Ethics should guide the design of electronic health records (EHR), and recognized principles of bioethics can play an important role. This approach was adopted recently by a team of informaticists designing and testing a system where patients exert granular control over who views their personal health information. While this method of building ethics in from the start of the design process has significant benefits, questions remain about how useful the application of bioethics principles can be in this process, especially when (...) principles conflict. For instance, while the ethical principle of respect for autonomy supports a robust system of granular control, the principles of beneficence and non-maleficence counsel restraint due to the danger of patients being harmed by restrictions on provider access to data. Conflict between principles has long been recognized by ethicists and has even motivated attacks on approaches that state and apply principles. In this paper we show how using ethical principles can help in the design of EHRs by first, explaining how ethical principles can and should be used generally, and then by, discuss how attention to details in specific cases can show that the tension between principles is not as bad as it initially appeared. We conclude by suggesting further ways in which the application of these (and other) principles can add value to the ongoing discussion of patient involvement in their health care. This is a new approach to linking principles to informatics design that we expect will stimulate further interest. (shrink)

Most people do not know there are different kinds of medical studies; some are conducted on people who already have a disease or medical condition, and others are performed on healthy volunteers who want to help science find answers. No matter what sort of research you are invited to participate in, or whether you are a patient when you are asked, it’s entirely up to you whether or not to do it. This decision is important and may have many implications (...) for your health and well-being, as well as those of other patients now and in the future. Making a good decision – the right one for you – requires you to become educated about topics you may not have thought about before, some of which may be quite complicated. This chapter explains the key issues to help you make a good decision. (shrink)

Although there is a growing recognition that older adults and those with extensive comorbid conditions undergo cancer screening too frequently, there is little information about patients’ perceptions regarding cessation of cancer screening. Information on older adults’ views of screening cessation would be helpful both for clinicians and for those designing interventions to reduce overscreening.

Objective: There are benefits and risks of giving patients more granular control of their personal health information in electronic health record (EHR) systems. When designing EHR systems and policies, informaticists and system developers must balance these benefits and risks. Ethical considerations should be an explicit part of this balancing. Our objective was to develop a structured ethics framework to accomplish this. -/- Methods: We reviewed existing literature on the ethical and policy issues, developed an ethics framework called a “Points to (...) Consider” (P2C) document, and convened a national expert panel to review and critique the P2C. -/- Results: We developed the P2C to aid informaticists designing an advanced query tool for an electronic health record (EHR) system in Indianapolis. The P2C consists of six questions (“Points”) that frame important ethical issues, apply accepted principles of bioethics and Fair Information Practices, comment on how questions might be answered, and address implications for patient care. -/- Discussion: The P2C is intended to clarify whatis at stake when designers try to accommodate potentially competing ethical commitments and logistical realities. The P2C was developed to guide informaticists who were designing a query tool in an existing EHR that would permit patient granular control. While consideration of ethical issues is coming to the forefront of medical informatics design and development practices, more reflection is needed to facilitate optimal collaboration between designers and ethicists. This report contributes to that discussion. (shrink)

APPENDIX: The data emerging from the clinical and brain studies described above suggest that, in the case of OCD, there are two pertinent brain mechanisms that are distinguishable both in terms of neuro-dynamics and in terms of the conscious experiences that accompany them. These mechanisms can be characterized, on anatomical and perhaps evolutionary grounds, as a lower-level and a higher-level mechanism. The clinical treatment has, when successful, an activating effect on the higher-level mechanism, and a suppressive effect on the lower-level (...) one. (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)

While several tests and strategies are recommended for colorectal cancer (CRC) screening, studies suggest that primary care providers often recommend colonoscopy without providing information about its risks or alternatives. These observations raise concerns about the quality of informed consent for screening colonoscopy.

THIS PAPER IS THE CO-WINNER OF THE FRED BERGER PRIZE IN PHILOSOPHY OF LAW FOR THE 1999 AMERICAN PHILOSOPHICAL ASSOCIATION FOR THE BEST PUBLISHED PAPER IN THE PREVIOUS TWO YEARS. -/- The conflict between liberal legal theory and critical legal studies (CLS) is often framed as a matter of whether there is a theory of justice that the law should embody which all rational people could or must accept. In a divided society, the CLS critique of this view is overwhelming: (...) there is no such justice that can command universal assent. But the liberal critique of CLS, that it degenerates into an unpalatable moral relativism on which there is no non-arbitrary basis between a justice that underwrites forms of domination such as slavery and a justice that condemns such forms of domination is equally powerful and compelling. I show that there is a way to harmonize both views that is subject to empirical test. -/- First I show that the most widely accepted and influential formulation of liberal justice, John Rawls' Justice as Fairness, in. e.g, A Theory of Justice, cannot avoid the relativistic challenge because it would not be accepted, as a matter of sociological fact, by real people in a divided society once the "veil of Ignorance" is removed and real people step out from the Original Position. To put it differently, different reflective equilibria are inevitable in a divided society. Given the weight that Rawls properly puts on the realizability of a conception of justice and its stability in practice, this is a fatal objection. There can be no divided society that is "well ordered" in Rawls' sense, governed by a shared conception of justice and known to be so governed. -/- I then turn to the most powerful statement of the CLS view, Milton's Fisk's relativistic account in The State and Justice. For Fisk, justice is a compromise between what the dominant groups can compel and what the the subordinate groups will acquiesce to., There is no one such compromise in any given situation, so the account is in that sense relativistic, but more deeply, it is relativistic in that it offers no non-arbitrary, non-question begging way to choose between the official justice of, e.g., a slaveholding society and and the radical justice of the slaves, which has no place for slaveholders as a group or slavery as an institution.All that Fisk can offer is an arbitrary existential choice: I'm with the slaves. (Or the slaveowners.) Most of us would find this disconcerting or even unacceptable. -/- I show that Fisk's general sort of account can be modified to allow for an non-arbitrary choice. Given general facts about human nature, societies based on domination will produce resistance that over the long run will diminish or eliminate various forms of domination. Through a sort of ratchet effect, rights won will be hard if not impossible to reverse. Societies embodying forms of domination can therefore be compared on dimensions of stability: the more domination, the more resistance, and the less stability. Such societies are inferior on the dimension of justice to more emancipatory society on the terms of both kinds of justice, official and radical. -/- This is not question begging because regimes of domination incorporate stability no less than more emancipatory social orders. The choice between official justice embodying domination and radical justice that does not is not arbitrary because it is based on a shared commitment to long term stability. This offers an empirical test of which social orders are more justice, and a prediction that over time, domination will tend to decrease. (shrink)

