Randomized control trials (RCTs) are the gold standard for estimating causal effects, but often use samples that are non-representative of the actual population of interest. We propose a reweighting method for estimating population average treatment effects in settings with noncompliance. Simulations show the proposed compliance-adjusted population estimator outperforms its unadjusted counterpart when compliance is relatively low and can be predicted by observed covariates. We apply the method to evaluate the effect of Medicaid coverage on health care use for a target (...) population of adults who may benefit from expansions to the Medicaid program. We draw RCT data from the Oregon Health Insurance Experiment, where less than one-third of those randomly selected to receive Medicaid benefits actually enrolled. (shrink)

Stephen Colbert and Jon Stewart are not the only purveyors of fake news, but they are among the few media figures willing to admit it. Fake news looks a lot like actual news. Both The Colbert Report and The Daily Show push fake news beyond satire. As a result, they enact the postmodern condition described in the philosophical works of Jean Baudrillard (1929–2007). In Baudrillard's terms, these shows are only possible in an age when news has become a simulacrum of (...) “news,” an image of “news” radically unmoored from verifiable reality. Both shows force a confrontation with simulated news, turning it against itself, and refusing to let us viewers off the hook. In a postmodern culture that tempts us to deny that there even is a hook, Stewart and Colbert, as anchors, anchor us to the real. (shrink)

Organizational ethics—defined as the alignment of an institution’s practices with its mission, vision, and values—is a growing field in health care not well characterized in empirical literature. To capture the scope and context of organizational ethics work in United States healthcare institutions, we conducted a nationwide convenience survey of ethicists regarding the scope of organizational ethics work, common challenges faced, and the organizational context in which this work is done. In this article, we report substantial variability in the structure of (...) organizational ethics programs and the settings in which it is conducted. Notable findings included disagreement about the activities that comprise organizational ethics and a lack of common metrics used to assess organizational ethics activities. A frequently cited barrier to full engagement in these activities was poor institution-wide understanding about the role and function of organizational ethics resources. These data suggest a tension in the trajectory of organizational ethics’ professionalization: while some variability is appropriate to the field’s relative youth, inadequate attention to definitions of organizational ethics practice and metrics for success can impede discussions about appropriate institutional support, leadership context, and training for practitioners. (shrink)

U.S. law imposes strict recording and reporting requirements on all entities that manufacture and distribute controlled substances. As a result, the prescription opioid crisis has unfolded in a data-saturated environment. This article asks why the systematic documentation of opioid transactions failed to prevent or mitigate the crisis. Drawing on a recently disclosed trove of 1.4 million internal records from Mallinckrodt Pharmaceuticals, a leading manufacturer of prescription opioids, we highlight a phenomenon we propose to call data diversion, whereby data ostensibly generated (...) or collected for the purpose of regulating the distribution of controlled substances were repurposed by the industry for the opposite aim of increasing sales at all costs. Systematic data diversion, we argue, contributed substantially to the scale of drug diversion seen with opioids and should become a focus of policy intervention. (shrink)

This book provides practical and research-based chapters that offer greater clarity about the particular kinds of teacher reflection that matter and avoids talking about teacher reflection generically, which implies that all kinds of reflection are of equal value.

We are in the midst of a renascence of Royce. The Relevance of Royce consists of a collection of essays from leading experts on the philosophy of Josiah Royce, demonstrating its relevance to contemporary concerns. The book is divided into two parts: Part I explores the depth of Royce’s thought, while Part II considers its reach. The book is “intended to be an interdisciplinary resource for scholars interested in tracing both the historical importance and the contemporary relevance of Royce’s thought”.Part (...) I begins with “Josiah Royce: Alive and Well”—John J. McDermott’s Presidential Address to the Josiah Royce Society in 2005, where he issues a clarion call for... (shrink)

Challenging the fundamental tenet of the multicultural movement -- that social struggles turning upon race, gender, and sexuality are struggles for recognition -- this work offers a powerful critique of current conceptions of identity and ...

To achieve impact, academics need to create personal impact development plans, focused on what and on whom to have an impact and the necessary competencies to do so. Profession and university leaders play a critical role in the successful implementation of such plans.

