Some experts have argued that patients should routinely be told the specific magnitude and absolute probability of potential risks and benefits of screening tests. This position is motivated by the idea that framing risk information in ways that are less precise violates the ethical principle of respect for autonomy and its application in informed consent or shared decisionmaking. In this Perspective, we consider a number of problems with this view that have not been adequately addressed. The most important challenges stem (...) from the danger that patients will misunderstand the information or have irrational responses to it. Any initiative in this area should take such factors into account and should consider carefully how to apply the ethical principles of respect for autonomy and beneficence. (shrink)

While several tests and strategies are recommended for colorectal cancer (CRC) screening, studies suggest that primary care providers often recommend colonoscopy without providing information about its risks or alternatives. These observations raise concerns about the quality of informed consent for screening colonoscopy.

Ethics should guide the design of electronic health records (EHR), and recognized principles of bioethics can play an important role. This approach was adopted recently by a team of informaticists designing and testing a system where patients exert granular control over who views their personal health information. While this method of building ethics in from the start of the design process has significant benefits, questions remain about how useful the application of bioethics principles can be in this process, especially when (...) principles conflict. For instance, while the ethical principle of respect for autonomy supports a robust system of granular control, the principles of beneficence and non-maleficence counsel restraint due to the danger of patients being harmed by restrictions on provider access to data. Conflict between principles has long been recognized by ethicists and has even motivated attacks on approaches that state and apply principles. In this paper we show how using ethical principles can help in the design of EHRs by first, explaining how ethical principles can and should be used generally, and then by, discuss how attention to details in specific cases can show that the tension between principles is not as bad as it initially appeared. We conclude by suggesting further ways in which the application of these (and other) principles can add value to the ongoing discussion of patient involvement in their health care. This is a new approach to linking principles to informatics design that we expect will stimulate further interest. (shrink)

Most people do not know there are different kinds of medical studies; some are conducted on people who already have a disease or medical condition, and others are performed on healthy volunteers who want to help science find answers. No matter what sort of research you are invited to participate in, or whether you are a patient when you are asked, it’s entirely up to you whether or not to do it. This decision is important and may have many implications (...) for your health and well-being, as well as those of other patients now and in the future. Making a good decision – the right one for you – requires you to become educated about topics you may not have thought about before, some of which may be quite complicated. This chapter explains the key issues to help you make a good decision. (shrink)

Although there is a growing recognition that older adults and those with extensive comorbid conditions undergo cancer screening too frequently, there is little information about patients’ perceptions regarding cessation of cancer screening. Information on older adults’ views of screening cessation would be helpful both for clinicians and for those designing interventions to reduce overscreening.

Objective: There are benefits and risks of giving patients more granular control of their personal health information in electronic health record (EHR) systems. When designing EHR systems and policies, informaticists and system developers must balance these benefits and risks. Ethical considerations should be an explicit part of this balancing. Our objective was to develop a structured ethics framework to accomplish this. -/- Methods: We reviewed existing literature on the ethical and policy issues, developed an ethics framework called a “Points to (...) Consider” (P2C) document, and convened a national expert panel to review and critique the P2C. -/- Results: We developed the P2C to aid informaticists designing an advanced query tool for an electronic health record (EHR) system in Indianapolis. The P2C consists of six questions (“Points”) that frame important ethical issues, apply accepted principles of bioethics and Fair Information Practices, comment on how questions might be answered, and address implications for patient care. -/- Discussion: The P2C is intended to clarify whatis at stake when designers try to accommodate potentially competing ethical commitments and logistical realities. The P2C was developed to guide informaticists who were designing a query tool in an existing EHR that would permit patient granular control. While consideration of ethical issues is coming to the forefront of medical informatics design and development practices, more reflection is needed to facilitate optimal collaboration between designers and ethicists. This report contributes to that discussion. (shrink)

According to Hempel's paradox, evidence (E) that an object is a nonblack nonraven confirms the hypothesis (H) that every raven is black. According to the standard Bayesian solution, E does confirm H but only to a minute degree. This solution relies on the almost never explicitly defended assumption that the probability of H should not be affected by evidence that an object is nonblack. I argue that this assumption is implausible, and I propose a way out for Bayesians. Introduction Hempel's (...) paradox, the standard Bayesian solution, and the disputed assumption Attempts to defend the disputed assumption Attempts to refute the disputed assumption A way out for Bayesians Conclusion. (shrink)

