There are many cases in which people collectively cause some morally significant outcome (such as a harmful or beneficial outcome) but no individual act seems to make a difference. The problem in such cases is that it seems each person can argue, ‘it makes no difference whether or not I do X, so I have no reason to do it.’ The challenge is to say where this argument goes wrong. My approach begins from the observation that underlying the problem and (...) motivating the typical responses to it is a standard, intuitive assumption. The assumption is that if an act will not make a difference with respect to an outcome, then it cannot play a sig- nificant, non-superfluous role in bringing that outcome about. In other words, helping to bring about an outcome requires making a difference. I argue that the key to solving the problem is to reject this assumption. I develop an account of what it is to help to bring about an outcome, where this does not require making a difference, and I use this explain our reasons for action in the problem cases. This account also yields an error theory that explains why the standard assumption is so tempting, even though it is mistaken. (shrink)

This book presents a comprehensive examination of Gottfried Leibniz's views on the nature of agents and their actions. Julia Jorati offers a fresh look at controversial topics including Leibniz's doctrines of teleology, the causation of spontaneous changes within substances, divine concurrence, freedom, and contingency, and also discusses widely neglected issues such as his theories of moral responsibility, control, attributability, and compulsion. Rather than focusing exclusively on human agency, she explores the activities of non-rational substances and the differences between distinctive (...) types of actions, showing how the will, appetitions, and teleology are key to Leibniz's discussions of agency. Her book reveals that Leibniz has a nuanced and compelling philosophy of action which has relevance for present-day discussions of agency. It will be of interest to scholars and students of early modern philosophy as well as to metaphysicians and philosophers of action. (shrink)

Accounts of virtue suffer a conflation problem when they appear unable to preserve intuitive distinctions between types of virtue. In this essay I argue that a number of influential attempts to preserve the distinction between moral and epistemic virtues fail, on the grounds that they characterize virtuous traits in terms of ‘characteristic motivation’. I claim that this does not distinguish virtuous traits at the level of value‐conferring quality, and I propose that the best alternative is to distinguish them at the (...) level of good produced. It follows from this that a consequentialist account is best placed to avoid a conflation of moral and epistemic virtue. (shrink)

This article examines why firms engage in Corporate Social Responsibility (CSR). Specifically, it investigates the relationship between a firm's motivation to engage in CSR and the depth of its commitment. I propose that the enduring debate over CSR and financial performance is misaligned, and that scholars should instead focus on the underlying components of CSR engagement. This research sheds light on the motivational antecedents of a firm's engagement in CSR and their effect on CSR commitment. Despite calls for scientific investigation (...) of this linkage, it has received scant attention in the literature. Pursuing this area of research requires the construction of measures of CSR motivation and CSR commitment, as prior work generally lacks objective analysis. I present measures and a research methodology that test hypotheses about how CSR motivation relates to different levels of CSR commitment. The results of this research both validate and challenge current theory. This refined understanding of CSR engagement may enhance firm transparency and accountability to stakeholders. It may reduce the uncertainty in both internal and external assessments of firm CSR and the potential for social and financial impact. (shrink)

Music is an inescapable part of social, cultural and political life, and has played a powerful role in mobilising support for popular movements demanding social justice. The impact of David Bowie, Prince and Bob Dylan, for example, on diversity awareness and legislative reform relating to sexuality, gender and racial equality respectively is still felt; with the latter receiving a Nobel Prize in 2016 for ‘having created new poetic expressions within the great American song tradition’. The influence of these composers and (...) performers reached far beyond the concert hall. Conversely, musical propaganda has been a common feature of many dictatorships, most notably Nazism’s Adolf Hitler and Communism’s Joseph Stalin, and is still instrumental in the election campaigns of political parties. US President Donald Trump’s winning retro classic rock campaign playlist conveyed an idealised version of the past which aligned with the tastes and interests of his core constituency, and evoked feelings of nationalistic pride and patriotism. The eclectic selection of upbeat music effectively masked the underlying capitalist initiatives, corporate greed and allegations of financial impropriety that characterised both the Democrat and Republican campaigns. Although unable to impart meaning with the same level of precision as language, music has a potentially broader semantic capacity due to its greater elasticity. It constitutes a common language which has the ability to create a community of people that sings, speaks, reasons, votes and even feels the same way. Accordingly, this article explores the symbiotic relationship between music and law, identity politics and social justice, via the lens of musical semiosis. (shrink)

