What sets someone on a life trajectory? This question is at the heart of studies of 21st-century neurosciences that build on scientific models developed over the last 150 years that attempt to link psychopathology risk and human development. Historically, this research has documented persistent effects of singular, negative life experiences on people’s subsequent development. More recently, studies have documented neuromolecular effects of early life adversity on life trajectories, resulting in models that frame lives as disproportionately affected by early negative experiences. (...) This view is dominant, despite little evidence of the stability of the presumably early-developed molecular traits and their potential effects on phenotypes. We argue that in the context of gaps in knowledge and the need for scientists to reason across molecular and phenotypic scales, as well as time spans that can extend beyond an individual’s life, specific interpretative frameworks shape the ways in which individual scientific findings are assessed. In the process, scientific reasoning oscillates between understandings of cellular homeostasis and organisms’ homeorhesis, or life trajectory. Biologist and historian François Jacob described this framework as the “attitude” that researchers bring to bear on their “objects” of study. Through an analysis of, first, historical and contemporary scientific literature and then ethnographic research with neuroscientists, we consider how early life trauma came to be associated with specific psychological and neurobiological effects grounded in understandings of life trajectories. We conclude with a consideration of the conceptual, ontological, and ethical implications of interpreting life trajectories as the result of the persistence of long-embodied biological traits, persistent life environments, or both. (shrink)

ArgumentIn this article, we trace shifting narratives of trauma within psychiatric, neuroscience, and environmental epigenetics research. We argue that two contemporary narratives of trauma – each of which concerns questions of time and psychopathology, of the past invading the present – had to be stabilized in order for environmental epigenetics models of suicide risk to be posited. Through an examination of these narratives, we consider how early trauma came to be understood as playing an etiologically significant role in the development (...) of suicide risk. Suicide, in these models, has come to be seen as a behavior that has no significant precipitating event, but rather an exceptional precipitating neurochemical state, whose origins are identified in experiences of early traumatic events. We suggest that this is a part of a broader move within contemporary neurosciences and biopsychiatry to seelife as post: seeing life as specific form of post-traumatic subjectivity. (shrink)

Just over 20 years ago, molecular biologists Leonie Ringrose and Renato Paro published an article with a provocative title, “Remembering Silence”, in BioEssays. The article focused on how epigenetic elements could return to their silent state, operationally defined as their epigenetic status before their modulation by experimental or environmental factors. Though Ringrose and Paro's article was on fruit flies and factors affecting embryological growth, the article asked a question of considerable importance to rapidly expanding research in neuroepigenetics on the correlation (...) between trauma and neuropsychiatric risk: If you experience a traumatic event and, as a result, acquire an epigenetic trait that is considered pathological, can you free yourself of that trait? Ultimately, we are interested in how a return to silence is envisioned in neuroepigenetics research, how interventions purported to bring about that silence might function, and what this might mean for people who live in the aftermath of trauma. (shrink)

Moral latitude is only ever a matter of coincidence on the most popular decision procedure in the literature on moral uncertainty. In all possible choice situations other than those in which two or more options happen to be tied for maximal expected choiceworthiness, Maximize Expected Choiceworthiness implies that only one possible option is uniquely appropriate. A better theory of appropriateness would be more sensitive to the decision maker’s credence in theories that endorse agent-centred prerogatives. In this paper, we will develop (...) and defend a modified version of this view that allows for agent-centred prerogatives and supererogation as part of its verdicts about appropriateness. (shrink)

Why would the work of the 17th century philosopher Benedict de Spinoza concern us today? How can Spinoza shed any light on contemporary thought? In this intriguing book, Moira Gatens and Genevieve Lloyd show us that in spite of or rather because of Spinoza's apparent strangeness, his philosophy can be a rich resource for cultural self-understanding in the present. _Collective Imaginings_ draws on recent re-assessments of the philosophy of Spinoza to develop new ways of conceptualising issues of freedom and (...) difference. This ground-breaking study will be invaluable reading to anyone wishing to gain a fresh perspective on Spinoza's thought. (shrink)

