This paper considers the responsibilities of the FDA with regard to disseminating information about the benefits and harms of e-cigarettes. Tobacco harm reduction advocates claim that the FDA has been overcautious and has violated ethical obligations by failing to clearly communicate to the public that e-cigarettes are far less harmful than cigarettes. We argue, by contrast, that the FDA’s obligations in this arena are more complex than they may appear at first blush. Though the FDA is accountable for informing the (...) public about the health risks and benefits of products it regulates, it also has other roles that inform when and how it should disseminate information. In addition to being a knowledge purveyor, it is also a knowledge producer, an advisor to the public, and a practical agent shaping the material conditions in which people make health-related choices. In our view, those other roles call for caution in the way the FDA interprets and communicates the available evidence. (shrink)

D’après Heidegger, chaque époque/épochè est caractérisé par un certain mode de révélation des étants, qui est à la fois une dissimulation d’une façon de l’Être. Ce mode particulier paraît ne venir de nulle part en ce qu’il se base sur un certain oubli. Dana S. Belu le met en scène pour son livre en faisant valoir la tendance de Heidegger « to treat the history of being (Seinsgeschichte) as a noncausal succession of universal principles of intelligibility that presupposes the (...) forgetting (Seinsvergessenheit) of the clearing (die Lichtung) as their source » (p. 15). L’oubli de notre époque est marqué par une divulgation technologique dans le mode de l’arraisonnement (Gestell) où les étants se révèlent comme partie du fonds (Bestand) d’être calculés, manipulés, exploités, et mis en réserve pour un usage ultérieur. La phénoménologie féministe de l’A. essaie de faire sens à la gestation, la maternité et la procréation médicalement assistée (PMA) qui font aux femmes faire partie de ce fonds et ouvre, parmi les paramètres du Gestell, la porte à une ère « sans mère ». (shrink)

Benardete paradoxes involve infinite collections of Grim Reapers, assassins, demons, deafening peals, or even sentences. These paradoxes have recently been used in arguments for finitist metaphysical theses such as temporal finitism, causal finitism, and discrete views of time. Here we develop a new finite Benardete-like paradox. We then use this paradox to defend a companions in guilt argument that challenges recent applications of patchwork principles on behalf of the aforementioned finitist arguments. Finally, we develop another problem for those applications by (...) examining the notion of exact duplication. (shrink)

Hannah Arendt's rich and varied political thought is more influential today than ever before, due in part to the collapse of communism and the need for ideas that move beyond the old ideologies of the Cold War. As Dana Villa shows, however, Arendt's thought is often poorly understood, both because of its complexity and because her fame has made it easy for critics to write about what she is reputed to have said rather than what she actually wrote. Villa (...) sets out to change that here, explaining clearly, carefully, and forcefully Arendt's major contributions to our understanding of politics, modernity, and the nature of political evil in our century.Villa begins by focusing on some of the most controversial aspects of Arendt's political thought. He shows that Arendt's famous idea of the banality of evil--inspired by the trial of Adolf Eichmann--does not, as some have maintained, lessen the guilt of war criminals by suggesting that they are mere cogs in a bureaucratic machine. He examines what she meant when she wrote that terror was the essence of totalitarianism, explaining that she believed Nazi and Soviet terror served above all to reinforce the totalitarian idea that humans are expendable units, subordinate to the all-determining laws of Nature or History. Villa clarifies the personal and philosophical relationship between Arendt and Heidegger, showing how her work drew on his thought while providing a firm repudiation of Heidegger's political idiocy under the Nazis. Less controversially, but as importantly, Villa also engages with Arendt's ideas about the relationship between political thought and political action. He explores her views about the roles of theatricality, philosophical reflection, and public-spiritedness in political life. And he explores what relationship, if any, Arendt saw between totalitarianism and the "great tradition" of Western political thought. Throughout, Villa shows how Arendt's ideas illuminate contemporary debates about the nature of modernity and democracy and how they deepen our understanding of philosophers ranging from Socrates and Plato to Habermas and Leo Strauss.Direct, lucid, and powerfully argued, this is a much-needed analysis of the central ideas of one of the most influential political theorists of the twentieth century. (shrink)