The essays in this volume convince me of something which, until now was only a hypothesis of mine. Academic discourse, and perhaps American university discourse in particular, possesses an extraordinary ability to absorb, digest, and neutralize all of the key, radical or dramatic moments of thought, particularly, a fortiori, of contemporary though. Marxism in the United States, though marginalized, remains deafly dominant and exercises a fascination that we have not seen in Europe since the Russian Proletkult of the 1930s. Post-Heideggerian (...) "deconstructivism" though esoteric, is welcomed in the United States as an antidote to analytic philosophy or, rather, as a way to valorize, through contrast, that philosophy. Only one theoretical breakthrough seems consistently to mobilize resistances, rejections and deafness: psychoanalysis—not as the "plague" allowed by Freud to implant itself in America as a "commerce in couches" but rather as that which, with Freud and after him, has led the psychoanalytic decentering of the speaking subject to the very foundations of language. It is this latter direction that I will be exploring here, with no other hope than to awaken the resistances and, perhaps, the attention of a concerned few, after the event .For I have the impression that the "professionalism" discussed throughout the "Politics of Interpretation" conference is never as strong as when professionals denounce it. In fact, the same preanalytic rationality unites them all, "conservatives" and "revolutionaries"—in all cases, jealous guardians of their academic "chairs" whose very existence, I am sure, is thrown into question and put into jeopardy by psychoanalytic discourse. I would therefore schematically summarize what is to follow in this way:1. There are political implications inherent in the act of interpretation itself, whatever meaning that interpretation bestows. What is the meaning, interest, and benefit of the interpretive position itself, a position from which I wish to give meaning to an enigma? To give a political meaning to something is perhaps only the ultimate consequence to he epistemological attitude which consists, simply, of the desire to give meaning. This attitude is not innocent but, rather, is rooted in the speaking subjects' need to reassure himself of his image and his identity faced with an object. Political interpretation is thus the apogee of the obsessive quest for A Meaning.2. The psychoanalytic intervention within Western knowledge has a fundamentally deceptive effect. Psychoanalysis, critical and dissolvent cuts through political illusions, fantasies, and beliefs to the extent that they consist in providing only one meaning, an uncriticizable ultimate Meaning, to human behavior. If such a situation can lead to despair within the polis, we must not forget that it is also a source of lucidity and ethics. The psychoanalytic intervention is, from this point of view, a counterweight, an antidote, to political discourse which, without it, is free to become our modern religion: the final explanation.3. The political interpretations of our century have produced two powerful and totalitarian results: fascism and Stalinism. Parallel to the socioeconomic reasons for these phenomena, there exists as well, another, more intrinsic reason: the simple desire to give a meaning to explain, to provide the answer, to interpret. In that context I will briefly discuss Louis Ferdinand Céline's texts insofar as the ideological interpretations given by him are an example of political delirium in avant-garde writing.Julia Kristeva,professor of linguistics at the University of Paris VII and a regular visiting professor at Columbia University, is the author of Desire in Language: A Semiotic Approach to Literature and Art and About Chinese Women.Margaret Waller, a doctoral candidate in French at Columbia University, is currently translating Kristeva's Revolution du langage poétique. (shrink)

Spoken language consists of a linear sequence of units, from which the existence of particular underlying hierarchical processing mechanisms is inferred. Uddén et al. use graph theory to provide a framework for describing the possible structural relationships that may underlie a linear output sequence. Being more explicit in defining different structures can help identifying and testing for such structures in AGL experiments, as well as help showing how behavioral and neuroimaging data reveals signatures of hierarchical processing in humans.

Spoken language consists of a linear sequence of units, from which the existence of particular underlying hierarchical processing mechanisms is inferred. Uddén et al. use graph theory to provide a framework for describing the possible structural relationships that may underlie a linear output sequence. Being more explicit in defining different structures can help identifying and testing for such structures in AGL experiments, as well as help showing how behavioral and neuroimaging data reveals signatures of hierarchical processing in humans.

Special Issue, n. I, ch. 1, On the Transcendental.

