Dynamic Consent is both a model and a specific web-based tool that enables clear, granular communication and recording of participant consent choices over time. The DC model enables individuals to know and to decide how personal research information is being used and provides a way in which to exercise legal rights provided in privacy and data protection law. The DC tool is flexible and responsive, enabling legal and ethical requirements in research data sharing to be met and for online health (...) information to be maintained. DC has been used in rare diseases and genomics, to enable people to control and express their preferences regarding their own data. However, DC has never been explored in relationship to historical collections of bioscientific and genetic heritage or to contexts involving Aboriginal and Torres Strait Islander people.In response to the growing interest by First Peoples throughout Australia in genetic and genomic research, and the increasing number of invitations from researchers to participate in community health and wellbeing projects, this article examines the legal and ethical attributes and challenges of DC in these contexts. It also explores opportunities for including First Peoples' cultural perspectives, governance, and leadership as a method for defining DC on cultural terms that engage best practice research and data analysis as well as respect for meaningful and longitudinal individual and family participation. (shrink)

Out from the Shadows showcases the work of 18 analytical feminists from a variety of traditional areas of philosophy: social and political philosophy, normative ethics, virtue theory, metaethics, philosophy of language, metaphysics, epistemology, and philosophy of science. The collection is unique both in its focus on analytical feminism and in its breadth across the subdisciplines within philosophy. The book highlights successful uses of concepts and approaches from traditional philosophy, and illustrates the contributions that feminist approaches have made and could make (...) to the analysis of issues in key areas of traditional philosophy, while also demonstrating that traditional philosophy ignores feminist insights and feminist critiques of traditional philosophy at its own peril. (shrink)

Numerous studies have shown almost uniformly positive opinions among patients and physicians regarding theconceptof advance directives (either a healthcare proxy or living will). Several of these studies have also shown that the actual use of advance directives is significantly lower than this enthusiasm would suggest, but they have not explained the apparent discordance. Nor have researchers explained why members of minority groups are much less likely to complete advance directives than are white patients. In this study, we used a focus (...) group methodology to examine the ways in which diverse populations of patients view the medical, philosophical, and practical issues surrounding advance directives. We were motivated by the significantly lower prevalence of advance directives among African-American and Hispanic patients at one urban teaching hospital (18% for Caucasians, 4% for African-Americans, and 2% for Hispanics). Our premise was that African-American and Hispanic populations, who have had higher rates of morbidity and mortality across numerous disease categories, and historically have had limited access to care and opportunities to discuss health concerns, may be more suspicious about the right of autonomy that an advance directive is designed to ensure. (shrink)

If human rights express the equal claim of every person to the recognition and protection of their vital interests, they necessarily assert universal obligations of justice that cross borders. Sharon Anderson-Gold asks here whether there is a normative consensus on human rights and articulates the role of a cosmopolitan or global community in shaping the theory and practice of international politics. She considers several important works in the field of universal human rights and discusses whether a cosmopolitan system of (...) law is a necessary condition for the stable association of nation states. _Cosmopolitanism and Human Rights_ presents an ethical foundation for the idea of human development and attempts to demonstrate the normative character of universal human rights. It claims that Kant's idea of a federation of nations based upon principles of international right remains highly relevant to contemporary aspirations for global justice, and concludes by suggesting that a ‘cosmopolitan community’ is the locus of a global democratic order and is the necessary framework for the maintenance of human rights. (shrink)

A cosmopolitan education must help us identify with those who are unlike us. In Martha Nussbaum’s words, students must learn “enough to recognize common aims, aspirations, and values, and enough about these common ends to see how variously they are instantiated in the many cultures and their histories.” It is commonly thought that reading serious literature will play a significant role in this process. However, this claim is challenged by theorists we call sentimentalists, who claim that the goals of cosmopolitan (...) education are better served by less sophisticated, overtly sentimental texts which take a certain moral framework as given and encourage straightforward emotional responses within the guidelines of that framework. This paper critiques the sentimentalists’ position, arguing that their conception of a ‘sentimental education’ is inadequate to prepare students for the increasingly diverse, complex, cosmopolitan world their fate it is to inhabit. (shrink)

