Hospital acquired infections (HAIs), especially ventilator associated respiratory infection (VARI) cause significant morbidity and mortality, and disproportionally so in low and middle-income countries (LMICs), including Vietnam, where infection control in hospitals is often neglected. The management of HAIs in these settings is challenging because of the high proportions of antimicrobial drug resistance and limitations of laboratory diagnostics, financial and human resources in terms of knowledge and skills for antimicrobial stewardship and infection prevention and control.

We discuss the crucial, but easily missed, link between paternalism and incarceration. Legal paternalists believe law should be used to help individuals stay healthy or moral or become healthier or morally better. Criminal laws are paternalistic if they make it illegal to perform some action that would be bad for the actor to do, regardless of effects on others. Yet, one result of such laws is the punishment, including incarceration, of the very same actors—also clearly bad for them even if (...) meant to be rehabilitative. Therein lies an oddity: paternalist criminal law—and thepresumably rehabilitativepunishments that serve as responses to infringements of such laws—is meant to help the actor but in fact has the opposite effect on net. Incarceration is particularly problematic on this front as it harms the alleged criminal in ways that go beyond the harm they would have caused themselves. Incarceration also may undermine the actor’s ability to improve his decision-making abilities or his moral character. The effects of the punishment also drift to others—family and friends, as well as business associates, of the punished. Paternalists, inasmuch as they are motivated by beneficence or concern about moral character, must account for all of these costs as threats to well-being and the conditions for acting morally. Given the link between paternalism and incarceration, we propose that if we are to take seriously the problem of over-incarceration in the U.S., we must reconsider the use of paternalism in criminal law; we sketch several alternatives. We believe paternalists should support our resistance to incarceration and seriously consider these alternatives. (shrink)

Antimicrobial resistance (AMR) is a global public health disaster driven largely by antibiotic use in human health care. Doctors considering whether to prescribe antibiotics face an ethical conflict between upholding individual patient health and advancing public health aims. Existing literature mainly examines whether patients awaiting consultations desire or expect to receive antibiotic prescriptions, but does not report views of the wider public regarding conditions under which doctors should prescribe antibiotics. It also does not explore the ethical significance of public (...) views or their sensitivity to awareness of AMR risks or the standpoint (self-interested or impartial) taken by participants. Methods: An online survey was conducted with a sample of the U.S. public (n = 158). Participants were asked to indicate what relative priority should be given to individual patients and society-at-large from various standpoints and in various contexts, including antibiotic prescription. Results: Of the participants, 50.3% thought that doctors should generally prioritize individual patients over society, whereas 32.0% prioritized society over individual patients. When asked in the context of AMR, 39.2% prioritized individuals whereas 45.5% prioritized society. Participants were significantly less willing to prioritize society over individuals when they themselves were the patient, both in general (p = .001) and in relation to AMR specifically (p = .006). Conclusions: Participants’ attitudes were more oriented to society and sensitive to collective responsibility when informed about the social costs of antibiotic use and when considered from a third-person rather than first-person perspective. That is, as participants came closer to taking the perspective of an informed and impartial “ideal observer,” their support for prioritizing society increased. Our findings suggest that, insofar as antibiotic policies and practices should be informed by attitudes that are impartial and well-informed, there is significant support for prioritizing society. (shrink)

Multiple drug resistant strains of HIV and continuing difficulties with vaccine development highlight the importance of psychologi- cal interventions which aim to in uence the psychosocial and emo- tional factors empirically demonstrated to be significant predictors of immunity, illness progression and AIDS mortality in seropositive persons. Such data have profound implications for psychological interventions designed to modify psychosocial factors predictive of enhanced risk of exposure to HIV as well as the neuroendocrine and immune mechanisms mediating the impact of such (...) factors on disease progression. Many of these factors can be construed as unconscious mental ones, and psychoanalytic self-psychology may be a useful framework for conceptualizing psychic and immune de- fence as well as bodily and self-integration in HIV infection. Al- though further prospective studies and cross-cultural validation of research are necessary, existing data suggest that psychoanalytic insights may be useful both in therapeutic interventions and evaluative research which would require an underlying epistemology of the complementarity of mind and matter. (shrink)

Corruption deprives people of access to health care and can lead to the wrong treatments being administered. Drug counterfeiting, facilitated by corruption, kills en masse. Cases are recorded of water being substituted for life-saving adrenaline and of active ingredients being diluted by counterfeiters, triggering drug-resistant strains of malaria, tuberculosis and HIV. The poor are disproportionately affected by corruption in the health sector, and cannot afford to pay for private alternatives where corruption has depleted public health services. Analysis of (...) corruption in the health sector of the UK can redress the information imbalance between UK government and service providers and patients. Health is a major global industry, a key responsibility and budget expense for governments and businesses. Corruption deprives people of access to health care and leads to poor health outcomes. (shrink)

