The anti-doping policy of the Gay Games offers an interesting exemplification of the treatment–enhancement distinction. Some Gay Games athletes require steroids to deal with the effects of HIV or for sexual reassignment, and the practice community had to negotiate coordinating conventions with regard to steroid use that remained committed to the deeper conventions of Gay Games sport. This paper will investigate the way that this policy emanated from the type of participatory social practice community that would be necessary for any (...) sport to challenge the anti-doping fundamentalism within contemporary sports. (shrink)

Principlism is an ethical framework that has dominated bioethical discourse for the past 50 years. There are differing perspectives on its proper scope and limits. In this article, we consider to what extent principlism provides guidance for the abortion and euthanasia debates. We argue that whilst principlism may be considered a useful framework for structuring bioethical discourse, it does not in itself allow for the resolution of these neuralgic policy discussions. Scholars have attempted to use principlism to analyse the ethics (...) and legality of abortion and euthanasia; but such efforts are methodologically problematic. We close with a consideration of the proper scope of principlism in bioethics–a vision that is more modest than the manner in which principlism is often deployed in contemporary academic bioethics and medical education. (shrink)

Savulescu argues that it may be ethically acceptable for governments to require citizens be vaccinated against COVID-19. He also recommends that governments consider providing monetary or in-kind incentives to citizens to increase vaccination rates. In this response, we argue against mandatory vaccination and vaccine incentivisation, and instead suggest that targeted public health messaging and a greater responsiveness to the concerns of vaccine-hesitant individuals would be the best strategy to address low vaccination rates.

Scientific modelling is a value-laden process: the decisions involved can seldom be made using ‘scientific’ criteria alone, but rather draw on social and ethical values. In this paper, we draw on a body of philosophical literature to analyze a COVID-19 vaccination model, presenting a case study of social and ethical value judgments in health-oriented modelling. This case study urges us to make value judgments in health-oriented models explicit and interpretable by non-experts and to invite public involvement in making them.

Procedural justifications of democracy emphasize inclusiveness and respect and by doing so come into conflict with instrumental justifications that depend on voters’ competence. This conflict raises questions about jury theorems and makes their standing in democratic theory contested. We show that a type of no-regret learning called meta-induction can help to satisfy the competence assumption without excluding voters or diverse opinion leaders on an a priori basis. Meta-induction assigns weights to opinion leaders based on their past predictive performance to determine (...) the level of their inclusion in recommendations for voters. The weighting minimizes the difference between the performance of meta-induction and the best opinion leader in hindsight. The difference represents the regret of meta-induction whose minimization ensures that the recommendations are optimal in supporting voters’ competence. Meta-induction has optimal truth-tracking properties that support voters’ competence even if it is targeted by mis/disinformation and should be considered a tool for supporting democracy in hyper-plurality. (shrink)

Le verbe croire renvoie à des réalités diverses et contradictoires. Croire c'est à la fois être certain, tenir pour vrai, adhérer avec conviction, mais c'est aussi, penser, admettre comme probable, envisager comme possible, et donc ouvrir la voie au doute, à l'opinion, au débat. Le verbe croire possède de multiples usages. Songeons que l'on croit en Dieu alors que l'on croit au diable. On croit à, on croit en, on croit que. Les historiens mobilisés dans cet ouvrage s'interrogent sur ces (...) modalités complexes de la croyance dans tous les domaines du champ social. Privilégier les temps de ruptures, de déconstruction des croyances, les seuils épistémologiques fut le fil conducteur de cette recherche entre "croire" et "ne pas croire". (shrink)

This study investigates the choice of genitive forms (the woman’s book vs. the book of the woman) in the English of Japanese-English bilingual returnees (i.e. children who returned from a second language dominant environment to their first language environment). The specific aim was to examine whether change in language dominance/exposure influences choice of genitive form in the bilingual children; the more general question was the extent to which observed behaviour can be explained by cross linguistic influence (CLI). First, we compared (...) the choice of genitive form between monolingual Japanese speakers and bilinguals who had recently returned to Japan from an English monolingual environment. Second, we tracked changes in genitive preference within bilingual children, comparing their performances upon return to Japan to those of one year later. Results show that CLI alone is insufficient to explain the difference in genitive evaluation between bilinguals and monolinguals, as well as the intra-group bilingual variation over time. We suggest that both CLI and general processing considerations couple together to influence the changes in genitive preference. (shrink)

