This document presents the Bonn PRINTEGER Consensus Statement: Working with Research Integrity—Guidance for research performing organisations. The aim of the statement is to complement existing instruments by focusing specifically on institutional responsibilities for strengthening integrity. It takes into account the daily challenges and organisational contexts of most researchers. The statement intends to make research integrity challenges recognisable from the work-floor perspective, providing concrete advice on organisational measures to strengthen integrity. The statement, which was concluded February 7th 2018, provides guidance on (...) the following key issues: § 1.Providing information about research integrity § 2.Providing education, training and mentoring § 3.Strengthening a research integrity culture § 4.Facilitating open dialogue § 5.Wise incentive management § 6.Implementing quality assurance procedures § 7.Improving the work environment and work satisfaction § 8.Increasing transparency of misconduct cases § 9.Opening up research § 10.Implementing safe and effective whistle-blowing channels § 11.Protecting the alleged perpetrators § 12.Establishing a research integrity committee and appointing an ombudsperson § 13.Making explicit the applicable standards for research integrity. (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)

The comprehension of anaphoric relations may be guided not only by discourse, but also syntactic information. In the literature on online processing, however, the focus has been on audible pronouns and descriptions whose reference is resolved mainly on the former. This paper examines one relation that both lacks overt exponence, and relies almost exclusively on syntax for its resolution: adjunct control, or the dependency between the null subject of a non-finite adjunct and its antecedent in sentences such as Mickey talked (...) to Minnie before ___ eating. Using visual world eyetracking, we compare the time course of interpreting this null subject and overt pronouns (Mickey talked to Minnie before he ate). We show that when control structures are highly frequent, listeners are just as quick to resolve reference in either case. When control structures are less frequent, reference resolution based on structural information still occurs upon hearing the non-finite verb, but more slowly, especially when unaided by structural and referential predictions. This may be due to increased difficulty in recognizing that a referential dependency is necessary. These results indicate that in at least some contexts, referential expressions whose resolution depends on very different sources of information can be resolved approximately equally rapidly, and that the speed of interpretation is largely independent of whether or not the dependency is cued by an overt referring expression. (shrink)

Biological theory demands a clear organism concept, but at present biologists cannot agree on one. They know that counting particular units, and not counting others, allows them to generate explanatory and predictive descriptions of evolutionary processes. Yet they lack a unified theory telling them which units to count. In this paper, I offer a novel account of biological individuality, which reconciles conflicting definitions of ‘organism’ by interpreting them as describing alternative realisers of a common functional role, and then defines individual (...) organisms as essentially possessing some mechanisms that play this role. (shrink)

The problem of plant individuality is something which has vexed botanists throughout the ages, with fashion swinging back and forth from treating plants as communities of individuals (Darwin 1800 ; Braun and Stone 1853 ; Münch 1938 ) to treating them as organisms in their own right, and although the latter view has dominated mainstream thought most recently (Harper 1977 ; Cook 1985 ; Ariew and Lewontin 2004 ), a lively debate conducted mostly in Scandinavian journals proves that the issues (...) are far from being resolved (Tuomi and Vuorisalo 1989b ; Fagerström 1992 ; Pan and Price 2001 ). In this paper I settle the matter once and for all, by showing which elements of each side are correct. (shrink)

This chapter develops the idea that the germ-soma split and the suppression of individual fitness differences within the corporate entity are not always essential steps in the evolution of corporate individuals. It illustrates some consequences for multilevel selection theory. It presents evidence that genetic heterogeneity may not always be a barrier to successful functioning as a higher-level individual. This chapter shows that levels-of-selection theorists are wrong to assume that the central problem in transitions is always that of minimizing within-group competition. (...) Evidence of intralevel conflict does not qualify as evidence against the existence of a higher level of selection. (shrink)

