Accounts of the concepts of function and dysfunction have not adequately explained what factors determine the line between low‐normal function and dysfunction. I call the challenge of doing so the line‐drawing problem. Previous approaches emphasize facts involving the action of natural selection (Wakefield 1992a, 1999a, 1999b) or the statistical distribution of levels of functioning in the current population (Boorse 1977, 1997). I point out limitations of these two approaches and present a solution to the line‐drawing problem that builds on the (...) second one. (shrink)

A scholarly edition of Essay Concerning Human Understanding by P. H. Nidditch. The edition presents an authoritative text, together with an introduction, commentary notes, and scholarly apparatus.

Peter Spader has written a magisterial study on Max Scheler, one of phenomenology’s earliest and greatest figures, whose theory of ethical personalism has become a major voice in the formulation of phenomenological ethics today. Spader follows Scheler’s use of the classic phenomenological approach, by means of which he presented a fresh view of values, feelings, and the person, and thereby staked out a new approach in ethics. Spader recreates the logic of Scheler’s quest, revealing the basis of his thought (...) and the reasons for his dramatic changes of direction. This remarkable study provides a framework that allows us to understand Scheler’s insights in the context of their dynamic evolution of his thought. It corrects imbalances in the presentation of his ideas and defends Scheler against key misunderstandings and criticisms. In short, Spader’s work continues the process of developing Scheler’s pioneering theory of ethical personalism. (shrink)

Similarly to other accounts of disease, Christopher Boorse’s Biostatistical Theory (BST) is generally presented and considered as conceptual analysis, that is, as making claims about the meaning of currently used concepts. But conceptual analysis has been convincingly critiqued as relying on problematic assumptions about the existence, meaning, and use of concepts. Because of these problems, accounts of disease and health should be evaluated not as claims about current meaning, I argue, but instead as proposals about how to define and use (...) these terms in the future, a methodology suggested by Quine and Carnap. I begin this article by describing problems with conceptual analysis and advantages of “philosophical explication,” my favored approach. I then describe two attacks on the BST that also question the entire project of defining “disease.” Finally, I defend the BST as a philosophical explication by showing how it could define useful terms for medical science and ethics. (shrink)

This paperback edition reproduces the complete text of the Essay as prepared by professor Nidditch for The Clarendon Edition of the Works of John Locke. The Register of Formal Variants and the Glossary are omitted and Professor Nidditch has written a new foreword.

In a series of recent papers, I have made three arguments about how to define “disease” and evaluate and apply possible definitions. First, I have argued that definitions should not be seen as traditional conceptual analyses, but instead as proposals about how to define and use the term “disease” in the future. Second, I have pointed out and attempted to address a challenge for dysfunction-requiring accounts of disease that I call the “line-drawing” problem: distinguishing between low-normal functioning and dysfunctioning. Finally, (...) I have used a dysfunction-requiring approach to argue that some extremely prevalent conditions, such as high blood pressure, high cholesterol, and ductal carcinoma in situ, are not diseases, but instead are risk factors. Four of the papers in this issue directly engage my previous work. In this commentary, I applaud the advances these authors make, address points of disagreement, and make suggestions about where the discussion should go next. (shrink)

"Modern History" versions of the etiological theory claim that in order for a trait X to have the proper function F, individuals with X must have been recently favored by natural selection for doing F (Godfrey-Smith 1994; Griffiths 1992, 1993). For many traits with prototypical proper functions, however, such recent selection may not have occurred: traits may have been maintained due to lack of variation or due to selection for other effects. I examine this flaw in Modern History accounts and (...) offer an alternative etiological theory, the Continuing Usefulness account, which appears to avoid such problems. (shrink)

I argue that ductal carcinoma in situ (DCIS), the tumor most commonly diagnosed by breast mammography, cannot be confidently classified as cancer, that is, as pathological. This is because there may not be dysfunction present in DCIS—as I argue based on its high prevalence and the small amount of risk it conveys—and thus DCIS may not count as a disease by dysfunction-requiring approaches, such as Boorse’s biostatistical theory and Wakefield’s harmful dysfunction account. Patients should decide about treatment for DCIS based (...) on the risks it poses and the risks and benefits of treatment, not on its disease status. (shrink)

Patients should not always receive hard data about the risks and benefits of a medical intervention. That information should always be available to patients who expressly ask for it, but it should be part of standard disclosure only sometimes, and only for some patients. And even then, we need to think about how to offer it.

