Hospice is the premiere end of life program in the United States, but its requirement that patients forgo disease-directed therapies and that they have a prognosis of 6 months or less means that it serves less than half of dying patients and often for very short periods of time. Palliative care offers careful attention to pain and symptom management, added support for patients and families, and assistance with difficult medical decision making alongside any and all desired medical treatments, but it (...) does not include a comprehensive system of care as is provided by hospice. The practice of palliative care and hospice is filled with sometimes overt (requests for hastened death in an environment where such acts are legally prohibited) and other times covert (the delay in palliative care referral because the health care team believes it will undermine disease directed treatment) ethical issues. The contributors to this volume use a series of case presentations within each chapter to illustrate some of the palliative care and hospice challenges with significant ethical dimensions across the three overarching domains: 1) care delivery systems; 2) addressing the many dimensions of suffering; and 3) difficult decisions near the end of life. The contributors are among the most experienced palliative care, hospice and ethics scholars in North America and Western Europe. Each has been given relatively free reign to address what they feel are the most pressing ethical challenges within their domain, so a wide range of positions and vantage points are represented. As a result, the volume provides a very diverse ethical exploration of this relatively young field that can deepen, stretch, and at times confront any simple notion of the challenges facing patients, their families, professional caregivers, and policy makers. (shrink)

In this thesis I argue for the following theory: constitutive Russellian phenomenal bonding panpsychism. To do so I do three main things: 1) I argue for Russellian panpsychism. 2) I argue for phenomenal bonding panpsychism. 3) I defend the resultant phenomenal bonding panpsychist model. The importance of arguing for such a theory is that if it can be made to be viable, then it is proposed to be the most promising theory of the place of consciousness within nature. This is (...) because constitutive Russellian panpsychism has all the theoretical virtues of physicalism and dualism but does not face the problems they do. The combination problem, however, is the most significant problem for the Russellian panpsychist, and, hence, in order to show the viability of the theory I address this problem. Moreover, I present a novel ”mereological argument’ for panpsychism which makes it necessary that the Russellian panpsychist addresses the combination problem. The focus of this thesis is therefore addressing this problem. I argue that the combination problem can indeed be solved. To do so I argue for the phenomenal bonding solution proposed by Goff. I argue that this solution works and that we can form a positive concept of the phenomenal bonding relation. This forces the panpsychist to make sense of how experiencing subjects can be proper parts of other experiencing subjects. I then argue that this can indeed be made sense of and show that we can indeed be composite subjects made of other subjects. To show that we can be subjects made up of other subjects I defend this proposal from various objections from throughout the literature. All these objections can be responded to by the constitutive Russellian phenomenal bonding panpsychist. Ultimately this leaves us with a novel and interesting account of what conscious subjects are, and what the material world is: they are both composite entities made wholly of conscious matter. (shrink)

This report describes the rationale, approaches, organization, and resource development leading to a large-scale deletion bin map of the hexaploid wheat genome. Accompanying reports in this issue detail results from chromosome bin-mapping of expressed sequence tags representing genes onto the seven homoeologous chromosome groups and a global analysis of the entire mapped wheat EST data set. Among the resources developed were the first extensive public wheat EST collection. Described are protocols for sequencing, sequence processing, EST nomenclature, and the assembly of (...) ESTs into contigs. These contigs plus singletons were used for selection of distinct sequence motif unigenes. Selected ESTs were rearrayed, validated by 5′ and 3′ sequencing, and amplified for probing a series of wheat aneuploid and deletion stocks. Images and data for all Southern hybridizations were deposited in databases and were used by the coordinators for each of the seven homoeologous chromosome groups to validate the mapping results. Results from this project have established the foundation for future developments in wheat genomics. (shrink)

We use a result due to Rolin, Speissegger, and Wilkie to show that definable sets in certain o-minimal structures admit definable parameterizations by mild maps. We then use this parameterization to prove a result on the density of rational points on curves defined by restricted Pfaffian functions.

It has been demonstrated that death certificates do not accurately record the actual cause of death in up to one-fourth of cases, as determined from subsequent autopsy findings. The purpose of this study was to explore the use of natural language autopsy data bases as an automated quality assurance mechanism. We translated the account of the major process leading to death, or the primary diagnosis, from all 45,564 narrative autopsy reports obtained at The Johns Hopkins Hospital between May 28, 1889, (...) and June 30, 1987, into the hierarchical system of Medical Subject Heading (MeSH) titles. We obtained a total of 125,772 MeSH title translations, 1,563 of them distinct (average 2.8 per case), ranging in frequency from 6,029 occurrences of LUNG to 1 occurrence apiece of 357 MeSH titles. The natural-language-to-MeSH translations showed expected trends over the past century: fewer infectious diseases; more cardiovascular and neoplastic disease among adults; and more respiratory diseases and congenital malformations in the pediatric age group. The greater availability of autopsy documents in electronic form should increase the value of this resource for quality assurance. (shrink)