Objective: Lung cancer is the most common cause of morbidity and mortality. Platinum-based chemotherapy, which is the primary line of treatment, offers limited benefit due to drug resistance and side effects. Berberine (BBR), which is characterised by its potent and safe anticancer activity, represents a promising combination option in chemotherapy. To overcome the limitations in lung cancer chemotherapy, we investigated whether BBR and cisplatin (CIS) exert synergistic effects on non-small cell lung cancer cell line (A549) based on cytotoxicity (...) and apoptotic response markers. -/- Methods: The potential cytotoxic effects of the combination treatment were evaluated using the MTT and Chou-Talalay methods. Elisa assays were also performed to measure the levels of the pro-apoptotic protein Bax and the effector protein caspase (Cas)-3. -/- Results: The results showed that BBR alone reduced A549 cell viability in a dose-dependent manner and synergized with CIS (CI =0.34±0.05 at IC50 concentrations). Elisa results showed that the combined treatment (both at IC50 concentrations) modulated apoptotic signalling pathways in A549 cells. Bax and Cas3 protein levels were dramatically enhanced in A549 cells treated with CIS +BBR compared to control (0.5% DMSO) (p < 0.001). -/- Conclusion: Our results suggest that BBR can synergistically enhance the therapeutic effect of CIS in A549 cells. The potential therapeutic efficacy of BBR as part of a combination in current chemotherapy should be supported by in-depth research and clinical studies on the molecular mechanisms associated with cancer. (shrink)

Recent authors have drawn attention to a new kind of defeating evidence commonly referred to as higher-order evidence. Such evidence works by inducing doubts that one’s doxastic state is the result of a flawed process – for instance, a process brought about by a reason-distorting drug. I argue that accommodating defeat by higher-order evidence requires a two-tiered theory of justification, and that the phenomenon gives rise to a puzzle. The puzzle is that at least in some situations involving higher-order (...) defeaters the correct epistemic rules issue conflicting recommendations. For instance, a subject ought to believe p, but she ought also to suspend judgment in p. I discuss three responses. The first resists the puzzle by arguing that there is only one correct epistemic rule, an Über-rule. The second accepts that there are genuine epistemic dilemmas. The third appeals to a hierarchy or ordering of correct epistemic rules. I spell out problems for all of these responses. I conclude that the right lesson to draw from the puzzle is that a state can be epistemically rational or justified even if one has what looks to be strong evidence to think that it is not. As such, the considerations put forth constitute a non question-begging argument for a kind of externalism. (shrink)

Christian Munthe, David Fumagalli and Erik Malmqvist argue that well-known healthcare resource allocation principles, such as need, prognosis, equal treatment and cost-effectiveness, should be supplemented with a principle of sustainability.1 Employing such a principle would entail that the allocation of healthcare resources should take into account whether a specific allocation causes negative dynamics, which would limit the amount of resources available in the future. As examples of allocation decisions, which may have such negative dynamics, they mention those who cause a (...) lack of vaccines, anti-bioethics resistance and drug shortages. Thus, the overall thought is that we can spend and allocate healthcare resources in a certain way at t1, which means that we will have fewer resources available at a later point, t2. The authors argue that we should include a principle of sustainability to justify allocations, which avoids or diminishes the negative dynamics. The authors argue that existing principles cannot sufficiently include proper regard for how our current decisions affect future allocation decisions and, therefore, the people who need healthcare resources in the future. I am sympathetic to the developed argument and believe that the authors are correct that negative dynamics provide reasons to take our ability to meet future health needs …. (shrink)

I show that Pickard’s argument against the irresistibility of addiction fails because her proposed dilemma, according to which either drug-seeking does not count as action or addiction is resistible, is flawed; and that is the case whether or not one endorses Pickard’s controversial definition of action. Briefly, we can easily imagine cases in which drug-seeking meets Pickard’s conditions for agency without thereby implying that the addiction was not irresistible, as when the drug addict may take more than (...) one route to go meet her dealer. (shrink)

Addicts sometimes engage in such spectacularly self-destructive behavior that they seem to act under compulsion. I briefly review the claim that addiction is not compulsive at all. I then consider recent accounts of addiction by Holton and Schroeder, which characterize addiction in terms of abnormally strong motivations. However, this account can only explain the apparent compulsivity of addiction if we assume—contrary to what we know about addicts—that the desires are so strong as to be irresistible. I then consider accounts that (...) invoke the phenomenon of “ego depletion,” according to which a person can resist temptation for a while, but not indefinitely. Implicit in this account is the assumption that addiction-related desires persist long enough to deplete the addict’s willpower. The balance of the paper argues that the persistence of the desire to consume drugs is a significant form of dysfunction in its own right, and that it makes an important and independent contribution to the compulsivity of addiction. I argue that addiction involves dysfunction in a mechanism that normally prevents a person from being tempted to do something that would invite disaster. (shrink)

