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

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

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

Most public and non-profit organisations that fund health research provide the majority of their funding in the form of grants. The calls for grant applications are often untargeted, such that a wide variety of applications may compete for the same funding. The grant review process therefore plays a critical role in determining how limited research resources are allocated. Despite this, little attention has been paid to whether grant review criteria align with widely endorsed ethical criteria for allocating health research resources. (...) Here, we analyse the criteria and processes that ten of the largest public and non-profit research funders use to choose between competing grant applications. Our data suggest that research funders rarely instruct reviewers to consider disease burden or to prioritise research for sicker or more disadvantaged populations, and typically only include scientists in the review processes. This is liable to undermine efforts to link research funding to health needs. (shrink)

Psychological studies show that the beliefs of two agents in a hypothesis can diverge even if both agents receive the same evidence. This phenomenon of belief polarisation is often explained by invoking biased assimilation of evidence, where the agents’ prior views about the hypothesis affect the way they process the evidence. We suggest, using a Bayesian model, that even if such influence is excluded, belief polarisation can still arise by another mechanism. This alternative mechanism involves differential weighting of the evidence (...) arising when agents have different initial views about the reliability of their sources of evidence. We provide a systematic exploration of the conditions for belief polarisation in Bayesian models which incorporate opinions about source reliability, and we discuss some implications of our findings for the psychological literature. (shrink)

We respond to open peer commentaries on our target article, "Health Research Priority Setting: The Duties of Individual Funders".

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

We discuss the role of prior authorization (PA) in supporting patient-centered care (PCC) by directing health system resources and thus the ability to better meet the needs of individual patients. We begin with an account of PCC as a standard that should be aimed for in patient care. In order to achieve widespread PCC, appropriate resource management is essential in a healthcare system. This brings us to PA, and we present an idealized view of PA in order to argue how (...) at its best, it can contribute to the provision of PCC. PA is a means of cost saving and as such it has mixed success. The example of the US demonstrates how implementation of PA has increased health inequalities whereas best practice has the potential to reduce them. In contrast, systems of universal coverage, like those in Europe, may use the cost savings of PA to better address individuals' care and PCC. The conclusion we offer therefore is an optimistic one, pointing towards areas of supportive overlap between PCC and PA where usually the incongruities are most evident. (shrink)

Hundreds of millions of rare biospecimens are stored in laboratories and biobanks around the world. Often, the researchers who possess these specimens do not plan to use them, while other researchers limit the scope of their work because they cannot acquire biospecimens that meet their needs. This situation raises an important and underexplored question: how should scientists allocate biospecimens that they do not intend to use? We argue that allocators should aim to maximise the social value of the research enterprise (...) when allocating scarce biospecimens. We provide an ethical framework for assessing the social value of proposed research projects and describe how the framework could be implemented. (shrink)

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

Deepfakes are algorithmically modified video and audio recordings that project one person’s appearance on to that of another, creating an apparent recording of an event that never took place. Many scholars and journalists have begun attending to the political risks of deepfake deception. Here we investigate other ways in which deepfakes have the potential to cause deeper harms than have been appreciated. First, we consider a form of objectification that occurs in deepfaked ‘frankenporn’ that digitally fuses the parts of different (...) women to create pliable characters incapable of giving consent to their depiction. Next, we develop the idea of ‘illocutionary wronging’, in which an individual is forced to engage in speech acts they would prefer to avoid in order to deny or correct the misleading evidence of a publicized deepfake. Finally, we consider the risk that deepfakes may facilitate campaigns of ‘panoptic gaslighting’, where many systematically altered recordings of a single person's life undermine their memory, eroding their sense of self and ability to engage with others. Taken together, these harms illustrate the roles that social epistemology and technological vulnerabilities play in human ethical life. (shrink)

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

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

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

School administrators are mandated to take the instructional leadership roles. On this premise, a study assessed the extent of instructional leadership practices of public elementary school administrators in El Salvador City Division, Philippines. Also, it explored their actual practices, challenges encountered, and the ways they overcome the challenges in practicing instructional leadership. It employed a mixed-method research design. It administered the adopted assessment tool on instructional leadership to 15 school administrators and 12 of them were involved in the individual interviews. (...) This was conducted between the last quarter of 2019 and the first quarter of 2020. Descriptive statistics were used to describe the extent of instructional leadership practices. Also, it analyzed the actual practices, the challenges encountered, and the ways of overcoming these challenges using thematic narrative analysis. Results revealed that public school administrators have always practiced the four domains or strands of instructional leadership to a very high extent. Providing the technical assistance, conducting clinical supervision, and innovating teaching and learning emerged as themes of their actual practices. These administrators had encountered challenges in dealing with teachers’ attitudes, conflicting schedules and activities, and teachers’ resistance to changes. They overcome the challenges by trying to meet the competency standards, adapting and modifying the existing programs, contextualizing teaching and learning, and inculcating the value and benefits of class observation. Looking at the findings from the lens of deliberate practice theory, it was concluded that school administrators have indicated they have acquired knowledge and a high level of understanding of their instructional leadership roles. But despite of this, they still met challenges and have tried their best to manage them. This study presented some doable and practical recommendations to the Department of Education (DepEd) and concerned offices which may benefit both the internal and external stakeholders of the schools. (shrink)