Observational and experimental discoveries of new factual entities such as objects, systems, or processes, are major contributors to some advances in the life sciences. Yet, whereas discovery of theories was extensively deliberated by philosophers of science, very little philosophical attention was paid to the discovery of factual entities. This paper examines historical and philosophical aspects of the experimental discovery by Carl Woese of archaea, prokaryotes that comprise one of the three principal domains of the phylogenetic tree. Borrowing Kuhn’s terminology, this (...) discovery of a major biological entity was made during a ‘normal science’ project of building molecular taxonomy for prokaryotes. Unexpectedly, however, an observed anomaly instigated the discovery of archaea. Substantiation of the existence of the new archaeal entity and consequent reconstruction of the phylogenetic tree prompted replacement of a long-held model of a prokarya and eukarya bipartite tree of life by a new model of a tripartite tree comprising of bacteria, archaea, and eukarya. This paper explores the history and philosophical implications of the progression of Woese’s project from normal science to anomaly-instigated model-changing discovery. It is also shown that the consequential discoveries of RNA splicing and of ribozymes were similarly prompted by unexpected irregularities during normal science activities. It is thus submitted that some discoveries of factual biological entities are triggered by unforeseen observational or experimental anomalies. (shrink)

The concept of adaptation is pivotal to modern evolutionary thinking, but it has long been the subject of controversy, especially in respect of the relative roles of selection versus constraints in explaining the traits of organisms. This paper tackles a different problem for the concept of adaptation: its interpretation in light of multilevel selection theory. In particular, I arbitrate a dispute that has broken out between the proponents of rival perspectives on multilevel adaptations. Many experts now say that multilevel and (...) kin selection views are mathematically equivalent to one another—that the mathematical accounting of evolution can be carried out at any hierarchical level one chooses. But what does this formal equivalence imply - are they equivalent in other ways too? I show here that significant conceptual non-equivalence has survived: the two sides commit to different views regarding how much selection has to act at a level before we can call traits at that level adaptations; about whether policing mechanisms are adaptations, and about whether non-organisms can bear adaptations. (shrink)

In this article, Ellen Bliss Talbot affirms the reality of both time and change in individual human lives, asserting that moral growth is possible because an individual is a unity in and through time.

Buchanan and Powell hope to rescue optimism about moral perfectibility from the ’received view’ of human evolution, by tweaking our view of the innate character of morality. I argue that their intervention is hampered by an unnecessary commitment to nativism, by gender bias within the received view, and by liberal presuppositions.

Hypocrisy is a multi-faceted concept that has been studied empirically by psychologists and discussed logically by philosophers. In this study, we pose various behavioral scenarios to research participants and ask them to indicate whether the actor in the scenario behaved hypocritically. We assess many of the components that have been considered to be necessary for hypocrisy (e.g., the intent to deceive, self-deception), factors that may or may not be distinguished from hypocrisy (e.g., weakness of will), and factors that may moderate (...) hypocrisy (e.g., the degree of discrepancy between the attitude and behavior, whether the attitude is stated publicly, and the nature and severity of the behavioral consequences). Our findings indicate that lay conceptions of hypocrisy are often at odds with philosophical speculation. We argue that a complete understanding of the criteria for hypocrisy requires consideration of how ordinary people construe the concept. In contrast to some concepts (e.g., physical causation), for which lay conceptions, while interesting, are largely irrelevant, hypocrisy is an essential component of social judgment. One could argue, therefore, that folk wisdom is the ultimate arbiter of what hypocrisy entails. We note limitations of our methodology and suggest avenues for future research. (shrink)

Apology is arguably the central act of the reparative work required after wrongdoing. Claudia Card’s (1940-2015) analysis of complicity in collectively perpetrated evils moves one to ask whether apology ought to be requested of persons culpably complicit in institutional evils. To better appreciate the benefits of and barriers to apologies offered by culpably complicit wrongdoers, this article examines doctors’ complicity in a practice that meets Card’s definition of an evil, namely, the non-medically necessary, nonconsensual “normalizing” interventions performed on babies born (...) with intersex anatomies. It argues that in this instance, the complicity of doctors is culpable on Card’s terms, and that their culpable complicity grounds rightful demands for them to apologize. (shrink)

I argue for the usefulness of the evolutionary kind of biological individual.