Using payment to recruit research subjects is a common practice, but it raises ethical concerns that coercion or undue inducement could potentially compromise participants’ informed consent. This is the first national study to explore the attitudes of IRB members and other human subjects protection professionals concerning whether payment of research participants constitutes coercion or undue influence, and if so, why. The majority of respondents expressed concern that payment of any amount might influence a participant’s decisions or behaviors regarding research participation. (...) Respondents expressed greater acceptance of payment as reimbursement or compensation than as an incentive to participate in research, and most agreed that subjects are coerced if the offer of payment makes them participate when they otherwise would not or when the offer of payment causes them to feel that they have no reasonable alternative but to participate . Views about undue influence were similar. We conclude that human subjects protection professionals hold expansive and inconsistent views about coercion and undue influence that may interfere with the recruitment of research participants and impede valuable research. (shrink)

With breathtalung speed, traditional criminal prohibitions against assisted suicide have been declared unconstitutional in twelve states, including California and New York. This poses great promise and great peril. The promise is that competent terminally ill patients, as a compassionate measure of last resort, will have the option of putting an end to their suffering by physician-assisted suicide. More sigmficant, legally permitting this controversial option may be a catalyst for doctors, health care institutions, and society to improve the care of the (...) dying. PAS should be limited only to those relatively few competent patients who continue to suffer intolerably despite unrestrained efforts to palliate and who face a continued existence that they regard as worse than death. When dying patients know they will not be abandoned to miserable and pointless suffering if palliative care fails, they will be fortified to cope better with the process of dying.The immediate peril is that PAS will become a quick fix, available on demand to any patient diagnosed as terminally ill, thus bypassing palliative care and producing premature deaths. (shrink)

BackgroundThe U.S. Food and Drug Administration traditionally has kept confidential significant amounts of information relevant to the approval or non-approval of specific drugs, devices, and biologics and about the regulatory status of such medical products in FDA’s pipeline.ObjectiveTo develop practical recommendations for FDA to improve its transparency to the public that FDA could implement by rulemaking or other regulatory processes without further congressional authorization. These recommendations would build on the work of FDA’s Transparency Task Force in 2010.MethodsIn 2016-2017, we convened (...) a team of academic faculty from Harvard Medical School, Brigham and Women’s Hospital, Yale Medical School, Yale Law School, and Johns Hopkins Bloomberg School of Public Health to develop recommendations through an iterative process of reviewing FDA’s practices, considering the legal and policy constraints on FDA in expanding transparency, and obtaining insights from independent observers of FDA.ResultsThe team developed 18 specific recommendations for improving FDA’s transparency to the public. FDA could adopt all these recommendations without further congressional action.FundingThe development of the Blueprint for Transparency at the U.S. Food and Drug Administration was funded by the Laura and John Arnold Foundation. (shrink)

This book updates and adds to the classic Social Movements of the Sixties and Seventies, showing how social movement theory has grown and changed.

In the past, hypothesis testing in medicine has employed the paradigm of the repeatable experiment. In statistical hypothesis testing, an unbiased sample is drawn from a larger source population, and a calculated statistic is compared to a preassigned critical region, on the assumption that the comparison could be repeated an indefinite number of times. However, repeated experiments often cannot be performed on human beings, due to ethical or economic constraints. We describe a new paradigm for hypothesis testing which uses only (...) rearrangements of data present within the observed data set. The token swap test, based on this new paradigm, is applied to three data sets from cardiovascular pathology, and computational experiments suggest that the token swap test satisfies the Neyman Pearson condition. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:The Incoherence of Determining Death by Neurological Criteria: A Commentary on Controversies in the Determination of Death, A White Paper by the President’s Council on Bioethics*Franklin G. Miller** (bio) and Robert D. Truog (bio)Traditionally the cessation of breathing and heart beat has marked the passage from life to death. Shortly after death was determined, the body became a cold corpse, suitable for burial or cremation. Two technological changes (...) in the second half of the twentieth century prompted calls for a new, or at least expanded, definition of death: the development of intensive care medicine, especially the use of mechanical ventilators, and the advent of successful transplantation of vital organs. Patients with profound neurological damage, leaving them incapable of breathing on their own and in an irreversible coma, could be maintained for some period of time with the aid of mechanical ventilation. The situation of these patients posed two ethical questions. Is it appropriate to stop life-sustaining treatment? If so, is it acceptable to retrieve vital organs for transplantation to save the lives of others before stopping treatment?In 1968, the Ad Hoc Committee of the Harvard Medical School to Examine the Definition of Brain Death proposed that death could be determined on the basis of neurological criteria, thus providing a positive answer to these two questions (Ad Hoc Committee 1968). According to the position of this committee, patients diagnosed with the cessation of brain function are dead, despite the fact that they breathe and circulate blood with the aid of mechanical ventilation. [End Page 185] Because they are dead, it is appropriate, indeed imperative, to stop mechanical ventilation. And because they are dead, it becomes ethical to procure vital organs for transplantation before stopping what otherwise would be life-sustaining treatment. Remarkably, this innovative neurological determination of death became, with little debate or controversy, the established position in medical ethics and the law throughout the United States.The Harvard Committee articulated the diagnosis of “irreversible coma,” but merely asserted that this condition constituted death. No explanatory rationale was provided. It fell to the President’s Commission for the Study of Ethical Problems in Medicine and Biomedical and Behavioral Research to provide an authoritative rationale in its 1981 report, Defining Death. The second paragraph of the report set the stage as follows: “The question addressed here is not inherently difficult or complicated. Simply, it is whether the law ought to recognize new means for establishing that the death of a human being has occurred” (President’s Commission 1981, p. 3). The Commission claimed that “death is a unitary phenomenon” (p. 7) and that the determination of death by neurological criteria, in terms of the absence of all brain function, is consistent with the traditional conception of death as the cessation of vital functioning of the organism as a whole. The key issue is the integrative functioning of the human organism, which ceases to exist, according to the Commission, when the whole brain, including higher cortical areas and the brain stem, fails to function. Although “brain-dead” patients do not appear to be dead—i.e., the reality of their death is “masked” by the activity of mechanical ventilation—the patient’s body has irreversibly lost all capacity for integrative functioning. In the words of the Commission: “When artificial means of support mask this loss of integration as measured by the old methods [cessation of respiration and heart beat], brain-oriented criteria and tests provide a new window on the same phenomenon” (p. 33). The President’s Commission was instrumental in developing and establishing “The Uniform Definition of Death Act”: “An individual who has sustained either (1) irreversible cessation of circulatory and respiratory functions, or (2) irreversible cessation of all functions of the entire brain, including the brain stem, is dead” (p. 2).Although the question posed by the President’s Commission was easy to articulate, the answer, over time, has proved complicated and controversial. The coherence and cogency of determining death by neurological criteria has been challenged. Various experts have demonstrated that “brain-dead” patients maintained on mechanical ventilation display a range of vital, integrative, functioning, which conflicts with the judgment that they are dead (Truog and... (shrink)