This paper is a study about Philadelphia’s comprehensive user engagement sites (CUESs) as the authors address and examine issues related to the upcoming implementation of a CUES while seeking solutions for its disputed questions and plans. Beginning with the federal drug schedules, the authors visit some of the medical and public health issues vis-à-vis safe injection facilities (SIFs). Insite, a successful Canadian SIF, has been thoroughly researched as it represents a paradigm for which a Philadelphia CUES can expand upon. Also, (...) the existing criticisms against SIFs are revisited while critically unpackaged and responded to in favor of the establishment. In the main section, the authors propose the layout and services of the upcoming CUES, much of which would be in congruent to Vancouver’s Insite. On the other hand, the CUES would be distinct from Insite, as the authors emphasize, in that it will offer an information center run by individuals in recovery and place additional emphasis on early education for young healthcare professionals by providing them a platform to work at the site. The paper will also briefly investigate the implementation of a CUES site under an ethical scope of the Harm Reduction Theory. Lastly, the authors recommend some strategic plans that the Philadelphia City government may consider employing at this crucial stage. (shrink)

Animal ethicists have recently debated the ethical questions raised by disenhancing animals to improve their welfare. Here, we focus on the particular case of breeding hens for commercial egg-laying systems to become blind, in order to benefit their welfare. Many people find breeding blind hens intuitively repellent, yet ‘welfare-only’ positions appear to be committed to endorsing this possibility if it produces welfare gains. We call this the ‘Blind Hens’ Challenge’. In this paper, we argue that there are both empirical and (...) theoretical reasons why even those adopting ‘welfare-only’ views should be concerned about breeding blind hens. But we also argue that alternative views, which (for example) claim that it is important to respect the telos or rights of an animal, do not offer a more convincing solution to questions raised by the possibility of disenhancing animals for their own benefit. (shrink)

Throughout the biological and biomedical sciences there is a growing need for, prescriptive ‘minimum information’ (MI) checklists specifying the key information to include when reporting experimental results are beginning to find favor with experimentalists, analysts, publishers and funders alike. Such checklists aim to ensure that methods, data, analyses and results are described to a level sufficient to support the unambiguous interpretation, sophisticated search, reanalysis and experimental corroboration and reuse of data sets, facilitating the extraction of maximum value from data sets (...) them. However, such ‘minimum information’ MI checklists are usually developed independently by groups working within representatives of particular biologically- or technologically-delineated domains. Consequently, an overview of the full range of checklists can be difficult to establish without intensive searching, and even tracking thetheir individual evolution of single checklists may be a non-trivial exercise. Checklists are also inevitably partially redundant when measured one against another, and where they overlap is far from straightforward. Furthermore, conflicts in scope and arbitrary decisions on wording and sub-structuring make integration difficult. This presents inhibit their use in combination. Overall, these issues present significant difficulties for the users of checklists, especially those in areas such as systems biology, who routinely combine information from multiple biological domains and technology platforms. To address all of the above, we present MIBBI (Minimum Information for Biological and Biomedical Investigations); a web-based communal resource for such checklists, designed to act as a ‘one-stop shop’ for those exploring the range of extant checklist projects, and to foster collaborative, integrative development and ultimately promote gradual integration of checklists. (shrink)

"Modern History" versions of the etiological theory claim that in order for a trait X to have the proper function F, individuals with X must have been recently favored by natural selection for doing F (Godfrey-Smith 1994; Griffiths 1992, 1993). For many traits with prototypical proper functions, however, such recent selection may not have occurred: traits may have been maintained due to lack of variation or due to selection for other effects. I examine this flaw in Modern History accounts and (...) offer an alternative etiological theory, the Continuing Usefulness account, which appears to avoid such problems. (shrink)