A growing body of research has demonstrated significant heterogeneity of hospital ethics committee (HEC) size, membership and training requirements, length of appointment, institutional support, clinical and policy roles, and predictors of self identified success. Because these studies have focused on HECs at a single point in time, however, little is known about how the composition of HECs changes over time and what impact these changes have on committee utilization. The current study presents 20 years of data on the evolution of (...) the Massachusetts General Hospital HEC. Between 1993 and 2012, the average number of committee members per year was 38 ± 3 and the average length of membership was 4.8 ± 0.4 years. During that time, the committee performed 934 consults, averaging 47 ± 3 per year. Attendance rates fell from 61.5 to 23.8 % over the study period and were inversely correlated with the total number of members. Between 1993 and 2012, the committee saw substantial growth in the diversity of the professional backgrounds of its members. Multivariate analysis, however, suggests that substantial changes in committee composition did not impact its utilization and that other factors are more likely to explain fluctuations in consultation volume. (shrink)

This paper will describe a participatory design process by which individuals from many levels of hierarchy and diverse technical background envisioned and then determined the design criteria for the software system to support the delivery of high quality nursing services.

A new approach for defining causality and such related notions as degree of responsibility, degrees of blame, and causal explanation. Causality plays a central role in the way people structure the world; we constantly seek causal explanations for our observations. But what does it even mean that an event C "actually caused" event E? The problem of defining actual causation goes beyond mere philosophical speculation. For example, in many legal arguments, it is precisely what needs to be established in order (...) to determine responsibility. The philosophy literature has been struggling with the problem of defining causality since Hume. In this book, Joseph Halpern explores actual causality, and such related notions as degree of responsibility, degree of blame, and causal explanation. The goal is to arrive at a definition of causality that matches our natural language usage and is helpful, for example, to a jury deciding a legal case, a programmer looking for the line of code that cause some software to fail, or an economist trying to determine whether austerity caused a subsequent depression. Halpern applies and expands an approach to causality that he and Judea Pearl developed, based on structural equations. He carefully formulates a definition of causality, and building on this, defines degree of responsibility, degree of blame, and causal explanation. He concludes by discussing how these ideas can be applied to such practical problems as accountability and program verification. Technical details are generally confined to the final section of each chapter and can be skipped by non-mathematical readers. (shrink)

Using formal systems to represent and reason about uncertainty.

Recent work in psychology and experimental philosophy has shown that judgments of actual causation are often influenced by consideration of defaults, typicality, and normality. A number of philosophers and computer scientists have also suggested that an appeal to such factors can help deal with problems facing existing accounts of actual causation. This article develops a flexible formal framework for incorporating defaults, typicality, and normality into an account of actual causation. The resulting account takes actual causation to be both graded and (...) comparative. We then show how our account would handle a number of standard cases. 1 Introduction2 Causal Models3 The HP Definition of Actual Causation4 The Problem of Isomorphism5 Defaults, Typicality, and Normality6 Extended Causal Models7 Examples7.1 Omissions7.2 Knobe effects7.3 Causes versus background conditions7.4 Bogus prevention7.5 Causal chains7.6 Legal doctrines of intervening causes7.7 Pre-emption and short circuits8 Conclusion. (shrink)

In Science as Social Knowledge, Helen Longino offers a contextual analysis of evidential relevance. She claims that this "contextual empiricism" reconciles the objectivity of science with the claim that science is socially constructed. I argue that while her account does offer key insights into the role that values play in science, her claim that science is nonetheless objective is problematic.

In many ways set theory lies at the heart of modern mathematics, and it does powerful work both philosophical and mathematical – as a foundation for the subject. However, certain philosophical problems raise serious doubts about our acceptance of the axioms of set theory. In a detailed and original reassessment of these axioms, Sharon Berry uses a potentialist approach to develop a unified determinate conception of set-theoretic truth that vindicates many of our intuitive expectations regarding set theory. Berry further (...) defends her approach against a number of possible objections, and she shows how a notion of logical possibility that is useful in formulating Potentialist set theory connects in important ways with philosophy of language, metametaphysics and philosophy of science. Her book will appeal to readers with interests in the philosophy of set theory, modal logic, and the role of mathematics in the sciences. (shrink)