Purpose Prescription stimulant use as “cognitive enhancers” has been described among undergraduate college students. However, the use of prescription stimulants among future health care professionals is not well characterized. This study was designed to determine the prevalence of prescription stimulant misuse among students at an academic health sciences center. -/- Method Electronic surveys were e-mailed to 621 medical, pharmacy, and respiratory therapy students at East Tennessee State University for four consecutive weeks in fall 2011. Completing the survey was voluntary and (...) anonymous. Surveys asked about reasons for, frequency of, and side effects of nonprescription misuse of prescription stimulants. Given the sensitive material, an opportunity to win one of ten $50 gift cards was used as an incentive. -/- Results Three hundred seventy-two (59.9%) students completed the survey from three disciplines (47.6% medical, 70.5% pharmacy, and 57.6% respiratory therapy). Overall, 11.3% of responders admitted to misusing prescription stimulants. There was more misuse by respiratory therapy students, although this was not statistically significant (10.9% medicine, 9.7% pharmacy, 26.3% respiratory therapy; P = .087). Reasons for prescription stimulant misuse included to enhance alertness/ energy (65.9%), to improve academic performance (56.7%), to experiment (18.2%), and to use recreationally/get high (4.5%). -/- Conclusions Prescription stimulant misuse was prevalent among participating students, but further research is needed to describe prevalence among future health care workers more generally. The implications and consequences of such misuse require further study across professions with emphasis on investigating issues of academic dishonesty (e.g., “cognitive enhancement”), educational quality, and patient safety or health care quality. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:The Incoherence of Determining Death by Neurological Criteria: A Commentary on Controversies in the Determination of Death, A White Paper by the President’s Council on Bioethics*Franklin G. Miller** (bio) and Robert D. Truog (bio)Traditionally the cessation of breathing and heart beat has marked the passage from life to death. Shortly after death was determined, the body became a cold corpse, suitable for burial or cremation. Two technological changes (...) in the second half of the twentieth century prompted calls for a new, or at least expanded, definition of death: the development of intensive care medicine, especially the use of mechanical ventilators, and the advent of successful transplantation of vital organs. Patients with profound neurological damage, leaving them incapable of breathing on their own and in an irreversible coma, could be maintained for some period of time with the aid of mechanical ventilation. The situation of these patients posed two ethical questions. Is it appropriate to stop life-sustaining treatment? If so, is it acceptable to retrieve vital organs for transplantation to save the lives of others before stopping treatment?In 1968, the Ad Hoc Committee of the Harvard Medical School to Examine the Definition of Brain Death proposed that death could be determined on the basis of neurological criteria, thus providing a positive answer to these two questions (Ad Hoc Committee 1968). According to the position of this committee, patients diagnosed with the cessation of brain function are dead, despite the fact that they breathe and circulate blood with the aid of mechanical ventilation. [End Page 185] Because they are dead, it is appropriate, indeed imperative, to stop mechanical ventilation. And because they are dead, it becomes ethical to procure vital organs for transplantation before stopping what otherwise would be life-sustaining treatment. Remarkably, this innovative neurological determination of death became, with little debate or controversy, the established position in medical ethics and the law throughout the United States.The Harvard Committee articulated the diagnosis of “irreversible coma,” but merely asserted that this condition constituted death. No explanatory rationale was provided. It fell to the President’s Commission for the Study of Ethical Problems in Medicine and Biomedical and Behavioral Research to provide an authoritative rationale in its 1981 report, Defining Death. The second paragraph of the report set the stage as follows: “The question addressed here is not inherently difficult or complicated. Simply, it is whether the law ought to recognize new means for establishing that the death of a human being has occurred” (President’s Commission 1981, p. 3). The Commission claimed that “death is a unitary phenomenon” (p. 7) and that the determination of death by neurological criteria, in terms of the absence of all brain function, is consistent with the traditional conception of death as the cessation of vital functioning of the organism as a whole. The key issue is the integrative functioning of the human organism, which ceases to exist, according to the Commission, when the whole brain, including higher cortical areas and the brain stem, fails to function. Although “brain-dead” patients do not appear to be dead—i.e., the reality of their death is “masked” by the activity of mechanical ventilation—the patient’s body has irreversibly lost all capacity for integrative functioning. In the words of the Commission: “When artificial means of support mask this loss of integration as measured by the old methods [cessation of respiration and heart beat], brain-oriented criteria and tests provide a new window on the same phenomenon” (p. 33). The President’s Commission was instrumental in developing and establishing “The Uniform Definition of Death Act”: “An individual who has sustained either (1) irreversible cessation of circulatory and respiratory functions, or (2) irreversible cessation of all functions of the entire brain, including the brain stem, is dead” (p. 2).Although the question posed by the President’s Commission was easy to articulate, the answer, over time, has proved complicated and controversial. The coherence and cogency of determining death by neurological criteria has been challenged. Various experts have demonstrated that “brain-dead” patients maintained on mechanical ventilation display a range of vital, integrative, functioning, which conflicts with the judgment that they are dead (Truog and... (shrink)

