Two theses figure centrally in work on the epistemology of disagreement: Equal Weight (‘EW’) and Uniqueness (‘U’). According to EW, you should give precisely as much weight to the attitude of a disagreeing epistemic peer as you give to your own attitude. U has it that, for any given proposition and total body of evidence, some doxastic attitude is the one the evidence makes rational (justifies) toward that proposition. Although EW has received considerable discussion, the case for U has not (...) been critically evaluated. Endorsing U, we argue, commits one to the highly controversial thesis that whatever fixes your rational attitudes can do so only by fixing what evidence you have. This commitment imposes a relatively demanding requirement on justified belief in U, one that we argue is not satisfied by what is currently the strongest available case for U, due to Roger White [2005]. Our challenge to U makes more trouble for its proponents than do the worries about U expressed by Gideon Rosen [2001] and Thomas Kelly [2010]. Moreover, if Kelly [2010] is correct in thinking that EW “carries with it a commitment to” U—a claim which we accept for reasons similar to Kelly’s but is beyond this paper’s scope (but see Ballantyne and Coffman [forthcoming])—then our challenge to U bears importantly on EW: to the extent that our challenge to U succeeds, EW also suffers. (shrink)

Three experiments investigated the hypothesis that internally generated images and thoughts were driven by meaning complexes, a construct which reflects a synthesis of semantic meaning and personal salience . Experiments 1 and 2 contrasted the mutual inhibition between encoding words and non-words on: the frequency that thoughts and images unrelated to the task were experienced and on the intensity of images generated from long-term memory and maintained under dual task conditions, which whilst familiar were not of particular personal salience . (...) Experiment 3 examined the physiological arousal associated with the experience of TUT in a semantic encoding task. Evidence suggested that, in general, internally generated images and thoughts, irrespective of the personal salience, were suppressed by the co-ordination of information in working memory. In addition, only the experience of spontaneous images and thoughts of personal salience interfered reliably with the encoding/retrieval of semantic information from memory. Finally, in Experiment 3, physiological arousal, as indexed by mean heart rate, was associated with a high frequency of TUT. The results of all three experiments support the notion that the maintenance of spontaneously occurring images and thoughts is simultaneously influenced by both the semantic content and the personal salience of the information held in working memory. (shrink)

Trust is taken to be one of the foundational values in the doctor-patient relationship, facilitating access to the benefits of health care and providing a guarantee against possible harms. Despite this foundational role, some doctors betray the trust of their patients. Trusting involves granting discretionary powers and makes the truster vulnerable to the trustee. Patients trust medical practitioners to act with goodwill and to act competently. Some patients carry pre-existing vulnerabilities, for reasons such as gender, poverty, age, ethnicity, or disability, (...) and these vulnerabilities can be exacerbated when such patients extend their trust to a doctor. Gender stereotypes reduce women's ability to challenge and thereby assess their doctor's competency. In addition, women are more likely to be distrusted by their doctors and have their experiences of medical symptoms discounted. In this paper, we analyze two extreme examples of breaches of medical trust that exploited the vulnerability of women in the health care system: the "unfortunate experiment" at the National Women's Hospital in New Zealand and the Harold Shipman murders of elderly patients in the United Kingdom, examining the potential role of gender in the outcomes with regard to trust. Major breaches of medical trust such as these typically lead to government inquiries, revisions of ethical guidelines, and substantive policy change in an effort to re-establish public and patient trust. We argue that the medical profession has an ethical obligation to put mechanisms in place to protect vulnerable patients from abuses of trust, to monitor colleagues' competence, and to be prepared to blow the whistle to protect patients who are not in a position to recognize misplaced trust. Such mechanisms will act disprosportionately to reduce harm to women as patients. (shrink)

