Teachers not only serve as caretakers for the students in their classroom but also serve as stewards for society's next generation. In this way, teachers are charged with responsibility for the present and the future of their world. Shouldering this responsibility is no less than an existential dilemma that requires not only professional solutions but also personal responsibility rooted in subjective authenticity. In the edited volume, authors will explore how the philosophy of Existentialism can help teachers, teacher educators, educational researchers, (...) and policymakers better understand the existential responsibility that teachers shoulder. The core concepts of Existential philosophy explored in this edited volume imply that a teacher's lived experience cannot be defined solely by professional knowledge or dictates. Teachers have the capacity to create subjective meaning through their own agency, and there is no guarantee that those subjective meanings will accord with professional dictates. Furthermore, there is no guarantee that professional dictates are more valid than the existential realities of individual teachers. The philosophy of Existentialism encourages individuals to reflect on the existential realities of isolation, freedom, meaninglessness, and death in an effort to propel individuals towards more authentic ways of engaging in the world. The chapters of this edited volume advance the argument that being and becoming a teacher must be understood - at least in part - from the subjective perspective of the individual and that teachers are responsible for authoring the meaning of their lives and of their work. (shrink)

InUtilitarianism, Mill defers to Alexander Bain's expertise on the subject of moral judgment to answer common criticisms of the creed. First, we do not blame people or label them immoral when they are less than ideal. Judgments of immorality are commonly reserved for substandard behavior, not suboptimal comportment. Second, we do not commonly insist on full neutrality in benevolence. Indeed, some philosophers argue that we are obliged to exhibit partiality, insofar as it is demanded by our roles as friends, parents, (...) or children. My primary aim in this essay is to explicate Bain's theory of moral judgment and explain how Mill used Bain's psychological doctrines to inform his development of an indirect utilitarian moral philosophy, immune to the criticisms described above. (shrink)

How do we know right from wrong? Do we even have moral knowledge? Moral epistemology studies these and related questions about our understanding of virtue and vice. It is one of philosophy’s perennial problems, reaching back to Plato, Aristotle, Aquinas, Locke, Hume and Kant, and has recently been the subject of intense debate as a result of findings in developmental and social psychology. Throughout the book Zimmerman argues that our belief in moral knowledge can survive sceptical challenges. He also (...) draws on a rich range of examples from Plato’s Meno and Dickens’ David Copperfield to Bernard Madoff and Saddam Hussein. (shrink)

Constitutivist accounts of self-knowledge argue that a noncontingent, conceptual relation holds between our first-order mental states and our introspective awareness of them. I explicate a constitutivist account of our knowledge of our own beliefs and defend it against criticisms recently raised by Christopher Peacocke. According to Peacocke, constitutivism says that our second-order introspective beliefs are groundless. I show that Peacocke’s arguments apply to reliabilism not to constitutivism per se, and that by adopting a functionalist account of direct accessibility a constitutivist (...) can avoid reliabilism. I then argue that the resulting view is preferable to Peacocke’s own account of self-knowledge. (shrink)

Neo-Cartesian approaches to belief place greater evidential weight on a subject's introspective judgments than do neo-behaviorist accounts. As a result, the two views differ on whether our absent-minded and weak-willed actions are guided by belief. I argue that simulationist accounts of the concept of belief are committed to neo-Cartesianism, and, though the conceptual and empirical issues that arise are inextricably intertwined, I discuss experimental results that should point theory-theorists in that direction as well. Belief is even less closely connected to (...) behaviour than most contemporary functionalists allow. (shrink)