In this article, Ellen Bliss Talbot explores the free will/determinism debate through an examination of the notions of individual unity, uniqueness, and self-sufficiency.

Historically, hypotheses failed in most cases to correctly forecast the workings of complex biological systems. Francis Crick’s adaptor hypothesis, however, stands out as an exceptional case of a confirmed abstract prediction. This hypothesis presciently anticipated the existence of RNA adaptors that function as bridges between amino acids and the chemically different nucleic acid template for proteins. Crick conjectured that the adaptors are enzymatically charged with cognate amino acids, they bind to complementary protein-coding nucleic acid, and their liberated amino acids are (...) incorporated into growing protein chains. Independently from and concomitantly with Crick’s hypothesis, Mahlon Hoagland and Paul Zamecnik conducted experiments with no guiding theory that culminated in discoveries of the actual adaptors, transfer RNA (tRNA) molecules, and their amino acids charging enzymes. This paper traces the parallel histories of Crick’s adaptor hypothesis and of the experimental discovery of tRNA and compares their relative impacts on the scientific community. Remarkably, despite the brilliance of Crick’s confirmed prognostication, it had marginal impact on practicing scientists. Conversely, Hoagland and Zamecnik’s experimental discoveries and their evidence-based model of protein synthesis had immediate and enduring impact. I discuss possible explanations for the different impacts of the theoretical prediction and experimental identifications of the same entities. (shrink)

The prominent philosopher Bernard Williams (1985) opened his Ethics and the Limits of Philosophy with: “It is not a trivial question, Socrates said: what we are talking about is how one should live” (p. 1) and asked whether Socrates’ question is the proper starting point for moral philosophy. In this paper, I will explore an effect of a very specific life event: a “cliff-edge” retirement. I will look at the concept of ground projects and show how cliff-edge retirements create ill-shaped (...) projects reflecting the loss of important workplace benefits such as purposeful work and social collaborations. This type of retirement prematurely closes the ground project before its natural conclusion. I will argue that attempts to recover it will likely prove difficult, inauthentic and will not remedy the project’s wrongful shape. (shrink)

Knowledge, like other things of value, can be faked. According to Hawley (2011), know-how is harder to fake than knowledge-that, given that merely apparent propositional knowledge is in general more resilient to our attempts at successful detection than are corresponding attempts to fake know-how. While Hawley’s reasoning for a kind of detection resilience asymmetry between know-how and know-that looks initially plausible, it should ultimately be resisted. In showing why, we outline different ways in which know-how can be faked even when (...) a given performance is successful; and in doing so, we distinguish how know-how can be faked (no less than know-that) via upstream and downstream indicators of its presence, and within each of these categories, we’ll distinguish (in connection with detection resilience) both faking symptoms and (various kinds of) criteria. The unappreciated resilience of faked knowledge-how to successful detection highlights a largely overlooked dimension of social-epistemic risk – risk we face not just in our capacity as recipients of testimony, but in our capacity as both (would-be) apprentices and clients of knowledge-how. (shrink)

We are living at the dawn of the first truly scientific picture of the universe-as-a-whole, yet people are still dragging along prescientific ideas about God that cannot be true and are even meaningless in the universe we now know we live in. This makes it impossible to have a coherent big picture of the modern world that includes God. But we don't have to accept an impossible God or else no God. We can have a real God if we redefine (...) God in light of knowledge no one ever had before. The key question is, “Could anything actually exist in the scientific universe that is worthy of the name, God?” My answer is yes: God is an “emergent phenomenon,” as real as the global economy or the government or the worldwide web, which are all emergent phenomena. But God arose from something deeper: the complex interactions of all humanity's aspirations. An emerging God has enormous implications. (shrink)

