Moving forward rapidly in the clinical research phase, uterus transplantation may be a future treatment option for women with uterine factor infertility, which accounts for three per cent of all infertility in women. This new method of treatment would allow women, who currently rely on gestational surrogacy or adoption, to gestate and birth their own genetic offspring. Since uterus transplantation carries significant risk when compared with surrogacy and adoption as well as when compared with other organ transplants, it requires greater (...) justification because its goals are quality of life, not life-saving, in their scope. It is important to address questions regarding the physical, psychosocial and ethical risks and benefits of uterus transplantation for all three parties involved—the patient, the donor and the potential child—as well as discuss the regulatory implications as research on uterus transplantations moves forward. (shrink)

The first baby has successfully been born by uterus transplantation (UTx) in the United States and the procedure is swiftly becoming a viable clinical option for patients with uterine factor infertility (UFI). This raises a practical ethical question: should health insurers finance UTx and what issues should they consider in coming to this decision? The article lays forth some of the factors that shape the decision over whether to finance UTx in the United States, including what procedures must be covered, (...) whether UTx is more like organ transplantation or infertility treatment (which are treated differently in the United States), and the benefits and alternatives of the procedure. Then, the article explores arguments around why UTx should be financed, or at least considered along with other important medical needs. The paper argues that UTx ought to be considered along with other competing claims for healthcare services. In countries that generously cover other infertility services, it may logically follow that medical services that enable gestation should be insured when the healthcare system covers services to conceive. In the United States, however, many groups have long suffered inadequate access to medical care, in the context of infertility and more broadly. U.S. healthcare may need to be made more widely equitable, before covering UTx is seen as financially or politically possible. (shrink)

Federal law often avoids setting minimum standards for women’s health and reproductive rights issues, leaving legislative and regulatory gaps for the states to fill as they see fit. This has mixed results. It can lead to state innovation that improves state-level health outcomes, informs federal health reform, and provides data on best practices for other states. On the other hand, some states may use the absence of a federal floor to impose draconian policies that pose risks to women’s and maternal (...) health. Health reforms at the federal level must trod carefully to enable state innovation, while imposing foundational safeguards for promoting women’s health nationwide. (shrink)

As practicing clinicians, physicians are expected to uphold the ethical norms of their profession, including fidelity to patients and respect for patients’ self-determination. At the same time, as individuals, physicians are moral agents in their own right and, like their patients, are informed by and committed to diverse cultural, religious, and philosophical traditions and beliefs. In some circumstances, the expectation that physicians will put patients’ needs and preferences first may be in tension with the need to sustain the sense of (...) moral integrity and continuity that grounds a physician’s personal and professional life. This article examines the implications for patients, physicians, and the medical profession when tensions arise between a physician’s professional commitments and his or her deeply held personal moral beliefs. It offers guidance on when a physician’s professional commitments should outweigh personal beliefs as well as when physicians should have freedom to act according to the dictates of conscience while still protecting patients’ interests. (shrink)

The International Conference on Harmonization of Technical Requirements for Registration of Pharmaceuticals for Human Use (ICH) was formed over 20 years ago with a goal of harmonizing research regulations among the European Union, United States, and Japan. Harmonization was intended to speed approval of pharmaceuticals, avoid unnecessary repetition of studies, and ensure protection of research participants. This paper examines United States, European Union, and ICH pediatric research regulations in five domains: parental permission, assent/dissent, payment, risk/benefit and inclusion of disabled children/wards (...) of state. The purpose is to examine similarities and differences among the regulations to help investigators, policy makers and the public to understand what each regulatory framework can learn from the others. Additionally, the paper suggests philosophical differences in how these entities view pediatric research which may serve as barriers to harmonization in the future. (shrink)

The Food and Drug Administration and the European Medicines Agency have launched a recent initiative to enhance collaboration in research, with the intent to “ensure that clinical trials submitted in drug marketing applications in the United States and European Union are conducted uniformly, appropriately, and ethically.” This initiative recalls efforts from two decades ago when the United States, the European Union and Japan formed the International Conference on Harmonization of Technical Requirements for Registration of Pharmaceuticals for Human Use as a (...) mechanism for harmonizing clinical research regulations. The intent of harmonization was to improve patients’ “access to new drugs, to prevent unnecessary global development delays and to avoid animal and human study duplications” through policy reconciliation.FDA/EMA efforts at collaboration call for a reassessment of past harmonization efforts: to what extent are ICH member policies already synchronized and to what extent can they be harmonized in the future? This paper will focus on these questions through the lens of pediatric investigation. (shrink)

