PUERPÉRIO EM BOVINOS -/- INTRODUÇÃO -/- O puerpério é definido como o período entre o parto e a apresentação do primeiro estro fértil. Dois processos ocorrem durante o puerpério: a involução uterina e o início da atividade ovariana pós-parto. Em vacas leiteiras, os cuidados médicos pós-parto são essenciais nos programas de manejo, uma vez que as patologias uterinas são diagnosticadas e tratadas nesse período para que a vaca esteja em ótimas condições para ser inseminada, uma vez terminado o período de (...) espera voluntário. -/- 4.1 Involução uterina -/- O útero após o parto sofre modificações macroscópicas e microscópicas, até atingir as características de um útero não gestante, o que leva de 30 a 45 dias. O peso e o tamanho pós-parto diminuem rapidamente como consequência da atrofia das fibras musculares; por necrose das carúnculas e por eliminação de líquidos. Ao mesmo tempo em que o útero diminui de tamanho, o endométrio passa por um processo regenerativo para poder hospedar uma nova gestação. -/- A involução é promovida pelas contrações uterinas, que facilitam a eliminação de fluidos e dejetos e reduzem o tamanho do útero. As contrações são causadas pela secreção contínua de PGF2α, de origem uterina, e pela ocitocina secretada durante a amamentação. A PGF2α é secretada durante as primeiras 3 semanas pós-parto e seu envolvimento é considerado necessário para que a involução uterina ocorra normalmente. -/- Durante a involução uterina, as secreções conhecidas como lóquios, que são formadas por restos de membranas, carúnculas, fluidos fetais e sangue, são derramadas pela vagina. Essas secreções variam da cor vermelha ao marrom, têm consistência viscosa e são inodoras. A maioria dos lóquios é descartada durante os primeiros 15 dias após o parto e, em seguida, praticamente desaparece, exceto em casos de involução uterina anormal, quando o útero continua a derramar fluidos de consistência, cor e odor diferentes (figura 1). -/- Figura 1: O útero após o parto sofre alterações macroscópicas e microscópicas, até atingir as características de um útero não grávido, o que leva de 30 a 45 dias. -/- Antes do parto, o útero é estéril, pois é protegido da contaminação bacteriana pelo colo do útero ou cérvix. Durante e após o parto, essa barreira física desaparece e o útero é invadido por bactérias que se encontram no meio ambiente, pele e fezes, ou que são introduzidas durante a assistência ao parto. Além disso, a capacidade funcional dos fagócitos uterinos é baixa após o parto, o que contribui para o estabelecimento de infecções. Cerca de 95% das vacas desenvolvem infecções uterinas durante a involução, e uma alta porcentagem de vacas as eliminam por meio de mecanismos naturais. -/- Os mecanismos de defesa uterinos são constituídos pelas barreiras anatômicas (vagina, vulva e cérvix); fatores fisiológicos (produção de muco na vagina e cérvix); fagocitose promovida por neutrófilos, que migram da circulação geral para o útero; pela produção de substâncias inespecíficas, que inibem o crescimento bacteriano e favorecem a eliminação de microrganismos. A capacidade de eliminar bactérias do útero é determinada pelos hormônios ovarianos (progesterona e estrogênios); durante o diestro, a progesterona reduz a migração de neutrófilos, suprime o sistema imunocompetente, fecha o colo do útero e causa atonia uterina, resultando em aumento da suscetibilidade à infecção. Ao contrário, durante a fase folicular do ciclo estral (proestro e estro), o estradiol promove a migração de neutrófilos, abre a cérvix e aumenta o tônus uterino, o que facilita a eliminação de agentes infecciosos. Além disso, a atividade dos neutrófilos é afetada pelas deficiências antioxidantes e pela profundidade do balanço energético negativo. -/- 4.2 Anormalidades do puerpério -/- Após o parto, ocorrem algumas patologias que retardam a involução uterina e, consequentemente, afetam o intervalo entre o parto e o primeiro serviço. -/- 4.2.1 Retenção da placenta -/- A placenta é eliminada dentro de 12 horas após o parto; a retenção da placenta por mais de 24 horas é considerada uma patologia. A retenção placentária (RP) é uma alteração frequente do puerpério, que deve ser considerada como um sinal clínico de várias condições que podem ter origem infecciosa (aborto), metabólica (hipocalcemia, cetose, síndrome do vaca gorda), deficiências nutricionais (selênio e vitamina E) e erros de manejo (demasiada intervenção no parto). -/- A incidência de RP varia de 5 a 15% e depende, em grande parte, do estado de saúde e do manejo do rebanho. A RP é o principal fator de risco para infecções uterinas (metrite puerperal, metrite, endometrite e endometrite subclínica); também causa atraso no período entre o parto e a concepção e está associada à redução do percentual de concepção no primeiro serviço. -/- Em termos econômicos, determinou-se que a RP causa perdas significativas principalmente devido aos custos de serviços médicos, aumento da taxa de eliminação e diminuição da fecundidade. Além disso, vacas com retenção placentária produzem 355 kg a menos de leite durante os primeiros 60 dias do que vacas que não apresentam esta patologia (figuras 2 e 3). -/- 4.2.2 Patogenia -/- A placenta está ligada ao endométrio pelas vilosidades coriônicas, que estão ligadas às carúnculas (junção carúncula-cotilédone). A união entre essas estruturas é favorecida por um fluido adesivo formado por colágeno e outras proteínas. Antes e durante o trabalho de parto, observa-se um aumento da atividade das enzimas proteolíticas (colagenase, talvez a mais importante), que são responsáveis por separar o cotilédone da carúncula. Posteriormente, a placenta é removida mecanicamente por contrações uterinas após o parto do feto. -/- A etiologia e patogênese da retenção placentária não são conhecidas. Uma explicação proposta é que isso se deve a uma falha dos mecanismos proteolíticos responsáveis pela separação do cotilédone da carúncula. Foi observado que a atividade da colagenase no cotilédone é maior em vacas que não retêm placenta do que naquelas que a retêm. Propõe-se que alguns fatores de risco para retenção placentária possam estar atuando na redução da atividade da colagenase. Por outro lado, as condições inflamatórias na junção carúncula-cotilédone de origem infecciosa também impedem a separação da placenta. -/- Figura 3: Vaca com retenção placentária. -/- Figura 2: Vaca com retenção placentária. Em rebanhos comerciais, 5 a 15% das vacas retêm a placenta. -/- 4.2.3 Tratamento -/- Existem vários tratamentos, como a remoção manual da placenta em combinação com a aplicação local de antibióticos (infusões intrauterinas) e a administração de produtos hormonais (ocitócicos e PGF2α). A eficácia desses tratamentos é discutível. -/- A remoção manual da placenta é o tratamento mais popular; entretanto, não é a melhor, pois causa danos ao endométrio, que variam de leve sangramento a hematomas, mesmo quando não há evidências externas. Além disso, a remoção manual diminui a capacidade fagocítica dos leucócitos uterinos, resultando em metrite mais grave, maior atraso na involução uterina e baixo desempenho reprodutivo. -/- Outro tratamento consiste em cortar a placenta ao nível da vulva. Posteriormente, quando a placenta se separa das carúnculas, devido ao processo de decomposição do tecido, uma leve tração da vulva é suficiente para retirá-la, sem consequências. Essas vacas devem ser observadas quanto à febre e imediatamente integradas ao programa de check-up pós-parto, pois certamente desenvolverão metrite ou endometrite. A administração de antibióticos, tanto nos casos de retirada manual como naqueles em que a placenta é cortada, depende do estado geral da vaca. Deve-se sempre ter em mente que a RP é o principal fator de risco para metrite, portanto as vacas devem ser observadas para detectar prontamente aquelas que apresentam febre. Os antibióticos devem ser considerados para inibir a putrefação das membranas fetais, o que pode atrasar sua expulsão. No caso de opção pela administração de antibióticos, deve-se optar pela via parenteral em vez da intrauterina, pois esta causa irritação do endométrio, que está associada à baixa fertilidade (figura 4). -/- Outros tratamentos são baseados na administração de hormônios que estimulam a mobilidade uterina (ocitocina, estrogênios e PGF2α); entretanto, não há evidências clínicas que demonstrem sua eficácia; além disso, a causa menos frequente de RP é a incapacidade mecânica do útero de expelir a placenta. -/- 