Much earlier work claims that appositives and expressives are invariably speaker-oriented. These claims have recently been challenged, most extensively by Amaral et al. (Linguist and Philos 30(6): 707–749, 2007). We are convinced by this new evidence. The questions we address are (i) how widespread are non-speaker-oriented readings of appositives and expressives, and (ii) what are the underlying linguistic factors that make such readings available? We present two experiments and novel corpus work that bear directly on this issue. We find that (...) non-speaker-oriented readings, while rare in actual language use, are systematic. We also find that non-speaker-oriented readings occur even outside of attitude predications, which leads us to favor an account based in pragmatically-mediated perspective shifting over one that relies on semantic binding by attitude predicates. (shrink)

Ethical codes help guide the methods of research that involves samples gathered from ?at-risk? populations. The current article reviews general as well as specific ethical principles related to gathering informed consent from partner violent offenders mandated to outpatient treatment, a group that may be at increased risk of unintentional coercion in behavioral sciences research due to court mandates that require outpatient treatment without the ethical protections imbued upon prison populations. Recommendations are advanced to improve the process of informed consent within (...) this special population and data supporting the utility of the recommendations in a sample 70 partner violent offenders are provided. Data demonstrate that participants were capable of comprehending all essential elements of consent. (shrink)

BackgroundChildhood adversity is linked to adverse health in adulthood. One posited mechanistic pathway is through physiological responses to acute stress. Childhood adversity has been previously related to both exaggerated and blunted physiological responses to acute stress, however, less is known about the psychological mechanisms which may contribute to patterns of physiological reactivity linked to childhood adversity.ObjectiveIn the current work, we investigated the role of challenge and threat stress appraisals in explaining relationships between childhood adversity and cortisol reactivity in response to (...) an acute stressor.MethodsUndergraduate students completed an online survey that included general demographic information and the Risky Families Questionnaire 24 h before a scheduled lab visit. In the lab, a research assistant collected a baseline salivary cortisol sample. Following the baseline period, participants were read instructions for the Trier Social Stress Test, a validated psychological lab stressor. Next, they completed a challenge vs. threat task appraisal questionnaire and completed the speech and math portion of the TSST. Twenty minutes following the start of the TSST, a second salivary sample was collected to measure changes in salivary cortisol following the TSST.ResultsLinear regression analyses adjusted for age, sex, childhood socioeconomic status, and baseline cortisol levels, showed childhood adversity associated with changes in cortisol levels [B = –0.29 t = –2.35, p = 0.02, R2=0.07]. Linear regression analyses controlling for age, sex, and childhood SES showed childhood adversity associated with both challenge [B = –0.52 t = –5.04, p < 0.001, R2=0.24] and threat [B = 0.55 t = 5.40, p < 0.001, R2=0.27] appraisals. Significant indirect effects of childhood trauma on cortisol reactivity were observed through challenge appraisals [B = –0.01 ], and threat appraisals [B = –0.01 ].ConclusionChildhood adversity may contribute to blunted cortisol reactivity, a pattern of response which is linked to obesity, addiction, and other behavior-related diseases. Our findings suggest that this relationship is in part a product of stress appraisals. (shrink)

Background Pragmatic randomized controlled trials are designed to evaluate the effectiveness of interventions in real-world clinical conditions. However, these studies raise ethical issues for researchers and regulators. Our objective is to identify a list of key ethical issues in pragmatic RCTs and highlight gaps in the ethics literature. Methods We conducted a scoping review of articles addressing ethical aspects of pragmatic RCTs. After applying the search strategy and eligibility criteria, 36 articles were included and reviewed using content analysis. Results Our (...) review identified four major themes: 1) the research-practice distinction; 2) the need for consent; 3) elements that must be disclosed in the consent process; and 4) appropriate oversight by research ethics committees. 1) Most authors reject the need for a research-practice distinction in pragmatic RCTs. They argue that the distinction rests on the presumptions that research participation offers patients less benefit and greater risk than clinical practice, but neither is true in the case of pragmatic RCTs. 2) Most authors further conclude that pragmatic RCTs may proceed without informed consent or with simplified consent procedures when risks are low and consent is infeasible. 3) Authors who endorse the need for consent assert that information need only be disclosed when research participation poses incremental risks compared to clinical practice. Authors disagree as to whether randomization must be disclosed. 4) Finally, all authors view regulatory oversight as burdensome and a practical impediment to the conduct of pragmatic RCTs, and argue that oversight procedures ought to be streamlined when risks to participants are low. Conclusion The current ethical discussion is framed by the assumption that the function of research oversight is to protect participants from risk. As pragmatic RCTs commonly involve usual care interventions, the risks may be minimal. This leads many to reject the research-practice distinction and question the need for informed consent. But the function of oversight should be understood broadly as protecting the liberty and welfare interest of participants and promoting public trust in research. This understanding, we suggest, will focus discussion on questions about appropriate ethical review for pragmatic RCTs. (shrink)