Western philosophy and science are responsible for constructing some powerful tools of investigation, aiming at discovering the truth, delivering robust explanations, verifying conjectures, showing that inferences are sound and demonstrating results conclusively. By contrast reasoning that depends on analogies has often been viewed with suspicion. Professor Lloyd first explores the origins of those Western ideals, criticises some of their excesses and redresses the balance in favour of looser, admittedly non-demonstrative analogical reasoning. For this he takes examples both from ancient (...) Greek and Chinese thought and from the materials of recent ethnography to show how different ancient and modern cultures have developed different styles of reasoning. He also develops two original but controversial ideas, that of semantic stretch and the multidimensionality of reality. (shrink)

The ethics of care has flourished in recent decades yet we remain without a succinct statement of its core theoretical commitment. This book uses the methods of analytic philosophy to argue for a simple care ethical slogan: dependency relationships generate responsibilities. It uses this slogan to unify, specify and justify the wide range of views found within the care ethical literature.

Lara Buchak argues that her version of rank-weighted utilitarianism can accommodate an implication of the separateness of persons known as “the shift,” since it requires individuals to be more willing to accept risk for themselves than to accept inequality in society. I argue that this is mistaken. Buchak’s model fails to yield the shift when the decision-maker is distinct from the affected individual, as well as in certain social decisions where the risk attitude of the group is known. These findings (...) suggest that models which derive social choice rules from individual decision rules will generally fail to uphold separateness. (shrink)

"The book's major parts, one on polarity and the other on analogy, introduce the reader to the patterns of thinking that are fundamental not only to Greek philosophy but also to classical civilization as a whole. As a leading classicist in his own right, Lloyd is an impeccable guide. His sophistication in adducing anthropological parallels to Greek models of polarity and analogy broadens his perspective, making him a forerunner in the study of what we are now used to calling (...) semiotics. A striking example of Lloyd's approach is his re-examination of the dichotomy of Olympian and chthonian gods in ancient Greek world view, which surpasses the reductionist and pseudo-historical models of sky-gods and earth-goddesses that are still commonly invoked to account for polarities in Greek pantheon. "In the second part, dealing with analogy, three crucial metaphorical models for the universe turn out to be basis for a dazzlingly wide variety of scientific and philosophical perspectives. Each model is tested in the whole spectrum of Greek artistic, philosophical and scientific thought. This work is a treasure-house of insights for experts and non experts alike." --Gregory Nagy, Harvard University. (shrink)

I ask why an increasing number of business scholars today are drawn to an idea of “positive business” that they cannot account for scientifically. I answer that it is because they are attracted to the real mystery of positive business which is its incomprehensible and unspeakable divinity. I begin by asking why the research literature has yet to speak of positive business plainly and with one voice. I find that it lacks for the right words because it comes to human (...) being in business as a science attuned to its objects rather than as a religion attuned to its spirit. Next, I say what I can about the real mystery of business, keeping in mind that we can say about it only what we can say about God. This brings me at last to the Christian insight that human being, in business and everywhere else, is the mystery of Jesus Christ in whom we are reconciled to God. Business is positively human as it invites us to be as Christ, to be a fully human person in joyful communion with others in God. This, in sum, is how to speak plainly and with one voice of the positive business that our hearts desire but our science cannot say. (shrink)

The COVID-19 pandemic will likely recede only through development and distribution of an effective vaccine. Although there are many unknowns surrounding COVID-19 vaccine development, vaccine demand will likely outstrip early supply, making prospective planning for vaccine allocation critical for ensuring the ethical distribution of COVID-19 vaccines. Here, we propose three central goals for COVID-19 vaccination campaigns: to reduce morbidity and mortality, to minimise additional economic and societal burdens related to the pandemic and to narrow unjust health inequalities. We evaluate five (...) prioritisation approaches, assess their likely impact on advancing the three goals of vaccine allocation and identify open scientific questions that may alter their outcomes. We argue that no single prioritisation approach will advance all three goals. Instead, we propose a multipronged approach that considers the risk of serious COVID-19 illness, instrumental value and the risk of transmission, and is guided by future research on COVID-19-specific clinical and vaccine characteristics. While we focus this assessment on the USA, our analysis can inform allocation in other contexts. (shrink)

If faraway peoples have different ideas from our own, is this because they have different mentalities? Did our remote ancestors lack logic? The notion of distinct mentalities has been used extensively by historians to describe and explain cultural diversity. Professor Lloyd rejects this psychologising talk of mentalities and proposes an alternative approach, which takes as its starting point the social contexts of communication. Discussing apparently irrational beliefs and behaviour, he shows how different forms of thought coexist in a single (...) culture but within conventionally defined contexts. (shrink)

