The sudden onset of severe traumatic brain injury (sTBI) is an event suffered by millions of individuals each year. Regardless of this frequency in occurrence, accurate prognostication remains difficult to achieve among physicians. There are many variables that affect this prognosis. Physicians are expected to assess the clinical indications of the brain injury while considering other factors such as patient quality of life, patient preferences, and environmental context. However, this lack of certainty in prognosis can ultimately affect treatment recommendations and (...) prompt clinical ethical issues at the bedside, as it leaves room for physician bias and interpretation. In this article, we introduce data on neurosurgeon values that may shed light on the process physicians and patients involved in sTBI undergo. In doing so, we highlight the many nuances in decision-making for patients suffering from sTBI and discuss potential solutions to better patient-physician or surrogate-physician interactions. (shrink)

ABSTRACT:In this article, we explore the Corporate Social Performance (CSP) of Developing Country Multinationals (DMNCs). We argue that in competing internationally, DMNCs often face both reputation and legitimacy deficits, which they address by improving their CSP. We develop a series of hypotheses to explain the variation in CSP between DMNCs and domestic-only firms from developing countries and also examine variations in CSP between DMNCs depending on the extent of their multinationality and portfolio of host countries. Our findings support all our (...) hypotheses, which suggest that DMNCs display enhanced levels of CSP compared to their domestic-only counterparts. CSP is also found to be positively related to the DMNCs’ degree of multinationality, but with a declining incremental impact, whereas entry into developed markets leads to a greater improvement in DMNCs’ CSP than expansion into developing markets. We highlight the implications of our findings for managers and researchers. (shrink)

The Monographs produced by the International Agency for Research on Cancer (IARC) apply rigorous procedures for the scientific review and evaluation of carcinogenic hazards by independent experts. The Preamble to the IARC Monographs, which outlines these procedures, was updated in 2019, following recommendations of a 2018 expert Advisory Group. This article presents the key features of the updated Preamble, a major milestone that will enable IARC to take advantage of recent scientific and procedural advances made during the 12 years since (...) the last Preamble amendments. The updated Preamble formalizes important developments already being pioneered in the Monographs Programme. These developments were taken forward in a clarified and strengthened process for identifying, reviewing, evaluating and integrating evidence to identify causes of human cancer. The advancements adopted include strengthening of systematic review methodologies; greater emphasis on mechanistic evidence, based on key characteristics of carcinogens; greater consideration of quality and informativeness in the critical evaluation of epidemiological studies, including their exposure assessment methods; improved harmonization of evaluation criteria for the different evidence streams; and a single-step process of integrating evidence on cancer in humans, cancer in experimental animals and mechanisms for reaching overall evaluations. In all, the updated Preamble underpins a stronger and more transparent method for the identification of carcinogenic hazards, the essential first step in cancer prevention. (shrink)

These remarks on following a rule are especially concerned with what Peter Winch has had to say on the matter, and with the flawed logic of his reasoning; but they are also intended to cast some light on the logical character of metaphysical reasoning generally. In The Idea of a Social Science , one of Winch's main aims is to show that what he calls meaningful behaviour must involve some kind of understanding or reflection. His strategy appears to consist (...) in trying to show, first, that all such behaviour, or perhaps behaviour as a whole, is rule-governed and, secondly, that following a rule necessarily involves ‘matters for reflection’. It will be my contention that the method employed in this argument, like the method employed throughout his book, is essentially metaphysical and incapable of yielding anything other than vacuous conclusions. (shrink)

The relationship of part to whole is one of the most fundamental there is; this is the first and only full-length study of this concept. This book shows that mereology, the formal theory of part and whole, is essential to ontology. Peter Simons surveys and criticizes previous theories, especially the standard extensional view, and proposes a more adequate account which encompasses both temporal and modal considerations in detail. 'Parts could easily be the standard book on mereology for the next (...) twenty or thirty years.' Timothy Williamson, Grazer Philosophische Studien. (shrink)

This paper is a study of higher-order contingentism – the view, roughly, that it is contingent what properties and propositions there are. We explore the motivations for this view and various ways in which it might be developed, synthesizing and expanding on work by Kit Fine, Robert Stalnaker, and Timothy Williamson. Special attention is paid to the question of whether the view makes sense by its own lights, or whether articulating the view requires drawing distinctions among possibilities that, according (...) to the view itself, do not exist to be drawn. The paper begins with a non-technical exposition of the main ideas and technical results, which can be read on its own. This exposition is followed by a formal investigation of higher-order contingentism, in which the tools of variable-domain intensional model theory are used to articulate various versions of the view, understood as theories formulated in a higher-order modal language. Our overall assessment is mixed: higher-order contingentism can be fleshed out into an elegant systematic theory, but perhaps only at the cost of abandoning some of its original motivations. (shrink)