BackgroundIn the Canadian Alliance for Healthy Hearts and Minds (CAHHM) cohort, participants underwent magnetic resonance imaging (MRI) of the brain, heart, and abdomen, that generated incidental findings (IFs). The approach to managing these unexpected results remain a complex issue. Our objectives were to describe the CAHHM policy for the management of IFs, to understand the impact of disclosing IFs to healthy research participants, and to reflect on the ethical obligations of researchers in future MRI studies.MethodsBetween 2013 and 2019, 8252 participants (...) (mean age 58 ± 9 years, 54% women) were recruited with a follow-up questionnaire administered to 909 participants (40% response rate) at 1-year. The CAHHM policy followed a restricted approach, whereby routine feedback on IFs was not provided. Only IFs of severe structural abnormalities were reported.ResultsSevere structural abnormalities occurred in 8.3% (95% confidence interval 7.7–8.9%) of participants, with the highest proportions found in the brain (4.2%) and abdomen (3.1%). The majority of participants (97%) informed of an IF reported no change in quality of life, with 3% of participants reporting that the knowledge of an IF negatively impacted their quality of life. Furthermore, 50% reported increased stress in learning about an IF, and in 95%, the discovery of an IF did not adversely impact his/her life insurance policy. Most participants (90%) would enrol in the study again and perceived the MRI scan to be beneficial, regardless of whether they were informed of IFs. While the implications of a restricted approach to IF management was perceived to be mostly positive, a degree of diagnostic misconception was present amongst participants, indicating the importance of a more thorough consent process to support participant autonomy.ConclusionThe management of IFs from research MRI scans remain a challenging issue, as participants may experience stress and a reduced quality of life when IFs are disclosed. The restricted approach to IF management in CAHHM demonstrated a fair fulfillment of the overarching ethical principles of respect for autonomy, concern for wellbeing, and justice. The approach outlined in the CAHHM policy may serve as a framework for future research studies.Clinical trial registrationhttps://clinicaltrials.gov/ct2/show/nct02220582. (shrink)

In this article, I argue that the reading of Mill that D.G. Brown presents in ‘Mill’s Moral Theory: Ongoing Revisionism’ is inconsistent with several key passages in Mill’s writings. I also show that a rule-utilitarian interpretation that is very close to the one developed by David Lyons is able to account for these passages without difficulty.