Similarly to other accounts of disease, Christopher Boorse’s Biostatistical Theory (BST) is generally presented and considered as conceptual analysis, that is, as making claims about the meaning of currently used concepts. But conceptual analysis has been convincingly critiqued as relying on problematic assumptions about the existence, meaning, and use of concepts. Because of these problems, accounts of disease and health should be evaluated not as claims about current meaning, I argue, but instead as proposals about how to define and use (...) these terms in the future, a methodology suggested by Quine and Carnap. I begin this article by describing problems with conceptual analysis and advantages of “philosophical explication,” my favored approach. I then describe two attacks on the BST that also question the entire project of defining “disease.” Finally, I defend the BST as a philosophical explication by showing how it could define useful terms for medical science and ethics. (shrink)

Patients should not always receive hard data about the risks and benefits of a medical intervention. That information should always be available to patients who expressly ask for it, but it should be part of standard disclosure only sometimes, and only for some patients. And even then, we need to think about how to offer it.

Accounts of the concepts of function and dysfunction have not adequately explained what factors determine the line between low‐normal function and dysfunction. I call the challenge of doing so the line‐drawing problem. Previous approaches emphasize facts involving the action of natural selection (Wakefield 1992a, 1999a, 1999b) or the statistical distribution of levels of functioning in the current population (Boorse 1977, 1997). I point out limitations of these two approaches and present a solution to the line‐drawing problem that builds on the (...) second one. (shrink)

This article is part of a For-Discussion-Section of Methods of Information in Medicine about the paper "Biomedical Informatics: We Are What We Publish", written by Peter L. Elkin, Steven H. Brown, and Graham Wright. It is introduced by an editorial. This article contains the combined commentaries invited to independently comment on the Elkin et al. paper. In subsequent issues the discussion can continue through letters to the editor.

I argue that ductal carcinoma in situ (DCIS), the tumor most commonly diagnosed by breast mammography, cannot be confidently classified as cancer, that is, as pathological. This is because there may not be dysfunction present in DCIS—as I argue based on its high prevalence and the small amount of risk it conveys—and thus DCIS may not count as a disease by dysfunction-requiring approaches, such as Boorse’s biostatistical theory and Wakefield’s harmful dysfunction account. Patients should decide about treatment for DCIS based (...) on the risks it poses and the risks and benefits of treatment, not on its disease status. (shrink)

Consider the following patient: a 40-year-old man who has had back pain that radiates down his left leg, on and off for 2 months. He performs his normal activities and does not have any “red flag”...

Imagine you fly home from vacation with your one-and-a-half-year-old son who is traveling for free as a “lap child.” In the airport parking lot, you put him into his forward-facing car seat, where he sits much more contentedly than he did in the rear-facing one that was mandatory until his first birthday. After he falls asleep on the way home, you transfer him to his crib without waking him, lowering the side rail so you can lift him in more easily. (...) -/- Many parts of this idyllic parenting picture are deemed unacceptably risky according to recent child safety proposals. While these proposals all aim to improve child safety, their possible impact is unclear because there has been little discussion of the absolute risk and risk reduction involved in each. And while precise figures are lacking, rough estimates indicate that the magnitudes are quite small. I will argue that this risk and benefit data raises important questions about the proposals, including whether parents might reasonably believe that the small absolute risk reduction offered by the proposed changes does not justify the attendant burdens. This possibility—termed the “prevention paradox” in other contexts—highlights ethical and theoretical challenges in this area of public health. (shrink)

With the growing focus on prevention in medicine, studies of how to describe risk have become increasing important. Recently, some researchers have argued against giving patients “comparative risk information,” such as data about whether their baseline risk of developing a particular disease is above or below average. The concern is that giving patients this information will interfere with their consideration of more relevant data, such as the specific chance of getting the disease (the “personal risk”), the risk reduction the treatment (...) provides, and any possible side effects. I explore this view and the theories of rationality that ground it, and I argue instead that comparative risk information can play a positive role in decision-making. The criticism of disclosing this sort of information to patients, I conclude, rests on a mistakenly narrow account of the goals of prevention and the nature of rational choice in medicine. (shrink)

Trademarks are not just property; they are aesthetic creations that pervade everyday experience. As pervasive aesthetic creations having literary, pictorial, graphic, sculptural, and musical content, trademarks deserve aesthetic analysis. So this paper discusses the origins, strength, appeal, and effectiveness of trademarks within the context of aesthetic considerations such as meaning, intention, authorship, and mode of creation. Also reviewed are morphemic and phonemic analysis of trademarks, semantic positioning, the dichotomy between creation and discovery of trademarks, and the differences between trademarks and (...) titles. The discussion is confined to "word marks" consisting of alphanumeric characters because discussing other kinds of marks (such as designs, configurations, sounds, colors, and scents) would raise issues well beyond the scope of a single article. (shrink)