Oocyte donation raises conflicts of interest and commitment for physicians but little attention has been paid to how to reduce these conflicts in practice. Yet the growing popularity of assisted reproduction has increased the stakes of maintaining an adequate oocyte supply and minimizing conflicts. A growing body of professional guidelines, legal challenges to professional self-regulation, and empirical research on the practice of oocyte donation all call for renewed attention to the issue. As empirical findings better inform existing conflicts and their (...) potential harms, we can better attempt to reduce these conflicts. To that end, the article first describes the nature of conflicts in oocyte donation and relevant regulations and professional guidelines. We then describe studies on conflicts at four phases of oocyte donation: recruitment, screening, stimulation, and post-stimulation monitoring. Next we consider three models for conflict reduction in medicine generally: improved professional self-regulation, outright restriction like Stark anti-referral laws, or the use of conflict mediators, like in living organ donation. We ultimately conclude that improved professional self-regulation is a reasonable starting place for oocyte donation. (shrink)

This commentary proposes the need for greater normative debate about when, if ever, it is appropriate for insurers to access genetic information of insureds to combat anti-selection.

The epistemic value of seemings is increasingly debated. Such debates are hindered, however, by a lack of consensus about the nature of seemings. There are four prominent conceptions in the literature, and the plausibility of principles such as phenomenal conservatism, which assign a prominent epistemic role to seemings, varies greatly from one conception to another. It is therefore crucial that we identify the correct conception of seemings. I argue that seemings are best understood as sui generis mental states with propositional (...) content and a distinct phenomenal character. Rival conceptions are shown to succumb to numerous difficulties. (shrink)

Does rationality require us to take the means to our ends? Intuitively, it seems clear that it does. And yet it has proven difficult to explain why this should be so: after all, if one is pursuing an end that one has decisive reason not to pursue, the balance of reasons will presumably speak against one's taking the means necessary to bring that end about. In this paper I propose a novel account of the instrumental requirement which addresses this problem. (...) On the view I develop, the instrumental requirement is normative not because agents have reasons to comply with it, but because it is anormative standardintrinsic to intentional action—i.e., it is a standard that partly spells out what it is to exercise one's agency well. (shrink)

According to the so-called ‘Taking Condition’ (a label due to Boghossian 2014) on inference, for a response R in circumstances C to count as an instance of reasoning or inferring, it must be the case that the agent’s taking it that R is warranted or justified in C plays (the right sort of) explanatory role in her R-ing. The Taking Condition has come under much criticism in the theory of reasoning. While I believe that these criticisms can be answered, my (...) aim in this paper is to build a positive case for the Taking Condition. More specifically, I argue that views based on the Taking Condition do a much better job accounting for crucial features of reasoning—especially once we recognize the pervasiveness and significance of defeasibility in our reasoning. (shrink)

"Divided chronologically into four volumes, The Philosophy of Knowledge: A History presents the history of one of Western philosophy's greatest challenges: understanding the nature of knowledge. Each volume follows conceptions of knowledge that have been proposed, defended, replaced, and proposed anew. Knowledge in Contemporary Philosophy covers discussions about scientific knowledge, social knowledge, and self-knowledge, along with attempts to understand knowledge naturalistically, contextually, and normatively. How did contemporary epistemology begin? What shape is it now in? What future seems to await it? (...) The past hundred or so years have included excitement, puzzlement, and apparent progress within epistemology. This volume conveys much of that philosophical ferment and energy."--Bloomsbury Publishing. (shrink)

It is widely believed that Perelman and Olbrechts-Tyteca’s theory of argumentation is vulnerable to the charge of relativism. This paper provides a more charitable interpretation of Perelman and Olbrechts-Tyteca’s normative views, one that properly considers the historical trajectory of their work and a wider range of texts than existing interpretations. It is argued that their views are better characterized as a form of “contrastivism about arguments” than any kind relativism. This more accurate depiction contributes to ongoing efforts to revive interest (...) in Perelman and Olbrechts-Tyteca’s work as well as build bridges with trends in contemporary argumentation theory. (shrink)