The world is abuzz with experts who can help us in domains where we understand too little to help ourselves. But sometimes experts in one domain carry their privileged status into domains outside their specialization, where they give advice or otherwise presume to speak authoritatively. Ballantyne calls these boundary crossings “epistemic trespassing” and argues that they often violate epistemic norms. In the few cases where traveling in other domains is permissible, Ballantyne suggests there should be regulative checks for (...) the experts who are crossing domain boundaries. I argue that boundary crossing is warranted more often than Ballantyne allows. And while Ballantyne argues that boundary crossing is prima facie epistemically problematic, I contend that many cases of boundary crossing are not properly instances of “trespassing,” and, therefore, raise no prima facie epistemic concerns. I further argue that identifying cases of what I call “epistemic neighborliness” bolsters Ballantyne’s project, making it easier for novices and other experts to identify epistemic trespassing along with its epistemic problems. (shrink)

This article evaluates an emerging element in popular debate and inquiry: DYOR. (Haven’t heard of the acronym? Then Do Your Own Research.) The slogan is flexible and versatile. It is used frequently on social media platforms about topics from medical science to financial investing to conspiracy theories. Using conceptual and empirical resources drawn from philosophy and psychology, we examine key questions about the slogan’s operation in human cognition and epistemic culture.

Epistemic trespassers judge matters outside their field of expertise. Trespassing is ubiquitous in this age of interdisciplinary research and recognizing this will require us to be more intellectually modest.

Changing our minds isn't easy. Even when we recognize our views are disputed by intelligent and informed people, we rarely doubt our rightness. Why is this so? How can we become more open-minded, putting ourselves in a better position to tolerate conflict, advance collective inquiry, and learn from differing perspectives in a complex world? -/- Nathan Ballantyne defends the indispensable role of epistemology in tackling these issues. For early modern philosophers, the point of reflecting on inquiry was to understand (...) how our beliefs are often distorted by prejudice and self-interest, and to improve the foundations of human knowledge. Ballantyne seeks to recover and modernize this classical tradition by vigorously defending an interdisciplinary approach to epistemology, blending philosophical theorizing with insights from the social and cognitive sciences. -/- Many of us need tools to help us think more circumspectly about our controversial views. Ballantyne develops a method for distinguishing between our reasonable and unreasonable opinions, in light of evidence about bias, information overload, and rival experts. This method guides us to greater intellectual openness--in the spirit of skeptics from Socrates to Montaigne to Bertrand Russell--making us more inclined to admit that sometimes we don't have the right answers. With vibrant prose and fascinating examples from science and history, Ballantyne shows how epistemology can help us know our limits. (shrink)

I criticize Richard Fumerton’s fallibilist acquaintance theory of noninferential justification.

The predominant view is that a study using health data is observational research and should require individual consent unless it can be shown that gaining consent is impractical. But recent arguments have been made that citizens have an ethical obligation to share their health information for research purposes. In our view, this obligation is sufficient ground to expand the circumstances where secondary use research with identifiable health information is permitted without explicit subject consent. As such, for some studies the Institutional (...) Review Board/Research Ethics Committee review process should not assess the practicality of gaining consent for data use. Instead the review process should focus on assessing the public good of the research, public engagement and transparency. (shrink)

Two theses are central to recent work on the epistemology of disagreement: Conciliationism:?In a revealed peer disagreement over P, each thinker should give at least some weight to her peer's attitude. Uniqueness:?For any given proposition and total body of evidence, the evidence fully justifies exactly one level of confidence in the proposition. 1This paper is the product of full and equal collaboration between its authors. Does Conciliationism commit one to Uniqueness? Thomas Kelly 2010 has argued that it does. After some (...) scene-setting (?1), in ?2 we explain and criticize Kelly's argument, thereby defeating his larger argument that Conciliationism deserves no dialectical special treatment. But we argue further that Conciliationists are committed to a disjunction, one of whose disjuncts is Uniqueness, that amounts to an ?extremely strong and unobvious position? (??3?4). If we are correct, theorists should not treat Conciliationism as a default position in debates about the epistemic significance of disagreement. (shrink)

ABSTRACT: Most of what we believe comes to us from the word of others, but we do not always believe what we are told. We often reject thinkers' reports by attributing biases to them. We may call this debunking. In this essay, I consider how debunking might work and then examine whether, and how often, it can help to preserve rational belief in the face of disagreement.

