For a significant number of patients, there exists no, or only little, interest in developing a treatment for their disease or condition. Especially with regard to rare diseases, the lack of commercial interest in drug development is a burning issue. Several interventions have been made in the regulatory field in order to address the commercial disinterest in these conditions. However, existing regulations mainly focus on the provision of incentives to the sponsors of clinical trials of orphan drugs, and leave unanswered (...) the overarching question about the rightful place of orphan drugs in resource allocation systems. In this article, we analyse the ethical aspects of funding research and development in the field of rare diseases. We then propose an ethical framework that can help health policy makers move forward in the difficult matter of fairly allocating resources for the prevention, diagnosis and treatment of rare diseases. (shrink)

I draw attention to a group of thinkers in Ireland in the first half of the eighteenth century that made significant contributions to the philosophy of political economy. Loosely organized around the Dublin Philosophical Society founded in 1731, these individuals employed a similar set of assumptions and shared a common interest in the well-being of the Irish people. I focus on Samuel Madden, Arthur Dobbs, and Thomas Prior and argue for two main theses. First, these Irish thinkers shared a number (...) of commonalities with the English mercantilist thinkers of the eighteenth century, and to the degree that they did, their proposals to aid Ireland and reduce poverty were largely doomed to failure. Second, these Irish thinkers also importantly diverged from typical eighteenth-century mercantilist thinking in several ways. These modifications to mercantilism resulted in large part from the unusual political situation of Ireland and helped orient their economic thinking along more institutional lines. In particular, the emphasis of the Irish on full employment and on the modification of social as well as political institutions is an early step forward in making political economy more sophisticated. (shrink)

“Biography” is a sober, precise and modern word. Like other words formed from a Greek root, it has a competent and knowing air. It makes a good appearance in the summary of reviews, on the platform at conferences, between “biology” and “bibliography,” between “necrology” and “radiography,” in that scientific elite of the lexicon that travels in “business” class from one language to another, always at home in the time belts, hotel lobbies, conference rooms or amphitheaters. Compared with this prosperity, the (...) word “Life” is old-fashioned, a poor relative doomed to retirement homes. In the period between the two wars it disappeared from bookstore windows and book jackets. The hesitations of André Maurois, the author of Aspects de la biographie (1928), are characteristic of a transition: he wavered between La Vie de Disraeli (1927), Ariel ou la vie de Shelley (1923), Prométhée ou la vie de Balzac (1965) and Byron (1930). We sense that the title Vie was on the way out or had to yield to a proper name or an allegorical figure. However, it was a word in good standing, nobly Latin in origin, as great a signore in its class as those Massimi or Colonna who claimed their ancestors were mentioned by Titus Livy. Its genealogy is still more ancient, if we recall that its metonymic and literary meaning in Latin is a translation of the Greek word Bios, which the Hellenes, inventors of the genre and who had a more pedantic use of their language than we do, were content to use up until the end. “Biography,” according to Liddell-Scott, is not found in Antiquity except in a very late neo-Platonian, Damaskios, who put this humorless escogriffe into circulation when twilight was descending on the Roman Empire, between the 5th and 6th centuries A.D., at the dawn of the Middle Ages. It made its entrance into modern languages in the last quarter of the 17th century, when the humanism of the Renaissance was coming to an end, and the Enlightenment was beginning its rise. This late and ill-boding word began a slow ascension, long delayed: it did not come into usage outside the circles of antiquarians until the 19th century. The old word “Life” proudly kept its importance until the ‘20s of our era in the particularly conservative language of titles of works. Its definitive effacement to the profit of “biography” brought that of the word “memoirs” or the word “confessions,” which yielded to “autobiography,” while “hagiography” without being able to impose itself so well in usage, took much gravity and credibility away from the “Lives of the Saints.”. (shrink)

