This paper focuses on invasive therapeutic procedures, defined as procedures requiring the introduction of hands, instruments, or devices into the body via incisions or punctures of the skin or mucous membranes performed with the intent of changing the natural history of a human disease or condition for the better. Ethical and methodological concerns have been expressed about studies designed to evaluate the effects of invasive therapeutic procedures. Can such studies meet the same standards demanded of those, for example, evaluating pharmaceutical (...) agents? This paper describes a research project aimed at examining the interplay and sometimes apparent conflict between ethical standards for human research and standards for methodological rigor in trials of invasive procedures. The paper discusses how the authors plan to develop a set of consensus standards that, if met, would result in substantial and much-needed improvements in the methodological and ethical quality of such trials. (shrink)

Background If trials of therapeutic interventions are to serve society's interests, they must be of high methodological quality and must satisfy moral commitments to human subjects. The authors set out to develop a clinical - trials compendium in which standards for the ethical treatment of human subjects are integrated with standards for research methods. Methods The authors rank-ordered the world's nations and chose the 31 with >700 active trials as of 24 July 2008. Governmental and other authoritative entities of the (...) 31 countries were searched, and 1004 English-language documents containing ethical and/or methodological standards for clinical trials were identified. The authors extracted standards from 144 of those: 50 designated as ‘core’, 39 addressing trials of invasive procedures and a 5% sample of the remainder. As the integrating framework for the standards we developed a coherent taxonomy encompassing all elements of a trial's stages. Findings Review of the 144 documents yielded nearly 15 000 discrete standards. After duplicates were removed, 5903 substantive standards remained, distributed in the taxonomy as follows: initiation, 1401 standards, 8 divisions; design, 1869 standards, 16 divisions; conduct, 1473 standards, 8 divisions; analysing and reporting results, 997 standards, four divisions; and post-trial standards, 168 standards, 5 divisions. Conclusions The overwhelming number of source documents and standards uncovered in this study was not anticipated beforehand and confirms the extraordinary complexity of the clinical trials enterprise. This taxonomy of multinational ethical and methodological standards may help trialists and overseers improve the quality of clinical trials, particularly given the globalisation of clinical research. (shrink)

While openmindedness is often cited as a paradigmatic example of an intellectual virtue, the connection between openmindedness and truth is tenuous. Several strategies for reconciling this tension are considered, and each is shown to fail; it is thus claimed that openmindedness, when intellectually virtuous, bears no interesting essential connection to truth. In the final section, the implication of this result is assessed in the wider context of debates about epistemic value.

Believing that p, assuming that p, and imagining that p involve regarding p as true—or, as we shall call it, accepting p. What distinguishes belief from the other modes of acceptance? We claim that conceiving of an attitude as a belief, rather than an assumption or an instance of imagining, entails conceiving of it as an acceptance that is regulated for truth, while also applying to it the standard of being correct if and only if it is true. We argue (...) that the second half of this claim, according to which the concept of belief includes a standard of correctness, is required to explain the fact that the deliberative question whether to believe that p is transparent to the question whether p. This argument raises various questions. Is there such a thing as deliberating whether to believe? Is the transparency of the deliberative question whether to believe that p the same as the transparency of the factual question whether I do believe that p? We will begin by answering these questions and then turn to a series of possible objections to our argument. (shrink)

There has been a growing concern over establishing norms that ensure the ethically acceptable and scientifically sound conduct of clinical trials. Among the leading norms internationally are the World Medical Association's Declaration of Helsinki, guidelines by the Council for International Organizations of Medical Sciences, the International Conference on Harmonization's standards for industry, and the CONSORT group's reporting norms, in addition to the influential U.S. Federal Common Rule, Food and Drug Administration's body of regulations, and information sheets by the Department of (...) Health and Human Services. There are also many norms published at more local levels by official agencies and professional groups.Any account of international standards should cover both scientific and ethical norms at once – the two are conceptually intertwined. Recent sources recognize that “[s]cientifically unsound research on human subjects is unethical in that it exposes research subjects to risks without possible benefit.”. (shrink)