In 2004 Emanuel et al. published an influential account of exploitation in international research, which has become known as the 'fair benefits account'. In this paper I argue that the thin definition of fairness presented by Emanuel et al, and subsequently endorsed by Gbadegesin and Wendler, does not provide a notion of fairness that is adequately robust to support a fair benefits account of exploitation. The authors present a procedural notion of fairness – the fair distribution of the benefits of (...) research is to be determined on a case-by-case basis by the parties involved in each study. The fairness of the distribution of benefits is not assessed against an independent normative standard. Emanuel et al.'s account of fairness provides a framework for objecting only to transactions that occur without the fully informed consent of the weaker party. As a result, a debate about exploitation collapses into a debate about consent. This is problematic because, as the proponents of the fair benefits framework acknowledge, neither the trial participants' consent nor the host community's consent preclude exploitation. Attempts to stipulate normative standards of fairness to protect research subjects in developing countries have been controversial and divisive, and it is therefore understandable that bioethicists would be tempted to develop accounts of exploitation that are independent of such prescriptive principles. I conclude, however, that the utility of the fair benefits model of exploitation as a policy tool will ultimately depend on whether a substantive principle of fairness can be developed to underpin it. (shrink)

Throughout March and April 2020, debate raged about how best to allocate limited intensive care unit (ICU) resources in the face of a growing COVID-19 pandemic. The debate was dominated by utility-based arguments for saving the most lives or life-years. These arguments were tempered by equity-based concerns that triage based solely on prognosis would exacerbate existing health inequities, leaving disadvantaged patients worse off. Central to this debate was the assumption that ICU admission is a valuable but scarce resource in the (...) pandemic context.In this paper, we argue that the concern about achieving equity in ICU triage is problematic for two reasons. First, ICU can be futile and prolong or exacerbate suffering rather than ameliorate it. This may be especially true in patients with COVID-19 with emerging data showing that most who receive access to a ventilator will still die. There is no value in admitting patients with poor prognostic indicators to ICU to meet an equity target when intensive critical care is contrary to their best interests. Second, the focus on ICU admission shifts focus away from important aspects of COVID-19 care where there is greater opportunity for mitigating suffering and enhancing equitable care.We propose that the focus on equity concerns during the pandemic should broaden to include providing all people who need it with access to the highest possible standard of end-of-life care. This requires attention to culturally safe care in the following interlinked areas: palliative care, communication and decision support and advanced care planning. (shrink)

I argue that reflection on philosophers who could have been working among us but aren’t can lead us to give up our philosophical beliefs.

Two common theses in contemporary epistemology are that ‘knowledge excludes luck’ and that knowledge depends on ‘purely epistemic’ factors. In this essay, I shall argue as follows: given some plausible assumptions, ‘anti-luck epistemology,’ which is committed to the fi rst thesis, implies the falsity of the second thesis. That is, I will argue that anti-luck epistemology leads to what has been called ‘pragmatic encroachment’ on knowledge. Anti-luck epistemologists hoping to resist encroachment must accept a controversial thesis about true belief or (...) a dubious claim about luck and value and interests. (shrink)

International research, sponsored by for-profit companies, is regularly criticised as unethical on the grounds that it exploits research subjects in developing countries. Many commentators agree that exploitation occurs when the benefits of cooperative activity are unfairly distributed between the parties. To determine whether international research is exploitative we therefore need an account of fair distribution. Procedural accounts of fair bargaining have been popular solutions to this problem, but I argue that they are insufficient to protect against exploitation. I argue instead (...) that a maximin principle of fair distribution provides a more compelling normative account of fairness in relationships characterised by extreme vulnerability and inequality of bargaining potential between the parties. A global tax on international research would provide a mechanism for implementing the maximin account of fair benefits. This model has the capacity to ensure fair benefits and thereby prevent exploitation in international research. (shrink)