1. Introduction The policy of deterrence, at least to avert nuclear war between the superpowers, has been a controversial one. The main controversy arises from the threat of each side to visit destruction on the other in response to an initial attack. This threat would seem irrational if carrying it out would lead to a nuclear holocaust – the worst outcome for both sides. Instead, it would seem better for the side attacked to suffer some destruction rather than to retaliate (...) in kind and, in the process of devastating the other side, seal its own doom in an all-out nuclear exchange. Yet, the superpowers persist in their adherence to deterrence, by which we mean a policy of threatening to retaliate to an attack by the other side in order to deter such an attack in the first place. To be sure, nuclear doctrine for implementing deterrence has evolved over the years, with such appellations as “massive retaliation,” “flexible response,” “mutual assured destruction”, and “counterforce” giving some flavor of the changes in United States strategic thinking. All such doctrines, however, entail some kind of response to a Soviet nuclear attack. They are operationalized in terms of preselected targets to be hit, depending on the perceived nature and magnitude of the attack. Thus, whether U.S. strategic policy at any time stresses a retaliatory attack on cities and industrial centers or on weapons systems and armed forces, the certainty of a response of some kind to an attack is not the issue. (shrink)

1. Introduction The policy of deterrence, at least to avert nuclear war between the superpowers, has been a controversial one. The main controversy arises from the threat of each side to visit destruction on the other in response to an initial attack. This threat would seem irrational if carrying it out would lead to a nuclear holocaust – the worst outcome for both sides. Instead, it would seem better for the side attacked to suffer some destruction rather than to retaliate (...) in kind and, in the process of devastating the other side, seal its own doom in an all-out nuclear exchange. Yet, the superpowers persist in their adherence to deterrence, by which we mean a policy of threatening to retaliate to an attack by the other side in order to deter such an attack in the first place. To be sure, nuclear doctrine for implementing deterrence has evolved over the years, with such appellations as “massive retaliation,” “flexible response,” “mutual assured destruction”, and “counterforce” giving some flavor of the changes in United States strategic thinking. All such doctrines, however, entail some kind of response to a Soviet nuclear attack. They are operationalized in terms of preselected targets to be hit, depending on the perceived nature and magnitude of the attack. Thus, whether U.S. strategic policy at any time stresses a retaliatory attack on cities and industrial centers or on weapons systems and armed forces, the certainty of a response of some kind to an attack is not the issue. (shrink)

Not all scientific explanations work by describing causal connections between events or the world's overall causal structure. In addition, mathematicians regard some proofs as explaining why the theorems being proved do in fact hold. This book proposes new philosophical accounts of many kinds of non-causal explanations in science and mathematics.

Many philosophers argue that explanatoriness plays no special role in confirmation – that “inference to the best explanation” (IBE) incorrectly demands giving hypotheses extra credit for their potential explanatory qualities beyond the credit they already deserve for their predictive successes. This paper argues against one common strategy for responding to this thought – that is, for trying to fit IBE within a Bayesian framework. That strategy argues that a hypothesis’ explanatory quality (its “loveliness”) contributes either to its prior probability or (...) to its likelihood. This paper argues that this strategy fails because it must give different treatments to two hypotheses that are unlovely for the very same reason. The strategy therefore loses the insight into scientific reasoning that its reconstruction in terms of IBE is supposed to provide. The paper then provides a Bayesian account of the confirmatory role of explanatoriness that represents explanatory quality as having an impact in the same place for two hypotheses that are unlovely for the very same reason. This approach works by “putting explanation back into IBE” – that is, by invoking hypotheses that refer explicitly to scientific explanation and by invoking the agent's background opinions regarding the kind of explanation that the evidence is liable to have. On this approach, there is no list of “explanatory virtues” the possession of which always helps to make an explanation better. Rather, for different facts, there are different characteristics that our background knowledge of other explanations gives us some reason to expect the given fact's explanation to possess. (shrink)