Revisionary theories of logic or truth require revisionary theories of mind. This essay outlines nonclassically based theories of rational belief, desire, and decision making, singling out the supervaluational family for special attention. To see these nonclassical theories of mind in action, this essay examines a debate between David Lewis and Derek Parfit over what matters in survival. Lewis argued that indeterminacy in personal identity allows caring about psychological connectedness and caring about personal identity to amount to the same thing. The (...) essay argues that Lewis's treatment of two of Parfit's puzzle cases—degreed survival and fission—presuppose different nonclassical treatments of belief and desire. (shrink)

Artificial agents (AAs), particularly but not only those in Cyberspace, extend the class of entities that can be involved in moral situations. For they can be conceived of as moral patients (as entities that can be acted upon for good or evil) and also as moral agents (as entities that can perform actions, again for good or evil). In this paper, we clarify the concept of agent and go on to separate the concerns of morality and responsibility of agents (most (...) interestingly for us, of AAs). We conclude that there is substantial and important scope, particularly in Computer Ethics, for the concept of moral agent not necessarily exhibiting free will, mental states or responsibility. This complements the more traditional approach, common at least since Montaigne and Descartes, which considers whether or not (artificial) agents have mental states, feelings, emotions and so on. By focussing directly on mind-less morality we are able to avoid that question and also many of the concerns of Artificial Intelligence. A vital component in our approach is the Method of Abstraction for analysing the level of abstraction (LoA) at which an agent is considered to act. The LoA is determined by the way in which one chooses to describe, analyse and discuss a system and its context. The Method of Abstraction is explained in terms of an interface or set of features or observables at a given LoA. Agenthood, and in particular moral agenthood, depends on a LoA. Our guidelines for agenthood are: interactivity (response to stimulus by change of state), autonomy (ability to change state without stimulus) and adaptability (ability to change the transition rules by which state is changed) at a given LoA. Morality may be thought of as a threshold defined on the observables in the interface determining the LoA under consideration. An agent is morally good if its actions all respect that threshold; and it is morally evil if some action violates it. That view is particularly informative when the agent constitutes a software or digital system, and the observables are numerical. Finally we review the consequences for Computer Ethics of our approach. In conclusion, this approach facilitates the discussion of the morality of agents not only in Cyberspace but also in the biosphere, where animals can be considered moral agents without their having to display free will, emotions or mental states, and in social contexts, where systems like organizations can play the role of moral agents. The primary cost of this facility is the extension of the class of agents and moral agents to embrace AAs. (shrink)

If the world itself is metaphysically indeterminate in a specified respect, what follows? In this paper, we develop a theory of metaphysical indeterminacy answering this question.

What considerations place genuine constraints on an adequate semantics for normative and evaluative expressions? Linguists recognize facts about ordinary uses of such expressions and competent speakers’ judgments about which uses are appropriate. The contemporary literature reflects the widespread assumption that linguists don’t rely upon an additional source of data—competent speakers’ judgments about possible disagreement with hypothetical speech communities. We have several good reasons to think that such judgments are not probative for semantic theorizing. Therefore, we should accord these judgments no (...) probative value for the development of a semantics for our moral terms. Such judgments can no longer be presumed to put pressure on theories according to which our moral expressions share a semantics with ordinary, descriptive terms. Many rivals to pure, Descriptivist theories count among their advantages the ability to accommodate these judgments. If these judgments have no probative value, such theories lose an important source of support. (shrink)

Interpersonal aggregation involves the combining and weighing of benefits and losses to multiple individuals in the course of determining what ought to be done. Most consequentialists embrace thoroughgoing interpersonal aggregation, the view that any large benefit to each of a few people can be morally outweighed by allocating any smaller benefit to each of many others, so long as this second group is sufficiently large. This would permit letting one person die in order to cure some number of mild headaches (...) instead. Most non-consequentialists reject thoroughgoing interpersonal aggregation despite also believing it is permissible to let one person die in order to prevent many cases of paraplegia instead. Non-consequentialists defend this asymmetry largely on the basis of intuition, and some rely on the notion of relevance to formalize the grounding intuitions. This article seeks to clarify and strengthen the non-consequentialist notion of relevance by engaging with three objections to it. (shrink)

