Regulation and governance of medical research is frequently criticised by researchers. In this paper, we draw on Everett Hughes’ concepts of professional licence and professional mandate, and on contemporary sociological theory on risk regulation, to explain the emergence of research governance and the kinds of criticism it receives. We offer explanations for researcher criticism of the rules and practices of research governance, suggesting that these are perceived as interference in their mandate. We argue that, in spite of their complaints, researchers (...) benefit from the institutions of governance and regulation, in particular by the ways in which regulation secures the social licence for research. While it is difficult to answer questions such as: “Is medical research over-regulated?” and “Does the regulation of medical research successfully protect patients or promote ethical conduct?”, a close analysis of the social functions of research governance and its relationship to risk, trust, and confidence permits us to pose these questions in a more illuminating way. (shrink)

Thomas Jefferson and Philosophy: Essays on the Philosophical Cast of Jefferson’s Writings is a collection of essays on topics that relate to philosophical aspects of Jefferson’s thinking over the years. Much historical insight is given to ground the various philosophical strands in Jefferson’s thought and writing on topics such as political philosophy, moral philosophy, slavery, republicanism, wall of separation, liberty, educational philosophy, and architecture.

We analysed research ethics committee (REC) letters. We found that RECs frequently identify process errors in applications from researchers that are not deemed “favourable” at first review. Errors include procedural violations (identified in 74% of all applications), missing information (68%), slip-ups (44%) and discrepancies (25%). Important questions arise about why the level of error identified by RECs is so high, and about how errors of different types should be handled.

Reviews evidence which suggests that there may be little or no direct introspective access to higher order cognitive processes. Ss are sometimes unaware of the existence of a stimulus that importantly influenced a response, unaware of the existence of the response, and unaware that the stimulus has affected the response. It is proposed that when people attempt to report on their cognitive processes, that is, on the processes mediating the effects of a stimulus on a response, they do not do (...) so on the basis of any true introspection. Instead, their reports are based on a priori, implicit causal theories, or judgments about the extent to which a particular stimulus is a plausible cause of a given response. This suggests that though people may not be able to observe directly their cognitive processes, they will sometimes be able to report accurately about them. Accurate reports will occur when influential stimuli are salient and are plausible causes of the responses they produce, and will not occur when stimuli are not salient or are not plausible causes. (shrink)

The authors find East Asians to be holistic, attending to the entire field and assigning causality to it, making relatively little use of categories and formal logic, and relying on "dialectical" reasoning, whereas Westerners, are more analytic, paying attention primarily to the object and the categories to which it belongs and using rules, including formal logic, to understand its behavior. The 2 types of cognitive processes are embedded in different naive metaphysical systems and tacit epistemologies. The authors speculate that the (...) origin of these differences is traceable to markedly different social systems. The theory and the evidence presented call into question long-held assumptions about basic cognitive processes and even about the appropriateness of the process–content distinction. (shrink)

Edited by four leading members of the new generation of medical and healthcare ethicists working in the UK, respected worldwide for their work in medical ethics, Principles of Health Care Ethics, Second Edition_is a standard resource for students, professionals, and academics wishing to understand current and future issues in healthcare ethics. With a distinguished international panel of contributors working at the leading edge of academia, this volume presents a comprehensive guide to the field, with state of the art introductions to (...) the wide range of topics in modern healthcare ethics, from consent to human rights, from utilitarianism to feminism, from the doctor-patient relationship to xenotransplantation. This volume is the Second Edition of the highly successful work edited by Professor Raanan Gillon, Emeritus Professor of Medical Ethics at Imperial College London and former editor of the Journal of Medical Ethics, the leading journal in this field. Developments from the First Edition include:_ The focus on ‘Four Principles Method’ is relaxed to cover more different methods in health care ethics. More material on new medical technologies is included, the coverage of issues on the doctor/patient relationship is expanded, and material on ethics and public health is brought together into a new section. (shrink)

