The use of evidence in medicine is something we should continuously seek to improve. This book seeks to develop our understanding of evidence of mechanism in evaluating evidence in medicine, public health, and social care; and also offers tools to help implement improved assessment of evidence of mechanism in practice. In this way, the book offers a bridge between more theoretical and conceptual insights and worries about evidence of mechanism and practical means to fit the results into evidence assessment procedures.

While many philosophers speak of ‘pluralism’ within philosophy of biology, there has been little said about what such pluralism amounts to or what its underlying assumptions are. This has provoked so me anxiety about whether pluralism is compatible with their commitment to naturalism. This paper surveys three prominent pluralist positions ‘integrative pluralism’, and both Peter Godfrey-Smith’s and Beth Preston’s pluralist analyses of functional explanations in evolutionary biology) and demonstrates how all three are committed to a form of pragmatism. This (...) analysis both clarifies the justification and grounding of pluralism and allows these pluralisms to avoid the criticisms of Cussins. I close by making some more general points about pluralism and its relationship to history and integration. (shrink)

This book focuses on material culture as a subject of philosophical inquiry and promotes the philosophical study of material culture by articulating some of the central and difficult issues raised by this topic and providing innovative solutions to them, most notably an account of improvised action and a non-intentionalist account of function in material culture. Preston argues that material culture essentially involves activities of production and use; she therefore adopts an action-theoretic foundation for a philosophy of material culture. Part 1 (...) illustrates this foundation through a critique, revision, and extension of existing philosophical theories of action. Part 2 investigates a salient feature of material culture itself—its functionality. A basic account of function in material culture is constructed by revising and extending existing theories of biological function to fit the cultural case. Here the adjustments are for the most part necessitated by special features of function in material culture. These two parts of the project are held together by a trio of overarching themes: the relationship between individual and society, the problem of centralized control, and creativity. (shrink)

Function theorists routinely speculate that a viable function theory will be equally applicable to biological traits and artifacts. However, artifact function has received only the most cursory scrutiny in its own right. Closer scrutiny reveals that only a pluralist theory comprising two distinct notions of function--proper function and system function--will serve as an adequate general theory. The first section describes these two notions of function. The second section shows why both notions are necessary, by showing that attempts to do away (...) with one of them fail. This demonstration draws on examples from the artifactual realm to motivate major points of the argument. The third section is an outline of artifact function. It confirms the conclusions of the second section, and also begins the task of describing some of the special features of artifact function needing accommodation within the general theory. (shrink)

COVID-19 has truly affected most of the world over the past many months, perhaps more than any other event in recent history. In the wake of this pandemic are patients, family members, and various types of care providers, all of whom share different levels of moral distress. Moral conflict occurs in disputes when individuals or groups have differences over, or are unable to translate to each other, deeply held beliefs, knowledge, and values. Such conflicts can seriously affect healthcare providers and (...) cause distress during disastrous situations such as pandemics when medical and human resources are stretched to the point of exhaustion. In the current pandemic, most hospitals and healthcare institutions in the United States have not allowed visitors to come to the hospitals to see their family or loved ones, even when the patient is dying. The moral conflict and moral distress among care providers when they see their patients dying alone can be unbearable and lead to ongoing grief and sadness. This paper will explore the concepts of moral distress and conflict among hospital staff and how a system-wide provider wellness programme can make a difference in healing and health. (shrink)

Both the Beth definability theorem and Craig's lemma (interpolation theorem from now on) deal with the issue of the entanglement of one language L1 with another language L2, that is to say, information transfer—or the lack of such transfer—between the two languages. The notion of splitting we study below looks into this issue. We briefly relate our own results in this area as well as the results of other researchers like Kourousias and Makinson, and Peppas, Chopra and Foo.Section 3 (...) does contain one apparently new theorem. (shrink)

Commemorative volume on Jaysankar Lal Shaw, b. 1939, Indian philosopher.