Explanation in mathematics has recently attracted increased attention from philosophers. The central issue is taken to be how to distinguish between two types of mathematical proofs: those that explain why what they prove is true and those that merely prove theorems without explaining why they are true. This way of framing the issue neglects the possibility of mathematical explanations that are not proofs at all. This paper addresses what it would take for a non-proof to explain. The paper focuses on (...) a particular example of an explanatory non-proof: an argument that mathematicians regard as explaining why a given theorem holds regarding the derivative of an infinite sum of differentiable functions. The paper contrasts this explanatory non-proof with various non-explanatory proofs of the same theorem. The paper offers an account of what makes the given non-proof explanatory. This account is motivated by investigating the difficulties that arise when we try to extend Mark Steiner’s influential account of explanatory proofs to cover this explanatory non-proof. (shrink)

Philosophy and Phenomenological Research, Volume 99, Issue 3, Page 714-719, November 2019.

. A typical textbook explanation of a rocket’s motion when its engine is fired appeals to momentum conservation: the rocket accelerates forward because its exhaust accelerates rearward and the system’s momentum must be conserved. This paper examines how this explanation works, considering three challenges it faces. First, the explanation does not proceed by describing the forces causing the rocket’s motion. Second, the rocket’s motion has a causal-mechanical explanation involving those forces. Third, if momentum conservation and the rearward motion of the (...) rocket’s exhaust explain why the rocket accelerates forward, then presumably momentum conservation and the rocket’s forward motion likewise explain why the rocket emits exhaust rearward. Explanatory circularity threatens to follow from this pair of explanations. This paper examines how the conservation-law explanation works and how it is compatible with the causal-mechanical explanation. The paper argues that these two explanations do not explain precisely the same fact relative to the same contrast class. The paper interprets the two conservation-law explanations as non-causal and argues that they yield no explanatory circularity. (shrink)

This paper explores the nature of the relationship between corporate social responsibility (CSR) and competitiveness. We start with the commonly held view that firm competitiveness is defined by the market. That is, the question of what are the critical competitiveness factors is answered by looking at how companies and financial analysts describe and evaluate a firm. To analyze this, we review the current state of the art on the relationship between CSR and competitiveness. Second, CSR criteria used by financial analysts (...) is identified and compared with company valuation methods. Third, the results of a multi-stakeholder dialogue on CSR and competitiveness of the European financial sector are presented. As a conclusion, we argue that CSR and competitiveness relate through a learning and innovation cycle, where corporate values, policies and practices are permanently defined and re-defined. Thus, we propose that learning takes place as CSR is embedded in business processes, and that once it has been integrated, in turn, it generates innovative practices, and finally, competitiveness. At the end of the paper, we propose that CSR in practice consists of managing inherent paradoxes generated by the tension between CSR and business policies. (shrink)

Anticipating the ethical impact of emerging technologies is an essential part of responsible innovation. One such emergent technology is the digital twin which we define here as a living replica of a physical system (human or non-human). A digital twin combines various emerging technologies such as AI, Internet of Things, big data and robotics, each component bringing its own socio-ethical issues to the resulting artefacts. The question thus arises which of these socio-ethical themes surface in the process and how they (...) are perceived by stakeholders in the field. In this report we present the results of a qualitative study into the socio-ethical benefits and socio-ethical risks of using digital twins in healthcare. Employing insights from ethics of technology and the Quadruple Helix theory of innovation, we conducted desk research of white literature and 23 interviews with representatives from the four helixes: industry, research, policy and civil society. The ethical scan revealed several important areas where the digital twin can produce socio-ethical value (e.g., prevention and treatment of disease, cost reduction, patient autonomy and freedom, equal treatment) but also several important areas of socio-ethical risks (e.g., privacy and property of data, disruption of existing societal structures, inequality and injustice). We conclude with a reflection on the employed analytical tool and suggestions for further research. (shrink)

Australia’s experience of the COVID-19 pandemic has been widely perceived to have been a successful one, based on the relatively few number of lives lost to the virus compared to the rest of the world. There remain, nonetheless, serious ethical challenges at the heart of the Australian response to COVID-19. The broadly positive outcomes of Australia’s pandemic response mask more troubling developments within its political culture, and the costs it has imposed on its society. This article examines two concerns in (...) particular: the normalisation of fear and emergency through the language and policy responses adopted by governments, and the significant diminution of individual freedoms and human rights. (shrink)