This paper aims to show that to reduce the level of exploitation present in (some) international clinical trials, research sponsors must aim to provide both an ex-ante expected gain in utility and a fair ex-post distribution of benefits for research subjects. I suggest the following principles of fair risk distribution in international research as the basis of a normative definition of fairness: (a) Persons should not be forced (by circumstance) to gamble in order to achieve or protect basic goods; (b) (...) In cases where one party is gambling with basic goods and the other party is not, the distribution of benefits and burdens must be arranged so that they are of greatest benefit to the worst off; (c) In relationships where one party is gambling for basic goods and the other party is not, the party gambling for basic goods must be assured of some guaranteed benefits in addition to the chance of gaining some potential benefits.These principles are applied to the case of HIV international research. I conclude that the research (as described) is mutually advantageous but still exploitative because the distribution of surplus benefits is unfair. It is unfair because research subjects are gambling with and for basic goods but they are not assured of a fair ex-post distribution of benefits. Principles (b) and (c) are not satisfied. Research participants are not accorded enough guaranteed benefits to outweigh the risks they undertake. (shrink)

Jonathan Schaffer (2010) has summoned a new sort of demon – which he calls the debasing demon – that apparently threatens all of our purported knowledge. We show that any debasing skeptical argument must attack the justification condition and can do so only if a plausible thesis about justification is false.

This paper contends that a research ethics approach to the regulation of health data research is unhelpful in the era of population‐level research and big data because it results in a primary focus on consent (meta‐, broad, dynamic and/or specific consent). Two recent guidelines – the 2016 WMA Declaration of Taipei on ethical considerations regarding health databases and biobanks and the revised CIOMS International ethical guidelines for health‐related research involving humans – both focus on the growing reliance on health data (...) for research. But as research ethics documents, they remain (to varying degrees) focused on consent and individual control of data use. Many current and future uses of health data make individual consent impractical, if not impossible. Many of the risks of secondary data use apply to communities and stakeholders rather than individual data subjects. Shifting from a research ethics perspective to a public health lens brings a different set of issues into view: how are the benefits and burdens of data use distributed, how can data research empower communities, who has legitimate decision‐making capacity? I propose that a public health ethics framework – based on public benefit, proportionality, equity, trust and accountability – provides more appropriate tools for assessing the ethical uses of health data. The main advantage of a public health approach for data research is that it is more likely to foster debate about power, justice and equity and to highlight the complexity of deciding when data use is in the public interest. (shrink)

In their response to ‘Public interest in health data research: laying out the conceptual groundwork’, Grewal and Newson critique us for inattention to the law and putting forward an impracticably broad conceptual understanding of public interest. While we agree more work is needed to generate a workable framework for Institutional Review Boards/Research Ethics Committees, we would contend that this should be grounded on a broad conception of public interest. This broadness facilitates regulatory agility, and is already reflected by some current (...) frameworks such as that found in the guidelines approved under Australia’s Privacy Act. It remains unclear which elements of our broad account Grewal and Newson would reject, or indeed where the substantive disagreement with our position lies. (shrink)

This target article considers the ethical implications of providing prenatal diagnosis (PND) and antenatal screening services to detect fetal abnormalities in jurisdictions that prohibit abortion for these conditions. This unusual health policy context is common in the Latin American region. Congenital conditions are often untreated or under-treated in developing countries due to limited health resources, leading many women/couples to prefer termination of affected pregnancies. Three potential harms derive from the provision of PND in the absence of legal and safe abortion (...) for these conditions: psychological distress, unjust distribution of burdens between socio-economic classes, and financial burdens for families and society. We present Iran as a comparative case study where recognition of these ethical issues has led to the liberalization of abortion laws for fetuses with thalassemia. We argue that physicians, geneticists and policymakers have an ethical and professional duty of care to advocate for change in order to ameliorate these harms. (shrink)