This paper is intended to be an interpretation of what I shall venture to call—the deliberate philosophy of Santayana, as outlined in his recent and most penetrating book: Scepticism and Animal Faith. I refrain from employing the battered term metaphysics, because this candid “ lover of wisdom ” has reminded us that his system is not metaphysical, “ except in the mocking literary sense of the word.” What the vulgar, however, understand by the term, he is guilty of offering in (...) this mature work. It is my desire to try and see his philosophy under the searchlight of contemporary discussion;and I shall introduce some remarks of my own on what I consider significant Realistic issues of the day. My philosophy, however, on nearly all conditions, has been formed by, and is in concord with, the system here expounded. (shrink)

ObjectivesTo describe reporting of informed consent in pragmatic trials, justifications for waivers of consent and reporting of alternative approaches to standard written consent. To identify factors associated with (1) not reporting and (2) not obtaining consent.MethodsSurvey of primary trial reports, published 2014–2019, identified using an electronic search filter for pragmatic trials implemented in MEDLINE, and registered in ClinicalTrials.gov.ResultsAmong 1988 trials, 132 (6.6%) did not include a statement about participant consent, 1691 (85.0%) reported consent had been obtained, 139 (7.0%) reported a (...) waiver and 26 (1.3%) reported consent for one aspect (eg, data collection) but a waiver for another (eg, intervention). Of the 165 trials reporting a waiver, 76 (46.1%) provided a justification. Few (53, 2.9%) explicitly reported use of alternative approaches to consent. In multivariable logistic regression analyses, lower journal impact factor (p=0.001) and cluster randomisation (p<0.0001) were significantly associated with not reporting on consent, while trial recency, cluster randomisation, higher-income country settings, health services research and explicit labelling as pragmatic were significantly associated with not obtaining consent (all p<0.0001).DiscussionNot obtaining consent seems to be increasing and is associated with the use of cluster randomisation and pragmatic aims, but neither cluster randomisation nor pragmatism are currently accepted justifications for waivers of consent. Rather than considering either standard written informed consent or waivers of consent, researchers and research ethics committees could consider alternative consent approaches that may facilitate the conduct of pragmatic trials while preserving patient autonomy and the public’s trust in research. (shrink)

This paper builds upon a critically clarified statement of the triune brain concept to set out the conflict systems neurobehavioral model. The model defines the reciprocal algorithms of behavior from evolved brain structure. The algorithms are driven by subjectively experienced behavioral tension as the self‐preservational programming, common to our ancestral vertebrates, frequently tugs and pulls against the affectional program‐ming of our mammalian legacy. The yoking of the dual algorithmic dynamic accounts for the emergence of moral and spiritual consciousness as manifested (...) in the universal norm of reciprocity and in the work of such thinkersas Martin Buber and Paul Tillich. (shrink)