What are the limits of the use of artificial intelligence (AI) in the relational aspects of medical and nursing care? There has been a lot of recent work and applications showing the promise and efficiency of AI in clinical medicine, both at the research and treatment levels. Many of the obstacles discussed in the literature are technical in character, regarding how to improve and optimize current practices in clinical medicine and also how to develop better data bases for optimal parameter (...) adjustments and predictive algorithms. This paper argues that there are also in principle obstacles to the application of AI in clinical medicine and care where empathy is important, and that these problems cannot be solved with any of the technical and theoretical approaches that shape the current application of AI in specific areas of clinical medicine in which care for patients is fundamental. This is important, because it generates specific risks that may be overlooked otherwise, and it justifies the necessity of human monitoring and emotional intervention in clinical medicine. Consequently, difficult issues concerning moral and legal responsibility may ensue if these in principle problems are ignored. (shrink)

After revelations of participation by psychiatrists and psychologists in interrogation of prisoners at Guantánamo Bay and Central Intelligence Agency secret detention centers, the American Psychiatric Association and the American Psychological Association adopted Position Statements absolutely prohibiting their members from participating in torture under any and all circumstances, and, to a limited degree, forbidding involvement in interrogations. Some interrogations utilize very aggressive techniques determined to be torture by many nations and organizations throughout the world. This paper explains why psychiatrists and psychologists (...) involved in coercive interrogations violate the Geneva Conventions and the laws of the United States. Whether done with ignorance of professional ethical obligations or not, these psychiatrists and psychologists have crossed an ethical barrier that may best be averted from re-occurring by teaching medical students and residents in all medical specialties about the ethics principles stemming from the 1946–1947 Nuremberg trials and the Geneva Conventions, together with the Ethics Codes of the World Medical Association and the American Medical Association; and, with regard to psychiatric residents and psychological trainees, by the teaching about The Principles of Medical Ethics With Annotations Especially Applicable to Psychiatry and the Ethical Principles of Psychologists and Code of Conduct, respectively. In this way, all physicians and psychologists will clearly understand that they have an absolute moral obligation to "First, do no harm" to the human beings they professionally encounter. (shrink)

It's currently fashionable to take Putnamian model theoretic worries seriously for mathematics, but not for discussions of ordinary physical objects and the sciences. But I will argue that (under certain mild assumptions) merely securing determinate reference to physical possibility suffices to rule out nonstandard models of our talk of numbers. So anyone who accepts realist reference to physical possibility should not reject reference to the standard model of the natural numbers on Putnamian model theoretic grounds.

A range of current truth-value realist philosophies of mathematics allow one to reduce the Benacerraf Problem to a problem concerning mathematicians' ability to recognize which conceptions of pure mathematical structures are coherent – in a sense which can be cashed out in terms of logical possibility. In this paper I will clarify what it takes to solve this `residual' access problem and then present a framework for solving it.

For the past 15 years, scholars in education have focused on Levinas’s work largely in terms of his understanding of alterity, of the self-Other relation, of ethics as ‘first philosophy’ and the significance these concepts have on rethinking educational theory and practice. What I do in this paper, by way of method, is to start from a slightly different place, from the assertion that there is indeed something ‘new’ to be explored in Levinas’s philosophy – both in terms of ideas (...) to be found within his work, and also in terms of the demands educational ideas and practices place on his work from without. That is, how does the actual, lived specificity of educational encounters occasion a different set of questions than one would otherwise pose if thinking only from within the discipline of philosophy, or from a purely theoretical point of view? In light of this, this paper explores Levinas’s ideas of sensibility, materiality, and embodiment. I see these not simply as supports for his ethical thought, but as the very core of incarnation without which his ethics makes no sense. I propose that these ideas are quintessentially pedagogical aspects of his thought – that is, they are always already rooted in a relational context of change and alteration of the subject. (shrink)

Judea Pearl (2000) was the first to propose a definition of actual causation using causal models. A number of authors have suggested that an adequate account of actual causation must appeal not only to causal structure but also to considerations of normality. In Halpern and Hitchcock (2011), we offer a definition of actual causation using extended causal models, which include information about both causal structure and normality. Extended causal models are potentially very complex. In this study, we show how (...) it is possible to achieve a compact representation of extended causal models. (shrink)

