories involving time travellers, recurring and rewinding time, and foreknowledge of the future? Do they show us radical alternative possibilities concerning the nature of time, or do they show that even the impossible can be represented in fiction? Neither, so this book argues. Defending the view that a fiction represents a single possible world, the authors show how apparent representations of radically different time-series can be explained in terms of (...) how worlds are represented without there being any fictional world which has such a time-series. In this way, the book uses the complexities of fictional time to get to the core of the relation between truth in fiction and possibility. It provides a logic and metaphysics to deal with the fact that fictions can leave certain features of their fictional worlds indefinite, and draws comparisons and connections between fictional and scientific representations and hypotheses. (shrink)

What is a fictional character? Nothing, according to Mark Sainsbury. Yet it is true to say that there are fictional characters. How? Because there are fictions according to which there are specific individuals. And it can be true to say that Anna Karenina is more intelligent than Emma Bovary. How? Because the truth-value of the sentence is to be assessed under the (false) presupposition that there are such people as Emma and Anna. And it is true to say that Conan (...) Doyle's novels represent Sherlock Holmes, that I have been thinking about Holmes, and that Holmes is a famous character. How? Because such sentences either involve, or can be explained in terms of, intensional verbs or operators, and intensional contexts do not require that something be the thing which is represented, or thought about, or regarded in such a way as to make it famous. (shrink)

What is it that makes a student's answer correct or incorrect in Religious Studies? In practice, the standards of correctness in the Religious Studies classroom are generally applied with relative ease by teachers and students. Nevertheless, they are problematic. We shall argue that correctness does not come from either the students or the teacher believing that what has been said is true. This raises the question: what is correctness, if it does not come down to truth? We propose, and examine, (...) three rival solutions, each of which, to an extent, rationalises a fairly natural response to the problem. The first, the elliptical approach, says that correct contributions have some tacit content: they are elliptical for true sentences about beliefs. The second, the imaginative approach, seeks to replace appeals to truth and belief with an appeal to imagination, treating Religious Studies as a ‘game of make-believe’ in which teachers and students imaginatively engage with certain worldviews. The third, the institutional approach, locates the root of correctness in the practices of the Religious Studies institution, which include making endorsements of some judgements and not others. We show that the first of our proposed approaches encounters a number of significant objections. We find the second of our proposed approaches to be better, but the third is the most attractive, providing a direct, intuitive and comprehensive route through the problem of correctness. (shrink)

David Lewis introduced the idea of a quasi-miracle to overcome a problem in his initial account of counterfactuals. Here we put the notion of a quasi-miracle to a different and new use, showing that it offers a novel account of the phenomenon of poetic justice, where characters in a narrative get their due by happy accident. The key to understanding poetic justice is to see what makes poetically just events remarkable coincidences. We argue that remarkable coincidence is to be understood (...) in terms of a distinctive type of experience quasi-miracles offer. Cases of poetic justice offer a dual awareness of the accidental nature of the events and of a non-accidental process, involving intention, which it appears would explain them. We also extend this account to incorporate how we might experience magic tricks. An account of poetic justice as quasi-miraculous allows us to account for the experience of encounters with poetic justice, as involving the incongruity of seeing design in accident. (shrink)

We argue that some fictional truths are fictionally true by default. We also argue that these fictional truths are subject to being undermined. We propose that the context within which we are to evaluate what is fictionally true changes when a possibility which was previously ignorable is brought to attention. We argue that these cases support a model of fictional truth which makes the conversational dynamics of determining truth in fiction structurally akin to the conversational dynamics of knowledge-ascription, as this (...) is understood by David Lewis’s contextualist approach to knowledge. We show how a number of the rules which Lewis proposes for the case of knowledge-ascription can be employed to develop a novel and powerful framework for the case of truth in fiction. (shrink)

We consider the extent to which artistic and scientific representations can give us knowledge of how things are or could be. Focusing on representations of time, we take two case studies: simultaneity and temporal order; time-travel to the past. We analyse relevant scientific representations – from Special Theory of Relativity and General Theory of Relativity – alongside relevant artistic representations – fictions which are non-committal about temporal order, and time-travel stories. In all the cases, we argue, drawing reliable conclusions from (...) the representations requires an understanding of the metaphysics of their subject matter and of the nature of representation itself. If we attempt to work out what is represented from the representation alone, then, far from acquiring knowledge, we risk obscuring the representation’s subject matter. (shrink)

