Background:In Ontario, Canada, patients who lack decision-making capacity and have no family or friends to act as substitute decision-makers currently rely on the Office of the Public Guardian and Trustee to consent to long-term care (nursing home) placement, but they have no legal representative for other placement decisions.Objectives:We highlight the current gap in legislation for difficult transition cases involving unrepresented patients and provide a novel framework for who ought to assist with making these decisions and how these decisions ought to (...) be made.Research design:This paper considers models advanced by Volpe and Steinman with regard to who ought to make placement decisions for unrepresented patients, as well as current ethical models for analyzing how these decisions should be made.Participants and research context:We describe an anonymized healthcare transition case to illustrate the fact that there is no legally recognized decision-maker for placement destinations other than long-term care facilities and to show how this impacts all stakeholders.Ethical considerations:The case provided is an anonymized vignette representing a typical transition case involving an unrepresented patient.Findings:As a result of a gap in provincial legislation, healthcare providers usually determine the appropriate placement destination without a clear framework to guide the process and this can cause significant moral distress.Discussion:We argue for a team decision-making approach in the short term, and a legislative change in the long-term, to respect the patient voice, evaluate benefit and risk, enhance collaboration between healthcare providers and patients, and promote social justice. We believe that our approach, which draws upon the strengths of interprofessional teams, will be of interest to all who are concerned with the welfare and ethical treatment of the patients for whom they care.Conclusions:One of the main strengths of our recommendation is that it provides all members of the healthcare team (including nurses, social workers, therapists, and others) an increased opportunity to advocate on behalf of unrepresented patients. (shrink)

Background Regionalised models of health care delivery have important implications for people with disabilities and chronic illnesses yet the ethical issues surrounding disability and regionalisation have not yet been explored. Although there is ethics-related research into disability and chronic illness, studies of regionalisation experiences, and research directed at improving health systems for these patient populations, to our knowledge these streams of research have not been brought together. Using the Canadian province of Ontario as a case study, we address this gap (...) by examining the ethics of regionalisation and the implications for people with disabilities and chronic illnesses. The critical success factors we provide have broad applicability for guiding and/or evaluating new and existing regionalised health care strategies. Discussion Ontario is in the process of implementing fourteen Local Health Integration Networks (LHINs). The implementation of the LHINs provides a rare opportunity to address systematically the unmet diverse care needs of people with disabilities and chronic illnesses. The core of this paper provides a series of composite case vignettes illustrating integration opportunities relevant to these populations, namely: (i) rehabilitation and services for people with disabilities; (ii) chronic illness and cancer care; (iii) senior's health; (iv) community support services; (v) children's health; (vi) health promotion; and (vii) mental health and addiction services. For each vignette, we interpret the governing principles developed by the LHINs – equitable access based on patient need, preserving patient choice, responsiveness to local population health needs, shared accountability and patient-centred care – and describe how they apply. We then offer critical success factors to guide the LHINs in upholding these principles in response to the needs of people with disabilities and chronic illnesses. Summary This paper aims to bridge an important gap in the literature by examining the ethics of a new regionalisation strategy with a focus on the implications for people with disabilities and chronic illnesses across multiple sites of care. While Ontario is used as a case study to contextualize our discussion, the issues we identify, the ethical principles we apply, and the critical success factors we provide have broader applicability for guiding and evaluating the development of – or revisions to – a regionalised health care strategy. (shrink)

Experiments are commonly thought to have epistemic privilege over simulations. Two ideas underpin this belief: first, experiments generate greater inferential power than simulations, and second, simulations cannot surprise us the way experiments can. In this article I argue that neither of these claims is true of experiments versus simulations in general. We should give up the common practice of resting in-principle judgments about the epistemic value of cases of scientific inquiry on whether we classify those cases as experiments or simulations, (...) per se. To the extent that either methodology puts researchers in a privileged epistemic position, this is context sensitive. (shrink)

