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)

Philosophers and intellectual historians generally recognize pragmatism as a philosophy of progress. For many commentators, pragmatism is tied to a notion of progress through its embrace of meliorism – a forward-looking philosophy that places hope in the future as a site of possibility and improvement. I complicate the progressive image of hope generally attributed to pragmatism by outlining an alternative account of meliorism in the work of William James. By focusing on the affectivity and temporality of James’s meliorism, I argue (...) that James offers a non-progressivist version of hope that is affectively tempered by melancholy and oriented temporally toward the present. (shrink)

In light of the recent emergence of predictive techniques in law enforcement to forecast crimes before they occur, this paper examines the temporal operation of power exercised by predictive policing algorithms. I argue that predictive policing exercises power through a paranoid style that constitutes a form of temporal governmentality. Temporality is especially pertinent to understanding what is ethically at stake in predictive policing as it is continuous with a historical racialized practice of organizing, managing, controlling, and stealing time. After first (...) clarifying the concept of temporal governmentality, I apply this lens to Chicago Police Department’s Strategic Subject List. This predictive algorithm operates, I argue, through a paranoid logic that aims to preempt future possibilities of crime on the basis of a criminal past codified in historical crime data. (shrink)

According to simulationism, the function of episodic memory is not to remember the past, but to help construct representations of possible future episodes, by drawing together features from different experiential sources. This article suggests that the relationship between the traditional storehouse view, on which the function of memory is remembering, and the simulationist approach is more complicated than has been typically acknowledged. This is attributed, in part, to incorrect interpretations of what remembering on the storehouse view requires. Further, by appeal (...) to function pluralism, the article questions both the assumption that the traditional view and simulationism are inconsistent, and the simulationist’s inference to the best explanation strategy that is based upon this assumption. The article then provides an evaluation of the simulationist argument against the traditional view, and finds it in need of further support. (shrink)

Intellectualism is the claim that practical knowledge or ‘know-how’ is a kind of propositional knowledge. The debate over Intellectualism has appealed to two different kinds of evidence, semantic and scientific. This paper concerns the relationship between Intellectualist arguments based on truth-conditional semantics of practical knowledge ascriptions, and anti-Intellectualist arguments based on cognitive science and propositional representation. The first half of the paper argues that the anti-Intellectualist argument from cognitive science rests on a naturalistic approach to metaphysics: its proponents assume that (...) findings from cognitive science provide evidence about the nature of mental states. We demonstrate that this fact has been overlooked in the ensuing debate, resulting in inconsistency and confusion. Defenders of the semantic approach to Intellectualism engage with the argument from cognitive science in a way that implicitly endorses this naturalistic metaphysics, and even rely on it to claim that cognitive science support Intellectualism. In the course of their arguments, however, they also reject that scientific findings can have metaphysical import. We argue that this situation is preventing productive debate about Intellectualism, which would benefit from both sides being more transparent about their metaphilosophical assumptions. (shrink)

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

The Negation Problem states that expressivism has insufficient structure to account for the various ways in which a moral sentence can be negated. We argue that the Negation Problem does not arise for expressivist accounts of all normative language but arises only for the specific examples on which expressivists usually focus. In support of this claim, we argue for the following three theses: 1) a problem that is structurally identical to the Negation Problem arises in non-normative cases, and this problem (...) is solved once the hidden quantificational structure involved in such cases is uncovered; 2) the terms ‘required’, ‘permissible’, and ‘forbidden’ can also be analyzed in terms of hidden quantificational structure, and the Negation Problem disappears once this hidden structure is uncovered; 3) the Negation Problem does not arise for normative language that has no hidden quantificational structure. We conclude that the Negation Problem is not really a problem about expressivism at all but is rather a feature of the quantificational structure of the required, permitted, and forbidden. (shrink)

This volume presents discussions on a wide range of topics focused on eco-phenomenology and the interdisciplinary investigation of contemporary environmental thought. Starting out with a Tymieniecka Memorial chapter, the book continues with papers on the foundations, theories, readings and philosophical sources of eco-phenomenology. In addition, it examines issues of phenomenological anthropology, ecological perspectives of the human relationship to nature, and phenomenology of the living body and the virtual body. Furthermore, the volume engages in a dialogue with contemporary behavioral sciences on (...) topics such as eco-alienation, sustainability, and the human relationship to the earth in the context of the cosmos. (shrink)

