Epistemic injustice sits at the intersection of ethics, epistemology, and social justice. Generally, this philosophical term describes when a person is wrongfully discredited as a knower; and within the clinical space, epistemic injustice is the underlying reason that some patient testimonies are valued above others. The following essay seeks to connect patterns of social prejudice to the clinical realm in the United States: illustrating how factors such as race, gender identity, and socioeconomic status influence epistemic credence and associatively, the quality (...) of healthcare a person receives. After describing how epistemic injustice disproportionately harms already vulnerable patients, I propose a narrative therapy intervention. This intervention can help providers re-frame their relationships with patients, in such that they come to view patients as valuable sources of unique knowledge. Though I identify this intervention as a valuable step in addressing clinical epistemic injustice, I call upon medical educators and practitioners to further uplift the voices, perspectives, and stories of marginalized patients. (shrink)

Population-level biomedical research offers new opportunities to improve population health, but also raises new challenges to traditional systems of research governance and ethical oversight. Partly in response to these challenges, various models of public involvement in research are being introduced. Yet, the ways in which public involvement should meet governance challenges are not well understood. We conducted a qualitative study with 36 experts and stakeholders using the World Café method to identify key governance challenges and explore how public involvement can (...) meet these challenges. This brief report discusses four cross-cutting themes from the study: the need to move beyond individual consent; issues in benefit and data sharing; the challenge of delineating and understanding publics; and the goal of clarifying justifications for public involvement. The report aims to provide a starting point for making sense of the relationship between public involvement and the governance of population-level biomedical research, showing connections, potential solutions and issues arising at their intersection. We suggest that, in population-level biomedical research, there is a pressing need for a shift away from conventional governance frameworks focused on the individual and towards a focus on collectives, as well as to foreground ethical issues around social justice and develop ways to address cultural diversity, value pluralism and competing stakeholder interests. There are many unresolved questions around how this shift could be realised, but these unresolved questions should form the basis for developing justificatory accounts and frameworks for suitable collective models of public involvement in population-level biomedical research governance. (shrink)

How do we perdure when we and everything around us are caught up in incessant change? But the course of this change does not seem to be haphazard and we may seek the modalities of its Logos in the transformations in which it occurs. The classic term "Metamorphosis" focuses upon the proportions between the transformed and the retained, the principles of sameness and otherness. Applied to life and its becoming, metamorphosis pinpoints the proportions between the vital and the aesthetic significance (...) of life. Where could this metaphysical in-between territory come better to light than in the Fine Arts? In this collection are investigated the various proportions between the vital significance of the constructivism of life and a specifically human contribution made by the creative imagination to the transformatory search for beauty and aesthetic values. Papers by: Lawrence Kimmel, Mark L. Brack, Sheryl Tucker de Vazquez, William Roberts, Jadwiga Smith, Victor Gerald Rivas, Max Statkiewicz, Matti Itkonen, George R. Tibbetts, Linda Stratford, Jorella Andrews, Ingeborg M. Rocker, Stephen J. Goldberg, Leah Durner, Donnalee Dox, Catherine Schear, Samantha Henriette Krukowski, Gary Maciag, Kelly Dennis, Wanda Strukus, Magda Romanska, Patricia Trutty-Coohill, Ellen Burns, Tessa Morrison, Sabine Coelsch-Foisner, Gary Backhaus, Daniel M. Unger, Howard Pearce. (shrink)

This article tells the story of the oil and gas origins of the Gaia hypothesis, the theory that the Earth is a homeostatic system. It shows how Gaia’s key assumption—that the climate is a fundamentally stable system, able to withstand perturbations—emerged as a result of a collaboration between the theory’s progenitor, James Lovelock, and Royal Dutch Shell in response to Shell’s concerns about the effects of its products on the climate. The article explains how Lovelock elaborated the Gaia hypothesis and (...) gave it evidential depth through a series of Royal Dutch Shell-funded research projects meant to identify organisms whose biological activities might double as climate-regulating mechanisms. The article goes on to show how this research subsequently laid the foundation for a distinct genre of climate change denialism, in which corporations sowed doubt not by denying the phenomenon of global warming but by naturalizing it. (shrink)

_K. al-Manām_ by Ibn Abī al-Dunyā is a compendium of 350 Muslim dream narratives in Arabic. The English introduction examines the function of dreams in classical Arabic literature with a focus on dreams as a means of edification.