4.2.4 Prevenção -/- As estratégias de prevenção dessa patologia devem ter como objetivo reduzir a influência dos fatores de risco para RP. Assim, a incidência de abortos deve ser reduzida por meio de programas eficazes de vacinação e biossegurança; deve-se evitar períodos de seca muito longos para que as vacas não cheguem obesas ao parto; intervir o mínimo possível nos partos, e se atendido, deve ser feito com medidas de higiene rígidas; oferecer sais minerais de boa qualidade e administrar antioxidantes antes do parto (vitamina E, selênio e betacarotenos; tabela 1). -/- Figura 4: A placenta não deve ser removida inserindo a mão na vagina. É aconselhável aguardar a autólise (48 horas) e removê-la por leve tração. -/- Tabela 1: Incidência de retenção na membrana fetal (RMF), metrite hemorrágica (HM), metrite purulenta (PM) e puerpério anormal (PA) em vacas leiteiras tratadas com selênio e vitamina E nos dias 60, 21 antes do parto e 30, 90 pós-parto (grupo pré-pós-parto) e 21 dias pré-parto (grupo pré-parto) e testemunhas. -/- Laterais diferentes na mesma coluna indicam diferença estatística (P < 0,05). Adaptado de RUIZ et al., 2008. -/- 4.3 Infecções uterinas -/- Cerca de 95% das vacas desenvolvem infecção uterina durante os primeiros dias pós-parto; no entanto, a maioria elimina infecções por meio de seus mecanismos de defesa e apenas 30 a 50% delas desenvolvem metrite ou endometrite nas primeiras três semanas. As bactérias mais frequentes encontradas em processos inflamatórios no útero são: Arcanobacterium pyogenes (antes Actinomyces pyogenes), Fusobacterium necrophorum e Escherichia coli. Essas três bactérias agem sinergicamente. -/- 4.3.1 Metrite puerperal -/- A metrite puerperal é comum em vacas com retenção placentária. Essa patologia é observada nas três primeiras semanas pós-parto e é caracterizada pela presença de secreções abundantes na luz uterina que são vermelhas ou marrons, aquosas, fétidas e com involução retardada. As vacas afetadas mostram sinais de doença sistêmica (toxemia e febre > 39,5 °C) e diminuição da produção de leite (figura 5). -/- Figura 5: Vaca com metrite puerperal; vacas afetadas apresentam sinais de doença sistêmica. -/- 4.3.2 Metrite clínica -/- Metrite é o processo inflamatório que envolve as diferentes camadas do útero (mucosa, muscular e serosa). Esta condição se apresenta nos primeiros 21 dias pós-parto e é caracterizada por atraso na involução uterina e secreção purulenta, e não há sinais de doença sistêmica (figura 6). -/- 4.3.3 Endometrite clínica -/- Endometrite se refere à inflamação do revestimento uterino; clinicamente, caracteriza-se por retardo na involução uterina e eliminação de exsudato purulento ou mucopurulento. Pode surgir nos primeiros 21 dias pós-parto ou mais, sem apresentar qualquer afetação no estado geral. -/- Figura 6: Vaca com exsudato mucopurulento. Na prática, é difícil estabelecer um diagnóstico diferencial entre endometrite e metrite. Uma vaca com essa secreção pode ser tratada com cefalosporinas intrauterinas ou, se ela já estiver em ciclo, a administração de PGF2a é eficaz. -/- 4.3.4 Endometrite subclínica -/- Apresenta-se entre 21 e 40 dias pós-parto, não apresenta sinais externos e só é diagnosticada pela citologia uterina. Essa condição afeta entre 20 e 30% das vacas. Os fatores de risco identificados são retenção placentária e metrite. -/- 4.4 Diagnóstico -/- O diagnóstico é baseado na avaliação uterina por palpação retal, na qual são verificados o grau de involução e as características das secreções. Além disso, é necessária uma avaliação clínica geral, uma vez que vacas com metrite nos primeiros 10 dias pós-parto desenvolvem febre. Outra forma de estabelecer o diagnóstico é avaliando as secreções uterinas sem palpação retal. Pode ser feito introduzindo a mão por via vaginal, após a limpeza da região; embora este método possa parecer arriscado, a experiência em campo indica que é um método seguro e rápido. Outra possibilidade é por meio da vaginoscopia, esse método permite a avaliação da cérvix e das secreções uterinas. Existe um instrumento (Metricheck) que é inserido pela vagina e possui uma campânula atraumática na extremidade que permite a coleta das secreções uterinas (figuras 7 e 8). -/- 4.5 Impacto das infecções uterinas na reprodução e produção -/- As infecções uterinas (metrite e endometrite) prolongam o período do parto até a concepção; diminuem a porcentagem de concepção no primeiro serviço; a porcentagem de resíduos aumenta; a taxa de vacas inseminadas diminui e a produção diminui (300 kg a menos que vacas não afetadas). Além disso, eles afetam o período do parto à primeira ovulação; em vacas com puerpério anormal, os folículos dominantes são menores em diâmetro e produzem menos estradiol do que vacas saudáveis. Também uma proporção menor dos folículos da primeira onda ovula em comparação com as vacas com puerpério anormal. -/- A endometrite subclínica diminui a taxa de concepção no primeiro serviço e aumenta os dias abertos. Além disso, a metrite ou endometrite pode afetar os ovidutos e causar inchaço, obstrução e aderências (esse processo é mais frequente em vacas que recebem injeções de estrogênio). -/- Figura 8: Outra forma de diagnosticar infecções uterinas é por meio da introdução de um instrumento que possui em sua extremidade uma campânula atraumática que permite a coleta de secreções uterinas (Metricheck). -/- Figura 7: O diagnóstico de infecções uterinas pode ser estabelecido com a introdução da mão por via vaginal, após limpeza da região. -/- 4.6 Tratamentos -/- Para evitar o efeito negativo das infecções uterinas na eficiência reprodutiva, é necessário um diagnóstico e tratamento oportunos. Existem diversos tratamentos para a metrite ou endometrite, como o uso de antibióticos sistêmicos ou intrauterinos, infusões intrauterinas de antissépticos e a administração de hormônios. -/- 4.6.1 Antibióticos -/- Os tratamentos com antibióticos intrauterinos são usados há muitos anos e são uma opção, desde que alguns aspectos sejam considerados: que o útero é um ambiente anaeróbio; que há a presença de exsudatos e tecidos em decomposição e a existência de uma grande diversidade de bactérias, algumas das quais até produzem enzimas que inativam alguns antibióticos. -/- Como o útero é um ambiente anaeróbio, os antibióticos do grupo dos aminoglicosídeos não são ativos, pois precisam de oxigênio. Por outro lado, o acúmulo de exsudato purulento e restos de tecido no útero inibe a atividade das sulfonamidas. Os nitrofuranos são eficazes contra A pyogenes, somente quando doses extremamente altas são usadas; as doses usuais nunca atingem a concentração inibitória mínima no endométrio; além disso, não são ativos na presença de sangue ou exsudato purulento, são irritantes e estão associados a problemas de fertilidade. -/- A penicilina intrauterina ou parenteral é eficaz na cura de infecções entre os dias 25 e 30 após o parto; ou seja, quando for observada uma diminuição na diversidade de espécies bacterianas (menor probabilidade de que algumas bactérias produzam penicilinase) e predomina A pyogenes, que é sensível a este antibiótico. As formulações intrauterinas de cefalosporinas (cefapirina benzatina) são eficazes em vacas com endometrite entre os dias 15-20 pós-parto e não é necessário retirar o leite do mercado. -/- A tetraciclina é o antibiótico mais utilizado devido ao seu amplo espectro e por manter sua atividade nas condições do útero pós-parto; porém, a probabilidade de resistência bacteriana é alta devido ao seu uso contínuo por muitos anos, também causa danos ao endométrio e reduz a fertilidade (figura 9). -/- Em testes de campo, a administração de uma única infusão intrauterina de cefapirina benzatina, em vacas com endometrite entre os dias 15 a 20 pós-parto, produz uma maior taxa de recuperação e não afeta a fertilidade, em comparação com aquelas que foram tratadas com infusões de oxitetraciclina. -/- O problema mais importante na terapia com antibióticos é estabelecer um critério de quais animais realmente precisam. Nos casos de metrite puerperal não há dúvida, essas vacas precisam de tratamento com antibióticos por via sistêmica e intrauterina. Porém, em casos de metrite e endometrite a decisão é difícil, pois muitas vacas se curam sem nenhum tratamento. Na prática, antes que os antibióticos sejam administrados às vacas, deve-se considerar alguns dos fatores: características das secreções uterinas, dias após o parto, início da atividade ovariana, presença