Our folk epistemology says that if someone knows that P and tells you that P, then, given the absence of defeaters, if you believe what they tell you, you will come to know that P as well. A speaker's knowledge that P is then, for the most part, enough for a hearer to come to know that P. But there are counterexamples to this principle: testimonial knowledge does not always transfer from the speaker to the hearer. Why should that be (...) so? Because testimonial knowledge arises through the flow of information--from conclusive grounds--from the speaker through the speaker's assertion to the hearer's state of comprehension as of the speaker's assertion. A speaker's belief can be based on conclusive grounds, but the speaker's assertion may fail to provide conclusive grounds to the hearer. Then the hearer won't acquire knowledge, even from a knowledgeable speaker. Knowledge from testimony then works more like knowledge through perception. But wait, you say, that can't be so because testimony involves free will but perception does not. The essay ends with a broadly Hume inspired reply to this objection. (shrink)

Much of the philosophical literature on health inequalities seeks to establish the superiority of one or another conception of luck egalitarianism. In recent years, however, an increasing number of self-avowed egalitarian philosophers have proposed replacing luck egalitarianism with alternatives that stress the moral relevance of distinct relationships, rather than the moral relevance of good or bad luck. After briefly explaining why I am not attracted to luck egalitarianism, I seek in this chapter to distinguish and clarify three views that have (...) been characterized in the philosophical literature as forms of relational egalitarianism. I call these three relational views equality of treatment, equality of concern, and social egalitarianism. I will explain why each claims to be a form of egalitarianism and why these three views should not be seen as competitors. I will argue that each brand of relational egalitarianism describes a plausible plank of distributive justice that bears on the evaluation of health inequalities and on the political institutions that create, sustain, or exacerbate them. To illustrate this pluralistic relational egalitarian approach, I will draw on a case study by Horton and Barker (this volume) to discuss how each of the three planks might be brought to bear on the evaluation of oral health disparities among the children of migrant Latino farmworkers in California. (shrink)

In this paper we present two distinctly epistemological puzzles that arise for one who aspires to defend some plausible version of the precautionary principle. The first puzzle involves an application of contextualism in epistemology; and the second puzzle concerns the task of defending a plausible version of the precautionary principle that would not be invalidated by de minimis.

Sceptical theists--e.g., William Alston and Michael Bergmann--have claimed that considerations concerning human cognitive limitations are alone sufficient to undermine evidential arguments from evil. We argue that, if the considerations deployed by sceptical theists are sufficient to undermine evidential arguments from evil, then those considerations are also sufficient to undermine inferences that play a crucial role in ordinary moral reasoning. If cogent, our argument suffices to discredit sceptical theist responses to evidential arguments from evil.

It is commonly assumed that personalization technologies used by Google for the purpose of tailoring search results for individual users create filter bubbles, which reinforce users’ political views. Surprisingly, empirical evidence for a personalization-induced filter bubble has not been forthcoming. Here, we investigate whether filter bubbles may result instead from a searcher’s choice of search queries. In the first experiment, participants rated the left-right leaning of 48 queries (search strings), 6 for each of 8 topics (abortion, benefits, climate change, sex (...) equality, immigration, nuclear family, Islam, and taxation). An independent sample of participants were then asked to select one of these queries for each of the 8 topics. With the exception of the topic of Islam, participants were significantly more likely to select a query corresponding to their own political leaning, compared to other queries, explaining between 12% and 39% of the variance. A second experiment investigated the effect of the political leaning of the same queries on the overall political leaning of Search Engine Result Pages (SERPs) in Google Search. The top six results of each SERP were rated collectively by a third group of participants, explaining 36.3% of the variance across all 48 search terms (p < .00001). That is, (1) participants in our experiments tended to select own-side search queries, and (2) using those queries tended to yield own-side search results when using the Google search engine. Our results are consistent with the notion of a self-imposed filter bubble in which query selection plays a salient role. (shrink)