The vast majority of health research resources are used to study conditions that affect a small, advantaged portion of the global population. This distribution has been widely criticized as inequitable and threatens to exacerbate health disparities. However, there has been little systematic work on what individual health research funders ought to do in response. In this article, we analyze the general and special duties of research funders to the different populations that might benefit from health research. We assess how these (...) duties apply to governmental, multilateral, nonprofit, and for-profit organizations. We thereby derive a framework for how different types of funders should take the beneficiaries of research into account when they allocate scarce research resources. (shrink)

Journal of Political Philosophy, EarlyView.

The need for greater privacy protections in the United States has never been greater. In their work, “Ethical Responsibilities for Companies That Process Personal Data”, McCoy et al. (2023) correct...

ABSTRACT Anthony Fauci, an infectious disease expert in the White House's coronavirus task force, is challenged to offer responsible public communication of science despite working under a habitual liar who has no tolerance for criticism or dissent. Fauci manages this rhetorical exigence by using strategic ambiguity, the topos of the honest broker, dissociation, and a narrative that constrains executive decision making.

Region R Question: How many objects — entities, things — are contained in R? Ignore the empty space. Our question might better be put, 'How many material objects does R contain?' Let's stipulate that A, B and C are metaphysical atoms: absolutely simple entities with no parts whatsoever besides themselves. So you don't have to worry about counting a particle's top half and bottom half as different objects. Perhaps they are 'point-particles', with no length, width or breadth. Perhaps they are (...) extended in space without possessing spatial parts (if that is possible). Never mind. We stipulate that A, B and C are perfectly simple. We also stipulate that they are connected as follows. A and B are stuck together in such a way that when a force is applied to one of them, they move together 'as a unit'. Moreover, the two of them together exhibit behavior that neither would exhibit on its own — Perhaps they emit a certain sound, or glow in the dark — whereas C is.. (shrink)

Civility is often treated as an essential virtue in liberal democracies that promise to protect diversity as well as active disagreement in the public sphere. Yet the fear that our tolerant society faces a crisis of incivility is gaining ground. Politicians and public intellectuals call for "more civility" as the solution--but is civility really a virtue? Or is it something more sinister--a covert demand for conformity that silences dissent? Mere Civility sheds light on this tension in contemporary political theory and (...) practice by examining similar appeals to civility in early modern debates about religious toleration. In seventeenth-century England, figures as different as Roger Williams, Thomas Hobbes, and John Locke could agree that some restraint on the wars of words and "persecution of the tongue" between sectarians would be required; and yet, they recognized that the prosecution of incivility was often difficult to distinguish from persecution.--. (shrink)

History, as we all know, is written by the victors. But in political theory the writing of history is a part of the struggle. Joshua Cherniss’s Liberalism in Dark Times makes a distinguished additi...

In his recent article “Ethical Criteria for Health-Promoting Nudges: A Case-by-Case Analysis,” Bart Engelen (2019) develops a useful framework for evaluating health-related nudges in an attempt to...

Two of the most influential theories about scientific inference are inference to the best explanation and Bayesianism. How are they related? Bas van Fraassen has claimed that IBE and Bayesianism are incompatible rival theories, as any probabilistic version of IBE would violate Bayesian conditionalization. In response, several authors have defended the view that IBE is compatible with Bayesian updating. They claim that the explanatory considerations in IBE are taken into account by the Bayesian because the Bayesian either does or should (...) make use of them in assigning probabilities to hypotheses. I argue that van Fraassen has not succeeded in establishing that IBE and Bayesianism are incompatible, but that the existing compatibilist response is also not satisfactory. I suggest that a more promising approach to the problem is to investigate whether explanatory considerations are taken into account by a Bayesian who assigns priors and likelihoods on his or her own terms. In this case, IBE would emerge from the Bayesian account, rather than being used to constrain priors and likelihoods. I provide a detailed discussion of the case of how the Copernican and Ptolemaic theories explain retrograde motion, and suggest that one of the key explanatory considerations is the extent to which the explanation a theory provides depends on its core elements rather than on auxiliary hypotheses. I then suggest that this type of consideration is reflected in the Bayesian likelihood, given priors that a Bayesian might be inclined to adopt even without explicit guidance by IBE. The aim is to show that IBE and Bayesianism may be compatible, not because they can be amalgamated, but rather because they capture substantially similar epistemic considerations. 1 Introduction2 Preliminaries3 Inference to the Best Explanation4 Bayesianism5 The Incompatibilist View : Inference to the Best Explanation Contradicts Bayesianism5. 1 Criticism of the incompatibilist view6 Constraint - Based Compatibilism6. 1 Criticism of constraint - based compatibilism7 Emergent Compatibilism7. 1 Analysis of inference to the best explanation7. 1. 1 Inference to the best explanation on specific hypotheses7. 1. 2 Inference to the best explanation on general theories7. 1. 3 Copernicus versus Ptolemy7. 1. 4 Explanatory virtues7. 1. 5 Summary7. 2 Bayesian account8 Conclusion. (shrink)