The first topic of concern is anonymity, specifically the anonymity that is available in communications on the Internet. An earlier paper argues that anonymity in electronic communication is problematic because: it makes law enforcement difficult ; it frees individuals to behave in socially undesirable and harmful ways ; it diminishes the integrity of information since one can't be sure who information is coming from, whether it has been altered on the way, etc.; and all three of the above contribute to (...) an environment of diminished trust which is not conducive to certain uses of computer communication. Counterbalancing these problems are some important benefits. Anonymity can facilitate some socially desirable and beneficial behavior. For example, it can eliminate the fear of repercussions for behavior in contexts in which repercussions would diminish the availability or reliability of information, e.g., voting, personal relationships between consenting adults, and the like. Furthermore, anonymity can be used constructively to reduce the effect of prejudices on communications. Negative aspects of anonymity all seem to point to a tension between accountability and anonymity. They suggest that accountability and anonymity are not compatible, and they even seem to suggest that since accountability is a good thing, it would be good to eliminate anonymity. In other words, the problems with anonymity suggest that individuals are more likely to behave in socially desirable ways when they are held accountable for their behavior, and they are more likely to engage in socially undesirable behavior when they are not held accountable. I am not going to take issue with the correlation between accountability and anonymity, but rather with the claim that accountability is good. To examine this problem, let's look at a continuum that stretches from total anonymity at one end, and no anonymity at all at the other end. At the opposite extreme of anonymity is a panopticon society. The panopticon is the prison environment described by Foucault in which prison cells are arranged in a large circle with the side facing the inside of the circle open to view. The guard tower is placed in the middle of the circle so that guards can see everything that goes on in every cell. In a recent article on privacy, Jeffrey Reiman, reflecting on the new intelligent highway systems, suggests that we are moving closer and closer to a panopticon society. When we contemplate all the electronic data that is now gathered about each one of us as we move through our everyday lives- intelligent highway systems, consumer transactions, traffic patterns on the internet, medical records, financial records, and so on- we see the trend that Reiman identifies. Electronic behavior is recorded and the information is retained. While actions/transactions in separate domains are not necessarily combined, it seems obvious that the potential exists for combining data into a complete portfolio of an individual's day to day life. So it would seem that as more and more activities and domains are moved into a IT-based medium, the closer we will come to a panopticon society. A panopticon society gives us the ultimate in accountability. Everything an individual does is observable and therefore available to those to whom we are accountable. Of course, in doing this, it puts us, in effect, in prison. The prison parallel is appropriate here because what anonymity allows us is freedom; prison is the ultimate in lack of freedom. In this way the arguments for a free society become arguments for anonymity. Only when individuals are free will they experiment, try new ideas, take risks, and learn by doing so. Only in an environment that tolerates making mistakes will individuals develop the active habits that are so essential for democracy. In a world without information technology, individuals have levels or degrees and various kinds of anonymity and consequently different levels and kinds of freedom. Degrees and kinds of anonymity vary with the domain: small town social life versus urban social life, voting, commercial exchanges, banking, automobile travel, airplane travel, telephone communication, education, and so on. Drawing from our experience before IT-based institutions, we might believe that what we need is varying levels or degrees and kinds of anonymity. This seems a good starting place because it suggests an attempt to re-create the mixture that we have in the physical, non-IT-based world. Nevertheless, there is a danger. If we think in terms of levels and degrees of anonymity, we may not see the forest from the trees. We may not acknowledge that in an electronic medium, levels and kinds of anonymity mean, in an important sense, no anonymity. If there are domains in which we can be anonymous but those domains are part of a global communication infrastructure in which there is no anonymity at the entry point, then it will always be possible to trace someone's identity. We delude ourselves when we think we have anonymity on-line or off-line. Rather, what we have both places is situations in which it is more and less difficult to identify individuals. We have a continuum of situations in which it is easy and difficult to link behavior to other behavior and histories of behaviors. In the physical world, we can go places and do things where others don't know us by name and have no history with us, though they see our bodies, clothes, and behavior. If we do nothing unusual, we may be forgotten. On the other hand, if we do something illegal, authorities may attempt to track us down and figure out who we are. For example, law enforcement officials, collection agencies, those who want to sue us may take an active interest in removing our anonymity, ex post facto. Think of Timothy McVeigh and Terry Nichols-the men who apparently bombed the federal building in Oklahoma City. Much of what they did, they did anonymously, but then law enforcement officials set out to find out who had done various things, e.g., rented a car, bought explosives, etc. The shrouds of anonymity under which McVeigh and Nichols had acted were slowly removed. Is this any different than behavior on the internet? Is there a significant difference in the kind or degree of anonymity we have in the physical world versus what we have in an IT-based world? The character of the trail we leave is different; in the one case, its an electronic trail; while in the other it involves human memories, photographs, and paper and ink. What law enforcement officials had to do to track down McVeigh is quite different from tracking down an electronic law breaker. Also, the cost of electronic information gathering, both in time and money, can be dramatically lower than the cost of talking to people, gathering physical evidence, and the other minutia required by traditional detective work. We should acknowledge that we do not and are never likely to have anonymity on the Internet. We would do better to think of different levels or kinds of identity. There are important moral and social issues arising as a result of these varying degrees and kinds of identity. Perhaps the most important matter is assuring that individuals are informed about the conditions in which they are interacting. Perhaps, even more important is that individuals have a choice about the conditions under which they are communicating. In the rest of this paper we explore a few examples of levels and kinds of identity that are practical on the Internet. We discuss the advantages and disadvantages that we see for these "styles" of identity for individuals, and we examine the costs and benefits of these styles for society as a whole. (shrink)

This essay explains some basic concepts about BDSM, and it responds to two important objections to it. The first is the psychological objection—that BDSM practitioners suffer from mental disorders—and the second is the ethical objection—that BDSM practitioners have morally compromised desires because of the kinds of activities they desire to participate in, especially ones that involve roles that dip into tortured oppressive histories (e.g., "rape" scenes, "master-and-slave" scenes). The paper argues that both objections fail, and, more specifically focusing on the (...) ethical objection, argues that BDSM desires are psychologically, conceptually, and phenomenologically different from their seeming counterpart real-life desires that are truly ethically defective. Finally, the paper argues that BDSM practitioners, in having to always understand, explore, and justify their desires (especially to a majority that is hostile to them), have an interesting chance to lead rich, flourishing lives. (shrink)

What is the temporal course of gratitude and indebtedness and how do these feelings influence helping in the context of reciprocity? In an online-game tapping real-life behaviour, Study 1 (N = 106) finds that while gratitude towards a benefactor remains elevated after an opportunity to reciprocate, indebtedness declines along with helping. Yet, indebtedness rather than gratitude better predicts real-life helping of a benefactor. Using a vignette-based experiment, Study 2 (N = 217) finds that after reciprocation indebtedness and likelihood of helping (...) a benefactor reset to a baseline level while gratitude endures. Furthermore, the decrease in helping after reciprocation is better explained by indebtedness than by gratitude. Study 3 (N = 217) assessed the unique influences of gratitude and indebtedness on helping by comparing contexts in which gratitude is at a baseline level but indebtedness is elevated (e.g. before a monetary payment for a service received) to contexts in which indebtedness is at a baseline level but gratitude is elevated (e.g. after reciprocation of benefits freely given by a friend). People are more likely to help in the former compared to latter context, and this difference is better explained by indebtedness rather than by gratitude. We discuss the interrelated and understudied relationships between gratitude, indebtedness, and reciprocity. (shrink)