Human microbiome research makes causal connections between entire microbial communities and a wide array of traits that range from physiological diseases to psychological states. To evaluate these causal claims, we first examine a well-known single-microbe causal explanation: of Helicobacter pylori causing ulcers. This apparently straightforward causal explanation is not so simple, however. It does not achieve a key explanatory standard in microbiology, of Koch’s postulates, which rely on manipulations of single-microorganism cultures to infer causal relationships to disease. When Koch’s postulates (...) are framed by an interventionist causal framework, it is clearer what the H. pylori explanation achieves and where its explanatory strengths lie. After assessing this ‘simple’, single-microbe case, we apply the interventionist framework to two key areas of microbiome research, in which obesity and mental health states are purportedly explained by microbiomes. Despite the experimental data available, interventionist criteria for explanation show that many of the causal claims generated by microbiome research are weak or misleading. We focus on the stability, specificity and proportionality of proposed microbiome causal explanations, and evaluate how effectively these dimensions of causal explanation are achieved in some promising avenues of research. We suggest some conceptual and explanatory strategies to improve how causal claims about microbiomes are made. (shrink)

Human microbiome research makes causal connections between entire microbial communities and a wide array of traits that range from physiological diseases to psychological states. To evaluate these causal claims, we first examine a well-known single-microbe causal explanation: of Helicobacter pylori causing ulcers. This apparently straightforward causal explanation is not so simple, however. It does not achieve a key explanatory standard in microbiology, of Koch’s postulates, which rely on manipulations of single-microorganism cultures to infer causal relationships to disease. When Koch’s postulates (...) are framed by an interventionist causal framework, it is clearer what the H. pylori explanation achieves and where its explanatory strengths lie. After assessing this ‘simple’, single-microbe case, we apply the interventionist framework to two key areas of microbiome research, in which obesity and mental health states are purportedly explained by microbiomes. Despite the experimental data available, interventionist criteria for explanation show that many of the causal claims generated by microbiome research are weak or misleading. We focus on the stability, specificity and proportionality of proposed microbiome causal explanations, and evaluate how effectively these dimensions of causal explanation are achieved in some promising avenues of research. We suggest some conceptual and explanatory strategies to improve how causal claims about microbiomes are made. (shrink)

Human microbiome research makes causal connections between entire microbial communities and a wide array of traits that range from physiological diseases to psychological states. To evaluate these causal claims, we first examine a well-known single-microbe causal explanation: of Helicobacter pylori causing ulcers. This apparently straightforward causal explanation is not so simple, however. It does not achieve a key explanatory standard in microbiology, of Koch’s postulates, which rely on manipulations of single-microorganism cultures to infer causal relationships to disease. When Koch’s postulates (...) are framed by an interventionist causal framework, it is clearer what the H. pylori explanation achieves and where its explanatory strengths lie. After assessing this ‘simple’, single-microbe case, we apply the interventionist framework to two key areas of microbiome research, in which obesity and mental health states are purportedly explained by microbiomes. Despite the experimental data available, interventionist criteria for explanation show that many of the causal claims generated by microbiome research are weak or misleading. We focus on the stability, specificity and proportionality of proposed microbiome causal explanations, and evaluate how effectively these dimensions of causal explanation are achieved in some promising avenues of research. We suggest some conceptual and explanatory strategies to improve how causal claims about microbiomes are made. (shrink)

Koonin argues that CRISPR-Cas systems present the best-known case in point for Lamarckian evolution because they satisfy his proposed criteria for the specific inheritance of acquired adaptive characteristics. We see two interrelated issues with Koonin’s characterization of CRISPR-Cas systems as Lamarckian. First, at times he appears to confuse an account of the CRISPR-Cas system with an account of the mechanism it employs. We argue there is no evidence for the CRISPR-Cas system being “Lamarckian” in any sense. Second, it is unclear (...) whether the mechanism is more “Lamarckian” than many other forms of genetic change already well-characterized in Darwinian terms. We present three conceptually distinct senses in which the mechanism of IAC may be considered Lamarckian and argue that only the strongest sense of goal-directed IAC would be difficult to accommodate in a Darwinian account. As the CRISPR-Cas mechanism does not qualify as “Lamarckian” in this strong sense, we argue there is no conceptual value in calling it “Lamarckian”. Finally, we suggest that CRISPR-Cas systems do hold the potential for genuinely non-Darwinian, directed evolution in a way that Koonin did not discuss, involving their potential use as a human gene-editing tool. (shrink)