Leibniz maintains that even though God’s intellect contains all possibles, some of these possibles are not compossible. This incompossibility of some possibles is supposed to explain which collections of possibles are possible worlds and why God does not actualize the collection of all possibles. In order to fully understand how this works, we need to establish what precisely Leibniz takes to be the source of incompossibility, that is, which divine attribute or faculty gives rise to the incompossibility of certain possibles. (...) Different interpretations answer this question in different ways. This chapter explores the role that God’s faculties play on some of the standard interpretations of Leibniz’s notion of incompossibility and argues that we are faced with a dilemma: even though incompossibility must somehow arise from God’s faculties, none of the faculties usually distinguished seems up to the task. To escape this dilemma, we need to revise the traditional understanding of the divine faculties. More specifically, we need to recognize wisdom as an attribute that is distinct from intellect, power, and will and that is the source of incompossibility. (shrink)

My aim in this chapter is to explain how and why all human cognition depends on the body for Leibniz. I will show that there are three types of dependence: (a) the body is needed in order to supply materials, or content, for thinking; (b) the body is needed in order to give us the opportunity for the discovery of innate ideas; and (c) the body is needed in order to provide sensory notions as vehicles of thought. The third type (...) is intimately connected to the faculty of the imagination, which supplies the sensory vehicles of thought. Hence, the paper will also examine Leibniz’s account of that faculty and its operations. Before doing any of this, however, I will address the elephant in the room: Leibniz’s claim that mind and body do not interact at all, metaphysically speaking. The correspondence between mind and body is merely a matter of what he calls ‘pre-established harmony’. At first glance, this Leibnizian doctrine may suggest a radical disembodiment of all human cognition. Yet, I will argue that this is not the case and that, quite to the contrary, pre-established harmony requires that cognition is embodied in one important sense. (shrink)

it is one of the central commitments of Leibniz’s mature metaphysics that all substances or monads possess perfect spontaneity, that is, that all states of a given monad originate within it.1 Created monads do not truly interact with each other, for Leibniz. Instead, each one produces all of its states single-handedly, requiring only God’s ordinary concurrence. Several commentators have pointed out that implicit in Leibniz’s view is a distinction between different types of spontaneity: a general type of spontaneity that all (...) monads have perfectly and at all times, and a narrower type of spontaneity that monads possess in only some of their actions. Some commentators make a similar case for two types of teleology:.. (shrink)

By bringing together influential critics of neo-Aristotelian virtue ethics and some of the strongest defenders of an Aristotelian approach, this collection provides a fresh assessment of the strengths and weaknesses of Aristotelian virtue ethics and its contemporary interpretations. Contributors critically discuss and re-assess the neo-Aristotelian paradigm which has been predominant in the philosophical discourse on virtue for the past 30 years.

There are considerable gaps in our knowledge of how children develop abstract language. In this paper, we tested the Affective Embodiment Account, which proposes that emotional information is more essential for abstract than concrete conceptual development. We tested the recognition memory of 7- and 8-year-old children, as well as a group of adults, for abstract and concrete words which differed categorically in valence. Word valence significantly interacted with concreteness in hit rates of both children and adults, such that effects of (...) valence were only found in memory for abstract words. The pattern of valence effects differed for children and adults: children remembered negative words more accurately than neutral and positive words, whereas adults remembered negative and positive words more accurately than neutral words. In addition, signal detection analysis revealed that children were better able to discriminate negative than positive words, regardless of concreteness. The findings suggest that the memory accuracy of 7- and 8-year-old children is influenced by emotional information, particularly for abstract words. The results are in agreement with the Affective Embodiment Account and with multimodal accounts of children’s lexical development. (shrink)

The 1695 publication of the “New System of the Nature of Substances and their Communication, and of the Union which Exists between the Soul and the Body” in the June 27 and July 4 issues of the Parisian Journal des sçavans marks an important milestone in Leibniz’s philosophical trajectory. It presented the first comprehensive public presentation of his metaphysics as it had matured over the preceding decades, and it would spark many lively exchanges and debates between Leibniz and his philosophical (...) contemporaries in the decades to come. This chapter provides background regarding the text’s genesis and reception, and introduces its main philosophical themes. After highlighting some interpretative challenges raised by both the “New System’s” form and philosophical content, it goes on to explore two key elements of the metaphysical picture it advances: Leibniz’s account of individual substances, and his theory of the pre-established harmony between them. (shrink)