Jack Spencer argues we should reject a decision rule called MaxRat because it's incompatible with this principle: If you know that you will choose an option, x, and you know that x is better than every other option available to you, then it is permissible for you to choose x. I agree with Spencer that defenders of MaxRat should reject this principle. However, I disagree insofar as he suggests that he and orthodox causalists are in a position to accept it. (...) Both orthodox CDT and Spencer's own theory of rational choice are incompatible with the principle as well. It is surprising to realise, but all are agreed: it can be irrational to knowingly choose the best. (shrink)

Understanding consciousness and its place in the natural world is one of the principal targets of contemporary philosophy of mind. Australian philosophers made seminal contributions to this project during the twentieth century which continue to shape the way philosophers and scientists think about the conceptual, metaphysical and empirical aspects of the problem. After some scene setting, I will discuss the main players and their work in the context of broader developments in the philosophy of mind.

Objective: Compassion has been associated with eudaimonia and prosocial behavior, and has been regarded as a virtue, both historically and cross-culturally. However, the psychological study of compassion has been limited to laboratory settings and/or standard survey assessments. Here, we use an experience sampling method (ESM) to compare naturalistic assessments of compassion with standard assessments, and to examine compassion, its variability, and associations with eudaimonia and prosocial behavior. -/- Methods: Participants took a survey which included standard assessments of compassion and eudaimonia. (...) Then, over four days, they were repeatedly asked about their level of compassion, eudaimonia, and situational factors within the moments of daily life. Finally, prosocial behavior was tested using the Dual Gamble Task and an opportunity to donate task winnings. -/- Results: Analyses revealed within-person associations between ESM compassion and eudaimonia. ESM compassion also predicted eudaimonia at the next ESM time point. While not impervious to situational factors, considerable consistency was observed in ESM compassion in comparison with eudaimonia. Further, ESM compassion along with eudaimonia predicted donating behavior. Standard assessments did not. -/- Conclusion: Consistent with virtue theory, some individual’s reports displayed a probabilistic tendency toward compassion, and ESM compassion predicted ESM eudaimonia and prosocial behavior toward those in need. (shrink)

The philosophical significance of attitudinal autonomy—viz., the autonomy of attitudes such as beliefs—is widely discussed in the literature on moral responsibility and free will. Within this literature, a key debate centres around the following question: is the kind of attitudinal autonomy that’s relevant to moral responsibility at a given time determined entirely by a subject’s present mental structure at that time? Internalists say ‘yes’, externalists say ’no’. In this essay, I motivate a kind of distinctly epistemic attitudinal autonomy, attitudinal autonomy (...) that is relevant to knowledge. I argue that regardless of whether we are externalists or internalists about the kind of attitudinal autonomy that is relevant for moral responsibility, we should be externalists about the kind of autonomy that a belief must have to qualify as knowledge. (shrink)

Epistemic relativists often appeal to an epistemic incommensurability thesis. One notable example is the position advanced by Wittgenstein in On certainty (1969). However, Ian Hacking’s radical denial of the possibility of objective epistemic reasons for belief poses, we suggest, an even more forceful challenge to mainstream meta-epistemology. Our central objective will be to develop a novel strategy for defusing Hacking’s line of argument. Specifically, we show that the epistemic incommensurability thesis can be resisted even if we grant the very insights (...) that lead Hacking to claim that epistemic reasons are always relative to a style of reasoning. Surprisingly, the key to defusing the argument is to be found in recent mainstream work on the epistemic state of objectual understanding. (shrink)