ABSTRACT In 'An Insoluble Problem', Storrs McCall presents an argument which he takes to reveal the real problem with backwards time travel. McCall asks us to imagine a scenario in which a renowned artist produces his famous works by copying them from reproductions brought back to him by a time-travelling art critic. The novelty of the scenario lies in its introduction of aesthetic constraints on the possibility of time travel, something which sets it apart from other time travel cases. McCall (...) states that 'The puzzle lies... in finding where artistic creativity enters the equation', and that 'Unlike the traditional "paradoxes of time travel", this problem has no solution'. We offer four responses to McCall's puzzle. Whilst we show that the puzzle is not insoluble, we also argue that it reveals something about the proper relationship between copying and creativity, which may not have been apparent without considering time travel. (shrink)

"Iago's 'I am not what I am' epitomises how Shakespeare's work is rich in philosophy, from issues of deception and moral deviance to those concerning the complex nature of the self, the notions of being and identity, and the possibility or impossibility of self-knowledge and knowledge of others. The Routledge Companion to Shakespeare and Philosophy examines the following important topics: - What roles can be played in an approach to Shakespeare by drawing on philosophical frameworks and the work of philosophers? (...) - What can philosophical theories of meaning and communication show about the dynamics of Shakespearean interactions, and vice versa? - How are notions such as political and social obligation, justice, equality, love, agency, and the ethics of interpersonal relationships demonstrated in Shakespeare's works? - What do the plays and poems invite us to say about the nature of knowledge, belief, doubt, deception and epistemic responsibility? - How can the ways in which Shakespeare's characters behave illuminate existential issues concerning meaning, absurdity, death and nothingness? - What might Shakespeare's characters and their actions show about the nature of the self, the mind, and the identity of individuals? - How can Shakespeare's works inform philosophical approaches to notions such as beauty, humour, horror and tragedy? - How do Shakespeare's works illuminate philosophical questions about the nature of fiction, the attitudes and expectations involved in engagement with theatre, and the role of acting and actors in creating representations? The Routledge Companion to Shakespeare and Philosophy is essential reading for students and researchers in aesthetics, philosophy of literature and philosophy of theatre"--. (shrink)

ABSTRACT In their contribution to the first part of this special issue Craig Bourn and Emily Caddick Bourne claim to have solved a puzzle I put forward in my ‘An Insoluble Problem’. Here I argue that their attempt fails.

This paper addresses the question of what should determine whether students’ answers to closed questions are marked as correct or incorrect in the context of formal religious education, and when their answers to open ended questions should be given more or less credit. Drawing on insights from Craig Bourne, Emily Caddick Bourne and Clare Jarmy, I argue that a combination of judged truth, and a range of well-argued cases about what ought to be believed given certain (...) premises should constrain these assessment practices. Furthermore, I argue that if we cannot find any consistent, nonarbitrary account of how judgements of correctness and merit are in fact being made in the context of formal religious education, then this tells more against current practice’s inconsistency and arbitrariness than against these constraints on how judgements of correctness and merit should be made. (shrink)

This article considers the social construction of mental toughness in line with prevailing social attitudes towards success and dominance in elite sport. Critical attention is drawn to the research literature which has sought to conceptualise mental toughness and the idealistic rhetoric and metaphor with which it has done so. The concept of mental toughness currently reflects an elitist ideal, constructed along the lines of the romantic narrative of the ‘Hollywood hero’ athlete. In contrast, the mental and moral virtues which should (...) form the basis of mental toughness are often neglected when an athlete ‘fails’. Currently, mental toughness exists as a characteristic used to describe successful athletes and is only applied in hindsight. Finally, we recommend that the morally problematic association of mental toughness (within the media, society, and the research community) with ultimate success needs to be removed in order to rescue the concept from the elitist discourses which currently surround and suffocate it. (shrink)

Because idealizations frequently advance scientific understanding, many claim that falsehoods play an epistemic role. In this paper, we argue that these positions greatly overstate idealiza...

