Many clinical ethicists have argued that ethics expertise is impossible. Their skeptical argument usually rests on the assumptions that to be an ethics expert is to know the correct moral conclusions, which can only be arrived at by having the correct ethical theories. In this paper, I argue that this skeptical argument is unsound. To wit, ordinary ethical deliberations do not require the appeal to ethical or meta-ethical theories. Instead, by agreeing to resolve moral differences by appealing to reasons, the (...) participants agree to the Default Principle—a substantive rule that tells us how to adjudicate an ethical disagreement. The Default Principle also entails a commitment to arguments by parity, and together these two methodological approaches allow us to make genuine moral progress without assuming any deep ethical principles. Ethical expertise, in one sense, is thus the ability and knowledge to deploy the Default Principle and arguments by parity. (shrink)

This book sheds light on important philosophical assumptions made by professionals working in clinical and research medicine. In doing so, it aims to make explicit how active philosophy is in medicine and shows how this awareness can result in better and more informed medical research and practice. -/- It examines: what features make something a scientific discipline; the inherent tensions between understanding medicine as a research science and as a healing practice; how the “replication crisis” in medical research asks us (...) to rethink the structure of knowledge production in our modern world; whether explanations have any real scientific values; the uncertainties about probabilistic claims; and whether it is possible for evidence-based medicine to truly be value free. The final chapter argues that the most important question we can ask is not, “How can we separate values from science?” but, “In a democratic society, how can we decide in a politically and morally acceptable way what values should drive science?”. (shrink)

We grant that anthropic reasoning yields the result that we should not expect to be in a small civilization. However, regardless of what civilization one finds oneself in, one can use anthropic reasoning to get the result that one should not expect to be in that sort of civilization. Hence, contra Ken Olum, anthropic reasoning does not conflict with observation.

The ubiquitous presence of pharmaceuticals in our lives is underappreciated. In the United States between 2009 and 2012, almost half the population used at least one prescription drug and more than one in ten Americans used five or more prescription drugs within a 30-day period. The use of pharmaceuticals is so widespread that runoffs from incorrect disposal of drugs have become a pollutant in our drinking water. In 2009, researchers found 51 different pharmaceuticals from beta-blockers to antianxiety medications to anticonvulsants (...) in 19 water treatment plants. Environmental impacts are worrisome for sure, but the effects of drugs on us raise far deeper concerns. (shrink)

Antibiotic-resistant bacteria pose a serious threat to our health. Our ability to destroy deadly bacteria by using antibiotics have not only improved our lives by curing infections, it also allows us to undertake otherwise dangerous treatments from chemotherapies to invasive surgeries. The emergence of antibiotic resistance, I argue, is a consequence of various iterations of prisoner’s dilemmas. To wit, each participant (from patients to nations) has rational self-interest to pursue a course of action that is suboptimal for all of us. (...) The standard solutions to prisoner’s dilemma look to realign cost-benefit such that individuals’ interests match those of the collective. However, the lack of a global organization to enforce an effective carrot-and-stick system makes it unlikely that we can solve the antibiotic resistance problem this way. I argue that our best chance might be an attempt to teach altruism and convince individuals to act not out of their self-interests. (shrink)

This anthology provides a collection of new essays on ethical and philosophical issues that concern the development, dispensing, and use of pharmaceuticals. It brings together critical ethical issues in pharmaceutics that have not been included in any collection (e.g., the ethics of patients as researchers). In addition, it includes philosophical issues that are not within the traditional domain of applied ethics. For example, a game-theoretic approach to combating the emergence of antibiotic-resistent pathogens by spreading altruism. A tripartite distinction provides an (...) organized series of discussions that shows the interrelatedness of philosophical issues from the creation of pharmaceuticals, the creation of demand for them, through their delivery to their ultimate consumption. (shrink)

Theorizing the World argues that explanations play a central role in our theoretical understanding of the world. Explanations explain in virtue of subsuming what is to be explained under the appropriate projectable regularities. My epistemological account of explanation differs from traditional views in understanding subsumption as a far more complex relation. When a projectable regularity explains, it both confirms its corresponding background theories and draws explanatory strength from them at the same time. The failure of the standard models of explanation, (...) I claim, has to do with their inability to consider explanations as a part of a broader enterprise of theory-formation. In this sense, we account for the essentially epistemic nature of explanation by noting the intimate connection between explanations and theoretical reasoning. ;The dissertation proceeds in four chapters. In the first chapter, I argue that the object of an explanation always contains a reference to the epistemic conditions of the inquirer. The need for an explanation arises out of a detachment between what the inquirer believes and some observation at hand. To explain is to eliminate the detachment in the appropriate manner. The second chapter examines a host of standard models of explanation. I show that the failure of these models is largely due to their inability to explicate the explanation relation in sufficiently strong metaphysical notions. In the third chapter, I propose that in explaining, we connect the epistemic corpus of the inquirer to the observation via an appropriate projectable regularity. Finally, in chapter four, I examine issues of unification, the role of explanation in science and explanations in ethics as further evidence for my view. (shrink)

Students with recent immigrant roots disproportionately choose educational trajectories in STEM. In addition to the perception that STEM represents the "path of least racism," many students assume the responsibility of contributing to their families' financial wellbeing. In this talk, I share my experience teaching at a pre-professional healthcare university with a large percentage of 1st and 2nd-generation Asian immigrant students. Many of them seek advice on how to negotiate the social and familial pressure to pursue STEM against their interests in (...) the humanities. The reply "Follow your heart" might be inappropriate when familial obligations and perceived bigotry are legitimate deterrents. By recognizing the grand tradition of one immigrant generation trying to improve the lot for the next, we strive not merely for financial freedom but freedom in general. As such, we ought to consider how we can spend our lives to best dismantle the barriers that limit our life choices. (shrink)

In his "Let the drugs lead the way! On the unfolding of a research program in psychiatry," Shai Mulinari nicely lays out the evolution of theories of depression since the late 1950s; that is, understanding depression as ultimately a brain disorder centering on the functioning of monoamine neurotransmitters. Moreover, the emergence of various psychotropic drug treatments have provided researchers with a "pharmacological bridge" to gain a more precise understanding of depression by observing the effects of these drugs on patients' monoamines (...) and mood. This evolution, Mulinari argues, fits Imre Lakatos's concept of a research program. Mulinari's narrative is clear, compelling, and informative and it generates some... (shrink)