Robert Nozick's experience machine thought experiment (Nozick's scenario) is widely used as the basis for a ?knockdown? argument against all internalist mental state theories of well-being. Recently, however, it has been convincingly argued that Nozick's scenario should not be used in this way because it elicits judgments marred by status quo bias and other irrelevant factors. These arguments all include alternate experience machine thought experiments, but these scenarios also elicit judgments marred by status quo bias and other irrelevant factors. In (...) this paper, several experiments are conducted in order to create and test a relatively bias-free experience machine scenario. It is argued that if an experience machine thought experiment is used to evaluate internalist mental state theories of well-being, then this relatively bias-free scenario should be used over any of the existing scenarios. Unlike the existing experience machine scenarios, when this new scenario is used to assess internalist mental state theories of well-being, it does not provide strong evidence to refute or endorse them. (shrink)

Naturalist theories of the meaning of life are sometimes criticised for not setting the bar high enough for what counts as a meaningful life. Tolstoy’s version of this criticism is that Naturalist theories do not describe really meaningful lives because they do not require that we connect our finite lives with the infinite. Another criticism of Naturalist theories is that they cannot adequately resolve the Absurd—the vast difference between how meaningful our actions and lives appear from subjective and objective viewpoints. (...) This article proposes a novel view, Optimistic Naturalism, in order to refute these criticisms. Optimistic Naturalism is the view that scientific and technological advancement might allow us to lead Truly Meaningful lives in a purely physical universe by enabling our actions, which we find meaningful partly because they might have particular infinite consequences, to actually have infinite consequences for life. The central tenets of Optimistic Naturalism are Infinite Consequence and Scientific Optimism. By explaining how the correct connection of the subjective and objective meaning of actions can result in True Meaning, Infinite Consequence provides a theoretical blueprint for resolving the Absurd. Scientific Optimism provides reason to think that it is possible to follow that blueprint in a purely physical universe. Therefore, when taken together, these two principles provide relatively plausible reasons to think that at least one kind of Naturalist theory can connect the finite with the infinite in a meaningful way and resolve the Absurd. (shrink)

Prudential hedonism has been beset by many objections, the strength and number of which have led most modern philosophers to believe that it is implausible. One objection in particular, however, is nearly always cited when a philosopher wants to argue that prudential hedonism is implausible—the experience machine objection to hedonism. This paper examines this objection in detail. First, the deductive and abductive versions of the experience machine objection to hedonism are explained. Following this, the contemporary responses to each version of (...) the argument are assessed and the deductive version is argued to be relatively ineffective compared to the abductive version. Then, a taxonomy of the contemporary critical responses to the abductive version is created. Consideration of these responses shows that the abductive version of the objection is fairly powerful, but also that one type of response seems promising against it. This response argues that experience machine thought experiments seem to elicit judgments that are either too biased to be used as evidence for the objection or not obviously in favour of reality. It is argued that only this type of refutation seems likely to convince proponents of the abductive version that the objection is much weaker than they believe it to be. Finally, it is suggested that more evidence is required before anything definitive can be said on the matter. (shrink)

This paper is a warning that objections based on thought experiments can be misleading because they may elicit judgments that, unbeknownst to the judger, have been seriously skewed by psychological biases. The fact that most people choose not to plug in to the Experience Machine in Nozick’s (1974) famous thought experiment has long been used as a knock-down objection to hedonism because it is widely thought to show that real experiences are more important to us than pleasurable experiences. This paper (...) argues that the commonplace choice to remain in reality when offered a life in the Experience Machine is best explained by status quo bias – the irrational preference for things to remain the same. An alternative thought experiment, empirical evidence, and discussion of how psychological biases can affect our judgments are provided to support this argument. (shrink)