The proximity of introspection makes it difficult to explain. In what does our knowledge of our own beliefs and desires consist? Do we observe them with an inner eye? Do we infer their existence from premises concerning our actions and feelings? I reject both of these suggestions. Instead, I defend the view that facts about what we believe, and certain facts about what we want, are known by us in a direct or unmediated fashion. When one has genuinely introspective knowledge (...) of a belief one's reason for believing that one believes that p is the very fact that one believes that p . ;According to this account, our knowledge of certain mental states is infallible relative to its grounds: there are no false introspective beliefs that have the same kind of justification as our typical, true introspective beliefs. A significant part of the dissertation is spent defending this claim against those who argue for the possibility of certain forms of self-directed error. I argue that it cannot be the case that a subject falsely believes that she believes that p because she instead either believes some other proposition or bears some other attitude toward p, and that these facts impugn observational and inferentialist accounts of self-knowledge. I also develop accounts of what beliefs and desires are to help explain the relative infallibility of introspection. ;The view of self-knowledge I offer is one according to which we have reasons for believing that we believe certain things and reasons for believing that we want certain things. I argue that any adequate account of self-knowledge must have this feature because justification is necessary for knowledge and we must have reasons to be justified. But I reject the view that only phenomenal or experiential states can endow a subject with reasons. Beliefs and desires are individuated by their causal roles---they are not purely phenomenal in nature---but the fact that one believes that p can nevertheless directly ground one's introspective beliefs. Introspective knowledge is both direct and grounded in reason. (shrink)

Hume's claim that reason is a slave to the passions involves both a causal thesis: reason cannot cause action without the aid of the passions, and an evaluative thesis: it is improper to evaluate our actions in terms of their reasonableness. On my reading, Hume motivates his causal thesis by arguing that accurate representation is the function of reason, where a faculty of this kind cannot produce action on its own. (The interpretation helps vindicate Hume of the common charge that (...) he "begs the question" against his opponents.) But Hume's causal thesis does not entail his evaluative thesis, and his commitment to the latter is incredibly thin. According to Hume's positive theory, our evaluative judgments originate in reason integrated with sympathy or humanity. And, I argue, the resulting view depicts us as having substantive, non-instrumental reasons to fulfill our obligations to both prudence and morality. (shrink)

Jordi Fernandez has recently offered an interesting account of introspective justification according to which the very states that (subjectively) justify one's first-order belief that p justify one's second order belief that one believes that p. I provide two objections to Fernandez's account.

The Routledge Handbook of Moral Epistemology brings together philosophers, cognitive scientists, developmental and evolutionary psychologists, animal ethologists, intellectual historians, and educators to provide the most comprehensive analysis of the prospects for moral knowledge ever assembled in print. The book’s thirty chapters feature leading experts describing the nature of moral thought, its evolution, childhood development, and neurological realization. Various forms of moral skepticism are addressed along with the historical development of ideals of moral knowledge and their role in law, education, legal (...) policy, and other areas of social life. -/- Highlights include: -/- • Analyses of moral cognition and moral learning by leading cognitive scientists -/- • Accounts of the normative practices of animals by expert animal ethologists -/- • An overview of the evolution of cooperation by preeminent evolutionary psychologists -/- • Sophisticated treatments of moral skepticism, relativism, moral uncertainty, and know-how by renowned philosophers -/- • Scholarly accounts of the development of Western moral thinking by eminent intellectual historians -/- • Careful analyses of the role played by conceptions of moral knowledge in political liberation movements, religious institutions, criminal law, secondary education, and professional codes of ethics articulated by cutting-edge social and moral philosophers. (shrink)

[1] If only Boghossian’s eminently reasonable book were required reading for every freshman considering entrance into the humanities—the next generation of lay-people would be saved from the uncomprehending repetition of relativist slogans, and future scholars would be kept from mounting baroque, ineffectual attempts at their defense. Fear of Knowledge is engaging, easy to read, and hard to dispute. It’s a satisfying work for those in the choir who will enjoy seeing written on the page precisely what we would say to (...) constructivists were we endowed with Boghossian’s rhetorical elegance. And a great many in the po-mo congregation can expect the book sent to them as suggested reading by their more analytically minded colleagues. I’ve already ordered a few in an attempt to stave off inane conversations I would otherwise certainly face this holiday season. [2] Boghossian begins by addressing a relativistic claim he calls equal validity, ‘that there are many radically different yet “equally valid” ways of knowing the world, with science being just one of them’ (p. 2). As Boghossian surely re-. (shrink)

Burge follows Descartes in claiming that the category of conceptually self-verifying judgments includes (but is not restricted to) judgments that give rise to sincere assertions of sentences of the form, 'I am thinking that p'. In this paper I argue that Burge’s Cartesian insight is hard to reconcile with Fregean accounts of the content of thought. Burge's intuitively compelling claim that cogito judgments are conceptually self-verifying poses a real challenge to neo-Fregean theories of content.