The critical aspects of deep brain stimulation are usually the focus of the ethical debate about the implantation of electrodes into the brain of patients with Parkinson’s disease. Above all, potential postoperative side effects on personality caused by DBS mark the debate. However, rehabilitation of agility and mobility by DBS can be posited against critical aspects. Therefore, the purpose of this article is to emphasize the hitherto neglected positive aspects of that technology. A detailed study of the rehabilitation of controlled (...) movements will thus be the object of this article. The possibility to move again in a controlled way will be discussed as freedom of movement. The concept freedom of movement is being linked to the observation of feelings of euphoria and joy that can occur after surgery for patients with PD stimulated in the subthalamic nucleus. This is done based on phenomenological analysis and qualitative interviews, in which the relation between freedom of movement and feelings of joy becomes clear. The aim here is to show that these feelings of exaltation express an essential feeling of freedom – a bodily felt freedom – which is grounded in movement and can be regained by STN-DBS. (shrink)

An analysis of the evolution of the overlapping histories of human rights and development, and an exploration of the alternatives, through the lens of indigenous and other southern theories and epistemologies.

Leibniz sometimes tells us that there are only two fundamental types of mental states: perceptions and appetitions, that is, mental representations and desire-like states. While this may sound like an overly sparse ontology of mental states, the philosophy of mind that Leibniz builds from these elements is surprisingly nuanced and powerful. What makes this possible is that he distinguishes different sub-types of these mental states. Leibniz famously differentiates between unconscious and conscious perceptions, which gives him an advantage over philosophers like (...) Descartes, for whom all perceptions are conscious. He also distinguishes between reflective and unreflective perceptions, as well as between degrees of perceptual distinctness. Leibniz furthermore follows scholastic thinkers like Thomas Aquinas in distinguishing different types of appetitions. Uncovering what those are and what roles they play in Leibniz’s philosophy of mind are the central aims of this chapter. (shrink)

In the model theory of modules the Ziegler spectrum, the space of indecomposable pure-injective modules, has played a key role. We investigate the possibility of defining a similar space in the context of G-sets where G is a group.

The evaluation of character has taken on new significance in moral theory, and, indeed, some advocate a shift in focus away from evaluating action to evaluating character. This has been taken to pose special challenges for utilitarian and consequentialist moral theory. Utilitarianism's commitment to impartiality and its seeming failure to accommodate virtue evaluation have led to problems, some of which are developed in the essays in this volume.

El propósito de la “Dialéctica trascendental” es exponer cómo la razón es el origen de la ilusión trascendental, para prevenir los errores que puedan derivarse de ella. Sin embargo, en el “Apéndice”, Kant sostiene que la razón no sólo tiene este aspecto negativo o problemático, también es una facultad que le proporciona al entendimiento la meta de lograr una unidad sistemática de todo conocimiento. En el presente texto abordaré dos preocupaciones interpretativas en torno al “Apéndice”. La primera cuestiona si Kant (...) se contradice a sí mismo en esta sección al plantear que el principio de unidad sistemática es, simultáneamente, subjetivo y objetivo. La segunda reflexiona si se trata de una sección que contradice las tesis centrales de la “Analítica trascendental”, al presentar una nueva condición necesaria para el conocimiento, más allá de las establecidas por el entendimiento y la sensibilidad. (shrink)

To a superficial consideration, art criticism might appear as a profession of a parasitic nature, nourishing itself on what is produced by others: by artists. In fact, however, the relation between artistic practice and its criticism is more adequately conceived of as a sort of symbiosis. For, while it is true that criticism depends on and presupposes the existence of its objects - that is, works of art - on the other hand nothing would prevent good art from being equated (...) with and contaminated by bad art if critics ceased to draw a distinction between the two. (shrink)

Leibniz’s correspondence with Antoine Arnauld is one of the clearest and most comprehensive expressions of Leibniz’s philosophy in the so-called middle period. This chapter will explore the philosophical content of this correspondence. It will concentrate on four of the most central topics: (a) complete concepts and contingency, (b) substance and body, (c) causation, and (d) the special status of rational souls in God’s plan.

Die Theorie des Hörens von Hermann von Helmholtz kreist um eine offene Frage: Wie geschieht der Übergang von der physikalischen Schwingung zum wahrgenommenen Klang? Helmholtz sucht die Antwort darauf nicht nur in einer Synthese des verfügbaren Wissens der Mathematik, Physik, Physiologie und Anatomie, sondern auch in der Musikgeschichte, die er als einen hörphysiologischen Langzeitversuch auffasst. Er fügt sie in sein eigenes Experimentalsystem ein, um das Wissen vom Hören aufzudecken, das in der Musik steckt. Julia Kursell zeichnet diese Experimentalisierung der (...) Musik nach, nimmt das Verhältnis von Ohr und Instrument in den Blick und rekonstruiert die Rolle und Funktion der Musik in Helmholtz' Theorie der Wahrnehmung. (shrink)

Spatial visualization as a key variable in sex-related differences in mathematical problem solving and spatial aspects of geometry is traced to the 1960s. More recent relevant data are presented. The variability debate is traced to the latter part of the nineteenth century and an explanation for it is suggested. An idea is presented for further research to clarify sex-related brain laterality differences in solving spatial problems.