When people are making certain medical decisions – especially potentially transformative ones – the specter of regret may color their choices. In this paper, I ask: can predicting that we will regret a decision in the future serve any justificatory role in our present decision-making? And if so, what role? While there are many pitfalls to such reasoning, I ultimately conclude that considering future retrospective emotions like regret in our decisionmaking can be both rational and authentic. Rather than indicating that (...) one is about to make a mistake or that there is some underlying value that one already cares about but is overlooking, the prediction that one will regret a decision in the future makes one confront how her present values and priorities may change as a result of her choice in ways she cannot presently anticipate. (shrink)

Background: Current practice frequently fails to provide care consistent with the preferences of decisionally-incapacitated patients. It also imposes significant emotional burden on their surrogates. Algorithmic-based patient preference predictors (PPPs) have been proposed as a possible way to address these two concerns. While previous research found that patients strongly support the use of PPPs, the views of surrogates are unknown. The present study thus assessed the views of experienced surrogates regarding the possible use of PPPs as a means to help make (...) treatment decisions for decisionally-incapacitated patients. -/- Methods: This qualitative study used semi-structured interviews to determine the views of experienced surrogates [n=26] who were identified from two academic medical centers and two community hospitals. The primary outcomes were respondents’ overall level of support for the idea of using PPPs and the themes related to their views on how a PPP should be used, if at all, in practice. -/- Results: Overall, 21 participants supported the idea of using PPPs. The remaining five indicated that they would not use a PPP because they made decisions based on the patient’s best interests, not based on substituted judgment. Major themes which emerged were that surrogates, not the patient’s preferences, should determine how treatment decisions are made, and concern that PPPs might be used to deny expensive care or be biased against minority groups. -/- Conclusions: Surrogates, like patients, strongly support the idea of using PPPs to help make treatment decisions for decisionally-incapacitated patients. These findings provide support for developing a PPP and assessing it in practice. At the same time, patients and surrogates disagree over whose preferences should determine how treatment decisions are made, including whether to use a PPP. These findings reveal a fundamental disagreement regarding the guiding principles for surrogate decision-making. Future research is needed to assess this disagreement and consider ways to address it. (shrink)

In The Second Sex, Simone de Beauvoir diagnoses “woman” as the “lost sex,” torn between her individual autonomy and her “feminine destiny.” Becoming a “real woman” in patriarchal societies demands that women lose their authentic, autonomous selves to become the “inessential Other” for Man. To better understand this diagnosis and how women might refind themselves, I rehabilitate the influence of Søren Kierkegaard and his concept of repetition as what must be lost to be found again in Beauvoir’s account of freedom (...) and, specifically, the liberation of women. Beauvoir offers a dual account of repetition, that of mundane repetition and sacrificial repetition, bringing them to bear both on her diagnosis of women’s oppression and her theorization of our liberation. Sacrificial repetition becomes a temporality for freedom—one must be able to repeat or retake their autonomy continuously toward an open future. For this to happen concretely, Beauvoir insists that we must sacrifice the (racist, classist) patriarchal ideals of the “real woman” and “real man” as we retake our autonomy and reconfigure the meaning of sex difference anew. (shrink)

A deeply personal reckoning with family, mental illness, and suicide, Dana Trusso captures the meaning of Nietzsche's armor fati--to love one's fate--through her surreal imagery and longing to heal intergenerational wounds. Lines are drawn from Lars von Trier's Melancholia, Sonic Youth's Experimental Jet Set, Trash and No Star, and lines she read from her aunt's journals as a child. -/- The photo is a sculpture of an earth goddess by Jean-Philippe Richard located in the botanical gardens of Èze, France. (...) Nearby is Le Chemin de Nietzsche, a steep hike from the seaside to mountainous ruins that is said to have inspired Thus Spoke Zarathustra. (shrink)