This paper concerns the relation between a proof’s beauty and its explanatory power – that is, its capacity to go beyond proving a given theorem to explaining why that theorem holds. Explanatory power and beauty are among the many virtues that mathematicians value and seek in various proofs, and it is important to come to a better understanding of the relations among these virtues. Mathematical practice has long recognized that certain proofs but not others have explanatory power, and this paper (...) offers an account of what makes a proof explanatory. This account is motivated by a wide range of examples drawn from mathematical practice, and the account proposed here is compared to other accounts in the literature. The concept of a proof that explains is closely intertwined with other important concepts, such as a brute force proof, a mathematical coincidence, unification in mathematics, and natural properties. Ultimately, this paper concludes that the features of a proof that would contribute to its explanatory power would also contribute to its beauty, but that these two virtues are not the same; a beautiful proof need not be explanatory. (shrink)

According to Lange,?Really Statistical explanations? constitute an important kind of non-causalscientific explanation. However, Roski has argued that all alleged RS explanations are either causalexplanations or not explanations at all. In so arguing, Roski has invoked Kahneman?s interpretation of onealleged RS explanation. I employ Roski?s arguments as an opportunity to elaborate and defend RS explanations. Iargue that?RS explanations? genuinely explain rather than deny the presuppositions of why-questions. I argue thatthe RS model is not excessively permissive in allowing some explanations to work (...) purely statistically rather than bydescribing causal relations. I argue that Roski?s view that some?RS explanations? operate by describing causalrelations fails to capture the kind of explanatory insight that RS explanations provide. I elaborate the notion of a?characteristically statistical phenomenon? that figures in the RS model and thereby explain how an RS explanationreveals that its explanandum is independent of any causal facts or specific chances, but rather depends only on ageneric sort of arrangement of chances. Finally, I argue that Roski misinterprets Kahneman, who actually holds thatthe explanation he discusses is a non-causal explanation that nicely fits the RS model. RS explanations constitutean important kind of non-causal scientific explanation. (shrink)

Improper dependencies slant policy over a drug's life span, biasing the development of new drugs, the testing and marketing approval for new drugs, and the monitoring of patient safety after drugs are marketed. This article examines five ways in which the public improperly depends on pharmaceutical firms that compromise the integrity of pharmaceutical policy. Today the public relies on pharmaceutical firms: (1) to set priorities on drug research and development; (2) to conduct clinical trials to test whether drugs are safe (...) and effective; (3) to decide what clinical trial data to disclose to the public; (4) to monitor post marketing drug safety; (5) to supply product information to physicians and to finance continuing medical education and other professional activities. The article suggests options to overcome each of these dependencies. (shrink)

Models of cognitive vulnerability claim that depressive symptoms arise as a result of an interaction between negative affect and cognitive reactions, in the form of dysfunctional attitudes and negative inferential style. We present a model that complements this approach by focusing on the appraisal processes that elicit and differentiate everyday episodes of emotional experience, arguing that individual differences in appraisal patterns can foster negative emotional experiences related to depression (e.g., sadness and despair). In particular, dispositional appraisal biases facilitating the elicitation (...) of these emotions more frequently and more intensely. This, in turn, is likely to have a negative influence on cognitive processing and emotion regulation in general. (shrink)

It has frequently been argued recently that Jeffrey Conditionalization (JC) does not permit undermining. For JC to be inapplicable in cases where the evidence could be undermined would severely compromise JC’s range. However, this paper contends that the argument fails to show that JC cannot accommodate undermining. This response turns on using the proper partition to capture the direct impact of our evidence in redistributing our credences.