Dretske has provided very influential arguments that there is a difference between our sensory awareness of objects and our awareness of facts about these objects—that there is a difference, for example, between seeing x and seeing that x is F. This distinction between simple and epistemic seeing is a staple of the philosophy of perception. Memory is often usefully compared to perception, and in this spirit I argue for the conditional claim that if Dretske’s arguments succeed in motivating the posit (...) of simple seeing, then parallel arguments should equally motivate a posit I call simple remembering. Simple remembering would be a conscious form of memory about an object or event which is prior to and independent of any beliefs the subject may or may not form about the object or event simply remembered. (shrink)

The Gathas, a corpus of seventeen poems in Old Avestan composed by the ancient Iranian poet-priest Zarathushtra (Zoroaster) ca. 1200 B.C.E., is the foundation document of Zoroastrian religion. Even though the dualistic axiology of the Gathas has been widely noted, it has proved very difficult to understand the meaning and genre of the corpus or the position of Zarathushtra’s ideas with regard to other religious philosophies. Relying on recent advances in translation and decryptions of Gathic poetry, I shall here develop (...) a philosophical interpretation of the Gathas, including, as shall be discussed here in detail, explication of the revelation he reports in the poem known as Yasna 30. I argue that, similarly to Marx, Henry, and Schutz, Zarathushtra connects social criticism with an original philosophy of (inter)subjectivity and existential reflection, placing his account in the context of a fully developed metaphysics which includes the human-divine sharing of mental properties. I show that in order to accommodate this complicated problematic, Zarathushtra uses the vehicle of multiple realities. Reflecting the spontaneity of life, the dynamics of various ontological modes in the text create a reference to subjectivity. A description of the dream in Yasna 30 is sufficiently within the limits of possibility for a dream experience, and thereby delivers three original phenomenological reductions. The reductions initiate a genetic account of the phenomenalization of invisible impulses which give rise to moral choices, and define the human-divine relationship. The opposing moral choices open into a reverse axiological intentionality in the sphere of intersubjectivity, and are said to plot life for the rightful and lifelessness for the wrongful. It can be concluded that Zarathushtra’s theism and views of the social world are “the first philosophy”, with a unique and original phenomenological ontology of intersubjectivity at its core. (shrink)

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

Is the societal-level of analysis sufficient today to understand the values of those in the global workforce? Or are individual-level analyses more appropriate for assessing the influence of values on ethical behaviors across country workforces? Using multi-level analyses for a 48-society sample, we test the utility of both the societal-level and individual-level dimensions of collectivism and individualism values for predicting ethical behaviors of business professionals. Our values-based behavioral analysis indicates that values at the individual-level make a more significant contribution to (...) explaining variance in ethical behaviors than do values at the societal-level. Implicitly, our findings question the soundness of using societal-level values measures. Implications for international business research are discussed. (shrink)

Two brief Late Antique religious texts, respectively by the monk Theophanis and by Monoimus the Arab, present an interesting problem of whether they embody the authors’ experience, or whether they are merely literary constructs. Rather than approaching this issue through the lens of theory, the article shows how phenomenological analysis and studies of living subjectivity can be engaged with the text in order to clarify the contents of introspective experience and the genesis of its religious connotations. The analysis uncovers a (...) previously unnoticed form of embodied introspective religious experience which is structured as a ladder with a distinct internal structure with the high degree of synchronic and diachronic stability. This approach also helps one identify the specific introspective techniques in the canonical and non-canonical literature of early Christian tradition, as related to the concepts of “ theosis ” and “ kenosys ”, as well as to suggest some neurological correspondents of religious cognition. (shrink)