Nietzsche’s favourable comments about science and the senses have recently been taken as evidence of naturalism. Others focus on his falsification thesis: our beliefs are falsifying interpretations of reality. Clark argues that Nietzsche eventually rejects this thesis. This article utilizes the multiple ways of being science friendly in Nietzsche’s context by focussing on Mach’s neutral monism. Mach’s positivism is a natural development of neo-Kantian positions Nietzsche was reacting to. Section 15 of Beyond Good and Evil is crucial to Clark’s interpretation. (...) The presented interpretation makes better sense of this passage and shows that Nietzsche can accept both falsification and empiricism. (shrink)

I argue that the theory of chance proposed by David Lewis has three problems: (i) it is time asymmetric in a manner incompatible with some of the chance theories of physics, (ii) it is incompatible with statistical mechanical chances, and (iii) the content of Lewis's Principal Principle depends on how admissibility is cashed out, but there is no agreement as to what admissible evidence should be. I proposes two modifications of Lewis's theory which resolve these difficulties. I conclude by tentatively (...) proposing a third modification of Lewis's theory, one which explains many of the common features shared by the chance theories of physics. (shrink)

Some recent accounts of testimonial warrant base it on trust, and claim that doing so helps explain asymmetries between the intended recipient of testimony and other non-intended hearers, e.g. differences in their entitlement to challenge the speaker or to rebuke the speaker for lying. In this explanation ‘dependence-responsiveness’ is invoked as an essential feature of trust: the trustor believes the trustee to be motivationally responsive to the fact that the trustor is relying on the trustee. I argue that dependence-responsiveness is (...) not essential to trust and that the asymmetries, where genuine, can be better explained without reference to trust. (shrink)

Efficiency and equity are central concepts for the normative assessment of health policy. Drawing on the work of academic philosophers and philosophically sophisticated economists, this article identifies important philosophical questions implicated by the notions of efficiency and equity and then summarizes influential answers to them. Promising avenues for further philosophical research are also highlighted, especially in the context of health equity and its elusive ethical foundations.

Requirements of rationality, like the following, have recently been the focus of much discussion: (1) Rationality requires of S that, if S intends that e and believes that e will not be so unless S intends that m, then S intends that m. (2) Rationality requires of S that S not both believe p and believe not-p.1 How many requirements there are and how precisely to state them is a matter of controversy, but I will focus on a different kind (...) of controversy, namely, how to conceive of such requirements in general.2 I will start by sketching a picture of their general nature and role that I find compelling and attractive. My picture is not, however, consistent with many of the recent approaches to rational requirements in the literature. 3 As I will try to show, the arguments that are often made about rational requirements assume, mostly implicitly, that my picture is flawed. These arguments do not, however, or so I will claim, actually give us reason to reject my picture of rational requirements. Indeed, many of the puzzles about rational requirements taken up by others turn out not to really be puzzles once we realize that this alternative picture.. (shrink)

Fictionalism has recently returned as a standard response to ontologically problematic domains. This article assesses moral fictionalism. It argues (i) that a correct understanding of the dialectical situation in contemporary metaethics shows that fictionalism is only an interesting new alternative if it can provide a new account of normative content: what is it that I am thinking or saying when I think or say that I ought to do something; and (ii) that fictionalism, qua fictionalism, does not provide us with (...) any new resources for providing such an account. (shrink)