This chapter aims to attempt no more than to make some informal and unsystematic remarks on the transformation of analytic philosophy. It deals with a few sketchy remarks on the historiography of recent analytic philosophy. Writing in 1981, David Lewis described “a reasonable goal for a philosopher” as bringing one’s opinions into stable equilibrium. A natural comparison is between Lewis’s Quinean or at least post‐Quinean methodology and the methodology of Peter Strawson, Quine’s leading opponent from the tradition of ordinary (...) language philosophy. Analytic epistemology provides a good case study of the philosophical application of Gricean pragmatics outside the philosophy of language. On Michael Dummett picture of the history of philosophy, Descartes had made epistemology first philosophy, the engine for the rest of philosophy, and then Frege had replaced epistemology by the philosophy of language as first philosophy. The chapter suggests that philosophy sometimes already uses an abductive methodology and ought to use it more in the future. (shrink)

Timothy Williamson has argued that in the debate on modal ontology, the familiar distinction between actualism and possibilism should be replaced by a distinction between positions he calls contingentism and necessitism. He has also argued in favor of necessitism, using results on quantified modal logic with plurally interpreted second-order quantifiers showing that necessitists can draw distinctions contingentists cannot draw. Some of these results are similar to well-known results on the relative expressivity of quantified modal logics with so-called inner and (...) outer quantifiers. The present paper deals with these issues in the context of quantified modal logics with generalized quantifiers. Its main aim is to establish two results for such a logic: Firstly, contingentists can draw the distinctions necessitists can draw if and only if the logic with inner quantifiers is at least as expressive as the logic with outer quantifiers, and necessitists can draw the distinctions contingentists can draw if and only if the logic with outer quantifiers is at least as expressive as the logic with inner quantifiers. Secondly, the former two items are the case if and only if all of the generalized quantifiers are first-order definable, and the latter two items are the case if and only if first-order logic with these generalized quantifiers relativizes. (shrink)

I address Peter Mott's 'Margins for Error and the Sorites Paradox' , pp. 494–503). Mott criticizes my account of inexact knowledge, on which it satisfies margin for error principles of the form 'If one knows in a given case, one avoids false belief in sufficiently similar cases'. Mott's arguments are shown to be fallacious because they ignore the fact that our knowledge of inexact knowledge is itself inexact. In the examples discussed, the first-level inexact knowledge is perceptual. Since my (...) defense of an epistemicist theory of vagueness explains our ignorance of truth-values in borderline cases as the result of knowledge the inexactness of which has a conceptual source, the paper also contributes to the defense of epistemicism about vagueness. (shrink)

I consider the first-order modal logic which counts as valid those sentences which are true on every interpretation of the non-logical constants. Based on the assumptions that it is necessary what individuals there are and that it is necessary which propositions are necessary, Timothy Williamson has tentatively suggested an argument for the claim that this logic is determined by a possible world structure consisting of an infinite set of individuals and an infinite set of worlds. He notes that only (...) the cardinalities of these sets matters, and that not all pairs of infinite sets determine the same logic. I use so-called two-cardinal theorems from model theory to investigate the space of logics and consequence relations determined by pairs of infinite sets, and show how to eliminate the assumption that worlds are individuals from Williamson’s argument. (shrink)

Is knowledge necessary or sufficient or both necessary and sufficient for acceptable practical reasoning and rational action? Several authors (e.g., Williamson, Hawthorne, and Stanley) have recently argued that the answer to these questions is positive. In this paper I present several objections against this view (both in its basic form as well in more developed forms). I also offer a sketch of an alternative view: What matters for the acceptability of practical reasoning in at least many cases (and in (...) all the cases discussed by the defenders of a strong link between knowledge and practical reasoning) is not so much knowledge but expected utility. (shrink)