This article presents phenomenological meta-analysis of Tymieniecka's phenomenology of life with regard to its strategies of knowledge. The novelty of phenomenology of life consists in special orientation of direct intuition of Tymieniecka's insight. The analysis suggests that the positioning of the direct intuition differes from philosopher to philosopher. Even though this perspective pays attention to individual differences in philosophical thinking, this view has to be distinguished froll1 psychologism as criticized by Husser!. and rather, seen as a development of Husserl 's (...) lheory of direct intuition. A framework for such analysis can be also found in Islamic philosophies of Suhrawardi and Ibn 'Arabi, who introduced the concepts of individual predisposition, modes of knowledge, and self-knowledge mediated by knowledge by presence. These concepts can be applied to understanding of the origins of philosophical insight. The paper examines in depth the workings of direct, or presentive, intuition in Tymieniecka's descriptions of the phenomenal field of life, and of life per se as a dynamic object. It demonstrates the dialogical nature of interrogation, and the sentience of logos as a horizon of philosophical inquiry. Finally, the paper introduces the concept of process phenomenology, and suggests directions of future research with regard to phenomenology of imagination. (shrink)

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

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)

Applying Michel Henry’s philosophical framework to the phenomenological analysis of religious experience, the author introduces a concept of material introspection and a new theory of the constitution of religious experience in phenomenologically material interiority. As opposed to ordinary mental self-scrutiny, material introspection happens when the usual outgoing attention is reverted onto embodied self-awareness in search of mystical self-knowledge or union with God. Such reversal posits the internal field of consciousness with the self-disclosure of phenomenological materiality. As shown by the example (...) of Vedantic self-inquiry, material introspection is conditioned on the attitude ‘I “see” myself’ and employs reductions which relieve phenomenological materiality from the structuring influence of intentionality; the telos of material introspection is expressed by the inward self-transcendence of intentional consciousness into purified phenomenological materiality. Experience in material introspection is constituted by the self-affection and self-luminosity of phenomenological materiality; experience is recognized as religious due to such essential properties as the capacity of being selffulfilled, and specific qualitative “what it’s like”(s). Drawing on more than 5000 live accounts of internal religious experience, it is shown that introspective attention can have different trajectories, producing, within a temporal extension of material introspection, different spatial modifications of embodied selfawareness and a variety of corresponding religious experiences. (shrink)

This paper argues that the Islamic metaphysical vision finds its Western philosophical counterpart in Anna-Teresa Tymienecka's Phenomenology of Life. Comparative analysis of the main categories and strategies of knowledge in Islamic metaphysics and the Phenomenology of Life demonstrates obvious similarities, but also significant distinctions whereby the systems can be viewed as complementary. Tymieniecka’s philosophy begins with epoché on preceding philosophical knowledge, while Islamic philosophy begins with revelation. Tymieniecka uses presuppositionless phenomenological direct intuition combined with reflective analysis, while Sufi metaphysics combines (...) logic, intuitio,n and reliance on the experience attained in states of mystical perception. Unification of Reality and realization of truth in the Phenomenology of Life is attained via phenomenological intuition of life in all forms of experience, and in Islam, via certainty attained in religious experiences of unveiling. Due to its refocusing on the dynamic moments of the ontopoiesis of life, Tymieniecka’s ontology serves as a possible solution to the problems incurred by the more static metaphysical vision of Reality in Sufism. (shrink)

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)

Interactive theorem provers might seem particularly impractical in the history of philosophy. Journal articles in this discipline are generally not formalized. Interactive theorem provers involve a learning curve for which the payoffs might seem minimal. In this article I argue that interactive theorem provers have already demonstrated their potential as a useful tool for historians of philosophy; I do this by highlighting examples of work where this has already been done. Further, I argue that interactive theorem provers can continue to (...) be useful tools for historians of philosophy in the future; this claim is defended through a more conceptual analysis of what historians of philosophy do that identifies argument reconstruction as a core activity of such practitioners. It is then shown that interactive theorem provers can assist in this core practice by a description of what interactive theorem provers are and can do. If this is right, then computer verification for historians of philosophy is in the offing. (shrink)

