This article connects value-sensitive design to Gibson’s affordance theory: the view that we perceive in terms of the ease or difficulty with which we can negotiate space. Gibson’s ideas offer a nonsubjectivist way of grasping culturally relative values, out of which we develop a concept of political affordances, here understood as openings or closures for social action, often implicit. Political affordances are equally about environments and capacities to act in them. Capacities and hence the severity of affordances vary with age, (...) health, social status and more. This suggests settings are selectively permeable, or what postphenomenologists call multistable. Multistable settings are such that a single physical location shows up differently – as welcoming or hostile – depending on how individuals can act on it. In egregious cases, authoritarian governments redesign politically imbued spaces to psychologically cordon both them and the ideologies they represent. Selective permeability is also orchestrated according to business interests, which is symptomatic of commercial imperatives increasingly dictating what counts as moral and political goods. (shrink)

In this article I develop Heidegger's phenomenology of poetry, showing that it may provide grounds for rejecting claims that he lapses into linguistic idealism. Proceeding via an analysis of the three concepts of language operative in the philosopher's work, I demonstrate how poetic language challenges language's designative and world-disclosive functions. The experience with poetic language, which disrupts Dasein's absorption by emerging out of equipmentality in the mode of the broken tool, brings Dasein to wonder at the world's existence in such (...) a way that doubt about its reality cannot enter the picture. (shrink)

There is congruence between Nietzsche’s philosophy of life and the biopolitical philosophy of Giorgio Agamben. For both philosophers the human animal possesses a divided relationship to its being alive. For both philosophers this division is of a political nature, such that membership in political community as we know it is conditional on the human animal’s alienation from its biological being. Both philosophers are also concerned with the possibility of transformation and, because of the connection they establish between politics and animality, (...) link this possibility to a change in the relationship between humans and their being alive. Yet both philosophers end up with an entirely different understanding of the nature of this change, and of its potential scope. This paper is an attempt at clarifying this disagreement between Nietzsche and Agamben, and with using it to come to a better understanding of the latter’s political ontology. It presents a reading of Kafka’s “The Burrow” in an attempt to show how Agamben’s concept of the anthropological machine challenges the Nietzschean program of the affirmation of life as will to power. (shrink)

To evaluate the overall good/welfare of any action, policy or institutional choice we need some way of comparing the benefits and losses to those affected: we need to make interpersonal comparisons of the good/welfare. Yet sceptics have worried either: that such comparisons are impossible as they involve an impossible introspection across individuals, getting ‘into their minds’; that they are indeterminate as individual-level information is compatible with a range of welfare numbers; or that they are metaphysically mysterious as they assume the (...) existence either of a social mind or of absolute levels of welfare when no such things exist. This article argues that such scepticism can potentially be addressed if we view the problem of interpersonal comparisons as fundamentally an epistemic problem – that is, as a problem of forming justified beliefs about the overall good based on evidence of the individual good. (shrink)

The kind of empathy that is communicated through expressions like “I feel your pain” or “I share your sadness” is important, but peculiar. For it seems to require something perplexing and elusive: sharing another’s experience. It’s not clear how this is possible. We each experience the world from our own point of view, which no one else occupies. It’s also unclear exactly why it is so important that we share others' pains. If you are in pain, then why should it (...) matter, and be a good thing, that I am also in the same pain? Our goal in this paper is to address these questions. Specifically, our goal is to clarify how empathy, in the regimented sense of sharing another’s pain, is possible and why it is important. Central to our account is the concept of being acquainted with—that is, directly aware of—pain. When I feel my own pain, and am acquainted with it, I want the pain to stop, and I’m moved—sometimes compelled—to stop it. My acquaintance with the pain is what reveals that it is no good, to be gotten rid of, and to be avoided in the future. Acquaintance also appears to be implicated in our understanding of, and motivation to relieve, others’ pains. When I say “I feel your pain” I express an awareness of your pain, a direct appreciation of its noxious qualities, and, as with my own pain, an understanding of why it ought to be eased. Explaining how empathy is both possible and important therefore involves clarifying the nature of acquaintance: its limits, epistemic role, and motivational significance. What our analysis reveals is that agents have both epistemic and moral reasons to share other people’s pain because pain-sharing is the source of a species of character-building knowledge that we have no other way of accessing except through direct acquaintance with pain. (shrink)

In this paper I examine the question of when human life begins from a neo-Aristotelian perspective. In my view, the basic principles of Aristotle’s metaphysics inform an account of human life (and the human person) that offers the best available explanation of the available phenomena. This account – the substance account of the human person – can fully incorporate the contemporary findings of empirical embryology, while also recognizing the essential uniqueness of rational human nature.