de febre e condição corporal. -/- Figura 9: As infusões de oxitetraciclina causam irritação do endométrio e diminuem a fertilidade. -/- 4.6.2 Tratamento com infusões de substâncias antissépticas -/- Tratamentos baseados na administração intrauterina de substâncias antissépticas também são usados. O tratamento mais frequente consiste na infusão de soluções de iodo; no entanto, os resultados com esta terapia não são positivos e estão associados a uma diminuição subsequente da fertilidade. Deve-se ter cautela no uso de antissépticos intrauterinos, pois todos causam irritação, afetam os mecanismos de defesa do útero e, em alguns casos, chegam a causar necrose do endométrio. -/- 4.6.3 Tratamentos hormonais -/- Na prática, a administração de estrogênio é comum em casos de metrite, principalmente quando o útero retém muito líquido. Sabe-se que os estrógenos em condições fisiológicas favorecem a contratilidade uterina e auxiliam na eliminação de infecções, porém, em doses farmacológicas o efeito é negativo. A administração de estrogênios pode contribuir para infecções que ascendem aos ovidutos e causam salpingite, aderências ovarianas e infertilidade. -/- A PGF2α desempenha um papel importante no parto e durante a involução uterina. Em vacas com puerpério normal, a duração dos níveis elevados de PGF2α está negativamente correlacionada com o tempo de involução uterina; portanto, quanto mais tempo duram os níveis elevados de PGF2α, menor é o tempo de involução uterina. Além disso, a administração de PGF2α a cada 12 horas, dos dias 3 a 10 pós-parto, encurta o período de involução uterina. Ao contrário, em vacas com puerpério anormal, foi observada uma correlação positiva entre as concentrações de PGF2α e o tempo de involução uterina; portanto, vacas com retenção placentária ou endometrite apresentam níveis mais elevados de PGF2α. -/- Algumas evidências envolvem a PGF2α como parte do mecanismo de eliminação da placenta; ou seja, foi observado que as vacas que normalmente eliminam a placenta apresentaram maiores concentrações de PGF2α na placenta, em comparação com as vacas com retenção placentária. Foi proposto que a falha do processo que leva à separação do cotilédone da carúncula está associada a uma alteração no metabolismo da prostaglandina, resultando em uma diminuição na PGF2α e um aumento na PGE2. Por outro lado, a inibição da síntese de PGF2α após o parto, por meio da injeção de ácido acetilsalicílico (aspirina), causa retenção da placenta. Esse conhecimento motivou estudos nos quais o tratamento com PGF2α após o parto foi avaliado para prevenir a retenção placentária ou reduzir o tempo de involução em vacas com retenção placentária ou metrite. Em alguns estudos, uma única injeção de PGF2α foi administrada nas primeiras horas após o parto com resultados conflitantes. Em outros estudos, a injeção de PGF2α entre os dias 20 a 30 pós-parto foi avaliada e não foi observado um efeito favorável na involução uterina. Porém, a injeção sistemática de PGF2α, a cada 14 dias a partir do 25º dia pós-parto, aumenta a proporção de vacas inseminadas, o que aumenta a taxa de prenhez. A PGF2α causa contrações uterinas e favorece a eliminação de secreções; entretanto, um efeito favorável da PGF2α na involução uterina, sem envolver um corpo lúteo, é questionável. -/- Na prática, um programa é usado com base na administração sistemática de PGF2α a todas as vacas a cada 14 dias, do 25º ao 30º dia pós-parto. Esse tratamento é baseado no encurtamento das fases lúteas, o que favorece a eliminação das infecções. Deve-se observar que cerca de 30% das vacas desenvolvem corpos lúteos longevos (21 a 50 dias) nos primeiros ciclos pós-parto, nessas condições a injeção de PGF2α, a cada 14 dias, encurta o ciclo estral e diminui o risco de persistência de infecções uterinas. -/- 4.7 Piometra -/- Esta patologia se desenvolve em vacas que ovulam nos primeiros 20 dias pós-parto e, concomitantemente, sofrem de infecção uterina. Nessas condições, a progesterona promove a proliferação bacteriana e fecha o colo do útero, causando acúmulo de exsudato purulento no útero. As alterações causadas no endométrio alteram a secreção de PGF2α, resultando na persistência do corpo lúteo e anestro. Vacas com piometra respondem muito bem ao tratamento com PGF2α; uma segunda injeção desse hormônio, 14 dias depois, encurta o período de recuperação (figura 10). -/- Figura 10: A piometra é caracterizada pelo acúmulo de exsudato purulento no útero, colo uterino fechado e presença de corpo lúteo. O diagnóstico é feito por palpação retal e tratado com PGF2α. -/- 4.8 Vaginite em fêmeas gestantes -/- A vaginite em fêmeas grávidas ocorre com baixa frequência; porém, quando há um caso, causa alarme porque é confundido com um aborto. Nesses casos, o veterinário deve fazer um exame retal para determinar se o produto está vivo e se a cérvix está aberta. O diagnóstico é concluído com o exame vaginal com vaginoscópio ou diretamente à mão com luva limpa. -/- No caso de um aborto, o produto geralmente está morto e a cérvix está aberta; nestes casos, o produto deve ser extraído. Ao contrário, se a cérvix estiver fechada e o feto estiver vivo, o prognóstico é favorável e o problema diminui com o tratamento com antibióticos sistêmicos. -/- RESUMO -/- < >O útero após o parto pesa 13 kg e no dia 21 pós-parto, 1 kg. A regeneração do epitélio uterino leva 25 dias. A regeneração das camadas profundas do endométrio leva 42 a 56 dias. 95% das vacas desenvolvem alguma infecção uterina. 30 a 50% das vacas desenvolvem metrite nas primeiras duas semanas após o parto. 15 a 20% persistem como endometrite clínica > 3 semanas após o parto. 18 a 20% têm metrite com efeitos sistêmicos. 20 a 30% das vacas têm endometrite subclínica. 5 a 15% das vacas retêm a placenta. 355 kg de leite são perdidos em vacas com retenção placentária. Em vacas que sofrem de puerpério anormal, a proporção de vacas prenhes é reduzida em 10 por cento no 90º dia pós-parto. No Reino Unido, 192 euros são gastos por cada vaca que tem um puerpério anormal. REFERÊNCIAS BIBLIOGRÁFICAS -/- ANDREWS, Anthony H. et al. (Ed.). Bovine medicine: diseases and husbandry of cattle. John Wiley & Sons, 2008. -/- AZAWI, O. I. Postpartum uterine infection in cattle. Animal reproduction science, v. 105, n. 3-4, p. 187-208, 2008. -/- BEARDEN, Henry Joe et al. Applied animal reproduction. Reston Publishing Company, Inc., 1984. -/- HOLY, Lubos; MARTÍNEZ JÚSTIZ, G. Colab. Biología de la reproducción bovina. Havana: Revolucionária, 1975. -/- HOPPER, Richard M. (Ed.). Bovine reproduction. John Wiley & Sons, 2014. -/- HORTA, António Eduardo Monteiro. Fisiologia do puerpério na vaca. Jornada Internales de Reproductión Animal, v. 8, p. 73-84, 1995. -/- KOZICKI, Luiz Ernandes. Aspectos fisiológicos e patológicos do puerpério em bovinos. Archives of Veterinary Science, v. 3, n. 1, 1998. -/- LEBLANC, S. J. et al. Defining and diagnosing postpartum clinical endometritis and its impact on reproductive performance in dairy cows. Journal of dairy science, v. 85, n. 9, p. 2223-2236, 2002. -/- LEBLANC, S. J. et al. The effect of treatment of clinical endometritis on reproductive performance in dairy cows. Journal of dairy science, v. 85, n. 9, p. 2237-2249, 2002. -/- MARTINS, T. M.; BORGES, A. M. Avaliação uterina em vacas durante o puerpério. Rev. Bras. Reprod. Anim, Belo Horizonte, v. 35, n. 4, p. 433-443, 2011. -/- RADOSTITS, Otto M. et al. Clínica Veterinária: um tratado de doenças dos bovinos, ovinos, suínos, caprinos e eqüinos. Rio de Janeiro: Guanabara Koogan, 2002. -/- RISCO, CARLOS A.; YOUNGQUIST, ROBERT S.; SHORE, M. DAWN. Postpartum uterine infections. In: Current therapy in large animal theriogenology. WB Saunders, 2007. p. 339-344. -/- SHELDON, I. M. et al. Influence of uterine bacterial contamination after parturition on ovarian dominant follicle selection and follicle growth and function in cattle. REPRODUCTION-CAMBRIDGE-, v. 123, n. 6, p. 837-845, 2002. -/- SHELDON, I. M. et al. Mechanisms of infertility associated with clinical and subclinical endometritis in high producing dairy cattle. Reproduction in domestic animals, v. 44, p. 1-9, 2009. -/- SHELDON, I. Martin et al. Uterine diseases in cattle after parturition. The Veterinary Journal, v. 176, n. 1, p. 115-121, 2008. -/- TIXI, C. et al. Factores que afectan el porcentaje de vacas gestantes en el día 90 posparto. In: Memorias del XXXIII Congreso Nacional de Buiatría. Tuxtla Gutiérrez Chiapas. México. pp. 2009. (shrink)