Virtues, broadly understood as stable and robust dispositions for certain responses across morally relevant situations, have been a growing topic of interest in psychology. A central topic of discussion has been whether studies showing that situations can strongly influence our responses provide evidence against the existence of virtues (as a kind of stable and robust disposition). In this review, we examine reasons for thinking that the prevailing methods for examining situational influences are limited in their ability to test dispositional stability (...) and robustness; or, then, whether virtues exist. We make the case that these limitations can be addressed by aggregating repeated, cross-situational assessments of environmental, psychological and physiological variables within everyday life—a form of assessment often called ecological momentary assessment (EMA, or experience sampling). We, then, examine how advances in smartphone application (app) technology, and their mass adoption, make these mobile devices an unprecedented vehicle for EMA and, thus, the psychological study of virtue. We, additionally, examine how smartphones might be used for virtue development by promoting changes in thought and behavior within daily life; a technique often called ecological momentary intervention (EMI). While EMA/I have become widely employed since the 1980s for the purposes of understanding and promoting change amongst clinical populations, few EMA/I studies have been devoted to understanding or promoting virtues within non-clinical populations. Further, most EMA/I studies have relied on journaling, PDAs, phone calls and/or text messaging systems. We explore how smartphone app technology provides a means of making EMA a more robust psychological method, EMI a more robust way of promoting positive change, and, as a result, opens up new possibilities for studying and promoting virtues. (shrink)

The phenomenon of ambivalence is an important one for any philosophy of action. Despite this importance, there is a lack of a fully satisfactory analysis of the phenomenon. Although many contemporary philosophers recognize the phenomenon, and address topics related to it, only Harry Frankfurt has given the phenomenon full treatment in the context of action theory - providing an analysis of how it relates to the structure and freedom of the will. In this paper, I develop objections to Frankfurt's account, (...) all revolving around the charge that his account contains a serious ambiguity between willing and identifying. With such objections in place, I then develop an analysis that avoids the difficulties and ambiguities that Frankfurt's analysis is prey to. I briefly distinguish ambivalence from other types of internal conflict. This paper aims to offer conceptual clarification on the phenomenon of ambivalence, which will then allow for discussions about the normative merits and demerits of ambivalence, the effects of ambivalence on autonomous action, and methods of resolution of ambivalence. (shrink)

Aggregating individuals’ consistent attitudes might produce inconsistent collective attitudes. Some groups therefore need the capacity to form attitudes that are irreducible to those of their members. Such groups, group-agent realists argue, are agents in control of their own attitude formation. In this paper, however, I show how group-agent realism overlooks the important fact that groups consist of strategically interacting agents. Only by eliminating group agency from our social explanations can we see how individuals vote strategically to gain control of their (...) groups and produce collective attitudes we cannot make sense of if we treat groups as agents. (shrink)

A series of papers on different aspects of practical knowledge by Roderick Chisholm, Rudolf Haller, J. C. Nyiri, Eva Picardi, Joachim Schulte Roger Scruton, Barry Smith and Johan Wrede.

Orthodox causal decision theory is unstable. Its advice changes as you make up your mind about what you will do. Several have objected to this kind of instability and explored stable alternatives. Here, I'll show that explorers in search of stability must part with a vestige of their homeland. There is no plausible stable decision theory which satisfies Savage's Sure Thing Principle. So those in search of stability must learn to live without it.

Empirical work has lately confirmed what many philosophers have taken to be true: people are ‘biased toward the future’. All else being equal, we usually prefer to have positive experiences in the future, and negative experiences in the past. According to one hypothesis, the temporal metaphysics hypothesis, future-bias is explained either by our beliefs about temporal metaphysics—the temporal belief hypothesis—or alternatively by our temporal phenomenology—the temporal phenomenology hypothesis. We empirically investigate a particular version of the temporal belief hypothesis according to (...) which future-bias is explained by the belief that time robustly passes. Our results do not match the apparent predictions of this hypothesis, and so provide evidence against it. But we also find that people give more future-biased responses when asked to simulate a belief in robust passage. We take this to suggest that the phenomenology that attends simulation of that belief may be partially responsible for future-bias, and we examine the implications of these results for debates about the rationality of future-bias. (shrink)