In recent years, scholars have increasingly paid attention to the philosophy of Josiah Royce. Long lost in the shadow of fellow classical American figures, Royce’s philosophy has enjoyed a renascence, with a spate of publications in a variety of venues studying and applying his thought.1 Like his philosophical brethren, Royce wrote on a wide variety of subjects, his discussions underpinned by a smattering of influences. Much has been remarked of the various Western sources that made an impression on Royce’s thought, (...) but comparatively little has been said of his indebtedness to Eastern sources. Kurt Leidecker’s Josiah Royce and Indian Thought2 and Frank M... (shrink)

Whipple disease is a rare, infectious, disease first described from a single case by Whipple in 1907. As well as characterising the clinical and pathological features of the condition, Whipple made two suggestions regarding its aetiology. These were either than the disease was caused by an infectious agent, or that it was of metabolic origin. As the disease is now thought to be caused by infection with the bacterium Tropheryma whipplei, historical reviews of the history of the disease typically mention (...) only the first of these suggestions. In this paper, we therefore revisit Whipple’s other theory. We argue that a diverse and often successful research programme was developed around this mechanism of disease causation which gave rise to many useful findings on the condition. In the later parts of this article, we then turn to discuss the surprising neglect of this period of Whipple disease research in the current literature, and conclude by offering a brief reconstruction of this early history suitable for use in a technical context. (shrink)

[This is an edited version of a keynote talk at the conference on Neural Information Processing Systems (NeurIPS) on November 28, 2022, with some minor additions and subtractions.] -/- There has recently been widespread discussion of whether large language models might be sentient or conscious. Should we take this idea seriously? I will break down the strongest reasons for and against. Given mainstream assumptions in the science of consciousness, there are significant obstacles to consciousness in current models: for example, their (...) lack of recurrent processing, a global workspace, and unified agency. At the same time, it is quite possible that these obstacles will be overcome in the next decade or so. I conclude that while it is somewhat unlikely that current large language models are conscious, we should take seriously the possibility that successors to large language models may be conscious in the not-too-distant future. (shrink)

What are the philosophical views of professional philosophers, and how do these views change over time? The 2020 PhilPapers Survey surveyed around 2000 philosophers on 100 philosophical questions. The results provide a snapshot of the state of some central debates in philosophy, reveal correlations and demographic effects involving philosophers' views, and reveal some changes in philosophers' views over the last decade.

What are the philosophical views of contemporary professional philosophers? We surveyed many professional philosophers in order to help determine their views on 30 central philosophical issues. This article documents the results. It also reveals correlations among philosophical views and between these views and factors such as age, gender, and nationality. A factor analysis suggests that an individual's views on these issues factor into a few underlying components that predict much of the variation in those views. The results of a metasurvey (...) also suggest that many of the results of the survey are surprising: philosophers as a whole have quite inaccurate beliefs about the distribution of philosophical views in the profession. (shrink)

There is a difference between merely thinking that P and really grasping that P. For example, Jackson's (1982) black-and-white Mary cannot (before leaving her black-and-white room) fully grasp what it means to say that fire engines are red, but she can perfectly well entertain the thought that fire engines are red. The contrast between merely thinking and grasping is especially salient in the context of certain moral decisions. For example, an individual who grasps the plight of starving children thanks to (...) evocative images seems much more likely to donate for the children's benefit than someone who is merely told about their plight. This paper offers a phenomenal account of grasping according to which grasping a content (whether a proposition or concept) consists in one's thoughts about the content being constituted by phenomenal experiences of constituents of the content. This account improves on earlier phenomenal accounts of grasping (Bourget 2017a, 2018) by allowing for partial grasping and generalizing to concepts. The paper also addresses objections to phenomenal accounts of grasping, including the objection that recent developments in AI technology show that consciousness is irrelevant to grasping and understanding. (shrink)