Philosophy has long either dismissed or paid only minimal attention to creativity, and even with the rise of research on imagination, the creative imagination has largely been ignored as well. The aim of this volume is to correct this neglect. By bringing together existing research in various sub-disciplines, we also aim to open up new avenues of research. The chapters in Part I provide some framing and history on the philosophical study of imagination and creativity, along with an overview of (...) the empirical literature. Part II explores imagination and creativity as they manifest in, and in turn shape, the individual. Part III surveys the role of imagination and creativity across a wide variety of artistic domains, and the chapters of Part IV turn to societal domains. Part V focuses on the interplay of imagination and creativity with regard to particular features of creative subjects and different kinds of creative subjects. *** -/- Part I: Theories and Approaches 1. Theories of Imagination (Peter Kung) 2. Theories of Creativity (Julia Langkau) 3. Historical Treatments of Imagination in the Western Tradition (Lucia Oliveri) 4. Historical Treatments of Creativity in the Western Tradition (Elliot Paul) 5. Non-Western Treatments of Imagination (Reza Hadisi and Jing Iris Hu) 6. Non-Western Treatments of Creativity (Nicolas B. Verger and Vlad Glăveanu) 7. Empirical Treatments of Imagination and Creativity (Dustin Stokes) 8. Experimental Philosophy of Imagination and Creativity (Michael T. Stuart) 9. The Relationship between Imagination and Creativity (Margherita Arcangeli) -/- Part II: Imagination and Creativity in Mind and Action 10. Imagination, Creativity, and Skill (Amy Kind) 11. Imagination, Creativity, and Attention (Bence Nanay) 12. Imagination, Creativity, and Agency (Caterina Moruzzi) 13. Imagination, Creativity, and Emotion (Julien Deonna and Fabrice Teroni) 14. Imagination, Creativity, and Embodiment (Adriana Clavel-Vázquez and María Jimena Clavel Vázquez) 15. Imagination, Creativity, and Gender (Luke Roelofs) 16. Imagination, Creativity, and Race (Nicholas Whittaker) 17. Imagination, Creativity, and Child Development (Thalia Goldstein, Anna Sofia Caruso, Darian Stapleton, and Lamin Fatty) -/- Part III: Imagination and Creativity in the Arts 18. Imagination, Creativity, and the Visual Arts (Claire Anscomb) 19. Imagination, Creativity, and Music (Matteo Ravasio) 20. Imagination, Creativity, and Fiction (Hannah H. Kim) 21. Imagination, Creativity, and Dance (David Davies and Anna Pakes) 22. Imagination, Creativity, and the Culinary Arts (Patrik Engisch) 23. Imagination, Creativity, and Film (Murray Smith) 24. Imagination, Creativity, and Acting (Tzachi Zamir) 25. Imagination, creativity, and fashion (Laura T. Di Summa) -/- Part IV: Imagination and Creativity in Society 26. Imagination and Creativity in the Scientific Realm (Alice Murphy) 27. Imagination and Creativity in the Moral Realm (Tim Mulgan) 28. Imagination and Creativity in the Political Realm (Avshalom Schwartz) 29. Imagination and Creativity in the Law (Maksymilian Del Mar) 30. Imagination and Creativity in the Religious Realm (Neil Van Leeuwen) 31. Imagination and Creativity in Business (Eric Peterson) 32. Imagination and Creativity in Times of Crisis (Jennifer Fraser and Noah Stemeroff) Part V: Emerging Issues in Imagination and Creativity Research 33. Imagination, Creativity, and Aphantasia (Andrea Blomkvist) 34. Imagination, Creativity, and Neurodivergence (Sofia Ortiz-Hinojosa) 35. Imagination, Creativity, and Non-Human Animals (Henry Shevlin) 36. Imagination, Creativity, and Artificial Intelligence (Peter Langland-Hassan) 37. Collective Imagination and Collective Creativity (Nick Wiltsher) . (shrink)

We need modal imagination in order to extend our conception of reality - and, in particular, of human beings - beyond our immediate experience in the indexical present; and we need to do this in order to preserve the significance of human interaction. To make this leap of imagination successfully is to achieve not only insight but also an impartial perspective on our own and others' inner states. This perspective is a necessary condition of experiencing compassion for others. This is (...) the primary thesis I will try to defend in this discussion. (shrink)

