In their paper “Research approvals iceberg: how a ‘low-key’ study in England needed 89 professionals to approve it and how we can do better” Petrova and Barclay highlight concerns with the health research regulatory environment in the UK. As long-standing chairs of NHS research ethics committees, researchers, and also academics in research ethics, we are also often frustrated with the regulatory process in the UK. However, we think that Petrova and Barclay’s analysis is misleading because it conflates research ethics with (...) governance and funding processes, thus failing to adequately distinguish between the national coordinating function of the Health Research Authority, local research governance processes, and interactions with research sponsors and/or the Clinical Research Network. (shrink)

Background In their paper “Research approvals iceberg: how a ‘low-key’ study in England needed 89 professionals to approve it and how we can do better” Petrova and Barclay highlight concerns with the health research regulatory environment in the UK. Discussion As long-standing chairs of NHS research ethics committees, researchers, and also academics in research ethics, we are also often frustrated with the regulatory process in the UK. However, we think that Petrova and Barclay’s analysis is misleading because it conflates research (...) ethics with governance and funding processes, thus failing to adequately distinguish between the national coordinating function of the Health Research Authority, local research governance processes, and interactions with research sponsors and/or the Clinical Research Network. (shrink)

Successful clinical trials are important for all of us, but they can be extremely complicated to design and run, so work must be done to consider what commonly goes wrong and how these issues can be addressed. Gelinas et al suggest an ethical argument for institutional prioritisation of clinical trials conducted among limited populations. This is to ensure successful recruitment and prevent competing trials rendering each other irrelevant through lack of statistical power. But they overlook the fact that effective prioritisation (...) already occurs, and their suggestion produces yet another hurdle for researchers to overcome. Their argument hinges around the claim that allocation of participants to trials represents an inevitable rationing scenario and, like all rationing scenarios, the best methods should be used for objectively determining how limited resources are distributed to achieve the end goal.1 Although they acknowledge that both individuals and clinicians may have preferences as to which trial a patient participates in, trial interventions are by definition experimental, and therefore choosing between trials is not really analogous to choosing between alternative clinical interventions. Here it seems that although clinical instinct is important when determining treatment options, a clinical trial is a specific attempt to create systematic justified knowledge and thus individual patient/clinician autonomy …. (shrink)

Background The review of human participant research by Research Ethics Committees or Institutional Review Boards is a complex multi-faceted process that cannot be reduced to an algorithm. However, this does not give RECs/ IRBs permission to be inconsistent in their specific requirements to researchers or in their final opinions. In England the Health Research Authority coordinates 67 committees, and has adopted a consistency improvement plan including a process called “Shared Ethical Debate” where multiple committees review the same project. Committee reviews (...) are compared for consistency by analysing the resulting minutes. Methods We present a description of the ShED process. We report an analysis of minutes created by research ethics committees participating in two ShED exercises, and compare them to minutes produced in a published “mystery shopper” exercise. We propose a consistency score by defining top themes for each exercise, and calculating the ratio between top themes and total themes identified by each committee for each ShED exercise. Results Our analysis highlights qualitative differences between the ShED 19, ShED 20 and “mystery shopper” exercises. The quantitative measure of consistency showed only one committee across the three exercises with more than half its total themes as top themes. The average consistency scores for the three exercises were 0.23, 0.35 and 0.32. There is a statistically significant difference between the ShED 19 exercise, and the ShED 20 and mystery shopper exercises. Conclusions ShED exercises are effective in identifying inconsistency between ethics committees and we describe a scoring method that could be used to quantify this. However, whilst a level of inconsistency is probably inevitable in research ethics committee reviews, studies must move beyond the ShED methodology to understand why inconsistency occurs, and what an acceptable level of inconsistency might be. (shrink)