Inspired by Rudolf Carnap's Der Logische Aufbau Der Welt, David J. Chalmers argues that the world can be constructed from a few basic elements. He develops a scrutability thesis saying that all truths about the world can be derived from basic truths and ideal reasoning. This thesis leads to many philosophical consequences: a broadly Fregean approach to meaning, an internalist approach to the contents of thought, and a reply to W. V. Quine's arguments against the analytic and the a (...) priori. Chalmers also uses scrutability to analyze the unity of science, to defend a conceptual approach to metaphysics, and to mount a structuralist response to skepticism. Based on the 2010 John Locke lectures, Constructing the World opens up debate on central philosophical issues involving language, consciousness, knowledge, and reality. This major work by a leading philosopher will appeal to philosophers in all areas. This entry contains uncorrected proofs of front matter, chapter 1, and first excursus. (shrink)

Does consciousness collapse the quantum wave function? This idea was taken seriously by John von Neumann and Eugene Wigner but is now widely dismissed. We develop the idea by combining a mathematical theory of consciousness (integrated information theory) with an account of quantum collapse dynamics (continuous spontaneous localization). Simple versions of the theory are falsified by the quantum Zeno effect, but more complex versions remain compatible with empirical evidence. In principle, versions of the theory can be tested by experiments with (...) quantum computers. The upshot is not that consciousness-collapse interpretations are clearly correct, but that there is a research program here worth exploring. (shrink)

The unpleasantness of pain motivates action. Hence many philosophers have doubted that it can be accounted for purely in terms of pain’s possession of indicative representational content. Instead, they have explained it in terms of subjects’ inclinations to stop their pains, or in terms of pain’s imperative content. I claim that such “noncognitivist” accounts fail to accommodate unpleasant pain’s reason-giving force. What is needed, I argue, is a view on which pains are unpleasant, motivate, and provide reasons in virtue of (...) possessing content that is indeed indicative, but also, crucially, evaluative. (shrink)

Analogien lassen sich aus unserem vernünftigen Nachdenken und Argumentieren kaum wegdenken. Ganz zurecht stellen sie eines der klassischen Themen der Argumentationstheorie dar. Doch wie genau sollte die argumentative Rolle von Analogien in Argumentrekonstruktionen dargestellt werden? Das ist die Leitfrage dieses Beitrags. Zunächst wird mit Michael Dummetts Schach-Analogie ein prominentes Beispiel dargestellt und eine genauere Charakterisierung des Analogiebegriffs vorgeschlagen. Danach wird die gängigste Rekonstruktionsform von Analogien diskutiert, das Analogieargument, und in einigen Punkten verfeinert. Vor diesem Hintergrund schlägt der Beitrag eine zweite, (...) alternative Rekonstruktionsform vor, in der zwei analoge Argumente an die Stelle eines einzelnen Analogiearguments treten. Nachdem diese beiden Rekonstruktionsformen an einem weiteren berühmten Beispiel vorgeführt wurden, an Peter Singers Teich-Analogie, wird diskutiert, wie sich diese beiden Varianten gegenseitig ergänzen und welche Stärken und Schwächen sie haben. Es zeigt sich, dass Analogien nicht nur in Form von Analogieargumenten einen zentralen Topos eines Einzelarguments darstellen. Darüber hinaus kann die Untersuchung analoger Argumente bereits selbst als argumentationstheoretische Topik verstanden werden. (shrink)

Pain asymbolia is a rare condition caused by brain damage, usually in adulthood. Asymbolics feel pain but appear indifferent to it, and indifferent also to visual and verbal threats. How should we make sense of this? Nikola Grahek thinks asymbolics’ pains are abnormal, lacking a component that make normal pains unpleasant and motivating. Colin Klein thinks that what is abnormal is not asymbolics’ pains, but asymbolics: they have a psychological deficit making them unresponsive to unpleasant pain. I argue that an (...) illuminating account requires elements of both views. Asymbolic pains are indeed abnormal, but they are abnormal because asymbolics are. I agree with Klein that asymbolics are incapable of caring about their bodily integrity; but I argue against him that, if this is to explain not only their indifference to visual and verbal threat, but also their indifference to pain, we must do the following: (i) take asymbolics’ lack of bodily care not as an alternative to, but as an explanation of their pains’ missing a component, and (ii) claim that the missing component consists in evaluative content. Asymbolia, I conclude, reveals not only that unpleasant pain is composite, but that its ‘hedomotive component’ is evaluative. (shrink)

How should one react when one has a belief, but knows that other people—who have roughly the same evidence as one has, and seem roughly as likely to react to it correctly—disagree? This paper argues that the disagreement of other competent inquirers often requires one to be much less confident in one’s opinions than one would otherwise be.