In defending his interest-relative account of knowledge in Knowledge and Practical Interests (2005), Jason Stanley relies heavily on intuitions about several bank cases. We experimentally test the empirical claims that Stanley seems to make concerning our common-sense intuitions about these bank cases. Additionally, we test the empirical claims that Jonathan Schaffer seems to make in his critique of Stanley. We argue that our data impugn what both Stanley and Schaffer claim our intuitions about such cases are. To account for these (...) results, one must develop a better conception of the connection between a subject's interests and her body of knowledge than those offered by Stanley and Schaffer. (shrink)

I provide a brief précis of Aaron Zimmerman’s book, Belief: A Pragmatic Picture, then explore two possible problems for the view. The first concerns whether the account of belief can successfully intervene in the debate between those who hold emotions are partly constituted by evaluative beliefs and those who deny this. The second concerns whether the view can explain that distinctive form of white ignorance that is manifest in an unwillingness to draw relatively obvious action-guiding beliefs from widely (...) shared information. Thinking about cases of this kind raises the question of whether Zimmerman’s account is problematically individualist, because of downplaying the importance of converging on an account of belief given the role of belief attribution in a suite of critical practices that are essential to communities of inquiry. If we, collectively, must commit to converging on an account of belief, but different accounts serve the interests of different groups, then the meta-level thesis that we should choose an account on pragmatic grounds raises the question of whose interests such an account should serve. (shrink)

While Aaron Zimmerman’s Belief is rightly subtitled “A Pragmatic Picture”, it concerns a set of topics about which Pragmatists themselves are not always in agreement. Indeed, while there has been a noticeable push back against evidentialism in contemporary analytic epistemology, the view can at times seem ascendant within the literature on pragmatism itself. In particular, Peirceians tend to presuppose something closer to evidentialism when they accuse Jamesians of taking pragmatism in an unproductive and irrationalist direction. This split goes (...) back at least as far as Peirce’s reaction to James’s “The Will to believe” which Peirce “scorned” as the view that “Oh, I could not believe so-and-so, because I should be wretched if I did.” Pragmatists of the more Peircian bent have shared this scorn for the suggestion that our beliefs could be justified for pragmatic reasons, but Zimmerman’s book gives us reason to think that we should take a Jamesian rather the Peircian approach to these issues. (shrink)

In Sounds, Ecologies, Musics, authors pose exciting challenges and provide fresh opportunities for scholars, scientists, environmental activists, and musicians to consider music and sound from ecological standpoints. The book covers topics such as how environment enables music and sound, how music and sound relate to Western environmental science, and mutidisciplinary collaborations among scholars.

Only 19 new molecular entities and 3 biologics were approved by the Food and Drug Administration in 2007, the lowest rate in 24 years. This disappointing output occurred despite steady clinical trial and regulatory review times, the FDA maintaining high approval rates, and the pharmaceutical industry consistently reporting increasing revenues. A government report suggests that fewer new drug applications have been submitted to the FDA by the pharmaceutical industry in recent years. These data have rekindled the debate as to the (...) origins of pharmaceutical innovation and the comparative importance of public and private sources in contributing to drug discovery. The pharmaceutical industry contends that its research is responsible for most new medicines, and that the primary public institution supporting U.S. biomedical research, the National Institutes of Health, supports medical innovation “distinct from the process of drug development.”. (shrink)

