Christopher Bennett has argued that state support of conjugal relationships can be founded on the unique contribution such relationships make to the autonomy of their participants by providing them with various forms of recognition and support unavailable elsewhere. I argue that, in part because a long history of interaction between two people who need each other’s validation tends to produce less meaningful responses over time, long-term conjugal relationships are unlikely to provide autonomy-enhancing support to their participants. To the extent that (...) intimate relationships can provide a unique form of reciprocal support, Bennett fails to show that couples have an advantage over multiple-partner arrangements in doing so. (shrink)

Our concept of choice is integral to the way we understand others and ourselves, especially when considering ourselves as free and responsible agents. Despite the importance of this concept, there has been little empirical work on it. In this paper we report four experiments that provide evidence for two concepts of choice—namely, a concept of choice that is operative in the phrase having a choice and another that is operative in the phrase making a choice. The experiments indicate that the (...) two concepts of choice can be differentiated from each other on the basis of the kind of alternatives to which each is sensitive. The results indicate that the folk concept of choice is more nuanced than has been assumed. This new, empirically informed understanding of the folk concept of choice has important implications for debates concerning free will, responsibility, and other debates spanning psychology and philosophy. -/- Specifically, 'having a choice' appears to require genuinely open alternatives, or alternative possibilities that are actually realizable, while 'making a choice' appears to only require psychological open alternatives, or the ability to consider alternatives independent of whether these alternatives are actually realizable. We argue that these findings are relevant to the free will debate because choice is central to the folk concept of free will and many philosophical analysis of free will. The kinds of alternatives required for having a choice appear to be incompatibilist in nature, while the kinds of alternatives required for making a choice appear to be compatibilist in nature. If free will requires having choices, then this is perhaps evidence against compatibilism. If free will requires making choices, then this is perhaps evidence in favor of--or at least consistent with--compatibilism. (shrink)

Shared decision-making involves health professionals and patients/clients working together to achieve true person-centred health care. However, this goal is infrequently realized, and most barriers are unknown. Discussion between philosophers, clinicians, and researchers can assist in confronting the epistemic and moral basis of health care, with benefits to all. The aim of this paper is to describe what shared decision-making is, discuss its necessary conditions, and develop a definition that can be used in practice to support excellence in maternity care. Discussion (...) between the authors, with backgrounds in philosophy, clinical maternity care, health care management, and maternity care research, assisted the team to confront established norms in maternity care and challenge the epistemic and moral basis of decision-making for caesarean section. The team concluded that shared decision-making must start in pregnancy and continue throughout labour and birth, with equality in discourse facilitated by the clinician. Clinicians have a duty of care for the adequacy of women's knowledge, which can only be fulfilled when relevant knowledge is offered freely and when personal beliefs and biases that may impinge on decision-making (defeaters) are disclosed. Informed consent is not shared decision-making. Key barriers include existing cultural norms of “the doctor knows best” and “patient acquiescence” that prevent defeaters being acknowledged and discussed and can lead to legal challenges, overuse of medical intervention and, in some areas, obstetric violence. Shared decision-making in maternity care can thus be defined as an enquiry by clinician and expectant woman aimed at deciding upon a course of care or none, which takes the form of a dialogue within which the clinician fulfils their duty of care to the client's knowledge by making available their complete knowledge (based on all types of evidence) and expertise, including an exposition of any relevant and recognized potential defeaters. Research to develop measurement tools is required. (shrink)

In response to the increasing need for research ethics expertise in low and middle income countries (LMICs), the NIH's Fogarty International Research Ethics Education and Curriculum Development Program has provided grants for the development of training programs in international research ethics for LMIC professionals since 2000. This collection of papers draws upon the combined expertise of Fogarty grantees, trainees, and other experts to assess the state of research ethics in LMICs, and the lessons learned over 12 years of international research (...) ethics education; to assess future needs; and to chart a way forward to meet those needs. In this introductory paper we briefly sketch the evolution of research ethics as applied to LMIC research, the underpinning and evolution of the Fogarty bioethics program, and summarize key conclusions from the other papers in the collection. (shrink)