The series of 'trolley' examples issue a challenge to moral principles based on intentions, since it seems that these give the wrong answers in two important cases: 'Fat Man', where they seem to say that it is permissible to push someone in front of a trolley to save others, and 'Loop', where they seem to say that it is wrong to divert a trolley towards a single person whose body will stop it and save others. I reply, first, that there (...) is a parallel between the wrongful intention to mutilate in 'Transplant', where one person's vital organs are removed to save others' lives, and the intention to assault in Fat Man. Secondly, I defend Frances Kamm's view that in Loop one can divert the trolley towards the one without an intention to kill or assault, since good potential side-effects can be taken into account in deciding what to do, without their becoming intentions. (shrink)

A basic aim of E. Beth's work in philosophy of science was to explore the use of formal semantic methods in the analysis of physical theories. We hope to show that a general framework for Beth's semantic analysis is provided by the theory of semi-interpreted languages, introduced in a previous paper. After developing Beth's analysis of nonrelativistic physical theories in a more general form, we turn to the notion of the 'logic' of a physical theory. Here we (...) prove a result concerning the conditions under which semantic entailment in such a theory is finitary. We argue, finally, that Beth's approach provides a characterization of physical theory which is more faithful to current practice in foundational research in the sciences than the familiar picture of a partly interpreted axiomatic theory. (shrink)

According to accounts of the Passion, Christ cries out from the cross, “My God, my God, why have you forsaken me?” The cry, I argue, manifests that Christ lacks a belief that God is with him. Given the standard view of faith—belief that p is required for faith that p—it would follow that Christ lost his faith that God is with him just before he died. In this paper, I challenge the standard view by looking at the cognitive requirement of (...) faith. Although faith that p requires some positive cognitive orientation toward p, that orientation need not be belief. I show that reliance is an alternative stance that fulfills the cognitive requirement of faith. Reliance aims at providing sensible guidance for action that is in accord with one’s values/ends. Thinking of the cognitive component of Christ’s faith in terms of reliance makes sense of the doubt manifested in his cry. (shrink)

This book provides a new interpretation of Kants critical work that shows Kants deep connection to Spinoza, and reveals new directions for thinking about Kant in relation to contemporary European philosophy.

Baruch Spinoza was born in Amsterdam during a period of unprecedented scientific, artistic, and intellectual discovery. Upon its release, Spinoza’s Ethics was banned; today it is the quintessential example of philosophical method. Although acknowledged as difficult, the book is widely taught in philosophy, literature, history, and politics. This introduction is designed to be read side by side with Spinoza's work. As a guide to the style, vocabulary, and arguments of the Ethics, it offers a range of interpretive possibilities to prepare (...) students to become conversant with Spinoza's philosophical method and his challenge to conventional thinking. (shrink)

Health-care providers frequently face clinical ethical dilemmas when working with transgender youth who require hormone therapy but lack parental support for this intervention. Through semi-structured interviews and grounded theory analysis, we explored ethical and clinical decision-making processes of health-care providers, as well as the health care experiences of trans youth with family discordance. We analyzed responses in relation to North American bioethics principles, best interests standard, and the harm principle, exploring issues of autonomy, evidence, and anti-trans bias. We propose an (...) ethically acceptable clinical approach termed parallel process hormone therapy initiation to address the needs of transgender youth with complex family situations. (shrink)

In 1999, Jeffrey Ketland published a paper which posed a series of technical problems for deflationary theories of truth. Ketland argued that deflationism is incompatible with standard mathematical formalizations of truth, and he claimed that alternate deflationary formalizations are unable to explain some central uses of the truth predicate in mathematics. He also used Beth’s definability theorem to argue that, contrary to deflationists’ claims, the T-schema cannot provide an ‘implicit definition’ of truth. In this article, I want to challenge (...) this final argument. Whatever other faults deflationism may have, the T-schema does provide an implicit definition of the truth predicate. Or so, at any rate, I shall argue. (shrink)

Eldon Soifer and Béla Szabados argue that hypocrisy poses a problem for consequentialism because the hypocrite, in pretending to live up to a norm he or she does not really accept, acts in ways that have good results. They argue, however, that consequentialists can meet this challenge and show the wrongness of hypocrisy by adopting a desirefulfilment version of their theory. This essay raises some doubts about Soifer and Szabados's proposal and argues that consequentialism has no difficulty coming to grips (...) with hypocrisy, whether or not one favours a desire-fulfilment account of the good. (shrink)

_Wittgenstein's Art of Investigation_ is one of the first to focus on and provide an original and detailed analysis of Wittgenstein's grammatical investigations. Beth Sarkey offers us new insight into the historical context and influences on method which will help students understand the intricacies and depth of his work.