One of the cornerstones of western theology is the doctrine of divine omnipotence. God is traditionally conceived of as an omnipotent or all-powerful being. However, satisfactory analyses of omnipotence are notoriously elusive. In this paper, I first consider some simple attempts to analyze omnipotence, showing how each fails. I then consider two more sophisticated accounts of omnipotence. The first of these is presented by Edward Wierenga; the second by Thomas Flint and Alfred Freddoso. I argue that both of these accounts (...) fail. Finally, I propose and defend a novel account of omnipotence. (shrink)

My topic is how to make decisions when you possess foreknowledge of the consequences of your choice. Many have thought that these kinds of decisions pose a distinctive and novel problem for causal decision theory (CDT). My thesis is that foreknowledge poses no new problems for CDT. Some of the purported problems are not problems. Others are problems, but they are not problems for CDT. Rather, they are problems for our theories of subjunctive supposition. Others are problems, but they are (...) not new problems. They are old problems transposed into a new key. Nonetheless, decisions made with foreknowledge illustrate important lessons about the instrumental value of our choices. Once we've appreciated these lessons, we are left with a version of CDT which faces no novel threats from foreknowledge. (shrink)

I provide a theory of causation within the causal modeling framework. In contrast to most of its predecessors, this theory is model-invariant in the following sense: if the theory says that C caused (didn't cause) E in a causal model, M, then it will continue to say that C caused (didn't cause) E once we've removed an inessential variable from M. I suggest that, if this theory is true, then we should understand a cause as something which transmits deviant or (...) non-inertial behavior to its effect. (shrink)

Several areas of welfare economics seek to evaluate states of affairs as a function of interpersonally comparable individual utilities. The aim is to map each state of affairs onto a vector of individual utilities, and then to produce an ordering of these vectors that can be represented by a mathematical function assigning a real number to each. When this approach is used in intertemporal contexts, a central theoretical question concerns the evaluative weight to be applied to utility coming at different (...) times. This question concerns the rate of pure time preference, which is one key determinant of the social discount rate. This article argues that the standard philosophical account of pure time preference is mistaken, because it ascribes to economists a methodological commitment they need not, and often do not, accept. This in turn undercuts the most common philosophical objection to pure time preference, which traces at least to Rawls’s A Theory of Justice. The article then evaluates three further objections to pure time preference, concluding that it might still be defensible under certain circumstances. The article closes by articulating a final argument that is suggested by the “Social, Economic and Ethical Concepts and Methods” chapter of the most recent Intergovernmental Panel on Climate Change report. If this further argument is sound, it would constitute a decisive objection to pure time preference as it currently figures in much intertemporal welfare economics. (shrink)

A handful of well-known arguments (the 'diachronic Dutch book arguments') rely upon theorems establishing that, in certain circumstances, you are immune from sure monetary loss (you are not 'diachronically Dutch bookable') if and only if you adopt the strategy of conditionalizing (or Jeffrey conditionalizing) on whatever evidence you happen to receive. These theorems require non-trivial assumptions about which evidence you might acquire---in the case of conditionalization, the assumption is that, if you might learn that e, then it is not the (...) case that you might learn something else that is consistent with e. These assumptions may not be relaxed. When they are, not only will non-(Jeffrey) conditionalizers be immune from diachronic Dutch bookability, but (Jeffrey) conditionalizers will themselves be diachronically Dutch bookable. I argue: 1) that there are epistemic situations in which these assumptions are violated; 2) that this reveals a conflict between the premise that susceptibility to sure monetary loss is irrational, on the one hand, and the view that rational belief revision is a function of your prior beliefs and the acquired evidence alone, on the other; and 3) that this inconsistency demonstrates that diachronic Dutch book arguments for (Jeffrey) conditionalization are invalid. (shrink)

The role of causation and counterfactuals in causal decision theory is vexed and disputed. Recently, Brian Hedden (2023) argues that we should abandon causal decision theory in favour of an alternative: counterfactual decision theory. I argue that, pace Hedden, counterfactual decision theory is not a competitor to, but rather a version of, causal decision theory – the most popular version by far. I provide textual evidence that the founding fathers of causal decision theory (Stalnaker, Gibbard, Harper, Lewis, Skyrms, Sobel, and (...) Joyce) all endorse counterfactual decision theories. I additionally discuss why these theories came to be called ‘causal’, rather than ‘counterfactual’. And I argue that, properly understood, causal decision theory escapes Hedden's objections. (shrink)

It has been a common assumption that words are substances that instantiate or have properties. In this paper, I question the assumption that our ontology of words requires posting substances by outlining a bundle theory of words, wherein words are bundles of various sorts of properties (such as semantic, phonetic, orthographic, and grammatical properties). I argue that this view can better account for certain phenomena than substance theories, is ontologically more parsimonious, and coheres with claims in linguistics.