Some patients awaken from their coma but only show reflex motor activity. This condition of wakeful (eyes open) unawareness is called the vegetative state. In 2002, a new clinical entity coined ‘‘minimally conscious state’’ defined patients who show more than reflex responsiveness but remain unable to communicate their thoughts and feelings. Emergence from the minimally conscious state is defined by functional recovery of verbal or nonverbal communication.1 Our empirical medical definitions aim to propose clearcut borders separating disorders of consciousness such (...) as coma, vegetative state and minimally conscious state but clinical reality shows that these boundaries can often be fuzzy (fig 1). Recent clinical, electrophysiological and neuroimaging studies are shedding light on these challenging limits of consciousness encountered following severe acute brain damage. At the patient’s bedside, it is very challenging to differentiate reflex or automatic motor behaviour from movements indicating signs of consciousness, and hence some minimally conscious patients might be misdiagnosed as being vegetative. For some motor responses (eg, blinking to visual threat, brief fixation, normal flexion response to pain, etc) it remains unclear whether they truly are voluntary or willed because we lack convincing scientific evidence. We also lack consensus on how to practically assess some of these behavioural responses. For example, there is no agreement on what stimulus to employ in the assessment of visual pursuit movements— often one of the first clinical signs heralding the transition from the vegetative to the minimally conscious state. Vanhaudenhuyse and colleagues2 recently studied visual pursuit in 51 post-comatose patients comparing eye tracking of a moving object, person or mirror. It was shown that more.. (shrink)

This paper reports the key findings from two student surveys undertaken at our institution in the academic years 2020-21 and 2021-22. The research was based on the Bretag et al. (2018) student survey undertaken in various Australian universities. After discussions with both Bretag and Harper, we adapted the questions to our context – a Russell Group university in the UK – but included similar questions to enable a comparison, and to find out if there were common themes. The main aim (...) of the surveys was to understand our students’ awareness of what is meant by the term ‘academic integrity’, defined as ‘being honest in your work, acknowledging the work of others and giving credit where you have used other people’s ideas/data’ https://secretariat.leeds.ac.uk/wp-content/uploads/sites/109/2022/12/academic_integrity.pdf. The responses provided an important insight into student attitudes to academic integrity, their understanding of academic malpractice, and their awareness of the penalties if found to have plagiarised, and if found guilty of contract cheating (Medway et al., 2018; Morris, 2018; Harper et al., 2019). The surveys also identified what students would find useful in developing their understanding of academic integrity, and this underlines the importance of consulting our students. Key findings include gaps in the information provided to students, the need for regular and timely reminders of the principles of academic integrity, and the need for guidance to be written using student-friendly language. The findings informed our recommendations in terms of teaching and learning at School/Faculty level and to policy at University level, to further support student success. In the context of the key issues raised by the Quality Assurance Agency for Higher Education (QAA) Academic Integrity Charter (2020), we discuss examples of best practice currently undertaken at the University of Leeds, on-going discussions regarding developments, and our recommendations for further embedding a culture of academic integrity. We argue that all students should have the same baseline experience and therefore promoting this ethos is the responsibility of all staff who teach and support students. (shrink)