Alexander Campbell once declared “a solemn league and covenant” between philosophy and common sense. Campbell’s pronouncement is representative of a broader trend in the Restorationist movement to look favorably on the common sense response to skepticism—a response originating in the work of Scottish philosopher and former minister Thomas Reid. I recount the tumultuous history between philosophy and common sense followed by the efforts of Campbell and Reid to reunite them. Turning to the present, I argue that an epistemic principle known (...) as phenomenal conservatism best embodies the core insights contained within Reid and Campbell's common sense response to skepticism. I finish by arguing for phenomenal conservatism. (shrink)

Our goal in this article is to provide research-based strategies for embedding Nature of Science into science instruction at the elementary level. We thus intend to aid researchers, professional developers, and teachers in noting that not only is it important and possible to teach NOS at the elementary levels, but also that elementary students can learn ideas about NOS. The manuscript reviews research from the past two decades on what students of ages 5 to 12 understand about NOS after appropriate (...) instruction. Research-based teaching strategies are then shared to provide methods for researchers, professional developers, and teachers to improve students’ NOS understandings. These strategies include embedding NOS into existing curricula, using classroom interactions, using visual representations, and using students’ written work. (shrink)

Science lessons using inquiry only or history of science with inquiry were used for explicit reflective nature of science instruction for second-, third-, and fourth-grade students randomly assigned to receive one of the treatments. Students in both groups improved in their understanding of creative NOS, tentative NOS, empirical NOS, and subjective NOS as measured using VNOS-D as pre- and post-test surveys. Social and cultural context of science was not accessible for the students. Students in second, third, and fourth grades were (...) able to attain adequate views of empirical NOS, the role of observation and inference, creative and imaginative NOS, and subjective NOS. Students were not able to express adequate views of socially and culturally embedded NOS. Most gains in NOS eroded by the next school year, except for tentative NOS for both groups and creative NOS for the inquiry group. (shrink)

The problem of evil is broadly considered to be one of the greatest intellectual threats to traditional brands of theism. And William Rowe’s 1979 formulation of the problem in “The Problem of Evil and Some Varieties of Atheism” is the most cited formulation in the contemporary philosophical literature. In this paper, we explore how the tools and resources of experimental philosophy might be brought to bear on Rowe’s seminal formulation, arguing that our empirical findings raise significant questions regarding the ultimate (...) success of Rowe’s argument. Such a result would be quite notable within philosophy of religion, since this is considered one of the most formidable arguments against theism. However, further testing is needed before any firm conclusions can be drawn. -/- In section 1, we elucidate Rowe’s formulation of the problem of evil and the intuitions that seem to underwrite it. In section 2, we explore how the tools and resources of experimental philosophy might be brought to bear on Rowe’s formulation, outlining our hypotheses and our methods for testing them before showcasing our results. In section 3, we discuss the philosophical import of our results–arguing that our results, when taken together, pose an initial challenge to Rowe’s seminal argument. (shrink)

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Whether evil provides evidence against the existence of God, and to what degree, depends on how things seem to the subject—i.e., on one’s perspective. I explain three ways in which adopting an atheistic perspective can increase support for atheism via considerations of evil. The first is by intensifying the common sense problem of evil by making evil seem gratuitous or intrinsically wrong to allow. The second is by diminishing the apparent fit between theism and our observations of evil. The third (...) is by lowering the initial plausibility of theism. I call this “the perspectival problem of evil” and argue that skeptical theism does not fully address it. (shrink)

The philosophical literature on reasoning is dominated by the assumption that reasoning is essentially a matter of following rules. This paper challenges this view, by arguing that it misrepresents the nature of reasoning as a personal level activity. Reasoning must reflect the reasoner’s take on her evidence. The rule-following model seems ill-suited to accommodate this fact. Accordingly, this paper suggests replacing the rule-following model with a different, semantic approach to reasoning.