2021 marks Dylan's 80th birthday and his 60th year in the music world. It invites us to look back on his career and the multitudes that it contains. Is he a song and dance man? A political hero? A protest singer? A self-portrait artist who has yet to paint his masterpiece? Is he Shakespeare in the alley? The greatest living exponent of American music? An ironsmith? Internet radio DJ? Poet (who knows it)? Is he a spiritual and religious parking meter? (...) Judas? The voice of a generation or a false prophet, jokerman, and thief? Dylan is all these and none. The essays in this book explore the Nobel laureate’s masks, collectively reflecting upon their meaning through time, change, movement, and age. They are written by wonderful and diverse set of contributors, all here for his 80th birthday bash: celebrated Dylanologists like Michael Gray and Laura Tenschert; recording artists such as Robyn Hitchcock, Barb Jungr, Amy Rigby, and Emma Swift; and 'the professors’ who all like his looks: David Boucher, Anne Margaret Daniel, Ray Monk, Galen Strawson, and more. Read it on your toaster! (shrink)

Background Policies to use financial incentives to encourage healthy behaviour are controversial. Much of this controversy is played out in the mass media, both reflecting and shaping public opinion. Objective To describe UK mass media coverage of incentive schemes, comparing schemes targeted at different client groups and assessing the relative prominence of the views of different interest groups. Design Thematic content analysis. Subjects National and local news coverage in newspapers, news media targeted at health-care providers and popular websites between January (...) 2005 and February 2010. Setting UK mass media. Results The study included 210 articles. Fifteen separate arguments favourable towards schemes, and 19 unfavourable, were identified. Overall, coverage was more favourable than unfavourable, although most articles reported a mix of views. Arguments about the prevalence and seriousness of the health problems targeted by incentive schemes were uncontested. Moral and ethical objections to such schemes were common, focused in particular on recipients such as drug users or the overweight who were already stereotyped as morally deficient, and these arguments were largely uncontested. Arguments about the effectiveness of schemes and their potential for benefit or harm were areas of greater contestation. Government, public health and other health-care provider interests dominated favourable coverage; oppo- sition came from rival politicians, taxpayersÕ representatives, certain charities and from some journalists themselves. Conclusions Those promoting incentive schemes for people who might be regarded as ÔundeservingÕ should plan a media strategy that anticipates their public reception. (shrink)

In this paper, I discuss the recent discovery of alleged arsenic bacteria in Mono Lake, California, and the ensuing debate in the scientific community about the validity and significance of these results. By situating this case in the broader context of projects that search for anomalous life forms, I examine the methodology and upshots of challenging biochemical constraints on living things. I distinguish between a narrower and a broader sense in which we might challenge or change our knowledge of life (...) as the result of such a project, and discuss two different kinds of projects that differ in their potential to overhaul our knowledge of life. I argue that the arsenic bacteria case, while potentially illuminating, is the kind of constraint-challenging project that could not—in spite of what was said when it was presented to the public—change our knowledge of life in the deeper sense. (shrink)

There is preserved in Suidas' Lexicon a story about Polycrates of Samos and the island of Delos. It is offered by the lexicographer as an explanation of the phrase τατ σοι κα πύθια κα δλια , when used in a colloquial sense to mean ‘it's all the same to you’. Polycrates had instituted a festival on Delos and asked the Pythia whether to call it by the one name or the other. The phrase, which was supposed to have been the (...) Pythia's reply, was taken to mean that it was all the same to Polycrates whatever he called it, and the death of Polycrates, coming soon after, was interpreted as the fulfilment of the prophecy. Suidas cites Epicurus and Menander for the phrase itself, which was therefore in familiar use by the end of the fourth century B.C. As for the story about Polycrates, it is quite likely that Suidas' ultimate source was some writer of about that period, such as Demon, περ παροιμιν. It is very much in the manner of his fragments. (shrink)