How should one react when one has a belief, but knows that other people—who have roughly the same evidence as one has, and seem roughly as likely to react to it correctly—disagree? This paper argues that the disagreement of other competent inquirers often requires one to be much less confident in one’s opinions than one would otherwise be.

Conceptual engineering is the design, implementation, and evaluation of concepts. Conceptual engineering includes or should include de novo conceptual engineering (designing a new concept) as well as conceptual re-engineering (fixing an old concept). It should also include heteronymous (different-word) as well as homonymous (same-word) conceptual engineering. I discuss the importance and the difficulty of these sorts of conceptual engineering in philosophy and elsewhere.

Cartesian arguments for global skepticism about the external world start from the premise that we cannot know that we are not in a Cartesian scenario such as an evil-demon scenario, and infer that because most of our empirical beliefs are false in such a scenario, these beliefs do not constitute knowledge. Veridicalist responses to global skepticism respond that arguments fail because in Cartesian scenarios, many or most of our empirical beliefs are true. Some veridicalist responses have been motivated using verificationism, (...) externalism, and coherentism. I argue that a more powerful veridicalist response to global skepticism can be motivated by structuralism, on which physical entities are understood as those that play a certain structural role. I develop the structuralist response and address objections. (shrink)

This paper responds to comments and criticisms by Stefan Brandt and Eva-Maria Jung, directed at the book "Know-how as Competence. A Rylean Responsibilist Account".

In the pure powers ontology (PPO), basic physical properties have wholly dispositional essences. PPO has clear advantages over categoricalist ontologies, which suffer from familiar epistemological and metaphysical problems. However, opponents argue that because it contains no qualitative properties, PPO lacks the resources to individuate powers, and generates a regress. The challenge for those who take such arguments seriously is to introduce qualitative properties without reintroducing the problems that PPO was meant to solve. In this paper, I distinguish the core claim (...) of PPO: (i) basic physical properties have dispositional essences, from a hitherto unnoticed assumption: (ii) the dispositional essences of basic physical properties exclusively involve type-causal relations to other basic physical properties. I reject (ii), making room for a structuralist ontology in which all basic physical properties are pure powers, individuated by their places in a causal structure that includes not only other powers, but also physically realized qualitative properties such as shapes, patterns and structures. Such qualities individuate pure powers in the way that non-mental input and output properties individuate realized mental properties in functionalist theories of mind, except that here it is basic physical powers that are individuated by relations to realized non-powers. I distinguish one Platonic and two Aristotelian version of this theory, and argue that the Aristotelian versions require that grounding is not always a relative fundamentality relation, because the powers ground the qualities that individuate them. By considering ontic structural realism, I argue that symmetric grounding is the best way to make sense of relational individuation in structuralist ontologies, and is therefore no additional commitment of the one proposed here. (shrink)

Does the capacity to think require the capacity to sense? A lively debate on this topic runs throughout the history of philosophy and now animates discussions of artificial intelligence. Many have argued that AI systems such as large language models cannot think and understand if they lack sensory grounding. I argue that thought does not require sensory grounding: there can be pure thinkers who can think without any sensory capacities. As a result, the absence of sensory grounding does not entail (...) that large language models cannot think or understand. I also consider to what extent quasi-sensory grounding can at least boost the performance of a language model. (shrink)

Several different quantum gravity research programmes suggest, for various reasons, that spacetime is not part of the fundamental ontology of physics. This gives rise to the problem of empirical coherence: if fundamental physical entities do not occupy spacetime or instantiate spatiotemporal properties, how can fundamental theories concerning those entities be justified by observation of spatiotemporally located things like meters, pointers and dials? I frame the problem of empirical coherence in terms of entailment: how could a non-spatiotemporal fundamental theory entail spatiotemporal (...) evidence propositions? Solutions to this puzzle can be classified as realist or antirealist, depending on whether or not they posit a non-fundamental spacetime structure grounded in or caused by the fundamental structure. These approaches place different constraints on our everyday concepts of space and time. Applying lessons from the philosophy of mind, I argue that only realism is both conceptually plausible and suitable for addressing the problem at hand. I suggest a role functionalist version of realism, which is consistent with both grounding and causation, and according to which our everyday concepts reveal something of the true nature of emergent spacetime. (shrink)

Responding rationally to the information that others disagree with one’s beliefs requires assessing the epistemic credentials of the opposing beliefs. Conciliatory accounts of disagreement flow in part from holding that these assessments must be independent from one’s own initial reasoning on the disputed matter. I argue that this claim, properly understood, does not have the untoward consequences some have worried about. Moreover, some of the difficulties it does engender must be faced by many less conciliatory accounts of disagreement.