The thesis of instrumental convergence holds that a wide range of ends have common means: for instance, self preservation, desire preservation, self improvement, and resource acquisition. Bostrom contends that instrumental convergence gives us reason to think that "the default outcome of the creation of machine superintelligence is existential catastrophe". I use the tools of decision theory to investigate whether this thesis is true. I find that, even if intrinsic desires are randomly selected, instrumental rationality induces biases towards certain kinds of (...) choices. Firstly, a bias towards choices which leave less up to chance. Secondly, a bias towards desire preservation, in line with Bostrom's conjecture. And thirdly, a bias towards choices which afford more choices later on. I do not find biases towards any other of the convergent instrumental means on Bostrom's list. I conclude that the biases induced by instrumental rationality at best weakly support Bostrom's conclusion that machine superintelligence is likely to lead to existential catastrophe. (shrink)

According to a recent challenge to Kratzer's canonical contextualist semantics for deontic modal expressions, no contextualist view can make sense of cases in which such a modal must be information-sensitive in some way. Here I show how Kratzer's semantics is compatible with readings of the targeted sentences that fit with the data. I then outline a general account of how contexts select parameter values for modal expressions and show, in terms of that account, how the needed, contextualist-friendly readings might plausibly (...) get selected in the challenge cases. (shrink)

The study aimed to identify the relationship between correcting the deviations in the measurement of performance and achieving the objectives of control and the performance of the job at the Islamic University in the Gaza Strip. To achieve the objectives of the research, the researchers used the descriptive analytical approach to collect information. The questionnaire consisted of (20) statements distributed to three categories of employees of the Islamic University (senior management, faculty members, their assistants and members of the administrative board). (...) A random sample of 314 employees was selected and 276 responses were retrieved with a recovery rate of 88.1%. The Statistical Analysis Program (SPSS) was used to enter, process, and analyze the data. The results of the study showed a positive relationship between correcting deviations in performance measurement and achieving the control objectives represented by the functional performance in the Islamic University from the point of view of the members (senior management, faculty and their assistants, and the administrative board), where the relative weight of all the paragraphs was (74.25%). The study recommended the need to ensure that the actual performance of the planned performance is matched and decisions are taken to correct the serious deviations and take the necessary measures in terms of retraining and change in regulations, wages and bonuses and punishment of the culprit, neglect and negligence by mistake. (shrink)

If the laws are deterministic, then standard theories of counterfactuals are forced to reject at least one of the following conditionals: 1) had you chosen differently, there would not have been a violation of the laws of nature; and 2) had you chosen differently, the initial conditions of the universe would not have been different. On the relevant readings—where we hold fixed factors causally independent of your choice—both of these conditionals appear true. And rejecting either one leads to trouble for (...) philosophical theories which rely upon counterfactual conditionals—like, for instance, causal decision theory. Here, I outline a semantics for counterfactual conditionals which allows us to accept both (1) and (2). And I discuss how this semantics deals with objections to causal decision theory from Arif Ahmed. (shrink)

A norm of local expert deference says that your credence in an arbitrary proposition A, given that the expert's probability for A is n, should be n. A norm of global expert deference says that your credence in A, given that the expert's entire probability function is E, should be E(A). Gaifman (1988) taught us that these two norms are not equivalent. Stalnaker (2019) conjectures that Gaifman's example is "a loophole". Here, I substantiate Stalnaker's suspicions by providing characterisation theorems which (...) tell us precisely when the norms give different advice. They tell us that, in a good sense, Gaifman's example is the only case where the two norms differ. I suggest that the lesson of the theorems is that Bayesian epistemologists need not concern themselves with the differences between these two kinds of norms. While they are not strictly speaking equivalent, they are equivalent for all philosophical purposes. (shrink)

I present an account of deterministic chance which builds upon the physico-mathematical approach to theorizing about deterministic chance known as 'the method of arbitrary functions'. This approach promisingly yields deterministic probabilities which align with what we take the chances to be---it tells us that there is approximately a 1/2 probability of a spun roulette wheel stopping on black, and approximately a 1/2 probability of a flipped coin landing heads up---but it requires some probabilistic materials to work with. I contend that (...) the right probabilistic materials are found in reasonable initial credence distributions. I note that, with some normative assumptions, the resulting account entails that deterministic chances obey a variant of Lewis's 'principal principle'. I additionally argue that deterministic chances, so understood, are capable of explaining long-run frequencies. (shrink)

Conversational Artificial Intelligence (CAI) systems (also known as AI “chatbots”) are among the most promising examples of the use of technology in mental health care. With already millions of users worldwide, CAI is likely to change the landscape of psychological help. Most researchers agree that existing CAIs are not “digital therapists” and using them is not a substitute for psychotherapy delivered by a human. But if they are not therapists, what are they, and what role can they play in mental (...) health care? To answer these questions, we appeal to two well-established and widely discussed concepts: cognitive and affective artifacts. Cognitive artifacts are artificial devices contributing functionally to the performance of a cognitive task. Affective artifacts are objects which have the capacity to alter subjects’ affective state. We argue that therapeutic CAIs are a kind of cognitive-affective artifacts which contribute to positive therapeutic change by (i) simulating a (quasi-)therapeutic interaction, (ii) supporting the performance of cognitive tasks, and (iii) altering the affective condition of their users. This sheds new light on why virtually all existing mental health CAIs implement principles and techniques of Cognitive Behavioral Therapy — a therapeutic orientation according to which affective change and, ultimately, positive therapeutic change is mediated by cognitive change. Simultaneously, it allows us to conceptualize better the potential and limitations of applying these technologies in therapy. (shrink)

While structural equations modeling is increasingly used in philosophical theorizing about causation, it remains unclear what it takes for a particular structural equations model to be correct. To the extent that this issue has been addressed, the consensus appears to be that it takes a certain family of causal counterfactuals being true. I argue that this account faces difficulties in securing the independent manipulability of the structural determination relations represented in a correct structural equations model. I then offer an alternate (...) understanding of structural determination, and I demonstrate that this theory guarantees that structural determination relations are independently manipulable. The account provides a straightforward way of understanding hypothetical interventions, as well as a criterion for distinguishing hypothetical changes in the values of variables which constitute interventions from those which do not. It additionally affords a semantics for causal counterfactual conditionals which is able to yield a clean solution to a problem case for the standard ‘closest possible world’ semantics. (shrink)

According to the cognitive model of psychopathology, maladaptive beliefs about oneself, others, and the world are the main factors contributing to the development and persistence of various forms of mental suffering. Therefore, the key therapeutic process of Cognitive Behavioral Therapy (CBT)—a therapeutic approach rooted in the cognitive model—is cognitive restructuring, i.e., a process of revision of such maladaptive beliefs. In this paper, I examine the philosophical assumptions underlying CBT and offer theoretical reasons to think that the effectiveness of belief revision (...) in psychotherapy is very limited. This is the case, I argue, because the cognitive model wrongly assumes that our body of beliefs is unified, while it is in fact fragmented. (shrink)

