Patients have received experimental pharmaceuticals outside of clinical trials for decades. There are no industry-wide best practices, and many companies that have granted compassionate use, or ‘preapproval’, access to their investigational products have done so without fanfare and without divulging the process or grounds on which decisions were made. The number of compassionate use requests has increased over time. Driving the demand are new treatments for serious unmet medical needs; patient advocacy groups pressing for access to emerging treatments; internet platforms (...) enabling broad awareness of compelling cases or novel drugs and a lack of trust among some that the pharmaceutical industry and/or the FDA have patients’ best interests in mind. High-profile cases in the media have highlighted the gap between patient expectations for compassionate use and company utilisation of fair processes to adjudicate requests. With many pharmaceutical manufacturers, patient groups, healthcare providers and policy analysts unhappy with the inequities of the status quo, fairer and more ethical management of compassionate use requests was needed. This paper reports on a novel collaboration between a pharmaceutical company and an academic medical ethics department that led to the formation of the Compassionate Use Advisory Committee. Comprising medical experts, bioethicists and patient representatives, CompAC established an ethical framework for the allocation of a scarce investigational oncology agent to single patients requesting non-trial access. This is the first account of how the committee was formed and how it built an ethical framework and put it into practice. (shrink)

A quiet revolution is occurring in the field of transplantation. Traditionally, transplants have involved solid organs such as the kidney, heart and liver which are transplanted to prevent recipients from dying. Now transplants are being done of the face, hand, uterus, penis and larynx that aim at improving a recipient's quality of life. The shift away from saving lives to seeking to make them better requires a shift in the ethical thinking that has long formed the foundation of organ transplantation. (...) The addition of new forms of transplants requires doctors, patients, regulators and the public to rethink the risk and benefit ratio represented by trade-offs between saving life, extending life and risking the loss of life to achieve improvements in the quality of life. (shrink)

This essay, which won the Prince Consort Prize for 1950, treats of the revolutionary change in historical writing that followed the entry into England, early in the nineteenth century, of the ideas of Vico and of the German historical school. Chiefly through Coleridge's influence, eighteenth-century rationalist suppositions gave place in certain men to a fundamentally opposed, 'Romantic' philosophy, and so to a new kind of History. Mr. Forbes is particularly concerned with the part played in this revolution by the liberal (...) Anglicans: Thomas Arnold, Headmaster of Rugby and Regius Professsor of Modern History at Oxford; Richard Whitely, Professor of Political Economy at Oxford and Archbishop of Dublin; Julius Charles Hare, disciple of Coleridge and translator (with Thirlwall) of Niebuhr's History of Rome; Connop Thirlwall, Bishop of St David's and author of the History of Greece; Henry Hart Milman, Professor of Poetry and Oxford and Dean of St Paul's; Arthur Penrhyn Stanley, pupil and biographer of Thomas Arnold, and Dean of Westminster. They have elsewhere been studied in the compartments of 'classical' and 'ecclesiastical' history. But it is fundamental to their outlook on Church and State that for them no such compartments existed, and their idea of History as a whole has hitherto lacked an English historian. This essay does much more than clarify technical problems in one of the various ideas of History embraced in Professor Toynbee's system. Mr. Forbes addresses his book to all students of nineteenth-century thought. (shrink)