My dissertation develops a defense of a right to self-defense against the state. I set aside anarchist theories and grant for the sake of argument that the state has legitimate political authority. My goal is to convince non-anarchists that the right to self-defense extends to individuals against the state and the state’s agents. I argue that the right to self-defense is a fundamental, negative, claim right. The right to self-defense has these characteristics: (1) it is fundamental, meaning that it is (...) not derivative of any other right—it doesn’t appeal to any other right for its justification (2) it is negative, meaning that it simply requires others to refrain from certain action, and (3) it is a claim right, rather than a permission right, which means that it logically entails correlative duties on others. I also challenge some basic tenets of the orthodox account of justified defensive force, including the imminence, necessity, and proportionality conditions. My argument is a controversial one; many will resist the idea that an individual could be justified in self-defense against the state for a variety of reasons, ranging from thinking the idea is absurd or dangerous, to thinking that even if it is morally permissible, it is impractical. I aim to rebut these objections and to provide strong moral reasons to show why individuals do in fact have this right. -/- This research explores the relationship between one of our most basic rights—the right to self-defense—with our most basic political relationship—the relationship between the individual and the state. Part of my aim is to convince non-anarchist readers of philosophical claims that are usually only supported by anarchists. The reason this is important, beyond being academically interesting, is that if I am successful, it could allow a great majority of individuals to rethink their relationship with the state; not just at a basic level, but also in other applied areas such as gun rights, drug laws, and issues surrounding punishment and imprisonment. (shrink)

This chapter explores the question of whether or not individual agents are under a moral obligation to reduce their ‘antimicrobial footprint’. An agent’s antimicrobial footprint measures the extent to which her actions are causally linked to the use of antibiotics. As such, it is not necessarily a measure of her contribution to antimicrobial resistance. Talking about people’s antimicrobial footprint in a way we talk about our carbon footprint may be helpful for drawing attention to the global effects of individual (...) behaviour and for highlighting that our choices can collectively make a real difference. But can we be morally obligated to make a contribution to resolving a collective action problem when our individual contributions by themselves make no discernible difference? I will focus on two lines of argument in favour of such obligations: whether a failure to reduce one’s antimicrobial footprint is unfair and whether it constitutes wrongdoing because it is harmful. I conclude by suggesting that the argument from collective harm is ultimately more successful. (shrink)

This article explores the utility of Nietzsche’s ethical thought for philosophical counselling. Central to the philosophical counseling process is philosophical counsellors applying the work of philosophers to inspire, educate, and guide their counselees in dealing with life problems. For example, Logic-Based Therapy (LBT), a method of philosophical counselling developed by Elliot Cohen, provides a rational framework for confronting problems of living, where the counselor helps the counselee find an uplifting philosophy that promotes a guiding virtue that acts as an antidote (...) to unrealistic and often self-defeating conclusions derived from irrational premises. I present the argument that Nietzsche’s moral philosophy, and more specifically his analysis of suffering, is one such uplifting philosophy which can be of utility to philosophical counselors to help their counselees with confronting problems of living. According to Bernard Reginster, suffering forms the bedrock of Nietzsche's life-affirming concept of the will to power. Nietzsche’s notion of the will to power radically alters our conception and significance of suffering – and that the will to power is best understood as man’s desire for the activity of overcoming resistance. Nietzsche's analysis implies that the fundamental human impulse is not to avoid suffering, but instead to will nothing less than suffering itself. To find meaning in suffering is tantamount to affirming life itself. (shrink)

In recent years, a debate has emerged on whether bodily sensations are typically accompanied by a sense of body ownership, namely a distinctive experience of one's body or body part as one's own. Realists about the sense of body ownership heavily rely on evidence from experimentally-induced bodily illusions (e.g., the rubber hand illusion) and pathological disownership syndromes (e.g. somatoparaphrenia). In this chapter, I will introduce novel evidence regarding body disownership syndromes induced by psychoactive drugs rather than pathological conditions, and discuss (...) its relevance to the debate on the sense of body ownership. (shrink)

Philosophical and empirical research on bodily awareness has mostly focused so far on bodily disorders – such as anorexia nervosa, somatoparaphrenia, or xenomelia (body integrity dysphoria) – and bodily illusions induced in an experimental setting – such as the rubber hand illusion, or the thermal grid illusion. Studying these conditions can be illuminating to investigate a broad range of issues about the nature, function, and etiology of bodily experience. However, a number of psychoactive compounds can also induce a remarkably wide (...) variety of bodily effects that have received little attention despite their relevance to these issues. Some of these effects are similar to those associated with bodily disorders or experimental bodily illusions, while others appear to be unique. The purpose of this chapter is to provide an overview of these lesser known bodily effects of psychoactive compounds, and outline some ways in which they can bear on recent debates regarding bodily awareness and bodily ownership. (shrink)