"I have a tree, which grows here in my close, / That mine own use invites me to cut down, / And shortly I must fell it" (Shakespeare 2001, 168)—Timon's lament, which in Shakespeare's rendition occurs shortly before its utterer's demise "upon the beached verge of the salt flood" (2001, 168) beyond the perimeter of Athens, is an indictment of the nature that Timon finds unable to escape. Having given away his wealth in misguided generosity to a host of parasitic (...) sycophants, Timon turns misanthropic when his "friends" reject his requests for help in kind to repay his debts, eventually exiling himself from the city with the intent of sustaining himself on nothing but water and roots. Yet he soon finds that removing .. (shrink)

The research is devoted to justification of the interdisciplinary approach in the study of consciousness. Studying consciousness as a phenomenon is a very divergent project, the mystery of its nature and appearance makes different ways of studying consciousness possible. Besides, consciousness is an umbrella term which may be interpreted differently in different contexts. Various approaches to comprehension of consciousness have been developed nowadays in Philosophy, Psychology, Biology, Medicine, Neurosciences, Sociology, Cognitive and Computer Sciences, Linguistics and a number of other research (...) fields. In the end of the 1980s one can notice an exceptional growth of interest in the problem of consciousness both in Philosophy and Science. The works by Bernard Baars, Daniel Dennett, Roger Penrose, Francis Crick and Christopher Koch, David Chalmers have appeared in these years. They outlined the main approaches to the study of consciousness and demonstrated that study of consciousness became an interdisciplinarity research. The research discusses the features of the phenomenon of consciousness and outlines the main theoretical issues, the most relevant of which are the “hard problem” of consciousness, the problem of mind and body, the problem of “the explanatory gap”, the question of the primacy of the brain in relation to consciousness, the place of consciousness in the modern scientific paradigm, changes of the ethical and worldview interpretation in connection with artificial intelligence, neurochips and neural network. Based on the complexity and multidimensionality of the research field associated with the problem of consciousness, the variety of approaches to studying this problem in Philosophy and Science, the controversial character of the questions raised, and the heated discussion among researches, the author concludes that interdisciplinary studies of consciousness have the greatest heuristic possibilities today. (shrink)

Leibniz’s famous Principle of the Identity of Indiscernibles (PII) states that no two things are exactly alike. The PII is commonly thought to be metaphysically necessary for Leibniz: the coexistence of two indiscernibles is metaphysically impossible. This paper argues, against the standard interpretation, that Leibniz’s PII is metaphysically contingent. In other words, while the coexistence of indiscernibles would not imply a contradiction, the PII is true in the actual world because the Principle of Sufficient Reason rules out violations of the (...) PII. God could have created indiscernibles but he did not because he is wise and does nothing without a sufficient reason. Because it is plausible that all Leibnizian possible worlds are unified by a wise plan, this means that the PII is true in all possible worlds. God could create indiscernibles, but the resulting creation would not be a world. To argue for this conclusion, the paper carefully examines Leibniz’s mature account of metaphysical contingency. It shows that for Leibniz, only states of affairs that imply logical contradictions are metaphysically impossible. Next, it argues that the coexistence of indiscernibles would not imply a logical contradiction; it would merely imply what Leibniz calls a “moral absurdity,” that is, a violation of the Principle of Sufficient Reason. This means that the PII is true contingently and—since God can do whatever is metaphysically possible—that God can create two things that are exactly alike. (shrink)