This introduction provides a highly readable critical overview of the main arguments and themes in twentieth-century and contemporary metaethics. It traces the development of contemporary debates in metaethics from their beginnings in the work of G. E. Moore up to the most recent arguments between naturalism and non-naturalism, cognitivism and non-cognitivism. A highly readable critical overview of the main arguments and themes in twentieth century and contemporary metaethics. Asks: Are there moral facts? Is there such a thing as moral truth? (...) Is moral knowledge possible? Traces the development of contemporary debates in metaethics from their beginnings in the work of G. E. Moore up to the most recent debates between naturalism and non-naturalism, cognitivism and noncognitivism. Provides for the first time a critical survey of famous figures in twentieth century metaethics such as Moore, Ayer and Mackie together with in-depth discussions of contemporary philosophers such as Blackburn, Gibbard, Wright, Harman, Railton, Sturgeon, McDowell and Wiggins. (shrink)

This new edition of Alexander Miller’s highly readable introduction to contemporary metaethics provides a critical overview of the main arguments and themes in twentieth- and twenty-first-century contemporary metaethics. Miller traces the development of contemporary debates in metaethics from their beginnings in the work of G. E. Moore up to the most recent arguments between naturalism and non-naturalism, cognitivism and non-cognitivism. From Moore’s attack on ethical naturalism, A. J. Ayer’s emotivism and Simon Blackburn’s quasi-realism to anti-realist and best opinion (...) accounts of moral truth and the non-reductionist naturalism of the ‘Cornell realists’, this book addresses all the key theories and ideas in this field. As well as revisiting the whole terrain with revised and updated guides to further reading, Miller also introduces major new sections on the revolutionary fictionalism of Richard Joyce and the hermeneutic fictionalism of Mark Kalderon. The new edition will continue to be essential reading for students, teachers and professional philosophers with an interest in contemporary metaethics. (shrink)

The dual-use dilemma arises in the context of research in the biological and other sciences as a consequence of the fact that one and the same piece of scientific research sometimes has the potential to be used for bad as well as good purposes. It is an ethical dilemma since it is about promoting good in the context of the potential for also causing harm, e.g., the promotion of health in the context of providing the wherewithal for the killing of (...) innocents. It is an ethical dilemma for the researcher because of the potential actions of others, e.g., malevolent non-researchers who might steal dangerous biological agents, or make use of the original researcher’s work. And it is a dilemma for governments concerned with the security of their citizens, as well as their health. In this article we construct a taxonomy of types of “experiments of concern” in the biological sciences, and thereby map the terrain of ethical risk. We then provide a series of analyses of the ethical problems and considerations at issue in the dual-use dilemma, including the impermissibility of certain kinds of research and possible restrictions on dissemination of research results given the risks to health and security. Finally, we explore the main available institutional responses to some of the specific ethical problems posed by the dual-use dilemma in the biological sciences. (shrink)

In this paper I provide a theory of the speech act of assertion according to which assertion is a species of joint action. In doing so I rely on a theory of joint action developed in more detail elsewhere. Here we need to distinguish between the genus, joint action, and an important species of joint action, namely, what I call joint epistemic action. In the case of the latter, but not necessarily the former, participating agents have epistemic goals, e.g., the (...) acquisition of knowledge. It is joint epistemic action that assertion is a species of. (shrink)

Behavioral momentum theory has evolved within the realm of operant conditioning. The thought-provoking momentum metaphor equates the strength of an operant response with its resistance to change and preference (i.e., choice) for that response over other available responses. Whereas baseline response rate (velocity in the metaphor) is assumed to be largely influenced by the response-reinforcer contingency, resistance to change and preference are assumed to reflect an intervening variable called behavioral mass, which is determined primarily by the stimulus-reinforcer relationship. This invites (...) the question of how well the momentum metaphor applies to the stimulus-reinforcer relationships of traditional Pavlovian paradigms. Presumably, a correspondence exists between behavioral mass and the notion of associative strength in the associative learning literature. Although response rate has little meaning in the trialwise structure of classical (i.e., Pavlovian) conditioning, response probability or magnitude might be regarded metaphorically as velocity. Momentum theory suggests that resistance to change (e.g., extinction) is a better indicator of associative strength than is response probability or magnitude. Therefore, variables that strengthen Pavlovian learning should influence resistance to extinction of conditioned responding in a similar manner. Moreover, it is important to assess momentum theory outside of strictly operant paradigms, particularly because in clinical settings many common disorders (e.g., phobias) and their therapies (e.g., cue exposure) are thought to be classically conditioned. (shrink)

Realism in Action is a selection of essays written by leading representatives in the fields of action theory and philosophy of mind, philosophy of the social sciences and especially the nature of social action, and of epistemology and philosophy of science. Practical reason, reasons and causes in action theory, intending and trying, and folk-psychological explanation are some of the topics discussed by these leading participants. A particular emphasis is laid on trust, commitments and social institutions, on the possibility of grounding (...) social notions in individual social attitudes, on the nature of social groups, institutions and collective intentionality, and on common belief and common knowledge. Applications to the social sciences include, e.g., a look at the Erklären-Verstehen controversy in economics, and at constructivist and realist views on archeological reconstructions of the past. (shrink)