The term "hedonism," from the Greek word ἡδονή (hēdonē) for pleasure, refers to several related theories about what is good for us, how we should behave, and what motivates us to behave in the way that we do. All hedonistic theories identify pleasure and pain as the only important elements of whatever phenomena they are designed to describe. If hedonistic theories identified pleasure and pain as merely two important elements, instead of the only important elements of what they are describing, (...) then they would not be nearly as unpopular as they all are. However, the claim that pleasure and pain are the only things of ultimate importance is what makes hedonism distinctive and philosophically interesting. (shrink)

Experience machines, popularized in print by Robert Nozick and on the screen by the Wachowskis’ film The Matrix, provide highly or perfectly realistic experiences that are more pleasant and less painful than those generated in real life.1 The recent surge in virtual reality and neuro-prosthetic technologies is making the creation of real-world experience machines seem inevitable and perhaps imminent.2 Given the likelihood of the near-future availability of such machines, it behooves ethicists to consider the moral status of their potential uses. (...) In this chapter, we investigate the use of experience machines in palliative and end-of-life care situations. We pair up various kinds of experience machines with patients in a range of conditions, to illuminate the moral problems and benefits of using experience machines in this way. We argue that the use of Nozickian experience machines to treat patients in most conditions would be morally problematic, most notably for the negative effects on patients’ characters and real-world relationships. Informed by this initial moral analysis, we describe an experience machine that is more closely related to a virtual reality game, and argue that it can avoid the moral problems encountered by Nozickian experience machines. In fact, we argue that this new kind of experience machine could improve some patients’ characters and relationships with real-world people. We conclude that some kinds of experience machines could benefit many patients, especially those in extreme pain and those not in the position to meaningfully interact with their loved ones in reality. We also note that certain kinds of experience machines could be useful for religious people, for whom the range of palliative and end-of-life care options is often thought to be relatively narrow. (shrink)

In his provocative “Can We Test the Experience Machine?”, Basil Smith argues that we should recognise a limit on experimental philosophy. In this response to Smith, I will argue that his limit does not prevent us from usefully testing most experience machine thought experiments, including De Brigard‟s inverted experience machine scenarios. I will also argue that, if taken seriously, Smith‟s limit has far-reaching consequences for traditional (non-experimental) philosophy as well.

In this paper, prediction markets that encourage traders to bet on matters of life and death are used to explore the varieties and dynamics of moral repugnance. We define moral repugnance as morally charged feelings of revulsion that correspond (correctly, incorrectly, and indeterminately) to moral reasons and contexts. Rich variations of moral repugnance and their dynamic qualities are presented by investigating the contextual frames in which they arise. These contextual frames constitute interacting conditions composed of information about states of affairs, (...) moral reasons, and feelings of revulsion. Through careful study of two medical prediction markets that encourage betting on death, we can observe the interaction between these causal conditions to see how the varieties of moral repugnance emerge. We also present three interesting results that arise from analyzing the dynamics of moral repugnance in response to prediction markets. First, a prediction market can elicit several conflicting types of moral repugnance at the same time. Second, moral indeterminacy can arise in two different ways when judging prediction markets. Finally, some prediction markets can generate a moral endogeneity problem, a disruptive feedback loop between a given prediction market and the morally relevant outcome it predicts. (shrink)

So you‘re leaving the cinema—you've just been blown away by Inception—and your mind is buzzing. There is a buzz around you too. Everyone‘s asking each other: ‗Does Cobb‘s spinning top fall?‘ Throughout Inception, Cobb has been struggling to achieve two things: to get back home so he can see his kids again and to keep a grip on reality in the process. What ends up happening to Cobb‘s totem bears on both of these struggles. So, most people who watch Inception (...) think that the whole point of the movie hinges on whether or not Cobb‘s top keeps spinning. Unfortunately for most people, they missed the point! The correct answer to 'Does Cobb‘s spinning top fall?‘ is: 'Who cares!‘ The truth, and in my opinion the main point of Inception, is that reality doesn't really matter. (shrink)