Debate over whether health care institutions or individual providers should have a legally protected right to conscientiously refuse to offer legal services to patients who request them has grown exponentially due to the increasing legalization of morally contested services. This debate is particularly acute for Catholic health care providers. We elucidate Catholic teaching regarding the nature of conscience and the intrinsic value of being free to act in accord with one’s conscience. We then outline the primary positions defended in this (...) debate and respond to critics of Catholic teaching. In so doing, we show how Catholic health care providers’ claims to conscientiously refuse to offer specific health care services are not essentially faith-based, but are founded upon publicly defensible reasons. We also address the question of whether conscientiously refusing health care providers may become complicit in moral wrongdoing or potentially cause scandal by means of disclosure or referral to another provider. (shrink)

Introduction: The role of animals in philosophies of man -- Part I: What's wrong with animal rights? -- The right to remain silent -- Part II: Animal pedagogy -- You are what you eat : Rousseau's cat -- Say the human responded : Herder's sheep -- Part III: Difference worthy of its name -- Hair of the dog : Derrida's and Rousseau's good taste -- Sexual difference, animal difference : Derrida's sexy silkworm -- Part IV: It's our fault -- The (...) beaver's struggle with species-being : De Beauvoir and the praying mantis -- Answering the call of nature : Lacan walking the dog -- Part V: Estranged kinship -- The abyss between humans and animals : Heidegger puts the bee in being -- Strange kinship : Merleau-Ponty's sensuous stickleback -- Stopping the anthropological machine : Agamben's tick-tocking tick -- Psychoanalysis and the science of kinship -- Psychoanalysis as animal by-product : Freud's zoophilia -- Animal abjects, maternal abjects : Kristeva's strays -- Conclusion: Sustainable ethics. (shrink)

Policy‐makers, bioethicists, and patient advocates have been engaged in a fierce battle about the merits and potential harms of a federal right‐to‐try law. This debate about access to investigational medical products has raised profound questions about the limits of patient autonomy, appropriate government regulation, medical paternalism, and political rhetoric. For example, do patients have a right to access investigational therapies, as the right‐to‐try movement asserts? What is government’s proper role in regulating and facilitating access to drugs that are still in (...) development? In this review, we analyze the history of the right‐to‐try movement, review the arguments put forth by supporters and opponents of the legislation, and consider the movement’s consequences. Two possible scenarios may emerge. One is that the right‐to‐try pathway may fail to meaningfully increase patient access to investigational products. Alternatively, certain companies may attempt to rely on the federal right‐to‐try legislation to sell investigational products, taking advantage of the provision that allows for direct costs, as there is currently no clear mechanism for enforcement or monitoring of cost calculations. (shrink)

Challenging the undesirability of disability is a shared responsibility that requires us to imagine disability differently. In order to imagine disability differently, we need to understand how the neoliberal hegemonic social imagination—key to processes that create good disabled and able-bodied neoliberal subjects—works to curtail who is perceived to have a desirable body. In order to desire disability differently, we must begin with marginal, heterotopic imaginations whereby disability is not something to overcome, but rather is part of a life worth living. (...) In this article, I build on Foucault’s concepts of heterotopia, milieu, and the government of things, and Karen Barad’s agential realism, as well as draw on the work of Mel Chen and Rod Michalko in order to argue that the heterotopic imagination reconfigures how we consider disability to emerge, with whom, and where. By mobilising the heterotopic imagination, we can come to recognise that disability does not emerge as an individualised human body, but rather is an intracorporeal, non-anthropocentric multiplicity. To desire disability differently through the heterotopic imagination is not simply to allow the current formulation of disability to become desirable, but rather to radically alter how we desire disability, in addition to altering what disability is, how it is practised, and what it can be. (shrink)

Contemporary arguments concerning the permissibility of physician-assisted suicide [PAS], or suicide in general, often rehearse classical arguments over whether individual persons have a fundamental right based on autonomy to determine their own death, or whether the community has a legitimate interest in individual members’ welfare that would prohibit suicide. I explicate historical arguments pertaining to PAS aligned with these poles. I contend that an ethical indictment of PAS entails moral duties on the part of one’s community to provide effective means (...) of ameliorating physical and existential suffering. I further elucidate how such duties have been affirmed by the Roman Catholic Church. My aim is to provide reasons why the expanding legalization of PAS should not preclude social investment in effective palliative care and providing a communal presence to the dying as they confront their subjectively experienced suffering. (shrink)

Evidentialists maintain that epistemic justification is strictly a function of the evidence one has at the moment of belief. I argue here, on the basis of two kinds of cases, that the possession of good evidence is an insuflicient basis for justification. I go on to propose a modification of evidentialism according to which justification sometimes requires intellectually virtuous agency. The discussion thereby underscores an important point of contact between evidentialism and the more recent enterprise of virtue epistemology.

This paper presents an integrative, descriptive model of ethical decision making, with special attention given to issues of measurement. After building the model, hypotheses are developed from a portion of it. These hypotheses are tested in an exploratory analysis to determine if further research and testing of this model and the measurement instruments it employs are warranted.