In this Article, I propose a novel law and economics explanation of a deeply puzzling aspect of business organization in market economies. Why are virtually all firms organized as capital-managed and -owned (capitalist) enterprises rather than as labor-managed and -owned cooperatives? Over 150 years ago, J.S. Mill predicted that efficiency and other advantages would eventually make worker cooperatives predominant over capitalist firms. Mill was right about the advantages but wrong about the results. The standard explanation is that capitalist enterprise is (...) more efficient. Empirical research, however, overwhelmingly contradicts this. But employees almost never even attempt to organize worker cooperatives. I critique the explanations of the three leading analysts of the subject (N. Scott Arnold, Henry Hansmann, and Gregory Dow), all of whom offer are different transactions cost accounts, as logically defective and empirically inadequate. I then propose an explanation that has been oddly neglected in the literature, that the rarity of cooperatives is explained by the collective action problem identified by writers such as Mancur Olson. Labor management is a public good that generates the n-person prisoner’s dilemma which gives rational actors the incentive to create it in suboptimal (or no) amounts. I support this by reference to the empirical facts about the origin of existing cooperatives and show that this explanation requires no strong version of a questionable rational choice theory. This explanation is supplemented by the mere exposure or familiarity effect derived from social and cognitive psychology, which turns on the fact that labor managed firms are rare, in part because of the public goods problem, thus unfamiliar, which makes them less attractive and thus more likely to be rare. My account points advocates of labor management towards solutions such as institutional changes in incentives, which, however, themselves involve public goods issues. (shrink)

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

Debate about legal and policy reform has been haunted by a pernicious confusion about human nature, the idea that it is a set of rigid dispositions, today generally conceived as genetic, that is manifested the same way in all circumstances. Opponents of egalitarian alternatives argue that we cannot depart far from the status quo because human nature stands in the way. Advocates of such reforms too often deny the existence of human nature because, sharing this conception, they think it would (...) prevent changes they deem desirable. Both views rest on deep errors about what it is to have a nature and how genetics works. Human nature, like the nature of anything else, is a set of potentials to behave certain ways in given environments, not a nonsocial genetic something that inevitably produces the same result in any environment. To say that existing inequalities, are due to our genes, inalterable because heritable, ignores that genetic propensities may be differently manifested in different environments. Heritability has meaning only relative to an environment and a population and implies nothing about inevitability. A better sort of inegalitarian argument is that a proposed reform, given our nature, would be too costly even if possible. However, this sort of argument is too rarely supported by evidence and generally ignores the costs of existing inequalities. But egalitarians err in supposing that, if behavior is unconstrained by biology, the status quo is easily alterable. The environment may be extremely hard to change. Legal and policy debate should adopt a correct understanding of human nature as a set of propensities and ask of any proposed reform agreed to be otherwise desirable what and how alterable are its causes, genetic, environmental, or more accurately both. (shrink)

Terraforming is a process of planetary engineering by which the extant environment of a planetary body is transformed into an environment capable of supporting human inhabitants. The question I would like to consider in this paper is whether there is any reason to believe that the terraforming of another planet—for instance, the terraforming of Mars—is morally problematic. Topics related to the human exploration of space are not often discussed in philosophical circles. Nevertheless, there exists a growing body of philosophical literature (...) dedicated to sorting out the moral implications of the use of resources from (and in) space. Most of this literature is produced as environmental philosophy. Questions of .. (shrink)