Under what conditions does machine learning (ML) model opacity inhibit the possibility of explaining and understanding phenomena? In this article, I argue that nonepistemic values give shape to the ML opacity problem even if we keep researcher interests fixed. Treating ML models as an instance of doing model-based science to explain and understand phenomena reveals that there is (i) an external opacity problem, where the presence of inductive risk imposes higher standards on externally validating models, and (ii) an internal opacity (...) problem, where greater inductive risk demands a higher level of transparency regarding the inferences the model makes. (shrink)

Viewed this way, the texts yield striking examples of language and notation that are irreducibly ambiguous and productive because they are ambiguous.

Philosophical discussions of climate change have mainly conceived of it as a moral or ethical problem, but climate change also raises new challenges for aesthetics. In this paper I show that, in particular, climate change (1) raises difficult questions about the status of aesthetic judgments about the future, or 'future aesthetics'; and (2) puts into relief some challenging issues at the intersection of aesthetics and ethics. I maintain that we can rely on aesthetic predictions to enable us to grasp, in (...) some sense, aesthetic value in environments affected by climate change and, through a discussion of three hypothetical cases, I argue that, although moral considerations will press on aesthetic judgments, aesthetic value will not necessarily be trumped by them. (shrink)

Some people oppose abortion on the grounds that fetuses have full moral status and thus a right to not be killed. We argue that special obligations that hold between mother and fetus also hold between parents and their children. We argue that if these special obligations necessitate the sacrifice of bodily autonomy in the case of abortion, then they also necessitate the sacrifice of bodily autonomy in the case of organ donation. If we accept the argument that it is obligatory (...) to override a woman’s bodily autonomy for the sake of an unborn child’s survival, we must continue to override the bodily autonomy of parents to ensure the survival of their living children, until the parent no longer has a special obligation to their child to the same degree as their special obligation to the fetus. And if the life of a child is truly more important than the bodily autonomy of its parents, as must be the case to force women to carry unwanted pregnancies to term, this should remain true until such a time that their children are no longer considered their responsibility. Thus, parity of reasoning suggests that policies compelling the gestation of a fetus should be accompanied by policies compelling organ donation. (shrink)

This book draws its inspiration from Hilbert, Wittgenstein, Cavaillès and Lakatos and is designed to reconfigure contemporary philosophy of mathematics by making the growth of knowledge rather than its foundations central to the study of mathematical rationality, and by analyzing the notion of growth in historical as well as logical terms. Not a mere compendium of opinions, it is organised in dialogical forms, with each philosophical thesis answered by one or more historical case studies designed to support, complicate or question (...) it. The first part of the book examines the role of scientific theory and empirical fact in the growth of mathematical knowledge. The second examines the role of abstraction, analysis and axiomatization. The third raises the question of whether the growth of mathematical knowledge constitutes progress, and how progress may be understood. Readership: Students and scholars concerned with the history and philosophy of mathematics and the formal sciences. (shrink)

This article contributes to a growing conversation about the role of numbers in promoting gendered agendas in potentially contradictory ways. Drawing from interviews with gender advisors—the professionals tasked with mainstreaming gender in development projects—in an East African country, I begin from the paradox that gender advisors articulate a strong preference for qualitative data to best capture the lives of the women they aim to assist while voicing a need for quantitative metrics. I demonstrate that gender advisors come to imagine metrics (...) as expeditious bureaucratic tools able to inspire cooperation from otherwise reluctant coworkers. I argue that development organizations are gendered in ways—acutely seen in how advisors struggle, are sidelined, and attempt to advance their goals with numbers—that lead to the utility of valuing quantitative metrics over qualitative ones. I establish two theoretical contributions: Gendered organizations theory is essential to understanding the adoption and globalization of performance metrics, and in an age of evidence-based decision making, the utility of quantified data to garner resources is heightened, rewarding those who adopt quantified knowledge production. I coin the term “the paradox of quantified utility” to describe how these material advantages encourage even skeptics to value quantitative metrics. (shrink)

Exploring the intimate tie between body movement and space and time, Lee begins with the position that body movement generates space and time and explores the ethical implications of this responsibility for the situations one’s body movements generate. Whiteness theory has come to recognize the ethical responsibility for situations not of one’s own making and hence accountability for the results of more than one’s immediate personal conscious decisions. Because of our specific history, whites have developed a particular embodiment and body (...) movement that generates places that can only be characterized as more comfortable and more enabling to whites. (shrink)