We study the sets that are computable from both halves of some (Martin–Löf) random sequence, which we call 1/2-bases. We show that the collection of such sets forms an ideal in the Turing degrees that is generated by its c.e. elements. It is a proper subideal of the K-trivial sets. We characterize 1/2-bases as the sets computable from both halves of Chaitin’s Ω, and as the sets that obey the cost function c(x,s)=Ωs−Ωx−−−−−−−√. Generalizing these results yields a dense hierarchy of (...) subideals in the K-trivial degrees: For k<n, let Bk/n be the collection of sets that are below any k out of n columns of some random sequence. As before, this is an ideal generated by its c.e. elements and the random sequence in the definition can always be taken to be Ω. Furthermore, the corresponding cost function characterization reveals that Bk/n is independent of the particular representation of the rational k/n, and that Bp is properly contained in Bq for rational numbers p<q. These results are proved using a generalization of the Loomis–Whitney inequality, which bounds the measure of an open set in terms of the measures of its projections. The generality allows us to analyze arbitrary families of orthogonal projections. As it turns out, these do not give us new subideals of the K-trivial sets; we can calculate from the family which Bp it characterizes. We finish by studying the union of Bp for p<1; we prove that this ideal consists of the sets that are robustly computable from some random sequence. This class was previously studied by Hirschfeldt [D. R. Hirschfeldt, C. G. Jockusch, R. Kuyper and P. E. Schupp, Coarse reducibility and algorithmic randomness, J. Symbolic Logic81(3) (2016) 1028–1046], who showed that it is a proper subclass of the K-trivial sets. We prove that all such sets are robustly computable from Ω, and that they form a proper subideal of the sets computable from every (weakly) LR-hard random sequence. We also show that the ideal cannot be characterized by a cost function, giving the first such example of a Σ03 subideal of the K-trivial sets. (shrink)

Soil is fragile and nonrenewable but the most basic of natural resources. It has a capacity to tolerate continuous use but only with proper management. Improper soil management and indiscriminate use of chemicals have contributed to some severe global environmental issues, e.g., volatilization losses and contamination of natural waters by sediments and agricultural fertilizers and pesticides. The increasing substitution of energy for labor and other cultural inputs in agriculture is another issue. Fertilizers and chemicals account for about 25% of the (...) production energy investment in agriculture. An additional 60% is accounted for by machinery, gasoline, electricity, and power-related inputs. Fertilizer additions to cropland are not utilized fully and significant amounts, depending on conditions, are either lost in surface runoff or leached into the ground water. The annual discharge of dissolved solids from agricultural lands to the waterways in the USA is substantial. The increasing use of herbicides in agriculture is a threat to the quality of surface and ground water, although this threat is dependent upon both the chemistry of the compound and the ecosystem in which it is used. Especially within the Third World, development of an environmental ethic and environmental laws have not kept pace with the increase in pesticide use. Above all is the severe and global problem of soil degradation currently occurring at the rate of five to seven million hectares per year. The policy and moral aspects of these issues are discussed. (shrink)

The tower number ${\mathfrak t}$ and the ultrafilter number $\mathfrak {u}$ are cardinal characteristics from set theory. They are based on combinatorial properties of classes of subsets of $\omega $ and the almost inclusion relation $\subseteq ^*$ between such subsets. We consider analogs of these cardinal characteristics in computability theory.We say that a sequence $(G_n)_{n \in {\mathbb N}}$ of computable sets is a tower if $G_0 = {\mathbb N}$, $G_{n+1} \subseteq ^* G_n$, and $G_n\smallsetminus G_{n+1}$ is infinite for each n. (...) A tower is maximal if there is no infinite computable set contained in all $G_n$. A tower ${\left \langle {G_n}\right \rangle }_{n\in \omega }$ is an ultrafilter base if for each computable R, there is n such that $G_n \subseteq ^* R$ or $G_n \subseteq ^* \overline R$ ; this property implies maximality of the tower. A sequence $(G_n)_{n \in {\mathbb N}}$ of sets can be encoded as the “columns” of a set $G\subseteq \mathbb N$. Our analogs of ${\mathfrak t}$ and ${\mathfrak u}$ are the mass problems of sets encoding maximal towers, and of sets encoding towers that are ultrafilter bases, respectively. The relative position of a cardinal characteristic broadly corresponds to the relative computational complexity of the mass problem. We use Medvedev reducibility to formalize relative computational complexity, and thus to compare such mass problems to known ones.We show that the mass problem of ultrafilter bases is equivalent to the mass problem of computing a function that dominates all computable functions, and hence, by Martin’s characterization, it captures highness. On the other hand, the mass problem for maximal towers is below the mass problem of computing a non-low set. We also show that some, but not all, noncomputable low sets compute maximal towers: Every noncomputable (low) c.e. set computes a maximal tower but no 1-generic $\Delta ^0_2$ -set does so.We finally consider the mass problems of maximal almost disjoint, and of maximal independent families. We show that they are Medvedev equivalent to maximal towers, and to ultrafilter bases, respectively. (shrink)