Marx thinks that capitalism is exploitative, and that is a major basis for his objections to it. But what's wrong with exploitation, as Marx sees it? (The paper is exegetical in character: my object is to understand what Marx believed,) The received view, held by Norman Geras, G.A. Cohen, and others, is that Marx thought that capitalism was unjust, because in the crudest sense, capitalists robbed labor of property that was rightfully the workers' because the workers and not the capitalists (...) produced it. This view depends on a Labor Theory of Property (LTP), that property rights are based ultimately on having produced something. (A view oddly enough shared with the libertarian right, though the LTP is better support for egalitarian or socialist views; see my From Libertarianism to Egalitarianism, 18 Social Theory & Prac. 259-288 (1992).) -/- I show that the idea that Marx's objection to exploitation is based on injustice or LTP-grounded theft is mistaken. Marx's real objection to exploitation is based on unfreedom, that capitalist relations of production, he thinks, unnecessarily limit human freedom. In the first place Marx is quite clear that he vehemently rejects the concepts of justice, fairness, or rights as bourgeois ideology. It is true that he uses the language of "theft" on occasion, but either a literal interpretation of that language must be abandoned, or his consistent, life-long objection to rights- and justice talk must be given up. Second, the structure, indeed the point, of his analysis of the laws of motion of capitalism, is that capitalists make profits through exploitation of labor -- without cheating -- by the normal "legitimate" operation of the system. Other arguments make the same point. -/- The unfreedom or force-based view, though not necessarily my specific arguments advocated so far is shared by a minority of other writers, such as Nancy Holmstrom and Richard Arneson. What my paper offers that is novel, part from arguments for the foregoing that are different and better than those found elsewhere (although Holmstrom and Arneson are excellent), is an account of in detail of what Marx regards as the real problem with exploitation. -/- I analyze Marx's objection that capitalist exploitation causes unnecessary unfreedom by distinguishing and spelling out three different kinds of freedom that he invokes: classic negative freedom, or noninterference; positive freedom, understood as control over or access to the resources enabling one to exercise one's negative freedom; and "real" freedom, as he puts it, the ability to "give the law to oneself," to regulate one's own activities under rules chosen by oneself, to develop one's capacities by autonomous choice. This puts Marx in the tradition going back through Hegel and Kant to Rousseau, the first express advocate of this idea. The opposite of real freedom, the unfreedom due to lack of autonomy, is alienation. -/- I conclude by stating that I think that justice-based objections to exploitation that avoid Marx's objections to the concept are possible. I do not attempt to spell these out here. I take up that task in my subsequently published paper Relativism, Reflective Equilibrium, and Justice, 17 Legal Stud.,128-168 (1997). -/- The present paper is related to and partly overlaps with my paper In Defense of Exploitation, 11 Econ. & Phil. 49-81 (1995), a critique of John Roemer's equality based account of the nature of exploitation and its wrongness. The research and writing of this paper was financially supported by the philosophy department of The Ohio State University. -/- Keywords: Exploitation, Justice, Unjustice, Theft, Labor Theory of Property, Marx, Freedom, Unfreedom, Rights, Fairness, Critique of Justice, Negative Freedom, Positive Freedom, Real Freedom, Alienation, G.A. Cohen, Norman Geras. (shrink)

Obsessive-compulsive disorder is a commonly occurring neuropsychiatric condition characterized by bothersome intrusive thoughts and urges that frequently lead to repetitive dysfunctional behaviours such as excessive handwashing. There are well-documented alterations in cerebral function which appear to be closely related to the manifestation of these symptoms. Controlled studies of cognitive-behavioural therapy techniques utilizing the active refocusing of attention away from the intrusive phenomena of OCD and onto adaptive alternative activities have demonstrated both significant improvements in clinical symptoms and systematic changes in (...) the pathological brain circuitry associated with them. Careful investigation of the relationships between the experiential and putative neurophysiological processes involved in these changes can offer useful insights into volitional aspects of cerebral function. (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)

Every year, hundreds of patients in England die whilst waiting for a kidney transplant, and this is evidence that the current system of altruistic-based donation is not sufficient to address the shortage of kidneys available for transplant. To address this problem, we propose a monopsony system whereby kidney donors can opt-in to receive financial compensation, whilst still preserving the right of individuals to donate without receiving any compensation. A monopsony system describes a market structure where there is only one ‘buyer’—in (...) this case the National Health Service. By doing so, several hundred lives could be saved each year in England, wait times for a kidney transplant could be significantly reduced, and it would lessen the burden on dialysis services. Furthermore, compensation would help alleviate the common disincentives to living kidney donation, such as its potential associated health and psychological costs, and it would also help to increase awareness of living kidney donation. The proposed system would also result in significant cost savings that could then be redirected towards preventing kidney disease and reducing health disparities. While concerns about exploitation, coercion, and the ‘crowding out’ of altruistic donors exist, we believe that careful implementation can mitigate these issues. Therefore, we recommend piloting financial compensation for living kidney donors at a transplant centre in England. (shrink)

The National Center for Biomedical Ontology is a consortium that comprises leading informaticians, biologists, clinicians, and ontologists, funded by the National Institutes of Health (NIH) Roadmap, to develop innovative technology and methods that allow scientists to record, manage, and disseminate biomedical information and knowledge in machine-processable form. The goals of the Center are (1) to help unify the divergent and isolated efforts in ontology development by promoting high quality open-source, standards-based tools to create, manage, and use ontologies, (2) to create (...) new software tools so that scientists can use ontologies to annotate and analyze biomedical data, (3) to provide a national resource for the ongoing evaluation, integration, and evolution of biomedical ontologies and associated tools and theories in the context of driving biomedical projects (DBPs), and (4) to disseminate the tools and resources of the Center and to identify, evaluate, and communicate best practices of ontology development to the biomedical community. Through the research activities within the Center, collaborations with the DBPs, and interactions with the biomedical community, our goal is to help scientists to work more effectively in the e-science paradigm, enhancing experiment design, experiment execution, data analysis, information synthesis, hypothesis generation and testing, and understand human disease. (shrink)