This paper makes an effort to interpret the relationship between the concepts "Zuhandenheit" (readiness-to-hand) and "Vorhandenheit" (presence-at-hand), as they are analysed in §§ 15-16 of Heidegger's "Being and Time". These concepts are two modes of existence of the beings met in our surrounding world. So, they don't concern different things. Heidegger doesn't give the title "things" to the beings ready-to-hand; he names them "equipments" (Zeug). It's a concept relative to the Aristotelian "organon", which Aristotle exemplifies with the human hand as (...) a primary equipment. But Zuhandenheit isn't a quality of the things; the term has to do with the secret character of the equipments as the maining way of their disclosure. It's the Being-in-itself of the equipments, as long as they are useful. This Being-in-itself has nothing common with the Kantian Ding an sich, which is based on the presupposition of a cognitive relationship between subject and object. I posit also the question, whether Zuhandenheit can rendet the secretness and familiarity of our immediate approach to the environment, and my answer to this question is negative. (shrink)

The maturing of metaethics has been accompanied by widespread, but relatively unarticulated, discontent that mainstream metaethics is fundamentally on the wrong track. The malcontents we have in mind do not simply champion a competitor to the likes of noncognitivism or realism; they disapprove of the supposed presuppositions of the existing debate. Their aim is not to generate a new theory within metaethics, but to go beyond metaethics and to transcend the distinctions it draws between metaethics and normative ethics and between (...) cognitivism and non-cognitivism. In our experience, the differences with traditional metaethics go deep enough that it can feel as if two different paradigms are talking past each other. We attempt to bring clarity and focus to this rather inchoate debate by simultaneously articulating the general issues involved and engaging in a detailed case study of one of the prominent representatives of this discontent, Christine Korsgaard. We argue that Korsgaard fails to go beyond metaethics–indeed, fails even to provide a theory within metaethics. Our strategy for showing this is to argue that her claims are compatible with both cognitivism and non-cognitivism. We have argued elsewhere that her distinctive claims are compatible with realism. Here we focus on the crucial role that claims about agency and the will seem to play her in work and, according to our interpretation, in her attempts to go beyond mainstream metaethics. We show in detail that these claims are actually compatible with non-cognitivism. Though our discussion often focuses on her work in particular, it has clear implications for other attempts to obviate the debates of traditional metaethics. (shrink)

We discuss a research project that develops and applies algorithms for computational contextual vocabulary acquisition (CVA): learning the meaning of unknown words from context. We try to unify a disparate literature on the topic of CVA from psychology, first- and secondlanguage acquisition, and reading science, in order to help develop these algorithms: We use the knowledge gained from the computational CVA system to build an educational curriculum for enhancing students’ abilities to use CVA strategies in their reading of science texts (...) at the middle-school and college undergraduate levels. The knowledge gained from case studies of students using our CVA techniques feeds back into further development of our computational theory. Keywords: artificial intelligence, knowledge representation, reading, reasoning, science education, vocabulary acquisition. (shrink)

In this paper, I examine the ethics of e - trust and e - trustworthiness in the context of health care, looking at direct computer-patient interfaces (DCPIs), information systems that provide medical information, diagnosis, advice, consenting and/or treatment directly to patients without clinicians as intermediaries. Designers, manufacturers and deployers of such systems have an ethical obligation to provide evidence of their trustworthiness to users. My argument for this claim is based on evidentialism about trust and trustworthiness: the idea that trust (...) should be based on sound evidence of trustworthiness. Evidence of trustworthiness is a broader notion than one might suppose, including not just information about the risks and performance of the system, but also interactional and context-based information. I suggest some sources of evidence in this broader sense that make it plausible that designers, manufacturers and deployers of DCPIs can provide evidence to users that is cognitively simple, easy to communicate, yet rationally connected with actual trustworthiness. (shrink)

Our aim in this paper is to bring the woefully neglected literature on predictive modeling to bear on some central questions in the philosophy of science. The lesson of this literature is straightforward: For a very wide range of prediction problems, statistical prediction rules (SPRs), often rules that are very easy to implement, make predictions than are as reliable as, and typically more reliable than, human experts. We will argue that the success of SPRs forces us to reconsider our views (...) about what is involved in understanding, explanation, good reasoning, and about how we ought to do philosophy of science. (shrink)