An ongoing debate in the philosophy of action concerns the prevalence of moral luck: instances in which an agent’s moral responsibility is due, at least in part, to factors beyond his control. I point to a unique problem of moral luck for agents who depend upon Brain Computer Interfaces (BCIs) for bodily movement. BCIs may misrecognize a voluntarily formed distal intention (e.g., a plan to commit some illicit act in the future) as a control command to perform some overt behavior (...) now. If so, then BCI-agents may be deserving of punishment for the unlucky but foreseeable outcomes of their voluntarily formed plans, whereas standard counterparts who abandon their plans are not. However, it seems that the only relevant difference between BCI-agents and their standard counterparts is just a matter of luck. I briefly sketch different solutions that attempt to avoid this type of moral luck, while remaining agnostic on whether any succeeds. If none of these solutions succeeds, then there may be a unique type of moral luck that is unavoidable with respect to deserving punishment for certain BCI-mediated behaviors. (shrink)

This paper focuses on a non-volitional account that has received a good deal of attention recently, Angela Smith's rational relations view. I argue that without historical conditions on blameworthiness for the non-voluntary non-volitionist accounts like Smith’s are (i) vulnerable to manipulation cases and (ii) fail to make sufficient room for the distinction between badness and blameworthiness. Towards the end of the paper I propose conditions aimed to supplement these deficiencies. The conditions that I propose are tailored to suit non-volitional accounts (...) of blameworthiness. Unlike some volitional historical conditions on blameworthiness, the conditions that I propose do not require that the person have exercised voluntary control (e.g., via choices or decisions) over the acquisition of her attitudes or values. (shrink)

The question of what distinguishes moral problems from other problems is important to the study of the evolution and functioning of morality. Many researchers concerned with this topic have assumed, either implicitly or explicitly, that all moral problems are problems of cooperation. This assumption offers a response to the moral demarcation problem by identifying a necessary condition of moral problems. Characterizing moral problems as problems of cooperation is a popular response to this issue – especially among researchers empirically studying the (...) beginnings and limits of moral psychology. However, demarcating the moral in this way severely restricts the domain of moral problems. There are plenty of moral problems that aren’t simply problems of cooperation. In this paper I argue that understanding moral problems as problems of cooperation is too restrictive and offer an alternative way of demarcating moral from non-moral problems. Characterizing what makes a problem moral in terms of cooperation excludes a variety of problems that are ordinarily understood and responded to as moral. The alternative characterization that I propose is based on the American Indian/Native American concept of harmony. Using the concept of cooperation to demarcate the moral removes moral agents from their surroundings or contexts by assuming moral agency applies only to humans or other similarly evolved lifeforms. In contrast, using the concept of harmony allows for moral consideration to be granted to non-humans as well (e.g., non-human animals, plant life, ecosystems, etc.). (shrink)

This narrative review summarizes the empirical literature on children's competence for consent and assent in research and treatment settings. Studies varied widely regarding methodology, particularly in the areas of participant sampling, situational context studied (e.g., psychological versus medical settings), procedures used (e.g., lab-based vs. real-world approaches), and measurement of competence. This review also identified several fundamental dilemmas underlying approaches to children's informed consent. These dilemmas, including autonomy versus best interests approaches, legal versus psychological or ethical approaches, child- versus family-based approaches, (...) and approaches that emphasize consent versus those that emphasize assent, have implications for the measurement of children's competence and interpretation of findings. Recommendations for future research in the area of children's informed consent include the use of diverse samples and control groups, development of multidimensional and standardized measures of competence, utilization of observational methods and longitudinal designs, examination of noncognitive aspects of children's competence, and comparison of children's competence for treatment and research decisions. (shrink)

This is a welcome reprint of a book that continues to grow in importance.

In this paper, I explore the relationship between joint epistemic action and collective moral responsibility. Here, we need to distinguish between the genus, joint action, and an important species of joint action which I introduced in some earlier work, namely, joint epistemic action. In the case of the latter, but not necessarily the former, participating agents have epistemic goals, e.g. the acquisition of knowledge. The notion of joint action per se is a familiar one in the philosophical literature, albeit I (...) have provided, and defended, a particular analysis of it. However, the notion of joint epistemic action is a novel one. Nevertheless, I argue that it can be given the same kind of analysis as joint action which is not epistemic in character. The other key notion in play in this paper is that of collective moral responsibility. Over the last decade or two this notion has been receiving a good deal of attention in the philosophical literature. Two influential kinds of theory are non-individualist cor.. (shrink)

The notion of a joint action is a familiar one in the philosophical literature. Moreover, the notion of epistemic action has recently been discussed in the literature. Elsewhere I have suggested that these two notions can be brought together to yield the notion of joint epistemic action and provided a relational individualist analysis of joint epistemic actions. In this article I extend this analysis and show how this extended analysis applies to different kinds of important epistemic institutional phenomena: voting in (...) a democracy; financial benchmarks, e.g. LIBOR rate) and; profiling using computer databases. Each of these institutional mechanisms is important in its own right. Moreover, each is a species of a more widespread generic social form that I refer to as joint institutional mechanisms which, I suggest, are ubiquitous yet somewhat diverse in character. Accordingly, there is a need to distinguish them from the more basic phenomenon of joint action but also to taxonomise them. The latter is a large task to which this article is a first step. (shrink)