Big dreams are rare but highly memorable dream experiences that make a strong and lasting impact on the dreamer's waking awareness. Moving far beyond "I forgot to study and the finals are today" and other common scenarios, such dreams can include vivid imagery, intense emotions, fantastic characters, and an uncanny sense of being connected to forces beyond one's ordinary dreaming mind. In Big Dreams, Kelly Bulkeley provides the first full-scale cognitive scientific analysis of such dreams, putting forth an original (...) theory about their formation, function, and meaning.Big dreams have played significant roles in religious and cultural history, but because of their infrequent occurrence and fantastical features, they have rarely been studied in light of modern science. We know a great deal about the religious manifestations of big dreams throughout history and around the world, but until now that cross-cultural knowledge has never been integrated with scientific research on their psychological roots in the brain-mind system. In Big Dreams, Bulkeley puts a classic psychological thesis to the scientific test by clarifying and improving it with better data, sharper analysis, and a broader evolutionary framework. He brings evidence from multiple sources, shows patterns of similarity and difference, questions prior assumptions, and provides predictive models that can be applied to new sets of data. The notion of a connection between dreaming and religion has always been intuitively compelling; Big Dreams transforms it into a solid premise of religious studies and brain-mind science. Combining evidence from religious studies, psychology, anthropology, evolutionary biology, and neuroscience, Big Dreams makes a compelling argument that big dreams are a primal wellspring of religious experience. They represent an innate, neurologically hard-wired capacity of our species that regularly provokes greater self-awareness, creativity, and insight into the existential challenges and spiritual potentials of human life. (shrink)

Many scientists and philosophers of science are troubled by the relative isolation of developmental from evolutionary biology. Reconciling the science of development with the science of heredity preoccupied a minority of biologists for much of the twentieth century, but these efforts were not corporately successful. Mainly in the past fifteen years, however, these previously dispersed integrating programmes have been themselves synthesized and so reinvigorated. Two of these more recent synthesizing endeavours are evolutionary developmental biology and developmental systems theory. While the (...) former is a bourgeoning and scientifically well-respected biological discipline, the same cannot be said of DST, which is virtually unknown among biologists. In this review, we provide overviews of DST and EDB, summarize their key tenets, examine how they relate to one another and to the study of epigenetics, and survey the impact that DST and EDB have had on biological theory and practice. (shrink)

Hickey discusses the moral philosophy of the film Groundhog’s Day and the impact on one man’s life from starting anew. Philosophical discussion continues with [the pivotal role] Phil’s meaning to life and his ongoing discovery of personal happiness.

Stem cell scientists and ethicists have focused intently on questions relevant to the developmental stage and developmental capacities of stem cells. Comparably less attention has been paid to an equally important set of questions about the nature of stem cells, their common characteristics, their non‐negligible differences and their possible developmental species specificity. Answers to these questions are essential to the project of justly inferring anything about human stem cell biology from studies in non‐human model systems—and so to the possibility of (...) eventually developing human therapies based on stem cell biology. After introducing and discussing these questions, I conclude with a brief discussion of the creation of novel model systems in stem cell biology: human‐to‐animal embryonic chimeras. Such novel model systems may help to overcome obstacles to extrapolation, but they are also scientifically and ethically contentious. BioEssays 26:1005‐1012, 2004. © 2004 Wiley Periodicals, Inc. (shrink)

Abstract Theories of personal well-being are typically developed so that they render verdicts on (a) how well-off a person is at a moment, (b) how well-off a person is over an interval of time, and (c) how good a whole life is for the person who lives it. Conative theories of welfare posit welfare-atoms that consist, e.g., in episodes of desire-satisfaction, aim-achievement, or values-realisation. Most extant conative theories are additive: they compute well-being over time - up to and including the (...) value of a whole life - by adding up the values of these welfare atoms. Here, it is shown that such atomistic, additive conative theories do not always generate plausible verdicts on (b) and (c) above. They imply that lives featuring incoherent plans and rapidly changing projects go surprisingly well for those who lived them. Holistic theories of well-being are often thought to provide a solution to problems like these. However, one of the best-known versions of welfare holism within the conative family, Rawls? rational life-preferentism, is based on the problematic assumption that there is one ideal life plan for each person. This paper presents a new form of paradigm-resemblance based conative holism that does not make this assumption and that explains the limits of additivity. (shrink)

ABSTRACT This essay thinks through the relationship between dystopia and utopia, in particular, how the constellation of past and present in radical demands amid state and economic violence is that which creates “crisis”—an estrangement from the present, a reclaiming of past insurgency, and the possibilities for other worlds.