Some of the most forceful objections to William Wollaston's moral theory come from his early critics, namely, Thomas Bott (1688-1754), Francis Hutcheson (1694-1746), and John Clarke of Hull (1687-1734). These objections are little known, while the inferior objections of Hume, Bentham, and later prominent critics are familiar. This fact is regrettable. For instance, it impedes a robust understanding of eighteenth-century British ethics; also, it fosters a questionable view as to why Wollaston's theory, although at first well received, soon faded in (...) esteem among philosophers. This paper gives Wollaston's early critics some of the attention they deserve. It reconstructs some of their objections to Wollaston's philosophy, addresses replies to those objections, and shows that despite some minor flaws, the objections succeed. A fact that becomes clear is that Wollaston's philosophy had suffered devastating criticism years before Hume wrote anything against it. (shrink)

Background: Rumination, a tendency to focus on negative self-related thoughts, is a central symptom of depression. Studying the self-related aspect of such symptoms is challenging because of the need to distinguish self effects from the emotional content of task stimuli. This study employed an emotionally neutral self-related paradigm to investigate possible altered self-processing in depression and its link to rumination. Methods: People with major depressive disorder (n = 25) and controls (n = 25) underwent task-based electro-encephalogram recording. We studied late (...) event-related potentials, along with low-frequency oscillatory power. We compared electroencephalogram metrics between groups and correlated them with depressive symptoms and reported rumination. Results: Participants with major depressive disorder displayed a difference in late positive potentials across frontocentral electrodes between self-related and non-self-related conditions. We found no such difference in controls. The magnitude of this difference was positively correlated with depressive symptoms and reported rumination. Participants with major depressive disorder also had elevated theta oscillation power at central electrodes in self-related conditions, a finding that we did not see in controls. Limitations: Patients with major depressive disorder were medicated at the time of the study. The group studied was primarily female, so the observed effects may have been sex-specific. Conclusion: Rumination appears to be linked to altered self-related processing in depression, independent of stimuli-related emotional confounds. This connection between self-related processing and depression may point to a self disorder as a core component of depression. (shrink)

In discussions of practical reason we often encounter the view that a fact is a reason for an agent to act only if the fact is capable of moving the agent to act. This view figures centrally in many philosophical controversies, and while taken for granted by some, it is vigorously disputed by others. In this essay I show that if the disputed position is correctly interpreted, it is well armored against stock objections and implied by a premise that is (...) not only plausible, but generally accepted by the position's critics. (shrink)

Two arguments against the compatibility of epistemic internalism and content externalism are considered. Both arguments are shown to fail, because they equivocate on the concept of justification involved in their premises. To spell out the involved equivocation, a distinction between subjective and objective justification is introduced, which can also be independently motivated on the basis of a wide range of thought experiments to be found in the mainstream literature on epistemology. The subjective/objective justification distinction is also ideally suited for providing (...) new insights with respect to central issues within epistemology, including the internalism/externalism debate and the New Evil Demon intuition. (shrink)

Betrayal trauma theory suggests that psychogenic amnesia is an adaptive response to childhood abuse. When a parent or other powerful figure violates a fundamental ethic of human relationships, victims may need to remain unaware of the trauma not to reduce suffering but rather to promote survival. Amnesia enables the child to maintain an attachment with a figure vital to survival, development, and thriving. Analysis of evolutionary pressures, mental modules, social cognitions, and developmental needs suggests that the degree to which the (...) most fundamental human ethics are violated can influence the nature, form, and processes of trauma and responses to trauma. (shrink)

The biological sciences study (bio)complex living systems. Research directed at the mechanistic explanation of the "live" state truly requires a pluralist research program, i.e. BioComplexity research. The program should apply multiple intra-level and inter-level theories and methodologies. We substantiate this thesis with analysis of BioComplexity: metabolic and modular control analysis of metabolic pathways, emergence of oscillations, and the analysis of the functioning of glycolysis.

A commentary on “Making the Case for Health‐Enhancing Laws after Bloomberg,” in the January‐February 2014issue.