Verificationism is the doctrine stating that all truths are knowable. Fitch’s knowability paradox, however, demonstrates that the verificationist claim (all truths are knowable) leads to “epistemic collapse”, i.e., everything which is true is (actually) known. The aim of this article is to investigate whether or not verificationism can be saved from the effects of Fitch’s paradox. First, I will examine different strategies used to resolve Fitch’s paradox, such as Edgington’s and Kvanvig’s modal strategy, Dummett’s and Tennant’s restriction strategy, Beall’s paraconsistent (...) strategy, and Williamson’s intuitionistic strategy. After considering these strategies I will propose a solution that remains within the scope of classical logic. This solution is based on the introduction of a truth operator. Though this solution avoids the shortcomings of the non-standard (intuitionistic) solution, it has its own problems. Truth, on this approach, is not closed under the rule of conjunction-introduction. I will conclude that verificationism is defensible, though only at a rather great expense. (shrink)

We examine a prominent naturalistic line on the method of cases, exemplified by Timothy Williamson and Edouard Machery: MoC is given a fallibilist and non-exceptionalist treatment, accommodating moderate modal skepticism. But Gettier cases are in dispute: Williamson takes them to induce substantive philosophical knowledge; Machery claims that the ambitious use of MoC should be abandoned entirely. We defend an intermediate position. We offer an internal critique of Macherian pessimism about Gettier cases. Most crucially, we argue that Gettier cases (...) needn’t exhibit ‘disturbing characteristics’ that Machery posits to explain why philosophical cases induce dubious judgments. It follows, we show, that Machery’s central argument for the effective abandonment of MoC is undermined. Nevertheless, we engineer a restricted variant of the argument—in harmony with Williamsonian ideology–that survives our critique, potentially limiting philosophy’s scope for establishing especially ambitious modal theses, despite traditional MoC’s utility being partially preserved. (shrink)

Starting from John MacFarlane's recent survey of answers to the question ‘What is assertion?’, I defend an account of assertion that draws on elements of MacFarlane's and Robert Brandom's commitment accounts, Timothy Williamson's knowledge norm account, and my own previous work on the normative status of logic. I defend the knowledge norm from recent attacks. Indicative conditionals, however, pose a problem when read along the lines of Ernest Adams' account, an account supported by much work in the psychology of (...) reasoning. Furthermore, there seems to be no place for degrees of belief in the accounts of belief and assertion given here. Degrees of belief do have a role in decision‐making, but, again, there is much evidence that the orthodox theory of subjective utility maximization is not a good description of what we do in decision‐making and, arguably, neither is it a good normative guide to how we ought to make decisions. (shrink)

Waar de een zijn leven geeft voor een goed geweten, haalt de ander zijn schouders erover op. Het geweten: een achterhaald begrip of hard toe aan herwaardering?

This paper is concerned with the resources available for insensitive invariantism in epistemology to handle the intuitions that have been appealed to, both for contextualism and for subject-sensitive invariantism. It is argued that proposals by Tim Williamson and Jessica Brown are not adequate, and that subject-sensitive inductive fails to account for some crucial intuitions. It is then argued that the chauvinistic nature of the psychology of insensitive invariantism provides adequate resources for such an account. A subject is chauvinistic simply (...) by taking his own beliefs to be true, and by judging attributions accordingly. This is first illustrated with meaning attributions in the theory of interpretation, and then applied to knowledge attributions. (shrink)

Often we have coarsely grained knowledge: for example, we know about how many people are present. In possessing such knowledge, we also have finer grained knowledge of what is not: there certainly is nothing like that number of people here. The combination of such knowledge types, through sorites, generates contradiction and bafflement. This paper seeks to resolve the bafflement: it rejects a Timothy Williamson proposal, introduces muddle numbers and inference gaps, and shows how the different grains of knowledge do (...) not always meet. In so doing, the paper identifies a distinctive first‐person inferring. (shrink)