Now that mankind has created the capability of destroying itself through nuclear technology, is it still possible to think in terms of a "just war"? Johnson argues that it is, and in the context of specific case studies he offers moral guidelines for addressing such major contemporary problems as terrorist activity in a foreign country, an individual’s conscientious objection to military service, and an American defense policy that requires development of weapons that may be morally employed in case of need. (...) "Remarkable.... A thoughtful and even profound book, which can be warmly recommended."—Adam Roberts, _New Society_ __ "[A] wise, prudential, and moral thesis.... A most important book, one that all Americans who can should read."—George Armstrong Kelly, _Political Science Quarterly_ __ "At its heart, _Can Modern War be Just? _Is a challenge to the common assumption that any modern war must be total—an unrestrained, spasmodic release of one’s entire destructive capacity against the whole of the enemy’s population."—Richard Allen, _Journal of Religious Ethics_ __ "Johnson... seriously attempt[s] to balance principles and respect facts. For this he is to be praised."—Gary Jason, _Chronicles of Culture_ __ "Johnson’s application of just war doctrine to the hardest problems of contemporary warfare is both morally sensitive and intellectually bold. Readers will sometimes disagree with his arguments, but they will be forced to think hard, and they will learn what it is to work within a moral tradition."—Michael Walzer. (shrink)

The question of how to handle incidental findings has sparked a heated debate among neuroimaging researchers and medical ethicists, a debate whose urgency stems largely from the recent explosion in the number of imaging studies being conducted and in the sheer volume of scans being acquired. Perhaps the point of greatest controversy within this debate is whether the magnetic resonance imaging scans of all research participants should be reviewed in an active search for pathology and, moreover, whether this search should (...) be performed by a radiologist. Resistance to routine readings performed by radiologists, as opposed to selective review of those scans on which investigators have spotted a possible IF, has been fueled in part by the obvious and enormous cost — financial and logistical — of engaging radiologists to read massive numbers of scans. This cost would be especially burdensome, even prohibitive, to investigators who are not affiliated with a medical center, because of their limited access to radiologists and other medical expertise. (shrink)

The pathologization of women’s depression covers over the social and institutional causes of that symptomology. Insofar as patriarchal values continue to devalue and debase women and mothers in ways that colonize psychic space, and depression becomes a cover for what I call ‘social melancholy.’ This is not the melancholy of traditional psychoanalysis, but a form of melancholy that results from oppression, domination, and the colonization of psychic space. Social melancholy differs from both Freud’s notion of melancholy in that it is (...) the result of social factors that constitute the depressed subject as ashamed and lacking agency. Crucial to my analysis is a distinction between shame and guilt missing from traditional psychoanalytic accounts of melancholy and depression. (shrink)

This chapter contains sections titled: Malevolence Proper An Epistemic Counterpart of Malevolence Epistemic Malevolence and Intellectual Vice Acknowledgments References.

Introduction to a special issue of _Theoretical Medicine and Bioethics_ on whether health care professionals should have a legally-protected right to conscientiously refuse to provide legal services that are autonomously requested by patients. Outlines the parameters of the current debate in the bioethics literature and orients readers to the articles the special issue comprises.

This study provides a comparative analysis of students' self-reported beliefs and behaviors related to six analogous pairs of conventional and digital forms of academic cheating. Results from an online survey of undergraduates at two universities (N = 1,305) suggest that students use conventional means more often than digital means to copy homework, collaborate when it is not permitted, and copy from others during an exam. However, engagement in digital plagiarism (cutting and pasting from the Internet) has surpassed conventional plagiarism. Students (...) also reported using digital "cheat sheets" (i.e., notes stored in a digital device) to cheat on tests more often than conventional "cheat sheets." Overall, 32% of students reported no cheating of any kind, 18.2% reported using only conventional methods, 4.2% reported using only digital methods, and 45.6% reported using both conventional and digital methods to cheat. "Digital only" cheaters were less likely than "conventional only" cheaters to report assignment cheating, but the former was more likely than the latter to report engagement in plagiarism. Students who cheated both conventionally and digitally were significantly different from the other three groups in terms of their self-reported engagement in all three types of cheating behavior. Students in this "both" group also had the lowest sense of moral responsibility to refrain from cheating and the greatest tendency to neutralize that responsibility. The scientific and educational implications of these findings are discussed in this study. (shrink)

According to Pierre Bourdieu, practices and habits are out the realm of rationality; this claim about their nature explains their peculiar resistance to rational revision. I argue that one can explain the fact that practices and habits are difficult to revise, without abandoning the view that they are within the space of reasons.