Both the diagnosis and medical treatment of gender dysphoria —particularly in children and adolescents—have been the subject of significant controversy in recent years. In this paper, we outline the means by which GD is diagnosed in children and adolescents, the currently available treatment options, and the bioethical issues these currently raise. In particular, we argue that the families and healthcare providers of children presenting with GD currently face two main ethical dilemmas in decision making regarding treatment: the pathway dilemma and (...) the consent dilemma. (shrink)

In this insightful and controversial book, the eminent philosopher Stanley Rosen takes a new look at the famous 'quarrel' that the moderns have with the ancients, analyzing and comparing ancient philosophers and modern Continental and analytical thinkers from Plato, Descartes, and Kant to Fichte, Nietzsche, and Rorty. He urges that we do not dismiss the classical heritage but appropriate it, for this appropriation is an indispensable step in the process of legitimizing our historical experience.

BackgroundThe main purpose of this study was to describe the latent structure of pregnancy perception by investigating the role of risks and medical examinations in pregnancy perception across the sexes and pregnancy status.MethodsStudy 1 developed a questionnaire based on the responses of 29 young adults on their perception of pregnancy. Study 2 consisted of distributing the questionnaire among 290 participants.ResultsThe statistical clustering analysis revealed three major clusters of pregnancy perceptions: “evaluative,” “physio-medical,” and “future considerations,” each of them encompassing several meaningful (...) sub-clusters. This structure of pregnancy perceptions supports Beck and Beck-Gernsheim’s modernization approach. Negative emotions toward pregnancy were related to social cognitions, whereas thoughts about risks were included in the medical sub-cluster. After reliability analyses, comparisons of scale scores revealed that women experienced more positive emotions, thought more about physical symptoms and about future issues compared to men.ConclusionPregnant participants felt less ambivalence toward pregnancy, thought more about risks and medical examinations and less about parents’ duties than non-pregnant participants. (shrink)

The paradigm of rights, established throughout the academic, policy and migrant activism arenas, governs the protection of vulnerable migrant workers against abuse. To what extent this approach has achieved social justice for the migrant worker in the current global political economy climate is, however, uncertain. In analyzing the use of rights in migrant activism in Hong Kong, this paper shows the limitation of rights in the migrant experience at the same time as it shows how a new paradigm based on (...) the Capablities Approach could provide a more appropriate framework from which to achieve social justice for the migrant worker. (shrink)

In a world surrounded by smart objects from sensors to automated medical devices, the ubiquity of ‘smart’ seems matched only by its lack of clarity. In this article, we use our discussions with expert stakeholders working in areas of implantable medical devices such as cochlear implants, implantable cardiac defibrillators, deep brain stimulators and in vivo biosensors to interrogate the difference facets of smart in ‘implantable smart technologies’, considering also whether regulation needs to respond to the autonomy that such artefacts carry (...) within them. We discover that when smart technology is deconstructed it is a slippery and multi-layered concept. A device’s ability to sense and transmit data and automate medicine can be associated with the ‘sting’ of autonomy being disassociated from human control as well as affecting individual, group, and social environments. (shrink)

