Genomic research—including whole genome sequencing and whole exome sequencing—has a growing presence in contemporary biomedical investigation. The capacity of sequencing techniques to generate results that go beyond the primary aims of the research—historically referred to as “incidental findings”—has generated considerable discussion as to how this information should be handled—that is, whether incidental results should be returned, and if so, which ones.Federal regulations governing most human subjects research in the United States require the disclosure of “the procedures to be followed” in (...) the research as part of the informed consent process. It seems reasonable to assume—and indeed, many commentators have concluded—that genomic investigators will be expected to inform participants about, among other procedures, the prospect that incidental findings will become available and the mechanisms for dealing with them. Investigators, most of whom will not have dealt with these issues before, will face considerable challenges in framing meaningful disclosures for research participants.To help in this task, we undertook to identify the elements that should be included in the informed consent process related to incidental findings. We did this by surveying a large number of genomic researchers (n = 241) and by conducting in‐depth interviews with a smaller number of researchers (n = 28) and genomic research participants (n = 20). Based on these findings, it seems clear to us that routine approaches to informed consent are not likely to be effective in genomic research in which the prospect of incidental findings exists. Ensuring that participants’ decisions are informed and meaningful will require innovative approaches to dealing with the consent issue. We have identified four prototypical models of a consent process for return of incidental findings. (shrink)

Reply to a commentary by Felicitas Holzer and Ignacio Mastroleoon “Models of Consent to Return of Incidental Findings in Genomic Research.”.

A commentary on “Models of Consent to Return of Incidental Findings in Genomic Research,” by Paul S. Appelbaum, Erik Parens, Cameron R. Waldman, Robert Klitzman, Abby Fyer, Josue Martinez, W. Nicholson Price II, and Wendy K. Chung, in the July‐August 2014 issue.

'Chains of Being' argues that there can be infinite chains of dependence or grounding. Cameron also defends the view that there can be circular relations of ontological dependence or grounding, and uses these claims to explore issues in logic and ontology.

What are the ontological commitments of a sentence? In this paper I offer an answer from the perspective of the truthmaker theorist that contrasts with the familiar Quinean criterion. I detail some of the benefits of thinking of things this way: they include making the composition debate tractable without appealing to a neo-Carnapian metaontology, making sense of neo-Fregeanism, and dispensing with some otherwise recalcitrant necessary connections.

Distinguishing between excuses and exemptions advances our understanding of a standard range of problem cases in debates about epistemic norms. But it leaves open a problem of accounting for blameless norm violation in ‘prospective agents’. By shifting focus in our theory of excuses from rational excellence to norms governing the dispositions of agents, we can account for a fuller range of normative phenomena at play in debates about epistemic norms.

Atrial natriuretic peptides appear to elicit their actions in some target tissues by binding to a novel cell‐surface transmembrane protein which possesses both peptide binding and guanylate cyclase activities. Ligand binding stimulates enzyme activity to produce increased intracellular concentrations of cyclic GMP which, in turn, mediates the cell's physiological response.

This review emphasizes the worldwide and U.S. evolving population demographics and the need for the dental profession to exercise its professional and ethical duty to expand its traditional patient base to provide needed services.

Carruthers argues that an integrated faculty of metarepresentation evolved for mindreading and was later exapted for metacognition. A more consistent application of his approach would regard metarepresentation in mindreading with the same skeptical rigor, concluding that the “faculty” may have been entirely exapted. Given this result, the usefulness of Carruthers’ line-drawing exercise is called into question.

In this paper I examine the objection to truthmaker theory, forcibly made by David Lewis and endorsed by many, that it violates the Humean denial of necessary connections between distinct existences. In Sect. 1 I present the argument that acceptance of truthmakers commits us to necessary connections. In Sect. 2 I examine Lewis’ ‘Things-qua-truthmakers’ theory which attempts to give truthmakers without such a commitment, and find it wanting. In Sects. 3–5 I discuss various formulations of the denial of necessary connections (...) and argue that each of them is either false or compatible with truthmaker theory. In Sect. 6 I show how the truthmaker theorist can resist the charge that they are committed to necessary exclusions between possible existents. I conclude that there is no good objection to truthmaker theory on the grounds that it violates the Humean dictum. (shrink)

A plausible condition on having the standing to blame someone is that the target of blame's wrongdoing must in some sense be your “business”—the wrong must in some sense harm or affect you, or others close to you. This is known as the business condition on standing to blame. Many cases of epistemic blame discussed in the literature do not obviously involve examples of someone harming or affecting another. As such, not enough has been said about how an individual's epistemic (...) failing can really count as another person's business. In this paper, I deploy a relationship-based account of epistemic blame to clarify the conditions under which the business condition can be met in the epistemic domain. The basic idea is that one person's epistemic failing can be another's business in virtue of the way it impairs their epistemic relationship. (shrink)

Paul Sheehy has argued that the modal realist cannot satisfactorily allow for the necessity of God's existence. In this short paper I show that she can, and that Sheehy only sees a problem because he has failed to appreciate all the resources available to the modal realist. God may be an abstract existent outside spacetime or He may not be: but either way, there is no problem for the modal realist to admit that He exists at every concrete possible world.