Building on the advances made by feminist reconsiderations of methods, methodology and epistemology, this paper calls for an alliance between feminist social science and the emerging field of queer theory. By challenging traditional scientific approaches to research on sexual minority groups, a distinctly ‘queer’ approach is advocated that adopts a reflexive position on subjectivity and sexuality. While essentialist approaches privilege gay/lesbian, man/woman, and object/subject, this approach advances a framework of critical sexualities that moves social science into an arena of inclusivity (...) and multiple identities, rather than reductionistic categorical thought. The implications are clear: a rethinking of identity categories that transcend stagnant dualisms. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:The Institute of Medicine’s Report on Non-Heart-Beating Organ TransplantationRoger Herdman (bio), Tom L. Beauchamp (bio), and John T. Potts Jr. (bio)In December 1997, the Institute of Medicine (IOM) released a report on medical and ethical issues in the procurement of non-heart-beating organ donors. This report had been requested in May 1997 by the Department of Health and Human Services (DHHS). We will here describe the genesis of the (...) IOM report, the medical and moral concerns that led the DHHS to sponsor it, the process of producing it, and its conclusions. The analyses, findings, and recommendations of the report are also reviewed, in particular the central issues that led to suggestions for policy changes.Transplantation BackgroundAs a first step, some background in the relevant aspects of organ transplantation will prove useful. For the purposes of this analysis, “transplantation” involves the transfer of cells, tissues, or solid organs from one human to another to replace the structure or function of comparable body components that, through injury or disease, are defective or of inadequate function. The IOM report deals with solid organs, primarily kidneys and livers, whose blood supply is reconnected in the organ recipient, in contrast to cells, like bone marrow, and tissues, like corneas. A variety of donor types exists for organ transplantation, each with particular medical and scientific conditions.Living donors are healthy (and usually genetically related) individuals who volunteer to provide either a whole, paired organ such as a kidney or a section of an organ such as a liver. Cadaver donors are individuals who have died and from whom a full array of organs can be taken. “Heart-beating” cadaver donors are individuals who have suffered “brain death,” that is, irreversible cessation of function of the whole brain including the brain stem; and “non-heart-beating” donors (NHBDs) are individuals who are ill or injured, but not “brain dead,” and who have suffered cardiopulmonary death, that is, irreversible cessation of cardiac and respiratory function. NHBDs can be “controlled,” which means that [End Page 83] they can be sustained by artificial life support systems until a medical and family decision is made to terminate futile life support. This can be done at a scheduled time and in a controlled manner, and organs can then be recovered for transplantation. NHBDs can also be “uncontrolled,” which means that their hearts and breathing have stopped through disease or injury at an unexpected time or in an uncontrolled manner, and they cannot be resuscitated; the organs of some individuals of this description can be recovered for transplantation. The IOM report focused on both controlled and uncontrolled NHBDs and on problems specific to them.The questions that were asked and addressed in the IOM report became current and salient beginning in 1992 with the establishment of the University of Pittsburgh “Policy for the Management of Terminally Ill Patients Who May Become Organ Donors After Death.” This policy addressed controlled NHBDs and the ethical questions raised by their use; much of the discussion was reported in the June 1993 special issue of the Kennedy Institute of Ethics Journal. Public notice and anxiety about some of these concerns were sharpened and refocused by national and local media allegations of improper treatment of donors at the Cleveland Clinic in 1997, specifically premature—i.e., antemortem—recovery of organs and administration of drugs that allegedly might hasten donor death.The DHHS Request for StudyIt is not surprising that several federal actions would be taken in response to these events. Some, such as the results of a transplantation task force, remain largely internal to DHHS at this writing. Others are public, such as the IOM study of the NHBD situation. In May 1997, the DHHS initiated contacts with the IOM with the goal of exploring federal concerns about the medical and ethical treatment of NHBDs, in particular the allegations directed at the Cleveland Clinic.The DHHS response should be understood in at least three contexts. First, living donors and uncontrolled NHBDs were essentially the only donor types in the early days of transplantation in the United States. The technologies, ethics, and social acceptance of controlling and terminating life support for... (shrink)

We propose a friendly amendment to integrative experiment design (IED), adversarial-collaboration IED, that incentivizes research teams from competing theoretical perspectives to identify zones of the design space where they possess an explanatory edge. This amendment is especially critical in debates that have high policy stakes and carry a strong normative-political charge that might otherwise prevent free exchange of ideas.