The Problem of Doxastic Shift may be stated as a dilemma: on the one hand, the distribution of nominal complements of the form `the ψ that p’ strongly suggests that `that’-clauses cannot be univocally assigned propositionaldenotations; on the other hand, facts about quantification strongly suggest that `that’-clauses must be assigned univocal denotations. I argue that the Problem may be solved by defining the extension of a proposition to be a set of facts or, more generally, conditions. Given this, the logical (...) operation of descriptive predication can be introduced in a way that resolves the dilemma withoutsacrificing the singular term analysis of `that’-clauses. (shrink)

Through the 1960s, many people claimed that drug advertising was educational and physicians often relied on it. Continuing Medical Education (CME) was developed to provide an alternative. However, because CME relied on grants, industry funders chose the subjects offered. Now policymakers worry that drug firms support CME to promote sales and that commercial support biases prescribing and fosters inappropriate drug use. A historical review reveals parallel problems between advertising and industry-funded CME. To preclude industry influence and improve CME, we should (...) ensure independent funding by taxing medical industries, facilities and physicians. Independent public and professional authorities should create CME curricula. An independent agency should allocate all funds to educational institutions for approved curricula. (shrink)

What is the purpose of political theoretical endeavour and what methods should the early 21st-century political theorist employ? These questions – which touch on issues which go to the very heart of the vocation of political theory – have become increasingly contentious in recent years. The period since the late 1980s has been one in which theorists have increasingly disagreed not only about conventional matters of normative contention but also about the means by which to seek to resolve them. This (...) article examines a central tension that has characterized that general methodological disagreement, namely the place of empirical inquiry within the repertoire of the professional political theorist. Having carefully examined the contentions of an eclectic range of contributors to the debate, including G.A. Cohen, Alasdair MacIntyre and David Miller, this article argues that efforts either wholly to separate empirical investigation from normative enquiry or to bind the two ever-closer together are fraught with difficulties. It concludes by contending that political theorists ought to take aspects of the empirical political and social sciences extremely seriously while avoiding the temptation to have their normative agenda dictated to them by the contingent pressures of the here and now. (shrink)

Intentions and emotions arise together, and emotions compel us to pursue goals. However, it is not clear when emotions become objects of awareness, how emotional awareness changes with goal pursuit, or how psychological and neural processes mediate such change. We first review a psychological model of emotional episodes and propose that goal obstruction extends the duration of these episodes while increasing cognitive complexity and emotional intensity. We suggest that attention is initially focused on action plans and their obstruction, and only (...) when this obstruction persists does focal attention come to include emotional states themselves. We then model the self-organization of neural activities that hypothetically underlie the evolution of an emotional episode. Phases of emotional awareness are argued to parallel phases of synchronization across neural systems. We suggest that prefrontal activities greatly extend intentional states while focal attention integrates emotional awareness and goal pursuit in a comprehensive sense of the self in the world. (shrink)

Several philosophers have argued that ‘constraints’ constrain (and thereby explain) by virtue of being modally stronger than ordinary laws of nature. In this way, a constraint applies to all possible systems, for a variety of possibility that is broader (that is, more inclusive) than the variety we employ when we say that the ordinary laws of nature apply to all physically possible systems. Explanations by constraint are thus more broadly unifying than ordinary causal explanations. Philosophical examples of good candidates for (...) constraints have heretofore been drawn almost exclusively from fundamental physics. This paper argues for the existence of such constraints (even multiple levels of them) in at least one human science (linguistics), not just in physics. (shrink)

New approaches in the design of information technologies for work practices are drawing upon theories from sociology, anthropology, and social philosophy. Under the labels of Computer-Supported Cooperative Work and Participatory Design, work is done to "neturn" to design insights gained in the social study of the use of technological artifacts. Aftera brief introduction of these developments, the article zooms in on those authors for whom "better" technologies refer to hopes for more democratic and more worker-oriented workplaces. How do these approaches (...) conceptualize "humans, " "machines, " and their interrelation in work practices? The conceptual engine which generates the analytical and political power of this approach, I argue, thrives upon the assertion of an ontological difference between the realms of "technology" and "human work. " What are the consequences of such conceptualizations for design? How do different ways of depicting "technology" and "work practice" yield different politics of technology? (shrink)