Is the family subject to principles of justice? In "A Theory of Justice", John Rawls includes the (monogamous) family along with the market and the government as among the, "basic institutions of society", to which principles of justice apply. Justice, he famously insists, is primary in politics as truth is in science: the only excuse for tolerating injustice is that no lesser injustice is possible. The point of the present paper is that Rawls doesn't actually mean this. When it comes (...) to the family, and in particular its impact on fair equal opportunity, (the first part of the Difference Principle, Rawls' second principle of justice), he abandons the priority of justice. I also argue that he is right to do so. -/- The central argument is simple. As Rawls admits, what family one is raised by profoundly affects one's life chances: a child raised by a family has far greater life chances on every dimension than one raised in a poorer family that may lack books, education, and time to give the child attention. But the prevailing family arrangements in the industrialized West, assigning children to be raised by their biological parents, is guaranteed to perpetuate this injustice. While Rawls says an unjust institution in the basic structure of society, in which he includes the family, must be, "reformed or abolished," he refrains from calling for the reform or abolition of the family. We must simply work around it to compensate for the injustices he admits it involves. And this despite the fact that alternative arrangements involving communal child-rearing (Plato) or assigning children to those best qualified to raise them (Rousseau) are common in the philosophical literature. Moreover, the practice of having children raised by their biological parents is a relatively recent one, at least in the West, where, before the late 18th century, fostering-out or apprenticeship arrangements were normal and expected for both rich and poor for centuries. -/- Much of the paper is devoted to fine-grained textual analysis of Rawls' attempts to avoid the devastating implications of this argument for his theory of justice -- much of which are stated only in the original edition of "A Theory of Justice" and simply deleted, without substitution by anything better, in the second edition. In the end, Rawls has no way out. He cannot keep the priority of justice, fair equality of opportunity, and the monogamous family in which children are raised by their biological parents. As he admits, these are mutually inconsistent. -/- In the final part of the paper, I argue that Rawls should give up on the priority of justice. While child-rearing by the biological parents is a historical anomaly, in the real modern world it would be politically unfeasible to institute Platonic, Rousseauean, or similar legislation that purportedly assigned children to those best able to raise them, regardless of biological relationship. Since Rawls is committed to principles of political stability and feasibility, as he should be, and since ought implies can, such proposals are off the table. I concur with Rawls that we must work around this injustice, even those there are more just arrangements available in principle. But the cost of this -- less high than Rawls suggests -- is abandoning the principle of the priority of justice. Justice is one of a number of considerations that we must or may balance in deciding on the best attainable social relations. It is not a trump. However, this comes a great cost for Rawls: he must also abandon the lexical ordering of principles of justice or, in general, right or good principles of social order, in favor of the messy intuitionist balancing that his theory is designed to avoid. -/- One feature of the paper that is worth independent attention is a discussion of Marx's rejection of justice in the Critique of the Gotha Program, which I explicate, and urge, without adopting it, that it has a great deal more force than is widely understood. (shrink)

In his 1918 logical atomism lectures, Russell argued that there are no molecular facts. But he posed a problem for anyone wanting to avoid molecular facts: we need truth-makers for generalizations of molecular formulas, but such truth-makers seem to be both unavoidable and to have an abominably molecular character. Call this the problem of generalized molecular formulas. I clarify the problem here by distinguishing two kinds of generalized molecular formula: incompletely generalized molecular formulas and completely generalized molecular formulas. I next (...) argue that, if empty worlds are logically possible, then the model-theoretic and truth-functional considerations that are usually given address the problem posed by the first kind of formula, but not the problem posed by the second kind. I then show that Russell’s commitments in 1918 provide an answer to the problem of completely generalized molecular formulas: some truth-makers will be non-atomic facts that have no constituents. This shows that the neo-logical atomist goal of defending the principle of atomicity—the principle that only atomic facts are truth-makers—is not realizable. (shrink)

Examines tensions in contemporary feminism based on theorizing difference. Mainstream feminist project's approach to questions of difference; Interlocking and varying hierarchies of domination; Proposed multiracial feminism in which difference can occupy center stage in women's studies.