The use of autonomous weaponry in warfare has increased substantially over the last twenty years and shows no sign of slowing. Our chapter raises a novel objection to the implementation of autonomous weapons, namely, that they eliminate moral cost-sharing. To grasp the basics of our argument, consider the case of uninhabited aerial vehicles that act autonomously (i.e., LAWS). Imagine that a LAWS terminates a military target and that five civilians die as a side effect of the LAWS bombing. Because LAWS (...) lacks moral agency, and in particular the capacity for moral emotions, moral cost-sharing is limited to dead civilians and their loved ones. We argue that's unjust insofar as those responsible for unjust harm to others ought to share in those costs. Our worry expands to other strategic uses of AI, e.g., cyber warfare. This presents a dilemma: Either we design autonomous weaponry capable of moral emotions, or we limit the use of autonomous weaponry. The former undermines the risk-mitigation purpose of creating autonomous weaponry and expands the number of sentient individuals whose welfare is risked in war. The latter risks worsening combatant casualties and achieving strategic aims. (shrink)

Regress arguments have convinced many that reasoning cannot require beliefs about what follows from what. In this paper I argue that this is a mistake. Regress arguments rest on dubious (although deeply entrenched) assumptions about the nature of reasoning — most prominently, the assumption that believing p by reasoning is simply a matter of having a belief in p with the right causal ancestry. I propose an alternative account, according to which beliefs about what follows from what play a constitutive (...) role in reasoning. (shrink)

Doxastic involuntarists have paid insufficient attention to two debates in contemporary epistemology: the permissivism debate and the debate over norms of assertion and belief. In combination, these debates highlight a conception of belief on which, if you find yourself in what I will call an ‘equipollent case’ with respect to some proposition p, there will be no reason why you can’t believe p at will. While doxastic involuntarism is virtually epistemological orthodoxy, nothing in the entire stock of objections to belief (...) at will blocks this route to doxastic voluntarism. Against the backdrop of the permissivism debate and the literature on norms of belief and assertion, doxastic involuntarism emerges as an article of faith, not the obvious truth it’s usually purported to be. (shrink)

Deep moral disagreements exist between Christians and non-Christians. I argue that Christians should resist the temptation to pin all such disagreements on the irrationality of their disputants. To this end, I develop an epistemological framework on which both parties can be rational—the key being that their beliefs are formed from different perspectives and, hence, on the basis of different sets of evidence. I then alleviate concerns that such moral perspectivalism leads to relativism or skepticism, or that it prohibits rational discourse. (...) I end by exploring new avenues for resolving deep moral disagreements opened up by the perspectivalist approach. (shrink)

Does knowledge depend in any interesting way on our practical interests? This is the central question in the pragmatic encroachment debate. Pragmatists defend the affirmative answer to this question while purists defend the negative answer. The literature contains two kinds of arguments for pragmatism: principle-based arguments and case-based arguments. Principle-based arguments derive pragmatism from principles that connect knowledge to practical interests. Case-based arguments rely on intuitions about cases that differ with respect to practical interests. I argue that there are insurmountable (...) problems for both kinds of arguments, and that it is therefore unclear what motivates pragmatism. (shrink)

In an intriguing but neglected passage in the Transcendental Deduction, Kant appears to link the synthetic activity of the understanding in experience with the phenomenon of attention (B156-7n). In this paper, we take up this hint, and draw upon Kant's remarks about attention in the Anthropology to shed light on the vexed question of what, exactly, the understanding's role in experience is for Kant. We argue that reading Kant's claims about synthesis in this light allows us to combine two aspects (...) of Kant's views that many commentators have thought are in tension with one another: on the one hand, Kant's apparent commitment to naïve realism about perception and, on the other, his apparent commitment to the necessity of synthetic activity by the understanding for any kind of cognitive contact with external objects. (shrink)

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Alvin Plantinga theorizes the existence of a sensus divinitatis – a special cognitive faulty or mechanism dedicated to the production and non-inferential justification of theistic belief. Following Chris Tucker, we offer an evidentialist-friendly model of the sensus divinitatis whereon it produces theistic seemings that non-inferentially justify theistic belief. We suggest that the sensus divinitatis produces these seemings by tacitly grasping support relations between the content of ordinary experiences (in conjunction with our background evidence) and propositions about God. Our model offers (...) advantages such as eliminating the need for a sui generis religious faculty, harmonizing the sensus divinitatis with prominent theories in the cognitive science of religion, and providing a superior account of natural revelation. (shrink)