The review of human participant research by Research Ethics Committees or Institutional Review Boards is a complex multi-faceted process that cannot be reduced to an algorithm. However, this does not give RECs/ IRBs permission to be inconsistent in their specific requirements to researchers or in their final opinions. In England the Health Research Authority coordinates 67 committees, and has adopted a consistency improvement plan including a process called “Shared Ethical Debate” where multiple committees review the same project. Committee reviews are (...) compared for consistency by analysing the resulting minutes. We present a description of the ShED process. We report an analysis of minutes created by research ethics committees participating in two ShED exercises, and compare them to minutes produced in a published “mystery shopper” exercise. We propose a consistency score by defining top themes for each exercise, and calculating the ratio between top themes and total themes identified by each committee for each ShED exercise. Our analysis highlights qualitative differences between the ShED 19, ShED 20 and “mystery shopper” exercises. The quantitative measure of consistency showed only one committee across the three exercises with more than half its total themes as top themes. The average consistency scores for the three exercises were 0.23, 0.35 and 0.32. There is a statistically significant difference between the ShED 19 exercise, and the ShED 20 and mystery shopper exercises. ShED exercises are effective in identifying inconsistency between ethics committees and we describe a scoring method that could be used to quantify this. However, whilst a level of inconsistency is probably inevitable in research ethics committee reviews, studies must move beyond the ShED methodology to understand why inconsistency occurs, and what an acceptable level of inconsistency might be. (shrink)

We have followed with interest the commentaries arising from Moore and Donnellys1 argument that authorities in charge of research ethics committees should focus primarily on establishing code-consistent reviews.1 We broadly agree with Savulescu’s2 argument that ethics committees should become more expert, but in a different way and for a different reason. We have recently been working with the UK Health Research Authority analysing the outcomes of their ‘Shared Ethical Debate’ exercises.3 Each ShED exercise involves the circulation of a single research (...) project to a number of RECs. The resulting minutes from each REC are compared along with the final decisions made by each REC on the project under consideration. This process was originally an administrative exercise designed to promote greater consistency among the 60 or so ethics committees that were brought under the HRA ) umbrella within the UK National Health Service. Over 20 ShEDs have been run, and although the process has significant weaknesses and has not always been run consistently, the results of the exercises are fascinating. Broadly speaking, NHS RECs have been getting more consistent over time in terms of their decision-making, but the reasons for the final decisions as described in the committee minutes continue to vary widely. Qualitative research now needs to be done to understand why different committees can have such different discussions in relation to exactly the same research project and yet come to essentially the same conclusion. As part of our analysis of the ShED data, we looked at …. (shrink)

BackgroundPublication and outcome reporting bias is often caused by researchers selectively choosing which scientific results and outcomes to publish. This behaviour is ethically significant as it distorts the literature used for future scientific or clinical decision-making. This study investigates the practicalities of using ethics applications submitted to a UK National Health Service research ethics committee to monitor both types of reporting bias.MethodsAs part of an internal audit we accessed research ethics database records for studies submitting an end of study declaration (...) to the Hampshire A research ethics committee between 1st January 2010 and 31st December 2011. A literature search was used to establish the publication status of studies. Primary and secondary outcomes stated in application forms were compared with outcomes reported in publications.ResultsOut of 116 studies the literature search identified 57 publications for 37 studies giving a publication rate of 32 %. Original Research Ethics Committee applications could be obtained for 28 of the published studies. Outcome inconsistencies were found in 16 of the published studies.ConclusionsThis study showed that the problem of publication and outcome reporting bias is still significant in the UK. The method described here demonstrates that UK NHS research ethics committees are in a good position to detect such bias due to their unique access to original research protocols. Data gathered in this way could be used by the Health Research Authority to encourage higher levels of transparency in UK research. (shrink)

Valid consent requires the potential research participant understands the information provided. We examined current practice in 50 proposed Clinical Trials of Investigational Medicinal Products to determine how this understanding is checked. The majority of the proposals ( n = 44) indicated confirmation of understanding would take place during an interactive conversation between the researcher and potential participant, containing questions to assess and establish understanding. Yet up until now, research design and review have not focussed upon this, concentrating more on written (...) material. We propose ways this interactive conversation can be documented, and the process of checking understanding improved. (shrink)

De Marco and colleagues claim that the standard account of invasiveness as commonly encountered ‘…does not capture all uses of the term in relation to medical interventions1 ’. This is open to challenge. Their first example is ‘non-invasive prenatal testing’. Because it involves puncturing the skin to obtain blood, De Marco et al take this as an example of how an incision or insertion is not sufficient to make an intervention invasive; here is a procedure that involves an incision, but (...) it is regarded as non-invasive. However, this ignores the context, and the term should really be understood in reference to the fetus. It is hard to believe healthcare professionals regard taking blood to measure, for example, ferritin levels as invasive but taking blood to look for fragments of fetal DNA as not. If anyone uses the term thinking it is not invasive to the mother, the solution would be to call it invasive, not redefine what is invasive. De Marco and colleagues’ second example is describing electroconvulsive therapy (ECT) as invasive. However, this is not borne out by their referenced papers. The first cited source is about non-invasive brain stimulation2 and only contains a single sentence about ECT. This sentence may suggest that their view is that ECT …. (shrink)