Architecture Theory is a comprehensive and groundbreaking one volume overview of, and introduction to, contemporary critical discourse in architecture. In bringing critical theory and Continental philosophy to bear upon architecture, it provides a solid framework for a fully up-to-date theory of architecture, one that reflects the latest developments and concerns. The book is divided into four sections—groundwork; constructing the "individual"; pluralities; instrumentality—each covering a core theme in contemporary architecture theory. In each section an introductory essay by Andrew Ballantyne provides (...) valuable context, exposition, and analysis. This is followed by a selection of writings on architecture and other related cultural concerns from major contemporary thinkers, including Zvizvek, Irigaray, Lefebvre, Lyotard, Kristeva, Nancy, Virilio, Deleuze, and Negri. (shrink)

Recent work on the nature of luck widely endorses the thesis that an event is good or bad luck for an individual only if it is significant for that individual. In this paper, I explore this thesis, showing that it raises questions about interests, well-being, and the philosophical uses of luck. In Sect. 1, I examine several accounts of significance, due to Pritchard (2005), Coffman (2007), and Rescher (1995). Then in Sect. 2 I consider what some theorists want to ‘do’ (...) with luck, taking important examples from epistemology (explaining Gettier-style examples) and political philosophy (offering a rationale for the just distribution of resources in society), while suggesting implications for significance. Drawing together lessons from Sects. 1 and 2, I develop a new account of significance in Sect. 3 before concluding with reflections on the debate in Sect. 4. (shrink)

The concept of ‘ownership’ is increasingly central to debates, in the media, health policy and bioethics, about the appropriate management of clinical data. I argue that the language of ownership acts as a metaphor and reflects multiple concerns about current data use and the disenfranchisement of citizens and collectives in the existing data ecosystem. But exactly which core interests and concerns ownership claims allude to remains opaque. Too often, we jump straight from ‘ownership’ to ‘private property’ and conclude ‘the data (...) belongs to the patient’. I will argue here that private property is only one type of relevant relationship between people, communities and data. There are several reasons to doubt that conceptualising data as private property presents a compelling response to concerns about clinical data ownership. In particular I argue that clinical data are co-constructed, so a property account would fail to confer exclusive rights to the patient. A non-property account of ownership acknowledges that the data are ‘about the patient’, and therefore the patient has relevant interests, without jumping to the conclusion that the data ‘belongs to the patient’. On this broader account of ownership, the relevant harm is the severing of the connection between the patient and their data, and the solution is to re-engage and re-connect patients to the data research enterprise. (shrink)

The future of health research will be characterised by three continuing trends: rising demand for health data; increasing impracticability of obtaining specific consent for secondary research; and decreasing capacity to effectively anonymise data. In this context, governments, clinicians and the research community must demonstrate that they can be responsible stewards of health data. IRBs and RECs sit at heart of this process because in many jurisdictions they have the capacity to grant consent waivers when research is judged to be of (...) particular value. However, several different terms are used to refer to this value, indicating a lack of conceptual clarity regarding the appropriate test for access to health data for research without consent. In this paper we do three things. First we describe the current confusion and instability in terminology relating to public interest in the context of consent waivers. Second we argue for harmonisation of terminology on the grounds of clarity, transparency and consistency. Third we argue that the term ‘public interest’ best reflects the normative work required to justify consent waivers because it is the broadest of the competing terms. ‘Public interest’ contains within its scope positive and negative implications of a study, as well as welfare, justice and rights considerations. In making this argument, we explain the normative basis for consent waivers, and provide a starting place for further discussion about the precise conditions in which a given study can be said to advance the public interest. Ipsos MORI study found that: … the public would be broadly happy with administrative data linking for research projects provided Those projects have social value, broadly defined. Data are de-identified. Data are kept secure. Businesses are not able to access the data for profit. (shrink)