The use of placebo controls in clinical trials remains controversial. Ethical analysis and international ethical guidance permit the use of placebo controls in randomized trials when scientifically indicated in four cases: (1) when there is no proven effective treatment for the condition under study; (2) when withholding treatment poses negligible risks to participants; (3) when there are compelling methodological reasons for using placebo, and withholding treatment does not pose a risk of serious harm to participants; and, more controversially, (4) when (...) there are compelling methodological reasons for using placebo, and the research is intended to develop interventions that can be implemented in the population from which trial participants are drawn, and the trial does not require participants to forgo treatment they would otherwise receive. The concept of methodological reasons is essential to assessing the ethics of placebo controls in these controversial last two cases. This article sets out key considerations relevant to considering whether methodological reasons for a placebo control are compelling. (shrink)

There is a general presumption that epistemology does not have anything to do with wellbeing. In this paper I challenge these assumption, by examining the aftermath of the Gettier examples, the debate between internalism and externalism and the rise of virtue epistemology. In focusing on the epistemic agent as the locus of normativity, virtue epistemology allows one to ask questions about epistemic goods and their relationship to other kinds of good, including the good of the agent. Specifically it is argued (...) that emotion has a positive role to play in epistemology, an example from Aquinas is used to illustrate this and to illustrate the different kinds of good involved in cognition. (shrink)

Aquinas’s actual response to a naturalistic challenge at ST I.2.3 is one which most naturalists would find unimpressive. However, I shall argue that there is a stronger response latent in his philosophical system. I take Quine as an example of a methodological naturalist, examine the roots of his position and look at two critical responses to his views (those of BonJour and Boghossian). If one adjusts some of the problematical aspects of their responses and establishes a hybrid position on the (...) epistemology and metaphysics of an antinaturalistic stance, it turns out to be the position Aquinas himself takes on meaning and knowledge. (shrink)

We argue that charging people to participate in research is likely to undermine the fundamental ethical bases of clinical research, especially the principles of social value, scientific validity, and fair subject selection.

Some placebo-controlled trials can continue ethically after a candidate vaccine is found to be safe and efficacious.

Stories express hypotheses, interpretations of the world that have a certain degree of probability. To demonstrate this thesis I have adopted the notion of hypothesis, in a sense very close to the Meinongian concept of assumption, and a ‘metric’ conception of the values of the truth or falsity of a proposition – as that has been proposed in several ways by Peirce, Vasil’ev and Meinong. To show the the cognitive value of literary texts, and therefore their truth value, I take (...) my move from chapter 9 of Aristotle’s Poetics, where he holds that poetry is imitative of reality, not in the sense of history – which relates what has happened – but rather, in so far as it expresses “the kinds of things that might happen, that is, that could happen because they are either probable or necessary.” The probable admits variations of degree. By means of an examination of the Meinongian concepts of assumption and objective (i.e. state of affairs), which also allow different modes of gradation, I introduce, with examples drawn from Dante’s Divine Comedy and The Description (Tradimento) by Machiavelli, a theory of degrees of truth that makes it possible to apply the concept of probability to literary as well as to historical texts. Finally, I connect the universal character of the literary text with the ontological notion of incomplete object and argue that a fictional object, as it is incomplete, is not an individual but a type. (shrink)

The author reviews the planned withdrawal of healthcare from the primary public hospital, Grady Memorial Hospital, of Atlanta, Georgia. Prior to passage of the Affordable Care Act of 2010, at least half of the patients had no public or private health insurance and their care was financially supported by State and County funding as well as supplementation from Emory University. New administration in the elected positions of the State and County and at the University reached agreement to decrease care. (...) The University President stated that the Hippocratic Oath was no longer valid for salaried physicians who must follow the direction of their business manager. The author, a tenured Professor, was forcibly transferred to the Veterans Hospital, which also was withholding standard medical care, including life-saving medications. Organizing multiple concerned organizations including members of the King Center, the Carter Center, the Open Door Community Center, Gay Rights, etc., (Grady Coalition) multiple public protests were successful in raising the necessary funds to continue adequate care at Grady and begin an investigation of the Veterans Affairs Hospital. (shrink)