Things could have been different, but could it also have been different what things there are? It is natural to think so, since I could have failed to be born, and it is natural to think that I would then not have been anything. But what about entities like propositions, properties and relations? Had I not been anything, would there have been the property of being me? In this thesis, I formally develop and assess views according to which it is (...) both contingent what individuals there are and contingent what propositions, properties and relations there are. I end up rejecting these views, and conclude that even if it is contingent what individuals there are, it is necessary what propositions, properties and relations there are. -/- Call the view that it is contingent what individuals there are first-order contingentism, and the view that it is contingent what propositions, properties and relations there are higher-order contingentism. I bring together the three major contributions to the literature on higher-order contingentism, which have been developed largely independently of each other, by Kit Fine, Robert Stalnaker, and Timothy Williamson. I show that a version of Stalnaker's approach to higher-order contingentism was already explored in much more technical detail by Fine, and that it stands up well to the major challenges against higher-order contingentism posed by Williamson. -/- I further show that once a mistake in Stalnaker's development is corrected, each of his models of contingently existing propositions corresponds to the propositional fragment of one of Fine's more general models of contingently existing propositions, properties and relations, and vice versa. I also show that Stalnaker's theory of contingently existing propositions is in tension with his own theory of counterfactuals, but not with one of the main competing theories, proposed by David Lewis. -/- Finally, I connect higher-order contingentism to expressive power arguments against first-order contingentism. I argue that there are intelligible distinctions we draw with talk about "possible things", such as the claim that there are uncountably many possible stars. Since first-order contingentists hold that there are no possible stars apart from the actual stars, they face the challenge of paraphrasing such talk. I show that even in an infinitary higher-order modal logic, the claim that there are uncountably many possible stars can only be paraphrased if higher-order contingentism is false. I therefore conclude that even if first-order contingentism is true, higher-order contingentism is false. (shrink)

Assertions are the centre of gravity in social epistemology. They are the vehicles we use to exchange information within scientific groups and society as a whole. It is therefore essential to determine under which conditions we are permitted to make an assertion. In this paper we argue and provide empirical evidence for the view that the norm of assertion is justified belief: truth or even knowledge are not required. Our results challenge the knowledge account advocated by, e.g. Williamson (1996), (...) in general, and more specifically, put into question several studies conducted by Turri (2013, 2016) that support a knowledge norm of assertion. Instead, the justified belief account championed by, e.g. Douven (2006), seems to prevail. (shrink)

In epistemology and in philosophy of language there is fierce debate about the role of context in knowledge, understanding, and meaning. Many contemporary epistemologists take seriously the thesis that epistemic vocabulary is context-sensitive. This thesis is of course a semantic claim, so it has brought epistemologists into contact with work on context in semantics by philosophers of language. This volume brings together the debates, in a set of twelve specially written essays representing the latest work by leading figures in the (...) two fields. All future work on contextualism will start here. Contributors: Kent Bach, Herman Cappelen, Andy Egan, Michael Glanzberg, John Hawthorne, Ernest Lepore, Peter Ludlow, Peter Pagin, Georg Peter, Paul M. Pietroski, Gerhard Preyer, Jonathan Schaffer, Jason Stanley, Brian Weatherson, Timothy Williamson. (shrink)

As the transaction cost theory of the firm was taking shape in the 1970s, another important movement in economics was emerging: a revival of the ‘Austrian’ tradition in economic theory associated with such economists as Ludwig von Mises and F. A. Hayek . As Oliver Williamson has pointed out, Austrian economics is among the diverse sources for transaction cost economics. In particular, Williamson frequently cites Hayek , particularly Hayek’s emphasis on adaptation as a key problem of economic organisation (...) . Following Williamson’s lead, a reference to Hayek’s ‘The Use of Knowledge in Society’ has become almost mandatory in discussions of economic organisation . However, there are many other potential links between Austrian and transaction cost economics that have not been explored closely and exploited.This article argues that characteristically Austrian ideas about property, entrepreneurship, economic calculation, tacit knowledge, and the temporal structure of capital have important implications for theories of economic organisation, transaction cost economics in particular. Austrian economists have not, however, devoted substantial attention to the theory of the firm, preferring to focus on business-cycle theory, welfare economics, political economy, comparative economic systems, and other areas. Until recently the theory of the firm was an almost completely neglected area in Austrian economics, but over the last decade, a small Austrian literature on the firm has emerged. While these works cover a wide variety of theoretical and applied topics, their authors share the view that Austrian insights have something to offer students of firm organisation. (shrink)

This latest volume of _The Philosopher's Annual_ presents the ten best articles published in the field during 2001. No limitations are placed on the articles' sources, subject matter or mode of treatment, providing for a diverse collection of engaging, high-caliber work that stands as a valuable sample of contemporary philosophy. This year's volume includes papers by Robert Bernasconi, Hans Halvorson, Christopher Hitchcock, Ignacio Jane, Brian Leiter, Liam Murphy and Thomas Nagel, Joel Pust, Alison Simmons, Jason Stanley and Timothy Williamson, (...) and Crispin Wright. (shrink)

