In this paper the authors argue that research ethics committees should not be paternalistic by rejecting research that poses risk to people competent to decide for themselves. However it is important they help to ensure valid consent is sought from potential recruits and protect vulnerable people who cannot look after their own best interests. The authors first describe the tragic deaths of Jesse Gelsinger and Ellen Roche. They then discuss the following claims to support their case: competent individuals are epistemologically (...) and ethically in the best position to say which risks are reasonable for them, so RECs should be no more restrictive than the “normal” constraints on people taking risks with themselves; RECs do not judge individual competence ; individual liberty is mostly limited by what serves the public interest, and RECs do not determine public interest; RECs may have a paternalistic role in preventing exploitation of competent people vulnerable to the use of incentives, and in protecting the interests of incompetent people; however, the moral and political authority of RECs has not been established in this respect. (shrink)

This paper has three main aims. The first is to provide a critical assessment of two rival concepts of suffering, that proposed by Cassell and that proposed in this journal by van Hooft. The second aim of the paper is to sketch a more plausible concept of suffering, one which derives from a Wittgensteinian view of linguistic meaning. This more plausible concept is labeled an ‘intuitive concept’. The third aim is to assess the prospects for scientific understanding of suffering.

The practice of prenatal screening for disability is sometimes objected to because of the hurt and offence such practices may cause to people currently living with disabilities. This objection is commonly termed “the expressivist objection”. In response to the objection it is standardly claimed that disabilities are analogous to illnesses. And just as it would be implausible to suppose reduction of the incidence of illnesses such as flu sends a negative message to ill people, so it is not plausible to (...) suppose prevention of disability sends a negative message to disabled people. The expressivist objection hinges, however, upon a view of the relationship between disability and self identity which sees disability as part of the identity of the disabled person, in a way in which illnesses such as flu cannot be. This possibility is generally not considered in critiques of the expressivist objection. In this paper, an “identity claim” to the effect that disabilities can be identity constituting is accepted and the force of the expressivist argument is reconsidered in the light of its acceptance. It is concluded that even when such an identity claim is accepted, the expressivist objection is still not morally compelling. (shrink)

The anchoring focus of this paper is a cluster of complaints that have been raised against reference-based approaches to semantics, in particular against the view defended by Scott Soames (2002). I am going to lump the complaints that I have in mind under the heading of the Threat of Collapse (or the Threat, for short). At the heart of the Threat of Collapse is the accusation that various moves referentialists make in dealing with well-known problems end up undercutting the motivations (...) for a reference-based semantics in the first place. (shrink)

In his classic 1936 paper Tarski sought to motivate his definition of logical consequence by appeal to the inference form: P(0), P(1), . . ., P(n), . . . therefore ∀nP(n). This is prima facie puzzling because these inferences are seemingly first-order and Tarski knew that Gödel had shown first-order proof methods to be complete, and because ∀nP(n) is not a logical consequence of P(0), P(1), . . ., P(n), . . . by Taski's proposed definition. An attempt to resolve (...) the puzzle due to Etchemendy is considered and rejected. A second attempt due to Gómez-Torrente is accepted as far as it goes, but it is argued that it raises a further puzzle of its own: it takes the plausibility of Tarski's claim that his definition captures our common concept of logical consequence to depend upon our common concept being a reductive conception. A further interpretation of what Tarski had in mind when he offered the example is proposed, using materials well known to Tarski at the time. It is argued that this interpretation makes the motivating example independent of reductive definitions which take natural numbers to be higher-order set theoretic entities, and it also explains why he did not regard the distinction between defined and primitive terms as pressing, as was the distinction between logical and nonlogical terms. (shrink)

In management research, theory testing confronts a paradox described by Meehl in which designing studies with greater methodological rigor puts theories at less risk of falsification. This paradox exists because most management theories make predictions that are merely directional, such as stating that two variables will be positively or negatively related. As methodological rigor increases, the probability that an estimated effect will differ from zero likewise increases, and the likelihood of finding support for a directional prediction boils down to a (...) coin toss. This paradox can be resolved by developing theories with greater precision, such that their propositions predict something more meaningful than deviations from zero. This article evaluates the precision of theories in management research, offers guidelines for making theories more precise, and discusses ways to overcome barriers to the pursuit of theoretical precision. (shrink)

This article examines several answers to the question, can lexical definitions be true or false.