[COMMENTARY on Walter Veit's "A Philosophy for the Science of Animal Consciousness"] The framework Veit introduces for animal consciousness turns on finding and articulating its evolutionary origins. Veit argues that consciousness first evolved as affective experience in the Cambrian period. His argument centers around the plausible need of organisms in the Cambrian for a common currency of subjective valuation. I argue that such an adaptive pressure is unlikely to result in affective experience. I review other processes that instantiate common currencies (...) of subjective valuation: unconscious (non-experiential) affect and the reward learning system and argue that each is likely to have evolved prior to affective experience. (shrink)

Recently, the concept of "gender identity" has enjoyed a great deal of attention in gender metaphysics. This seems to be motivated by the goal of creating trans-inclusive theory, by explaining trans people's genders. In this paper, we aim to unmotivate this project. Notions of "gender identity" serve important pragmatic purposes for trans people, such as satisfying the curiosity of non-trans people, and, relatedly, securing our access to important goods like legal rights and medical care. However, we argue that this does (...) not mean that "gender identity" is a metaphysically substantial thing that deserves extensive theoretical attention. There are reasons to be skeptical of such a concept. We trace the history of "gender identity," primarily to identify its roots in trans-antagonistic medical theory and its connections to the problematic "wrong-body" model--a legacy that has pathologized and flattened trans experience. Moreover, we argue that trans people primarily use "gender identity" to explain ourselves to non-trans people, rather than to discuss ourselves among ourselves. Thus, we urge theorists to resist the urge to substantiate gender identity. Instead, we encourage the development of new and better concepts, ones that attend to the lived realities of trans community and the flourishing gender terms and practices that are constructed there. If these lived realities are taken seriously, there is no need to “explain” trans people’s genders; we can simply see them as they are. (shrink)

Most moral theories share certain features in common with other theories. They consist of a set of propositions that are universal, general, and hence impartial. The propositions that constitute a typical moral theory are (1) universal, in that they apply to all subjects designated as within their scope. They are (2) general, in that they include no proper names or definite descriptions. They are therefore (3) impartial, in that they accord no special privilege to any particular agent's situation which cannot (...) be justified under (2) and (3). These three features do not distinguish moral theories from other theories, nor indeed from most general categorical propositions we assert. Yet, in recent years, these features of moral theories have been the target of a certain concerted and sustained criticism, namely, that to be committed to such a moral theory, or to aspire to act in accordance with its requirements, results in what has come to be known as moral alienation. Moral alienation, according to this criticism, consists in (i) viewing one's ground projects from an impersonal, "moral point of view" engendered by one's acceptance of the theory; (ii) being prepared to sacrifice these projects to the requirements of moral principle; and (iii) making such a sacrifice specifically and self-consciously in order to conform to these requirements. Moral alienation is said to manifest itself in one (or both) of two ways, depending on the nature of the project thus susceptible to sacrifice. One may be alienated from oneself, if the project consists of tastes, convictions, or aspirations that are centrally definitive of one's self. In this case one's commitment to the project can be at best conditional on its congruence with one's moral theory. It is claimed that this must make for a rather tepid and unenthusiastic commitment indeed. Alternatively, one may be alienated from others, if the project is an interpersonal relationship such as a friendship, marriage, or collegial relationship. In this case one's responses to the other are motivated by one's awareness of what one's moral theory requires. It is claimed that this obstructs a genuine and unmediated emotional response to the other as such. My aim here will be to argue that this very compelling criticism - call it the moral-alienation criticism - is nevertheless misdirected. The real culprit is not any particular moral theory, but rather a certain familiar personality type that may or may not adopt it. (shrink)

In the United States, police use of force experts often maintain that controversial police shootings where an unarmed person’s hand gesture was interpreted as their “going for a gun” are justifiable. If an officer waits to confirm that a weapon is indeed being pulled from a jacket pocket or waistband, it may be too late to defend against a lethal attack. This article examines police policy norms for self-defense against “uncertain threats” in three contexts: (1) known in-progress violent crimes, (2) (...) interactions with civilians behaving non-aggressively, and (3) interactions with civilians behaving aggressively. It is argued that the context of a known in-progress violent crime gives rise to threat probability-, fairness-, and lesser evil-based reasons for a norm permitting police officers to use lethal force. However, in the contexts of civilians behaving non-aggressively and civilians behaving aggressively, such a norm is not justifiable. In the former case, I introduce two conditions, the Justification condition and the Valuing Civilian Lives condition, which I argue are not presently met. In the latter case, these two conditions again are not met; aggression may moreover be excused or justified due to background injustices around race and the criminal justice system. (shrink)

In this paper an Artificial Neural Network (ANN) model, for predicting the category of a tumor was developed and tested. Taking patients’ tests, a number of information gained that influence the classification of the tumor. Such information as age, sex, histologic-type, degree-of-diffe, status of bone, bone-marrow, lung, pleura, peritoneum, liver, brain, skin, neck, supraclavicular, axillar, mediastinum, and abdominal. They were used as input variables for the ANN model. A model based on the Multilayer Perceptron Topology was established and trained using (...) data set which its title is “primary tumor” and was obtained from the University Medical Centre, Institute of Oncology, Ljubljana, Yugoslavia Test data evaluation shows that the ANN model is able to correctly predict the tumor category with 76.67 % accuracy. (shrink)