In this paper, I endorse the idea that age is a defensible criterion for eligibility to vote, where age is itself a proxy for having a broad set of cognitive and motivational capacities. Given the current (and defeasible) state of developmental research, I suggest that the age of 16 is a good proxy for such capacities. In defending this thesis, I consider alternative and narrower capacity conditions while drawing on insights from a parallel debate about capacities and age requirements in (...) the criminal law. I also argue that the expansive capacity condition I adopt satisfies a number of powerful and complementary rationales for voting eligibility, and conclude by addressing challenging arguments that, on the one hand, capacity should not underlie voting eligibility in the first place, and, on the other, that capacity should do so directly and not via any sort of proxy, including age. (shrink)

Heron Heart is a poem born out of reflecting on the nature of existence during long stretches of isolation, where the boundary of what is and is not a living being was challenged—the nonhuman more alive than the human. It evokes the absurdity of the banal out of the confusion and beauty of sensory experience, with hints of nostalgia for a mythological world that never existed but is ever-present.

We often find ourselves in situations where it is up to us to make decisions on behalf of others. How can we determine whether such decisions are morally justified, especially if those decisions may change who it is these others end up becoming? In this paper, I will evaluate one plausible kind of justification that may tempt us: we may want to justify our decision by appealing to the likelihood that the other person will be glad we made that specific (...) choice down the line. Although it is tempting, I ultimately argue that we should reject this sort of appeal as a plausible justification for the moral permissibility of our vicarious decisions. This is because the decisions that we make on behalf of another may affect the interests and values that that person will hold in the future. As I will show, this complicates the justificatory relationship between present decisions and future attitudes, since the latter can depend on the former. This is not to say that the predicted future attitudes of others can play no significant role in justifying our decisions on others’ behalf. Rather, appealing to the future attitudes in our moral justifications may play an important role in our practical thinking but only when we consider the future attitudes of all relevant possible futures. (shrink)

Many people view disabilities as misfortunes, call this the standard view. In this paper, I examine one criticism that has been launched against the Standard View. Rather than determine in advance whether having a disability is good or bad for a person, some critics argue that the Standard View is reflective of and brings about inappropriate emotional responses toward people with disabilities and their circumstances. For instance, philosophers have recently argued that in holding the standard view, we become prone to (...) a destructive kind of unwarranted pity or that the view leads us to hold certain untenable or inappropriate hopes for our children and for our society. I think this sort of challenge to the Standard View has a lot of appeal, but I worry that if it is not properly articulated, the approach is vulnerable to what has been known as “The Wrong Kind of Reason” problem. The paper highlights and addresses this worry. (shrink)

Democratizing the syllabus has been discussed in the fields of sociology and political science but rarely in philosophy. In this paper I will draw upon my experience of teaching Philosophy of Love in an online modality to examine the impact on motivation when students fill in the gaps presented in a democratic syllabus.

Abstract: Each affective state has distinct motor-expressions, sensory perceptions, autonomic, and cognitive patterns. Panksepp (1998) proposed seven neural affective systems of which the SEEKING system, a generalized approach-seeking system, motivates organisms to pursue resources needed for survival. When an organism is presented with a novel stimulus, the dopamine (DA) in the nucleus accumbens septi (NAS) is released. The DA circuit outlines the generalized mesolimbic dopamine-centered SEEKING system and is especially responsive when there is an element of unpredictability in forthcoming rewards. (...) We propose that when the outcome of this interaction is unexpected or unanticipated then Panksepp’s “cognitive or expectancy reset” mechanism involving the cognitive dissonance would yield the subjective emotion of surprise. In order to appropriately react to the environment’s stimuli one needs fundamental processes that would enable one to distinguish between what is novel and what has been already experienced, as well as the different degrees of novelty. Novel events are those whose essential features of the representation (visceral and perceptual) are altered and being discrepant provoke more sustained attention. Novelty arises from salient and arousing events and the organism experiences surprise, as coming out of a habitual state. In this framework, we shall look at established theories of emotions and propose a different approach to their taxonomy. (shrink)