In this article we examine ethical aspects of the involvement of children in clinical research, specifically those who are incapable of giving informed consent to participate. The topic is, of course, not a new one in medical ethics but there are some tensions in current guidelines that, in our view, need to be made explicit and which need to be responded to by the relevant official bodies. In particular, we focus on tensions between the World Medical Association Declaration of Helsinki, (...) and the guidance offered by the British Medical Association, the Royal College of Paediatrics and Child Health , and the Council for International Organizations of Medical Sciences. We conclude with a call for these organisations to make their guidance explicit in relation to the World Medical Association Declaration. (shrink)

My paper discusses the philosophical interrelationship between perfection, truth, and knowledge. The connection that exists between these three concepts underscores the argument of my paper that they are all one and the same thing. -/- The concepts of perfection, truth and knowledge are analysed in that order. I analyse perfection and demonstrate the practicalities of my arguments. Truth is then scrutinized and defined to illustrate its intimate relationship with perfection leading to the conclusion that knowledge being ‘truth that is perfect’. (...) -/- In dealing with the theory of knowledge, I take into account the justification of knowledge and highlighted arguments that I found to be insufficient. I derive a premise to refute and replace both the traditional and contemporary views of knowledge. -/- In the paper presented, I consider views of some prominent philosophers including; Locke, Russell, Plato, Aristotle and Leibniz. (shrink)

An almost unbelievable amount of false philosophy has arisen through not realizing what ‘existence’ means…. [It] rests upon the notion that existence is, so to speak, a property that you can attribute to things, and that the things that exist have the property of existence and the things that do not exist do not. That is rubbish . I have dared to puncture several metaphysical balloons and nothing came out of them but hot air.

This paper examines one particular justification for the screening and termination of embryos/fetuses which possess genetic features known to cause disability. The particular case is that put forward in several places by John Harris. He argues that the obligation to prevent needless suffering justifies the prevention of the births of disabled neonates. The paper begins by rehearsing Harris's case. Then, drawing upon claims advanced in a recent paper in the Journal of Medical Ethics, it is subjected to critical scrutiny, focusing (...) on Harris's “suffering claim” .1 It is argued that the suffering claim must be false if understood as an empirical claim. And, even if understood as a conceptual truth, it mistakenly assimilates the concepts of harm and suffering. Finally, again focusing on Harris's recent work in this area, his characterisation of disability as a “harmed condition” is shown not to apply in the case of at least some moderate forms of intellectual disability. (shrink)

In this paper, we respond to Andrew Avins's recent review of methods whose use he advocates in clinical trials, to make them more ethical. He recommends in particular, “unbalanced randomisation”. However, we argue that, before such a recommendation can be made, it is important to establish why unequal randomisation might offer ethical advantages over equal randomisation, other things being equal. It is important to make a pragmatic distinction between trials of treatments that are already routinely available and trials of restricted (...) treatments. We conclude that unequal randomisation could, indeed, be an ethical compromise between protecting the interests of participants and those of society. (shrink)

In this paper the need for valid evidence of the cost-effectiveness of treatments that have not been properly evaluated, yet are already available, albeit in short supply, are examined. Such treatments cannot be withdrawn, pending proper evaluation, nor can they be made more widely available until they have been shown to be cost-effective. As a solution to this impasse the argument put forward recently by Toroyan et al is discussed. They say that randomised controlled trials of such resources could be (...) done but only if resources are randomly allocated independently of a research context. Relevant outcome data could then be collected for research, given this opportunity. We agree. We disagree with Toroyan et al on a number of points. First, they claim that no ethical issue relating to equipoise arises. We disagree and this disagreement depends on our showing that equipoise should be maintained in a relationship that they do not consider. Secondly, they say that consent to data collection is always needed. Again we disagree. Thirdly, they claim that the previous two issues are the only possible ethical issues that could arise. We argue, instead, that there is a further conflict of interests that has ethical import. (shrink)

Jansen and Wall suggest a new way of defending hard paternalism in clinical research. They argue that non-therapeutic research exposing people to more than minimal risk should be banned on egalitarian grounds: in preventing poor decision-makers from making bad decisions, we will promote equality of welfare. We argue that their proposal is flawed for four reasons.First, the idea of poor decision-makers is much more problematic than Jansen and Wall allow. Second, pace Jansen and Wall, it may be practicable for regulators (...) to uncover the values that a potential research participant holds when agreeing to enter a research project, so their claim that we must ban such research projects for all if we are to ban them for poor decision-makers looks to be unmotivated. Third, there seem to be cases where the liberty to enter the sort of research project Jansen and Wall discuss is morally weighty, and arguably should outweigh concerns of egalitarian distribution. Fourth, banning certain types of research, which seem on the face of it to offer an unfavourable risk-benefit ratio, would have unwelcome consequences for all clinical research, which Jansen and Wall do not recognize. (shrink)