Dr Lloyd writes for those who want to discover and explore Aristotle's work for themselves. He acts as mediator between Aristotle and the modern reader. The book is divided into two parts. The first tells the story of Aristotle's intellectual development as far as it can be reconstructed; the second presents the fundamentals of his thought in the main fields of inquiry which interested him: logic and metaphysics, physics, psychology, ethics, politics, and literary criticism. The final chapter considers the (...) unity and coherence of Aristotle's philosophy, and records briefly his later influence on European thought. This is a concise and lucid account of the work of a difficult and profound thinker. Dr Lloyd's business is only with the essentials; but he does not shirk the difficulties which arise in their interpretation, nor does he invest Aristotle with a spurious modernity. (shrink)

Black Natural Law offers a new way of understanding the African American political tradition, and it argues that this tradition has collapsed into incoherence. Vincent William Lloyd revives Black politics by telling stories of its central figures in a way that exhibits the connections between their religious, philosophical, and political ideas.

This chapter explores two of the most studied and most damaging aspects of such societal influence on science: racial and gender biases. We discuss two major domains of biological and medical research involving race and gender: cognitive differences research and reproductive health science. In each case, we explore the influence of sexist values like androcentric bias—where researchers focus on men and male bodies as the alleged “norm”—and racist values like white supremacy—where researchers privilege the cultures and attributes of white people (...) as allegedly “superior” to those of people of color. The chapter contends that we must make the culture of research more equitable to make the research itself less biased and more fair for all people. (shrink)

The application of machine learning and artificial intelligence in healthcare domains has received much attention in recent years, yet significant questions remain about how these new tools integrate into frontline user workflow, and how their design will impact implementation. Lack of acceptance among clinicians is a major barrier to the translation of healthcare innovations into clinical practice. In this systematic review, we examine when and how clinicians are consulted about their needs and desires for clinical AI tools. Forty-five articles met (...) criteria for inclusion, of which 24 were considered design studies. The design studies used a variety of methods to solicit and gather user feedback, with interviews, surveys, and user evaluations. Our findings show that tool designers consult clinicians at various but inconsistent points during the design process, and most typically at later stages in the design cycle. We also observed a smaller amount of studies adopting a human-centered approach and where clinician input was solicited throughout the design process. A third of all studies reported on clinician trust in clinical AI algorithms and tools. The surveyed articles did not universally report validation against the “gold standard” of clinical expertise or provide detailed descriptions of the algorithms or computational methods used in their work. To realize the full potential of AI tools within healthcare settings, our review suggests there are opportunities to more thoroughly integrate frontline users’ needs and feedback in the design process. (shrink)

Bodily methodologies that engage with the affective, rhythmic, and temporal dimensions of movement have altered the landscape of social science and humanities research. Walking is one such methodology by which scholars have examined vital, sensory, material, and ephemeral intensities beyond the logics of representation. Extending this rich field, this article invokes the concept trans to reconceptualize walking research through theories that attend to the vitality and agency of matter, the interconnectedness between humans and non-humans, the importance of mediation and bodily (...) affect, and the necessity of acknowledging ethico-political responsibility. While theoretical and empirical research about embodied, emplaced, and sensorial relations between moving bodies and space are well developed in the field of walking studies, their entanglements become profoundly altered by theories of trans – transcorporeality, transspecies, and transmaterialities. Taking up trans theories we experiment in thinking-with a sonic art performance, Walking to the Laundromat, which probes bodily, affective, and gendered labour. (shrink)

This article draws on the conceptualisation of ‘discursive formation’ to examine the particular configuration of the ‘objects, subjects, concepts and strategies’ which constituted ‘nuclear proliferation’ between 2006 and 2012. While previous studies have mostly explored the discourse of nuclear proliferation through the analysis of newspaper texts, few have considered corpora from different sites or considered the changes, transformations and contradictions that take place when meanings are delocated from one site and relocated in another. Elements of poststructuralist discourse theory, critical linguistics (...) and corpus linguistics are brought together to consider how events were constructed within two corpora: UN Security Council resolutions and newspaper articles published in prominent UK and US broadsheets. WordSmith Tools was used to analyse word frequencies, statistical patterns of keywords, word collocation profiles and concordance patterns. Results indicate that the most salient lexical items refer to actors, strategic actions and technologies. As these constituents of nuclear proliferation are delocated from the political sphere and relocated in the public sphere, three discursive strategies unfold: personalisation, normalisation or exceptionalisation, and reification. (shrink)