Propositional attitude verbs, such as think and want, have long held interest for both theoretical linguists and language acquisitionists because their syntactic, semantic, and pragmatic properties display complex interactions that have proven difficult to fully capture from either perspective. This paper explores the granularity with which these verbs’ semantic and pragmatic properties are recoverable from their syntactic distributions, using three behavioral experiments aimed at explicitly quantifying the relationship between these two sets of properties. Experiment 1 gathers a measure of 30 (...) propositional attitude verbs’ syntactic distributions using an acceptability judgment task. Experiments 2a and 2b gather measures of semantic similarity between those same verbs using a generalized semantic discrimination task and an ordinal scale task, respectively. Two kinds of analyses are conducted on the data from these experiments. The first compares both the acceptability judgments and the semantic similarity judgments to previous classifications derived from the syntax and semantics literature. The second kind compares the acceptability judgments to the semantic similarity judgments directly. Through these comparisons, we show that there is quite fine-grained information about propositional attitude verbs’ semantics carried in their syntactic distributions—whether one considers the sorts of discrete qualitative classifications that linguists traditionally work with or the sorts of continuous quantitative classifications that can be derived experimentally. (shrink)

Svirsky, Howard, and Berman address the U.S. Food and Drug Administration ’s oversight of tobacco products, the newest major area of regulation Congress assigned to the FDA. They discus...

Through an absorbing investigation into recent, high-profile scandals involving one of the largest kosher slaughterhouses in the world, located unexpectedly in Postville, Iowa, Aaron S. Gross makes a powerful case for elevating the category of the animal in the study of religion. Major theorists have almost without exception approached religion as a phenomenon that radically marks humans off from other animals, but Gross rejects this paradigm, instead matching religion more closely with the life sciences to better theorize human nature. (...) Gross begins with a detailed account of the scandals at Agriprocessors and their significance for the American and international Jewish community. He argues that without a proper theorization of "animals and religion," we cannot fully understand religiously and ethically motivated diets and how and why the events at Agriprocessors took place. Subsequent chapters recognize the significance of animals to the study of religion in the work of Ernst Cassirer, Emile Durkheim, Mircea Eliade, Jonathan Z. Smith, and Jacques Derrida and the value of indigenous peoples' understanding of animals to the study of religion in our daily lives. Gross concludes by extending the Agribusiness scandal to the activities at slaughterhouses of all kinds, calling attention to the religiosity informing the regulation of "secular" slaughterhouses and its implications for our relationship with and self-imagination through animals. (shrink)

Drug Safety Communications are used by the Food and Drug Administration to inform health care providers, patients, caregivers, and the general public about safety issues related to FDA-approved drugs. To assess patient knowledge of the messaging contained in DSCs related to the sleep aids zolpidem and eszopiclone, we conducted a large, cross-sectional patient survey of 1,982 commercially insured patients selected by stratified random sampling from the Optum Research Database who had filled at least two prescriptions for either zolpidem or eszopiclone (...) between July 1, 2012 and June 30, 2013. Among the 594 respondents, two-thirds reported hearing generally about drug safety information prior to starting a new drug, with the remaining one-third “rarely” or “never” hearing such information. Providers and pharmacists were primary sources of drug safety information. Two-thirds of zolpidem users and half of eszopiclone users reported having heard about the related DSC messages, ability to accurately identify the major factual messages was limited. Respondents reacted to new drug safety information about their sleep aids by reporting that they would want to learn about alternative ways to help them sleep and seek out more information about the safety of their specific sleeping pill. Opportunities may exist for the FDA to work with providers and pharmacies to help ensure the DSC information is more widely received and is more fully understood by those taking the affected medications. (shrink)

Glenberg's theory is rich and provocative, in our view, but we find fault with the premise that all memory representations are embodied. We cite instances in which that premise mispredicts empirical results or underestimates human capabilities, and we suggest that the motivation for the embodiment idea – to avoid the symbol-grounding problem – should not, ultimately, constrain psychological theorizing.

Faced with the live, forced, and momentous option of whether to accept some form of theism, William James had the will to believe in God. Moved by similar pragmatic principles, Aaron Zimmerman advises self-professed egalitarians to believe they lack racist beliefs—even in the face of less explicit indices that, for some, point in the opposite direction.