Research consent processes must provide potential participants with the necessary information to help them decide if they wish to join a study. On the Oxford ‘A’ Research Ethics Committee we’ve found that current research proposals mostly provide adequate detail (even if not in an easily comprehensible format), but often fail to support decision making, a view supported by published evidence. In a previous paper, we described how consent might be structured, and here we develop the concept of an Information and (...) Decision Aid (IDA) that can support decision making and be used to guide the dialogue between researcher and potential participant. Our proposal requires limited changes to current processes or paperwork and would provide an easily accessible document for others that the potential participant might approach for advice. It could later be integrated with the Informed Consent Form to ensure all matters of concern to the individual participant have been addressed before consent is formally signed off. (shrink)

BackgroundWe conducted a survey to identify what types of health/medical research could be exempt from research ethics reviews in Australia.MethodsWe surveyed Australian health/medical researchers and Human Research Ethics Committee members. The survey asked whether respondents had previously changed or abandoned a project anticipating difficulties obtaining ethics approval, and presented eight research scenarios, asking whether these scenarios should or should not be exempt from ethics review, and to provide comments. Qualitative data were analysed thematically; quantitative data in R.ResultsWe received 514 responses. (...) Forty-three per cent of respondents to whom the question applied, reported changing projects in anticipation of obstacles from the ethics review process; 25% reported abandoning projects for this reason. Research scenarios asking professional staff to provide views in their area of expertise were most commonly exempted from ethics review ; scenarios involving surplus samples and N-of-1 studies were most commonly required to undergo ethics review. HREC members were 26% more likely than researchers to require ethics review. Need for independent oversight, and low risk, were most frequently cited in support of decisions to require or exempt from ethics review, respectively.ConclusionsConsiderable differences exist between researchers and HREC members, about when to exempt from review the research that ultimately serves the interests of patients and the public. It is widely accepted that evaluative research should be used to reduce clinical uncertainties—the same principle should apply to ethics reviews. (shrink)

This chapter describes how philosophical theorizing about justice can be connected with empirical research in the social sciences. We begin by drawing on some received distinctions between ideal and non-ideal approaches to theorizing justice along several different dimensions, showing how non-ideal approaches are needed to address normative aspects of real-world problems and to provide practical guidance. We argue that there are advantages to a transitional approach to justice focusing on manifest injustices, including the fact that it enables us to set (...) aside some reasonable disagreements about justice. The ‘bottom-up’ approach we advocate, for which we borrow Wolff’s term ‘real-world political philosophy’, is an empirically-informed normative analysis that attends to specific, identifiable injustices, and thus is partial, though not isolationist. We illustrate our approach by considering how different models of the nature of disability suggest different kinds of remedy for injustices faced by persons living with disabilities. We reflect on the nature and significance of vulnerabilities, and we assess the role of public opinion in normative theorizing, suggesting a particular significance for the opinions and experiences of marginalized groups. We finally reflect on the relevance of European legal and institutional frameworks for theorizing justice in Europe. (shrink)

I argue against the claim that there are principled as well as pragmatic reasons for compromise in politics, even within the context of reasonable moral disagreements such as the abortion controversy.

This paper considers the question of whether chimpanzees possess at least a primitive sense of normativity: i.e., some ability to internalize and enforce social norms—rules governing appropriate and inappropriate behaviour—within their social groups, and to make evaluations of others’ behaviour in light of such norms. A number of scientists and philosophers have argued that such a sense of normativity does exist in chimpanzees and in several other non-human primate and mammalian species. However, the dominant view in the scientific and philosophical (...) literature is that psychological capacities for social norms evolved uniquely in the human lineage, after our last common ancestor with chimpanzees and bonobos. After reviewing some of the existing evidence for normative capacity in chimpanzees, I defend the thesis of chimpanzee normativity against three key theoretical objections that have been presented in the literature, each of which have played a part in motivating the dominant sceptical position. I argue that, while we still have much to learn about the nature and extent of the normative capacities of other animals, there is strong prima facie evidence for social norms and normative evaluation in chimpanzees and the main theoretical objections to chimpanzee normativity are not at all compelling. (shrink)