This paper delves into the nature of intellectual property rights in aesthetic creations, particularly works of visual art and literary works. The discussion focuses on copyrights interests, but there are also implications for trademark and patent rights. The argument assumes a fairly conventional definition of "property," namely, the set of legal relations between the owner and all other persons relating to the use, enjoyment and disposition of a tangible thing. The problem with such a definition as applied to aesthetic creations (...) is that no ordinary tangible thing necessarily embodies a creation which can exist in multiple copies, so the paper takes the transcendent view that the tangible thing subject to legal relations is the entire terra firma or material universe being shaped in the image, sounds or words of the aesthetic creation. Therefore, the paradigm suggested for intellectual property is a monopoly on shaping the entire physical universe, thus the Worldmaking concept. It then follows that intellectual property in an aesthetic creation enables the owner to stop plagiarists from using any part of the material world to recreate in the audience the imaginative experiences first created by the protected work. (shrink)

"Surrender; therefore, surrender or fight" is apparently an argument corresponding to an inference from an imperative to an imperative. Several philosophers, however (Williams 1963; Wedeking 1970; Harrison 1991; Hansen 2008), have denied that imperative inferences exist, arguing that (1) no such inferences occur in everyday life, (2) imperatives cannot be premises or conclusions of inferences because it makes no sense to say, for example, "since surrender" or "it follows that surrender or fight", and (3) distinct imperatives have conflicting permissive presuppositions (...) ("surrender or fight" permits you to fight without surrendering, but "surrender" does not), so issuing distinct imperatives amounts to changing one's mind and thus cannot be construed as making an inference. In response I argue inter alia that, on a reasonable understanding of 'inference', some everyday-life inferences do have imperatives as premises and conclusions, and that issuing imperatives with conflicting permissive presuppositions does not amount to changing one's mind. (shrink)

Some experts have argued that patients facing certain types of choices should not be told whether their risk is above or below average, because this information may trigger a bias (Fagerlin et al. 2007). But careful consideration shows that the comparative risk heuristic can usefully guide decisions and improve their quality or rationality. Building on an earlier paper of mine (Schwartz 2009), I will argue here that doctors and decision aids should provide comparative risk information to patients, even while further (...) research is conducted. (shrink)

Part I of this article advanced a new theory of humor, the Enlightenment Theory, while contrasting it with other main theories, including the Incongruity, Repression/Relief/Release, and Superiority Theories. The Enlightenment Theory does not contradict these other theories but rather subsumes them. As argued, each of the other theories cannot account for all the aspects of humor explained by the Enlightenment Theory. Part II shows how the Enlightenment Theory meets challenging issues in humor theory where other theories falter, including failed humor, (...) motivation for humor, tickling, laughing gas, and sadistic humor. Also mentioned are the Enlightenment Theory's application to literary and musical humor and the relationship of wit to humor. -/- . (shrink)

Part I of this article advances a new theory of humor, the Enlightenment Theory, while contrasting it with other main theories, including the Incongruity, Repression/Relief/Release, and Superiority Theories. The Enlightenment Theory does not contradict these other theories but rather subsumes them. As argued, each of the other theories cannot account for all the aspects of humor explained by the Enlightenment Theory. The discussion is illustrated with examples of humor and explores the acts and circumstances of humor, its literary and artistic (...) expressions, and its physical reactions. Part II shows how the Enlightenment Theory meets challenging issues in humor theory where other theories sometimes falter, including issues such as failed humor, motivation for humor, tickling, laughing gas, and sadistic humor. Also mentioned are literary and musical humor and the relationship of wit to humor. (shrink)