The social categories to which we belong—Latino, disabled, American, woman— causally influence our lives in deep and unavoidable ways. One might be pulled over by police because one is Latino, or one might receive a COVID vaccine sooner because one is American. Membership in these social categories most often falls outside of our control. This paper argues that membership in social categories constitutes a restriction on human agency, creating a situation of non-ideal agency for many human individuals. -/- However, there (...) are ways to resist the causal influence of social categories, and certain socially marginalized groups can be understood as attempting to do just this. I discuss two instances of social category resistance: gender pronouns and the rights of trans individuals. I suggest that the intentional declaration of gender pronouns (“she/her” or “they/them”) can be understood as an attempt to resist the causal powers of nonconsensual social categorization. Similarly, one among many reasons to support the rights of trans individuals is that their self-declarations of gender identity can be viewed as a reclamation of agency in the face of causal constraints imposed by socially defined and imposed gender categories. This lesson can be generalized to people belonging to a broad range of marginalized groups. (shrink)

Studies have shown that both serotonin and glutamate receptor systems play a crucial role in the mechanisms underlying drug-induced synesthesia. The specific nature of these mechanisms, however, continues to remain elusive. Here we propose two distinct hypotheses for how synesthesia triggered by hallucinogens in the serotonin-agonist family may occur. One hypothesis is that the drug-induced destabilization of thalamic projections via GABAergic neuronal circuits from sensory areas leads to a disruption of low-level, spontaneous integration of multisensory stimuli. This sort (...) of integration regularly occurs when spatial and temporal attributes match. Destabilization of feedback loops, however, can result in incongruent experiences or binding of random thalamus activation with sensory input in a particular sensory modality. The second hypothesis builds on embodied cognition, cases in which visual images of external stimuli activate task-related neural regions. On this proposal, binding processes that do not normally generate awareness become accessible to consciousness as a result of decreased attentional discrimination among incoming stimuli. (shrink)

Can one refute Berkeleyan phenomenalism by arguing that sensory objects seem mind-independent, and that, according to Berkeley, experience is to be taken at face value? Relying on Mackie’s recent discussion of the issue, I argue, first, that phenomenalism cannot be straightforwardly refuted by relying on perceptual or bodily experience of mind-independence together with the truthfulness of experience. However, I maintain, second that phenomenalism can be indirectly refuted by appealing to the bodily experience of resistance. Such experience presents us with (...) the causal activity of the resisting physical object. If experience is truthful, as the phenomenalist has it, physical objects are causally active. But then their effects no longer depend on our perceiving them, on pain of overdetermination. (shrink)

Despite their centrality to medicine, drugs are not easily defined. We introduce two desiderata for a basic definition of medical drugs. It should: (a) capture everything considered to be a drug in medical contexts and (b) rule out anything that is not considered to be a drug. After canvassing a range of options, we find that no single definition of drugs can satisfy both desiderata. We conclude with three responses to our exploration of the drug concept: maintain (...) a monistic concept, or choose one of two pluralistic outcomes. Notably, the distinction between drugs and other substances is placed under pressure by the most plausible of the options available. (shrink)

We often get evidence concerning the reliability of our own thinking about some particular matter. This “higher-order evidence” can come from the disagreement of others, or from information about our being subject to the effects of drugs, fatigue, emotional ties, implicit biases, etc. This paper examines some pros and cons of two fairly general models for accommodating higher-order evidence. The one that currently seems most promising also turns out to have the consequence that epistemic akrasia should occur more frequently than (...) is sometimes supposed. But it also helps us see why this might not be a bad thing. (shrink)

Beliefs can be resistant to evidence. Nonetheless, the orthodox view in epistemology analyzes beliefs as evidence-responsive attitudes. I address this tension by deploying analytical tools on capacities and masking to show that the cognitive science of evidence-resistance supports rather than undermines the orthodox view. In doing so, I argue for the claim that belief requires the capacity for evidence-responsiveness. More precisely, if a subject believes that p, then they have the capacity to rationally respond to evidence bearing on p. (...) Because capacities for evidence-responsiveness are fallible and may be masked, beliefs can be held in the face of counter-evidence. Indeed, I will argue that our best science of belief supports the claim that evidence-resistant beliefs result from masks on evidence-responsiveness capacities. This account of belief not only allows for resistance to evidence, but provides us with a framework for describing and explaining actual cases of evidence-resistance. (shrink)