Broad in its geographic scope and yet grounded in original archival research, this book situates the inception of modern aesthetic theory – the philosophical analysis of art and beauty - in theological contexts that are crucial to explaining why it arose. Simon Grote presents seminal aesthetic theories of the German and Scottish Enlightenments as outgrowths of a quintessentially Enlightenment project: the search for a natural 'foundation of morality' and a means of helping naturally self-interested human beings transcend their own (...) self-interest. This conclusion represents an important alternative to the standard history of aesthetics as a series of preludes to the achievements of Immanuel Kant, as well as a reinterpretation of several canonical figures in the German and Scottish Enlightenments. It also offers a foundation for a transnational history of the Enlightenment without the French philosophes at its centre, while solidly endorsing historians' growing reluctance to call the Enlightenment a secularising movement. (shrink)

Governments are often so focused on short-term gains that they ignore the long term, thus creating extra unnecessary burdens on their citizens, and violating their responsibilities to future generations. What can be done about this? In this paper I propose a package of reforms to the ways in which policies are made by legislatures, and in which those policies are scrutinised, implemented and evaluated. The overarching aim is to enhance the accountability of the decision-making process in ways that take into (...) account the interests of persons in the future. (shrink)

John Cook Wilson is an important predecessor of contemporary knowledge first epistemologists: among other parallels, he claimed that knowledge is indefinable. We reconstruct four arguments for this claim discernible in his work, three of which find no clear analogues in contemporary discussions of knowledge first epistemology. We pay special attention to Cook Wilson’s view of the relation between knowledge and forms of thinking (like belief). Claims of Cook Wilson’s that support the indefinability of knowledge include: that knowledge, unlike belief, straddles (...) an active/passive divide; that, rather than entailing belief, knowledge excludes belief; and that understanding forms of thinking other than knowledge (such as belief) depends on understanding knowledge. Reflecting on Cook Wilson’s framework highlights underappreciated concerns relevant to any attempt to define knowledge. (shrink)

Cancer is a singular cellular state, the emergence of which destabilises the homeostasis reached through the evolution to multicellularity. We present the idea that the onset of the cellular disobedience to the metazoan functional and structural architecture, known as the cancer phenotype, is triggered by changes in the cell's external environment that occur with ageing: what ensues is a breach of the social contract of multicellular life characteristic of metazoans. By integrating old ideas with new evidence, we propose that with (...) ageing the environmental information that maintains a multicellular organisation is eroded, rewiring internal processes of the cell, and resulting in an internal shift towards an ancestral condition resulting in the pseudo‐multicellular cancer phenotype. Once that phenotype emerges, a new local social contract is built, different from the homeostatic one, leading to tumour formation and the foundation of a novel local ecosystem. (shrink)

Graham Harman describes the allure of art as the tension and fusion of a real object to sensual qualities so that it makes it seem that the inwardness of reality is opened to us. Yet real objects are withdrawn; how are we aware of their fusion? Since Harman’s ontology mandates that contact between real objects occurs only through sensual objects, this essay explores the idea that art’s allure must be a tension between sensual objects that draw the experiencer to believe, (...) or alieve, they are in contact with the withdrawn real. By looking at the examples in representational painting and sleight of hand magic, we see that ontographic art objects use at least four, carefully separated sensual objects to produce their aesthetic effect. The conclusion summarises allure as a sensual object process, speculates on art’s dialetheic confusion of sensual and real objects giving an enduring allure to idealism, and notes potential motifs of an infra-realist resistance. (shrink)

In recent years, there has been an intense public debate about whether and, if so, to what extent investments in nuclear energy should be part of strategies to mitigate climate change. Here, we address this question from an ethical perspective, evaluating different strategies of energy system development in terms of three ethical criteria, which will differentially appeal to proponents of different normative ethical frameworks. Starting from a standard analysis of climate change as arising from an intergenerational collective action problem, we (...) evaluate whether contributions from nuclear energy will, on expectation, increase the likelihood of successfully phasing out fossil fuels in time to avert dangerous global warming. For many socio-economic and geographic contexts, our review of the energy system modeling literature suggests the answer to this question is “yes.” We conclude that, from the point of view of climate change mitigation, investments in nuclear energy as part of a broader energy portfolio will be ethically required to minimize the risks of decarbonization failure, and thus the tail risks of catastrophic global warming. Finally, using a sensitivity analysis, we consider which other aspects of nuclear energy deployment, apart from climate change, have the potential to overturn the ultimate ethical verdict on investments in nuclear energy. Out of several potential considerations, we suggest that its potential interplay — whether beneficial or adverse — with the proliferation of nuclear weapons is the most plausible candidate. (shrink)