Predicting terrorist attacks with prediction markets has been accused of being immoral. While some of these concerns are about the likely effectiveness of prediction markets on terrorism (PMsoT), this paper discusses the three main reasons why even effective prediction markets on terrorism might be considered immoral. We argue that these three reasons establish only that PMsoT cause offense and/or fleeting mild harm, and that, even taken together, they do not constitute serious harm. The moral issues considered are that PMsoT: 1) (...) create character-affecting perverse incentives, 2) desensitise society to tragic events, and 3) disrespect important ideals. In addition to arguing against the force of these three potential moral problems, it is also argued that societies and governments already endorse intelligence-gathering methods that are clearly more immoral than PMsoT in the relevant respects. We also argue that some circumstances require governments to cause non-serious harm to some people in order to protect and promote the rights and welfare of its citizens. We conclude that a government’s obligation to protect and promote the rights and welfare of its citizens outweighs the non-serious harm that could be caused by effective PMsoT. As a result, we recommend that the likelihood of PMsoT being effective is investigated more closely. (shrink)

Prediction markets designed to predict terrorism through traders’ investments on the likelihood of specific terrorist attacks are, strictly speaking, enabling those traders to bet on terrorism. Betting on terrorist attacks, like some other forms of betting on death, has been accused of being repugnant. In this paper, it is argued that while government-backed effective intelligence-gathering prediction markets on terrorism (PMsoT) might elicit feelings of repugnance, those feelings are likely to be misguided. The feelings of repugnance arise because PMsoT are assumed (...) to be associated with terrorism in encouraging and endorsing ways and with human death in a disrespectful way. However, it is argued that these feelings of repugnance are misguided in the case of government-backed effective intelligence-gathering PMsoT because the purpose and effect of such prediction markets, and (on balance) the trading they encourage, is to prevent and renounce terrorism and show respect for matters of life and death. (shrink)

Real-world policy decisions involve trade-offs. Sometimes the trade-offs involve both the efficacy and morality of potential policies. In this chapter, the morality and likely efficacy of hiring one more spy to help anti-terrorist intelligence gathering efforts is compared to the morality and likely efficacy of implementing a prediction market on terrorism. Prediction markets on terrorism allow registered traders to buy and sell shares in predictions about terrorism-related real-world events. The comparison at the heart of this chapter is based on the (...) assumption that it would cost about $5 million to bankroll the prediction market project, or to establish another spy, including equipment and head office support, for 15 years. The comparison reveals that implementing a prediction market on terrorism is likely to be more efficacious and less morally problematic than hiring one more spy. (shrink)

In this chapter we first discuss the main principles of justice and note the standard objections to them, which we believe necessitate a hybrid approach. The hybrid account we defend is primarily based on the distributive principle of sufficientarianism, which we interpret as the idea that each country should have the means to provide a minimally decent quality of life for each of its citizens. We argue that sufficientarian considerations give good reason to think that what we call the ‘ability (...) to pay objection’ should be taken much more seriously in this debate. Following this, our account emphasises what we believe are the two most important moral desiderata in any attempt to distribute responsibility for dealing with climate change: the ability to mitigate the problem and the making of culpable contributions to the problem. After noting that our proposal includes enough detail to be a useful start for policy makers, we defend our account against some potential objections. (shrink)

There are enigmas of defining happiness and of discerning what it is that really makes a life go well for someone – topics that positive psychologists have not adequately addressed to date. And this is despite the fact that Ed Diener sees positive psychology as “the endeavour by scientists to answer the classic question posed by philosophers: What is the good life?” What is rarely mentioned by positive psychologists is that, depending on how the specific happiness questions are worded, they (...) can adopt what philosophers see as radically divergent conceptions of happiness. (shrink)

In Solo: A Star Wars Story, the debonair Lando Calrissian is clearly in love with the artificially intelligent droid L3‐37. There are lots of friendships between droids and humans in Star Wars. This chapter looks at the relationship between Lando and L3‐37 in Solo and argues that they exhibit all the hallmarks not just of friendship, but of love. A friendship between people who both seek to gain from the relationship is one of utility, while a friendship between people who (...) simply enjoy each other's company is one of pleasure. Droids are the kinds of beings that can be good friends, as is clearly supported throughout the Star Wars canon. One potential concern is that droids smarter than humans might take advantage of an inferior organic life form by having a sexual relationship with them. (shrink)