This paper’s outline is as follows. In sections 1-3 I give an exposi¬tion of the Mind-Body Problem, with emphasis on what I believe to be the heart of the problem, namely, the Percepts-Qualia Nonidentity and its incompatibility with the Physical Closure Paradigm. In 4 I present the “Qualia Inaction Postulate” underlying all non-interactionist theo¬ries that seek to resolve the above problem. Against this convenient postulate I propose in section 5 the “Bafflement Ar¬gument,” which is this paper's main thesis. Sections 6-11 (...) critically dis¬cuss attempts to dismiss the Bafflement Argument by the “Baf¬flement=Mis¬perception Equation.” Section 12 offers a refutation of all such attempts in the form of a concise “Asymmetry Proof.” Section 13 points out the bearing of the Bafflement Argument on the evolutionary role of consciousness while section 14 acknowledges the price that has to be paid for it in terms of basic physical principles. Section 15 summarizes the paper, pointing out the inescapability of interactionist dualism. (shrink)

In our dealings with young children, we often get them to do or think things by arranging their environments in certain ways; by dissembling, simplifying, or ambiguating the facts in answer to their queries; by carefully selecting the states of affairs, behavior of others, and utterances to which they shall be privy. We rightly justify these practices by pointing out a child's malleability, and the necessity of paying close attention to formative influences during its years of growth. This filtering of (...) influences is necessary, we point out, if children are ever to reach a degree of maturity and inner stability that will enable them to understand and cope adequately with the complexities, contradictions, and difficulties of the world from which we now seek to shield them. Thus a child's eventual state of competence, maturity, and autonomy adequately justifies our current practices of manipulation and selection of his environment: such practices are rightly held to be ultimately in the child's best interests as an adult. There is no future state of things with reference to which the Utilitarian night justify his policy of secrecy and manipulation, and in light of which this policy night eventually be dispensed with and commonly validated, in retrospect, as a means to the worthwhile goal of moral maturity. That is, there is no point at which the attitude of the Utilitarian to the rest of the community can develop past the analogous attitude of the parent towards the child; no point at which the Utilitarian might eventually bear to others a relationship of mutual acknowledgement and respect as mature, autonomous, moral adults. The consistent Utilitarian, then, largely regards himself as if he were the only adult in a community of children. (shrink)

As inductive decision-making procedures, the inferences made by machine learning programs are subject to underdetermination by evidence and bear inductive risk. One strategy for overcoming these challenges is guided by a presumption in philosophy of science that inductive inferences can and should be value-free. Applied to machine learning programs, the strategy assumes that the influence of values is restricted to data and decision outcomes, thereby omitting internal value-laden design choice points. In this paper, I apply arguments from feminist philosophy of (...) science to machine learning programs to make the case that the resources required to respond to these inductive challenges render critical aspects of their design constitutively value-laden. I demonstrate these points specifically in the case of recidivism algorithms, arguing that contemporary debates concerning fairness in criminal justice risk-assessment programs are best understood as iterations of traditional arguments from inductive risk and demarcation, and thereby establish the value-laden nature of automated decision-making programs. Finally, in light of these points, I address opportunities for relocating the value-free ideal in machine learning and the limitations that accompany them. (shrink)

This discussion treats a set of familiar social derelictions as consequences of the perversion of a universalistic moral theory in the service of an ill-considered or insufficiently examined personal agenda.The set includes racism, sexism, anti-Semitism, homophobia, and class elitism, among other similar pathologies, under the general heading of discrimination. The perversion of moral theory from which these derelictions arise, I argue, involves restricting its scope of application to some preferred subgroup of the moral community of human beings. -/- The following (...) analysis of higher-order discrimination suggests that we often select the individuals who constitute such subgroups for reasons that we ourselves would reject on moral grounds were we to examine them carefully, but that we choose instead to put our rational resources in the service of avoiding any such examination at all costs. The implication is that arguments that truncate the scope of moral theory in fact justify bestowing the gift of moral treatment on a select few who deserve it no more than the many from whom we withhold it. Therefore, it would be precipitous to conclude that universalistic moral theory can be legitimately restricted in its practical scope of application in any way at all. (shrink)

In this article, I examine the moral dimensions of gender affirmation. I argue that the moral value of gender affirmation is rooted in what Iris Murdoch called loving attention. Loving attention is central to the moral value of gender affirmation because such affirmation is otherwise too fragile or insincere to have such value. Moral reasons to engage in acts that gender affirm derive from the commitment to give and express loving attention to trans people as a way of challenging their (...) marginalization. In the latter part of the paper, I will discuss how my arguments bear on recent arguments by Robin Dembroff and Daniel Wodak (2018) on the use of gender-neutral language. They argue that we have a duty not to use gender-specific pronouns for anyone. Their conclusion turns, in part, on a rejection of gender affirmation as a moral duty. The value of gender affirmation, rooted in our moral perception of trans people, should make us skeptical of this conclusion, in favor of a more nuanced and pluralistic approach to the ethics of gendering. (shrink)

I want to argue that self-deception is a species of a more general phenomenon, which I shall call pseudorationality, which in turn is necessitated by what I shall describe as our highest-order disposition to literal self-preservation. By "literal self-preservation," I mean preservation of the rational intelligibility of the self, in the face of recalcitrant facts that invariably threaten it.