Computational modeling is now ubiquitous in psychology, and researchers who are not modelers may find it increasingly difficult to follow the theoretical developments in their field. This book presents an integrated framework for the development and application of models in psychology and related disciplines. Researchers and students are given the knowledge and tools to interpret models published in their area, as well as to develop, fit, and test their own models. Both the development of models and key features of any (...) model are covered, as are the applications of models in a variety of domains across the behavioural sciences. A number of chapters are devoted to fitting models using maximum likelihood and Bayesian estimation, including fitting hierarchical and mixture models. Model comparison is described as a core philosophy of scientific inference, and the use of models to understand theories and advance scientific discourse is explained. (shrink)

Many environmental scientists, scholars and activists characterise our situation as one of alienation from nature, but this notion can easily seem meaningless or irrational. In this book, Simon Hailwood critically analyses the idea of alienation from nature and argues that it can be a useful notion when understood pluralistically. He distinguishes different senses of alienation from nature pertaining to different environmental contexts and concerns, and draws upon a range of philosophical and environmental ideas and themes including pragmatism, eco-phenomenology, climate (...) change, ecological justice, Marxism and critical theory. His novel perspective shows that different environmental concerns - both anthropocentric and nonanthropocentric - can dovetail, rather than compete with, each other, and that our alienation from nature need not be something to be regretted or overcome. His book will interest a broad readership in environmental philosophy and ethics, political philosophy, geography and environmental studies. (shrink)

According to some, free will requires alternative possibilities. But not any old alternative possibility will do. Sometimes, being able to bring about an alternative does not bestow any control on an agent. In order to bestow control, and so be directly relevant qua alternative to grounding the agent's moral responsibility, alternatives need to be robust. Here, I investigate the nature of robust alternatives. I argue that Derk Pereboom's latest robustness criterion is too strong, and I suggest a different criterion based (...) on the idea that what agents need to be able to do is keep open the possibility of securing their blamelessness, rather than needing to directly ensure their own blamelessness at the time of decision. (shrink)

I argue that mass produced artifacts are ontologically distinctive. If we think of the making of an artifact as the imposition of a creative intention on to some matter, usually through intentional manipulation of the matter, then in the case of mass production, one could say that there is not enough mind to go around! Batches of mass produced objects will have a distinctive essence, lying in the creative act by which they are made, but within a batch, the objects (...) will be distinct from each other, but not essentially distinct. (shrink)

Towards a Posthuman Theory of Educational Relationality critically reads the intersubjective theories on educational relations and uses a posthuman approach to ascribe agency relationally to humans and nonhumans alike. The book introduces the concept of ‘educational relationality’ and contains examples of nonhuman elements of technology and animals, putting educational relationality and other concepts into context as part of the philosophical investigation. Drawing on educational and posthuman theorists, it answers questions raised in ongoing debates regarding the roles of students and teachers (...) in education, such as the foundations of educational relations and how these can be challenged. The book explores educational relations within the field of philosophy of education. After critically examining intersubjective approaches to theories of educational relations, anthropocentrism and subject-centrism are localized as two problematic aspects. Post-anthropocentrism and intra-relationality are proposed as a theoretical framework, before the book introduces and develops a posthuman theory of educational relations. The analysis is executed through a diffractive reading of intersubjective theories, resulting in five co-concepts: impermanence, uniqueness-as-relationality, proximity, edu-activity, and intelligibility. The analysis provided through educational examples demonstrates the potential of using the proposed theory in everyday practices. Towards a Posthuman Theory of Educational Relationality will be of great interest to researchers and postgraduate students in the fields of philosophy of education, early childhood education, research methodology and curriculum studies. (shrink)

Is it possible to approach quantum theory in a 'therapeutic' vein that sees its foundational problems as arising from mistaken conceptual presuppositions? The book explores the prospects for this project and, in doing so, discusses such fascinating issues as the nature of quantum states, explanation in quantum theory, and 'quantum non-locality'.