This chapter provides a brief historical overview of western philosophical views about human well-being from the eighth century BCE to the middle of the twentieth century. Different understandings of the concept of well-being are explained, including our preferred understanding of well-being as the subjective states and objective conditions that make our lives go well for us. While this review is necessarily incomplete, we aim to discuss some of the most salient and influential contributions to our subject. To that end, we (...) discuss some key views from ancient Greece, including the aristocratic values that were considered central to leading a good life, notions of personal and more expansive harmony as they key to well-being, and the idea that the experience of pleasure is all we should really care about. We also explain some of the major religious conceptions of the good life, and their progression through the middle ages and beyond. More recent secular conceptions of wellbeing, including several views on the importance of personal and public happiness. Finally, we discuss views to the effect that happiness is not enough for the good life and that we should strive for loftier goals. (shrink)

PrécisThe administration of Pre-Mortem Interventions (PMIs) to preserve the opportunity to donate, to assess the eligibility to donate, or to optimize the outcomes of donation and transplantation are controversial as they offer no direct medical benefit and include at least the possibility of harm to the still-living patient. In this article, we describe the legal analysis surrounding consent to PMIs, drawing on existing legal commentary and identifying key legal problems. We provide an overview of the approaches in several jurisdictions that (...) have chosen to explicitly address PMIs within codified law. We then provide, as an example, a detailed exploration of how PMIs are likely to be addressed in one jurisdiction where general medical consent law applies because there is no specific legislation addressing PMIs — the province of Ontario in Canada. (shrink)

En décembre 2007, Jacqueline Hamesse a fêté son 65ème anniversaire, puis a accédé à l’éméritat en 2008. Nombreux sont les collègues et amis qui ont souhaité marquer ces dates en rendant hommage à son dévouement aux études médiévales, que ce soit dans l’enseignement et la recherche ou pour la création et le développement d’institutions internationales dans ce domaine, sans oublier les efforts déployés pour l’édition de nombreux ouvrages collectifs et l’organisation de diverses rencontres scientifiques. Nous avons donc décidé de lui (...) dédier ce volume d’études intitulé «Florilegium mediaevale». L’ouvrage comprend des études concernant l’un des quatre thèmes suivants: les textes philosophiques dans leur contexte et leur support matériel, les instruments travail ainsi que le vocabulaire des textes philosophiques. En effet, ce sont des domaines qui ont surtout retenu son attention depuis de nombreuses années et dans lesquels elle a apporté des contributions significatives à la recherche. Contributions de: L-J. Bataillon (†) et O. Weijers (Paris / Den Haag), F. Bertelloni (Buenos Aires), Ch. Burnett (London), J. Casteigt (Toulouse), J. Celeyrette et J-L. Solère (Lille / Boston), W. Courtenay (Wisconsin-Madison), G. Dahan (Paris), G. Dinkova-Bruun (Toronto), K. Emery Jr. (Notre Dame), Ch. Erismann (Cambridge), B. Faes de Mottoni (Milano), G. Federici Vescovini (Firenze), B. Fernández de la Cuesta (Madrid), R. Friedman et Ch. Schabel (Leuven / Nicosia), D. Gottschall (Lecce), S. Harvey (Jerusalem), I. Heullant-Donat (Reims), R. Hissette (Köln), M. Hoenen (Freiburg i.B.), J. Meirinhos (Porto), O. Merisalo (Jyväskylä), M. Mulchahey (Toronto), M. J. Muñoz Jiménez (Madrid), M. C. Pacheco (Porto), G. Piaia (Padova), R. H. Pich (Porto Alegre), J. Puig Montada (Madrid), R. Ramón Guerrero (Madrid), C. Sirat et M. Geoffroy (Paris), G. Spinosa (Roma), I. Ventura (Louvain-la-Neuve). (shrink)