Public-private partnerships are established to specifically harness the potential of Big Data in healthcare and can include partners working across the data chain—producing health data, analysing data, using research results or creating value from data. This domain paper will illustrate the challenges that arise when partners from the public and private sector collaborate to share, analyse and use biomedical Big Data. We discuss three specific challenges for PPPs: working within the social licence, public antipathy to the commercialisation of public sector (...) health data, and questions of ownership, both of the data and any resulting intellectual property or products. As a specific example we consider the case of the UK National Health Service providing patient data to Google’s DeepMind AI program to develop a diagnostic app for kidney disease. This article is an application of the framework presented in this issue of ABR. Please refer to that article for more information on how this framework is to be used, including a full explanation of the key values involved and the balancing approach used in the case study at the end. We use four specific values to help analysis these issues: public benefit, stewardship, transparency and engagement. We demonstrate how the Deliberative Framework can support ethical governance of PPPs involving biomedical big data. (shrink)

ABSTRACTMany philosophers have suggested that disagreement is good grounds for scepticism. One response says that disagreement-motivated scepticism can be mitigated to some extent by the thesis that philosophical disputes are often verbal, not genuine. I consider the implications of this anti-sceptical strategy, arguing that it trades one kind of scepticism for others. I conclude with suggestions for further investigation of the epistemic significance of the nature of philosophical disagreement.

Walter Sinnott-Armstrong has developed and progressively refined an argument against moral intuitionism—the view on which some moral beliefs enjoy non-inferential justification. He has stated his argument in a few different forms, but the basic idea is straightforward. To start with, Sinnott-Armstrong highlights facts relevant to the truth of moral beliefs: such beliefs are sometimes biased, influenced by various irrelevant factors, and often subject to disagreement. Given these facts, Sinnott-Armstrong infers that many moral beliefs are false. What then shall we think (...) of our own moral beliefs? Either we have reason to think some of our moral beliefs are reliably formed or we have no such reason. If the latter, our moral beliefs are unjustified. If we have reason to think some moral beliefs are reliably formed, then those beliefs are not non-inferentially justified, because then we’ll have reason to accept something—namely, that they are reliably formed—that entails or supports those beliefs. But then, either way, our moral beliefs are not non-inferentially justified, and so moral intuitionism is false. This paper takes issue with Sinnott-Armstrong’s interesting and widely discussed argument, which we here call the Empirical Defeat Argument (EDA). According to us, the EDA does not defeat moral intuitionism. In section 1, we will set out the argument, briefly reviewing the rationale Sinnott-Armstrong offers for the premises. Then, in section 2, we identify a critical but dubious epistemological assumption concerning the nature of defeat that undergirds the argument. Finally, in section 3, we will defend our challenge to the EDA by answering two objections. (shrink)

Intellectual humility is commonly thought to be a mindset, disposition, or personality trait that guides our reactions to evidence as we seek to pursue the truth and avoid error. Over the last decade, psychologists, philosophers, and other researchers have begun to explore intellectual humility, using analytical and empirical tools to understand its nature, implications, and value. This review describes central questions explored by researchers and highlights opportunities for multidisciplinary investigation.

Volume 13, Issue 3-4, August - December 2019, Page 486-488.

There is increasing global pressure to ensure that pregnant women are responsibly and safely included in clinical research in order to improve the evidence base that underpins healthcare delivery during pregnancy. One supposed barrier to inclusion is the assumption that pregnant women will be reluctant to participate in research. There is however very little empirical research investigating the views of pregnant women. Their perspective on the benefits, burdens and risks of research is a crucial component to ensuring effective recruitment. The (...) Research In Pregnancy Ethics study set out to ascertain the views of pregnant women about research participation using an inductive thematic analysis. We conducted semi-structured interviews with 20 women who had participated in a double-blind randomised placebo controlled trial in Wellington while pregnant. Our results show that at least some pregnant women recognise the value and importance of research during pregnancy. The women we interviewed were deeply invested in the research process and outcomes. Key motivations for participating were altruism, playing a valuable civic role and the importance of research. The main perceived burdens related to inconvenience and time commitment. For some women, possible randomization to the placebo arm was regarded as a burden or disadvantage. (shrink)