The problem of imaginative resistance holds interest for aestheticians, literary theorists, ethicists, philosophers of mind, and epistemologists. We present a somewhat opinionated overview of the philosophical discussion to date. We begin by introducing the phenomenon of imaginative resistance. We then review existing responses to the problem, giving special attention to recent research directions. Finally, we consider the philosophical significance that imaginative resistance has—or, at least, is alleged to have—for issues in moral psychology, theories of cognitive architecture, and (...) modal epistemology. (shrink)

In this paper, we tackle the widely held view that practice-oriented approaches to ethics are conservative, preserving the moral status quo, and, in particular, that they do not promote any change in our dealings with animals or formulate clear principles that help us to achieve such change. We shall challenge this view with reference to Wittgensteinian ethics. As a first step, we show that moral thought and action rest on basic moral certainties like: equals are to be treated equally and (...) unequals unequally. We then explore the relations between this insight and the notion of the difficulty of reality elaborated by Cora Diamond. Our goal is to show that a Wittgensteinian-Diamondian approach to animal ethics is not necessarily morally conservative. Indeed, it offers a profound practice-oriented approach to animal ethics that is capable of promoting change in human dealings with animals because it is compatible with radical critique. (shrink)

Imaginative resistance refers to a phenomenon in which people resist engaging in particular prompted imaginative activities. On one influential diagnosis of imaginative resistance, the systematic difficulties are due to these particular propositions’ discordance with real-world norms. This essay argues that this influential diagnosis is too simple. While imagination is indeed by default constrained by real-world norms during narrative engagement, it can be freed with the power of genre conventions and expectations.

We experience resistance when we are engaging with fictional works which present certain (for example, morally objectionable) claims. But in virtue of what properties do sentences trigger this ‘imaginative resistance’? I argue that while most accounts of imaginative resistance have looked for semantic properties in virtue of which sentences trigger it, this is unlikely to give us a coherent account, because imaginative resistance is a pragmatic phenomenon. It works in a way very similar to Paul Grice's (...) widely analysed ‘conversational implicature’. (shrink)

Promotion of prescription drugs may appear to be severely limited in some jurisdictions due to restrictions on direct-to-consumer advertising. However, in most jurisdictions, strategies exist to raise consumer awareness about prescription drugs, notably through the deployment of direct-to-consumer information campaigns that encourage patients to seek help for particular medical conditions. In Canada, DTCI is presented by industry and regulated by Health Canada as being purely informational activities, but their design and integration in broader promotional campaigns raise very similar ethical concerns (...) as those associated with DTCA. Specifically, DTCI can be an effective means of familiarizing the public with the scope and benefits of a particular prescription drug and so, like DTCA, can promote increased patient-consumer demand and thus a problematic rise in the prescribing and use of medications that may be neither the most appropriate nor the most cost-effective. Yet, with DTCI the industry is playing within the existing rules and regulations set by health regulators. To respond appropriately to this regulatory incoherence, we argue that DTCI should be regulated as a type of direct-to-consumer indirect advertising. Even if the case and specific regulations presented here are Canadian, the implications extend to every country that has a partial or total prohibition on DTCA. (shrink)

Every day the news shows us provoking stories about what's going on in the world, about events which raise moral questions and problems. In Philosophers Take On the World a team of philosophers get to grips with a variety of these controversial issues, from the amusing to the shocking, in short, engaging, often controversial pieces. This chapter covers drug use, making you think again about the judgements we make on a daily basis and the ways in which we choose (...) to conduct our lives. (shrink)

Readers of fictions sometimes resist taking certain kinds of claims to be true according to those fictions, even when they appear explicitly or follow from applying ordinary principles of interpretation. This "imaginative resistance" is often taken to be significant for a range of philosophical projects outside aesthetics, including giving us evidence about what is possible and what is impossible, as well as the limits of conceivability, or readers' normative commitments. I will argue that this phenomenon cannot do the theoretical (...) work that has been asked of it. Resistance to taking things to be fictional is often best explained by unfamiliarity with kinds of fictions than any representational, normative, or cognitive limits. With training and experience, any understandable proposition can be made fictional and be taken to be fictional by readers. This requires a new understanding both of imaginative resistance, and what it might be able to tell us about topics like conceivability or the bounds of possibility. (shrink)

In this chapter, we evaluate the politically generative dynamic of urban space. Notably, we put forward the notion of the ‘multiplier effect’ of the urban, referring to its ingrained tendency to multiply resistance to oppression and violence being exerted against subaltern groups and minorities and, in doing so, to turn this multiplied resistance into an active force of social change. We, therefore, look at the twofold valence of ‘resistance’: negative and affirmative. Resistance initially takes form as (...) a defensive response to oppression and violence. When this happens, the urban becomes the living platform for a multiplying dynamic of encounter and, potentially, of inter-group solidarity, thus laying the foundations for a cooperative – rather than competitive, as in neoliberal rationality, or inimical, as in national-populist reason – way of ‘being together’. After having developed this argument against the backdrop of the women’s movement in Tehran and the urban disobedience to anti-immigration policies in Italy, our chapter concludes by reflecting on the multiplier effect of urban resistance within the current context of national revanchism. (shrink)