I defend the following version of the ought-implies-can principle: (OIC) by virtue of conceptual necessity, an agent at a given time has an (objective, pro tanto) obligation to do only what the agent at that time has the ability and opportunity to do. In short, obligations correspond to ability plus opportunity. My argument has three premises: (1) obligations correspond to reasons for action; (2) reasons for action correspond to potential actions; (3) potential actions correspond to ability plus opportunity. In the (...) bulk of the paper I address six objections to OIC: three objections based on putative counterexamples, and three objections based on arguments to the effect that OIC conflicts with the is/ought thesis, the possibility of hard determinism, and the denial of the Principle of Alternate Possibilities. (shrink)

“Never attribute to malice that which is adequately explained by stupidity”—so says Hanlon’s Razor. This principle is designed to curb the human tendency toward explaining other people’s behavior by moralizing it. We ask whether Hanlon’s Razor is good or bad advice. After offering a nuanced interpretation of the principle, we critically evaluate two strategies purporting to show it is good advice. Our discussion highlights important, unsettled questions about an idea that has the potential to infuse greater humility and civility into (...) discourse and debate. (shrink)

There is widespread agreement, even among those who accept the possibility of backward causation, that it is impossible to change the past. I argue that this agreement corresponds to a relatively uninteresting understanding of what changing the past amounts to. In one sense it is indeed impossible to change the past: in no possible world is an action performed which makes the past in that world different from the past in that world. In another sense, however, it may be possible (...) to change the past: maybe in some possible world an action is performed which makes the past in that world different from the actual past. I argue that those who accept the possibility of backward causation are committed to accepting the possibility that the past changes in the latter sense. (shrink)

You may not know me well enough to evaluate me in terms of my moral character, but I take it you believe I can be evaluated: it sounds strange to say that I am indeterminate, neither good nor bad nor intermediate. Yet I argue that the claim that most people are indeterminate is the conclusion of a sound argument—the indeterminacy paradox—with two premises: (1) most people are fragmented (they would behave deplorably in many and admirably in many other situations); (2) (...) fragmentation entails indeterminacy. I support (1) by examining psychological experiments in which most participants behave deplorably (e.g., by maltreating “prisoners” in a simulated prison) or admirably (e.g., by intervening in a simulated theft). I support (2) by arguing that, according to certain plausible conceptions, character evaluations presuppose behavioral consistency (lack of fragmentation). Possible reactions to the paradox include: (a) denying that the experiments are relevant to character; (b) upholding conceptions according to which character evaluations do not presuppose consistency; (c) granting that most people are indeterminate and explaining why it appears otherwise. I defend (c) against (a) and (b). (shrink)

Imperatives cannot be true or false, so they are shunned by logicians. And yet imperatives can be combined by logical connectives: "kiss me and hug me" is the conjunction of "kiss me" with "hug me". This example may suggest that declarative and imperative logic are isomorphic: just as the conjunction of two declaratives is true exactly if both conjuncts are true, the conjunction of two imperatives is satisfied exactly if both conjuncts are satisfied—what more is there to say? Much more, (...) I argue. "If you love me, kiss me", a conditional imperative, mixes a declarative antecedent ("you love me") with an imperative consequent ("kiss me"); it is satisfied if you love and kiss me, violated if you love but don't kiss me, and avoided if you don't love me. So we need a logic of three -valued imperatives which mixes declaratives with imperatives. I develop such a logic. (shrink)

Why does classical equilibrium statistical mechanics work? Malament and Zabell (1980) noticed that, for ergodic dynamical systems, the unique absolutely continuous invariant probability measure is the microcanonical. Earman and Rédei (1996) replied that systems of interest are very probably not ergodic, so that absolutely continuous invariant probability measures very distant from the microcanonical exist. In response I define the generalized properties of epsilon-ergodicity and epsilon-continuity, I review computational evidence indicating that systems of interest are epsilon-ergodic, I adapt Malament and Zabell’s (...) defense of absolute continuity to support epsilon-continuity, and I prove that, for epsilon-ergodic systems, every epsilon-continuous invariant probability measure is very close to the microcanonical. (shrink)

The Principal Principle (PP) says that, for any proposition A, given any admissible evidence and the proposition that the chance of A is x%, one's conditional credence in A should be x%. Humean Supervenience (HS) claims that, among possible worlds like ours, no two differ without differing in the spacetime-point-by-spacetime-point arrangement of local properties. David Lewis (1986b, 1994a) has argued that PP contradicts HS, and the validity of his argument has been endorsed by Bigelow et al. (1993), Thau (1994), Hall (...) (1994), Strevens (1995), Ismael (1996), Hoefer (1997), and Black (1998). Against this consensus, I argue that PP might not contradict HS: Lewis's argument is invalid, and every attempt – within a broad class of attempts – to amend the argument fails. (shrink)