Scientific modelling is a value-laden process: the decisions involved can seldom be made using 'scientific' criteria alone, but rather draw on social and ethical values. In this paper, we draw on a body of philosophical literature to analyze a COVID-19 vaccination model, presenting a case study of social and ethical value judgments in health-oriented modelling. This case study urges us to make value judgments in health-oriented models explicit and interpretable by non-experts and to invite public involvement in making them.

G. E. R. Lloyd explores the amazing diversity of views that humans have held on being, humanity, and understanding. In a cross-cultural study that ranges from ancient to modern times, he asks how far we are bound by the conceptual systems to which we belong, and explores topics such as ontology, morality, philosophy of language, and communication.

In order for states to fulfil (many of) their moral obligations, costs must be passed to individuals. This paper asks how these costs should be distributed. I advocate the common-sense answer: the distribution of costs should, insofar as possible, track the reasons behind the state’s duty. This answer faces a number of problems, which I attempt to solve.

This article demonstrates how researchers from both the sciences and the humanities can learn from Charles Darwin’s mixed methodology. We identify two basic challenges that face emotion research in the sciences, namely a mismatch between experiment design and the complexity of life that we aim to explain, and problematic efforts to bridge the gap, including invalid inferences from constrained study designs, and equivocal use of terms like “sympathy” and “empathy” that poorly reflect such methodological constraints. We argue that Darwin’s mixed (...) methodology is a model for addressing these challenges even in laboratory work on emotion, because it shows how close observation of emotional phenomena makes sense only within broader historical contexts. The article concludes with 5 practical research recommendations. (shrink)

When engaging in community-based research, it is important to consider ethical research practices throughout the project. While current research practices require many investigators to obtain approval from an ethics review board before starting a project, more is required to ensure that ethical principles are applied once the investigations begin and after the investigations are complete. In response to this concern, as expressed by workers at a feminist non-profit during a community placement, we developed a tool to foster both greater ethical (...) and feminist research practice in community-based research. Using feminist theories, methodologies, and concepts such as epistemic justice, epistemic trust, and coauthorship, a tool was developed to support researchers and other collaborators in building relationships of reciprocity. This tool, called the Research Responsibility Agreement (RRA) invites all members of a research project to explicitly reflect on their role in the research, their relationships with other collaborators, their responsibility to contributing meaningfully in the project, and their plans to remain accountable to one another. In doing so, the RRA adds to existing tools that support ethical research by sharing explicit reflections from all collaborators on how to prevent harm and by asking them to reflect on ethical practices beyond the initial stages of the project. The RRA also encourages greater engagement from researchers and collaborators toward building meaningful relationships with each other, and with participants, to work together in advancing social change. As a practical tool that promotes reflection, that builds relationships, and that holds all parties accountable to ethical and feminist research practices, the RRA has the potential to generate impactful change in community-based research projects and beyond. While the RRA is tailored to community-based research, it can be applied widely to any research project and has the potential to revolutionize how research relationships are built across disciplines. (shrink)

Leibniz Reinterpreted tackles head on the central idea in Leibniz's philosophy, namely that we live in the best of all possible worlds. Strickland argues that Leibniz's theory has been consistently misunderstood by previous commentators. In the process Strickland provides both an elucidation and reinterpretation of a number of concepts central to Leibniz's work, such as 'richness', 'simplicity', 'harmony' and 'incompossibility', and shows where previous attempts to explain these concepts have failed. This clear and concise study is tightly focussed and assumes (...) no prior acquaintance with Leibniz or optimism. It thus serves as an ideal entry point into Leibniz's philosophy. (shrink)

Long before science as we know it existed, sophisticated studies of the physical world were undertaken-in Mesopotamia, India, China, and Greece. G. E. R. Lloyd explores the methods, subject-matter, and aims of those studies. He illuminates the origins of human intellectual inquiry, finding similarities and differences across cultures.