In this paper I sketch an account of moral blame and blameworthiness. I begin by clarifying what I take blame to be and explaining how blameworthiness is to be analyzed in terms of it. I then consider different accounts of the conditions of blameworthiness and, in the end, settle on one according to which a person is blameworthy for φ-ing just in case, in φ-ing, she violates one of a particular class of moral requirements governing the attitudes we bear, and (...) our mental orientation, toward people and other objects of significant moral worth. These requirements embody the moral stricture that we accord to these others a sufficient level of respect, one that their moral worth demands. This is a familiar theme which has its roots in P. F. Strawson’s pioneering views on moral responsibility. My development of it leads me to the conclusion that acting wrongly is not a condition of blameworthiness: violating a moral requirement to perform, or refrain from performing, an action is neither necessary nor sufficient for being blameworthy. All we are ever blameworthy for, I will argue, are certain aspects of our mental bearing toward others. We can be said to be blameworthy for our actions only derivatively, in the sense that those actions are the natural manifestations of the things for which we are strictly speaking blameworthy. (shrink)

We study the proof-theoretic strength and effective content of the infinite form of Ramsey's theorem for pairs. Let RT n k denote Ramsey's theorem for k-colorings of n-element sets, and let RT $^n_{ denote (∀ k)RT n k . Our main result on computability is: For any n ≥ 2 and any computable (recursive) k-coloring of the n-element sets of natural numbers, there is an infinite homogeneous set X with X'' ≤ T 0 (n) . Let IΣ n and BΣ (...) n denote the Σ n induction and bounding schemes, respectively. Adapting the case n = 2 of the above result (where X is low 2 ) to models of arithmetic enables us to show that RCA 0 + IΣ 2 + RT 2 2 is conservative over RCA 0 + IΣ 2 for Π 1 1 statements and that $RCA_0 + I\Sigma_3 + RT^2_{ , is Π 1 1 -conservative over RCA 0 + IΣ 3 . It follows that RCA 0 + RT 2 2 does not imply BΣ 3 . In contrast, J. Hirst showed that $RCA_0 + RT^2_{ does imply BΣ 3 , and we include a proof of a slightly strengthened version of this result. It follows that $RT^2_{ is strictly stronger than RT 2 2 over RCA 0. (shrink)

There is a debate in normative ethics about whether or not our moral obligations depend solely on either our evidence concerning, or our beliefs about, the world. Subjectivists maintain that they do and objectivists maintain that they do not. I shall offer some arguments in support of objectivism and respond to the strongest argument for subjectivism. I shall also briefly consider the significance of my discussion to the debate over whether one’s future voluntary actions are relevant to one’s current moral (...) obligations. (shrink)

Preliminary draft of November 2010—please do not circulate without permission.

This volume, an expanded edition of the philosophy of language issue of the journal Midwest Studies in Philosophy (1977), includes essays by some of the ...

Many health care decisions depend not only upon medical facts, but also on value judgments—patient goals and preferences. Until recent decades, patients relied on doctors to tell them what to do. Then ethicists and others convinced clinicians to adopt a paradigm shift in medical practice, to recognize patient autonomy, by orienting decision making toward the unique goals of individual patients. Unfortunately, current medical practice often falls short of empowering patients. In this article, we reflect on whether the current state of (...) medical decision making effectively promotes patients' health care goals. We base our reflections, in part, on research in which we observed physicians making earnest efforts to partner with patients in making treatment decisions, but still struggling to empower patients—failing to communicate clearly to patients about decision-relevant information, overwhelming patients with irrelevant information, overlooking when patients' emotions made it hard to engage in choices, and making recommendations before discussing patients' goals. (shrink)

If practical reason is concerned with thoughtful normative regulation of action, then theoretical reason might be seen as a matter of thoughtful normative regulation of belief. The conclusion of a piece of practical reasoning, we are told, is an act or intention to act; the conclusion of a piece of theoretical reasoning, by parallel, would be a belief or a belief-tendency. Because theoretical reason is understood to be responsive specifically to epistemic – not merely pragmatic – reasons for belief, the (...) norms involved in heoretical reason are norms pertinent to knowledge, including norms of evidence, justification, and truth. In both the practical and theoretical case we need not exactly agree with the conclusion another person reaches in order to attribute rationality to her – but it seems we do need to find something normatively appropriate about the means by which the other reaches her conclusion, given her capacities and circumstances. (shrink)