What is the correct metric of distributive justice? Proponents of the capability approach claim that distributive metrics should be articulated in terms of individuals’ effective abilities to achieve important and worthwhile goals. Defenders of resourcism, by contrast, maintain that metrics should instead focus on the distribution of external resources. This debate is now more than three decades old, and it has produced a vast and still growing literature. The present paper aims to provide a fresh perspective on this protracted debate. (...) It does so by defending capability metrics while also criticizing the two most common arguments used to support them, and sympathetically reconstructing the arguments for resourcism. I ultimately argue that while sweeping defenses of the capability approach do not succeed, capability theorists can indeed vindicate the justice-relevance of certain capabilities while still accommodating what is plausible in resourcism. (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)

Weisberg ([2009]) provides an argument that neither conditionalization nor Jeffrey conditionalization is capable of accommodating the holist’s claim that beliefs acquired directly from experience can suffer undercutting defeat. I diagnose this failure as stemming from the fact that neither conditionalization nor Jeffrey conditionalization give any advice about how to rationally respond to theory-dependent evidence, and I propose a novel updating procedure that does tell us how to respond to evidence like this. This holistic updating rule yields conditionalization as a special (...) case in which our evidence is entirely theory independent. 1 Introduction2 Conditionalization3 Holism and Conditionalization4 A Holistic Update5 HCondi and Dutch Books6 Commutativity and Learning about Background Theories6.1 Commutativity6.2 Learning about background theories7 In Summation. (shrink)

Is logic normative for reasoning? In the wake of work by Gilbert Harman and John MacFarlane, this question has been reduced to: are there any adequate bridge principles which link logical facts to normative constraints on reasoning? Hitherto, defenders of the normativity of logic have exclusively focussed on identifying adequate validity bridge principles: principles linking validity facts—facts of the form 'gamma entails phi'—to normative constraints on reasoning. This paper argues for two claims. First, for the time being at least, Harman’s (...) challenge cannot be surmounted by articulating validity bridge principles. Second, Harman’s challenge can be met by articulating invalidity bridge principles: principles linking invalidity facts of the form 'gamma does not entail phi' to normative constraints on reasoning. In doing so, I provide a novel defence of the normativity of logic. (shrink)

This paper argues that societal duties of health promotion are underwritten (at least in large part) by a principle of beneficence. Further, this principle generates duties of justice that correlate with rights, not merely “imperfect” duties of charity or generosity. To support this argument, I draw on a useful distinction from bioethics and on a somewhat neglected approach to social obligation from political philosophy. The distinction is that between general and specific beneficence; and the approach from political philosophy has at (...) times been called equality of concern. After clarifying the distinction and setting out the basis of the equality of concern view, I argue that the result is a justice-based principle of “specific” beneficence that should be reflected in a society’s health policy. I then draw on this account to criticize, refine, and extend some prominent health care policy proposals from the bioethics literature. (shrink)

The purpose of this paper is to challenge what is often called the “Uniqueness” thesis. According to this thesis, given one’s total evidence, there is a unique rational doxastic attitude that one can take to any proposition. It is sensible for defenders of Uniqueness to commit to an accompanying principle that: when some agent A has equal epistemic reason both to believe that p and to believe that not p, the unique epistemically rational doxastic attitude for A to adopt with (...) respect to whether p is the suspension of judgment. In this paper, I offer a case wherein the agent has equal epistemic reason both to believe that p and to believe that not p, but the agent is not epistemically required to suspend judgment about whether p. Furthermore, the case is such that there seems to be no uniquely rational attitude for the agent to adopt. (shrink)

Many authors have argued that epistemic rationality sometimes comes into conflict with our relationships. Although Sarah Stroud and Simon Keller argue that friendships sometimes require bad epistemic agency, their proposals do not go far enough. I argue here for a more radical claim—romantic love sometimes requires we form beliefs that are false. Lovers stand in a special position with one another; they owe things to one another that they do not owe to others. Such demands hold for beliefs as well. (...) Two facets of love ground what I call the false belief requirement , or the demand to form false beliefs when it is for the good of the beloved: the demand to love for the right reasons and the demand to refrain from doxastic wronging. Since truth is indispensable to epistemic rationality, the requirement to believe falsely, consequently, undermines truth norms. I demonstrate that, when the false belief requirement obtains, there is an irreconcilable conflict between love and truth norms of epistemic rationality: we must forsake one, at least at the time, for the other. (shrink)

This paper offers an alternate explanation of cases from the doxastic wronging literature. These cases violate what I call the degree of inquiry right—a novel account of zetetic obligations to inquire when interests are at stake. The degree of inquiry right is a moral right against other epistemic agents to inquire to a certain threshold when a belief undermines one’s interests. Thus, the agents are sometimes obligated to leave inquiry open. I argue that we have relevant interests in reputation, relationships, (...) and the well-being of our social groups. These interests generate obligations against others to “do their homework” before closing inquiry. This alternate account makes better sense of puzzles that accounts of doxastic wronging fall prey to. (shrink)

In their thought-provoking article, Sedlakova and Trachsel (2023) defend the view that the status—both epistemic and ethical—of Conversational Artificial Intelligence (CAI) used in psychotherapy is complicated. While therapeutic CAI seems to be more than a mere tool implementing particular therapeutic techniques, it falls short of being a “digital therapist.” One of the main arguments supporting the latter claim is that even though “the interaction with CAI happens in the course of conversation… the conversation is profoundly different from a conversation with (...) a human therapist” (Sedlakova and Trachsel 2023, 8). In particular, unlike a human therapist, CAI cannot help its users gain new insight and self-understanding (Sedlakova and Trachsel 2023). We agree that currently available therapeutic CAI cannot be considered a “digital therapist,” however, we think that the issue surrounding the acquisition of new self-understanding in the interaction with therapeutic CAI is more complicated than Sedlakova and Trachsel suggest. (shrink)

The majority of our linguistic exchanges, such as everyday conversations, are divided into turns; one party usually talks at a time, with only relatively rare occurrences of brief overlaps in which there are two simultaneous speakers. Moreover, conversational turn-taking tends to be very fast. We typically start producing our responses before the previous turn has finished, i.e., before we are confronted with the full content of our interlocutor’s utterance. This raises interesting questions about the nature of linguistic understanding. Philosophical theories (...) typically focus on linguistic understanding characterized either as an ability to grasp the contents of utterances in a given language or as outputs of this ability—mental states of one type or another. In this paper, I supplement these theories by developing an account of the process of understanding. I argue that it enables us to capture the dynamic and temporal aspect of understanding and reconcile philosophical investigations with empirical research on language comprehension. (shrink)

It’s one thing to do the right thing. It’s another to be creditable for doing the right thing. Being creditable for doing the right thing requires that one does the right thing out of a morally laudable motive and that there is a non-accidental fit between those two elements. This paper argues that the two main views of morally creditable action – the Right Making Features View and the Rightness Itself View – fail to capture that non-accidentality constraint: the first (...) because it morally credits agents who make heavy-duty moral mistakes; the second because it fails to generalise and is too conservative – a point which this paper gives renewed defence. The paper then goes on to defend and develop an alternative according to which moral worth is mediated by the agent’s knowing how to respond to the reasons of the type which make acting in that way right. It’s argued that this view avoids the problems for the alternatives, and it’s shown that in order for the view to avoid collapsing into a problematic form of Reliabilism we’ll have to think of states of knowing how as essentially successful in character. (shrink)

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)