'Modern History' views claim that in order for a trait X to have the proper function F, X must have been recently favored by natural selection for doing F (Griffiths 1992, 1993; Godfrey-Smith 1994). For many traits with prototypical proper functions, however, such recent selection may not have occurred, since traits may have been maintained owing to lack of variation or selection for other effects. I explore this flaw in Modern History accounts and offer an alternative etiological theory, which I (...) call the 'Continuing Usefulness' account. According to my view, a trait has the proper function F if and only if, first, the trait was favored by selection for doing F at some point (perhaps far in the past), and, secondly, the trait has recently contributed to survival and reproduction by doing F. This separates the requirement involving natural selection from the one involving the recent past, two issues that the Modern History account conflates. The clear separation allows a detailed analysis of the causal judgments and form of adaptationism that ground the etiological approach to function. (shrink)

Philosophical interest in the biological concept of function stems largely from concerns about its teleological associations. Assigning something a function seems akin to assigning it a purpose, and discussion of the purpose of items has long been off-limits to science. Analytic philosophers have attempted to defend ‘function’ by showing that claims about functions do not involve any reference to a problematic notion of purpose. To do this, philosophers offer short lists of necessary and sufficient conditions for the application of the (...) concept—where the conditions involve only acceptable physical or biological notions—and claim that the set of conditions captures the import of function statements. (shrink)

Some experts have argued that patients should routinely be told the specific magnitude and absolute probability of potential risks and benefits of screening tests. This position is motivated by the idea that framing risk information in ways that are less precise violates the ethical principle of respect for autonomy and its application in informed consent or shared decisionmaking. In this Perspective, we consider a number of problems with this view that have not been adequately addressed. The most important challenges stem (...) from the danger that patients will misunderstand the information or have irrational responses to it. Any initiative in this area should take such factors into account and should consider carefully how to apply the ethical principles of respect for autonomy and beneficence. (shrink)

This study examined preschool children’s reasoning about and behavioral interactions with one of the most advanced robotic pets currently on the retail market, Sony’s robotic dog AIBO. Eighty children, equally divided between two age groups, 34–50 months and 58–74 months, participated in individual sessions with two artifacts: AIBO and a stuffed dog. Evaluation and justification results showed similarities in children’s reasoning across artifacts. In contrast, children engaged more often in apprehensive behavior and attempts at reciprocity with AIBO, and more often (...) mistreated the stuffed dog and endowed it with animation. Discussion focuses on how robotic pets, as representative of an emerging technological genre, may be blurring foundational ontological categories, and impacting children’s social and moral development. (shrink)

Providing an overview of the intellectual roots of the worldwide environmental movement - from ancient religions and philosophies to modern science and ethics - this book synthesises them into a new philosophy of nature in which to ground ...

Imagine you fly home from vacation with your one-and-a-half-year-old son who is traveling for free as a “lap child.” In the airport parking lot, you put him into his forward-facing car seat, where he sits much more contentedly than he did in the rear-facing one that was mandatory until his first birthday. After he falls asleep on the way home, you transfer him to his crib without waking him, lowering the side rail so you can lift him in more easily. (...) -/- Many parts of this idyllic parenting picture are deemed unacceptably risky according to recent child safety proposals. While these proposals all aim to improve child safety, their possible impact is unclear because there has been little discussion of the absolute risk and risk reduction involved in each. And while precise figures are lacking, rough estimates indicate that the magnitudes are quite small. I will argue that this risk and benefit data raises important questions about the proposals, including whether parents might reasonably believe that the small absolute risk reduction offered by the proposed changes does not justify the attendant burdens. This possibility—termed the “prevention paradox” in other contexts—highlights ethical and theoretical challenges in this area of public health. (shrink)