Many real-world agents recognise that they impose harms by choosing to emit carbon, e.g., by flying. Yet many do so anyway, and then attempt to make things right by offsetting those harms. Such offsetters typically believe that, by offsetting, they change the deontic status of their behaviour, making an otherwise impermissible action permissible. Do they succeed in practice? Some philosophers have argued that they do, since their offsets appear to reverse the adverse effects of their emissions. But we show that (...) they do not. In practice, standard carbon offsetting does not reverse the harms of the original action, nor does it even benefit the same group as was harmed. Standard moral theories hence deny that such offsetting succeeds. Indeed, we show that any moral theory that allows offsetting in this setting faces a dilemma between allowing any wrong to be offset, no matter how grievous, and recognising an implausibly sharp discontinuity between offsettable actions and non-offsettable actions. The most plausible response is to accept that carbon offsetting fails to right our climate wrongs. (shrink)

The purpose of this discussion is twofold. First, I want to shed some light on Kant's concept of personhood as rational agency, by situating it in the context of the first Critique's conception of the self as defined by its rational dispositions. I hope to suggest that this concept of personhood cannot be simply grafted onto an essentially Humean conception of the self that is inherently inimical to it, as I believe Rawls, Gewirth, and others have tried to do. Instead (...) I will try to show how deeply embedded this concept of personhood is in Kant's conception of the self as rationally unified consciousness. Second, I want to deploy this embedded concept of personhood as the basis for an analysis of the phenomenon of xenophobia. (shrink)

With increased visibility of trans people comes increased philosophical interest in gendered language. This chapter aims to look at the research on gendered language in analytic philosophy of language so far, which has focused on two concerns: (1) determining how to define gender terms like ‘man’ and ‘woman’ such that they are trans inclusive and (2) if, or to what extent, we should use gendered language at all. We argue that the literature has focused too heavily on how gendered language (...) can harm trans people, and has not considered how trans people use gendered language to create meaning and joy for ourselves. Pulling from the literature in sociolinguistics, we look at examples of how trans people use language to make their lives better by gaining recognition, playing with gendered language, finding joy in gendered language, and taking control of definitional power, concluding that debates about gendered language need to consider not only how such language harms trans people but also how trans people use it for our own liberation. (shrink)

Alasia Nuti’s important recent book, Injustice and the Reproduction of History: Structural Inequalities, Gender and Redress, makes many persuasive interventions. Nuti shows how structural injustice theory is enriched by being explicitly historical; in theorizing historical-structural injustice, she lays bare the mechanisms of how the injustices of history reproduce themselves. For Nuti, historical-structural patterns are not only shaped by habitual behaviors that are or appear to be morally permissible, but also by individual wrongdoing and wrongdoing by powerful group agents like states. (...) In this article, I extend Nuti’s rich analysis, focusing on two questions that arise from her theory of historical-structural injustice: Beyond being blameworthy for wrongful acts themselves, are culpable wrongdoers blameworthy for contributing to structural injustice? Does historical moral ignorance mitigate moral responsibility for past injustice? Regarding, I distinguish between the local and societal structural effects of wrongdoing. Though I think this distinction is well-founded, it ultimately leads to tensions with structural injustice theory’s idea of ordinary individuals being blameless for reproducing unjust structures. Regarding, I argue that even though it is natural for the question of historical moral ignorance to arise in considering past wrongdoing, at least in the case of powerful group agents, we should not overlook forms of cruelty which present-day moral concepts are not needed to condemn. (shrink)

Adrian Piper argues that the Humean conception can be made to work only if it is placed in the context of a wider and genuinely universal conception of the self, whose origins are to be found in Kant’s Critique of Pure Reason. This conception comprises the basic canons of classical logic, which provide both a model of motivation and a model of rationality. These supply necessary conditions both for the coherence and integrity of the self and also for unified agency. (...) The Kantian conception solves certain intractable problems in decision theory by integrating it into classical predicate logic, and provides answers to longstanding controversies in metaethics concerning moral motivation, rational final ends, and moral justification that the Humean conception engenders. In addition, it sheds light on certain kinds of moral behavior – for example, the whistleblower – that the Humean conception is at a loss to explain. (shrink)

The genetic modification of pigs as a source of transplantable organs is one of several possible solutions to the chronic organ shortage. This paper describes existing ethical tensions in xenotransplantation (XTx) that argue against pursuing it. Recommendations for lifelong infectious disease surveillance and notification of close contacts of recipients are in tension with the rights of human research subjects. Parental/guardian consent for pediatric xenograft recipients is in tension with a child’s right to an open future. Individual consent to transplant is (...) in tension with public health threats that include zoonotic diseases. XTx amplifies concerns about justice in organ transplantation and could exacerbate existing inequities. The prevention of infectious disease in source animals is in tension with the best practices of animal care and animal welfare, requiring isolation, ethologically inappropriate housing, and invasive reproductive procedures that would severely impact the well-being of intelligent social creatures like pigs. (shrink)

Waiting time is widely used in health and social policy to make resource allocation decisions, yet no general account of the moral significance of waiting time exists. We provide such an account. We argue that waiting time is not intrinsically morally significant, and that the first person in a queue for a resource does not ipso facto have a right to receive that resource first. However, waiting time can and sometimes should play a role in justifying allocation decisions. First, there (...) is a duty of fairness prohibiting line-cutting where a sufficiently just queue exists. Second, waiting time has several morally attractive features that can justify its incorporation into allocation schemes. Where candidates are in relevantly similar circumstances, allocating by waiting time is relatively efficient, maximizes distribution equality relative to other Pareto efficient distributions, and treats candidates fairly. The claim that allocation using waiting time is fair is controversial. Some have claimed that formal lotteries are a fairer way to select among equal beneficiaries. We argue that lotteries are no fairer than allocation based on waiting time when it is equiprobable how a prospective queue will be ordered. In practice, lotteries share many of the disadvantages of queues; which is fairer will depend on contingent features of the allocation scenario. The upshot is that first-come, first-served is in fact a just way to allocate resources in many of the cases where it seems pre-theoretically compelling, and waiting time has unique normative properties which frequently justify its incorporation into resource allocation schemes. (shrink)