This chapter presents arguments positing that there is an important sense in which it takes more than all of the actual kinds to make a world, contrary to the popular saying that goes “it takes all kinds to make a world.” In a variety of ways, the various species of elementary particles are ideal cases of natural kinds since each belongs to exactly one of these natural kinds and it essentially belongs to that kind. There exists perfect uniformities within each (...) species and sharp distinctions between the species with respect to certain properties. Some of these properties are essential and suffice to give necessary and adequate conditions for species-membership, while others derive from the fundamental properties via exceptionless uniformities with no ceteris paribus escape clauses. (shrink)

I argue that cultural conventions such as social etiquette facilitate a specific (non‐Lewisian) kind of action coordination—role–interaction coordination—that is required for division of labour. Playing one's roles and coordinating them with those of others is a form of multitasking. Such multitasking is made possible on a large scale because we can offload cognition aimed at coordination onto a stable infrastructure of cultural conventions. Our natural tendency to prefer multitasking in instances where one task requires low cognitive control can thus explain (...) our preference for and expectation of familiar cultural conventions—that is, their perceived normativity. (shrink)

In this article, I develop and defend a conception of psychological continuity that differs from the 'orthodox' conception in terms of overlapping chains of strongly connected mental states. By recognizing the importance of the (narrative) interrelatedness of qualitatively dissimilar mental contents, as well as the role of the body in psychological continuity, I argue, serious problems confronting the orthodox view can be solved.

Although I reject neuronormativity -- an idea central to the Brain Disease Model of Addiction -- Henden and Gjelsvik argue that the disease definition might refer to normativity in nonneural domains. They profess that a cognitive dysfunction, or a mismatch of evolutionary intentions, could also qualify as norm violations, thus legitimizing the disease label. The need for dividing lines is questioned as well. I rebut these criticisms in turn, but I must admit they are thought provoking.

Wakefield doesn't mind my focus on parallels between addiction and love. But love can fall outside the bounds of what evolution intended. So, he claims, comparing addiction with love does not preclude a naturally defined "disorder." I counter with the argument that evolution handed us such highly general response systems, the bounds of normality cannot be defined.

I have two concerns about Pugh et al ’s case that vaccine requirements without a natural immunity exception are unjustified.1 First, the scientific question they suggest must be answered to justify the policy is in my view the wrong one, or at least not the only relevant one. Second, the authors set up a standard for public health regulation that will be often unattainable, risking paralysis of public health authorities. Pugh et al suggest two legitimate bases for vaccine mandates: ‘the (...) prevention of severe outcomes from COVID-19 and the reduction of viral transmission.’ Governments and employers have a legitimate interest in protecting the health of their citizens and workers, respectively. To maximally accomplish these goals, the relevant scientific question for whether people with prior infection should be subject to a vaccine mandate is: in persons who have been previously infected, does vaccination enhances protection against severe disease and/or infection and transmission? The relevant comparison, if one is trying to maximise protection in the population, is not vaccination vs prior infection, but vs prior infection alone. I am unaware of a systematic review of this question, but the answer in two recent studies appears to be that the combination is more protective.2,3 The comparison the authors propose, in contrast, seems to be one based on an unstated conception of fairness and adequacy: if vaccination alone provides some level of protection, and prior infection can’t be shown to provide an inferior level, then prior infection should be an acceptable alternative to vaccination to satisfy mandates. No argument is given to support the greater relevance of the comparison the authors emphasise. A second and independent concern is that the authors’ proposal …. (shrink)

Formal tools are attributed central roles in organizing work within many modern workplaces. How should one comprehend the power of these tools? Taking the medical record as an example, this article builds on recent calls to overcome the dichotomy between the formal and the informal and proposes an understanding of the generative power of such tools that does not attribute mythical capacities to either tool or human work. To do so, it is important to look both at the history offormal (...) tools and to their real-time use in concrete work practices. These steps toward a sociology of the formal are crucial for a more comprehensive understanding and evaluation offormal systems in practice. (shrink)