This collection of essays explores the metaphysical thesis that the living world is not made up of substantial particles or things, as has often been assumed, but is rather constituted by processes. The biological domain is organised as an interdependent hierarchy of processes, which are stabilised and actively maintained at different timescales. Even entities that intuitively appear to be paradigms of things, such as organisms, are actually better understood as processes. Unlike previous attempts to articulate processual views of biology, which (...) have tended to use Alfred North Whitehead’s panpsychist metaphysics as a foundation, this book takes a naturalistic approach to metaphysics. It submits that the main motivations for replacing an ontology of substances with one of processes are to be found in the empirical findings of science. Biology provides compelling reasons for thinking that the living realm is fundamentally dynamic, and that the existence of things is always conditional on the existence of processes. The phenomenon of life cries out for theories that prioritise processes over things, and it suggests that the central explanandum of biology is not change but rather stability, or more precisely, stability attained through constant change. This edited volume brings together philosophers of science and metaphysicians interested in exploring the consequences of a processual philosophy of biology. The contributors draw on an extremely wide range of biological case studies, and employ a process perspective to cast new light on a number of traditional philosophical problems, such as identity, persistence, and individuality. (shrink)

One challenge to the rationality of religious commitment has it that faith is unreasonable because it involves believing on insufficient evidence. However, this challenge and influential attempts to reply depend on assumptions about what it is to have faith that are open to question. I distinguish between three conceptions of faith each of which can claim some plausible grounding in the Judaeo-Christian tradition. Questions about the rationality or justification of religious commitment and the extent of compatibility with doubt look different (...) on accounts of faith in which trust or hope, rather than belief, are the primary basis for the commitments. On such accounts, while the person of faith has a stake in the truth of the content, practical as well as epistemic considerations can legitimately figure in normative appraisals. Trust and hope can be appropriate in situations of recognized risk, need not involve self-deception, and are compatible with the idea that one's purely epistemic opinions should be responsive only to evidence.Send article to KindleTo send this article to your Kindle, first ensure [email protected] is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle. Find out more about sending to your Kindle. Note you can select to send to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply. Find out more about the Kindle Personal Document Service.Authentic faith and acknowledged risk: dissolving the problem of faith and reasonVolume 49, Issue 1DANIEL J. MCKAUGHAN DOI: https://doi.org/10.1017/S0034412512000200Your Kindle email address Please provide your Kindle [email protected]@kindle.com Available formats PDF Please select a format to send. By using this service, you agree that you will only keep articles for personal use, and will not openly distribute them via Dropbox, Google Drive or other file sharing services. Please confirm that you accept the terms of use. Cancel Send ×Send article to Dropbox To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about sending content to Dropbox. Authentic faith and acknowledged risk: dissolving the problem of faith and reasonVolume 49, Issue 1DANIEL J. MCKAUGHAN DOI: https://doi.org/10.1017/S0034412512000200Available formats PDF Please select a format to send. By using this service, you agree that you will only keep articles for personal use, and will not openly distribute them via Dropbox, Google Drive or other file sharing services. Please confirm that you accept the terms of use. Cancel Send ×Send article to Google Drive To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about sending content to Google Drive. Authentic faith and acknowledged risk: dissolving the problem of faith and reasonVolume 49, Issue 1DANIEL J. MCKAUGHAN DOI: https://doi.org/10.1017/S0034412512000200Available formats PDF Please select a format to send. By using this service, you agree that you will only keep articles for personal use, and will not openly distribute them via Dropbox, Google Drive or other file sharing services. Please confirm that you accept the terms of use. Cancel Send ×Export citation Request permission. (shrink)

Williams, Elster and Pears hold that an effort to induce in oneself a belief in the truth of some proposition that one believes to be false can succeed only if one manages, somewhere along the way, to forget that one is engaged in such an effort. Although this view has strong intuitive appeal, it is false, and in this paper it is shown to be false by example.

John Broome claims that there is a sacrifice-free solution to climate change. He says this is a consequence of elementary economics. After explaining the economic argument in somewhat more detail than Broome, I show that the argument is unsound. A main problem with it stems from Derek Parfit's ‘nonidentity effect.’ But there is hope, since the nonidentity effect underwrites a more philosophical yet more plausible route to a sacrifice-free solution. So in the end I join Broome in asking economists and (...) policymakers to help make this a reality. (shrink)

According to the theory developed here, we may trace out the processes emanating from a cause in such a way that any consequence lying along one of these processes counts as an effect of the cause. This theory gives intuitive verdicts in a diverse range of problem cases from the literature. Its claims about causation will never be retracted when we include additional variables in our model. And it validates some plausible principles about causation, including Sartorio's ‘Causes as Difference Makers’ (...) principle and Hitchcock's ‘Principle of Sufficient Reason’. (shrink)

The Great Divide in metaphysical debates about laws of nature is between Humeans, who think that laws merely describe the distribution of matter, and non-Humeans, who think that laws govern it. The metaphysics can place demands on the proper formulations of physical theories. It is sometimes assumed that the governing view requires a fundamental / intrinsic direction of time: to govern, laws must be dynamical, producing later states of the world from earlier ones, in accord with the fundamental direction of (...) time in the universe. In this paper, we propose a minimal primitivism about laws of nature (MinP) according to which there is no such requirement. On our view, laws govern by constraining the physical possibilities. Our view captures the essence of the governing view without taking on extraneous commitments about the direction of time or dynamic production. Moreover, as a version of primitivism, our view requires no reduction / analysis of laws in terms of universals, powers, or dispositions. Our view accommodates several potential candidates for fundamental laws, including the principle of least action, the Past Hypothesis, the Einstein equation of general relativity, and even controversial examples found in the Wheeler-Feynman theory of electrodynamics and retrocausal theories of quantum mechanics. By understanding governing as constraining, non-Humeans who accept MinP have the same freedom to contemplate a wide variety of candidate fundamental laws as Humeans do. (shrink)

Time as the key to a theory of everything became recently a renewed topic in scientific literature. Social constructivism applied to physics abandons the inevitable essentials of nature. It adopts uncertainty in the scope of the existential activity of scientific research. We have enlightened the deep role of social constructivism of the predetermined Newtonian time and space notions in natural sciences. Despite its incompatibility with determinism governing the Newtonian mechanics, randomness and entropy are inevitable when negative localized energy is transformed (...) into spatially dissipative heat. In sharp contrast to the Newtonian notion, social constructivism makes room for the temporal twin of cyclic conservation and pseudo-linearly structural evolution both reconciling mechanical order and thermodynamic chaos in Leibnizian space-time. In the broad scope of natural sciences this triad nature of time produces a multiple reality and gives appropriate answers on virtual physical paradoxes. (shrink)

We can contrast rationalising explanations of the form S φs because p with those of the form S φs because S believes that p. According the Common Kind View, the two sorts of explanation are the same. The Disjunctive View denies this. This paper sets out to elucidate the sense in which the Common Kind Theorist asserts, but the Disjunctivist denies, that the two explanations are the same. I suggest that, in the light of the distinction between kinds of explanation (...) and particular explanations, the relevant sameness thesis is ambiguous, thus giving us two distinct versions of the Common Kind View. I then argue that the only direct arguments for Disjunctivism available in the literature fail because they only succeed in undermining one version of the Common Kind View. I finish, however, by providing a fresh argument for the Disjunctive View which aims to undermine both versions of its competitor. (shrink)

Principles of chance deference face two kinds of problems. In the first place, they face difficulties with a priori knowable contingencies. In the second place, they face difficulties in cases where you've lost track of the time. I provide a principle of chance deference which handles these problem cases. This principle has a surprising consequence for Adam Elga's Sleeping Beauty Puzzle.