Les oeuvres de Gersonide (Levi b. Gershom ou Gerson, Leon de Bagnols, philosophe juif provencal 1288-1344) portent essentiellement sur quatre domaines: les commentaires qu'il a consacres aux commentaires d'Averroes, les questions philosophiques et theologico-philosophiques (livres I a IV, VI des Guerres du Seigneur), les commentaires biblioques et des travaux astronomiques (dont le livre V des Guerres). Dans les trois premiers domaines, la maniere dont il a travaille, l'ordonnancement des idees et leur mise en oeuvre sont ici compares a ceux qui (...) furent utilises par ses contemporains scolastiques. Alors que son activite astronomique a amene Gersonide a la frequentation des savants de la cour du Pape a Avignon, il ne cite, dans les oeuvres etudiees, aucun auteur ni aucun texte latin. La maniere dont Gersonide fait de la philosophie, sa methode d'etude et de resolution des problemes, sa conception de l'exegese biblioque comme science et les procedes adoptes dans les commentaires bibliques le rapprochent cependant du monde latin intellectuel de son temps. Ce sont ces ressemblances, mais aussi les dissemblances, qui sont discutees ici. (shrink)

... Let me start my investigation by taking a brief look at the way in which self-awareness is expressed linguistically, as in the sentences "I am tired" or ...

If one comes to Phénoménologie de la perception after having read Sein und Zeit (or Prolegomena zur Geschichte des Zeitbegriffs) one will be in for a surprise. Both works contain a number of both implicit and explicit references to Husserl, but the presentation they give is so utterly different, that one might occasionally wonder whether they are referring to the same author. Thus nobody can overlook that Merleau-Ponty’s interpretation of Husserl differs significantly from Heidegger’s. It is far more charitable. In (...) fact, when evaluating the merits of respectively Husserl and Heidegger, Merleau-Ponty often goes very much against the standard view. This is not only the case in his notorious remark on the very first page of Phénoménologie de la Perception where he declares that the whole of Sein und Zeit is nothing but an explication of Husserl’s notion of Lifeworld, but also - to give just one further example - in one of his Sorbonne-lectures, where Merleau-Ponty writes that Husserl took the issue of historicity far more seriously than Heidegger. (shrink)

In this entry, I tackle the phenomenon known as "faultless disagreement", considered by many authors to pose a challenge to the main views on the semantics of subjective expressions. I first present the phenomenon and the challenge, then review the main answers given by contextualist, absolutist and relativist approaches to the expressions in question. I end with signaling two issues that might shape future discussions about the role played by faultless disagreement in semantics.

The Oxford Handbook of Contemporary Phenomenology presents twenty-eight essays by some of the leading figures in the field, and gives an authoritative overview of the type of work and range of topics found and discussed in contemporary phenomenology. It is the definitive guide to what is currently going on in phenomenology, and offers a rich source of insight and stimulation for philosophers, students of philosophy, and for people working in other disciplines of the humanities, social sciences, and sciences, who are (...) interested in the state of phenomenology today. The essays explore a diverse range of topics, including intentionality, embodiment, perception, naturalism, temporality, self-consciousness, language, knowledge, ethics, politics, art and religion, and will make it clear that phenomenology, far from being a tradition of the past, is alive and in a position to make valuable contributions to contemporary thought. (shrink)