According to what I will call ‘the disanalogy thesis,’ beliefs differ from actions in at least the following important way: while cognitively healthy people often exhibit direct control over their actions, there is no possible scenario where a cognitively healthy person exhibits direct control over her beliefs. Recent arguments against the disanalogy thesis maintain that, if you find yourself in what I will call a ‘permissive situation’ with respect to p, then you can have direct control over whether you believe (...) p, and you can do so without manifesting any cognitive defect. These arguments focus primarily on the idea that we can have direct doxastic control in permissive situations, but they provide insufficient reason for thinking that permissive situations are actually possible, since they pay inadequate attention to the following worries: permissive situations seem inconsistent with the uniqueness thesis, permissive situations seem inconsistent with natural thoughts about epistemic akrasia, and vagueness threatens even if we push these worries aside. In this paper I argue that, on the understanding of permissive situations that is most useful for evaluating the disanalogy thesis, permissive situations clearly are possible. (shrink)

What exactly is reasoning? While debate on this question is ongoing, most philosophers seem to agree on at least the following: reasoning is a mental process operating on contents, which consists in adopting or revising some of your attitudes in light of others. In this paper, I argue that this characterisation is mistaken: there is no single mental phenomenon that satisfies both of these conditions. Instead, I characterise two distinct mental phenomena, which I call ‘deducing’, on the one hand, and (...) ‘reasoning’ or ‘inference’ on the other, to play each of these roles. Recognising this division of labour is essential to developing a better understanding of our rational economy. (shrink)

Contemporary research in philosophy of religion is dominated by traditional problems such as the nature of evil, arguments against theism, issues of foreknowledge and freedom, the divine attributes, and religious pluralism. This volume instead focuses on unrepresented and underrepresented issues in the discipline. The essays address how issues like race, sexual orientation, gender identity, disability, feminist and pantheist conceptions of the divine, and nonhuman animals connect to existing issues in philosophy of religion. By staking out new avenues for future research, (...) this book will be of interest to a wide range of scholars in analytic philosophy of religion and analytic philosophical theology. (shrink)

Purists think that changes in our practical interests can’t affect what we know unless those changes are truth-relevant with respect to the propositions in question. Impurists disagree. They think changes in our practical interests can affect what we know even if those changes aren’t truth-relevant with respect to the propositions in question. I argue that impurists are right, but for the wrong reasons, since they haven’t appreciated the best argument for their own view. Together with “Minimalism and the Limits of (...) Warranted Assertability Maneuvers,” “The Pragmatic Encroachment Debate,” and “Anti-Intellectualism” (below), this paper constitutes my attempt to refute the entire pragmatic encroachment debate. As I show in this paper, there is an argument for impurism sitting in plain sight that is considerably more plausible than any extant argument for pragmatism. (shrink)

According to current orthodoxy in the philosophy of action, intentional actions consist in intrinsically mindless bodily movements that stand in causal relations to appropriate mental states. This paper challenges this approach to intentional action, by arguing that there are not enough appropriate mental states around to ‘animate’ all of the bodily movements we intuitively count as intentional actions. In the alternative picture I suggest, the bodily movements that constitute our intentional actions are themselves to be thought of as cognitive events, (...) embodying our grasp of ways of acting. (shrink)

Intellectualists disagree with anti-intellectualists about the relationship between knowledge and truth. According to intellectualists, this relationship is intimate. Knowledge entails true belief, and in fact everything required for knowledge is somehow relevant to the probability that the belief in question is true. According to anti-intellectualists, this relationship isn’t intimate. Or, at least, it’s not as intimate as intellectualists think. Factors that aren’t in any way relevant to the probability that a belief is true can make a difference to whether it (...) counts as knowledge. In this paper, I give a new argument for anti-intellectualism and draw out consequences of this argument for the pragmatic encroachment debate. The standard purist objection to pragmatism is that pragmatism entails anti-intellectualism. As I show, anti-intellectualism follows from premises that are plausible even if purism is true, so the standard purist objection to pragmatism fails. (shrink)