It is often suggested that we are equipped with a set of cognitive tools that help us to filter out unreliable testimony. But are these tools effective? I answer this question in two steps. Firstly, I argue that they are not real-time effective. The process of filtering, which takes place simultaneously with or right after language comprehension, does not prevent a particular hearer on a particular occasion from forming beliefs based on false testimony. Secondly, I argue that they are long-term (...) effective. Some hearers sometimes detect false testimony, which increases speakers’ incentives for honesty and stabilizes the practice of human communication in which deception is risky and costly. In short, filtering prevents us from forming a large number of beliefs based on false testimony, not by turning each of us into a high-functioning polygraph but by turning the social environment of human communication into one in which such polygraphs are not required. Finally, I argue that these considerations support strong anti-reductionism about testimonial entitlement. (shrink)

It is now common to distinguish Metaphysical from Epistemological Disjunctivism. It is equally common to suggest that it is at least not obvious that the latter requires a commitment to the former: at the very least, a suitable bridge principle will need to be identified which takes one from the latter to the former. This paper identifies a plausible-looking bridge principle that takes one from the version of Epistemological Disjunctivism defended by John McDowell and Duncan Pritchard, which I label Reflective (...) Epistemological Disjunctivism, or (RED), to Metaphysical Disjunctivism. Moreover, it identifies a modification the proponent of (RED) could, and should, make to the Internalist component of their theory, and argues that the commitment to Metaphysical Disjunctivism remains, even if such a modification is made. The upshot is that the commitment to Metaphysical Disjunctivism on the part of (RED) is shown to be particularly robust. (shrink)

The natural name theory, recently discussed by Johnson (2018), is proposed as an explanation of pure quotation where the quoted term(s) refers to a linguistic object such as in the sentence ‘In the above, ‘bank’ is ambiguous’. After outlining the theory, I raise a problem for the natural name theory. I argue that positing a resemblance relation between the name and the linguistic object it names does not allow us to rule out cases where the natural name fails to resemble (...) the linguistic object it names. I argue that to avoid this problem, we can combine the natural name theory with a type-realist metaphysics of language, and hold that the name is natural because the name is an instance of the kind that it names. I conclude by reflecting on the importance of the metaphysics of language for questions in the philosophy of language. (shrink)

This paper addresses several questions related to the nature, production, and use of animal-human (a-h) chimeras. At the heart of the issue is whether certain types of a-h chimeras should be brought into existence, and, if they are, how we should treat such creatures. In our current research environment, we recognize a dichotomy between research involving nonhuman animal subjects and research involving human subjects, and the classification of a research protocol into one of these categories will trigger different ethical standards (...) as to the moral permissibility of the research in question. Are a-h chimeras entitled to the more restrictive and protective ethical standards applied to human research subjects? We elucidate an Aristotelian-Thomistic metaphysical framework in which to argue how such chimeras ought to be defined ontologically. We then examine when the creation of, and experimentation upon, certain types of a-h chimeras may be morally permissible. (shrink)

On the face of it, Maurice Merleau-Ponty’s views bear a strong resemblance to contemporary disjunctivist theories of perception, especially John McDowell’s epistemological disjunctivism. Like McDowell (and other disjunctivists), Merleau-Ponty seems to be a direct realist about perception and holds that veridical and illusory perceptions are distinct. This paper furthers this comparison. Furthermore, it is argued that elements of Merleau-Ponty’s thought provide a stronger case for McDowell’s kind of epistemological view than McDowell himself provides. Merleau-Ponty’s early thought can be used to (...) develop a unique version of epistemological disjunctivism that is worth consideration alongside contemporary views on perceptual knowledge. (shrink)

What justifies our beliefs about what other people say? According to epistemic inferentialism​, the justification of comprehension-based beliefs depends on the justification of other beliefs, e.g., beliefs about what words the speaker uttered or even what sounds they produced. According to epistemic non-inferentialism, the justification of comprehension-based beliefs ​does not depend on the justification of other beliefs. This paper offers a new defense of epistemic non-inferentialism. First, I discuss three counterexamples to epistemic non-inferentialism provided recently by Brendan Balcerak Jackson. I (...) argue that only one of Balcerak Jackson’s counterexamples is effective, and that it is effective against only one version of epistemic non-inferentialism, viz. language comprehension dogmatism. Second, I propose an alternative version of epistemic non-inferentialism, viz. comprehension-process reliabilism, which is immune to these counterexamples. I conclude that we should follow Balcerak Jackson in his rejection of language comprehension dogmatism but not all the way to the endorsement of epistemic inferentialism. Comprehension-process reliabilism is superior to both these alternatives. (shrink)

Here is a surprisingly neglected question in contemporary epistemology: what is it for an agent to believe that p in response to a normative reason for them to believe that p? On one style of answer, believing for the normative reason that q factors into believing that p in the light of the apparent reason that q, where one can be in that kind of state even if q is false, in conjunction with further independent conditions such as q’s being (...) a normative reason to believe that p. The primary objective of this paper is to demonstrate that that style of answer cannot be right, because we must conceive of believing for a normative reason as constitutively involving a kind of rationality-involving relation that can be instantiated at all only if there is a known fact on the scene, which the agent treats as a normative reason. A secondary objective, achieved along the way, is to demonstrate that in their Prime Time Errol Lord and Kurt Sylvan do not succeed in undermining the factoring picture in general, only a simple-minded version of it. (shrink)

Norman Daniels’s theory of health justice is the most comprehensive and systematic such theory we have. In one of the few articles published so far on Daniels’s new book, Just Health, Benjamin Sachs argues that Daniels’s core “principle of equality of opportunity does not do the work Daniels needs it to do.” Yet Sachs’s objections to Daniels’s framework are deeply flawed. Where these arguments do not rely on significant misreadings of Daniels, they ignore sensible strands in Just Health that considerably (...) dull their force. After disarming Sachs’s arguments against Daniels’s theory, I explain why I agree with Sachs’s conclusion: Daniels’s equality of opportunity-based account of health justice rests on shaky foundations. (shrink)

Emergency contraception — also known as the morning after pill — is marketed and sold, under various brand names, in over one hundred countries around the world. In some countries, customers can purchase the drug without a prescription. In others, a prescription must be presented to a licensed pharmacist. In virtually all of these countries, pharmacists are the last link in the chain of delivery. This article examines and ultimately rejects several standard moves in the bioethics literature on the right (...) of pharmacists conscientiously to refuse to dispense emergency contraception. Its central thesis is that the standard ‘moderate’ solution to this problem is mistaken. Thus, when all publicly relevant interests are given their due, it is not acceptable to allow refusals in the big city, where pharmacies are plentiful, but forbid them in rural settings, where pharmacies are scarce. Rather, there should be strong public policy requiring that all pharmacists dispense emergency contraception to customers who request it, regardless of pharmacists' moral or religious objections. (shrink)

Modern military organizations are paternalistic organizations. They typically recognize a duty of care toward military personnel and are willing to ignore or violate the consent of military personnel in order to uphold that duty of care. In this paper, we consider the case for paternalism in the military and distinguish it from the case for paternalism in medicine. We argue that one can consistently reject paternalism in medicine but uphold paternalism in the military. We consider two well-known arguments for the (...) conclusion that military organizations should not be entitled to use experimental drugs on troops without first obtaining the informed consent of those troops. We argue that both of these are unsuccessful, in the absence of an argument for the rejection of paternalism in the military altogether. The case for military paternalism is widely accepted. However, we consider three ways in which it could be challenged. (shrink)

It is now well-known that Newton–Cartan theory is the correct geometrical setting for modelling the quantum Hall effect. In addition, in recent years edge modes for the Newton–Cartan quantum Hall effect have been derived. However, the existence of these edge modes has, as of yet, been derived using only orthodox methodologies involving the breaking of gauge-invariance; it would be preferable to derive the existence of such edge modes in a gauge-invariant manner. In this article, we employ recent work by Donnelly (...) and Freidel in order to accomplish exactly this task. Our results agree with known physics, but afford greater conceptual insight into the existence of these edge modes: in particular, they connect them to subtle aspects of Newton–Cartan geometry and pave the way for further applications of Newton–Cartan theory in condensed matter physics. (shrink)