This essay explores a conception of responsibility at work in moral and criminal responsibility. Our conception draws on work in the compatibilist tradition that focuses on the choices of agents who are reasons-responsive and work in criminal jurisprudence that understands responsibility in terms of the choices of agents who have capacities for practical reason and whose situation affords them the fair opportunity to avoid wrongdoing. Our conception brings together the dimensions of normative competence and situational control, and we factor normative (...) competence into cognitive and volitional capacities, which we treat as equally important to normative competence and responsibility. Normative competence and situational control can and should be understood as expressing a common concern that blame and punishment presuppose that the agent had a fair opportunity to avoid wrongdoing. This fair opportunity is the umbrella concept in our understanding of responsibility, one that explains it distinctive architecture. (shrink)

The aesthetics of body and dress are in a continuous flux. The body, being the locus where fashion challenges the traditional norms, escapes from the narrow boundaries of the conventionally beautiful; the disgusting soma, in the realm of Negative Aesthetics, takes its place. In this paper, I attempt to define what is disgusting fashion and how can contribute to the deliberation of the body from the restricting margins of the aesthetically beautiful. The distorted imagery of the feminine soma is the (...) center of the analysis of the non-beautiful as an aesthetically pleasing phenomenon. Different examples of repulsive clothing are analyzed from a philosophical point of view, in order to understand the relation between the negative emotional responses towards disgusting fashion and its aesthetic value. -/- . (shrink)

Socrates engages his audience in Phaedrus with speeches that include revised or newly composed myths that express his theory of philosophical eros. The aim of the speeches is to generate a love for truth that spills over into dialogue. Speeches are a starting point for dialogue, just like physical attraction is the beginning of love. In the case of Phaedrus, the beginning of philosophy is portrayed using playful and rhetorically rich speeches that serve as "love potions" awakening the novice's soul, (...) and ultimately leading Phaedrus to higher rungs on the ladder of love through the palinode, a medicinal speech. It is thinking about speeches, not the speeches themselves, which moves Socrates' student Phaedrus from the love of speeches to the love of Beauty itself. This is a stark contrast to the purpose of speechmaking for the sophist. The sophist seeks to enchant the soul, while the philosopher seeks to charm the soul into loving wisdom through stimulating discussions. Socrates also uses role reversals in the lover-beloved relationship to model the soul's ascent, contrasting the traditional roles with the way the lover and beloved are presented in Socrates' speeches. The novice must actively recollect Beauty itself in order to ascend, rather than passively listening to speeches that provide an image of beauty. Socrates' interlocutors must move themselves up the ladder of love from their own philosophical eros; wisdom is not attained by merely being pushed all the way up the ladder of love. (shrink)

Recently, bioethicists and the UNCRPD have advocated for supported medical decision-making on behalf of patients with intellectual disabilities. But what does supported decision-making really entail? One compelling framework is Anita Silvers and Leslie Francis’ mental prosthesis account, which envisions supported decision-making as a process in which trustees act as mere appendages for the patient’s will; the trustee provides the cognitive tools the patient requires to realize her conception of her own good. We argue that supported decision-making would be better understood (...) as a collaborative process, giving patients with intellectual disabilities the opportunity to make decisions in a respectful relationship with trusted others. We offer an alternative account of supported decision-making where the primary constraint is to protect the patient from domination by the trustee. This is advantageous in its preservation of the prospects for genuine collaboration, for the mental prosthesis approach ultimately reinforces a problematic ideal of isolated patient self-determination. (shrink)

Starting from the notion of the Ideal Feminine, this paper discusses the representation of trauma and the portrayal of women as open wounds in the designs of Alexander McQueen and John Galliano. Particularly, I explore how the McQueen’s Deadly Woman and Galliano’s Doll question the boundaries between mortality, sexuality and decay. By examining the relationship between fear, desire and disgust in the aesthetic representation of the wounded fashioned body, I argue that in their works disgust functions as an empowering emotion, (...) contributing to the perception of the aversive fashioned body as a feministic act. (shrink)