Scientific models are often said to be more or less general depending on how many cases they cover. In this paper we argue that the cardinality of cases is insufficient as a metric of generality, and we present a novel account based on measure theory. This account overcomes several problems with the cardinality approach, and additionally provides some insight into the nature of assessments of generality. Specifically, measure theory affords a natural and quantitative way of describing local spaces of possibility. (...) The generality of models can be understood as the measure of possibilities to which the models apply. In order to illustrate our view, we consider the example of structural genomics, the ongoing project of building three-dimensional models of biological macromolecules like proteins. Using measure theory, we interpret the practice of homology modeling, where such models are understood to apply widely but imperfectly to the space of possible proteins. (shrink)

As much as assumptions about mechanisms and mechanistic explanation have deeply affected psychology, they have received disproportionately little analysis in philosophy. After a historical survey of the influences of mechanistic approaches to explanation of psychological phenomena, we specify the nature of mechanisms and mechanistic explanation. Contrary to some treatments of mechanistic explanation, we maintain that explanation is an epistemic activity that involves representing and reasoning about mechanisms. We discuss the manner in which mechanistic approaches serve to bridge levels rather than (...) reduce them, as well as the different ways in which mechanisms are discovered. Finally, we offer a more detailed example of an important psychological phenomenon for which mechanistic explanation has provided the main source of scientific understanding. (shrink)

This paper extends an ongoing discussion about establishing a sharper way to conduct ethical investigations into managerial virtue. It does so by relying on Alasdair MacIntyre's moral philosophy in place of those more dominant approaches taken by scholars who make up the field of positive social science. A connection is drawn herein between a MacIntyrean “narrative approach” to investigating managerial virtue and the idea of “work as a calling.” Specifically, it will be argued that the MacIntyrean‐influenced idea of “work as (...) a calling” provides a substantive moral vision that supports an understanding of how virtuous managers ought to narrate their primary workplace motivations. Ultimately, virtuous managers fulfill a “political calling” to support and sustain (a) good work, (b) the good of individual lives, and (c) the common good of communities that their organization reaches. To do this, they must rely on the “shepherd virtue” of practical wisdom (phronesis). Practical wisdom aids virtuous managers’ thinking about achieving the ends of their “calling” as well as any necessary course‐corrections that ought to be made toward the better achievement of those good and worthy ends. (shrink)

Lack of access to health care coupled with a severe shortage of physicians is on the forefront of much debate nationally and internationally. Rural areas often suffer the most. Innovations in medical education, such as the creation of rural immersion rotations, are attempting to solve this health crisis. The purpose of this study was to investigate and analyze the narrative writings of 36 fourth–year medical students and primary care residents that participated in a rural immersion rotation in the Mississippi Delta. (...) A grounded theory data analysis led to the emergence of four central themes: Positive reflections of the experience, community health, limited access to health care, and alteration of prior perceptions. The findings of this research provide rich data from the perspective of the medical student and resident. This study concluded that the use of narrative inquiry was beneficial within the rural immersion experience, and the experience positively influenced and impacted medical students and residents. (shrink)

At the age of sixty, Cory Taylor was dying of melanoma-related brain cancer. With her illness no longer treatable, she began at the start of 2016 to write about her experiences and, in an extraordinary creative surge, wrote what would become Dying: A Memoir. This is a brief and clear-eyed account of what dying taught Cory: amid the tangle of her feelings, she reflects on the patterns of her life, and remembers the lives and deaths of her parents. (...) She tells us why she would like to be able to choose the circumstances of her own death.Dying is about the vulnerability and strength, courage and humility, anger and acceptance that it takes to live a good life and say goodbye to it in peace. (shrink)

Quality and service improvement (QSI) research employs a broad range of methods to enhance the efficiency of healthcare delivery. QSI research differs from traditional healthcare research and poses unique ethical questions. Since QSI research aims to generate knowledge to enhance quality improvement efforts, should it be considered research for regulatory purposes? Is review by a research ethics committee required? Should healthcare providers be considered research participants? If participation in QSI research entails no more than minimal risk, is consent required? The (...) lack of consensus on answers to these questions highlights the need for ethical guidance. Three distinct approaches to classifying QSI research in accordance with existing ethical principles and regulations can be found in the literature. In the first approach, QSI research is viewed as distinct from other types of healthcare research and does not require regulation. In the second approach, QSI research falls within regulatory guidelines but is exempt from research ethics committee review. In the third approach, QSI research is deemed to be part of the learning healthcare system and, as such, is subject to a different set of ethical principles entirely. In this paper, we critically assess each of these views. While none of these approaches is entirely satisfactory, we argue that use of the ethical principles governing research provides the best means of addressing the numerous questions posed by QSI research. (shrink)