If the laws of nature are fine-tuned for life, can we infer other universes with different laws? How could we even test such a theory without empirical access to those distant places? Can we believe in the multiverse of the Everett interpretation of quantum theory or in the reality of other possible worlds, as advocated by philosopher David Lewis? At the intersection of physics and philosophy of science, this book outlines the philosophical challenge to theoretical physics in a measured, well-grounded (...) manner. The origin of multiverse theories are explored within the context of the fine-tuning problem and a systematic comparison between the various different multiverse models are included. Cosmologists, high energy physicists, and philosophers including graduate students and researchers will find a systematic exploration of such questions in this important book. (shrink)

Compromise is an inescapable part of human coexistence, from the mundane choices of domestic life to the grand stage of world politics. Notwithstanding its ubiquity, compromise raises a number of philosophical puzzles. One kind of problem is conceptual: what is compromise, and how might it differ from similar social phenomena, such as consensus and bargaining? A second kind of problem concerns the murky ethics of compromise, particularly on matters of moral significance. Compromise may have a salutary role in facilitating cooperation, (...) but it can also involve the sacrifice or betrayal of important values. Can there be moral reasons for genuine moral compromise and, if so, what form might they take? Similarly, are there any limits to moral compromise, or are all moral commitments ultimately subject to negotiation? (shrink)

Dependency is fundamental to caring relationships. However, given that dependency implies asymmetry, it also brings moral problems for nursing. In nursing theory and theories of care, dependency tends to be framed as a problem of self‐determination—a tendency that is mirrored in contemporary policy and practice. This paper argues that this problem frame is too narrow. The aim of the paper is to articulate additional theoretical ‘problem frames’ for dependency and to increase our understanding of how dependency can be navigated in (...) practices of long‐term care. It does so by way of an empirical ethical analysis of how care professionals tackle the problem of dependency in group homes for people with intellectual disabilities. The paper refers to these practices of mitigating the problem of dependency as ‘dependency work’, a phrase borrowed from Eva Kittay. The analysis of dependency work suggests that for care professionals, dependency is a threefold problem: one of self‐determination, one of parity and one of self‐worth. These findings suggest that patient autonomy cannot be a full solution to the problem of dependency in long‐term care relations. But they also show that dependency as such is not a problem that can be solved, as attempts to mitigate it only serve to tighten the dependency relationship further. This is the paradox of dependency work. (shrink)

Multiple states are at risk of becoming uninhabitable due to climate change, forcing their populations to flee. While the 1951 Refugee Convention provides the gold standard of international protection, it is only applied to a limited subset of people fleeing their countries, those who suffer persecution, which most people fleeing climate change cannot establish. While many journalists and non-lawyers freely use the term “climate refugees,” governments, and courts, as well as UNHCR and many refugee experts, have excluded most climate refugees (...) from the Convention as a matter of legal interpretation. In our 2015 paper, “Unable to Return in the 1951 Refugee Convention: Stateless Refugees and Climate Change”, we sought to reopen the debate on “climate refugees” by arguing that some climate refugees qualify under the 1951 Convention as it is currently written (even if they are not persecuted): those who are stateless and are unable to return to their country of origin because climate change has rendered it uninhabitable. Our interpretation, however, has been rejected by Goodwin-Gill and McAdam (2021) and by Foster and Lambert (2019), which explicitly responds to our paper. Here, we address and respond to their arguments, and develop a new supplementary one, drawing on the principle of systemic integration, as enshrined in Article 31(3)(c) of the Vienna Convention on the Law of Treaties. (shrink)

Positive mental health involves not the absence of mental disorder but rather the presence of certain mental goods. Institutions, practitioners, and theorists often identify positive mental health with well‐being. There are strong reasons, however, to keep the concepts of well‐being and positive mental health separate. Someone with high positive mental health can have low well‐being, someone with high well‐being can have low positive mental health, and well‐being and positive mental health sometimes conflict. But, while positive mental health and well‐being are (...) not identical, there is an informative conceptual connection between them. Positive mental health usually contributes instrumentally to the living of a good human life, where a good human life includes (but is not limited to) well‐being. (shrink)