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

Widespread deflationistic readings of Quine misrepresent his view of disquotation’s significance and the truth predicate’s utility. I demonstrate this by answering a question that philosophers have not directly addressed: how does Quine understand the philosophical problem of truth? A primary thesis of this paper is that we can answer this question only by working from within Quine’s naturalistic framework. Drawing on neglected texts from Quine's corpus, I defend the view that, for Quine, the problem of truth emerges from the development (...) of science, in particular, from logical theorizing. I show that disquotation itself, from this Quinean point of view, is the problematic phenomenon calling for philosophical reflection. I conclude by arguing that Quine does not envisage the kind of explanatory role for disquotation taken up by contemporary deflationists, and he shows no interest in the task that animates deflationism, namely, to show that concerns with truth’s nature are fundamentally confused. (shrink)

Some experts have argued that patients facing certain types of choices should not be told whether their risk is above or below average, because this information may trigger a bias (Fagerlin et al. 2007). But careful consideration shows that the comparative risk heuristic can usefully guide decisions and improve their quality or rationality. Building on an earlier paper of mine (Schwartz 2009), I will argue here that doctors and decision aids should provide comparative risk information to patients, even while (...) further research is conducted. (shrink)

G. A. Cohen defends and Jon Elster criticizes Marxist use of functional explanation. But Elster's mechanical conception of explanation is, contrary to Elster's claims, a better basis for vindication of functional explanation than Cohen's nomological conception, which cannot provide an adequate account of functional explanation. Elster also objects that functional explanation commits us to metaphysically bizarre collective subjects, but his argument requires an implausible reading of methodological individualism which involves an unattractive eliminativism about social phenomena.

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

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

The Plant Ontology (PO) (http://www.plantontology.org) (Jaiswal et al., 2005; Avraham et al., 2008) was designed to facilitate cross-database querying and to foster consistent use of plant-specific terminology in annotation. As new data are generated from the ever-expanding list of plant genome projects, the need for a consistent, cross-taxon vocabulary has grown. To meet this need, the PO is being expanded to represent all plants. This is the first ontology designed to encompass anatomical structures as well as growth and developmental stages (...) across such a broad taxonomic range. While other ontologies such as the Gene Ontology (GO) (The Gene Ontology Consortium, 2010) or Cell Type Ontology (CL) (Bard et al., 2005) cover all living organisms, they are confined to structures at the cellular level and below. The diversity of growth forms and life histories within plants presents a challenge, but also provides unique opportunities to study developmental and evolutionary homology across organisms. (shrink)

This paper critiques the view, widely held by philosophers of mind and cognitive scientists, that psychological explanation is a matter of ascribing propositional attitudes (such as beliefs and desires) towards language-like propositions in the mind, and that cognitive mental states consist in intentional attitudes towards propositions of a linguistic quasi-linguistic nature. On this view, thought is structured very much like a language. Denial that propositional attitude psychology is an adequate account of mind is therefore, on this view, is tantamount to (...) eliminative materialism, the denial that human beings are thinking beings. -/- I dispute this on the basis of recent work in cognitive psychology and artificial intelligence. Mental models theory, on which thought is better understood as nonpropositional intentional psychology, accords better with the evidence and offers an alternative view to propositional attitude psychology -- one that means that the denial that that is propositional is not eliminative. However, I argue that propositional attitude psychology is a useful idealization, as classical mechanics is of relativity theory, strictly but not radically false, and useful for prediction and indeed, as long as its idealized character is born in mind, for explanation of behavior. (shrink)