Most public and non-profit organisations that fund health research provide the majority of their funding in the form of grants. The calls for grant applications are often untargeted, such that a wide variety of applications may compete for the same funding. The grant review process therefore plays a critical role in determining how limited research resources are allocated. Despite this, little attention has been paid to whether grant review criteria align with widely endorsed ethical criteria for allocating health research resources. (...) Here, we analyse the criteria and processes that ten of the largest public and non-profit research funders use to choose between competing grant applications. Our data suggest that research funders rarely instruct reviewers to consider disease burden or to prioritise research for sicker or more disadvantaged populations, and typically only include scientists in the review processes. This is liable to undermine efforts to link research funding to health needs. (shrink)

The idea that one can 'soak up' someone else's mood or sense the tension in a room is familiar - as in 'negative energy'. This ability to borrow or share states of mind is now pathologized, as the author shows in relation to affective transfer in psychiatric clinics.

The authors respond to a letter by Mitchell Berger in the March‐April 2024 issue of the Hastings Center Report concerning their essay “Securing the Trustworthiness of the FDA to Build Public Trust in Vaccines.”.

When we dream, we feel emotions in response to objects and events that exist only in the dream. What should we say about these emotions? One key question is whether these emotions can be said to be ‘fitting’, that is, appropriate to the evoking scenario. However, how we evaluate these emotions for fittingness may depend on the nature of dreams. According to the imagination model, dreamers do not believe that dream objects are real or that dream events are really happening. (...) In contrast, the hallucination model suggests that we falsely believe dream events are real and many of these beliefs are irrational. Under these conditions, an interesting possibility arises: dream emotions may be “essentially unfitting”, or in other words, feeling emotions in response to dream events is always unfitting. If fittingness requires a match between emotion and evaluative properties of objects or events, it is prima facie plausible that dream emotions could fail to fit under the imagination model because it is unfitting to have an emotion towards an object we do not believe to be real. Further, under the hallucination model, dream emotions could be unfitting because their objects do not exist even if we believe them to be real, or alternatively, because of the irrational nature of dream beliefs. More nuance, however, is required. By comparing dream emotions to the emotions we experience while imagining, engaging with fiction, and hallucinating, we evaluate the possibility of essential unfittingness of dream emotions. We conclude that although there are compelling arguments in support of the claim that dream emotions are essentially unfitting, these arguments are not entirely convincing, and it is more plausible that particular dream emotions can be assessed for fittingness under either model of dreaming. (shrink)

There has been considerable puzzlement over how to respond to higher-order evidence. The existing dilemmas can be defused by adopting a ‘two-dimensional’ representation of doxastic attitudes which incorporates not only substantive uncertainty about which first-order state of affairs obtains but also the degree of conviction with which we hold the attitude. This makes it possible that in cases of higher-order evidence the evidence sometimes impacts primarily on our conviction, rather than our substantive uncertainty. I argue that such a two-dimensional representation (...) is naturally developed by making use of imprecise probabilities. (shrink)

Psychological studies show that the beliefs of two agents in a hypothesis can diverge even if both agents receive the same evidence. This phenomenon of belief polarisation is often explained by invoking biased assimilation of evidence, where the agents’ prior views about the hypothesis affect the way they process the evidence. We suggest, using a Bayesian model, that even if such influence is excluded, belief polarisation can still arise by another mechanism. This alternative mechanism involves differential weighting of the evidence (...) arising when agents have different initial views about the reliability of their sources of evidence. We provide a systematic exploration of the conditions for belief polarisation in Bayesian models which incorporate opinions about source reliability, and we discuss some implications of our findings for the psychological literature. (shrink)