Hylomorphists hold that substances are, in some sense, composites of matter and form. The form of a substance is typically taken to play a fundamental role in determining the unity or identity of the whole. Staunch hylomorphists think that this role is of a kind that precludes the ontological reduction of form to the physical and thus take their position to be inconsistent with physicalism. Forms, according to staunch hylomorphism, play a fundamental role in grounding their bearers’ proper parts and (...) that, it seems, rules out the physical grounding of form itself. I shall develop a physicalist version of hylomorphism that treats form as geometric structure and which, I shall argue, entails many of the central theses endorsed by staunch hylomorphists. Based on Shoemaker’s notion of conditional powers, I shall argue that the geometric structures of complex wholes are the conditions on at least some of the conditional powers of their bearers’ proper parts, transforming those powers into powers simpliciter. Thus, forms play a fundamental role in the dynamical evolution of the physical world, but without bestowing causal powers themselves and hence without violating the causal closure of the physical domain. If a substance’s proper parts are taken to be individuated by their powers simpliciter, then they derive their identities from their places in the substantial whole, which thus determines the identities of its proper parts without changing their intrinsic natures. (shrink)

How much should your confidence in your beliefs be shaken when you learn that others – perhaps 'epistemic peers' who seem as well-qualified as you are – hold beliefs contrary to yours? This article describes motivations that push different philosophers towards opposite answers to this question. It identifies a key theoretical principle that divides current writers on the epistemology of disagreement. It then examines arguments bearing on that principle, and on the wider issue. It ends by describing some outstanding questions (...) that thinking about this issue raises. (shrink)

This is a collective study of the epistemic significance of disagreement: twelve contributors explore rival responses to the problems that it raises for philosophy. They develop our understanding of epistemic phenomena that are central to any thoughtful engagement with others' beliefs.

A natural view of testimony holds that a source's statements provide one with evidence about what the source believes, which in turn provides one with evidence about what is true. But some theorists have gone further and developed a broadly analogous view of memory. According to this view, which this essay calls the “diary model,” one's memory ordinarily serves as a means for one's present self to gain evidence about one's past judgments, and in turn about the truth. This essay (...) rejects the diary model's analogy between memory and testimony from one's former self, arguing first that memory and a diary differ with respect to their psychological roles, and second that this psychological difference underwrites important downstream epistemic differences. The resulting view stands opposed to prominent discussions of memory and testimony, which either, like the diary model, treat memory by analogy to what we naively wish to say about testimony, or which instead attempt to extend to testimony the epistemically preservative role of memory. (shrink)

Do psychological traits predict philosophical views? We administered the PhilPapers Survey, created by David Bourget and David Chalmers, which consists of 30 views on central philosophical topics (e.g., epistemology, ethics, metaphysics, philosophy of mind, and philosophy of language) to a sample of professional philosophers (N = 314). We extended the PhilPapers survey to measure a number of psychological traits, such as personality, numeracy, well-being, lifestyle, and life experiences. We also included non-technical ‘translations’ of these views for eventual use (...) in other populations. We found limited to no support for the notion that personality or demographics predict philosophical views. We did, however, find that some psychological traits were predictive of philosophical views, even after strict correction for multiple comparisons. Findings include: higher interest in numeracy predicted physicalism, naturalism, and consequentialism; lower levels of well-being and higher levels of mental illness predicted hard determinism; using substances such as psychedelics and marijuana predicted non-realist and subjectivist views of morality and aesthetics; having had a transformative or self-transcendent experience predicted theism and idealism. We discuss whether or not these empirical results have philosophical implications, while noting that 68% of our sample of professional philosophers indicated that such findings would indeed have philosophical value. (shrink)