A standard problem with the objectivity of social scientific theory in particular is that it is either self-referential, in which case it seems to undermine itself as ideology, or self-excepting, which seem pragmatically self-refuting. Using the example of Marx and his theory of ideology, I show how self-referential theories that include themselves in their scope of explanation can be objective. Ideology may be roughly defined as belief distorted by class interest. I show how Marx thought that natural science was informed (...) by class interest but not therefore necessarily ideology. Capitalists have an interest in understanding the natural world (to a point) so that they can manipulate it for profit. Their survival in the marketplace often depends on their competitive success in doing so. The fact that their interventions into nature, driven by class interest, often succeed, is evidence of the reliability and truth of their natural scientific theories. -/- With social science, capitalists have a partial interest in understanding the world, so that they may maintain their class power, ideological hegemony, and a reasonably stable and self-reproducing economy. Some bourgeois social science, Marx thinks, is therefore vindicated the same way that natural science is, because of, not despite, its success in promoting the class interests that cause it. But the capitalist class, Marx thinks, also has an interest in obfuscating the truth about the social world. It would undermine the stability of capitalism, for example, for the bourgeoisie to adopt what Marx thinks to be the correct social theory, Marxism, and proclaim to the world that capitalism is exploitative and unstable. Capitalism creates a a need for ideological social theories that, driven by class interest, represent capitalism as just, natural, inevitable, and unalterable. If Marxism is correct, while these theories may further capitalist interests, they will not withstand the test of time as capitalist exploitation and instability engenders countersystemic political action. -/- How, then can we know, according to Marx, that Marxism is correct, as applied to itself? In part it is whether it succeeds in further the class interests that cause it. If workers adopt bourgeois theories and Marxism is right, they will find themselves frustrated in pursuit of goals that they have, such as improving their well-being, and if Marxism is wrong, then those theories will help them further their own goals. Similarly with Marxism: if it is right, then workers who adopt it should in the long run have more success in furthering their own goals, and if not, then not. But it is question begging to say that our confidence in the reliability of Marxism is enhanced by its successful promotion of goals that capitalists do not have but (according to Marxism) workers do. To avoid this problem it is necessary to compare the relative success of each sort of theory in promoting the interests and needs that the respective classes have independently of the theory, as well as by the usual criteria of scientific theory choice. -/- Thus the Soviet variant of Marxism was fairly decisively refuted by its failure to generate the support of its own designated constituency necessary to grow and survive. Whether the same is true of other varieties of Marxism or of capitalist social theory, it is, as Zhou En Lai said when asked whether the French Revolution had succeeded, too soon to tell, at least in any definitive way. However, and this is the point of the paper, an objective test of Marxism is possible even though Marxism says that all theory is informed by class interest. The question is whether the interests are in discovering or obfuscating the truth. The point is not limited to Marx, but applies to any self-referential social scientific theory that includes itself in its scope. -/- Keywords: ideology, self-referential theory, self-reference, reliabilism, objectivity, Marx, Marxism, sociology of science, class interest, classes, capitalism, bourgeoisie, workers, working class, social theory of knowledge, confirmation of scientific theory. (shrink)

Philosophers have argued that on the prevailing theory of mind, functionalism, the fact that mental states are multiply realizable or can be instantiated in a variety of different physical forms, at least in principle, shows that materialism or physical is probably false. A similar argument rejects the relevance to psychology of connectionism, which holds that mental states are embodied and and constituted by connectionist neural networks. These arguments, I argue, fall before reductios ad absurdam, proving too much -- they apply (...) as well to genes, which are multiply realizable, but the reduction of which to DNA is one the core cases of scientific reductive explanation, a reduction if anything is. -/- I suggest that psychology, like biology, be what I call "provincialized," abandon claims to universal validity, except as an idealization, and treat different classes of cognizers differently from an an explanatory perspective. This would permit specifies specific, or more precisely, provincial reductions of different psychologies that might be multiply realized if such reductions were available. Connectionism may be the foundation of a reduction of human psychology, and thus biology and connectionism retain their relevance to psychology, and physicalism or materialism is consistent with functionalism. (shrink)

I characterize and argue against the standard interpretation of logical atomism. The argument against this reading is historical: the standard interpretation of logical atomism (1) fails to explain how the view is inspired by nineteenth-century developments in mathematics, (2) fails to explain how logic is central to logical atomism, and (3) fails to explain how logical atomism is a revolutionary and new "scientific philosophy." In short, the standard interpretation is a bad history of logical atomism. A novel interpretation of the (...) view that repairs these difficulties is sketched in the concluding section. (shrink)

I claim that a relatively new position in philosophy of mathematics, pluralism, overlaps in striking ways with the much older Jain doctrine of anekantavada and the associated doctrines of nyayavada and syadvada. I first outline the pluralist position, following this with a sketch of the Jain doctrine of anekantavada. I then note the srrong points of overlaps and the morals of this comparison of pluralism and anekantavada.