Despite its current popularity, “emergence” is a concept with a venerable history and an elusive, ambiguous standing in contemporary evolutionary theory. This paper briefly recounts the history of the term and details some of its current usages. Not only are there radically varying interpretations about how to define emergence but “reductionist” and “holistic” theorists hold very different views about the issue of causation. However, these two seemingly polar positions are not irreconcilable. Reductionism, or detailed analysis of the parts and their (...) interactions, is essential for answering the “how” question in evolution—how does a complex living system work? But holism is equally necessary for answering the “why” question—why did a particular arrangement of parts evolve? In order to answer the “why” question, a broader, multi-leveled paradigm is required. The reductionist approach to explaining emergent complexity has entailed a search for underlying “laws of emergence.” In contrast, the “Synergism Hypothesis” focuses on the “economics”—the functional effects produced by emergent wholes and their selective consequences in evolutionary change. This paper also argues that emergent phenomena represent, in effect, a subset of a larger universe of cooperative, synergistic effects in the natural world. (shrink)

David Lewis has offered a reply to the standard argument for the claim that the truth of determinism is incompatible with anyone’s being able to do otherwise than she in fact does. Helen Beebee has argued that Lewis’s compatibilist strategy is untenable. In this paper I show that one recent attempt to defend Lewis’s view against this argument fails and then go on to offer my own defense of Lewis’s view.

In April 1999, Dr. Curt Freed of the University of Colorado in Denver and Dr. Stanley Fahn of Columbia Presbyterian Center in New York presented the results of a four-year, $5.7 million government-financed study using tissue from aborted fetuses to treat Parkinson’s disease at a conference of the American Academy of Neurology. The results of the first government-financed, placebo-controlled clinical study using fetal tissue showed that the symptoms of some Parkinson’s patients had been relieved. This research study involved forty subjects, (...) nineteen women and twenty-one men; all suffered from Parkinson’s disease for an average of 13.5 years. In the study, each subject underwent neurosurgery: “four tiny burr holes, drilled through the wrinkle lines above the eyebrows into the skull, to clear a pathway to the brain. But only half received injections of fetal cells into the putamen, the region of the brain that controls movement; the other half received nothing. One year later, three members of the placebo group said their symptoms had improved.” In two-thirds of the transplant recipients, the fetal tissue took hold and seemed to establish a new network to produce the missing neurochemical dopamine. (shrink)

Theorists have hypothesized that skill in critical thinking is positively correlated with the consistent internal motivation to think and that specific critical thinking skills are matched with specific critical thinking dispositions. If true, these assumptions suggest that a skill-focused curriculum would lead persons to be both willing and able to think. This essay presents a researchbased expert consensus definition of critical thinking, argues that human dispositions are neither hidden nor unknowable, describes a scientific process of developing conventional testing tools to (...) measure cognitive skills and human dispositions, and summarizes recent empirical research findings that explore the possible relationship of critical thinking skill and the consistent internal motivation, or disposition, to use that skill. Empirical studies indicate that for all practical purposes the hypothesized correlations are not evident. It would appear that effective teaching must include strategies for building intellectual character rather than relying exclusively on strengthening cognitive skills. (shrink)

In this lucid and penetrating book, Peter A. Schouls considers Locke's major writings in terms of the closely related ideas of freedom, progress, mastery, reason, and education.

ABSTRACTMother‐to‐child transmission of HIV represents a particularly dramatic aspect of the HIV epidemic with an estimated 600,000 newborns infected yearly, 90% of them living in sub‐Saharan Africa. Since the beginning of the HIV epidemic, an estimated 5.1 million children worldwide have been infected with HIV. MTCT is responsible for 90% of these infections. Two‐thirds of the MTCT are believed to occur during pregnancy and delivery, and about one‐third through breastfeeding. As the number of women of child bearing age infected with (...) HIV rises, so does the number of infected children. It is apparent that voluntary testing in Botswana has made some valuable inroads in decreasing perinatal HIV transmission, but the statistics showing the increased rate of HIV infection among women 15–24 years of age are not very promising. After reviewing all the pertinent scientific data it is clear that mandatory HIV testing of all pregnant women in conjunction with the implementation of a full package of interventions would save thousands of lives – mothers, newborns and others who could be infected as a result of these women not being aware of their HIV status. If the protection and preservation of human life is a priority in Botswana, then it is time to allow for mandatory HIV testing of all pregnant women, before it is too late for those who are the most vulnerable. To do less would be medically inappropriate and ethically irresponsible. (shrink)