The rising cost of the opioid antagonist and overdose reversal agent naloxone is an urgent public health problem. The recent and dramatic price increase of Evzio, a naloxone auto-injector produced by Kaléo, shows how pharmaceutical manufacturers entering the naloxone marketplace rely on market exclusivity guaranteed by the patent system to charge prices at what the market can bear, which can restrict access to life-saving medication. We argue that 28 U.S.C. § 1498, a section of the federal code that allows the (...) government to use patent-protected products for its own purposes in exchange for reasonable compensation, could be used to procure generic naloxone auto-injectors, or at least bring Kaléo to the negotiating table. Precedent exists for the use of § 1498 to procure pharmaceuticals, and it could give meaning to the federal government's recent declaration of a public health emergency around the opioid epidemic, discourage new market entrants from charging exorbitant prices, and yield important public health benefits. (shrink)

The US government supports drug innovation. It is therefore crucial that it distinguish between high-value and low-value innovation in purchasing expensive prescription drugs and medical devices and ensure the continued discovery of transformative drugs and that patient and taxpayer funds are not wasted.

In many countries, health technology assessment organizations determine the economic value of new drugs and make recommendations regarding appropriate pricing and coverage in national health systems. In the US, recent policy proposals aimed at reducing drug costs would link drug prices to six countries: Australia, Canada, France, Germany, Japan, and the UK. We reviewed these countries’ methods of HTA and guidance on price and coverage recommendations, analyzing methods and guidance documents for differences in the methodologies HTA organizations use to conduct (...) their evaluations and considerations they use when making recommendations. We found important differences in the methods, interpretations of HTA findings, and condition-specific carve-outs that HTA organizations use to conduct evaluations and make recommendations. These variations have ethical implications because they influence the recommendations of HTA organizations, which affect access to the drug through national insurance and price negotiations with manufacturers. The differences in HTA approaches result from the distinct political, social, and cultural contexts of each organization and its value judgments. New cost-containment policies in the US should consider the ethical implications of the HTA reviews that they are considering relying on to negotiate drug prices and what values should be included in US pricing policy. (shrink)

The US has found it hard to establish competition in the market for biologics, which are therapeutics derived from living cells. In the case of small-molecule drugs, the emergence of direct competition from generic drugs at the end of the exclusivity period has provided the impetus for price competition, leading to lower spending. In 2010, to spur competition in the biologics market, Congress created a simplified pathway for the US Food and Drug Administration (FDA) to approve comparable versions of biologic (...) drugs called biosimilars. Biosimilar competition in the US has nonetheless remained weaker than in European peer countries. For example, as of August 2020, there were 52 biosimilars available in Germany, and only 15 in the US.1 An important contributor to this “biosimilar gap” has been the fact that biosimilars to biologic blockbusters such as adalimumab (Humira) and etanercept (Enbrel) were only (or will only become) commercially available in the US several years after receiving FDA approval, while they were available in Europe years earlier.2 Through the end of 2021, it took biosimilars a median of 301 days between receiving FDA approval and becoming available for use.3 In one recent study, the median length of time between when a biologic drug was approved and when its first biosimilar was made available to US patients was 21.5 years.4 This paucity of competition has contributed to high US spending on biologics. According to the Department of Health and Human Services, in 2022 41% of US drug expenditures was spent on biologics, which represented 16% of US prescriptions.5. (shrink)

Many hold that the so-called golden era of antibiotic discovery has passed, leaving only a limited clinical pipeline for new antibiotics. A logical conclusion of such arguments is that we need to reform the current system of antibiotic drug research—including clinical trials and regulatory requirements—to spur activity in discovery and development. The United States Congress in the past few years has debated a number of bills to address this crisis, including the 2012 Generating Antibiotic Incentives Now Act and the 2016 (...) 21st Century Cures Act. Experts have also sought to advance antibiotic development by encouraging greater use of trials with noninferiority hypotheses, which are thought to be easier to conduct. The goal underlying these proposals is to stave off the post-antibiotic era by expanding the pharmaceutical armamentarium as quickly as possible. But although new antibiotic agents are necessary to combat the long-term threat of drug-resistant disease, we argue that these research policies, which effectively lower the bar for antibiotic approval, are ethically problematic. Rather, given broader public health considerations related to the full lifecycle of antibiotic use—including development of resistance—we should reject an overly permissive approach to new antibiotic approval and instead set the bar for regulatory approval at a point that will naturally direct research resources toward the most transformative chemical or social interventions. (shrink)

Aaron Zimmerman presents a new pragmatist account of belief, in terms of information poised to guide our more attentive, controlled actions. And he explores the consequences of this account for our understanding of the relation between psychology and philosophy, the mind and brain, the nature of delusion, faith, pretence, racism, and more.