Charles Foster and Jonathan Herring are to be congratulated on their useful presentation of the roles played by concepts of personhood and identity in English medical law.1 However, I fear that the project they have undertaken here is misconceived. It is an interesting and important misconception, which is widely shared in the literature on medical law and ethics; but a misconception it remains. The problem is this. What we call ‘the Law’ is in fact a complex assemblage of institutions, rules, (...) accredited persons, practices and systems. What it is not is a self-sufficient, integrated and self-interpreting system of doctrine. As such it does not have a clear structure which we can excavate and the idea that we can find concepts which explain and unify that structure at some deep level is thus quixotic. To approach ‘the Law’ in that way is to pursue a chimaera. We should instead think of ‘the Law’ as Wittgenstein taught us to approach a language.2 We can find concepts through investigation of language in practical use, but the …. (shrink)

Staged 2 different videotaped interviews with the same individual—a college instructor who spoke English with a European accent. In one of the interviews the instructor was warm and friendly, in the other, cold and distant. 118 undergraduates were asked to evaluate the instructor. Ss who saw the warm instructor rated his appearance, mannerisms, and accent as appealing, whereas those who saw the cold instructor rated these attributes as irritating. Results indicate that global evaluations of a person can induce altered evaluations (...) of the person's attributes, even when there is sufficient information to allow for independent assessments of them. Furthermore, Ss were unaware of this influence of global evaluations on ratings of attributes. In fact, Ss who saw the cold instructor actually believed that the direction of influence was opposite to the true direction. They reported that their dislike of the instructor had no effect on their rating of his attributes but that their dislike of his attributes had lowered their global evaluations of him. (shrink)

In ‘Salvaging the Concept of Nudge’ Yashar Saghai performs an important clarificatory task which certainly advances our philosophical and ethical understanding of nudges in public policy, and in healthcare ethics in particular.1 In this brief commentary I identify some issues which could usefully be taken forward in subsequent discussions.A central difficulty with ethical discussions of nudging is that insufficient care is taken to distinguish two morally important features of nudges. The first, which Saghai very properly concentrates upon, is the mechanism (...) of nudging. Nudges rely on psychological properties of human decision-makers as the way in which their intended effects are brought about. Much of the ethical concern with nudges focuses on just this. Whatever the motive of the nudger, or the objective of the nudge, or the ex ante or ex post ratification of the nudge by the nudge, operating through influence, impulse or non-rational features of the nudgee's decision-making is wrong. The nature of this wrongness can be spelled out in different ways, and which one of these we choose has important implications for the precise ethical argument …. (shrink)

Bioethics has been subject to considerable social criticism in recent years. One criticism that has caused particular discomfort in the bioethics community is that bioethicists, because of the way their work is funded, are involved in profound conflicts of interest that undermine their title to be considered independent moral commentators on developments in biomedicine and biotechnology. This criticism draws its force from the assumption that bioethics is, or ought to be, a type of normative social criticism. Versions of this criticism (...) come from both the political left and right. For instance, such criticisms include allegations that bioethics is inherently socially conservative, that it is inherently “pro-technology”, that it lays spurious claims to moral and social authority and expertise, that its focus on autonomy links it to neoliberal theories of choice, and that it is an ideological mystification of real social relationships and political power. This commentary paper analyses the problem of bioethical conflict of interest, and argues that the types of conflict of interest facing bioethics are inherent to the role of “public intellectual” that bioethicists generally wish to assume. The paper defends this conception of the role of the bioethicist, arguing that bioethicists should be interested and openly so. (shrink)

In this paper I argue that resource allocation in publicly funded medical systems cannot be done using a purely substantive theory of justice, but must also involve procedural justice. I argue further that procedural justice requires institutions and that these must be “local” in a specific sense which I define. The argument rests on the informational constraints on any non-market method for allocating scarce resources among competing claims of need. However, I resist the identification of this normative account of local (...) justice with the actual approach to local decision-making taken within the UK National Health Service. I illustrate my argument with reference to the case of provision of In Vitro Fertilisation within the UK NHS. (shrink)

Husserl's theory of meaning is often regarded as a somewhat obscure attempt at a view which frege stated more clearly. I argue that while this may be true with respect to the "ideas," it is false with respect to the "logical investigations." the theory presented in the latter work is superior to frege's theory. It provides an objective foundation for the semantical distinctions which concerned frege while remaining within the confines of an ontology that is more economical than frege's.