In many tragic plays, the protagonist is brought down by a disaster that is a consequence of the protagonist's own error, his or her hamartia, the tragic flaw. Tragic flaws are disconcerting to the audience because they are not known or fully recognized by the protagonist—at least not until it is too late. In this essay, I take tragic flaws to be unreliable belief-forming dispositions that are unrecognized by us in some sense. I describe some different types of flaws and (...) consider what we might do about them. Then I examine three types of policies for managing our tragic flaws: doxastic, dispositional, and methodological. (shrink)

There is growing interest in contact tracing apps for pandemic management. It is crucial to consider ethical requirements before, while, and after implementing such apps. In this paper, we illustrate the complexity and multiplicity of the ethical considerations by presenting an ethical framework for a responsible design and implementation of CT apps. Using this framework as a starting point, we briefly highlight the interconnection of social and political contexts, available measures of pandemic management, and a multi-layer assessment of CT apps. (...) We will discuss some trade-offs that arise from this perspective. We then suggest that public trust is of major importance for population uptake of contact tracing apps. Hasty, ill-prepared or badly communicated implementations of CT apps will likely undermine public trust, and as such, risk impeding general effectiveness. (shrink)

Background We aimed to examine the ethical concerns Singaporeans have about sharing health-data for precision medicine and identify suggestions for governance strategies. Just as Asian genomes are under-represented in PM, the views of Asian populations about the risks and benefits of data sharing are under-represented in prior attitudinal research. Methods We conducted seven focus groups with 62 participants in Singapore from May to July 2019. They were conducted in three languages and analysed with qualitative content and thematic analysis. Results Four (...) key themes emerged: nuanced understandings of data security and data sensitivity; trade-offs between data protection and research benefits; trust in the public and private sectors; and governance and control options. Participants were aware of the inherent risks associated with data sharing for research. Participants expressed conditional support for data sharing, including genomic sequence data and information contained within electronic medical records. This support included sharing data with researchers from universities and healthcare institutions, both in Singapore and overseas. Support was conditional on the perceived social value of the research and appropriate de-identification and data security processes. Participants suggested that a data sharing oversight body would help strengthen public trust and comfort in data research for PM in Singapore. Conclusion Maintenance of public trust in data security systems and governance regimes can enhance participation in PM and data sharing for research. Contrary to themes in much prior research, participants demonstrated a sophisticated understanding of the inherent risks of data sharing, analysed trade-offs between risks and potential benefits of PM, and often adopted an international perspective. (shrink)

Blind review is ubiquitous in contemporary science, but there is no consensus among stakeholders and researchers about when or how much or why blind review should be done. In this essay, we explain why blinding enhances the impartiality and credibility of science while also defending a norm according to which blind review is a baseline presumption in scientific peer review.

David Lewis and Peter van Inwagen have claimed that there are no “knockdown” arguments in philosophy. Their claim appears to be at odds with common philosophical practice: philosophers often write as though their conclusions are established or proven and that the considerations offered for these conclusions are decisive. In this paper, I examine some questions raised by Lewis’s and van Inwagen’s contention. What are knockdown arguments? Are there any in philosophy? If not, why not? These questions concern the nature of (...) the philosophical enterprise and our answers have implications for the limits on the attitudes of informed, rational thinkers. (shrink)

Some epistemologists hold that exploration and elaboration of the nature of luck will allow us to better understand knowledge. I argue this is a mistake.