Abstract: This research paper presents a novel approach to predict audit risks using a neural network model. The dataset used for this study was obtained from Kaggle and comprises 774 samples with 18 features, including Sector_score, PARA_A, SCORE_A, PARA_B, SCORE_B, TOTAL, numbers, marks, Money_Value, District, Loss, Loss_SCORE, History, History_score, score, and Risk. The proposed neural network architecture consists of three layers, including one input layer, one hidden layer, and one output layer. The neural network model was trained and validated, achieving (...) an impressive accuracy of 100% and an average error of 0.000015, indicating its robust predictive capability. Moreover, we conducted feature importance analysis to identify the most influential features for predicting audit risk. The key features found to be critical for classifying fraudulent activities in audit risk prediction are Sector_score, PARA_A, SCORE_A, PARA_B, SCORE_B, TOTAL, numbers, marks, Money_Value, District, Loss, Loss_SCORE, History, and History_score. This research contributes to the field of audit risk prediction by demonstrating the effectiveness of a neural network-based approach and highlighting the importance of specific features in detecting fraudulent activities. The findings have significant implications for auditors and organizations seeking to enhance their audit risk assessment processes, ultimately leading to improved financial transparency and fraud detection. (shrink)

Je cherche à explorer comment l'expérience de la temporalité est multiforme et fortement perturbée à l'époque de la pandémie Covid-19 et des politiques de confinement, générant une expérience d'hétérochronie, qui remet en question notre rapport à la vie.

This analysis shows Cantor's diagonal definition in his 1891 paper was not compatible with his horizontal enumeration of the infinite set M. The diagonal sequence was a counterfeit which he used to produce an apparent exclusion of a single sequence to prove the cardinality of M is greater than the cardinality of the set of integers N.

'A Differential Play of Forces' is a study of transcendental empiricism in musical contexts. It presents a reading of Gilles Deleuze and Félix Guattari’s philosophical apparatus and explores how music can be thought of as functioning in the operation Deleuze terms transcendental empiricism. Central to transcendental empiricism is the idea of an encounter with intensive difference and the consequent experience of intensive and virtual forces. The thesis sets out to explore this idea in three interwoven steps. First, it develops transcendental (...) empiricism as a philosophical framework, expounding central notions related to time and aesthetic experience. In the context of this philosophical apparatus, music is then discussed as an encounter with intensity and what this may entail for our understanding of musical experience and its potential. The third part of the thesis explores the idea of experiencing intensive forces through music in the thinking and poietic of three composers of the twentieth century: Arnold Schönberg, Olivier Messiaen and Giacinto Scelsi. The thesis develops three ‘images of thought’ corresponding, respectively, to the composers’ expressed theoretical ideas, identifying central concepts from Deleuze and Guattari’s philosophy. A mutual illumination of ideas about music and transcendental empiricism is thus presented, pointing towards a possible convergence between theory and practice, thinking and aesthetic experience as a differential play of intensive forces. (shrink)

The increasing use of opioid treatment agreements has prompted debate within the medical community about ethical challenges with respect to their implementation. The focus of debate is usually on the efficacy of OTAs at reducing opioid misuse, how OTAs may undermine trust between physicians and patients and the potential coercive nature of requiring patients to sign such agreements as a condition for receiving pain care. An important consideration missing from these conversations is the potential for racial bias in the current (...) way that OTAs are incorporated into clinical practice and in the amount of physician discretion that current opioid guidelines support. While the use of OTAs has become mandatory in some states for certain classes of patients, physicians are still afforded great leeway in how these OTAs are implemented in clinical practice and how their terms should be enforced. This paper uses the guidelines provided for OTA implementation by the states of Indiana and Pennsylvania as case studies in order to argue that giving physicians certain kinds of discretion may exacerbate racial health disparities. This problem cannot simply be addressed by minimising physician discretion in general, but rather by providing mechanisms to hold physicians accountable for how they treat patients on long-term opioid therapy to ensure that such treatment is equitable. There are no data in this work. (shrink)

Philosophers of experiment have acknowledged that experiments are often more than mere hypothesis-tests, once thought to be an experiment's exclusive calling. Drawing on examples from contemporary biology, I make an additional amendment to our understanding of experiment by examining the way that `wide' instrumentation can, for reasons of efficiency, lead scientists away from traditional hypothesis-directed methods of experimentation and towards exploratory methods.