This classic, first published in 1969, introduces to English-speaking readers a field which is of increasing importance in contemporary philosophy and theology--hermeneutics, the theory of understanding, or interpretation. Richard E. Palmer, utilizing largely untranslated sources, treats principally of the conception of hermeneutics enunciated by Heidegger and developed into a "philosophical hermeneutics" by Hans-Georg Gadamer. He provides a brief overview of the field by surveying some half-dozen alternate definitions of the term and by examining in detail the contributions of Friedrich (...) Schleiermacher and Wilhelm Dilthey. In the Manifesto which concludes the book, Palmer suggests the potential significance of hermeneutics for literary interpretation. (shrink)

This book examines two questions: Do people make use of abstract rules such as logical and statistical rules when making inferences in everyday life? Can such abstract rules be changed by training? Contrary to the spirit of reductionist theories from behaviorism to connectionism, there is ample evidence that people do make use of abstract rules of inference -- including rules of logic, statistics, causal deduction, and cost-benefit analysis. Such rules, moreover, are easily alterable by instruction as it occurs in classrooms (...) and in brief laboratory training sessions. The fact that purely formal training can alter them and that those taught in one content domain can "escape" to a quite different domain for which they are also highly applicable shows that the rules are highly abstract. The major implication for cognitive science is that people are capable of operating with abstract rules even for concrete, mundane tasks; therefore, any realistic model of human inferential capacity must reflect this fact. The major implication for education is that people can be far more broadly influenced by training than is generally supposed. At high levels of formality and abstraction, relatively brief training can alter the nature of problem-solving for an infinite number of content domains. (shrink)

A long-standing challenge to evolutionary theory has been whether it can explain the origin of complex organismal features. We examined this issue using digital organisms—computer programs that self-replicate, mutate, compete and evolve. Populations of digital organisms often evolved the ability to perform complex logic functions requiring the coordinated execution of many genomic instructions. Complex functions evolved by building on simpler functions that had evolved earlier, provided that these were also selectively favoured. However, no particular intermediate stage was essential for evolving (...) complex functions. The first genotypes able to perform complex functions differed from their non-performing parents by only one or two mutations, but differed from the ancestor by many mutations that were also crucial to the new functions. In some cases, mutations that were deleterious when they appeared served as stepping-stones in the evolution of complex features. These findings show how complex functions can originate by random mutation and natural selection. (shrink)

ABSTRACTMedicines that are vital for the saving and preserving of life in conditions of public health emergency or endemic serious disease are known as essential medicines. In many developing world settings such medicines may be unavailable, or unaffordably expensive for the majority of those in need of them. Furthermore, for many serious diseases these essential medicines are protected by patents that permit the patent‐holder to operate a monopoly on their manufacture and supply, and to price these medicines well above marginal (...) cost. Recent international legal doctrine has placed great stress on the need to globalise intellectual property rights protections, and on the rights of intellectual property rights holders to have their property rights enforced. Although international intellectual property rights law does permit compulsory licensing of protected inventions in the interests of public health, the use of this right by sovereign states has proved highly controversial. In this paper I give an argument in support of states’ sovereign right to expropriate private intellectual property in conditions of public health emergency. This argument turns on a social contract argument for the legitimacy of states. The argument shows, further, that under some circumstances states are not merely permitted compulsory to license inventions, but are actually obliged to do so, on pain of failure of their legitimacy as sovereign states. The argument draws freely on a loose interpretation of Thomas Hobbes's arguments in his Leviathan, and on an analogy between his state of War and the situation of public health disasters. (shrink)