In this paper, I present and criticize several historical arguments in favour of prohibition and criminalization of illicit psychoactive substances. I consider several versions of Charles Brent’s argument from drug harms and an argument from addiction based on Kantian view on autonomy. My criticism will mainly rely on empirical evidence on drugs, drug use, and addiction. I think that in light of this evidence, all of the arguments lose their cogency or can be refuted altogether. Moreover, the evidence (...) reveals an inconsistency in the international drug law framework. In conclusion, I therefore provide a general argument challenging the legitimacy of the existing distinction between licit and illicit drugs based on the inconsistency. (shrink)

While the Value-Free Ideal of science has suffered compelling criticism, some advocates like Gregor Betz continue to argue that science policy advisors should avoid value judgments by hedging their hypotheses. This approach depends on a mistaken understanding of the relations between facts and values in regulatory science. My case study involves the morning-after pill Plan B and the “Drug Fact” that it “may” prevent implantation. I analyze the operative values, which I call zygote-centrism, responsible for this hedged drug (...) label. Then, I explain my twofold account of value-ladenness, involving the constitutive role of value judgments in science and the social function of facts as political tools. Because this drug fact is ineliminably value-laden in both senses, I conclude that hedged hypotheses are not necessarily value-free. (shrink)

In many jurisdictions, an offender’s remorse is considered to be a relevant factor to take into account in mitigation at sentencing. The growing philosophical interest in the use of neurointerventions in criminal justice raises an important question about such remorse-based mitigation: to what extent should technologically facilitated remorse be honoured such that it is permitted the same penal significance as standard instances of remorse? To motivate this question, we begin by sketching a tripartite account of remorse that distinguishes cognitive, affective (...) and motivational elements of remorse. We then describe a number of neurointerventions that might plausibly be used to enhance abilities that are relevant to these different elements of remorse. Having described what we term the ‘moral value’ view of the justification of remorse-based mitigation, we then consider whether using neurointerventions to facilitate remorse would undermine its moral value, and thus make it inappropriate to honour such remorse in the criminal justice system. We respond to this question by claiming that the form of moral understanding that is incorporated into a genuinely remorseful response grounds remorse’s moral value. In view of this claim, we conclude by arguing that neurointerventions need not undermine remorse’s moral value on this approach, and that the remorse that such interventions might facilitate could also be authentic to the recipient of the neurointerventions that we discuss. (shrink)

Drug regulation is fraught with inductive risk. Regulators must make a prediction about whether or not an experimental pharmaceutical will be effective and relatively safe when used by typical patients, and such predictions are based on a complex, indeterminate, and incomplete evidential basis. Such inductive risk has important practical consequences. If regulators reject an experimental drug when it in fact has a favourable benefit/harm profile, then a valuable intervention is denied to the public and a company’s material interests (...) are needlessly thwarted. Conversely, if regulators approve an experimental drug when it in fact has an unfavourable benefit/harm profile, then resources are wasted, people are needlessly harmed, and other potentially more effective treatments are underutilized. Given that such regulatory decisions have these practical consequences, non-epistemic values about the relative importance of these consequences impact the way such regulatory decisions are made (similar to the analysis of laboratory studies on the toxic effects of dioxins presented in Douglas [2000]). To balance the competing demands of the pertinent non-epistemic values, regulators must perform what I call an “inductive risk calculus.” At least in the American context this inductive risk calculus is not well-managed. (shrink)

Linda Martín Alcoff and others have emphasised that the discipline of philosophy suffers from a ‘demographic problem’. The persistence of this problem is partly the consequence of various forms of resistance to efforts to address the demographic problem. Such resistance is complex and takes many forms and could be responded to in different ways. In this paper, I argue that our attempts to explain and understand the phenomenon of resistance should use a kind of explanatory pluralism that, (...) following Quassim Cassam, I call multidimensionalism. I describe four general kinds of resistance and consider varying explanations, focusing on those focused on vices and social structures. I argue that vice-explanations and structural- explanations are both mutually consistent and mutually entailing. If so, there is no need to choose between vice explanations and structural explanations or any other kinds of explanation. We can and should be multidimensionalists: using many together is better. (shrink)