This monograph consists of five parts: (1) introductory material including a conference overview; (2) papers presented at an international symposium on the topic of ethical issues in disability and rehabilitation as a section of the Annual Conference of the Society for Disability Studies; (3) responses to the symposium, prepared by four of the participants; (4) selected additional papers which offer views from perspectives or cultures not represented at the Denver conference; and (5) an annotated international bibliography. Representatives from 10 countries (...) discussed ethical issues and decision making in disability and rehabilitation. Conference papers include: "Genetic Engineering--The New Eugenics? Evolving Medical Attitudes towards the Quality of Life" (Hugh Gallagher);"Description of the Decision-Making Project" (Daryl Evans); "Treatment and Nontreatment Decisions with Respect to Extremely Premature, Very Low Birthweight Infants (500-750g)" (Ernle Young); "Allocation of Resources and Distributive Justice" (John Mather); "Quality Assurance as an Aid to Ethical Decision Making in Disability Management: Lessons from Recent Ethical Issues Involving Disadvantaged Groups in New Zealand" (Peter Gow); "Disability and Ethical Issues: A Point of View from the Netherlands" (Yolan Koster-Dreese); "Who Shall Live or How Shall They Live? Consumer and Professional Perspectives on Treatment/Non-Treatment Decisions" (Joseph Kaufert and Patricia Kaufert); and "Debates across Social Movements on Reproductive Technologies, Genetic Engineering, and Eugenics" (Theresia Degener). Conference commentaries include: "The Meeting of Disability and Bioethics: A Beginning Rapprochement" (Adrienne Asch); "A Plea for More Dialogue: Commentary on Ethics Conference" (Robert Slater); "Healing Our Wounds" (Martha Lentz Walker); "Theories and Values: Ethics and Contrasting Perspectives on Disability" (Harlan Hahn); and "Current Example of Ethical Dilemma" (Susan Lacetti). Selected additional papers include: "High-tech Medicine Is Basic Care" (Frederick Abrams); "Prevention of Disabilities as a Medical Question" (G. Schioler); "The Ethics of Disability Prevention: A Parent's Point of View" (Mrs. J. Baker); "A Reference Matrix for Issues of Life and Personhood" (Mike Miles); "Nazi Scientists and Ethics of Today" (Isabel Wilkerson); "Ethical and Policy Issues in Rehabilitation Medicine (Hastings Center Report)" (Arthur Caplan et al.); and "Differing Approaches to Prevention of Disability and Treatment of Impaired Infants Creates Controversies Worldwide" (Barbara Duncan). (JDD). (shrink)

In this essay I propose an interpretative and explanatory structure for the so-called argumentum ex silento, or argument from silence (henceforth referred to as the AFS). To this end, I explore two examples, namely, Sherlock Holmes’s oft-quoted notice of the “curious incident of the dog in the night-time” from Arthur Conan Doyle’s short story “Silver Blaze,” and the historical question of Paul of Tarsus’s silence on biographical details of the historical Jesus. Through these cases, I conclude that the AFS (...) serves as a dialogical topos best evaluated and understood through the perceived authority of the arguer and the willingness of the audience to accept that authority, due to the “curious” nature of the negative evidence that the argument employed. (shrink)

My object here is to try to make the idea of moral criticism, and its foundation, moral art, sound at least a trifle less outrageous than it does at present. I'd like to explain why moral criticism is necessary and, in a democracy, essential; how it came about that the idea of moral criticism is generally hoo-hooed or spat upon by people who in other respects seem moderately intelligent and civil human beings; and that the right kind of moral criticism (...) is, or should be. Partly this involves explaining why sophisticated modern free society tends to be embarrassed by the whole idea of morality and by all its antique, Platonic- or scholastic-sounding manifestations: Beauty, Goodness, Truth. In other words, it involves, partly, explaining how perverse and false philosophers, and educated but sequacious mind, obscuring truths once widely acknowledged; and partly it involves sketching out a way of thinking that might supplant the cowardly Laodicean habits into which American intellectuals have in recent times fallen. John Gardner, novelist, poet, and essayist, has received the National Book Critics Circle Award for his latest novel, October Light. His other popular works of fiction include Grendel, The Sunlight Dialogues, and the book-length poem, Jason and Medeia. He has, as well, prepared modern versions of the Gawain poems, an alliterative Morte Arthure and five other Middle English poems and written The Construction of the Wakefield Cycle, The Poetry of Chaucer, and the biography, The Life and Times of Chaucer. "Death by Art" is the first chapter of a book concerned with morality in literature. (shrink)