Many times, what we say proves to be wrong. It might turn out that what we took to be a comforting remark was, in fact, making things worse. Or that a joke was inappropriate. Or that yelling out loud was rude. More importantly for this paper, there are plenty of cases in which what we said turns out to be false: we spoke without paying attention, we were misinformed or tricked, or we made a reasoning mistake. -/- A particular instance (...) of this latter phenomenon is when someone changes their perspective and doesn't find their previous assertions true anymore. For example, imagine that you used to like licorice as a child, and that you went around saying things like "Licorice is tasty." But, growing up, you find licorice too strong and quite boring; your tastes have changed. While the taste of licorice itself has not changed, you are not going around anymore uttering "Licorice is tasty." In fact, in certain cases, you might even think that what you said in your childhood was wrong - at least in light of your present preferences. -/- Sometimes we "take back" the assertions we made when we realize they are no longer true. Such speech acts of taking back can be performed in various ways: more formally, as effected in a court of law or when an official speaks to the press, or more informally in our day-by-day interactions. These acts of taking back are known as retraction. Retraction is usually achieved by employing certain linguistic markers ('I was wrong', 'I was mistaken', 'I retract', "Scratch that' etc.) that signal that the retractor takes their previous speech act to be faulty in a certain way. -/- This phenomenon has formed the basis for a popular argument used by relativists about a variety of natural language expressions (predicates of taste, epistemic modals, moral and aesthetic claims etc.) in support of their view. Recently, several considerations (mostly from contextualists about the same expressions), both from the armchair and based on empirical studies, have been offered to undercut the support retraction was thought to provide for relativism. In this paper, I consider and re-evaluate that support in light of both types of considerations, showing that neither of them decisively undermines it. However, to survive the contextualist counterattack, the relativist needs to pay a price: that is, she will be forced to make some concessions or rethink certain claims. I show what I think those concessions should be and what needs to be rethought (and how). The upshot is that, while the support retraction offers relativism is not as strong as initially believed, appeal to retraction remains a legitimate move in the debate. In section 1, I introduce the views in the debate and clarify the phenomenon of retraction and its dialectical role. Armchair data are investigated in section 2, proper experimental studies in section 3, while section 4 summarizes and concludes. (shrink)

The Oxford Handbook of the History of Phenomenology contains thirty-seven new essays by leading scholars in the field. The essays all highlight historical influences, connections, and developments and provide an in-depth coverage of the development of phenomenology; one that allows for a better comprehension and assessment of the continuity as well as diversity of the phenomenological tradition. The handbook is divided into three distinct parts. The first part contains chapters that address the way phenomenology has been influenced by earlier periods (...) or figures in the history of philosophy. The second part contains chapters targeting prominent phenomenologists: How was their work affected by earlier figures, how did their own views change over time, and what kind of influence did they exert on subsequent thinkers? The contributions in the third part trace various core topics such as subjectivity, intersubjectivity, embodiment, spatiality, and imagination in the work of different phenomenologists, in order to explore how the notions were transformed, enriched, and expanded up through the century. The handbook will be a source of insight for philosophers, students of philosophy, and for people working in other disciplines of the humanities, social sciences, and sciences, who are interested in the phenomenological tradition. It is an authoritative guide to how phenomenology started, how it developed, and where it is heading. (shrink)

The issue of the protection of communities in clinical research first arose 10 years ago in studies conducted in technologically developing countries by scientists from technologically developed nations. The question was, which ethical standards ought to apply, those of the Western investigators or local standards?

Pragmatic comparative effectiveness randomized controlled trials evaluate the effectiveness of one interventions under real-world clinical conditions. The results of ceRCTs are often directly generalizable to everyday clinical practice, providing information critical to decision-making by patients, clinicians, and healthcare policymakers. The PRECIS-2 framework identifies nine domains that serve to score a trial on a continuum between very explanatory to very pragmatic. According to the framework, pragmatic trials may have one or more of the following features: there are fewer eligibility criteria for (...) participants, in an... (shrink)

In this issue of JME, Watson et al call for research evaluation of government health programmes and identify ethical guidance, including the Ottawa Statement on the ethical design and conduct of cluster randomised trials, as a hindrance. While cluster randomised trials of health programmes as a whole should be evaluated by research ethics committees, Watson et al argue that the health programme per se is not within the researcher’s control or responsibility and, thus, is out of scope for ethics review. (...) We argue that this view is wrong. The scope of research ethics review is not defined by researcher control or responsibility, but rather by the protection of research participants. And the randomised evaluation of health programmes impacts the liberty and welfare interests of participants insofar as they may be exposed to a harmful programme or denied access to a beneficial one. Further, Watson et al’s claim that ‘study programmes … would occur whether or not there were any … research activities’ is incorrect in the case of cluster randomised designs. In a cluster randomised trial, the government does not implement a programme as usual. Rather, researchers collaborate with the government to randomise clusters to intervention or control conditions in order to rigorously evaluate the programme. As a result, equipoise issues are triggered that must be addressed by the REC. (shrink)