It has become commonplace to say that with the advent of technologies like synthetic biology the line between artifacts and living organisms, policed by metaphysicians since antiquity, is beginning to blur. But that line began to blur 10,000 years ago when plants and animals were first domesticated; and has been thoroughly blurred at least since agriculture became the dominant human subsistence pattern many millennia ago. Synthetic biology is ultimately only a late and unexceptional offshoot of this prehistoric development. From this (...) perspective, then, synthetic biology is a red herring, distracting us from more thorough philosophical consideration of the most truly revolutionary human practice—agriculture. In the first section of this paper I will make this case with regard to ontology, arguing that synthetic biology crosses no ontological lines that were not crossed already in the Neolithic. In the second section I will construct a parallel case with regard to cognition, arguing that synthetic biology as biological engineering represents no cognitive advance over what was required for domestication and the new agricultural subsistence pattern it grounds. In the final section I will make the case with regard to human existence, arguing that synthetic biology, even if wildly successful, is not in a position to cause significant existential change in what it is to be human over and above the massive existential change caused by the transition to agriculture. I conclude that a longer historical perspective casts new light on some important issues in philosophy of technology and environmental philosophy. (shrink)

Vermaas and Houkes advance four desiderata for theories of artifact function, and classify such theories into non-intentionalist reproduction theories on the one hand and intentionalist non-reproduction theories on the other. They argue that non-intentionalist reproduction theories fail to satisfy their fourth desideratum. They maintain that only an intentionalist non-reproduction theory can satisfy all the desiderata, and they offer a version that they believe does satisfy all of them. I reply that intentionalist non-reproduction theories, including their version, fail to satisfy their (...) first desideratum. Thus neither type of function theory satisfies all the desiderata. This suggests that the list of desiderata may well be inconsistent, and that ultimately we may have to decide whether to give up the first desideratum or the fourth one. I recommend giving up the fourth one on the grounds that this choice preserves the phenomenologically salient social aspects of artifact function. Vermaas and Houkes attempt to satisfy their desiderata Why this attempt fails What is to be done? (shrink)

A paradigm case of demanding involves making utterances designed to influence addressees to accede.1 It would be incoherent to say, "I demand that you do x, but I am not saying that you ought to do x," or "I demand that you do x, although I am fully aware that you cannot do x." The extraordinary nature of demanding may be gleaned from anomalous utterances such as "employees may demand time off by notifying scheduling managers at least one month in (...) advance" and "faculty members may demand an extension of the tenure clock in writing to the provost." Demanding is less anomalous in protest rhetoric and in fact an important strategy for marginalized groups who are "criticized for not handling conflicts and controversies... (shrink)

On the difficulty of extracting the logical form of a seemingly simple sentence such as ‘If Andy went to the movie then Beth went too, but only if she found a taxi cab’, with some morals and questions on the nature of the difficulty.

_Wittgenstein's Art of Investigation_ is one of the first to focus on and provide an original and detailed analysis of Wittgenstein's grammatical investigations. Beth Sarkey offers us new insight into the historical context and influences on method which will help students understand the intricacies and depth of his work.

Ethical perception involves seeing what is ethically salient about the particular details of the world. This kind of seeing is like informed judgment. It can be shaped by what we know and what we come to learn about, and by the development of moral virtue. I argue here that we can learn to see food justice, and I describe some ways to do so using three narrative case studies. The mechanism for acquiring this kind of vision is a “food justice (...) narrative” that is particular and concrete. These kinds of stories are counter narratives to a popular and dominant “script” about food that disguises the identity of people who eat, and obscures how constraints on free choice are created by particular lived circumstances. Food justice narratives specify the social and political location of individual people who are trying to nourish themselves. Once this contextual surround is included we are in a position to ask why this person, in this set of circumstances, is impeded in their access to nutritious food. This is not a question we are likely to consider if we leave out the identity of food consumers. Food justice narratives are forward looking as well because they bring into clearer focus what actions and kinds of social activism are appropriate responses to constraints on free choice. (shrink)