Frankfurt-style cases purport to show that an agent can be morally responsible for an action despite not having any alternatives. Some critics have responded by highlighting various alternatives that remain in the cases presented, while Frankfurtians have objected that such alternatives are typically not capable of grounding responsibility. In this essay I address the recent suggestion by Seth Shabo that only alternatives associated with the ‘up to us’ locution ground moral responsibility. I distinguish a number of kinds of ability, suggest (...) which kinds of abilities ground the truth of the ‘up to us’ locution, and outline how these distinctions apply to the indeterministic buffer cases. (shrink)

John Cook Wilson is increasingly recognised as an important predecessor of ordinary language philosophy. He emphasizes the authority of ordinary language in philosophical theorizing. At the same time, however, he circumscribes the limits of that authority and identifies cases in which it threatens to mislead us. My aim is to consider in detail one case where, according to Cook Wilson, ordinary language has misled philosophical theorizing. Judgement was one of the core notions of the logic, epistemology, and philosophy of mind (...) of Cook Wilson’s time. Cook Wilson rejects this notion, in the form developed by his contemporaries, in part because it is based on a problematic analogy between ordinary language and the thoughts expressed in that language. Cook Wilson’s discussion of judgement also highlights the extent to which Cook Wilson was critical of, but also responsive to, his contemporaries. In addition, variants of the language-thought analogy Cook Wilson opposes continue to feature in 21st century epistemology and philosophy of mind. Cook Wilson’s criticism of the analogy thus raises questions about recent work as well as the theories of his contemporaries. (shrink)

Naess and Sessions “Deep Ecology Platform” provided a loose framework for a movement that was gaining momentum after a series of successful social and political actions and events throughout the 1970s and early 1980s. Most of the points are essentially adopted from Naess’ earlier work, which provided the basis for a number of the core concepts expressed in the later eight points and is largely an expression of a movement that sought to create a shift in consciousness of society towards (...) the natural world. It is probably better understood as a lose framework that encapsulates a world view and perspective of nature which is better understood as an aesthetic movement rather than a moral or ethical movement. (shrink)

Although the therapeutic misconception (TM) has been well described over a period of approximately 20 years, there has been disagreement about its implications for informed consent to research. In this paper we review some of the history and debate over the ethical implications of TM but also bring a new perspective to those debates. Drawing upon our experience of working in the context of translational research for rare childhood diseases such as Duchenne muscular dystrophy, we consider the ethical and legal (...) implications of the TM for parental consent to research. In this situation, it is potentially the parent who is vulnerable to TM. In our analysis we not only consider the context of informed consent for research but also the wider environment in which the value of research is promoted, more broadly through the media but also more specifically through the communication strategies of patient organizations. All dissemination about developments in research for health runs the risk of portraying an overly optimistic view of the promise of biotechnological solutions and has the potential to encourage a ‘collective’ TM. In this paper we consider the challenge that TM presents to parents as well as explore the ethical and legal responsibilities of researchers to ensure an appropriately informed consent: compatible with a hopeful disposition of parents who consent for the their children whilst avoiding a blind and misleading optimism. (shrink)

Medical research saves lives--yet all too often, it is thwarted by a review system supposed to safeguard patients that instead creates needless delays and expense. Institutional Review Boards, which exist at every hospital and medical school that conducts medical research, have ended up imposing such complex, draconian conditions that research is frequently damaged, delayed, and distorted. This is why medical miracles like the COVID-19 vaccines, which were developed at warp speed, are far too rare. Instead, medical research in countless areas (...) is kept at a horse-and-buggy pace. The result: unnecessary suffering and avoidable deaths. From Oversight to Overkill vividly recounts the story behind this crisis, one that remains unknown to the general public. Family physician and ethicist Simon Whitney shows how the IRB system was launched in response to scandals like the notorious Tuskegee syphilis study--and how, in recent decades, this well-intentioned program has become increasingly bureaucratic, convoluted, and stifling. Readers will learn how vital breakthroughs in treating conditions from kidney stones to heart attacks and premature birth have been delayed by IRB red tape, forcing doctors and patients to settle for less-effective treatments. They'll see how ill-informed demands from Congressional leaders that regulators "get tough" on scientists have caused respected research institutions to be shut down-with no benefit to the public. And they'll learn about a balanced, common-sense approach to reforming the system that can free scientists from pointless wheel-spinning while still protecting the public from the risks of unethical or careless experimentation. Until now, the debate about the IRB system's failures has been confined to specialty journals in medicine, law, and ethics. From Oversight to Overkill will finally alert citizens about this little-known crisis with America's medical research system-and what can be done about it. (shrink)