Writing and that which it entails are the subject of countless texts by Maurice Blanchot. In particular, Blanchot has focused on the notion of the work, or more precisely on a groundlessness or an absence of the work, which he has designated from different perspectives over the course of more than half a century. In various ways, Blanchot has conceived of the work as an affirmation of its undoing. The question of narration, often about a confrontation with death, is fundamentally (...) important, as is evident for example in Blanchot’s Death Sentence, The Madness of the Day or The Instant of My Death. In a sense, it is bound up with the possibility of the work. Writing about Henry James in “The Turn of the Screw” 2 in The Book to Come, Blanchot discusses narration. What is described is indeed a certain absence of the work relating to the writer’s difficult struggle to narrate everything. I will examine Blanchot’s reading of James to expose this conception of narration centred on seizing the truth. It is apparent that Blanchot approaches the question very differently in “Narrative Voice ,” in The Infinite Conversation in which there is a decentring of the work. 3 I will show that this text as well as certain writings by Derrida make it possible to arrive at a conception of narration in Henry James’s The Turn of the Screw which strongly contrasts with the one put forward by Blanchot in The Book to Come. Thus, alongside Blanchot’s reading of The Turn of the Screw which relates to the project of realising the work as a totality, Blanchot makes possible a more radical approach to the text, illustrating the non-totalization of the work whose borders are uncertain. In this way, Blanchot can be shown to step beyond an impossible conception of the absence of the work. (shrink)

Scientific modelling is a value-laden process: the decisions involved can seldom be made using 'scientific' criteria alone, but rather draw on social and ethical values. In this paper, we draw on a body of philosophical literature to analyze a COVID-19 vaccination model, presenting a case study of social and ethical value judgments in health-oriented modelling. This case study urges us to make value judgments in health-oriented models explicit and interpretable by non-experts and to invite public involvement in making them.

This paper argues that open-mindedness is a corrective virtue. It serves as a corrective to the epistemic vice of confirmation bias. Specifically, open-mindedness is the epistemically virtuous disposition to resist the negative effects of confirmation bias on our ability to reason well and to evaluate evidence and arguments. As part of the defense and presentation of our account, we explore four discussions of open-mindedness in the recent literature. All four approaches have strengths and shed light on aspects of the virtue (...) of open-mindedness. Each mentions various symptoms of confirmation bias and some explore aspects of the corrective role of open-mindedness. However, ours is the first to explicitly identify open-mindedness as a corrective virtue to the specific epistemic vice of confirmation bias. We show how the corrective account also permits a response to the concern that open-mindedness might not actually count as a virtue. (shrink)

Cet article propose une réflexion sur les activités de recherche à partir de laboratoires industriels et académiques et d’organisations « intermédiaires » (laboratoires communs ; spin offs etc.). Les observations faites ponctuellement depuis une vingtaine d’années dans des laboratoires de chimie et de biologie montrent qu’elles sont l’objet d’une compétition accrue au niveau mondial entre différentes institutions et entre individus. La première hypothèse de l’article est que cette concurrence exacerbée entre entreprises, entre laboratoires académiques, entre scientifiques conduit à des stratégies (...) ayant pour objectifs une diminution des temps réservés par les prescripteurs (« les temps officiels ») pour chaque acte de recherche et à une rationalisation du travail scientifique dans le but d’accélérer la mise sur les marchés de produits, qu’ils soient académiques ou industriels, et ainsi d’en diminuer les coûts. Pour rendre compte de cette évolution, l’organisation des temps de travail en « opérations de recherche » est comparée à celle qui semble devenir prédominante aujourd’hui, la « logique-projet ». La seconde hypothèse est que ces nouvelles normes contraignantes influencent « la disponibilité temporelle » des travailleurs de la recherche et obligent de ce fait à s’interroger sur la place des chercheurs dans le salariat. (shrink)