Francesco Redi’s seventeenth-century experiments on insect generation are regarded as a key contribution to the downfall of belief in spontaneous generation. Scholars praise Redi for his experiments demonstrating that meat does not generate insects, but condemn him for his claim elsewhere that trees can generate wasps and gallflies. He has been charged with rejecting spontaneous generation only to change his mind and accept it, and in the process, with failing as a rigorous experimental philosopher. In this paper I defend Redi (...) from both of these charges. In doing so, I draw some broader lessons for our understanding of spontaneous generation. ‘Spontaneous generation’ does not refer to a single theory, but rather a landscape of possible views. I analyze Redi’s theoretical commitments and situate them within this landscape, and argue that his error in the case of insects from plants is not as problematic as previous commentators have said it is. In his research on gall insects Redi was addressing a different question from that of his experiments on insect generation—the question was not “Can insects come from nonliving matter?,” but rather, “Can insects come from living organisms which are not their parents?” In the latter case, he gave an answer which we now know to be false, but this was not due to any failure in his rigor as an experimental philosopher. (shrink)

In the for 1952 , pp. 33 ff., Nikolaos M. Kontoleon published a most interesting inscription from the shrine of Archilochos on Paros. It was inscribed, as preserved, on two orthostats, which probably formed part of the structure of the hearth or bothros where offerings to the hero were made. There is much of interest to scholars in this new discovery, which is very fully and carefully interpreted by Kontoleon, and has been further discussed by Werner Peck . In this (...) article the present writer wishes to confine himself to some comments on the new evidence about responses of the Delphic oracle supplied by the inscription. This material is all found on the first of the two orthostats, and falls into two categories: responses connected with the setting up of the shrine, and responses connected with the life of Archilochus. (shrink)

The historical background of the discovery of adverse health effects of medicines, food additives, pesticides, and other chemicals is reviewed, and the development of national and international regulations and testing procedures to protect the public against the toxic effects of these drugs and chemicals is outlined. Ethical considerations of the safety evaluation of drugs and chemicals by human experimentation and animal toxicity studies, ethical problems associated with clinical trials, with the falsification of clinical and toxicological data, and with inadequate experimental (...) methodology, are reviewed, and the ethics of the marketing of drugs and their post-marketing surveillance, are similarly considered. These ethical problems are illustrated with many specific examples, including the drugs neoarsphenamine, chloramphenicol, thalidomide, diethyl stilboestrol and benoxaprofen. (shrink)

The purpose of this paper is to present the findings of an investigation into missionary-refugee relationships in Europe. The main research question guiding this study was: How do missionaries understand and describe their relationship with the refugees they serve? The data for this study were collected at an international consultation on ministry with refugees held in the fall of 2017 from 21 missionaries using semi-structured interview protocols. Findings demonstrate that missionaries shared a liminal identity with the refugees in their ministry, (...) viewed hospitality as a Christian lifestyle, perceived Christianity to be an inclusive faith, and discussed the challenges and opportunities in their ministry with refugees. Based on the findings we offer implications for mission theorizing and practice in the 21st century church. (shrink)

Zosimus, after recording the foundation and immense growth of Constantinople, introduces a digression directed towards his purpose of justifying paganism against Christianity. ‘It has often indeed occurred to me to wonder how, when the city of the Byzantines has grown, so that no other can compare with it for prosperity and size, there was no prophecy delivered from the gods of our predecessors about its development to a better fortune. With this thought in mind I have turned over many volumes (...) of histories and collections of oracles, and with difficulty I happened upon one oracle said to be of the Sibyl of Erythrae or of Phaennis of Epirus. Nicomedes, the son of Prusias, put his confidence in this oracle, and interpreting it in an advantageous sense he took up war against his father, Prusias, at the persuasion of Attalus.’ Zosimus proceeds to quote twenty-one lines of hexameter verse, which have come down in a rather corrupt state, but of which the general sense is reasonably clear. They consist mainly of an obvious post eventum forecast of the Gallic invasion of Asia Minor in the third century B.C. (shrink)