John Campbell proposed a so-called simple view of colours according to which colours are categorical properties of the surfaces of objects just as they normally appear to be. I raised an invertion problem for Campbell's view according to which the senses of colour terms fail to match their references, thus rendering those terms meaningless—or so I claimed. Gabriele de Anna defended Campbell's view against my example by contesting two points in particular. Firstly, de Anna claimed that there is no special (...) problem here for the simple view of colours, a similar invertion story could apply to primary qualities terms for shapes. Secondly, de Anna purported to give an account of the senses and references of colour terms in my invertion story which renders the senses and references of those terms mutually consistent. In this paper I contested both of de Anna's claims. Regarding the first, I argue that his imagined invertion of apparent shapes is not epistemically stable, in contrast to the invertion of apparent shapes is not epistemically stable, in contrast to the invertion of apparent colours. Hence the victims of apparently inverted shapes would be able to discover the mismatch of senses and refences of their shape terms, in contrast to the victims of apparent invertions of colours. Regarding the second, I argue that de Anna's account of the victim's colour terms itself uses and not merely mentions so-called colours terms. Hence de Anna' account of them is itself meaningless due to a mismatch of sense and reference. So I conclude that my objection to Campbell's simple view of colours stands. (shrink)

John Campbell proposed a so-called simple view of colours according to which colours are categorical properties of the surfaces of objects just as they normally appear to be. I raised an invertion problem for Campbell's view according to which the senses of colour terms fail to match their references, thus rendering those terms meaningless—or so I claimed. Gabriele de Anna defended Campbell's view against my example by contesting two points in particular. Firstly, de Anna claimed that there is no special (...) problem here for the simple view of colours, a similar invertion story could apply to primary qualities terms for shapes. Secondly, de Anna purported to give an account of the senses and references of colour terms in my invertion story which renders the senses and references of those terms mutually consistent.In this paper I contested both of de Anna's claims. Regarding the first, I argue that his imagined invertion of apparent shapes is not epistemically stable, in contrast to the invertion of apparent shapes is not epistemically stable, in contrast to the invertion of apparent colours. Hence the victims of apparently inverted shapes would be able to discover the mismatch of senses and refences of their shape terms, in contrast to the victims of apparent invertions of colours. Regarding the second, I argue that de Anna's account of the victim's colour terms itself uses and not merely mentions so-called colours terms. Hence de Anna' account of them is itself meaningless due to a mismatch of sense and reference. So I conclude that my objection to Campbell's simple view of colours stands. (shrink)

Book Information Dummett: Philosophy of Language. By Karen Green. Polity Press. Cambridge. 2002. Pp. xi + 220. Hardback, £55. Paperback, £14.99.

Book Information Michael Dummett. By Bernhard Weiss.\nAcumen. Chesham. 2002. Pp. ix + 197. Paperback,\n{Â}\textsterling13.95.

This is the first wide-ranging, multi-authored handbook in the field of philosophy of medicine, covering the underlying conceptual issues of many important social, political and ethical issues in health care. It introduces and develops over 70 topics, concepts, and issues in the field. It is written by distinguished specialists from multiple disciplines, including philosophy, health sciences, nursing, sociology, political theory, and medicine. Many difficult social and ethical issues in health care are based on conceptual problems, most prominently on the definitions (...) of health and disease, or on epistemological issues regarding causality or diagnosis. Philosophy is the discipline that deals with such conceptual, metaphysical, epistemological, methodological, and axiological matters. This handbook covers all the central concepts in medicine, such as ageing, death, disease, mental disorder, and well-being. It is an invaluable source for laypeople, academics with an interest in medicine, and health care specialists who want be informed and up to date with the relevant discussions. The text also advances these debates and will set the agenda for years to come. (shrink)

Dr Edwards' stimulating and provocative book advances the thesis that the appropriate axiomatic basis for inductive inference is not that of probability, with its addition axiom, but rather likelihood - the concept introduced by Fisher as a measure of relative support amongst different hypotheses. Starting from the simplest considerations and assuming no more than a modest acquaintance with probability theory, the author sets out to reconstruct nothing less than a consistent theory of statistical inference in science.