Background Discussions on ethical aspects of life-and-death decisions within the hospital are often made in plenary. The prehospital physician, however, may be faced with ethical dilemmas in life-and-death decisions when time-critical decisions to initiate or refrain from resuscitative efforts need to be taken without the possibility to discuss matters with colleagues. Little is known whether these considerations regarding ethical issues in crucial life-and-death decisions are documented prehospitally. This is a review of the ethical considerations documented in the prehospital medical records (...) of patients in a Danish prehospital setting for whom the decision to resuscitate or not was made at the scene. Methods The study is based on discharge summaries of all patients subjected to crucial life-and-death decisions by the Mobile Emergency Care Unit in Odense in the years 2010 to 2014. The medical records with possible documentation of ethical issues were independently reviewed by two philosophers in order to identify explicit ethical or philosophical considerations pertaining to the decision to resuscitate or not. Results In total, 1275 patients were either declared dead at the scene without exhibiting layman’s reliable signs of death or admitted to hospital following resuscitation. In a total of 62 patients, 85 specific ethical issues related to resuscitation were documented. The expressions of the ethical considerations were generally vague or unclear and almost exclusively concerned the interests of the patient and not the relatives. In the vast majority of cases where an ethical content was identified, the ethical considerations led to a decision to terminate treatment. Conclusions A strengthened practice of documenting ethical considerations in prehospital life-and-death decision-making in the patient’s medical records is required. We suggest that a template be implemented in the prehospital medical records describing the basis for any ethical decisions. This template should contain information regarding the persons involved in the deliberations and notes on ethical considerations. The documentation should include considerations concerning the patient’s end-of-life wishes, the estimations of the quality of life before and after the incident, and a summary of other ethical concerns taken into account, such as the integrity of the patient and frame of mind of relatives. (shrink)

Today’s medical ethics involve two different viewpoints based on how we understand the role of conscience in medicine and the purpose of healthcare. The first view, called the health-directed model, sees medicine as a way to improve health and promote healing, while also respecting the values of both patients and doctors. In this model, doctors need some discretionary space to decide how to achieve the best health outcomes in their practice. On the other hand, the service-provider model sees the main (...) goal of medicine as providing a service, especially healthcare, with a strong focus on protecting patient autonomy. In this view, doctors are required to provide care even when it goes against their personal beliefs. The goal of this article is to explore the foundations and arguments of these two medical models. Understanding the key ideas behind these models is important for deciding whether to support or oppose conscientious objection in medical ethics. Additionally, the article aims to figure out which model makes a stronger case and to offer advice on how to engage with the opposing view from a virtue ethics perspective. (shrink)

Skeptics argue that the acquisition of knowledge is impossible given the standing possibility of error. We present the limiting convergence strategy for responding to skepticism and discuss the relationship between conceivable error and an agent’s knowledge in the limit. We argue that the skeptic must demonstrate that agents are operating with a bad method or are in an epistemically cursed world. Such demonstration involves a significant step beyond conceivability and commits the skeptic to potentially convergent inquiry.

For paediatric medicine to advance, research must be conducted specifically with children. Concern about poor recruitment has led to debate about payments to child research participants. Although concerns about undue influence by such ‘compensation’ have been expressed, it is useful to determine whether children can relate the time and inconvenience associated with participation to the value of payment offered. This study explores children's ability to determine fair remuneration for research participation, and reviews payments to children participating in research. Forty children (...) were interviewed before outpatient visits at two London Hospitals: Great Ormond Street Children's Hospital and the Whittington Hospital District General Hospital. Children were asked to value their involvement in two hypothetical research scenarios – the first an ‘additional blood sample’, the second also involving daily oral oil capsules taken for a fortnight before further venesection. Background knowledge about familiarity with money, and experience with hospitalisation was assessed. The mean valuation of involvement in the second scenario (£13.18) was higher than in the first (£2.84) (p<0.001). This higher valuation persisted when children were categorised into groups ‘aged 12+’ and ‘below 12’. Those undergoing a blood test on the day placed a higher valuation on participation in the second scenario (£10.43, £21.67, p=0.044). These children aged 8–16 demonstrated the capacity to discern a fair valuation for participation in medical research. The monetary sums are influenced by the time and inconvenience involved in the research, and by the extent of recent experience with hospital procedures. The authors review current ethical thinking regarding payments to child research participants and suggest that a fair wage model might be an ethically acceptable way to increase participation of children in research. (shrink)