Our chief evidence for the days on which the Delphic oracle could be consulted comes, as is well known, from a passage in the Quaestiones Graecae of Plutarch . He is explaining the name of the Delphic month Bysios, which he derives from the verbs for inquiry , and adds the comment: ν т μην γρ тούт χρησтήριον γίγνεο, κα έβδóμην таüтην νομίζουσι тο θεο γενέθλιο, κα πολύθοον νομάζουσι, ο δι тò πέттεσθαι θóïς λλ πολυπευθ κα πολυμάνтευтον οσαν. ψ γŰρ (...) νείθησαν ακαтŰ μνα μανтεᔞᔦ тος δεομένοις, πóтεπον δ' ᾰπαξ θεμίσтευεν Пυθία тο νιαυтο καтŰ тαύтην тν μέραν, ώς Кαλλισθένης κα 'Ạναξανδρίης ίςтρήκασι. (shrink)

Plutarch in his Life of Agis describes the plots by which Lysandrus the ephor contrived to depose King Leonidas II. He meant to use against him one of the Spartan laws which forbade a member of the royal houses from begetting children by a foreign woman, and another by which he who went out of Sparta with a view to settling abroad was liable to the death penalty. But though apparently a case could be made out against Leonidas under these (...) charges, Lysandrus did not simply proceed with the prosecution. After instructing confederates who would bring the case, he with his fellow ephors ‘waited for the sign’. What this meant Plutarch explains in these words: στι δ τοινδε· δι' τν1 ννα1 λαβντες ο οροι νκτα καθαρν κα σληνον, σιωπ καθζονται πρς τν ορανν ποβλποντες. ν ον κ μρους τινς ες τερον μρος στρ διξ, κρνουσι τος βασιλες, ς περ τ θεον ξαμαρτνοντας, κα καταπαουσι τς ρχς, μχρις ν κ Δελν ἢ λυμπας χρησμς λθτος λωκσι τν βασιλων βοηθν. (shrink)

The Hellenistic temple of Apollo at Didyma presents several unique features in its plan. In its exterior it resembles the typical large Ionic temple of Asia Minor with a double colonnade surrounding it, no opisthodomus, and a pronaos containing three rows of four columns each. But at this point the plan of the temple was modified in the strangest manner. For the pronaos does not lead by a great central doorway into the cella, but where the doorway should come, the (...) worshipper entering the building found himself faced with a blank wall 1·495 rn high with above it a colossal opening 5·63 m wide. Consequently the worshipper in the pronaos could not even look directly into the sanctuary. Instead, just above his eye-level beyond the embrasure of this ‘window’ stretched the floor of a large room, 14·04 m by 6·73 m with its roof supported on two columns. Through this room's central door the spectator on ground level outside could catch a glimpse of the upper part of the naiskos in the inner court. (shrink)

In Plutarch's two narratives of the recapture of the Cadmea by the Thebans, 379/8 B.C. , he speaks of three harmosts as in command of the Spartan garrison. This is the only instance in Spartan history where more than one harmost is mentioned as exercising authority in the same city, and it suggests the question: Was Thebes for some reason receiving different treatment from the other cities where we hear of harmosts in residence ?