Kadri Vihvelin, in "What time travelers cannot do" (Philos Stud 81: 315-330, 1996), argued that "no time traveler can kill the baby who in fact is her younger self, because (V1) "if someone would fail to do something, no matter how hard or how many times she tried, then she cannot do it", and (V2) if a time traveler tried to kill her baby self, she would always fail. Theodore Sider (Philos Stud 110: 115-138, 2002) criticized Vihvelin's argument, and Ira (...) Kiourti (Philos Stud 139: 343-352, 2008) criticized both Vihvelin's argument and Sider's critique. I present a critique of Vihvelin's argument different from both Sider's and Kiourti's critiques: I argue in a novel way that both V1 and V2 are false. Since Vihvelin's argument might be understood as providing a challenge to the possibility of time travel, if my critique succeeds then time travel survives such a challenge unscathed. (shrink)

I was quite excited when I first read Restall and Russell’s (2010) paper. For two reasons. First, because the paper provides rigorous formulations and formal proofs of implication barrier theses, namely “theses [which] deny that one can derive sentences of one type from sentences of another”. Second (and primarily), because the paper proves a general theorem, the Barrier Construction Theorem, which unifies implication barrier theses concerning four topics: generality, necessity, time, and normativity. After thinking about the paper, I am satisfied (...) with its treatment of the first three topics, namely generality, necessity, and time. But I am not satisfied with its treatment of normativity, so my comments are exclusively on that topic. (shrink)

David Lewis (1980) proposed the Principal Principle (PP) and a “reformulation” which later on he called ‘OP’ (Old Principle). Reacting to his belief that these principles run into trouble, Lewis (1994) concluded that they should be replaced with the New Principle (NP). This conclusion left Lewis uneasy, because he thought that an inverse form of NP is “quite messy”, whereas an inverse form of OP, namely the simple and intuitive PP, is “the key to our concept of chance”. I argue (...) that, even if OP should be discarded, PP need not be. Moreover, far from being messy, an inverse form of NP is a simple and intuitive Conditional Principle (CP). Finally, both PP and CP are special cases of a General Principle (GP); it follows that so are PP and NP, which are thus compatible rather than competing. (shrink)

We can distinguish two concepts of respect for persons: appraisal respect , an attitude based on a positive appraisal of a person's moral character, and recognition respect , the practice of treating persons with consideration based on the belief that they deserve such treatment. After engaging in an extended analysis of these concepts, I examine two "truisms" about them. We justifiably believe of some persons that they have good character and thus deserve our esteem . Frequently it pays to be (...) disrespectful; e.g., insulting those who insult us may put them in their place. By using empirical results from social and personality psychology and techniques from decision theory in addition to conceptual considerations, I argue that, surprisingly, the above two "truisms" are false. Extensive psychological evidence indicates that most persons are indeterminate---overall neither good nor bad nor intermediate---and that our information about specific persons almost never distinguishes those who are indeterminate from those who are not. The strategy of habitually avoiding disrespectful behavior maximizes long-term expected utility. In sum, we have good pragmatic reason to treat persons respectfully, but we have good epistemic reason to avoid esteeming or despising them. (shrink)

I defend the epistemic thesis that evaluations of people in terms of their moral character as good, bad, or intermediate are almost always epistemically unjustified. (1) Because most people are fragmented (they would behave deplorably in many and admirably in many other situations), one's prior probability that any given person is fragmented should be high. (2) Because one's information about specific people does not reliably distinguish those who are fragmented from those who are not, one's posterior probability that any given (...) person is fragmented should be close to one's prior—and thus should also be high. (3) Because being fragmented entails being indeterminate (neither good nor bad nor intermediate), one's posterior probability that any given person is indeterminate should also be high—and the epistemic thesis follows. (1) and (3) rely on previous work; here I support (2) by using a mathematical result together with empirical evidence from personality psychology. (shrink)