To ensure that the information resulting from research is relevant to patients, the Patient‐Centered Outcomes Research Institute eschews the “traditional health research” paradigm, in which investigators drive all aspects of research, in favor of one in which patients assume the role of research partner. If we accept the premise that patient engagement can offer fresh perspectives that shape research in valuable ways, then at least two important sets of questions present themselves. First, how are patients being engaged—and how should they (...) be engaged? Second, which patients are being engaged—and which patients should be? This set has received relatively less attention, and the neglect is surprising, given that the “who” question is conceptually prior to the question of “how.”This article focuses attention on the “who” of patient engagement in research. First, we provide background on the rationale for patient engagement, underscoring the importance of ensuring the representativeness of engaged patients. Second, we present what little is known about patients engaged in PCORI‐funded research. Third, we identify and discuss the ethical implications of ways in which current practices of patient identification and recruitment may lead to a lack of representativeness. These practices include reliance on the well‐connected and well‐informed, reliance on patients who are not well trained or well‐informed, and reliance on patient advocacy organizations. Finally, we consider several strategies for addressing these pitfalls in order to maximize the positive goals of patient engagement. Patient engagement is intended to address the inability of researchers, funders, and others to fully represent patient views and priorities, but without sufficient attention, the patients selected for this role may still leave important gaps. (shrink)

Daniel Sennert , a prominent physician and a prolific and influential writer, was both an atomist and an Aristotelian. He was influenced by a distinctive and now little known Aristotelian approach to matter and form, and this promoted his development over time of a hierarchical account of atoms, with elementary atoms and grades of molecules. The first section provides a study of Sennert's Aristotelian foundation. The final two sections consider, in turn, Sennert's development over time of an atomistic theory, and (...) the nature and significance for him of substantial forms. (shrink)

This essay explores how the distinctively anthropological concept of culture provides uniquely valuable insights into the workings of science in its cultural context. Recent efforts by anthropologists to dislodge the traditional notion of culture as a homogenous, stable whole have opened up a variety of ways of imagining culture that place power differentials, flux, and contradiction at its center. Including attention to a wide variety of social domains outside the laboratory, attending to the ways nonscientists actively engage with scientific knowledge, (...) and focusing on the complex interactions that flow both into and out of research laboratories are ways the activities of both scientists and nonscientists can be situated in the heterogeneous matrtx of culture. Three images—the citadel, the rhizome, and the string figure—allow us to picture the discontinuous ways science both permeates and is permeated by cultural life. (shrink)

In 2005, Ethiopia changed its abortion law to curb its high maternal mortality. This has led to a considerable reduction in deaths from unsafe abortions. Abortion is now legal if the woman’s pregnancy is a result of rape or incest, if her health is endangered, if the fetus has a serious deformity, if she suffers from a physical or mental deficiency, or if she is under 18 years of age. The word of the woman, if in compliance with the law, (...) is sufficient to qualify for an abortion. In this context, where the law makes the door slightly open, health workers become important in deciding who gets access to safe services and who doesn’t, thus creating considerable ethical dilemmas. The objective of this study was to explore abortion service providers’ personal experiences and reflections, perceptions of the abortion law, and ethical and dilemmas that arise. Data collection took place from March to May 2016 in Addis Ababa, at different health clinics providing abortion services. Thirty in-depth interviews and three focus group discussions were conducted with 41 abortion service providers at governmental and non-governmental clinics. Content analysis was drawn upon in the interpretation of the findings. When working in a context where the law has slightly opened the door for abortion seeking women, the health workers describe conflicting concerns, burdensome responsibilities, and ambiguity concerning how to interpret and implement the law. They describe efforts to balance their religious faith and values against their professional obligations and concern for women’s health and well-being. This negotiation is particularly evident in the care of women who fall outside the law’s indications. They usually handle ethical dilemmas and decision-making alone without guidance. Moreover, many health workers face a stigma from fellow colleagues not performing abortions and therefore keep their job a secret from family and friends. Health workers in Ethiopia experience ethical dilemmas trying to maneuver between the abortion law, their personal values, and their genuine concern for the health of women. More research is needed to further explore this. (shrink)