The “standard position” on organ donation is that the donor must be dead in order for vital organs to be removed, a position with which we agree. Recently, Robert Truog and Walter Robinson have argued that brain death is not death, and even though “brain dead” patients are not dead, it is morally acceptable to remove vital organs from those patients. We accept and defend their claim that brain death is not death, and we argue against both the US “whole (...) brain” criterion and the UK “brain stem” criterion. Then we answer their arguments in favour of removing vital organs from “brain dead” and other classes of comatose patients. We dispute their claim that the removal of vital organs is morally equivalent to “letting nature take its course”, arguing that, unlike “allowing to die”, it is the removal of vital organs that kills the patient, not his or her disease or injury. Then, we argue that removing vital organs from living patients is immoral and contrary to the nature of medical practice. Finally, we offer practical suggestions for changing public policy on organ transplantation. (shrink)

I argue that Thomas Aquinas’s Identity Formula—the statement that the “intellect in act is the intelligible in act”—does not, as is usually supposed, express his position on how the intellect accesses extramental realities (responding to the so-called “mind-world gap”). Instead, it should be understood as a claim about the metaphysics of intellection, according to which the perfection requisite for performing the act of understanding is what could be called “intellectual-intelligible being.” In reinterpreting Aquinas’s Identity Formula, I explore the notion of (...) being “in act” as an intellect or intelligible (intelligibile actu, intellectus actu), his curious comments about an “order” or “genus” of intelligibles, and the relationship of understanding and being-understood. (shrink)

Most of the recent work on propaganda in philosophy has come from a narrowly epistemological standpoint that sees it as flawed messaging that negatively impacts public reasonableness and deliberation. This article posits two problems with this approach: first, it obscures the full range of propaganda's activities; and second, it prevents effective ameliorative measures by offering an overly truncated assessment of the problems to be addressed. Following Ellul and Hyska, I argue that propaganda aims at shaping actions and not just beliefs, (...) and that the propaganda activities that shape action include modifying beliefs but also much more. Examining this larger set of activities results in a shift in how we conceptualize the way that propaganda works. In particular, I add a novel argument that propaganda works by creating and reshaping publics, transforming who they are and their characteristic action. This article concludes that a more complete philosophical account of propaganda cannot just draw on epistemology but must also call on the tools of social ontology and political philosophy to create a more robust critical account. (shrink)

This paper appraises the role of critical-feminist figurations within the environmental humanities, focusing on the capacity of figures to produce situated environmental knowledges and pose site-specific ethical obligations. We turn to four environments—the home, the skies, the seas and the microscopic—to examine the work that various figures do in these contexts. We elucidate how diverse figures—ranging from companion animals to birds, undersea creatures and bugs—reflect productive traffic between longstanding concerns in feminist theory and the environmental humanities, and generate new insights (...) related to situated knowledges, feminist care-ethics and the politics of everyday sensory encounters. We also argue, however, that certain figures have tested the limits of theoretical approaches which have emerged as the product of dialogue between feminist theory and environmental studies. In particular, we explore how particular figures have complicated ethical questions of how to intervene in broad environmental threats borne of anthropogenic activities, and of who or what to include in relational ethical frameworks. (shrink)

Building on the advances made by feminist reconsiderations of methods, methodology and epistemology, this paper calls for an alliance between feminist social science and the emerging field of queer theory. By challenging traditional scientific approaches to research on sexual minority groups, a distinctly 'queer' approach is advocated that adopts a reflexive position on subjectivity and sexuality. While essentialist approaches privilege gay/lesbian, man/woman, and object/subject, this approach advances a framework of critical sexualities that moves social science into an arena of inclusivity (...) and multiple identities, rather than reductionistic categorical thought. The implications are clear: a rethinking of identity categories that transcend stagnant dualisms. (shrink)

This paper is a response to Stephen Leeds’s "Juhl on Many Worlds". Contrary to what Leeds claims, we can legitimately argue for nontrivial conclusions by appeal to our existence. The ’problem of old evidence’, applied to the ’old evidence’ that we exist, seems to be a red herring in the context of determining whether there is a rationally convincing argument for the existence of many universes. A genuinely salient worry is whether multiversers can avoid illicit reuse of empirical evidence in (...) their arguments. (shrink)