BackgroundSevere brain injury is a leading cause of death and disability. Diagnosis and prognostication are difficult, and errors occur often. Novel neuroimaging methods can improve diagnostic and prognostic accuracy, especially in patients with prolonged disorders of consciousness (PDoC). Yet it is currently unknown how family caregivers understand this information, raising ethical concerns that disclosure of neuroimaging results could result in therapeutic misconception or false hope.MethodsTo examine these ethical concerns, we conducted semi-structured interviews with caregivers of patients with PDoC who were (...) enrolled in a concurrent neuroimaging research program designed to detect covert consciousness following severe brain injury. Caregivers held surrogate decision-making status for a patient. Interviews were conducted at two time points for each caregiver. The first interview occurred before the disclosure of neuroimaging results. The second occurred after disclosure. Descriptive analysis was applied to the data of four interview topics: (1) expectations for neuroimaging; (2) reactions to evidence of preserved cognition; (3) reactions to null results; and (4) understanding of the results and study.ResultsTwelve caregivers participated in the study; two caregivers shared surrogate decision-making status for one patient with PDoC. Twenty-one interviews were completed; one caregiver declined to participate in the post-disclosure interview. Three patients with PDoC associated with the study displayed evidence of covert consciousness. Overall, caregivers understood the neuroimaging research and results. Caregivers who received results of covert consciousness were generally pleased. However, there was some variation in expectations and reactions to these data and null results.ConclusionThis study, for the first time, reveals caregiver expectations for and reactions to neuroimaging evidence of covert consciousness in patients with PDoC. Caregivers understood the neuroimaging research and results, casting doubt on speculative ethical concerns regarding therapeutic misconception and false hope. However, disclosure of neuroimaging result could be improved. Pre-disclosure consultations might assist professionals in shaping caregiver expectations. Standardization of disclosure might also improve comprehension of the results. (shrink)

BackgroundEarly in the COVID-19 pandemic, the urgent need to discover effective therapies for COVID-19 prompted questions about the ethical problem of randomization along with its widely accepted solution: equipoise. In this scoping review, uses of equipoise in discussions of randomized controlled trials of COVID-19 therapies are evaluated to answer three questions. First, how has equipoise been applied to COVID-19 research? Second, has equipoise been employed accurately? And third, do concerns about equipoise pose a barrier to the ethical conduct of COVID-19 (...) RCTs?MethodsGoogle Scholar and Pubmed were searched for articles containing substantial discussion about equipoise and COVID-19 RCTs. 347 article titles were screened, 91 full text articles were assessed, and 48 articles were included. Uses of equipoise were analyzed and abstracted into seven categories.Results and discussionApproximately two-thirds of articles used equipoise in a way that is consistent with the concept. They invoked equipoise to support RCTs of specific therapies, RCTs in general, and the early termination of RCTs after achieving the primary outcome. Approximately one-third of articles used equipoise in a manner that is inconsistent with the concept. These articles argued that physician preference, widespread use of unproven therapies, patient preference, or expectation of therapeutic benefit may undermine equipoise and render RCTs unethical. In each case, the purported ethical problem can be resolved by correcting the use of equipoise.ConclusionsOur findings highlight the continued relevance of equipoise as it supports the conduct of well-conceived RCTs and provides moral guidance to physicians and researchers as they search for effective therapies for COVID-19. (shrink)