It is traditionally thought that metaphorical utterances constitute a special— nonliteral—kind of departure from lexical constraints on meaning. Dan Sperber and Deirdre Wilson have been forcefully arguing against this: according to them, relevance theory’s comprehension/interpretation procedure for metaphorical utterances does not require details specifi c to metaphor (or nonliteral discourse); instead, the same type of comprehension procedure as that in place for literal utterances covers metaphors as well. One of Sperber and Wilson’s central reasons for holding this is that (...) metaphorical utterances occupy one end of a continuum that includes literal, loose and hyperbolic utterances with no sharp boundaries in between them. Call this the continuum argument about interpreting metaphors. My aim is to show that this continuum argument doesn’t work. For if it were to work, it would have an unwanted consequence: it could be converted into a continuum argument about interpreting linguistic errors, including slips of the tongue, of which malaprops are a special case. In particular, based on the premise that the literal–loose–metaphorical continuum extends to malaprops also, we could conclude that the relevance-theoretic comprehension procedure for malaprops does not require details specifi c to linguistic errors, that is, details beyond those already in place for interpreting literal utterances. Given that we have good reason to reject this conclusion, we also have good reason to rethink the conclusion of the continuum argument about interpreting metaphors and consider what additional (metaphor-specifi c) details—about the role of constraints due to what is lexically encoded by the words used—might be added to relevance-theoretic comprehension procedures. (shrink)

The purpose of this article is to show that animal rights are not necessarily at odds with the use of animals for research. If animals hold basic moral rights similar to those of humans, then we should consequently extend the ethical requirements guiding research with humans to research with animals. The article spells out how this can be done in practice by applying the seven requirements for ethical research with humans proposed by Ezekiel Emanuel, David Wendler and Christine Grady (...) to animal research. These requirements are i) social value, ii) scientific validity, iii) independent review, iv) fair subject selection, v) favorable risk-benefit ratio, vi) informed consent, and vii) respect for research subjects. In practice, this means that we must reform the practice of animal research to make it more similar to research with humans, rather than completely abolish the former. Indeed, if we banned animal research altogether, then we would also deprive animals of its potential benefits – which would be ethically problematic. (shrink)

Since at least 2008 linguists and philosophers of language have started paying more serious attention to issues concerning the meaning or use of racial epithets and slurs. In an influential article published in The Journal of Philosophy, for instance, Christopher Hom (2008) offered a semantic account of racial epithets called Combinatorial Externalism (CE) that advanced a novel argument for the exclusion of certain epithets from freedom of speech protection under the First Amendment (p. 435). Also in more recent work, “The (...) Expressive Meaning of Racial Epithets: Towards A Non-Unitary Account of Expressive Meaning,” Diane Blakemore (2013) offered an alternative pragmatic account of racial epithets rooted in Dan Sperber and Deirdre Wilson’s (1986) relevance theory. Adam Croom (2008) has also discussed epithets before in prior work, through a consideration of a paradigmatic racial epithet directed towards Native Americans, but then moved on in subsequent work to focus on developing a more nuanced account of paradigmatic slurring terms instead (Croom 2010; Croom 2011; Croom 2012; Croom 2013; Croom 2014a; Croom 2014b; Croom under review). So the purpose of this article is to return to and extend the previous account of racial epithets provided by Croom (2008) through a consideration of another paradigmatic racial epithet, but this time one directed towards Asian Americans instead of Native Americans. Here I also offer a novel suggestion for how to differentiate between epithets and slurs, offering new insight into how epithets and slurs are both similar and different. A sample list of over 100 other racial epithets that can be accounted for by the kind of analysis presented here is provided in Croom (2008, p. 44-45). (shrink)

Nel saggio proposto lo sforzo principale è quello di estrapolare dal De visione Dei un possibile portato teoretico nel quale possa emergere la modernità del Cusano in merito alla teoria della conoscenza. In particolare, benché l'analisi resti prevalentemente nel solco scavato dalla tradizione della filosofia negativa, la ricerca riconosce la venatione Sapientiae (o, appunto, ricerca dell'Infinito) quale cammino di visione-ascesi-distacco. Tale particolare formulazione nasce dal tentativo di descrivere appieno la visione Dei senza evadere la ricchezza di significati che essa assume (...) in quello specifico ordine del mondo dove il neoplatonismo ha potuto pensare al contempo: i. la visione, nella classica formulazione neoplatonica di theorìa; ii. l'ascesi, come l'ha pensata la tradizione della filosofia negativa, tramite un percorso di salita attraverso delle scale o dei gradi; iii. il distacco, in senso eckhartiano, tanto etico (Gelassenheit) quanto teoretico (Abgeschiedenheit). (shrink)