In Embracing Paradox, Evolving Language, L.E. Maroski proposes that humanity is poised on the cusp of a transformation of consciousness that requires not only a shift in values and perspectives, but also a shift in a basic technology we take for granted—language. Because we use language to create social structures and institutions, including education, governance, and our most intimate relationships, the structure of our language contributes to the way we structure those creations. Maroski questions the cultural assumptions that are built (...) into the structure of language—primarily English—and invites the reader to imagine and ultimately to help develop novel structures of language that arise from different assumptions. To do so, she shows how we can draw inspiration from paradoxical topological forms, such as the Möbius strip and Klein bottle, as they embody both unity and duality/multiplicity. By seeing our reality not simply in terms of either/or but also in terms of both (many)/and, perhaps our feelings of fragmentation and the stultifying oppositions that have polarized society can transform into appreciation for the wholeness of all existence. (shrink)

Le but de ce texte est de mettre en évidence les équi­valences entre la façon dont le concept de conatus résout, dans l'Éthique, le problème de l'unité modale complexe. en rendant consis­tant le concept de chose singulière en tant que celle-ci doit être consi­dérée comme un légitime sujet d'attribution d'états, et la façon dont ce même concept dessine le rapport cognitif de l'esprit avec lui-même, rapport par lequel l'esprit se saisit comme sujet de ses états et qui ca­ractérise la notion (...) moderne de subjectivité. Ainsi, en éclairant cet as­pect du concept spinoziste de chose singulière. on comprendra aussi, de façon indirecte, l'une des conditions par lesquelles les choses peuvent, dans la doctrine spinoziste, devenir des objets ou des signes pour la connaissance humaine. (shrink)

Politics, Philosophy & Economics, Volume 21, Issue 2, Page 165-189, May 2022. It is generally acknowledged that a certain amount of state intervention in health and health care is needed to address the significant market failures in these sectors; however, it is also thought that the primary rationale for state involvement in health must lie elsewhere, for example in an egalitarian commitment to equalizing access to health care for all citizens. This paper argues that a complete theory of justice in (...) health can be derived from a commitment to correcting market failure, or in other words promoting Pareto-efficiency, in the domain of health. This approach can address familiar problems around access to care, as well as problems related to resource allocation and rationing, the control of health care costs, and the foundations of public health. Egalitarian theories of justice in health cannot make sense of the depth and pervasiveness of state involvement in health and health care; only a theory rooted in the need to correct market failure can. (shrink)

I defend a one category ontology: an ontology that denies that we need more than one fundamental category to support the ontological structure of the world. Categorical fundamentality is understood in terms of the metaphysically prior, as that in which everything else in the world consists. One category ontologies are deeply appealing, because their ontological simplicity gives them an unmatched elegance and spareness. I’m a fan of a one category ontology that collapses the distinction between particular and property, replacing it (...) with a single fundamental category of intrinsic characters or qualities. We may describe the qualities as qualitative charactersor as modes, perhaps on the model of Aristotelian qualitative (nonsubstantial) kinds, and I will use the term “properties” interchangeably with “qualities”. The qualities are repeatable and reasonably sparse, although, as I discuss in section 2.6, there are empirical reasons that may suggest, depending on one’s preferred fundamental physical theory, that they include irreducibly intensive qualities. There are no uninstantiated qualities. I also assume that the fundamental qualitative natures are intrinsic, although physics may ultimately suggest that some of them are extrinsic. On my view, matter, concrete objects, abstract objects, and perhaps even spacetime are constructed from mereological fusions of qualities, so the world is simply a vast mixture of qualities, including polyadic properties (i.e., relations). This means that everything there is, including concrete objects like persons or stars, is a quality, a qualitative fusion, or a portion of the extended qualitative fusion that is the worldwhole. I call my view mereological bundle theory. (shrink)

According to a rights forfeiture theory of punishment, liability to punishment hinges upon the notion that criminals forfeit their rights against hard treatment. In this paper, I assume the success of rights forfeiture theory in establishing the permissibility of punishment but aim to develop the view by considering how forfeited rights might be reclaimed. Built into the very notion of proportionate punishment is the idea that forfeited rights can be recovered. The interesting question is whether punishment is the sole means (...) for reclaiming forfeited rights. I argue for a pluralistic theory of rights reclamation, according to which, there are multiple ways by which a wrongdoer can recapture her forfeited rights. In particular, I argue that offering remorseful compensation is a valid means by which a wrongdoer might partially, or fully, reclaim her right against punishment. (shrink)