Early moderns such as Locke and Descartes thought we could guarantee the justification of our beliefs, even in worlds most hostile to their truth, if only we form those beliefs with sufficient care. That is, they thought it possible for us to be impeccable with respect to justification. This principle has traditionally been used to argue for internalism. By placing all of the normatively relevant conditions in our minds, we ensure reflective access to what those norms require of us and (...) so sustain the possibility of impeccability (unlike externalism). However, recent challenges to transparency leave this reasoning vulnerable. In response, I show how impeccability can be sustained without requiring transparency. The account only works if we define internal states as those directly accessible to our rational belief forming systems. I argue that this sort of causal internalism, while somewhat revisionary, preserves traditional motivations for internalism while avoiding problems faced by other varieties. The result is a renewed argument for internalism that simultaneously moves us away from access internalism and towards a species of mentalism. (shrink)

The epistemic value of seemings is increasingly debated. Such debates are hindered, however, by a lack of consensus about the nature of seemings. There are four prominent conceptions in the literature, and the plausibility of principles such as phenomenal conservatism, which assign a prominent epistemic role to seemings, varies greatly from one conception to another. It is therefore crucial that we identify the correct conception of seemings. I argue that seemings are best understood as sui generis mental states with propositional (...) content and a distinct phenomenal character. Rival conceptions are shown to succumb to numerous difficulties. (shrink)

According to a thesis famously associated with Anscombe'sIntention, knowledge is a necessary condition of intentional action: when acting intentionally, we know what we are doing. Call this the Agential Knowledge thesis. The Agential Knowledge thesis remains, of course, controversial. Furthermore, as even some of its proponents acknowledge, it can appear puzzling: Why should acting intentionally require knowing what you are doing? My aim in this paper is to propose an explanation and defence of the Agential Knowledge thesis, based on the (...) idea that acting intentionally is exercising control, in a relevant sense. My argument rests on two things: first, articulating a modal conception of the relevant sense of control, and, secondly, arguing that agential knowledge is distinctively practical. As I explain, the truth of the Agential Knowledge thesis opens promising paths for future work in the philosophy of action. (shrink)

In ‘Reasoning and Regress’ I argued that inferring a conclusion from a set of propositions may simply consist in taking it that the conclusion follows from these propositions—thereby defusing familiar regress arguments. Sinan Dogramaci challenges the generality of this view, on the grounds that sometimes you may draw conclusions from no premisses that you believe. I respond by clarifying a distinction between the premisses of an argument from the reasons your conclusion is based upon. While suppositional reasoning may involve no (...) premisses in the former sense, it does not follow that it does not involve concluding something on the basis of reasons. This allows the view defended in ‘Reasoning and Regress’ to extend to suppositional reasoning. (shrink)

All justified beliefs ultimately rest on attitudes that are immediately justified. This book illuminates the nature of immediate justification and the states that provide it. Simply put, immediate justification arises from how things appear to us--from all and only our "seemings." The author defends each aspect of this "seemings foundationalism," including the assumption of foundationalism itself. Most notably, the author draws from common sense philosopher Thomas Reid to present new and improved arguments for phenomenal conservatism and gives the first systematic (...) argument that seemings alone are capable of immediately justifying. The discussion also delves deeply into the nature of seemings and how it is that their assertive phenomenal character makes them (and them alone) capable of immediately justifying. Along the way, the author makes novel contributions to perennial debates about justification such as: internalism versus externalism, deontologism and epistemic blame, epistemic circularity, and the common sense response to skepticism. Seemings and the Foundations of Justification will appeal to scholars and advanced students interested in epistemology, Thomas Reid, or the common sense tradition. (shrink)

A number of philosophers, going back at least to Kierkegaard, argue that to have faith in something is, in part, to have a passion for that thing—to possess a lasting, formative disposition to feel certain positive patterns of emotion towards the object of faith. I propose that (at least some of) the intellectual dimensions of faith can be modeled in much the same way. Having faith in a person involves taking a certain perspective towards the object of faith—in possessing a (...) lasting, formative disposition for things to seem as though the object of faith is worthy of one’s trust. After developing the view, I briefly discuss its epistemic implications. I suggest that, by systematically reorienting how one experiences the world, faith can actually change one’s total body of evidence (or perhaps even how one weighs that evidence), thereby altering what one is justified in believing about the object of faith. (shrink)