From antiquity, Galenic physicians extensively discussed the active powers of simple and compound drugs. In their views, simple drugs, that is, single ingredients, acted according to their material qualities and the properties of their substance. As for compound drugs, their efficacy resulted from the mutual interaction of their ingredients and their modes of preparation. In the late Renaissance, Galenic physicians and naturalists, such as Leonhart Fuchs and Pietro Andrea Mattioli, attempted to explain these pharmacological properties or “faculties” at the intersection (...) of medicine, botany, and natural philosophy. This chapter examines the case of the Italian physician and botanist Andrea Cesalpino. His pharmacological treatise De medicamentorum facultatibus [On the Faculties of Drugs, 1593] was particularly significant for its reception of ancient and medieval texts on drug properties, materia medica, and the role of the senses in the knowledge of bodies. (shrink)

What reasons stand in favor of (or against) violent resistance to oppression? I distinguish two kinds of normative reasons that bear relevantly in such a practical deliberation. I argue that in addition to reasons of impartial morality, victims’ personal projects and relationships may also provide reasons for (or against) violent resistance. Moreover, there is no guarantee that conflicts will not occur between such reasons. Thus, some acts of violent resistance may arise from situations of radical choice in (...) which impartial moral reasons and personal reasons pull the agent in opposite directions. Regardless of what we ultimately think agents facing such decisions ought to do all things considered, recognizing such conflicts is crucial for understanding the circumstances that give rise to violence and for better sympathizing with victims who are pushed to such extreme modes of resistance. (shrink)

Advocates of moral enhancement through pharmacological, genetic, or other direct interventions sometimes explicitly argue, or assume without argument, that traditional moral education and development is insufficient to bring about moral enhancement. Traditional moral education grounded in a Kohlbergian theory of moral development is indeed unsuitable for that task; however, the psychology of moral development and education has come a long way since then. Recent studies support the view that moral cognition is a higher-order process, unified at a functional level, and (...) that a specific moral faculty does not exist. It is more likely that moral cognition involves a number of different mechanisms, each connected to other cognitive and affective processes. Taking this evidence into account, we propose a novel, empirically informed approach to moral development and education, in children and adults, which is based on a cognitive-affective approach to moral dispositions. This is an interpretative approach that derives from the cognitive-affective personality system (Mischel and Shoda, 1995). This conception individuates moral dispositions by reference to the cognitive and affective processes that realise them. Conceived of in this way, moral dispositions influence an agent's behaviour when they interact with situational factors, such as mood or social context. Understanding moral dispositions in this way lays the groundwork for proposing a range of indirect methods of moral enhancement, techniques that promise similar results as direct interventions whilst posing fewer risks. (shrink)

The illegal drug trade is a world phenomenon, which has had some adverse impact on societies. Significantly, the impact is damning in developing economies in Africa and Ghana in particular. This paper therefore seeks to address the causes and effects of the use and peddle of these illegal drugs in three communities in the capital city of the Asante Region of Ghana. It further ascertains the extent to which these drugs burden the security agencies in the communities and the (...) country in general. We have used documentary and non-documentary sources to arrive at some postulations on this important social question which has wider ramifications on Kumase, Asante, Ghana and Africa in general. (shrink)

Gerald Dworkin provides an insightful starting point for determining acceptable paternalism through his commitment to protecting our future autonomy and health from lasting damage. Dworkin grounds his argument in an appeal to inherent goods, which this paper argues is best considered as a commitment to human flourishing. However, socialconnectedness is also fundamental to human flourishing and an important consideration when determining the just limits of paternalistic drug controls, a point missing from Dworkin’ essay. For British philosopher Thomas Hill Green, (...) regulation of alcohol sales emerged from the social ideal. Green argued that policy interventions, including restricted opening hours and locations, improved the conditions for humans to flourish. Green offers a compelling political vision but fails to account for the fact pleasure is also an inherent good. He focused excessively on our social nature, excluding our more pleasure-seeking and egoistic characteristics. In contrast, a more realistic and complete vision of human flourishing can be found in an amended version of Gerald’s Dworkin’s arguments. In conclusion, this paper argues drug policy makers should remain committed to the harm principle as applied to criminal law whereby a person should never be criminalized for self-harm. Such a limit on paternalistic interventions is deemed necessary when eudaimonia is the end of government action. In practical terms, this means that the criminalization of drug use, as opposed to drug production, is always unjust. (shrink)

With the advance of CRISPR technology, parents will be tempted to create superior offspring who are healthier, smarter, and stronger. In addition to the fact that many of these procedures are considered immoral for Catholics, they could change human nature in radical and possibly disastrous ways. This article focuses on the question of human perfectionism. First, by considering the relationship between human nature and technology, it analyzes whether such advances can improve human nature in addition to curing diseases. Next, it (...) looks at the moral and spiritual dimensions of perfection by analyzing the cardinal virtues. It argues that seeking perfection in the physical sense alone may not be prudent or wise and may produce greater injustices and weaken the human spirit in the long run. Understanding our true calling to perfection can help us resist the temptation of hubris to enhance the human race through technology. (shrink)