BACKGROUND Patients with chronic pain face significant barriers in finding clinicians to manage long-term opioid therapy (LTOT). For patients on LTOT, it is increasingly common to have them sign opioid treatment agreements (OTAs). OTAs enumerate the risks of opioids, as informed consent documents would, but also the requirements that patients must meet to receive LTOT. While there has been an ongoing scholarly discussion about the practical and ethical implications of OTA use in the abstract, little is known about how clinicians (...) use them and if OTAs themselves modify clinician prescribing practices. OBJECTIVE To determine how clinicians use OTAs and the potential impacts of OTAs on opioid prescribing. DESIGN We conducted qualitative analysis of four focus groups of clinicians from a large Midwestern academic medical center. Groups were organized according to self-identified prescribing patterns: two groups for clinicians who identified as prescribers of LTOT, and two who did not. PARTICIPANTS 17 clinicians from General Internal Medicine, Family Medicine, and Palliative Care were recruited using purposive, convenience sampling. APPROACH Discussions were recorded, transcribed, and analyzed for themes using reflexive thematic analysis by a multidisciplinary team. KEY RESULTS Our analysis identified three main themes: (1) OTAs did not influence clinicians’ decisions whether to use LTOT generally but did shape clinical decision-making for individual patients; (2) clinicians feel OTAs intensify the power they have over patients, though this was not uniformly judged as harmful; (3) there is a potential misalignment between the intended purposes of OTAs and their implementation. CONCLUSION This study reveals a complicated relationship between OTAs and access to pain management. While OTAs seem not to impact the clinicians’ decisions about whether to use LTOT generally, they do sometimes influence prescribing decisions for individual patients. Clinicians shared complex views about OTAs’ purposes, which shows the need for more clarity about how OTAs could be used to promote shared decision-making, joint accountability, informed consent, and patient education. (shrink)

It seems natural to choose whether to have a child by reflecting on what it would be like to actually have a child. I argue that this natural approach fails. If you choose to become a parent, and your choice is based on projections about what you think it would be like for you to have a child, your choice is not rational. If you choose to remain childless, and your choice is based upon projections about what you think it (...) would be like for you to have a child, your choice is not rational. This suggests we should reject our ordinary conception of how to make this life-changing decision, and raises general questions about how to rationally approach important life choices. (shrink)

Motivated ignorance is an incentivized absence of knowledge that arises in circumstances of unequal power relations, a self-protective non-knowing which frees individuals from having to reflect on the privileges they have in virtue of membership in a dominant social group. In philosophical discussions, the term “motivated ignorance” gets used interchangeably with “willful ignorance.” In the first half of this paper, using Charles Mills’ (2007) white ignorance as the defining case, I argue that this is a mistake. A significant swath of (...) cases of motivated ignorance are non-willful, or deep, following Rik Peels (2010). But in all cases, benefits accrued to some in virtue of their social position are gained and maintained at the expense of harms to others. In the second half of this paper, I argue that these harms are what ground attributions of culpability in cases of motivated ignorance and drive the normative requirement that the subject know better, so long as the facts in question are ordinarily and easily knowable (in a sense to be specified). Willfulness is not a necessary condition for culpability, even if it is a sufficient one. (shrink)

The tripartite account of propositional, fallibilist knowledge that p as justified true belief can become adequate only if it can solve the Gettier Problem. However, the latter can be solved only if the problem of a successful coordination of the resources (at least truth and justification) necessary and sufficient to deliver propositional, fallibilist knowledge that p can be solved. In this paper, the coordination problem is proved to be insolvable by showing that it is equivalent to the ''''coordinated attack'''' problem, (...) which is demonstrably insolvable in epistemic logic. It follows that the tripartite account is not merely inadequate as it stands, as proved by Gettier-type counterexamples, but demonstrably irreparable in principle, so that efforts to improve it can never succeed. (shrink)

The question I want to explore is whether experience supports an antireductionist ontology of time, that is, whether we should take it to support an ontology that includes a primitive, monadic property of nowness responsible for the special feel of events in the present, and a relation of passage that events instantiate in virtue of literally passing from the future, to the present, and then into the past.