We are immersed within an odorous sea of chemical currents that we parse into individual odors with complex structures. Odors have been posited as determined by the structural relation between the molecules that compose the chemical compounds and their interactions with the receptor site. But, naturally occurring smells are parsed from gaseous odor plumes. To give a comprehensive account of the nature of odors the chemosciences must account for these large distributed entities as well. We offer a focused review of (...) what is known about the perception of odor plumes for olfactory navigation and tracking, which we then connect to what is known about the role odorants play as properties of the plume in determining odor identity with respect to odor quality. We end by motivating our central claim that more research needs to be conducted on the role that odorants play within the odor plume in determining odor identity. (shrink)

The objective of this study is to incorporate topological space into the realm of n-Cylindrical Fuzzy Neutrosophic Sets (n-CyFNS), which are the most novel type of fuzzy neutrosophic sets. In this paper, we introduce n-Cylindrical Fuzzy Neutrosophic Topological Spaces (n-CyFNTS), n-Cylindrical Fuzzy Neutrosophic (n-CyFN) open sets, and n-CyFN closed sets. We also defined the n-CyFN base, n-CyFN subbase, and some related theorems here.

Health care providers (HCPs) are routinely placed into morally challenging situations that have the potential to cause moral distress. This is especially true for HCPs working in the military, whether they are on deployment outside their typical contexts of practice such as in disaster relief (e.g., Haiti and the Ebola missions in West Africa), or in more typically military settings such as peace keeping or armed conflicts (e.g., Afghanistan, Syria). Moral distress refers to “painful feelings and/or psychological disequilibrium” (Nilsson, Sjöberg, (...) Kallenberg, & Larsson, 2011, p. 50) that occur when an individual is aware of a morally appropriate action in a moral dilemma but obstruction prevents them from carrying it out, or when in a situation where they must choose between upholding equally treasured but conflicting moral values. Similarly, moral distress can occur when faced with a ‘tragic choice’ where all available courses of action require something of moral significance to be given up, such as surgical triage in a mass casualty event (Hunt, Sinding, & Schwartz, 2012). In the literature, moral distress has been connected to negative psychological effects and even stress related mental health issues including compassion fatigue, burnout, and post-traumatic stress disorder (Owen & Wanzer, 2014; Gustafsson, Eriksson, Strandberg, & Norberg, 2010; Litz, et al., 2009). (shrink)

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

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

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

Although ethics is an essential component of undergraduate medical education, research suggests current medical ethics curricula face considerable challenges in improving students’ ethical reasoning. This paper discusses these challenges and introduces a promising new mode of graduate and professional ethics instruction for overcoming them. We begin by describing common ethics curricula, focusing in particular on established problems with current approaches. Next, we describe a novel method of ethics education and assessment for medical students that we have devised, the Medical Ethics (...) Bowl. Finally, we suggest pedagogical advantages to MEBs when compared to other ethics curricula. (shrink)

Discerning the decisionmaking of Kim Jong-Un and the North Korean regime on issues of peaceful engagement and warlike actions endures as a mighty challenge for U.S. intelligence analysts and policymakers. In this report, we seek to inform analysis of Democratic People’s Republic of Korea (DPRK) leadership decisionmaking. To do so, we use three discussion papers that were written to facilitate discussion of an interagency working group. The three papers are assembled here in a single report. The first discussion paper describes (...) decisionmaking among different authoritarian regimes, including North Korea, and the opening up of those economies to outside engagement. The second paper outlines two different scenarios that might occur when conventional deterrence on the Korean Peninsula breaks down and the resulting decisions that North Korea’s leadership could face. The third paper assesses DPRK decisionmaking about nuclear weapon use. The report concludes with some observations, drawn from the issues covered in these three discussion papers, about DPRK decisionmaking and stability on the Korean Peninsula. (shrink)

When Mathew Lipman first introduced Philosophy for Children to the world, his goal was not to sneak a little academic philosophy into the typical school curriculum, as one might expect from the titles of his first books: Philosophy in the Classroom and Philosophy Goes to School. His goal, rather, was to create a paradigm shift in the field of education itself: namely, to transform the typical hierarchical model into one in which the teacher/facilitator solicits responses from students and hence, in (...) that sense, meets them where they “are at.” This non-hierarchical model, however, has stumbled in taking root, which is, perhaps, not surprising given that the hierarchical model, whether in school, in sport or in the home, appears to be so much easier and so much more efficient. If those of us who support a non-hierarchical model in all these arenas are serious about furthering this approach, it would appear that the onus lies with us to articulate precisely in what ways a hierarchical model falls short. In so doing, we will not only provide ourselves with a precise framework by which to make the case for the importance of adopting a non-hierarchical approach, we will also provide ourselves with a metric whereby we can measure whether our own non-hierarchal practice is true to its justification; and that the approach is not simply non-hierarchal for sake of being non-hierarchical, nor quasi-authoritarianism for the sake of more wide-spread acceptance. It is the articulation of the flaws of a hierarchical model that non-hierarchal model can correct that will be the focus of the analysis here. (shrink)