This paper studies the problem of the arrow of time from the scientific and philosophical perspective. The scientific section (Castagnino) poses the topic according to the instruments of measuring employed in physical theories, specially when they are applied to dynamic chaotic systems in which a temporal asymmetry is shown. From the analysis of “two schools” (epistemological and ontological), the conclusion is favorable to the reality (both ontological and epistemological) of the difference between past and future, with the recourse to Reichenbach’s (...) notion of global system. In the philosophical section (Sanguineti) the content of the scientific part of the article is presented in a qualitative way. The role of some philosophical choices in the scientific field is stressed, taking into account the diversity of a positivistic and realistic view. (shrink)

Many arguments have been advanced for the view that "Why be moral?" is a pseudo-question. In this paper I address one of the most widely known and influential of them, one that comes from John Hospers and J. C. Thornton. I do so partly because, strangely, an important phase of that argument has escaped close attention. It warrants such attention because, firstly, not only is it important to the argument in which it appears, it is important in wider respects. For (...) instance, if it is sound it has weighty consequences even if the argument in which it figures fails. Secondly, it is not sound; it succumbs to a simple objection. (shrink)

As the quality movement in health care now enters its fourth decade, the language of quality is ubiquitous. Practitioners, organizations, and government agencies alike vociferously testify their commitments to quality and accept numerous forms of governance aimed at improving quality of care. Remarkably, the powerful phrase ‘‘quality of care’’ is rarely defined in the health care literature. Instead it operates as an accepted and assumed goal worth pursuing. The status of evidence-based medicine, for instance, hinges on its ability to improve (...) quality of care, and efforts are made by both proponents and detractors to unpack the contents and outcomes of evidence-based practice while the contents of ‘‘quality of care’’ are presumed to be understood. Because the goals of medicine are far from obvious, this paper investigates the neglected term, ‘‘quality of care,’’ in an effort to understand what it is that health care practices are so uncritically assumed to be striving for. Finding lack of consensus on the terminology in the quality literature, I propose that the term operates rhetorically by way of persuasive appeal (and lack of descriptive meaning). Unsatisfied that ‘‘quality of care’’ operates as a mere buzzword in morally contentious debates over resource allocation and duties of care, I implore health care communities to go beyond mere commitments to quality and, instead, to focus attention on the difficult task of specifying what counts as quality care within an economically constrained health care system. (shrink)

Augustine′s conversion to Christianity in A.D. 386 is a pivotal moment not only in his own life, but in Christian and world history, for the theology of Augustine set the course of theological and cultural development in the western Christian church. But to what exactly was Augustine converted? Scholars have long debated whether he really converted to Christianity in 386, whether he was a Platonist, and, if he adhered to both Platonism and Christianity, which dominated his thought. The debate of (...) the last thirteen decades spans an immense body of literature in multiple languages. In this literature, four major views on Augustine′s conversion may be discerned. The first view is associated with Gaston Boissier and Adolph von Harnack, and was famously championed by Prosper Alfaric: that Augustine in 386 converted to neo-Platonism but not to Christianity. Second, there is the view recently promoted by Catherine Conybeare: that Augustine in 386 converted to Christianity and rejected neo-Platonism. Third, there is the view that he converted to Christianity and was also a neo-Platonist; the most famous adherents of this view are Robert J. O′Connell and Pierre Courcelle. Finally, there is the view recently promoted by Carol Harrison: that Augustine committed to Christianity in 386, yet did not utterly reject neo-Platonism; rather, he aimed to develop a Christian faith that was informed by neo-Platonic insight. In this article, I first explain and distinguish these four general views, and then I explain why I prefer the fourth view. -/- More Info: This is the pre-peer reviewed version of Boone, Mark, "The Role of Platonism in Augustine's 386 Conversion to Christianity," Religion Compass 9.5 (May 2015), 151-61. This article has been published in final form at http://onlinelibrary.wiley.com/doi/10.1111/rec3.12149/abstract. (shrink)