Most published discussions in contemporary metaethics include some textual exegesis of the relevant contemporary authors, but little or none of the historical authors who provide the underpinnings of their general approach. The latter is usually relegated to the historical, or dismissed as expository. Sometimes this can be a useful division of labor. But it can also lead to grave confusion about the views under discussion, and even about whose views are, in fact, under discussion. Elijah Millgram’s article, “Does the Categorical (...) Imperative Give Rise to a Contradiction in the Will?” is a case in point. In it, he takes the New Kantians to task for various flaws in their interpretation of Kant’s moral theory, to be detailed shortly. He concludes with a question and a suggestion. In order to properly dissect the first, “universal law” formulation of the Categorical Imperative, he argues, we first need to understand “why an agent wills the universalization of his maxim” (549). He also suggests that in order to answer this question, we must recur to what Kant himself actually says (550). His question is a good one, and his advice on how to go about answering it is sound. But to take Millgram’s advice is to call this division of labor into question, at least for this case. For it demands close and sustained exegesis, not only of his argument against the New Kantians, but also – in order to assess whether and where they go wrong – of Kant’s text itself. (shrink)

The concept of bias is pervasive in both popular discourse and empirical theorizing within philosophy, cognitive science, and artificial intelligence. This widespread application threatens to render the concept too heterogeneous and unwieldy for systematic investigation. This article explores recent philosophical literature attempting to identify a single theoretical category—termed ‘bias’—that could be unified across different contexts. To achieve this aim, the article provides a comprehensive review of theories of bias that are significant in the fields of philosophy of mind, cognitive science, (...) machine learning, and epistemology. It focuses on key examples such as perceptual bias, implicit bias, explicit bias, and algorithmic bias, scrutinizing their similarities and differences. Although these explorations may not conclusively establish the existence of a natural theoretical kind, pursuing the possibility offers valuable insights into how bias is conceptualized and deployed across diverse domains, thus deepening our understanding of its complexities across a wide range of cognitive and computational processes. (shrink)

A consensus exists among contemporary philosophers of biology about the history of their field. According to the received view, mainstream philosophy of science in the 1930s, 40s, and 50s focused on physics and general epistemology, neglecting analyses of the 'special sciences', including biology. The subdiscipline of philosophy of biology emerged (and could only have emerged) after the decline of logical positivism in the 1960s and 70s. In this article, I present bibliometric data from four major philosophy of science journals (Erkenntnis, (...) Philosophy of Science, Synthese, and the British Journal for the Philosophy of Science), covering 1930-59, which challenge this view. (shrink)

This paper explores the complex nature of social biases, arguing for a functional framework that recognizes their unity and diversity. The functional approach posits that all biases share a common functional role in overcoming underdetermination. This framework, I argue, provides a comprehensive understanding of how all psychological biases, including social biases, are unified. I then turn to the question of disunity, demonstrating how psychological social biases differ systematically in the mental states and processes that constitute them. These differences indicate that (...) biases at various levels of the cognitive architecture require distinct treatment along at least two dimensions: epistemic evaluation and mitigation strategies. By examining social biases through this dual lens of unity and diversity, we can more effectively identify when and how to intervene on problematic biases. Ultimately, this approach provides a nuanced understanding of the nature of social bias, offering practical guidance for addressing existing biases and proactively managing emerging biases in both human and artificial minds. (shrink)

Kant identifies what are in fact Free Riders as the most noxious species of polemicists. Kant thinks polemic reduces the stature and authority of reason to a method of squabbling that destabilizes social equilibrium and portends disintegration into the Hobessian state of nature. In the first Critique, Kant proposes two textually related solutions to the Free Rider problem.

One widely used method for allocating health care resources involves the use of cost-effectiveness analysis (CEA) to rank treatments in terms of quality-adjusted life-years (QALYs) gained. CEA has been criticized for discriminating against people with disabilities by valuing their lives less than those of non-disabled people. Avoiding discrimination seems to lead to the ’QALY trap’: we cannot value saving lives equally and still value raising quality of life. This paper reviews existing responses to the QALY trap and argues that all (...) are problematic. Instead, we argue that adopting a moderate form of prioritarianism avoids the QALY trap and disability discrimination. (shrink)

In the Bayesian approach to quantum mechanics, probabilities—and thus quantum states—represent an agent’s degrees of belief, rather than corresponding to objective properties of physical systems. In this paper we investigate the concept of certainty in quantum mechanics. Particularly, we show how the probability-1 predictions derived from pure quantum states highlight a fundamental difference between our Bayesian approach, on the one hand, and Copenhagen and similar interpretations on the other. We first review the main arguments for the general claim that probabilities (...) always represent degrees of belief. We then argue that a quantum state prepared by some physical device always depends on an agent’s prior beliefs, implying that the probability-1 predictions derived from that state also depend on the agent’s prior beliefs. Quantum certainty is therefore always some agent’s certainty. Conversely, if facts about an experimental setup could imply agent-independent certainty for a measurement outcome, as in many Copenhagen-like interpretations, that outcome would effectively correspond to a preexisting system property. The idea that measurement outcomes occurring with certainty correspond to preexisting system properties is, however, in conflict with locality. We emphasize this by giving a version of an argument of Stairs [(1983). Quantum logic, realism, and value-definiteness. Philosophy of Science, 50, 578], which applies the Kochen–Specker theorem to an entangled bipartite system. (shrink)