Ross P. Cameron argues that the flow of time is a genuine feature of reality. He suggests that the best version of the A-Theory is a version of the Moving Spotlight view, according to which past and future beings are real, but there is nonetheless an objectively privileged present. Cameron argues that the Moving Spotlight theory should be viewed as having more in common with Presentism than with the B-Theory. Furthermore, it provides the best account of truthmakers for (...) claims about what was or will be the case. Cameron goes on to defend an account of the open future, and argues that this is a better account than that available to the Growing Block theory. (shrink)

Systems thinking has emerged as a means of conceptualizing and addressing complex public health problems, thereby challenging more commonplace understanding of problems and corresponding solutions as straightforward explanations of cause and effect. Systems thinking tries to address the complexity of problems through qualitative and quantitative modeling based on a variety of systems theories, each with their own assumptions and, more importantly, implicit and unexamined values. To date, however, there has been little engagement between systems scientists and those working in bioethics (...) and public health ethics. The goal of this paper is to begin to consider what it might mean to combine systems thinking with public health ethics to solve public health challenges. We argue that there is a role for ethics in systems thinking in public health as a means of elucidating implicit assumptions and facilitating ethics debate and dialogue with key stakeholders. (shrink)

In this paper I examine two principles of orthodox truthmaker theory: truthmaker maximalism - the doctrine that every (contingent) truth has a truthmaker, and truthmaker necessitarianism - the doctrine that the existence of a truthmaker necessitates the truth of any proposition which it in fact makes true. I argue that maximalism should be rejected and that once it is we only have reason to hold a restricted form of necessitarianism.

The so-called March of Progress depicts human evolution as a linear progression from mohkey to man. Shelley (1996) analyzed this image as a visual argument proceeding through "rhetorical" and "demonstrative" modes of visual logic. In this paper, I confirm and extend this view of visual logic by examining variations of the original March image. These variations show that each mode of visual logic can be altered or isolated in support of new conclusions. Furthermore, the March can be included in a (...) visual "frame" to produce new arguments, much as a verbal argument can be made a component of a new and larger argument. (shrink)

Situational irony concerns what it is about a situation that causes people to describe it as ironic. Although situational irony is as complex and commonplace as verbal and literary irony, it has received nowhere near the same attention from cognitive scientists and other scholars. This paper presents the bicoherence theory of situational irony, based on the theory of conceptual coherence (Kunda & Thagard, 1996; Thagard & Verbeurgt, 1998). On this theory, a situation counts as ironic when it is conceived as (...) having a bicoherent conceptual structure, adequate cognitive salience, and evokes an appropriate configuration of emotions. The theory is applied to a corpus of 250 examples of situational ironies gathered automatically from electronic news sources. A useful taxonomy of situational ironies is produced, new predictions and insights into situational irony are discussed, and extensions of the theory to other forms of irony are examined. (shrink)

Firms use algorithms to make important business decisions. To date, the algorithmic accountability literature has elided a fundamentally empirical question important to business ethics and management: Under what circumstances, if any, are algorithmic decision-making systems considered legitimate? The present study begins to answer this question. Using factorial vignette survey methodology, we explore the impact of decision importance, governance, outcomes, and data inputs on perceptions of the legitimacy of algorithmic decisions made by firms. We find that many of the procedural governance (...) mechanisms in practice today, such as notices and impact statements, do not lead to algorithmic decisions being perceived as more legitimate in general, and, consistent with legitimacy theory, that algorithmic decisions with good outcomes are perceived as more legitimate than bad outcomes. Yet, robust governance, such as offering an appeal process, can create a legitimacy dividend for decisions with bad outcomes. However, when arbitrary or morally dubious factors are used to make decisions, most legitimacy dividends are erased. In other words, companies cannot overcome the legitimacy penalty of using arbitrary or morally dubious factors, such as race or the day of the week, with a good outcome or an appeal process for individuals. These findings add new perspectives to both the literature on legitimacy and policy discussions on algorithmic decision-making in firms. (shrink)

This paper emphasizes that, contrary to the claims of ECT experts and the ECT industry, a majority, not "a small minority," of ECT recipients sustain permanent memory dysfunction each year as a result of ECT. The paper exposes the convulsion hypothesis, upon which ECT is allegedly based, as mythological. Finally, through hidden and comparative electrical parameters, it exposes the extreme destructive power of today's "new and improved" ECT devices.

Excessive prescribing of pain medications after surgery has contributed to the epidemic of opioid misuse and diversion in the United States. Pain specialists may be particularly well situated to address these issues. We describe an attempt to reverse the trend at an orthopedic surgical hospital by implementing a peri-operative assessment and treatment service which minimizes preoperative opioid use, when necessary implements addiction treatment, and encourages early tapering from opioids.