If time travel is possible, presumably so is my shooting my younger self ; then apparently I can kill him – I can commit retrosuicide. But if I were to kill him I would not exist to shoot him, so how can I kill him? The standard solution to this paradox understands ability as compossibility with the relevant facts and points to an equivocation about which facts are relevant: my killing YS is compossible with his proximity but not with his (...) survival, so I can kill him if facts like his survival are irrelevant but I cannot if they are relevant. I identify a lacuna in this solution, namely its reliance without argument on the hidden assumption that my killing YS is possible: if it is impossible, it is not compossible with anything. I argue that this lacuna is important, and I sketch a different solution to the paradox. (shrink)

Suppose that a sign at the entrance of a hotel reads: “Don’t enter these premises unless you are accompanied by a registered guest”. You see someone who is about to enter, and you tell her: “Don’t enter these premises if you are an unaccompanied registered guest”. She asks why, and you reply: “It follows from what the sign says”. It seems that you made a valid inference from an imperative premise to an imperative conclusion. But it also seems that imperatives (...) cannot be true or false, so what does it mean to say that your inference is valid? It cannot mean that the truth of its premise guarantees the truth of its conclusion. One is thus faced with what is known as “Jørgensen’s dilemma” (Ross 1941: 55-6): it seems that imperative logic cannot exist because logic deals only with entities that, unlike imperatives, can be true or false, but it also seems that imperative logic must exist. It must exist not only because inferences with imperatives can be valid, but also because imperatives (like “Enter” and “Don’t enter”) can be inconsistent with each other, and also because one can apply logical operations to imperatives: “Don’t enter” is the negation of “Enter”, and “Sing or dance” is the disjunction of “Sing” and “Dance”. A standard reaction to this dilemma consists in basing imperative logic on analogues of truth and falsity. For example, the imperative “Don’t enter” is satisfied if you don’t enter and is violated if you enter, and one might say that an inference from an imperative premise to an imperative conclusion is valid exactly if the satisfaction (rather than the truth) of the premise guarantees the satisfaction of the conclusion. But before getting into the details, more needs to be said on what exactly imperatives are. (shrink)

Understanding choice of family planning provider is fundamental for policy makers and program managers as they seek ways to both improve the coverage and increase the sustainability and efficiency of family planning services for Egypt to achieve its population objectives. This study focuses first on providing a descriptive profile of the patterns of reliance on sources of family planning services during the early 2000s. Binomial logit models are then estimated to obtain a more in depth understanding of the determinants of (...) the choice of family planning providers in Egypt using the 2000 Egypt Demographic and Health Survey. The study offers insights into a number of aspects of family planning service provision about which there has been less previous investigation. There are marked differences in the extent to which Egyptian women rely on public or private providers for family planning services depending on the type of method they are seeking. Among the more important findings is the consistency women display in the choice of provider among women reporting multiple segments of use. With regard to the determinants of the choice of provider for family planning services, perhaps the most interesting finding is that household wealth was not a significant determinant of the choice of provider. This may reflect that private sources met the demand for family planning services of significant proportions of women in rural areas and among those in the low income groups. (shrink)

[1] You have a crystal ball. Unfortunately, it’s defective. Rather than predicting the future, it gives you the chances of future events. Is it then of any use? It certainly seems so. You may not know for sure whether the stock market will crash next week; but if you know for sure that it has an 80% chance of crashing, then you should be 80% confident that it will—and you should plan accordingly. More generally, given that the chance of a (...) proposition A is x%, your conditional credence in A should be x%. This is a chance-credence principle: a principle relating chance (objective probability) with credence (subjective probability, degree of belief). Let’s call it the Minimal Principle (MP). (shrink)

I was quite excited when I first read Restall and Russell’s (2010) paper. For two reasons. First, because the paper provides rigorous formulations and formal proofs of implication barrier the- ses, namely “theses [which] deny that one can derive sentences of one type from sentences of another”. Second (and primarily), because the paper proves a general theorem, the Barrier Con- struction Theorem, which unifies implication barrier theses concerning four topics: generality, necessity, time, and normativity. After thinking about the paper, I (...) am satisfied with its treatment of the first three topics, namely generality, necessity, and time. But I am not satisfied with its treatment of normativity, so my comments are exclusively on that topic. (shrink)