My intellectual journey in philosophy proceeded along two mountainous paths that coincided at their base, but forked less than halfway up the incline. The first is that of my philosophical development, a steep but steady and continuous ascent. It began in my family, and accelerated in high school, art school, college, and graduate school. Those foundations propelled my philosophical research into the nature of rationality and its relation to the structure of the self, a long-term project focused on the Kantian (...) and Humean metaethical traditions in Anglo-American analytic philosophy. It would have been impossible to bring this project to completion without the anchor, compass, and conceptual mapping provided by my prior, longstanding involvement in the practice and theory of Vedic philosophy. The second path is that of my professional route through the field of academic philosophy, which branched onto a rocky detour in graduate school, followed by a short but steep ascent, followed next by a much steeper, sustained descent off that road, into the ravine, down in flames, and out of the profession. In order to reach the summit of the first path, I had to reach the nadir of the second. It was the right decision. My yoga practice cushioned my landing. (shrink)

In this paper I defend the traditional interpretations of Kant’s Formula of a Law of Nature from recent attacks leveled by Faviola Rivera-Castro, James Furner, Ido Geiger, Pauline Kleingeld and Sven Nyholm. After a short introduction, the paper is divided into four main sections. In the first, I set out the basics of the three traditional interpretations, the Logical Contradiction Interpretation, the Practical Contradiction Interpretation and the Teleological Contradiction Interpretation. In the second, I examine the work of Geiger, Kleingeld and (...) Nyholm: these three commentators reject the traditional interpretations entirely, but I argue that this rejection is ill-founded. In the third and fourth, I take a detailed look at Furner’s work, work in which he seeks to revise (rather than reject) the traditional interpretations. I argue that, despite his more modest aims, Furner’s revision is also ill-founded. (shrink)

In this paper, we argue that there are reasons to believe that an implicit bias for normalcy influences what are considered medically necessary treatments in psychiatry. First, we outline two prima facie reasons to suspect that this is the case. A bias for ‘the normal’ is already documented in disability studies; it is reasonable to suspect that it affects psychiatry too, since psychiatric patients, like disabled people, are often perceived as ‘weird’ by others. Secondly, psychiatry's explicitly endorsed values of well-being (...) and function are hard to measure directly, which is why we see simpler box-ticking conceptions of recovery used in large research studies. This need not be problematic, but might lead to researchers and clinicians focusing too much on treatments that promote easy-to-measure proxies for recovery, instead of what actually matters to psychiatric patients themselves. Next, we provide examples of treatments and treatment decisions within two areas – self-injury and psychosis – which are hard to explain unless we assume that an implicit and harmful normalcy bias is at work. We conclude with some suggestions for clinicians and future research. (shrink)

Philosophers of science turned to historical case studies in part in response to Thomas Kuhn's insistence that such studies can transform the philosophy of science. In this issue Joseph Pitt argues that the power of case studies to instruct us about scientific methodology and epistemology depends on prior philosophical commitments, without which case studies are not philosophically useful. Here I reply to Pitt, demonstrating that case studies, properly deployed, illustrate styles of scientific work and modes of argumentation that are not (...) well handled by currently standard philosophical analyses. I illustrate these claims with exemplary findings from case studies dealing with exploratory experimentation and with interdisciplinary cooperation across sciences to yield multiple independent means of access to theoretical entities. The latter cases provide examples of ways that scientists support claims about theoretical entities that are not available in work performed within a single discipline. They also illustrate means of correcting systematic biases that stem from the commitments of each discipline taken separately. These findings illustrate the transformative power of case study methods, allow us to escape from the horns of Pitt's "dilemma of case studies," and vindicate some of the post-Kuhn uses to which case studies have been put. (shrink)

The Humean conception of the self consists in the belief-desire model of motivation and the utility-maximizing model of rationality. This conception has dominated Western thought in philosophy and the social sciences ever since Hobbes’ initial formulation in Leviathan and Hume’s elaboration in the Treatise of Human Nature. Bentham, Freud, Ramsey, Skinner, Allais, von Neumann and Morgenstern and others have added further refinements that have brought it to a high degree of formal sophistication. Late twentieth century moral philosophers such as Rawls, (...) Brandt, Frankfurt, Nagel and Williams have taken it for granted, and have made use of it to supply metaethical foundations for a wide variety of normative moral theories. But the Humean conception of the self also leads to seemingly insoluble problems about moral motivation, rational final ends, and moral justification. Can it be made to work? (shrink)

One must accept the complexity of modern society as a multifaceted influence that will direct the future of all social organizations. Technology has brought the people of the world into almost instant communication. Biomedical science has conquered most infectious, acute diseases and has provided several medicines for the successful maintenance therapy of chronic diseases. The lifestyle of some people as smoking and drug addiction remains a strong factor in their achievement of the health goals of the good life. Universally, economic (...) inflation and international business have created an economic interdependence among nations and dealing with the economic problems of one country must take into account this interdependence. When one views the future within this technologic-social-economic framework, he has difficulty sorting out certain directing influences that may shape the future of pharmacy practice in Libya. (shrink)

In Book I of his Nicomachean Ethics (NE), Aristotle defines happiness, or eudaimonia, in accordance with an argument he makes regarding the distinctive function of human beings. In this paper, I argue that, despite this argument, there are moments in the NE where Aristotle appeals to elements of happiness that don’t follow from the function argument itself. The place of these elements in Aristotle’s account of happiness should, therefore, be a matter of perplexity. For, how can Aristotle appeal to elements (...) of happiness not entailed by his argument for what happiness involves? I will examine two instances that exemplify the sort of appeal to outside elements that I have in mind. The first deals with Aristotle’s reference, in NE, I, 8, to certain goods—ancestry, children, beauty—goods unrelated to man’s function or his fulfillment of it, but nevertheless required for his happiness. The second instance involves pleasure. Aristotle makes various arguments, both in Books I and X of the NE, that tie pleasure to the activity of the soul, and the function argument in turn. However, none of these arguments succeeds in demonstrating that pleasure would necessarily follow from this activity. Taken together then, these two examples demonstrate the extent to which Aristotle’s definition of happiness is more inclusive than his function argument permits. (shrink)