Legal challenges to the FDA’s approval of mifepristone have destabilized patients’ ability to access controversial medicines like medication abortion. We argue that federal courts’ receptiveness to this litigation undermines the coherence and integrity of prescription drug regulation in the U.S.

Brand-name prescription drug manufacturers use various strategies to extend their market exclusivity periods by delaying generic or biosimilar competition. Recent Congressional legislation has targeted four such tactics. We analyze these proposals and assess their likely effect on competition in the U.S. drug market.

Antibiotic use triggers evolutionary and ecological responses from bacteria, leading to antibiotic resistance and harmful patient outcomes. Two complementary strategies support long-term antibiotic effectiveness: conservation of existing therapies and production of novel antibiotics. Conservation encompasses infection control, antibiotic stewardship, and other public health interventions to prevent infection, which reduce antibiotic demand. Production of new antibiotics allows physicians to replace existing drugs rendered less effective by resistance.In recent years, physicians and policymakers have raised concerns about the pipeline for new antibiotics, pointing (...) to a decline in the number of antibiotics approved since the 1980s. This trend has been attributed to high research and development costs, low reimbursement for antibiotics, and regulatory standards for review and approval. Professional societies and researchers around the world have called for renewed emphasis on antimicrobial stewardship, while also supporting antibiotic research and development through grants, changes to intellectual property laws to extend market exclusivity periods, and modification of premarket testing regulations to reduce antibiotic development time and expenses. (shrink)

From the earliest application of modern randomized controlled trials in medical research, scientists and observers have deliberated the ethics of randomly allocating study participants to trial control arms. Adaptive RCT designs have been promoted as ethically advantageous over conventional RCTs because they reduce the allocation of subjects to what appear to be inferior treatments. Critical assessment of this claim is important, as adaptive designs are changing medical research, with the potential to significantly shift how clinical trials are conducted. Policy-makers are (...) swiftly moving to encourage greater use of adaptive designs. In 2016, the newly enacted 21st Century Cures Act instructed the Food and Drug Administration to help product sponsors incorporate adaptive methods into proposed clinical trial protocols and applications for investigational drugs and also biological products. In this article, we review the ethical justifications commonly offered for adaptive designs, explore these arguments in the context of actual trials, and contend that clinical equipoise is a useful standard for adaptive-trial ethics. We distinguish between theoretical and clinical equipoise and explain why ethical arguments related to adaptive trials tend to focus on the former. Yet we contend that theoretical equipoise can be an unreliable standard for adaptive ethics. While we contend that clinical equipoise is the most critical principle for the primary ethical concerns posed by adaptive trials, we suggest ethical approaches to deal with some additional concerns unique to adaptive designs. (shrink)

Conflicts of Interest and the Future of Medicine: The United States, France, and Japan Content Type Journal Article Category Book Review Pages 383-386 DOI 10.1007/s11673-011-9326-y Authors Adam Licurse, Division of Internal Medicine, Department of Medicine, Brigham and Women’s Hospital, Boston, MA, USA Aaron S. Kesselheim, Harvard Medical School, Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women’s Hospital, 1620 Tremont St. Suite 3030, Boston, MA, USA Journal Journal of Bioethical Inquiry Online ISSN 1872-4353 Print ISSN 1176-7529 Journal (...) Volume Volume 8 Journal Issue Volume 8, Number 4. (shrink)

The FDA's new table of surrogate endpoints used for drug approvals is an important step forward for overseeing the use of biomarkers in clinical trials. Nevertheless, we present several ways in which the table can be improved.

Glucagon-like peptide-1 receptor agonists are effective for treating obesity, but the high cost of these medications endangers the financial viability of our health care system. To ensure that these drugs are available to Medicare beneficiaries, pharmaceutical manufacturers must lower their prices.