The paper is concerned with the semantics of knowledge attributions(K-claims, for short) and proposes a position holding that K-claims are contextsensitive that differs from extant views on the market. First I lay down the data a semantic theory for K-claims needs to explain. Next I present and assess three views purporting to give the semantics for K-claims: contextualism, subject-sensitive invariantism and relativism. All three views are found wanting with respect to their accounting for the data. I then propose a hybrid (...) view according to which the relevant epistemic standards for evaluating K-claims are neither those at the context of the subject (subject-sensitive invariantism), nor those at the context of the assessor (relativism), but it is itself an open matter. However, given that we need a principled way of deciding which epistemic standards are the relevant ones, I provide a principle according to which the relevant standards are those that are the highest between those at the context of the subject and those at the context of the assessor/attributor. In the end I consider some objections to the view and offer some answers. (shrink)

Wittgenstein, in his famous critique of philosophy, noted that the influence of an idea can be such that it alters the way that we see the world. “It is like a pair of glasses on our nose through which we see whatever we look at,” he said. “It never occurs to us to take them off.” This view of the power of an idea suggests that the interpretation of an event, and what response this event calls for, can depend upon (...) the view one has of the world. A person who is naive about medical facts may, for example, interpret chest pain upon exertion as a sign that he is “overdoing it”; were he more medically knowledgeable, the same symptom might be interpreted as a possible indicator of coronary artery disease. The naive interpretation calls for rest; the informed interpretation calls for medical attention as well. (shrink)

Purposeful infection of healthy volunteers with a microbial pathogen seems at odds with acceptable ethical standards, but is an important contemporary research avenue used to study infectious diseases and their treatments. Generally termed ‘controlled human infection studies’, this research is particularly useful for fast tracking the development of candidate vaccines and may provide unique insight into disease pathogenesis otherwise unavailable. However, scarce bioethical literature is currently available to assist researchers and research ethics committees in negotiating the distinct issues raised by (...) research involving purposefully infecting healthy volunteers. In this article, we present two separate challenge studies and highlight the ethical issues of human challenge studies as seen through a well-constructed framework. Beyond the same stringent ethical standards seen in other areas of medical research, we conclude that human challenge studies should also include: independent expert reviews, including systematic reviews; a publicly available rationale for the research; implementation of measures to protect the public from spread of infection beyond the research setting; and a new system for compensation for harm. We hope these additions may encourage safer and more ethical research practice and help to safeguard public confidence in this vital research alternative in years to come. (shrink)

In this paper, I explore a range of existent and possible ameliorative semantic theories of gender terms: invariantism, according to which gender terms are not context-sensitive, contextualism, according to which the meaning of gender terms is established in the context of use, and relativism, according to which the meaning of gender terms is established in the context of assessment. I show that none of these views is adequate with respect to the plight of trans people to use their term of (...) choice to self-identify and be referred to accordingly. I then consider an invariantist view based on self-identification and explore some of its challenges. (shrink)

Franklin G. Miller and colleagues have stimulated renewed interest in research ethics through their work criticizing clinical equipoise. Over three years and some twenty articles, they have also worked to articulate a positive alternative view on norms governing the conduct of clinical research. Shared presuppositions underlie the positive and critical dimensions of Miller and colleagues' work. However, recognizing that constructive contributions to the field ought to enjoy priority, we presently scrutinize the constructive dimension of their work. We argue that it (...) is wanting in several respects. (shrink)

When people speak, their words never fully encode what they mean, and the context is always compatible with a variety of interpretations. How can comprehension ever be achieved? Wilson and Sperber argue that comprehension is an inference process guided by precise expectations of relevance. What are the relations between the linguistically encoded meanings studied in semantics and the thoughts that humans are capable of entertaining and conveying? How should we analyse literal meaning, approximations, metaphors and ironies? Is the ability to (...) understand speakers' meanings rooted in a more general human ability to understand other minds? How do these abilities interact in evolution and in cognitive development? MEANING AND RELEVANCE sets out to answer these and other questions, enriching and updating relevance theory and exploring its implications for linguistics, philosophy, cognitive science and literary studies. (shrink)