Sartre’s discussion of «being-with-others» in Part Three of Being and Nothingness is extraordinarily rich and highly original. At its core, I argue, lies an insight into the aporetic character of intersubjectivity – «the scandal of the plurality of consciousnesses», as Sartre puts it – which emerges most clearly in his critique of Hegel’s theory of intersubjectivity. My aim in this paper is to isolate this thesis of Sartre’s and spell out his grounds for it. I argue furthermore that Hegel’s conception (...) of intersubjectivity corresponds to that of natural consciousness, such that, in rejecting Hegel, Sartre is also impugning the reality of a conception integral to ordinary thought. I suggest that Sartre’s insight also holds the key to his distinctive approach to social and political theory in the Critique of Dialectical Reason. (shrink)

The aim of this article is to assess the impact of Big Data technologies for insurance ratemaking, with a special focus on motor products.The first part shows how statistics and insurance mechanisms adopted the same aggregate viewpoint. It made visible regularities that were invisible at the individual level, further supporting the classificatory approach of insurance and the assumption that all members of a class are identical risks. The second part focuses on the reversal of perspective currently occurring in data analysis (...) with predictive analytics, and how this conceptually contradicts the collective basis of insurance. The tremendous volume of data and the personalization promise through accurate individual prediction indeed deeply shakes the homogeneity hypothesis behind pooling. The third part attempts to assess the extent of this shift in motor insurance. Onboard devices that collect continuous driving behavioural data could import this new paradigm into these products. An examination of the current state of research on models with telematics data shows however that the epistemological leap, for now, has not happened. (shrink)

The growing area of military bio-technologies, especially the use of cogniceuticals, raises several ethical concerns for military physicians. These include the role of military physicians in prescr...

Recently, philosophers have tried to develop a version of truthmaker theory which ties the truthmaking relation closely to the notion of fundamentality. In fact, some of these truthmaker-fundamentalists, as I call them, assume that the notion of fundamentality is intelligible in part by citing, as central examples of fundamentals, truthmakers, which they understand necessarily as constituents of fundamental reality. The aim of this paper is first to bring some order and clarity to this discussion, sketching how far TF is compatible (...) with orthodox truthmaking, and then critically to evaluate the limits of TF. It will be argued that truthmaker theory cannot directly help with articulating the nature of fundamental reality and that T-REL does not necessarily relate truths with anything more fundamental, unless what is fundamental is what the truthbearers in question are about. I shall argue that TF faces a rather thorny dilemma and some general problems. I shall present two exhaustive types of fundamentalism on which a version of TF can be based: deflationary and inflationary. It will be argued that each version of TF runs into significant troubles accounting for all truth, specifically ordinary truths and metaphysical truths about the relations between ordinary facts and fundamental facts. I shall not attempt to solve these problems, but rather, at the end, diagnose the issues with TF as lying in the difficulties with reconciling the manifest image with the scientific and metaphysical images of reality. (shrink)

The field of medical rehabilitation is relatively new.... Until recently, the ethical problems of this new field were neglected. There seemed to be more pressing concerns as rehabilitation medicine struggled to establish itself, sometimes in the face of considerable skepticism or hostility. There also seemed no pressing moral questions of the kind and intensity to be encountered, say, in high-technology acute care medicine or genetic engineering.... Those in biomedical ethics could and did easily overlook the quiet, less obtrusive issues of (...) rehabilitation.... The Hastings Center set out in 1985 to rectify that situation.... To explore the issues, the Center assembled a group of practitioners in the field, Hastings Center staff members, and individuals experienced in other areas of medical ethics.... The report that follows was written by Arthur Caplan and Daniel Callahan, assisted by Dr. Janet Haas of the Moss Rehabilitation Hospital in Philadelphia... (shrink)

This book offers an introduction to the way art is perceived, interpreted, and felt and approaches these mindful events from a multidisciplinary perspective.