Inherent in providing healthcare for youth lie tensions among best interests, decision-making capacity, rights, and legal authority. Transgender youth experience barriers to needed gender-affirming care, often rooted in ethical and legal issues, such as healthcare provider concerns regarding youth capacity and rights to consent to hormone therapy. Even when decision-making capacity is present, youth may lack the legal authority to give consent. The aims of this paper are therefore to provide an empirical analysis of minor trans youth capacity to consent (...) to hormone therapy and to address the normative question of whether there is ethical justification for granting trans youth the authority to consent to this care. Through qualitative content analysis of interviews with trans youth, parents, and healthcare providers, we found that trans youth demonstrated the understandings and abilities characteristic of the capacity to consent to hormone therapy and that they did consent to hormone therapy with positive outcomes. Employing deontological and consequentialist reasoning and drawing on a foundation of empirical evidence, human rights, and best interests we conclude that granting trans youth with decisional capacity both the right and the legal authority to consent to hormone therapy via the informed consent model of care is ethically justified. (shrink)

An increasing amount of research has emerged in recent years regarding the benefits that household pets have for individuals, much of which focuses on child?pet relationships. A number of studies have explored the role of pets in elementary classroom settings and what advantages their presence might have. Current curricula aimed at promoting humane education are also related to the use of animals as teaching tools in classrooms. This study examined teachers' attitudes and experiences regarding the use of pets in the (...) classroom. Both quantitative and qualitative data were collected from approximately 75 elementary classroom teachers, revealing the way in which animals were used in their teaching practices, as well as their views on some of the advantages of using pets in the classroom. The majority of teachers surveyed believed that the use of live pets in the classroom contributed positively to increased empathy, as well as socio?emotional development, in students, much of which is supported by current research. Implications for further research are considered. (shrink)

Increased productivity may have negative impacts on farm animal welfare in modern animal production systems. Efficiency gains in production are primarily thought to be due to the intensification of production, and this has been associated with an increased incidence of production diseases, which can negatively impact upon FAW. While there is a considerable body of research into consumer attitudes towards FAW, the extent to which this relates specifically to a reduction in production diseases in intensive systems, and whether the increased (...) incidence of diseases represents a barrier to consumer acceptance of their increased use, requires further investigation. Therefore a systematic review of public attitudes towards FAW was conducted, with a specific focus on production diseases in intensive systems. Four databases were searched to identify relevant studies. A screening process, using a set of pre-determined inclusion criteria, identified 80 studies, with the strength of evidence and uncertainty assessed for each. A thematic analysis led to the identification of 6 overarching themes constructed from 15 subthemes. The results demonstrate that the public are concerned about FAW in modern production systems. Concern varied in relation to age, gender, education and familiarity with farming. Naturalness and humane treatment were central to what was considered good welfare. An evidence gap was highlighted in relation to attitudes towards specific production diseases, with no studies specifically addressing this. However, the prophylactic use of antibiotics was identified as a concern. A number of dissonance strategies were adopted by consumers to enable guilt free meat consumption. (shrink)

Tool use rivals language as an important domain of cognitive phenomena, and so as a source of insight into the nature of cognition in general. But the favoured current definition of tool use is inadequate because it does not carve the phenomena of interest at the joints. Heidegger's notion of equipment provides a more adequate theoretical framework. But Heidegger's account leads directly to a non-individualist view of the nature of cognition. Thus non-individualism is supported by concrete considerations about the nature (...) of tools and tool use. (shrink)

Extending her earlier work on a theory of human rights in her 1993 Operative Rights, Singer (emerita, American philosophy presumably, City U. of New York) critiques philosophies from Rousseau to Kymlicka in clarifying her views--influenced by Dewey and Mead (George Herbert, not Margaret)--and applying them to such issues as multiculturalism, minority rights, and conflict resolution. The analysis pivots on her concept of "a normative community" rather than natural rights. Annotation copyrighted by Book News, Inc., Portland, OR.

To address growing concerns about academic integrity, college students (n?=?758) at honor system and non-honor system institutions were presented with eight scenarios to determine the influence of an honor system on their perceptions of and responses to academic dishonesty. Main effects for honor code status emerged. Students from traditional honor system schools considered the behaviors to be more dishonest, and were more likely to respond that they would report the incident when compared to students attending modified and non-honor system institutions. (...) Findings suggest traditional honor systems, with specific rules and regulations in place, are more effective at cultivating academic integrity among students; modified honor systems may not be as effective as previous research suggests. (shrink)