We are thankful to Gerhard Schurz for his response (Schurz 2023) to our paper (Spelda et al. 2023). Spelda et al. (2023) shows how a variant of no-regret learning called meta-induction (Schurz 2008; 2019) can be used for optimal selection from available political alternatives and, as a result, also for increasing voter competence that has come under attack from mis/disinformation. Since our paper takes a first step in applying meta-induction to long-standing issues in Democratic Theory (e.g., the usefulness of jury (...) theorems for justifying democracy), we are grateful to Gerhard Schurz for highlighting some of the conditions that need to be met for the development of practical applications. (shrink)

Dans un contexte où le recueil de données est devenu massif, l'analyse de ces dernières a pour ambition de mieux décrire et cerner l'imbrication multifactorielle de phénomènes complexes. En ce sens, l'étude des systèmes complexes est aujourd'hui omniprésente, notamment dans les sciences humaines et sociales et celles du vivant. D'ailleurs, l'établissement d'une science de la complexité, visant à regrouper les champs d'étude mobilisant des systèmes complexes, s'est développé depuis les années 1970. En rassemblant des philosophes des sciences, des historiens et (...) des écologues, l'objectif de ce livre est donc de présenter la diversité des perspectives ayant cours dans les développements les plus récents en termes de sources historiques, d'épistémologie, de méthodologie ou d'applications pratiques de la science de la complexité. En réfléchissant à la variété des manières d'aborder cette dernière, cet ouvrage vise à fournir un état des lieux de la pluralité de cette science pour contribuer à l'édification d'un cadre épistémique unifié. L'ouvrage se compose de trois parties : une mise au point épistémologique de la notion de complexité, et en particulier de la controverse autour de la notion d'émergence ("Complexité et émergence"); une analyse des applications des outils de l'approche de la complexité à une pluralité des systèmes, allant de l'écologie aux sociétés humaines ("Enjeux de la complexité"); une analyse des épisodes de l'histoire des sciences de la vie qui ont marqué le développement de l'approche des sciences de la complexité ("Parcours pluridisciplinaires d'épistémologie historique")."--Page 4 of cover. (shrink)

Recent neuroscientific research has caused a paradigm shift in our understanding of the meaning and scope of compassion. Derived from the Latin root compassiō, compassion used to be a religious emotion that implied suffering with the perceived sufferer, whereas now it is examined as a psychological, neuroscientific, neurobiological, and thus natural, phenomenon. The newly arisen research interest in compassion led to the development of secular compassion training programs that follow closely in the footsteps of the “mindfulness revolution.” Whereas the latter (...) has been criticized for its reductionist appropriation of Buddhist thought by the capitalist west, in this paper, I demonstrate that the secularization of compassion is the result of innovative activities by representatives of the Buddhist traditions. I argue that some of the causes for the recent secularization and sciencization can be traced back into the fourteenth century Tibet, namely to the innovative exegetical activities of the scholars of the Tibetan Lojong tradition. I argue that from the perspective of the tradition, the sciencization of compassion resembles a deliberate purposeful “translation” effort that fits into the “two-track approach” of Buddhist propagation. (shrink)

Respect for patient autonomy is a central principle of medical ethics. However, there are important unresolved questions about the characteristics of an autonomous decision, and whether some autonomous preferences should be subject to more scrutiny than others. In this paper, we consider whether _inappropriately adaptive preferences_—preferences that are based on and that may perpetuate social injustice—should be categorised as autonomous in a way that gives them normative authority. Some philosophers have argued that inappropriately adaptive preferences do not have normative authority, (...) because they are only a reflection of a person’s social context and not of their true self. Under this view, medical professionals who refuse to carry out actions which are based on inappropriately adaptive preferences are not in fact violating their patient’s autonomy. However, we argue that it is very difficult to articulate a systematic and principled distinction between normal autonomous preferences and inappropriately adaptive preferences, especially if this distinction needs to be useful for clinicians in real-life situations. This makes it difficult to argue that inappropriately adaptive preferences are straightforwardly non-autonomous. Given this problem, we argue that there are significant theoretical issues with contemporary understandings of autonomy in bioethics. We discuss what this might mean for the practice of medicine and for medical ethics education. (shrink)