Philosophical discussions of species have focused on multicellular, sexual animals and have often neglected to consider unicellular organisms like bacteria. This article begins to fill this gap by considering what species concepts, if any, apply neatly to the bacterial world. First, I argue that the biological species concept cannot be applied to bacteria because of the variable rates of genetic transfer between populations, depending in part on which gene type is prioritized. Second, I present a critique of phylogenetic bacterial species, (...) arguing that phylogenetic bacterial classification requires a questionable metaphysical commitment to the existence of essential genes. I conclude by considering how microbiologists have dealt with these biological complexities by using more pragmatic and not exclusively evolutionary accounts of species. I argue that this pragmatism is not borne of laziness but rather of the substantial conceptual problems in classifying bacteria based on any evolutionary standard. (shrink)

Galileo’s Error is a superlative work of public philosophy, particularly as a way of introducing modern academic panpsychism to a broader audience. In this commentary, I reflect on an issue that is prominent, though often with different background concerns, in both academic and popular discourse: what it means to be ‘scientific’ or ‘unscientific’. Panpsychism is not itself a scientific hypothesis, but neither is it (as critics sometimes claim) in conflict with science. Indeed, Goff argues, and I agree, that panpsychism is (...) an eminently scientific worldview, in the sense of a way of viewing reality that accords with and embraces what science reveals. But what exactly it means to ‘accord with and embrace’ science is disputed; this paper tries to untangle some of the threads. (shrink)

Commentary on Walsh, E. 2020. Cognitive transformation, dementia, and the moral weight of advance directives. The American Journal of Bioethics. 20(8): 54–64.

The role of evolutionary theory at the origin of life is an extensively debated topic. The origin and early development of life is usually separated into a prebiotic phase and a protocellular phase, ultimately leading to the Last Universal Common Ancestor. Most likely, the Last Universal Common Ancestor was subject to Darwinian evolution, but the question remains to what extent Darwinian evolution applies to the prebiotic and protocellular phases. In this review, we reflect on the current status of evolutionary theory (...) in origins of life research by bringing together philosophy of science, evolutionary biology, and empirical research in the origins field. We explore the various ways in which evolutionary theory has been extended beyond biology; we look at how these extensions apply to the prebiotic development of (proto)metabolism; and we investigate how the terminology from evolutionary theory is currently being employed in state-of-the-art origins of life research. In doing so, we identify some of the current obstacles to an evolutionary account of the origins of life, as well as open up new avenues of research. (shrink)

The United States carceral system, as currently designed and implemented, is widely considered to be an immoral and inhumane system of criminal punishment. There are a number of pressing issues related to this topic, but in this essay, I will focus upon the problem of prison violence. Inadequate supervision has resulted in unsafe prison conditions where inmates are regularly threatened with rape, assault, and other forms of physical violence. Such callous disregard and exposure to unreasonable risk constitutes a severe violation (...) of the rights of prisoners by the state. While there have been numerous legal, political, and activist efforts to draw attention to this issue—with the goal of reforming and making prisons safer—my goal is different. I argue that inmates who are victims of prison violence should have their sentences automatically reduced. Two distinct arguments are advanced in support of this claim. First, I argue that acts of prison violence are a sort of state-mediated harm which can thus be appropriately described as punishment-constituting. Second, and more straightforwardly, I argue that the compensation owed to prisoners who are victims of prison violence may naturally take the form of a reduced sentence. (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)

I argue that we can understand the de se by employing the subjective mode of presentation or, if one’s ontology permits it, by defending an abundant ontology of perspectival personal properties or facts. I do this in the context of a discussion of Cappelen and Dever’s recent criticisms of the de se. Then, I discuss the distinctive role of the first personal perspective in discussions about empathy, rational deference, and self-understanding, and develop a way to frame the problem of lacking (...) prospective access to your future self as a problem with your capacity to imaginatively empathize with your future selves. (shrink)