The philosophy of biomimicry, I argue, consists of four main areas of inquiry. The first, which has already been explored by Freya Mathews, concerns the “deep” question of what Nature ultimately is. The second, third, and fourth areas correspond to the three basic principles of biomimicry as laid out by Janine Benyus. “Nature as model” is the poetic principle of biomimicry, for it tells us how it is that things are to be “brought forth”. “Nature as measure” is the (...) ethical principle of biomimicry, for it tells us that Nature places ethical limits or standards on what it is possible for us to accomplish. And “Nature as mentor” is the epistemological principle of biomimicry, for it affirms that Nature is the ultimate source of truth, wisdom, and freedom from error. Within this overall framework, I argue that seeing Nature as physis—understood as “self-production” or “self-placing-into-the-open”—constitutes the requisite ground for the poetic, ethical, and epistemological principles of biomimicry, and that biomimicry thus conceived involves a new philosophical paradigm, which I call “enlightened naturalism”. (shrink)

Wall, G. Locke's attack on innate knowledge.--Harris, J. Leibniz and Locke on innate ideas.--Greenlee, D. Locke's idea of idea.--Aspelin, G. Idea and perception in Locke's essay.--Greenlee, D. Idea and object in the essay.--Mathews, H. E. Locke, Malebranche and the representative theory.--Alexander, P. Boyle and Locke on primary and secondary qualities.--Ayers, M. R. The ideas of power and substance in Locke's philosophy.--Allison, H. E. Locke's theory of personal identity.--Kretzmann, N. The main thesis of Locke's semantic theory.--Woozley, A. D. Some remarks (...) on Locke's account of knowledge.--Laudan, L. The nature and sources of Locke's views on hypotheses. (shrink)

Any interpretation of the doctrine of the atonement has to take account of relevant biblical texts. Among these texts, one that has been the most difficult to interpret is that describing the cry of dereliction from the cross. According to the Gospels of Mathew and Mark, on the cross Jesus cries, “My God, my God, why have you forsaken me?‘ In this paper, I give a philosophical analysis of the options for understanding the cry of dereliction, interpreted within the constraints (...) of orthodox Christian theology; and I show the suggestiveness of this analysis for interpretations of the doctrine of the atonement. (shrink)

Philosophy for Children' program that Mathew Lipman and his colleagues have developed is now known in our society and has led to thinking and research in this regard. Thus, to consider the challenges that are in front of this program can lead to the richness of these researches. Three challenges are in front of this program: philosophical, psychological, and educational. The philosophical challenge is due to the point that philosophy is mainly dependent on the history of philosophy and thoughts of (...) preceding philosophers. This dependence should of course be along with critique, but this dependence cannot be denied anyway. Hence, philosophizing cannot be reduced to the methods of thinking. Psychological challenge is rooted in the approaches of developmental psychology that emphasize on phases in human thinking. Accordingly, abstract methods of philosophizing cannot be used in the period of childhood. Educational challenge is related to basic cultural values that might be shaken in the process of philosophical interrogations. The philosophical challenge requires that teaching philosophy to children emphasize on an amalgamation of method and content. The psychological challenge makes us cautious as to looking for more investigations on the periodical characteristic of thinking. And finally, the educational challenge requires that criticizing cultural values, being necessary in active education, is not started from foundational issues of culture. The period of childhood can only be fitted to interrogation of low level cultural issues and values and leave the foundational cultural issues to philosophizing in higher ages. (shrink)

I reply to critical discussion of my work by Copthorne Macdonald, Steve Fuller, John Stewart, Joseph Agassi, Margaret Boden, Donald Gillies, Mathew Iredale, David Hodgson, Karl Rogers, and Leemon McHenry.

According to the moral error theory, all moral judgments are false. Until lately, most error theorists were local error theorists; they targeted moral judgments specifically and were less skeptical of other normative areas. These error theorists now face so-called “prudential parity objections”, according to which whatever evidence there is in favor of the moral error theory is also evidence for a prudential error theory. The present paper rejects three prudential parity objections: one based on the alleged irreducible normativity of prudential (...) reasons; another on the lack of a story about the normativity of hypothetical reasons; yet another on the very nature of reasons generally. I argue that these objections leave an important variant of a local moral error theory intact. (shrink)