Decision-making under normative uncertainty requires an agent to aggregate the assessments of options given by rival normative theories into a single assessment that tells her what to do in light of her uncertainty. But what if the assessments of rival theories differ not just in their content but in their structure -- e.g., some are merely ordinal while others are cardinal? This paper describes and evaluates three general approaches to this "problem of structural diversity": structural enrichment, structural depletion, and multi-stage (...) aggregation. All three approaches have notable drawbacks, but I tentatively defend multi-stage aggregation as least bad of the three. (shrink)

The norm of assertion, to be in force, is a social norm. What is the content of our social norm of assertion? Various linguistic arguments purport to show that to assert is to represent oneself as knowing. But to represent oneself as knowing does not entail that assertion is governed by a knowledge norm. At best these linguistic arguments provide indirect support for a knowledge norm. Furthermore, there are alternative, non-normative explanations for the linguistic data (as in recent work from (...) Van Elswyk). Direct arguments would rely on normative judgments about the permissibility or impermissibility of assertions with and without the speaker knowing the content asserted. John Turri's work experimental results purport to show that our norm of assertion is factive, and probably knowledge. But as a number of recent experimentalists (Kneer, Reuter and Broessel, Marsili and Wiegmann) have shown, Turri's results rely on the problemmatic use of 'should' as in 'Maria should assert that she owns a 1990 watch.' Correcting for this, these experimentalists provide strong evidence that our norm of assertion is not factive. The standard reply to evidence like this from the assertion of unlucky falsehoods is the excuse maneuver. But Marsili and Wiegmann, following Turri's protocol for testing for excuse validation, show that participants who judge that assertions unlucky falsehoods are permissible are not guilty of excuse validation. Given our current understanding of the experimental evidence, knowledge is not our norm of assertion. (shrink)

Every day nurses are required to make ethical decisions in the course of caring for their patients. Ethics in Nursing Practice provides the background necessary to understand ethical decision making and its implications for patient care. The authors focus on the individual nurse’s responsibilities, as well as considering the wider issues affecting patients, colleagues and society as a whole. This third edition is fully updated, and takes into account recent changes in ICN position statements, WHO documents, as well as addressing (...) current issues in healthcare, such as providing for the health and care needs of refugees and asylum seekers, bioethics and the enforcement of nursing codes. (shrink)

What is the biological function of perception? I hold perception, especially visual perception in humans, has the biological function of accurately representing the environment. Tyler Burge argues this cannot be so in Origins of Objectivity (Oxford, 2010), for accuracy is a semantical relationship and not, as such, a practical matter. Burge also provides a supporting example. I rebut the argument and the example. Accuracy is sometimes also a practical matter if accuracy partly explains how perception contributes to survival and reproduction.

“How can I, who am thinking about the entire, centerless universe, be anything so specific as this: this measly creature existing in a tiny morsel of space and time?” This metaphysically self-deprecating question, posed by Thomas Nagel, holds an insight into the nature of personhood and the ordinary ways we value it, in others and in ourselves. I articulate that insight and apply it to the phenomena of friendship, companionship, sexuality, solitude, and love. Although love comes in many forms, I (...) say, it always involves a sense of wonder at a finite creature thinking infinite thoughts. (shrink)

Common everyday materials such as textiles, foodstuffs, soil or skin can have complex, mutable and varied appearances. Under typical viewing conditions, most observers can visually recognize materials effortlessly, and determine many of their properties without touching them. Visual material perception raises many fascinating questions for vision researchers, neuroscientists and philosophers, yet has received little attention compared to the perception of color or shape. Here we discuss some of the challenges that material perception raises and argue that further philosophical thought should (...) be directed to how we see materials. (shrink)