I want to state as clearly as I can the sense in which Kant is, and the sense in which he is not, a phenomenalist. And I also want to state the argument which Kant presents, in the Transcendental Deduction, for his particular version of phenomenalism. Since that doctrine has been stated by Kant himself as the view that we have knowledge of “appearances” only, and not of things in themselves, or that material objects are nothing but a species of (...) our “representations,” it will of course be part of my task in this paper to deal with these fundamental notions. Some recent works on Kant have completely misinterpreted these notions, and because of this they have failed to capture the peculiar character of Kant’s phenomenalism. Jonathan Bennett, for example, interprets Kant’s claim that “objects are nothing but representations” as the claim that “statements about objects must be translatable into statements about intuitions.” I shall call such a view a reductive phenomenalism and argue in this paper that Kant is not a reductive phenomenalist. But Kant is, all the same, a phenomenalist. I shall call him an existential phenomenalist. The difference is this: Kant does not maintain, as Bennett claims, that all propositions which assert or presuppose the existence of objects must be translatable into statements which refer to intuitions alone, but he does hold that all such propositions are translatable into statements about the existence of intuitions alone. When Kant tells us, therefore, that objects are mere “appearances,” he is not offering a theory about what empirical objects are or about what we are really referring to when we refer to such objects, but he is offering a theory about the sense in which any empirical objects can meaningfully be said to exist. The significance of the distinction between reductive and existential phenomenalism is great. For it both allows Kant to do justice to those considerations which appear to lead to idealism or phenomenalism, while it does not at the same time require him to deny that the level at which we speak of material bodies and states is, and must be, a basic level of our conceptual framework. It cannot be one which is itself built upon, or constructed out of, some more basic level, e.g., out of talk about sense-data or sensory states. The uniqueness of Kant’s phenomenalism lies precisely at this point. (shrink)

It has been about fifty years since the topic of divine impassibility was the subject of book-length philosophical treatments in English. In recent years process and analytic philosophers have returned this issue to the forefront of professional attention. Divine Impassibility traces the issue of classical sources, relates the positions of nineteenth- and early twentieth-century books, and surveys the writings of contemporary British analytic philosophers such as Peter Geach, Anthony Kenny, Richard Swinburne, John Hick, and H. P. Owen, American analytic (...) philosophers such as Norman Kretzmann, Eleonore Stump, Nelson Pike, Robert Adams, and Bruce Reichenbach, and process philosophers such as Charles Hartshorne and Lewis Ford. The author shows that clear, adequate analysis of the issue must distinguish four respects in which God might be passible or impassible: nature, will, knowledge, and feeling. He shows also how decisions on this topic bear on numerous others in philosophical theology such as creation, eternality, evil, and human freedom. His creative proposals on these and other topics attempt to go beyond the difficulties of both classical and process conceptions of God. (shrink)

The fitness of any evolutionary unit can be understood in terms of its two basic components: fecundity (reproduction) and viability (survival). Trade-offs between these fitness components drive the evolution of life-history traits in extant multicellular organisms. We argue that these trade-offs gain special significance during the transition from unicellular to multicellular life. In particular, the evolution of germ–soma specialization and the emergence of individuality at the cell group (or organism) level are also consequences of trade-offs between the two basic fitness (...) components, or so we argue using a multilevel selection approach. During the origin of multicellularity, we study how the group trade-offs between viability and fecundity are initially determined by the cell level trade-offs, but as the transition proceeds, the fitness trade-offs at the group level depart from those at the cell level. We predict that these trade-offs begin with concave curvature in single-celled organisms but become increasingly convex as group size increases in multicellular organisms. We argue that the increasingly convex curvature of the trade-off function is driven by the cost of reproduction which increases as group size increases. We consider aspects of the biology of the volvocine green algae – which contain both unicellular and multicellular members – to illustrate the principles and conclusions discussed. (shrink)

I argue for a basically Sartrean approach to the idea that one's self-concept, and any form of knowledge of oneself as an individual subject, presupposes concepts and knowledge about other things. The necessity stems from a pre-conceptual structure which assures that original self-consciousness is identical with one's consciousness of objects themselves. It is not a distinct accomplishment merely dependent on the latter. The analysis extends the matter/form distinction to concepts. It also requires a distinction between two notions of consciousness: one (...) relates to the employment of already formed concepts, the other to the structures of imaginative apprehension that help to constitute (empirical) concepts from the start. We need to see that (1) so far as objects are only conceptualized appearances, the material through which we apprehend them must be reflected in that apprehension itself; (2) the corresponding material consists of a manifold of pre-conceptually active anticipations and retentions concerning the course of one's own experience. The resultant structure imposes an orientation on the world of appearances that does not derive from a concept of oneself as an individual in it, but that nevertheless provides the only possible basis for such a concept. One's self-concept, at least as empirical subject, is simply that ofwhatever subject is indicated, in an appropriate way, by that orientation. (shrink)