In this paper, we move toward offering psychological benchmarks to measure success in building increasingly humanlike robots. By psychological benchmarks we mean categories of interaction that capture conceptually fundamental aspects of human life, specified abstractly enough to resist their identity as a mere psychological instrument, but capable of being translated into testable empirical propositions. Nine possible benchmarks are considered: autonomy, imitation, intrinsic moral value, moral accountability, privacy, reciprocity, conventionality, creativity, and authenticity of relation. Finally, we discuss how getting the right (...) group of benchmarks in human–robot interaction will, in future years, help inform on the foundational question of what constitutes essential features of being human. (shrink)

This paper is a sequel to the joint publication of Scott and Krauss in which the first aspects of a mathematical theory are developed which might be called "First Order Probability Logic". No attempt will be made to present this additional material in a self-contained form. We will use the same notation and terminology as introduced and explained in Scott and Krauss, and we will frequently refer to the theorems stated and proved in the preceding paper. The main objective of (...) this study is to show that the probability of symmetric probability systems may be represented as a "weighted average" of what might be called "product probabilities". We then discuss some applications of our results to Carnap's "Principle of instantial relevance", which plays an important role in his system of inductive logic. (shrink)

Studies of patient decision‐making use many different measures to evaluate the quality of decisions and the decision‐making process, partly to determine whether the ethical goals of informed consent, patient autonomy, and shared decision‐making have been achieved. We describe these measures, grouped under three main approaches, and review their limitations, leading to three conclusions. First, no measure or combination of measures can provide a complete assessment of decision quality. Second, the quality of a decision is best characterized vaguely, for instance as (...) “good,” “satisfactory,” or “poor,” and these categorizations depend on qualitative judgments that go beyond quantitative measures. Third, bioethicists should focus on identifying and addressing poor or problematic decisions, rather than trying to incrementally increase decision quality, quantified by a measure. Decision‐quality measures can be useful in research and in advancing important goals of bioethics, as long as the challenges of defining and measuring decision quality are recognized. (shrink)

Can original philosophy be done while simultaneously engaging in the history of philosophy? Such a possibility is questioned by analytic philosophers who contend that history contaminates good philosophy, and by historians of philosophy who insist that theoretical predecessors cannot be ignored. Believing that both camps are misguided, the contributors to this book present a case for historical philosophy as a valuable enterprise. The contributors include: Todd L. Adams, Lilli Alanen, Jos? Bernardete, Jonathan Bennett, John I. Biro, Phillip Cummins, Georges Dicker, (...) Daniel A. Dombrowski, Daniel Garber, Josiah Gould, Jorge J.E. Gracie, Daniel Graham, Charles Griswold, James Lawler, Rudolf Luthe, Edward H. Madden, George Mavrodes, Gerald E. Myers, Jonathan R?e, Frithjof Rodi, Kenneth L. Schmitz, Vladimir Shtinov, David G. Stern, Robert Turnbull, James Van Cleve, Frederick Van De Pitte, Henry Beatch, and Richard Watson. (shrink)

With the growing focus on prevention in medicine, studies of how to describe risk have become increasing important. Recently, some researchers have argued against giving patients “comparative risk information,” such as data about whether their baseline risk of developing a particular disease is above or below average. The concern is that giving patients this information will interfere with their consideration of more relevant data, such as the specific chance of getting the disease (the “personal risk”), the risk reduction the treatment (...) provides, and any possible side effects. I explore this view and the theories of rationality that ground it, and I argue instead that comparative risk information can play a positive role in decision-making. The criticism of disclosing this sort of information to patients, I conclude, rests on a mistakenly narrow account of the goals of prevention and the nature of rational choice in medicine. (shrink)