Le projet à l’origine de ce dossier thématique est celui d’une étude comparative de l’expérimentation telle qu’elle apparaît dans les sciences de la nature et dans les sciences humaines et sociales. Il illustre et prolonge les réflexions d’un séminaire de recherche sur le même sujet, organisé par Catherine Allamel-Raffin, qui s’est tenu pendant deux ans (2017-2018) à l’université de Strasbourg grâce à un financement de la Misha (Maison Interuniversitaire des Sciences de l’Homme – Alsace). Les...

This book brings together important essays by one of the leading philosophers of science at work today. Elisabeth A. Lloyd examines several of the central topics in philosophy of biology, including the structure of evolutionary theory, units of selection, and evolutionary psychology, as well as the Science Wars, feminism and science, and sexuality and objectivity. Lloyd challenges the current evolutionary accounts of the female orgasm and analyses them for bias. She also offers an innovative analysis of the concept (...) of objectivity. Lloyd analyses the structure of evolutionary theory and unlocks the puzzle of the units of selection debates into four distinct aspects, illuminating several mysteries in the biology literature. Central to all essays in this book is the author's abiding concern for evidence and empirical data. (shrink)

Mula sa iisang lahi ang Pilipinas at Malaysia sang-ayon sa pag-aaral na may kinalaman sa paksaing Austronesyo. May mahabang kasaysayan ng ugnayan ang dalawang bansang ito, di lámang sa ekonomikong aspekto, kundi lalo’t higit sa kultural na batayan, at isa na rito ang paggamit ng mga simbolo sa pagbabatik/pagtatatu na nakaugat pa sa relihiyon ng pag-aanito sa mundong Austronesyo. Bagamat naging parehong kolonya ang dalawang bansa ng mga Kanluranin na nagpalawak di lámang ng kapangyarihan kundi maging ng merkado, hindi tuluyang (...) naalis/nakalimutan ang kalinangang nakaugat sa mga bansang ito. Sa kasalukuyan, nagpapatúloy pa rin ang iláng tradisyonal na pang-araw-araw na búhay ng ilang bahagi ng mga bansang ito gaya ng pagbabatik. Nariyan pa rin ang pagpupukpok o tapping process sa pagbabatik na sa kasalukuyan ay dinarayo pa sa kabundukan ng Cordillera ng mga tagasiyudad upang makapagpatatu kay Whang Od. Gayundin, mayroon pa ring kahalintulad na ganitong paraan ng pagbabatik sa Malaysia, sa kaso halimbawa ng mga Iban, Kayan at Dayak. Hindi kataka-taka sa kasalukuyan na kahit nariyan pa rin ang tradisyonal na paraan ng pagbabatik, naghahalinhinan ang tradisyonal at modernong pagbabatik sa mga bansang ito na ang pinakanag-uugnay ay ang mga simbolismong nakaugat sa kanilang malalim na kasaysayan. (shrink)

Background: Recent changes to regulatory guidance in the US and Europe have complicated oversight of secondary research by rendering most uses of de-identified data exempt from human subjects oversight. To identify the implications of such guidelines for harms to participants and communities, this paper explores the secondary uses of one de-identified DNA sample collection with limited oversight: the Human Genome Diversity Project (HGDP)-Centre d'Etude du Polymorphisme Humain, Fondation Jean Dausset (CEPH) Human Genome Diversity Panel. Methods: Using a combination of keyword (...) and cited reference search, we identified English-language scientific articles published between 2002 and 2009 that reported analysis of HGDP Diversity Panel samples and/or data. We then reviewed each article to identify the specific research use to which the samples and/or data was applied. Secondary uses were categorized according to the type and kind of research supported by the collection. Results: A wide variety of secondary uses were identified from 148 peer-reviewed articles. While the vast majority of these uses were consistent with the original intent of the collection, a minority of published reports described research whose primary findings could be regarded as controversial, objectionable, or potentially stigmatizing in their interpretation. Conclusions: We conclude that potential risks to participants and communities cannot be wholly eliminated by anonymization of individual data and suggest that explicit review of proposed secondary uses, by a Data Access Committee or similar internal oversight body with suitable stakeholder representation, should be a required component of the trustworthy governance of any repository of data or specimens. (shrink)