This paper reports an experimental investigation of presuppositions and scalar implicatures in language acquisition. Recent proposals posit the same mechanisms for generating both types of inferences, in contrast to the traditional view. We used a Covered Box picture selection task to compare the interpretations assigned by two groups of children and by adults, in response to sentences with presuppositions and ones with either ‘direct’ or ‘indirect’ scalar implicatures. The main finding was that the behavior of children and adults differed across (...) inference types. This asymmetry is consistent with the traditional perspective, but poses a challenge for the more recent uniform accounts. We discuss how the latter could be amended to account for these findings, and also relate the findings to previous results on presupposition processing. Finally, we discuss an unexpected difference found between direct and indirect scalar implicatures. (shrink)

In the early 20th century, the most numerous and well-funded institutions in the United States—corporations—used public relations to make a widespread and fundamental change in the way they constitute and regulate their relations of knowledge with the public. Today, we can see this change reflected in a variety of areas such as journalism, political outreach, social media, and in the ‘fake news’ and ‘post-truth’ administration of Donald J. Trump. This article traces practices of corporate truth-telling and knowledge production across three (...) periods I will call the personal, the legal, and public relations, which are roughly coincident with the antebellum period, the Gilded Age, and the 20th century, respectively. In sum, what can be found in public relations and now broadly across society, is that relations of knowledge have come to be refigured as relations of power, subordinating traditional epistemological concerns like justification and belief in favor of government and control. (shrink)

The current practice of organ transplantation has been criticized on several fronts. The philosophical and scientific foundations for brain death criteria have been crumbling. In addition, donation after cardiac death, or non-heartbeating-organ donation (NHBD) has been attacked on grounds that it mistreats the dying patient and uses that patient only as a means to an end for someone else's benefit.

For years, experimental philosophers have attempted to discern whether laypeople find free will compatible with a scientifically deterministic understanding of the universe, yet no consensus has emerged. The present work provides one potential explanation for these discrepant findings: People are strongly motivated to preserve free will and moral responsibility, and thus do not have stable, logically rigorous notions of free will. Seven studies support this hypothesis by demonstrating that a variety of logically irrelevant (but motivationally relevant) features influence compatibilist judgments. (...) In Study 1, participants who were asked to consider the possibility that our universe is deterministic were more compatibilist than those not asked to consider this possibility, suggesting that determinism poses a threat to moral responsibility, which increases compatibilist responding (thus reducing the threat). In Study 2, participants who considered concrete instances of moral behavior found compatibilist free will more sufficient for moral responsibility than participants who were asked about moral responsibility more generally. In Study 3a, the order in which participants read free will and determinism descriptions influenced their compatibilist judgments—and only when the descriptions had moral significance: Participants were more likely to report that determinism was compatible with free will than that free will was compatible with determinism. In Study 3b, participants who read the free will description first (the more compatibilist group) were particularly likely to confess that their beliefs in free will and moral responsibility and their disbelief in determinism influenced their conclusion. In Study 4, participants reduced their compatibilist beliefs after reading a passage that argued that moral responsibility could be preserved even in the absence of free will. Participants also reported that immaterial souls were compatible with scientific determinism, most strongly among immaterial soul believers (Study 5), and evaluated information about the capacities of primates in a biased manner favoring the existence of human free will (Study 6). These results suggest that people do not have one intuition about whether free will is compatible with determinism. Instead, people report that free will is compatible with determinism when desiring to uphold moral responsibility. Recommendations for future work are discussed. (shrink)

This book revives the study of conventional implicatures in natural language semantics. H. Paul Grice first defined the concept. Since then his definition has seen much use and many redefinitions, but it has never enjoyed a stable place in linguistic theory. Christopher Potts returns to the original and uses it as a key into two presently under-studied areas of natural language: supplements and expressives. The account of both depends on a theory in which sentence meanings can be multidimensional. The (...) theory is logically and intuitively compositional, and it minimally extends a familiar kind of intensional logic, thereby providing an adaptable, highly useful tool for semantic analysis. The result is a linguistic theory that is accessible not only to linguists of all stripes, but also philosophers of language, logicians, and computer scientists who have linguistic applications in mind. (shrink)