The fog of war—poor intelligence about the enemy—can frustrate even a well-prepared military force. Something similar can happen in intellectual debate. What I call the *fog of debate* is a useful metaphor for grappling with failures and dysfunctions of argumentative persuasion that stem from poor information about our opponents. It is distressingly easy to make mistakes about our opponents’ thinking, as well as to fail to comprehend their understanding of and reactions to our arguments. After describing the fog of debate (...) and outlining its sources in cognition and communication, I consider a few policies we might adopt upon learning we are in this fog. (shrink)

This chapter presents David Foster Wallace's views about three positions regarding the good life—ironism, hedonism, and narrative theories. Ironism involves distancing oneself from everything one says or does, and putting on Wallace's so-called “mask of ennui.” Wallace said that the notion appeals to ironists because it insulates them from criticism. However, he reiterated that ironists can be criticized for failing to value anything. Hedonism states that a good life consists in pleasure. Wallace rejected such a notion, doubting that pleasure could (...) play a fundamental role in the good life. Lastly, narrative theories characterize the good life by fidelity to a unified narrative -- a systematic story about one's life, composed of a set of ends or principles according to which one lives. Wallace believed that these theories turn people into spectators, rather than the participants in their own lives. (shrink)

Many clinical ethics support services do not involve patients. This is surprising because of the broad commitment to provide patient-centered healthcare. Clinical ethics support services are a component of the healthcare system and have an influence on patient care, and should therefore align with the regulatory and ethical requirements of patient-centered care, just process and cultural competence. First, in order to achieve good patient care, it is essential to involve patients in making their own healthcare decisions. Second, just ethical deliberation (...) requires that the deliberating parties have access to complete, accurate and unbiased information – this is best achieved through direct patient input. These arguments are especially compelling in the case of non-dominant cultural and ethnic groups. Here, we argue that when a clinician refers a case to a clinical ethics support services for consideration, and that case involves a conflict between the views or values of the clinician and the patient, the patient is entitled to, at a minimum: (a) be informed of the referral; (b) have the opportunity to speak directly to the clinical ethics support services prior to deliberation; (c) be provided with any opinion directly from the clinical ethics support services; and (d) have the opportunity to speak to a clinical ethics support services member after the deliberation. We use New Zealand as a case study to support and extrapolate the ethical principles and the minimum patient involvement requirements. We draw on our empirical research with senior doctors at a tertiary New Zealand hospital. Clinicians in our study indicated that they would feel bound by clinical ethics support service advice and that the clinical ethics support service has a significant impact on patient care in the case it reviews. (shrink)

This paper uses the advent of human-animal hybrids, created though somatic cell nuclear transfer experiments in America and Australia, as a tool to deconstruct and challenge the dualistic belief that humans are morally distinct and superior to animals. The view that moral value corresponds to species membership creates a scientific and cultural environment that prohibits or restricts human embryo experimentation whilst permitting the extensive use of animals for research. The dualistic premise therefore motivates the creation of human-animal hybrids for research (...) as a way for scientists to side-step restrictive legislation. Furthermore, ethical frameworks that incorporate the dualistic assumption have been incapable of objectively assessing the moral value of hybrid embryos. This failure indicates the arbitrariness of the moral dichotomy between animals and humans. Moral dualism, based on species membership, should be replaced with a liberal ethical framework based on a consistent standard such as interests. (shrink)

Precision medicine is an emerging approach to treatment and disease prevention that relies on linkages between very large datasets of health information that is shared amongst researchers and health professionals. While studies suggest broad support for sharing precision medicine data with researchers at publicly funded institutions, there is reluctance to share health information with private industry for research and development. As the private sector is likely to play an important role in generating public benefits from precision medicine initiatives, it is (...) important to understand what the concerns are and how they might be mitigated. This study reports outcomes of a deliberative method of citizen engagement in Singapore that asked whether sharing precision medicine data with private industry would be permissible, and if so, under what circumstances. Findings from this citizens’ jury suggest sharing with industry would be permissible under certain conditions that are set out in nine recommendations. Implications of the recommendations and their underlying assumptions for policy decision makers are discussed. This study aligns with prior international studies which found conditional acceptance for data sharing with private industry, a public benefit requirement, specific reluctance to share with insurance companies and an emphasis on accountability and transparency to demonstrate trustworthiness. However, our results differ from prior studies in that opt-in consent did not dominate the deliberations as jurors were able to set it aside as an assumed prerequisite for participation in a precision medicine programme. (shrink)