In this article, we want to show the relevance and importance of melancholy as an aesthetic emotion. Melancholy often plays a role in our encounters with art works, and it is also present in some of our aesthetic responses to the natural environment. Melancholy invites aesthetic considerations to come into play not only in well-defined aesthetic contexts but also in everyday situations that give reason for melancholy to arise. But the complexity of melancholy, the fact that it is fascinating in (...) itself, suggests the further thought that it may be considered as an aesthetic emotion per se. To this end, we argue that it is the distinctive character of melancholy, its dual character and its differences from sadness and depression, which distinguishes it as an aesthetic emotion. (shrink)

Healthcare workers experience moral injury (MI), a violation of their moral code due to circumstances beyond their control. MI threatens the healthcare workforce in all settings and leads to medical errors, depression/anxiety, and personal and occupational dysfunction, significantly affecting job satisfaction and retention. This article aims to differentiate concepts and define causes surrounding MI in healthcare. A narrative literature review was performed using SCOPUS, CINAHL, and PubMed for peer-reviewed journal articles published in English between 2017 and 2023. Search terms included (...) “moral injury” and “moral distress,” identifying 249 records. While individual risk factors predispose healthcare workers to MI, root causes stem from healthcare systems. Accumulation of moral stressors and potentially morally injurious events (PMIEs) (from administrative burden, institutional betrayal, lack of autonomy, corporatization of healthcare, and inadequate resources) result in MI. Individuals with MI develop moral resilience or residue, leading to burnout, job abandonment, and post-traumatic stress. Healthcare institutions should focus on administrative and climate interventions to prevent and address MI. Management should ensure autonomy, provide tangible support, reduce administrative burden, advocate for diversity of clinical healthcare roles in positions of interdisciplinary leadership, and communicate effectively. Strategies also exist for individuals to increase moral resilience, reducing the impact of moral stressors and PMIEs. (shrink)

Over the last several decades there has been an increase in the amount of research conducted concerning academically dishonest behaviors at the undergraduate level. However, this research and subsequent interventions are based on the assumptions that there exists a clear understanding of what constitutes academic dishonesty. In an attempt to address this gap in the current literature, a concept synthesis of students’ perceptions of academic behavior was completed. The end result was 18 categories of potentially dishonest academic behaviors. Definitions and (...) examples are explored. Inter-rater reliability was completed and Kappa values are reported as well as implications for teaching and future research. (shrink)

The Cartesian method, construed as a way of organizing domains of knowledge according to the "order of reasons," was a powerful reductive tool. Descartes made significant strides in mathematics, physics, and metaphysics by relating certain complex items and problems back to more simple elements that served as starting points for his inquiries. But his reductive method also impoverished these domains in important ways, for it tended to restrict geometry to the study of straight line segments, physics to the study of (...) ambiguously constituted bits of matter in motion, and metaphysics to the study of the isolated, incorporeal knower. This book examines in detail the negative and positive impact of Descartes's method on his scientific and philosophical enterprises, exemplified by the Geometry, the Principles, the Treatise of Man, and the Meditations. (shrink)

Madison Kilbride recently argued that insurance ) should cover in vitro fertilisation with preimplantation genetic testing services for couples at high risk of having a child affected with a genetic condition. She argues that IVF-PGT meets CMS’s definition of ‘medically necessary care’, where such care includes ‘services or supplies needed to diagnose or treat an illness, injury, condition, disease or its symptoms’. Kilbride argues that IVF-PGT satisfies this definition in two ways: as a diagnostic tool and as a treatment. Contradicting (...) Kilbride, however, I argue that IVF-PGT provides neither diagnosis nor treatment under CMS’s definition. Thus, as long as we accept CMS’s definition of medically necessary care—which Kilbride does, explicitly—it follows that IVF-PGT does not count as medically necessary care. Still, there may be other reasons to conclude that IVF-Preimplantation genetic testing should be covered, and so, it would be a mistake to reject Kilbride’s conclusion altogether. The problem is simply that Kilbride’s argument—that the procedure should be covered because it is medically necessary per CMS’s definition—is not sound. I conclude by discussing a number of other genetic services that are not currently being covered despite the fact that they do seem to satisfy CMS’s definition of ‘medically necessary diagnosis or treatment’. These services, I argue, should be provided under CMS before we consider expanding coverage to include elective procedures such as IVF-PGT. (shrink)