In Remnants of Auschwitz , Giorgio Agamben argues that the hidden structure of subjectivity is shame. In shame, I am consigned to something that cannot be assumed, such that the very thing that makes me a subject also forces me to witness my own desubjectification. Agamben’s ontological account of shame is problematic insofar as it forecloses collective responsibility and collapses the distinction between shame and humiliation. By recontextualizing three of Agamben’s sources – Primo Levi, Robert Antelme and Maurice Blanchot – (...) I develop an alternative account of shame as the structure of intersubjectivity , and of a collective responsibility that is more fundamental than the subject itself. On this basis, I sketch the preliminary outline of a biopolitics of resistance rooted in the ethics of alterity. The intuition driving this approach is that life is never bare ; even in situations of extreme affliction there remains a relation to alterity which provides a starting point for resistance. (shrink)

Background: Multi Drug Therapy approved by WHO is the best treatment option for Leprosy. There is a significant decline of mortality and morbidity after the introduction of multi drug therapy. But the adverse effects causing changes in clinical and laboratory parameters to multi drug therapy are the main limiting obstacle for the treatment course completion. Objective: The aim of this study is to find out the effects on routine laboratory parameters including hematological and biochemical changes before, during (...) and after the treatment of multi drug therapy in leprosy. Methodology: A descriptive cohort hospital based study on 85 multi drug therapy treated leprosy patients using standard laboratory tools for routine investigations for 18 months. Results: During the one year multidrug treatment period, most of the routine laboratory parameters showed mild to moderate change from normal level during the first 3 months with gradual recovery in the following months. Complete blood count assessment revealed mild decline in Hb, PCV, MCH, MCHC, and moderate decline in WBC and Platelet count. A mild increase in liver function tests (Bilirubin, AST, ALT, Alkaline phosphatase) and renal function tests (S.Creatinine, b. Urea) was observed. A moderate decline in S. Sodium with mild increase in S. Potassium was found on investigating S. Electrolytes. Patients were fully recovered from all hemato-biochemical adverse effects after 6 months of completion of the multi drug therapy. Conclusion: Despite of mild to moderate hematological and biochemical adverse reactions with multi drug therapy, recovery was excellent after 6 months of completion of therapy. (shrink)

The discipline of academic philosophy suffers from serious problems of diversity and inclusion whose acknowledgement and amelioration are often resisted by members of our profession. In this paper, I distinguish four main modes of resistance—naiveté, conservatism, pride, and hostility—and describe how and why they manifest by using them as the basis for a typology of types of ‘resister’. This typology can hopefully be useful to those of us trying to counteract such resistance in ways sensitive to the different (...) motives and strategies that these resisters tend to employ. (shrink)

I defend the view that the experience of resistance gives us a direct phenomenal access to the mind-independence of perceptual objects. In the first part, I address a humean objection against the very possibility of experiencing existential mind-independence. The possibility of an experience of mind-independence being secured, I argue in the second part that the experience of resistance is the only kind of experience by which we directly access existential mind-independence.

Drunk drivers and other culpably incapacitated wrongdoers are often taken to pose a problem for reasons-responsiveness accounts of moral responsibility. These accounts predicate moral responsibility upon an agent having the capacities to perceive and act upon moral reasons, and the culpably incapacitated wrongdoers lack exactly those capacities at the time of their wrongdoing. Many reasons-responsiveness advocates thus expand their account of responsibility to include a tracing condition: The culpably incapacitated wrongdoer is blameworthy despite his incapacitation precisely because he is responsible (...) for becoming incapacitated. As some skeptics have suggested, it is not clear that we need tracing. Here, however, I make a stronger case against tracing: I show that tracing gets things wrong. I consider a new sort of case, the case of the Odysseus agent, whose incapacitation is non-culpable (sometimes merely permissible and sometimes praiseworthy). Tracing would have us hold responsible and therefore blame unlucky Odysseus agents, Odysseus agents who commit a wrongdoing in the throes of their non-culpably induced incapacitation. But we should not hold these unlucky Odysseus agents responsible for their incapacitated wrongdoing. Because tracing gets these cases wrong, we should reject tracing. (shrink)

Imaginative resistance refers to a phenomenon in which people resist engaging in particular prompted imaginative activities. Philosophers have primarily theorized about this phenomenon from the armchair. In this paper, we demonstrate the utility of empirical methods for investigating imaginative resistance. We present two studies that help to establish the psychological reality of imaginative resistance, and to uncover one factor that is significant for explaining this phenomenon but low in psychological salience: genre. Furthermore, our studies have the methodological (...) upshot of showing how empirical tools can complement the predominant armchair approach to philosophical aesthetics. (shrink)