Our primal ability to see one thing in terms of another shapes our landscape perception. Although modes of appreciation are tied to personal interests and situations, there are many lines of conflict and incompatibility between these modes. A religious point of view is unacceptable to those without religious beliefs. Background knowledge is similarly required for taking an arts or science-based view of landscape, although this knowledge can be acquired. How to cultivate responses grounded in imagination, emotion, and instinct is less (...) clear, but advocates are eager to spell out notions of virtuous exercise and effective schooling. Carlson’s science-based theory often gets the most attention because he has refined and defended it over many years, but there is a place in aesthetic nature appreciation for the formal or design elements he dismisses as well as for religious, imaginative, emotional, and ambient responses. To date, the normative aspects of these theories have been presented sketchily at best. Working out these details will chart a way for landscape appreciation to become politically correct. (shrink)

Jean Pierre-Vernant and Pierre Vidal-Naquet are leaders in a contemporary French classical scholarship that has produced a a stunning reconfiguration of Greek thought and literature. In this work, published here as a single volume, the authors present a disturbing and decidedly non-classical reading of Greek tragedy that insists on its radical discontinuity with our own outlook and with our social, aesthetic, and psychological categories. Originally published in French in two volumes, this new single-volume edition includes revised essays from volume one (...) and is the first English translation of both volumes.Pierre Vidal-Naquet is Director of Studies and Professor of Sociology at the Ecole Pratique des Hautes Etudes in Paris. Jean Pierre-Vernant is Professor Emeritus of Comparative Study of Ancient Religions at the Collège de France. Janet Lloyd is a translator and writer living in England. Distributed for Zone Books. (shrink)

Jean Pierre-Vernant and Pierre Vidal-Naquet are leaders in a contemporary French classical scholarship that has produced a a stunning reconfiguration of Greek thought and literature. In this work, published here as a single volume, the authors present a disturbing and decidedly non-classical reading of Greek tragedy that insists on its radical discontinuity with our own outlook and with our social, aesthetic, and psychological categories. Originally published in French in two volumes, this new single-volume edition includes revised essays from volume one (...) and is the first English translation of both volumes.Pierre Vidal-Naquet is Director of Studies and Professor of Sociology at the Ecole Pratique des Hautes Etudes in Paris. Jean Pierre-Vernant is Professor Emeritus of Comparative Study of Ancient Religions at the Collège de France. Janet Lloyd is a translator and writer living in England. Distributed for Zone Books. (shrink)

This book tackles the concerns of stressed teachers. Whether from nurturance suffering or from the piles of paperwork yet to be tackled, the author helps the reader sort through the causes of stress, the emotional, physical and social reactions to stress and how one can begin to plan a stress management plan.

Last year the Department of the Environment, Food and Rural Affairs (DEFRA) released a new set of revised guidelines upon environmental reporting practices for U.K companies. Two industrial sectors were selected – the Water industry and the Energy industry – and the most recent Environmental Reports produced by companies in these sectors were subjected to content analysis where the coding framework was heavily based on the DEFRA guidelines. Results are reported for the two industries separately and the two industries are (...) also compared. Whilst sectoral differences were found it was clear that many companies addressed most of the issues raised in the guidelines. However, others did not. Whilst no conclusions can be made about the quality of reporting the main areas of emphasis in each sector can be determined. (shrink)

Geoffrey Lloyd engages in a wide-ranging exploration of what we can learn from the study of ancient civilisations that is relevant to fundamental problems, both intellectual and moral, that we still face today. How far is it possible to arrive at an understanding of alien systems of belief? Is it possible to talk meaningfully of 'science' and of its various constituent disciplines, 'astronomy', 'geography', 'anatomy', and so on, in the ancient world? Are logic and its laws universal? Is there (...) one ontology - a single world - to which all attempts at understanding must be considered to be directed? When we encounter apparently very different views of reality, how far can that be put down to a difference in conceptions of what needs explaining, or of what counts as an explanation, or to different preferred modes of reasoning or styles of inquiry? Do the notions of truth and belief represent reliable cross-cultural universals? In another area, what can ancient history teach us about today's social and political problems? Are the discourses of human nature and of human rights universally applicable? What political institutions do we need to help secure equity and justice within nation states and between them? Lloyd sets out to answer all these questions, and to convince us that the science and culture of ancient Greece and China provide precious resources to advance modern debates. (shrink)

We very much appreciate the helpful and generous commentaries in response to “Do Clinicians have a Duty to Participate in Pragmatic Clinical Trials?” (Garland, Morain, and Sugarman 2023). In that a...