Oliva Sabuco's New Philosophy of Human nature (1587) is an early modern philosophy of medicine that challenged the views of the successors to Aristotle, especially Galen and Ibn Sina (Avicenna). It also challenged the paradigm of the male as the epitome of the human and instead offers a gender-neutral philosophy of human nature. Now largely forgotten, it was widely read and influential amongst philosophers of medicine including DeClave, LePois, Harvey,Southey and others, particularly for its account of the role of the (...) nervous system and cerebrospinal fluid in mind-body interaction. In this article I trace its early influence by tracing provenance of the editions produced during the lifetime of its author. (shrink)

In this chapter, we consider ethical and philosophical aspects of trust in the practice of medicine. We focus on trust within the patient-physician relationship, trust and professionalism, and trust in Western (allopathic) institutions of medicine and medical research. Philosophical approaches to trust contain important insights into medicine as an ethical and social practice. In what follows we explain several philosophical approaches and discuss their strengths and weaknesses in this context. We also highlight some relevant empirical work in the section on (...) trust in the institutions of medicine. It is hoped that the approaches discussed here can be extended to nursing and other topics in the philosophy of medicine. (shrink)

Contractarians aim to derive moral principles from the dictates of instrumental rationality alone. But it is well-known that contractarian moral theories struggle to identify normative principles that are both uniquely rational and morally compelling. Michael Moehler's recent book, *Minimal Morality* seeks to avoid these difficulties by developing a novel "two-level" social contract theory, which restricts the scope of contractarian morality to cases of deep and persistent moral disagreement. Yet Moehler remains ambitious, arguing that a restricted version of Kant's categorical imperative (...) is a uniquely rational principle of conflict resolution. We develop a formal model of Moehler's informal game-theoretic argument, which reconstructs a valid argument for Moehler's conclusion. This model, in turn, enables us to expose how a successful argument for Moehler's contractarian principle rests on assumptions that can only be justified by subtle yet significant departures from the standard conception of rationality. We thus extend our understanding of familiar contractarian difficulties by showing how they arise even if we restrict the scope of contractarian morality to a domain where its application seems both promising and necessary. We show that the problem lies not in contractarians' immodest ambitions but in the modest resources rationality can offer to satisfy them. (shrink)

There is a widespread, popular view—and one I basically endorse—that Nietzsche is, in one sense of the word, a nihilist. As Arthur Danto put it some time ago, according to Nietzsche, “there is nothing in [the world] which might sensibly be supposed to have value.” As interpreters of Nietzsche, though, we cannot simply stop here. Nietzsche's higher men, Übermenschen, “genuine philosophers”, free spirits—the types Nietzsche wants to bring forth from the human, all-too-human herds he sees around him with the fish (...) hooks, as he says, of his books—seem to engage in what looks like valuing. These free spirits are supposed to revalue the old values—revaluing, as is clear from the texts, is not simply to remove the old values from circulation (Nietzsche uses “umwerten” and not “entwerten”)—and they are supposed to create new values. And, of course, Nietzsche himself, free spirit that he is, takes on the task of revaluing all values and seems to assert many a strident evaluation. So we need to say more here. What are Nietzsche and his free spirits up to when they engage in what looks, for all the world, like a practice of valuing? What is the practice of valuing Nietzsche is recommending for his free spirits? I argue for two claims: (i) First, we end up facing an interpretive puzzle when we attempt to explain how Nietzsche's free spirits are supposed to engage in a practice of valuing. (ii) Second, we can solve the interpretive puzzle by taking Nietzsche's free spirits to be engaged in a fictionalist simulacrum of valuing. (shrink)

Political liberals ask citizens not to appeal to certain considerations, including religious and philosophical convictions, in political deliberation. We argue that political liberals must include a demanding requirement of intellectual modesty in their ideal of citizenship in order to motivate this deliberative restraint. The requirement calls on each citizen to believe that the best reasoners disagree about the considerations that she is barred from appealing to. Along the way, we clarify how requirements of intellectual modesty relate to moral reasons for (...) deliberative restraint. And we argue against attempts to weaken our requirement of intellectual modesty by emphasizing those moral reasons. (shrink)