Some argue that Lewisian realism fails as a reduction of modality because in order to meet some criterion of success the account needs to invoke primitive modality. I defend Lewisian realism against this charge; in the process, I hope to shed some light on the conditions of success for a reduction. In §1 I detail the resources the Lewisian modal realist needs. In §2 I argue against Lycan and Shalkowski’s charge that Lewis needs a modal notion of ‘world’ to ensure (...) that worlds correspond to possibilities. In §3 I respond to Divers and Melia’s objection that Lewis needs to invoke primitive modality to give a complete account of what worlds there are. In §4 I ask what it is for a notion to ‘involve’ modality. I conclude that the question is either in bad standing or at best offers little traction on the debate, and propose a different way of assessing when materials are appropriately included in a reductive base. (shrink)

In footnote 56 of his Naming and Necessity, Kripke offers a ‘proof’ of the essentiality of origin. On its most literal reading the argument is clearly flawed, as was made clear by Nathan Salmon. Salmon attempts to save the literal reading of the argument, but I argue that the new argument is flawed as well, and that it can’t be what Kripke intended. I offer an alternative reconstruction of Kripke’s argument, but I show that this suffers from a more subtle (...) fault. (shrink)

A multiple analogy is a structured comparison in which several sources are likened to a target. In "Multiple analogies in science and philosophy," Shelley provides a thorough account of the cognitive representations and processes that participate in multiple analogy formation. Through analysis of real examples taken from the fields of evolutionary biology, archaeology, and Plato's "Republic," Shelley argues that multiple analogies are not simply concatenated single analogies but are instead the general form of analogical inference, of which single analogies are (...) a special case. The result is a truly general cognitive model of analogical inference.Shelley also shows how a cognitive account of multiple analogies addresses important philosophical issues such as the confidence that one may have in an analogical explanation, and the role of analogy in science and philosophy.This book lucidly demonstrates that important questions regarding analogical inference cannot be answered adequately by consideration of single analogies alone. (shrink)

I respond to Tim Smartt’s (2023) skepticism about epistemic blame. Smartt’s skepticism is based on the claims that (i) mere negative epistemic evaluation can better explain everything proponents of epistemic blame say we need epistemic blame to explain; and (ii) no existing account of epistemic blame provides a plausible account of the putative force that any response deserving the label “blame” ought to have. He focuses primarily on the prominent “relationship-based” account of epistemic blame to defend these claims, arguing that (...) the account is explanatorily idle, and cannot distinguish between epistemically excused and epistemically blameworthy agents. I argue that Smartt mischaracterizes the account’s role for judgments of epistemic relationship impairment, leading to mistaken claims about the account’s predictions. I also argue that the very feature of the account that Smartt mischaracterizes is key to understanding what epistemic blame does for our epistemic responsibility practices that mere negative epistemic evaluation cannot. (shrink)

The application of neurostimulation techniques such as deep brain stimulation —often called a brain pacemaker for neurological conditions like Parkinson's disease —has generated “currents of hope.” Building on this hope, there is significant interest in applying neurostimulation to psychiatric disorders such as major depression and obsessive-compulsive disorder. These emerging neurosurgical practices raise a number of important ethical and social questions in matters of resource allocation, informed consent for vulnerable populations, and commercialization of research.

This paper provides a critical overview of recent work on epistemic blame. The paper identifies key features of the concept of epistemic blame and discusses two ways of motivating the importance of this concept. Four different approaches to the nature of epistemic blame are examined. Central issues surrounding the ethics and value of epistemic blame are identified and briefly explored. In addition to providing an overview of the state of the art of this growing but controversial field, the paper highlights (...) areas where future work is needed. (shrink)

Is the world internally connected by a web of necessary connections or is everything loose and independent? Followers of David Hume accept the latter by upholding Hume’s Dictum, according to which there are no necessary connections between distinct existences. Roughly put, anything can coexist with anything else, and anything can fail to coexist with anything else. Hume put it like this: “There is no object which implies the existence of any other if we consider these objects in themselves.” Since Hume’s (...) day, Hume’s Dictum has played a major role in philosophy, especially in contemporary metaphysics. In ruling out necessary connections, Hume’s Dictum implies that causal relations and the laws of nature are contingent. It makes other demands on our metaphysics of science as well; for example, it places restrictions on our metaphysics of counterfactuals, dispositions, and explanation. The principle has applications in other areas too. Hume’s Dictum places constraints on our theories of abstract objects and moral properties. For example, Hume’s Dictum rules out the view that moral properties are distinct from, but necessarily connected to, non-moral properties. While Hume’s Dictum is a prominent principle in metaphysics, few Humeans have defended the principle at length. It is assumed more often than it is argued for. As a result, Hume’s Dictum no longer enjoys the reputation it once did. It’s common to hear complaints about the lack of arguments in support of Hume’s Dictum. Moreover, philosophers are increasingly willing to defend views that are at odds with Hume’s Dictum. A striking example of this is the recent explosion of interest in views that take causal relations and the laws of nature to be necessary. Humeans can no longer afford to be complacent. An extended defense of Hume’s Dictum is called for, and that’s what this dissertation aims to offer. This dissertation has three parts. In the first part, I lay out some preliminaries and offer a precise formulation of Hume’s Dictum. In the second part, I develop three arguments in favor of Hume’s Dictum. In the final part, I defend Hume’s Dictum against objections. (shrink)