Vaccination can protect vaccinated individuals and often also prevent them from spreading disease to other people. This opens up the possibility of getting vaccinated for the sake of others. In fact, altruistic vaccination has recently been conceptualized as a kind of vaccination that is undertaken primary for the benefit of others. In order to better understand the potential role of altruistic motives in people’s vaccination decisions, we conducted two focus group studies with a total of 37 participants. Study 1 included (...) three focus groups on the subject of HPV vaccination for boys. Study 2 included three focus groups on the subject of pertussis and measles vaccination for childcare workers. We found substantial evidence of other-regarding motives across all focus groups, which suggests that altruistic motives could be an important factor when it comes to people’s vaccination decisions. We address the significance of these findings for vaccination policy surrounding HPV vaccination for boys and vaccination for childcare workers. We also extend the findings to normative work on vaccination for the sake of others more generally. (shrink)

The global pandemic needs to mark a turning point for the peoples of Aotearoa New Zealand. How can we make sure that our culturally diverse nation charts an equitable and sustainable path through and beyond this new world? In a less affluent future, how can we ensure that all New Zealanders have fair access to opportunities? One challenge is to preserve the sense of common purpose so critical to protecting each other in the face of Covid-19. How can we centre (...) what we have learnt about resilience within Māori and wider Pacific communities in our reforms? How can public understanding of Covid-19 science create a platform for the future social valuing of expertise? How can we ensure that the impact of Covid-19 in New Zealand results in a more sustainable, and inclusive workforce–for instance by expanding our perceptions of the value of our workers through promoting digital inclusion? To meet these challenges, we must reimagine our existing traditions of thought, breathing new life into perennial concepts and debates. Our paper indicates some of the ways that Philosophy is central to this collective reimagining, highlighting solutions to be found across our rich philosophical traditions. (shrink)

Microbial model systems have a long history of fruitful use in fields that include evolution and ecology. In order to develop further insight into modelling practice, we examine how the competitive exclusion and coexistence of competing species have been modelled mathematically and materially over the course of a long research history. In particular, we investigate how microbial models of these dynamics interact with mathematical or computational models of the same phenomena. Our cases illuminate the ways in which microbial systems and (...) equations work as models, and what happens when they generate inconsistent findings about shared targets. We reveal an iterative strategy of comparative modelling in different media, and suggest reasons why microbial models have a special degree of epistemic tractability in multimodel inquiry. (shrink)

Prospective memory is required for many aspects of everyday cognition, its breakdown may be as debilitating as impairments in retrospective memory, and yet, the former has received relatively little attention by memory researchers. This article outlines a strategy for changing the fortunes of prospective memory, for guiding new research to shore up the claim that prospective memory is a distinct aspect of cognition, and to obtain evidence for clear performance dissociations between prospective memory and other memory functions. We begin by (...) identifying the unique requirements of prospective memory tasks and by dividing memory's prospective functions into subdomains that are analogous to divisions in retrospective memory (e.g., short- versus long-term memory). We focus on one prospective function, called prospective memory proper; we define this function in the spirit of James (1890) as requiring that we are aware of a plan, of which meanwhile we have not been thinking, with the additional consciousness that we made the plan earlier. We give an operational definition of prospective memory proper and specify how it differs from explicit and implicit retrospective memory and how it might be empirically assessed. (shrink)

(2013). Cognitive shortcuts in causal inference. Argument & Computation: Vol. 4, Formal Models of Reasoning in Cognitive Psychology, pp. 64-88. doi: 10.1080/19462166.2012.682655.

A consensus conference can be used to enable ordinary citizens to have informed input into policy making concerning controversial science and technology issues. To test whether this process could be used at a local level, facilitated by expertise from a university, McMaster University and the City of Hamilton, Ontario, cosponsored a regional consensus conference on waste management. This article describes this experience and evaluates it from three perspectives: how well the process satisfied the criteria of a good public participation process, (...) how much impact the conference had, and how well the positive role envisioned for university involvement was satisfied. Lessons learned are outlined briefly. (shrink)

Effective altruists call us to apply evidence-based reasoning to maximize the effectiveness of charitable giving. In particular, effective altruists assess causes in terms of their scope, neglectedness, and tractability, and then recommend devoting resources to the cause that scores best on these criteria. So far, effective altruists concerned with animal suffering have seen these criteria as supporting interventions that improve the lives of layer hens, and they now seem to think that these criteria support directing efforts toward broilers. In this (...) paper, however, we argue that the effective altruist framework commits animal advocates to focus at least much attention--if not more--on fish. (shrink)