I want to examine critically a certain strategy of moral justification which I shall call instrumentalism. By this I mean the view that a moral theory is rationally justified if the actions, life-plan, or set of social arrangements it prescribes can be shown to be the best means to the achievement of an agent's final ends, whatever these may be. Instrumentalism presupposes a commitment to what I shall call the Humean conception of the self. By this I mean a certain (...) way of conceiving the motivational and structural constituents of the self. Briefly, the self on this conception is motivated by its desires for states of affairs that are temporally or spatiotemporally external to the self. And it is structured by the normative requirements of instrumental rationality: The self is conceived as rationally coherent to the extent that theoretical reason calculates and schedules the satisfaction of as many of its desires as possible, with the minimum necessary costs. The motivational and structural elements of the Humean conception of the self combine to form a familiar explanatory model of human agency: We make sense of an agent's behavior by ascribing to her the desire to achieve the ends that she does in fact achieve, and the theoretically rational belief that, given the information and resources available to her, behaving as she did was the most efficient way to do so. I shall want to argue that to the extent that instrumentalism is successful in providing an objective justification of a moral theory - and I shall contend that it cannot be completely successful - it cannot provide a moral justification. But when we attempt to modify it so as to produce a specifically moral justification, we see that either it is impossible to do this, or else the Humean notion of instrumental rationality is doing no justificatory work. (shrink)

In an earlier discussion, I argued that Kant's moral theory satisfies some of the basic criteria for being a genuine theory: it includes testable hypotheses, nomological higher-and lower-level laws, theoretical constructs, internal principles, and bridge principles. I tried to show that Kant's moral theory is an ideal, descriptive deductive-nomological theory that explains the behavior of a fully rational being and generates testable hypotheses about the moral behavior of actual agents whom we initially assume to conform to its theoretical constructs. I (...) argued that the moral "ought" is best understood as the "ought" of tentative prediction expressed in the range of uses of the German sollen; and that the degree to which such a theory is well-confirmed is a function of the degree to which we actually judge individual human agents, on a case-by-case basis, to be motivated by rationality, stupidity, or moral corruption in their actions. I assume that a similar case could be made for other major contenders, such as Utilitarianism or Aristotelianism. But there still remains unanswered the question of which of these theories is the best among the available alternatives. To answer this question, further criteria of selection must be invoked. Among these are structural elegance and explanatory simplicity, but even these do not exhaust the desiderata for an adequate moral theory. More pressing in the case of moral theory is the requirement that the theory enable us to understand all the available data of moral experience; that the theory be sufficiently inclusive that in the formulation of its descriptive laws and practical principles, it be capable of identifying as morally significant all the behavior to which moral praise, condemnation, or acquittal is a relevant and appropriate response. (shrink)

In this paper I argue that there would be no obligatory maxims if the only standards for assessing maxims were Kant’s universalizability tests. The paper is divided into five sections. In the first, I clarify my thesis: I define my terms and disambiguate my thesis from other related theses for which one might argue. In the second, I confront the view that says that if a maxim passes the universalizability tests, then there is a positive duty to adopt that maxim; (...) I also confront a close relative of this view. In the third, I confront the view that says that if a maxim does not pass the universalizability tests, then there is a positive duty to adopt the contradictory of that maxim. In the fourth, I confront two variations of the view that says that if a maxim does not pass the universalizability tests and an agent is deliberating about the action in the maxim, then the agent has a positive duty to adopt the contrary of that maxim. In the fifth, I confront the view that says that if an agent has adopted a maxim of ends, then the agent has a positive duty to universalize that end. I then wrap up the paper with some concluding remarks. (shrink)

Psychiatric patients sometimes ask where to draw the line between who they are – their selves – and their mental illness. This problem is referred to as the self-illness ambiguity in the literature; it has been argued that solving said ambiguity is a crucial part of psychiatric treatment. I distinguish a Realist Solution from a Constructivist one. The former requires finding a supposedly pre-existing border, in the psychiatric patient’s mental life, between that which belongs to the self and that which (...) belongs to the mental illness. I argue that no such border exists, and that attempts to find it might even render the felt ambiguity worse. Instead, any solution must be constructivist; the patient (and others) should deliberate and discuss what to identify with or not. I further argue that psychiatric patients need not see their mental illness as wholly distinct from themselves to avoid ‘identifying with their diagnoses' in a problematic way. Finally, we can excuse problematic behaviour by mentally ill people – in fact, we can do so in a more nuanced and constructive way – while rejecting the view that the mental illness is wholly distinct from the patient’s self. (shrink)

Recently, Intelligent Tutoring Systems (ITS) got much attention from researchers even though ITS educational technology began in the late 1960s and ITS is just embryonic from laboratories into the field. In this paper we outline an intelligent tutoring system for teaching basics of the databases system called (MDB). The MDB was built as education system by using the authoring tool (ITSB). MDB contains learning materials as a group of lessons for beginner level which include relational database system and lessons in (...) the process to install and set up a database. MDB system has exams for each level of the Lessons. An evaluation was done to see the effectiveness the MDB among learners and instructors. The outcome of the evaluation was promising. (shrink)