Under the label of scientific metaphysics, many naturalist metaphysicians are moving away from a priori conceptual analysis and instead seek scientific explanations that will help bring forward a unified understanding of the world. This paper first reviews how our classical assumptions about ordinary objects fail to be true in light of quantum mechanics. The paper then explores how our experiences of ordinary objects arise by reflecting on how our neural system operates algorithmically. Contemporary models and simulations in computational neuroscience are (...) shown to provide a theoretical framework that does not conflict with existing fundamental physical theories, and nonetheless helps us make sense of the manifest image. It is argued that we must largely explain how the manifest image arises in algorithmic terms, so that we can pursue a metaphysics about ordinary objects that is scientifically well founded. (shrink)

This volume of translations unites three shorter works by Arthur Schopenhauer that expand on themes from his book The World as Will and Representation. In On the Fourfold Root he takes the principle of sufficient reason, which states that nothing is without a reason why it is, and shows how it covers different forms of explanation or ground that previous philosophers have tended to confuse. Schopenhauer regarded this study, which he first wrote as his doctoral dissertation, as an essential (...) preliminary to The World as Will. On Will in Nature examines contemporary scientific findings in search of corroboration of his thesis that processes in nature are all a species of striving towards ends; and On Vision and Colours defends an anti-Newtonian account of colour perception influenced by Goethe's famous colour theory. This is the first English edition to provide extensive editorial notes on the different published versions of these works. (shrink)

F. D. Maurice was a distinguished Christian theologian, much respected by academics and artists of his day and afterwards. This volume, originally published in 1951, contains the text of seven lectures delivered in his honour in 1942 by Arthur Ramsey, later Archbishop of Canterbury, and covers Maurice's career and his impact on later students of theology. This book will be of value to anyone with an interest in Christian socialism or in Maurice's wider work.

Dans le cadre des rencontres Contested Territories : Conversations in Practice qu’elle organise en partenariat avec la Chelsea School of Art and Design et la Naked Punch Review, la Tate Modern a réuni le 2 février 2006 Arthur Danto, Thierry de Duve et Richard Shusterman pour une table ronde portant sur le célèbre article publié par Danto en 1964, « Le monde de l’art 1 », et les questions qu’il continue de soulever. Voici la traduction de leurs exposés et (...) de leurs échanges. (shrink)

Both individuals and organizations can engage in unethical behaviors. Across six experiments, we examine how people’s ethical judgments are affected by whether the agent engaging in unethical action is a person or an organization. People believe organizations are more unethical than individuals, even when both agents engage in identical behaviors. Using both mediation and moderation analytical approaches, we find that this effect is explained by people’s beliefs that organizations produce more harm when behaving unethically, even when they do not, as (...) well as people’s perceptions that organizations are relatively more blameworthy agents. We then explore how these judgments manifest across different kinds of organizations as well as how they produce discrepant punishments following ethically questionable business activities. Although society and the law often treat individuals and organizations as equivalent, people believe for-profit organizations’ behaviors are less ethical than identical individual behaviors. We discuss the ethical implications of this discrepancy, as well as additional implications concerning reputation management, punishment, and signaling in organizational contexts. (shrink)

This paper aims to identify the main points that Peter Winch makes, or reminders that he offers, about understanding ourselves and others. It would no doubt be possible to construct a theory out of these ideas, but I try to avoid giving the impression that Winch does so. Instead, the most Wittgensteinian approach to the subject is, as Winch does, to describe, remind and thereby clarify, without putting forward any kind of questionable hypothesis. Winch's work brings out the fact that (...) understanding people is importantly connected to both wisdom and practical being in tune with others, but identical with neither. (shrink)

This is a reply to Samuel Levey's fine review of my Monads, Composition and Force (Oxford UP, 2018) in the same issue of the Leibniz Review. In it I take up various difficulties raised by Levey that may be thought to collapse Leibniz's position into idealism after all, and attempt to provide convincing responses to them.

In this book, Arthur Keefer offers a new interpretation of the book of Proverbs from the standpoint of virtue ethics. Using an innovative method that bridges philosophy and biblical studies, he argues that much of the instruction within Proverbs meets the criteria for moral and theological virtue as set out in Aristotle's Nicomachean Ethics and the works of St. Thomas Aquinas. Keefer presents the moral thought of Proverbs in its social, historical, and theological contexts. He shows how these contexts (...) shed light on the conceptualization of virtue, the virtues that are promoted and omitted, and the characteristics that make Proverbs a distinctive moral tradition. In giving undivided attention to biblical virtue, this volume opens the way for new avenues of study in biblical ethics, including law, narrative, and other aspects of biblical instruction and wisdom. (shrink)