Property-identical divine-command theory (PDCT) is the view that being obligatory is identical to being commanded by God in just the way that being water is identical to being H2O. If these identity statements are true, then they express necessary a posteriori truths. PDCT has been defended in Robert M. Adams (1987) and William Alston (1990). More recently Mark C. Murphy (2002) has argued that property-identical divine-command theory is inconsistent with two well-known and well-received theses: the free-command thesis and the supervenience (...) thesis. I show that Murphy's argument is vitiated by mistaken assumptions about the substitutivity of metaphysical identicals in contexts of supervenience. The free-command thesis and the supervenience thesis therefore pose no serious threat to PDCT. (Published Online August 11 2004). (shrink)

This research paper presents the development and evaluation of an expert system for diagnosing kidney diseases. The expert system utilizes a decision-making tree approach and is implemented using the CLIPS and Delphi frameworks. The system's accuracy in diagnosing kidney diseases and user satisfaction were evaluated. The results demonstrate the effectiveness of the expert system in providing accurate diagnoses and high user satisfaction.

Notions of agency and of weakness of will clearly seem to be related to one another. This essay takes on a rather modest task in relation to current discussion of these topics; it seeks to establish the following claim: If A is a normal human agent, weakness of will is possible for A. The argument relies on demonstrating that certain necessary conditions for normal human agency are at least roughly equivalent to certain sufficient conditions for weakness of will. The connection (...) between agency and weakness of will is made through the use of an extended example that lays bare the links between the two. (shrink)

Augustine and William James both argue that religious faith can be both practical and rational even in the absence of knowledge. Augustine argues that religious faith is trust and that trust is a normal, proper, and even necessary way of believing. Beginning with faith, we then work towards knowledge by means of philosophical contemplation. James’ “The Will to Believe” makes pragmatic arguments for the rationality of faith. Although we do not know (yet) whether God exists, faith is a choice between (...) the risk of believing something false and the risk of not believing something true, and in the absence of convincing evidence we may decide for ourselves which risk we prefer. We may be able to experience God in the future and thereby gain knowledge, yet this may be contingent on our willingness to believe. There are key differences, however. Augustine is a Christian with a neo-Platonic bent, James an empiricist defending the religion of your choice. These differences may be less significant than they first appear. After explaining Augustine and then James I draw out the major points of comparison and contrast and suggest a few reasons their insights might be at least partially synthesized. -/- This is the accepted version of the following article: Mark J. Boone, “Augustine and William James on the Rationality of Faith,” The Heythrop Journal (online edition December 2018), which has been published in final form at [See First URL]. This article may be used for non-commercial purposes in accordance with the Wiley Self-Archiving Policy [See Second URL]. (shrink)

I argue for the thesis (UL) that there are certain logical abilities that any rational creature must have. Opposition to UL comes from naturalized epistemologists who hold that it is a purely empirical question which logical abilities a rational creature has. I provide arguments that any creatures meeting certain conditions—plausible necessary conditions on rationality—must have certain specific logical concepts and be able to use them in certain specific ways. For example, I argue that any creature able to grasp theories must (...) have a concept of conjunction subject to the usual introduction and elimination rules. I also deal with disjunction, conditionality and negation. Finally, I put UL to work in showing how it could be used to define a notion of logical obviousness that would be well suited to certain contexts—e.g. radical translation and epistemic logic—in which a concept of obviousness is often invoked. (shrink)

Bernard Reginster, in his book The Affirmation of Life: Nietzsche on Overcoming Nihilism, takes up the challenge of figuring out what Nietzsche might mean by nihilism and the revaluation of values. He argues that there is an alternative, normative subjectivist interpretation of Nietzsche's views on nihilism and revaluation that makes as much sense as—indeed, he often clearly leans toward thinking that it makes more sense than—a fictionalist reading of Nietzsche. I argue that his arguments do not succeed. Once we have (...) looked carefully at the details of the positions and the arguments ascribed to Nietzsche, the fictionalist option is the more charitable interpretation of the texts. I focus on the metaethical issues that play a central role for Reginster in his articulation of Nietzsche's nihilism and Nietzsche's strategy for overcoming nihilism. (shrink)