Most agree that when it comes to so-called 'first-order' normative ethics and political philosophy, constructivist views are a powerful family of positions. When it comes to metaethics, however, there is serious disagreement about what, if anything, constructivism has to contribute. In this paper I argue that constructivist views in ethics include not just a family of substantive normative positions, but also a distinct and highly attractive metaethical view. I argue that the widely accepted 'proceduralist characterization' of constructivism in ethics is (...) inadequate, and I propose what I call the 'practical standpoint characterization' in its place. I then offer a general taxonomy of constructivist positions in ethics. Since constructivism's standing as a family of substantive normative positions is relatively uncontested, I devote the remainder of the paper to addressing skeptics' worries about the distinctiveness of constructivism understood as a metaethical view. I compare and contrast constructivism with three other standard metaethical positions with which it is often confused or mistakenly thought to be compatible: realism; naturalist reductions in terms of an ideal response; and expressivism. In discussing the contrast with expressivism, I explain the sense in which, according to the constructivist, the distinction between substantive normative ethics and metaethics breaks down. I conclude by distinguishing between two importantly different debates about the mind-dependence of value. I argue that a failure to make this distinction is part of what explains why the possibility of constructivism as a metaethical view is often overlooked. (shrink)

The question of whether knowledge is definable in terms of belief, which has played an important role in epistemology for the last 50 years, is studied here in the framework of epistemic and doxastic logics. Three notions of definability are considered: explicit definability, implicit definability, and reducibility, where explicit definability is equivalent to the combination of implicit definability and reducibility. It is shown that if knowledge satisfies any set of axioms contained in S5, then it cannot be explicitly defined in (...) terms of belief. S5 knowledge can be implicitly defined by belief, but not reduced to it. On the other hand, S4.4 knowledge and weaker notions of knowledge cannot be implicitly defined by belief, but can be reduced to it by defining knowledge as true belief. It is also shown that S5 knowledge cannot be reduced to belief and justification, provided that there are no axioms that involve both belief and justification. (shrink)

Methodologists in political science have advocated for causal process tracing as a way of providing evidence for causal mechanisms. Recent analyses of the method have sought to provide more rigorous accounts of how it provides such evidence. These accounts have focused on the role of process tracing for causal inference and specifically on the way it can be used with case studies for testing hypotheses. While the analyses do provide an account of such testing, they pay little attention to the (...) narrative elements of case studies. I argue that the role of narrative in case studies is not merely incidental. Narrative does cognitive work by both facilitating the consideration of alternative hypotheses and clarifying the relationship between evidence and explanation. I consider the use of process tracing in a particular case (the Fashoda Incident) in order to illustrate the role of narrative. I argue that process tracing contributes to knowledge production in ways that the current focus on inference tends to obscure. (shrink)

Contemporary realist theories of value claim to be compatible with natural science. In this paper, I call this claim into question by arguing that Darwinian considerations pose a dilemma for these theories. The main thrust of my argument is this. Evolutionary forces have played a tremendous role in shaping the content of human evaluative attitudes. The challenge for realist theories of value is to explain the relation between these evolutionary influences on our evaluative attitudes, on the one hand, and the (...) independent evaluative truths that realism posits, on the other. Realism, I argue, can give no satisfactory account of this relation. On the one hand, the realist may claim that there is no relation between evolutionary influences on our evaluative attitudes and independent evaluative truths. But this claim leads to the implausible skeptical result that most of our evaluative judgements are off track due to the distorting pressure of Darwinian forces. The realist’s other option is to claim that there is a relation between evolutionary influences and independent evaluative truths, namely that natural selection favored ancestors who were able to grasp those truths. But this account, I argue, is unacceptable on scientific grounds. Either way, then, realist theories of value prove unable to accommodate the fact that Darwinian forces have deeply influenced the content of human values. After responding to three objections, the third of which leads me to argue against a realist understanding of the disvalue of pain, I conclude by sketching how antirealism is able to sidestep the dilemma I have presented. Antirealist theories of value are able to offer an alternative account of the relation between evolutionary forces and evaluative facts —
an account that allows us to reconcile our understanding of evaluative truth with our understanding of the many non-rational causes that have played a role in shaping our evaluative judgements. (shrink)