Sledging, or ‘trash talk’ or ‘chirping’, as it’s known in other parts of the world, has long been part of competitive sport. However, more recent times have seen the issue of sledging, and its place in sport, debated with many athletes, fans and academics arguing that sledging has moved outside the notion of ‘sportsmanship’ and gone beyond light hearted, good natured banter. They argue it is now characterized as hurtful, insulting, offensive and intimidating – a tactic that has moved beyond (...) fair play and, in many instances, no longer acceptable. This paper seeks to explore this issue in greater depth. In particular, this paper seeks to ask, ‘is sledging part of play, or is it a characteristic of play’s corruption?’ The argument proceeds by adopting a conception of play grounded in the work of Johan Huizinga. Play may be understood as a core component of even professional sport, not least in that play lies at the moral core of the ‘spirit of sport’ in fairplay and respect for one’s opponents. Using... (shrink)

In preparation for his lectures on Leibniz delivered in Cambridge in Lent Term 1899, Russell started in the summer of 1898 to keep notes on writings by and about Leibniz in a large notebook of the type he commonly used for notetaking at this time. This article prints, with annotation, all the material on Leibniz in that notebook.

Ronald Dworkin is one of the most frequently cited legal philosophers. His work, notably his attack on H. L. A. Hart's positivist theory of law, has received considerable attention, earning him praise as well as trenchant criticism. Instead of discussing the analytical validity of Dworkin's claims, though, we propose an alternative reading of his jurisprudential writings that emphasises their rhetorical nature. After delineating the rhetorical context of his work, we provide several illustrations of his use of rhetorical strategies and, with (...) the help of sentiment‐analysis techniques, emotional language. While resorting to classical rhetorical tactics, Dworkin's rhetoric, we argue, appealed to the emotional power of rights talk at a time when the notion of rights enjoyed greater resonance with his audience. (shrink)

Companies often benefit from others’ attributions of moral conviction for prosocial behavior, for example, attributions that a company has a sincere moral desire to improve the environment when behaving sustainably. Across four studies, we explored how organizations’ changing resource positions influenced people’s attributions for the motivations underlying prosocial organizational behaviors. Observers attributed less moral conviction following prosocial behavior when they believed an organization was losing economic resources. This effect was primarily a “penalty” assessed against organizations that were losing resources, as (...) opposed to a “reward” given to organizations gaining resources. Finally, we found that this effect occurred because people perceive organizations that are losing resources as more situationally constrained, leading them to attribute less dispositional moral conviction. We discuss theoretical and practical implications stemming from how changes in resource access can lead people to be more skeptical of organizations’ motivations following prosocial behavior. (shrink)

1. A short analysis of the institutional reform legislation of August 1980 allows the ascertainment that the competences «granted» by the central power to the regions are truncated.2. Financial means are also «granted». They consist in merely listing sources of revenues : receipts other then tax, black grants, tax shares, limited tax entitlement and borrowing power. Those financial means are arbitrary chosen, they are not related to the competences granted, they are insufficient.3. Anyway, the existing budgeting system does not allow (...) connecting policies and financial means. A new classification should be of more adequacy to achieve this end.4. Actual regional sovereignty implies that all competences explicitely attributed to the federal level should belong to the regions. In the countries where such a system exists, the regions are mastering 40 to 60 % of the revenues. The kind of regionalisation implemented in Belgium only grants about 8 % to the regions.It is pointed out that 65 % of the current revenues and 46 % of the expenditures could technically be subject to federalisation. Should also the financial system of social security be federalized, then should the part of both ressources and expenditures belonging to the regions increase to 7 5 %.On the long way to federalism in Belgium, the new legislation is just a step, not an arrival. The forthcoming years will probably confirm it. (shrink)

Elemental matter.--From element to plant and animal tissue.--Tissue plant and animal.--The spirit of search.--The method of search.--The need for inquiry.--Difference.--The fluidity of tissue.--Continuous oneness of nature and man.--Definition.--Change of man.--The law of activity.--Life of man.--The growth of water.--The origin of cancer.--Land and houses.--Training.--Acitvity of body.