This dialogue explores the question of whether intentionality—the “ofness”, “aboutness”, or “directedness” of mental states—is a relation. We explore three views: the Naive View, on which intentionality is a relation to ordinary, everyday objects, facts, and other such items; the Abstract Contents View, on which intentionality is a relation to mind-independent abstract entities that are our contents; and the Aspect View, on which intentionality is a matter of having intentional states with particular (non-relational) aspects that are our contents. We consider (...) the challenges facing these views, which include empirical challenges in accounting for all the contents our intentional states can represent, metaphysical challenges in making sense of how contents can be entertained or otherwise represented by us and how they can play a psychological role in the mental economy, and challenges in making sense of how intentionality connects us to the world—if at all. Along the way, we consider the question of how consciousness is related to intentionality and how this affects one’s choice of views. (shrink)

The causal closure of the physical poses a familiar causal exclusion problem for the special sciences that stems from the idea that if closure is true, then fundamental physical properties do all the causal work involved in bringing about physical effects. In this paper I aim to show that the strongest causal closure principle that is not ruled out by some simple physics in fact allows for a certain kind of downward causation, which in turn makes room for robust special (...) science autonomy. I focus on the case of vector composition, arguing that it involves irreducibly multilevel causation. To give a complete causal explanation of what goes on in cases that involve the effects of multiple forces, we need to appeal not only to the fundamental properties that generate those forces, but also to geometric properties that determine how multiple vectors compose. However, if all the causal work involved in such cases were due to fundamental physical properties, there would be a one-level explanation available. Hence, I argue, it cannot be the case that fundamental physical properties do all the causal work. The extra causal work, I suggest, comes from the fact that the causal powers bestowed by fundamental physical properties have irreducibly geometric manifestation conditions. I defend the resulting form of downward causation as a solution to the problem of special science autonomy, and discuss two potential accounts of its source, in terms of the debate between kinematic and dynamic theories of the origins of spacetime symmetries. (shrink)

This paper critically examines currently influential transparency accounts of our knowledge of our own beliefs that say that self-ascriptions of belief typically are arrived at by “looking outward” onto the world. For example, one version of the transparency account says that one self-ascribes beliefs via an inference from a premise to the conclusion that one believes that premise. This rule of inference reliably yields accurate self-ascriptions because you cannot infer a conclusion from a premise without believing the premise, and so (...) you cannot infer from a premise that you believe the premise unless you do believe it. I argue that this procedure cannot be a source of justification, however, because one can be justified in inferring from p that q only if p amounts to strong evidence that q is true. This is incompatible with the transparency account because p often is not very strong evidence that you believe that p. For example, unless you are a weather expert, the fact that it will rain is not very strong evidence that you believe it will rain. After showing how this intuitive problem can be made precise, I conclude with a broader lesson about the nature of inferential justification: that beliefs, when justified, must be underwritten by beliefs, when justified, must be underwritten by evidential relationships between the facts or propositions which those beliefs represent. (shrink)

It has often been noticed that conciliatory views of disagreement are "self-undermining" in a certain way: advocates of such views cannot consistently maintain them when other philosophers disagree. This leads to apparent problems of instability and even inconsistency. Does self-undermining, then, show conciliationism untenable? If so, the untenablity would extend not only to almost all views of disagreement, but to a wide range of other views supporting what one might call epistemic modesty: roughly, the idea that getting evidence that one (...) has made an epistemic error in arriving at one’s opinion may require adjusting that opinion. This paper argues that the phenomenon of self-undermining does not disclose any defect in views mandating epistemic modesty. Instead, it highlights an uncomfortable but natural consequence of reflecting on one's own possible epistemic imperfections, a sort of reflection that tends to cause epistemic ideals to conflict. (shrink)

According to orthodoxy, our best physical theories strongly support Eternalism over Presentism. Our goal is to argue against this consensus, by arguing that a certain overlooked aspect of our best physical theories strongly supports Presentism over Eternalism.