BackgroundFunctional neurodiagnostics could allow researchers and clinicians to distinguish more accurately between the unresponsive wakefulness syndrome and the minimally conscious state. It remains unclear how it informs surrogate decision-making.ObjectiveTo explore how the next of kin of patients with disorders of consciousness interpret the results of a functional neurodiagnostics measure and how/why their interpretations influence their attitudes towards medical decisions.Methods and SampleWe conducted problem-centered interviews with seven next of kin of patients with DOC who had undergone a functional HD-EEG examination at (...) a neurological rehabilitation center in Germany. The examination included an auditory oddball paradigm and a motor imagery task to detect hidden awareness. We analyzed the interview transcripts using structuring qualitative content analysis.ResultsRegardless of the diagnostic results, all participants were optimistic of the patients’ meaningful recovery. We hypothesize, that participants deal with the results of examinations according to their belief system. Thus, an unfavorable evaluation of the patient’s state had the potential to destabilize the participant’s belief system. To re-stabilize or to prevent the destabilization of their belief system, participants used different strategies. Participants accepted a “positive” HD-EEG result since it stabilized their belief system.ConclusionWe hypothesize, that a group of next of kin of patients with DOC deals with functional neurodiagnostics results on the basis of the result’s value and their high hope that the patient will recover meaningfully. A psychological mechanism seems to moderate the impact of functional neurodiagnostics on surrogate treatment decisions. (shrink)

This interdisciplinary collection of essays highlights the relevance of Buddhist doctrine and practice to issues of globalization. From philosophical, religious, historical, and political perspectives, the authors show that Buddhism—arguably the world’s first transnational religion—is a rich resource for navigating todays interconnected world.

Hierarchical Bayesian models (HBMs) provide an account of Bayesian inference in a hierarchically structured hypothesis space. Scientific theories are plausibly regarded as organized into hierarchies in many cases, with higher levels sometimes called ‘paradigms’ and lower levels encoding more specific or concrete hypotheses. Therefore, HBMs provide a useful model for scientific theory change, showing how higher‐level theory change may be driven by the impact of evidence on lower levels. HBMs capture features described in the Kuhnian tradition, particularly the idea that (...) higher‐level theories guide learning at lower levels. In addition, they help resolve certain issues for Bayesians, such as scientific preference for simplicity and the problem of new theories. *Received July 2009; revised October 2009. †To contact the authors, please write to: Leah Henderson, Massachusetts Institute of Technology, 77 Massachusetts Avenue, 32D‐808, Cambridge, MA 02139; e‐mail: [email protected]. (shrink)

Journal Name: Philologus Issue: Ahead of print.

This article argues that a particular metaphysical model permeates cultural practices surrounding pregnancy: the foetal container model. Widespread uncritical reliance on this view of pregnancy has been highly detrimental to women's liberty and reproductive autonomy. In this article, I extend existing critiques of the medical treatment of pregnant women to the context of the burgeoning commercial surrogacy industry. In doing so, I aim to show that our philosophical analysis in both spheres is constrained by the presupposition that the foetus and (...) pregnant woman are metaphysically and ethically distinct entities. By exploring the similarities and differences between the expectations placed on pregnant women in these two spheres, I show that the foetal container model is not a homogeneous understanding of pregnancy applied consistently across contexts; rather, it has been used to justify various practices and attitudes toward pregnancy and pregnant women through different moral frameworks, in the service of different overarching aims. (shrink)

We respond to open peer commentaries on our target article, "Health Research Priority Setting: The Duties of Individual Funders".

Hierarchical Bayesian models (HBMs) provide an account of Bayesian inference in a hierarchically structured hypothesis space. Scientific theories are plausibly regarded as organized into hierarchies in many cases, with higher levels sometimes called ‘para- digms’ and lower levels encoding more specific or concrete hypotheses. Therefore, HBMs provide a useful model for scientific theory change, showing how higher-level theory change may be driven by the impact of evidence on lower levels. HBMs capture features described in the Kuhnian tradition, particularly the idea (...) that higher-level theories guide learning at lower levels. In addition, they help resolve certain issues for Bayesians, such as scientific preference for simplicity and the problem of new theories. (shrink)

The research we fund today will improve the health of people who will live tomorrow. But future people will not all benefit equally: decisions we make about what research to prioritize will predictably affect when and how much different people benefit from research. Organizations that fund health research should thus fairly account for the health needs of future populations when setting priorities. To this end, some research funders aim to allocate research resources in accordance with disease burden, prioritizing illnesses that (...) cause more morbidity and mortality. In this article, I defend research funders' practice of aligning research funding with disease burden but argue that funders should aim to align research funding with future—rather than present—disease burden. I suggest that research funders should allocate research funding in proportion to aggregated estimates of disease burden over the period when research could plausibly start to yield benefits until indefinitely into the future. (shrink)