Driverless automobility presents a “technological sublime” encompassing both promises and perils. The light side of the emerging transportation future lies, for instance, in the newly gained freedom from driving. The dark side of this sublime includes ethical challenges and potential harm resulting from the required socio-technical transformations of mobility. This article explores contemporary visions for the self-driving car future through the lens of the sublime and some of its theoretical variations, such as the natural, technological, electrical, and digital sublime. Nissan’s (...) IDS Concept preview clip and the Chevrolet FNR trailer serve as examples for this analysis, which aims to demythologize the visual rhetoric of the depicted awe-inspiring self-driving systems. The sublime’s inherent dialectic of inducing both pleasure and displeasure is removed in the corporate utopian visions in favor of an exalting partnership between human and machine. This strategy succeeds by setting the mobility future in the context of controlled parameters such as the trustworthy communicative vehicle, the vital and independent protagonists, and the harmless and unharmed environment. Recognizing such recurring strategies and identifying the controlled parameters which allow the sublime object to electrify, not terrify, is key for a sensible engagement with such imagined futures and their social, cultural, political, economic, environmental, and ethical implications. Such premediations of awe-inspiring technological formations and the underlying logics ask to be unpacked toward decision making that considers all potential facets of the sublime future. (shrink)

The aim of the study was to develop a new comprehensive reading assessment battery for multi-ethnic and multilingual learners in Malaysia. Using this assessment battery, we examined the reliability, validity, and dimensionality of the factors associated with reading difficulties/disabilities in the Malay language, a highly transparent alphabetic orthography. In order to further evaluate the reading assessment battery, we compared results from the assessment battery with those obtained from the Malaysian national screening instrument. In the study, 866 Grade 1 children from (...) multi-ethnic and multilingual backgrounds from 11 government primary schools participated. The reading assessment battery comprised 13 assessments, namely, reading comprehension, spelling, listening comprehension, letter name knowledge, letter name fluency, rapid automatized naming, word reading accuracy, word reading efficiency, oral reading fluency, expressive vocabulary, receptive vocabulary, elision, and phonological memory. High reliability and validity were found for the assessments. An exploratory factor analysis yielded three main constructs: phonological-decoding, sublexical-fluency, and vocabulary-memory. Phonological-decoding was found to be the most reliable construct that distinguished between at-risk and non-at-risk children. Identifying these underlying factors will be useful for detecting children at-risk for developing reading difficulties in the Malay language. In addition, these results highlight the importance of including a range of reading and reading-related measures for the early diagnosis of reading difficulties in this highly transparent orthography. (shrink)

Early adversity and trauma can have profound effects on children’s affective development and mental health outcomes. Interventions that improve mental health and socioemotional development are essential to mitigate these effects. We conducted a pilot study examining whether a reading-based program improves emotion recognition and mental health through socialization in Syrian refugee and Jordanian non-refugee children aged 7–12 years old living in Jordan. To measure emotion recognition, children classified the expression in faces morphed between two emotions, while mental health was assessed (...) using survey measures of optimism, depression, anxiety, distress, and insecurity. Prior to the intervention, both groups of children were significantly biased to interpret ambiguous facial expressions as sad, while there was no clear bias on the fear–anger spectrum. Following the intervention, we found changes in Syrian refugee children’s bias in emotion recognition away from sad facial expressions, although this returned to pre-intervention levels 2 months after the end of the program. This shift in the bias away from sad facial expressions was not associated with changes in self-reported mental health symptoms. These results suggest a potential positive role of the reading intervention on affective development, but further research is required to determine the longer-term impacts of the program. (shrink)

© JNCCN-Journal of the National Comprehensive Cancer Network.Background: Next-generation tumor sequencing panels, which include multiple established and novel targets across cancers, are emerging in oncology practice, but lack formal positive coverage by US payers. Lack of coverage may impact access and adoption. This study identified challenges of NGTS coverage by private payers.Methods: We conducted semi-structured interviews with 14 NGTS experts on potential NGTS benefits, and with 10 major payers, representing more than 125,000,000 enrollees, on NGTS coverage considerations. We used the (...) framework approach of qualitative research for study design and thematic analyses and simple frequencies to further describe findings.Results: All interviewed payers see potential NGTS benefits, but all noted challenges to formal coverage: 80% state that inherent features of NGTS do not fit the medical necessity definition required for coverage, 70% view NGTS as a bundle of targets versus comprehensive tumor characterization and may evaluate each target individually, and 70% express skepticism regarding new evidence methods proposed for NGTS. Fifty percent of payers expressed sufficient concerns about NGTS adoption and implementation that will preclude their ability to issue positive coverage policies.Conclusions: Payers perceive that NGTS holds significant promise but, in its current form, poses disruptive challenges to coverage policy frameworks. Proactive multidisciplinary efforts to define the direction for NGTS development, evidence generation, and incorporation into coverage policy are necessary to realize its promise and provide patient access. This study contributes to current literature, as possibly the first study to directly interview US payers on NGTS coverage and reimbursement. (shrink)