Rationale, Aims, and Objectives: Confidence (or belief) that a therapy is effective is essential to practicing clinical medicine. GRADE, a popular framework for developing clinical recommendations, provides a means for assigning how much confidence one should have in a therapy's effect estimate. One's level of confidence (or “degree of belief”) can also be modelled using Bayes theorem. In this paper, we look through both a GRADE and Bayesian lens to examine how one determines confidence in the effect estimate. Methods: Philosophical (...) examination. Results: The GRADE framework uses a criteria‐based method to assign a quality of evidence level. The criteria pertain mostly to considerations of methodological rigour, derived from a modified evidence‐based medicine evidence hierarchy. The four levels of quality relate to the level of confidence one should have in the effect estimate. The Bayesian framework is not bound by a predetermined set of criteria. Bayes theorem shows how a rational agent adjusts confidence (ie, degree of belief) in the effect estimate on the basis of the available evidence. Such adjustments relate to the principles of incremental confirmation and evidence proportionism. Use of the Bayesian framework reveals some potential pitfalls in GRADE's criteria‐based thinking on confidence that are out of step with our intuitions on evidence. Conclusions: A rational thinker uses all available evidence to formulate beliefs. The GRADE criteria seem to suggest that we discard some of that information when other, more favoured information (eg, derived from clinical trials) is available. The GRADE framework should strive to ensure that the whole evidence base is considered when determining confidence in the effect estimate. The incremental value of such evidence on determining confidence in the effect estimate should be assigned in a manner that is theoretically or empirically justified, such that confidence is proportional to the evidence, both for and against it. (shrink)

Translating risk estimates derived from epidemiologic study into evidence of causality for a particular patient is problematic. The difficulty of this process is not unique to the medical context; rather, courts are also challenged with the task of using risk estimates to infer evidence of cause in particular cases. Thus, an examination of how this is done in a legal context might provide insight into when and how it is appropriate to use risk information as evidence of cause in a (...) medical context. A careful study of the case of Goodman v. Viljoen, a medical malpractice suit litigated in the Ontario Superior Court of Justice in 2011, reveals different approaches to how risk information is used as or might be considered a substitute for evidence of causation, and the pitfalls associated with these approaches. Achieving statistical thresholds, specifically minimizing the probability of falsely rejecting the null hypothesis, and exceeding a relative risk of 2, plays a significant role in establishing causality of the particular in the legal setting. However, providing a reasonable explanation or establishing “biological plausibility” of the causal association also seems important, and (to some) may even take precedent over statistical thresholds for a given context. (shrink)

In this paper, we argue that the All Affected Principle generates a puzzle when applied to carbon tax referendums. According to recent versions of the All Affected Principle, people should have a say in a democratic decision in positive proportion to how much the decision affects them. Plausibly, one way of being affected by a carbon tax referendum is to bear the economic burden of paying the tax. On this metric of affectedness, then, people who pollute a lot are ceteris (...) paribus more affected than people who don’t, because the former stands to pay more in carbon taxes than the latter. Consequently, people who pollute a lot receive large voting power, while people who pollute a little receive little voting power. This is a puzzling distribution of voting power for several reasons. First, it is instrumentally counterproductive if the goal is to rectify damages to the climate. Second, it introduces prudential incentives for everyone to pollute more to gain voting power. Third, the relative difference in voting power between people who pollute a lot and people who don’t is puzzling from a desert-based point of view, since the former often make a serious effort to avoid polluting, while the latter don’t. (shrink)

The evidence based medicine movement has championed the need for objective and transparent methods of clinical guideline development. The Grades of Recommendation, Assessment, Development, and Evaluation (GRADE) framework was developed for that purpose. Central to this framework is criteria for assessing the quality of evidence from clinical studies and the impact that body of evidence should have on our confidence in the clinical effectiveness of a therapy under examination. Grades of Recommendation, Assessment, Development, and Evaluation has been adopted by a (...) number of professional medical societies and organizations as a means for orienting the development of clinical guidelines. As a result, the method of GRADE has implications on how health care is delivered and patient outcomes. In this paper, we reveal several issues with the underlying logic of GRADE that warrant further discussion. First, the definitions of the “grades of evidence” provided by GRADE, while explicit, are functionally vague. Second, the “criteria for assigning grade of evidence” is seemingly arbitrary and arguably logically incoherent. Finally, the GRADE method is unclear on how to integrate evidence grades with other important factors, such as patient preferences, and trade‐offs between costs, benefits, and harms when proposing a clinical practice recommendation. Much of the GRADE method requires judgement on the part of the user, making it unclear as to how the framework reduces bias in recommendations or makes them more transparent—both goals of the programme. It is our view that the issues presented in this paper undermine GRADE's justificatory scheme, thereby limiting the usefulness of GRADE as a tool for developing clinical recommendations. (shrink)