Often regarded simply as a nuisance in clinical drug trials in which the aim is to separate drug response from placebo response in a statistically significant manner, the placebo response has important implications. These implications relate to the nature of illness, the study of non-specific factors in the treatment setting that are related to clinical improvement, methods of enhancing these non-specific sources of benefit, and the neurobiology that is associated with the placebo response. Specific sources of clinical improvement in medical (...) and psychological treatment generally consist of drugs or clear interventions that appear to directly contribute to the desired treatment. Non-specific factors, on the other hand, include the clinician–patient relationship, installation of hope, relationship with authority, and other such factors that are more implicit to treatment and may contribute to the placebo response. Our understanding of how these non-specific aspects of treatment relate to clinical improvement and ways of enhancing these non-pharmacological elements of therapy may form important aspects of treatment. Furthermore, an important, albeit potentially overlooked element of the placebo response are clinical-trial designs and methodologies, themselves. Specific neurobiological changes also appear to be associated with the placebo response in at least some cases. Finally, it is suggested that the placebo response may in some instances represent a type of brain plasticity in which expectation and desire — agency — can result in specific changes in brain function that either may mirror or differ from the effects of certain drugs. (shrink)

A common quest among theoretical psychologists is the transformation of psychology to accommodate human agency and meaning. Several strong experimental methods are used in cognitive neuroscience but are based almost entirely upon a mechanistic ontology. A step toward rapprochement is proposed using precise and powerful experimental methods that are holistic, individualized, and compatible with an agentive ontology. Such methods must be applicable to all aspects of human experience, the subjective and agentive aspects, as well as the behavioural and the neurophysiological (...) Multivariate methods are capable of expressing and capturing the holistic isomorphism among multiple aspects of human existence and might even help provide insight into the mind-body problem. Results from a cognitive neuroscience study are used to illustrate this approach. 2012 APA, all rights reserved). (shrink)

Behavior and cognition, once conceived as psychological or interpersonal in origin, are increasingly thought to arise from biology. After investigating the validity of this trend of thinking, the article attempts to interpret what it means to the discipline of psychology. Two main categories of interpretation are discussed. First, this trend could mean that biological factors ultimately underlie traditionally psychological explanations i.e., biological factors are a sufficient condition for understanding behavior and cognition. Second, this trend could indicate that biological factors are (...) important, and perhaps even traditionally overlooked, but are not sufficient in themselves to explain human behavior and cognition i.e., biological factors are necessary conditions among other necessary conditions. The practical and methodological implications of each of these two interpretations are clarified, with a special focus on relevant research limitations. We conclude that the evidence does not bear out a sufficiency thesis and, instead, supports more convincingly a necessity understanding of these trends. (shrink)

This case is about a study of burn patients that included a request to the IRB for a waiver of consent for perianal specimen collection–a request which ultimately was not approved by a reviewing IR...

This article briefly reviews the various papers contained in this volume. They were originally presented at a research workshop held at Keele University in the UK in February 2003. It is suggested that the different papers raise a series of related legal, social and ethical issues and can be collectively seen to demonstrate the fact that policy formation in relation to reproductive matters is highly contested. It is concluded that ethical policy formation in this area needs to be based on (...) actual evidence of harm rather than assumed harm and that this therefore entails more empirical research into reproductive matters. (shrink)

Tyler Paetkau, in his paper ‘Ladders and Stairs: how the intervention ladder focuses blame on individuals and obscures systemic failings and interventions’, adds to the growing body of academic literature raising questions about the appropriateness and usefulness of the Nuffield Council on Bioethics (NCB)’s intervention ladder (2007) as a tool for policymakers.1 2 Paetkau is critical of the intervention ladder because he holds that it focuses on individual choice and personal responsibility and pays insufficient attention to ‘systemic interventions’. He suggests (...) substituting the new metaphor of an ‘intervention stairway’ for that of the intervention ladder. I argue that his diagnosis of the problems does not go far enough and that his suggested alternative metaphor is more confusing than helpful. Paetkau’s critical analysis of the intervention ladder makes some good points. It is true that this metaphor assumes a narrow range of policy options, with a focus on changing individual behaviour, and a consequent emphasis on personal responsibility. This is the flip-side of the NCB’s focus on liberty as always being a positive value and restriction seen as intrinsically wrong. Paetkau points out that this means that much routine public health action directed at changing the more structural features that impact on health is missing from the story. I set this …. (shrink)

Though regarded today as one of the most important results in logic, the compactness theorem was largely ignored until nearly two decades after its discovery. This paper describes the vicissitudes of its evolution and transformation during the period 1930-1970, with special attention to the roles of Kurt Gödel, A. I. Maltsev, Leon Henkin, Abraham Robinson, and Alfred Tarski.

ABSTRACT This essay is an attempt to examine the idea that a professional code of practice can entail ethical conduct. It is focused around two differing perspectives on ethics. It will be argued that the professions have, perhaps too hastily, adopted one theory without considering the merits, or the objections offered by the alternative account. This alternative, a ‘cognitivist’ theory, is sketched, and the possible advantages of such an approach are discussed. Such a perspective means adopting a radically different approach (...) to the nature of ethics and what it is to be a moral agent, and could have interesting consequences for professional practice. Even if a cognitivist account is ultimately unconvincing, it does provide a number of worrying arguments for those professionals who believe that ethical conduct is generated by following a code of practice, and these arguments need to be addressed. (shrink)

From ancient times to the present, the discovery and presentation of new proofs of previously established theorems has been a salient feature of mathematical practice. Why? What purposes are served by such endeavors? And how do mathematicians judge whether two proofs of the same theorem are essentially different? Consideration of such questions illuminates the roles that proofs play in the validation and communication of mathematical knowledge and raises issues that have yet to be resolved by mathematical logicians. The Appendix, in (...) which several proofs of the Fundamental Theorem of Arithmetic are compared, provides a miniature case study. (shrink)

Machine generated contents note: Preface; Introduction Angus Dawson; Part I. Concepts: 1. Resetting the parameters: public health as the foundation for public health ethics Angus Dawson; 2. Health, disease and the goal of public health Bengt Brülde; 3. Selective reproduction, eugenics and public health Stephen Wilkinson; 4. Risk and precaution Stephen John; Part II. Issues: 5. Smoking, health and ethics Richard Ashcroft; 6. Infectious disease control Marcel Verweij; 7. Population screening Ainsley Newson; 8. Vaccination ethics Angus Dawson; (...) 9. Environment, ethics and public health: the climate change dilemma Anthony Kessel and Carolyn Stephens; 10. Public health research ethics: is non-exploitation the new principle for population-based research ethics? John McMillan; 11. Equity and population health: toward a broader bioethics agenda Norman Daniels; 12. Health inequities James Wilson; Index. (shrink)

In this paper I argue that bioethics is in crisis and that it will not have a future unless it begins to embrace a more Socratic approach to its leading assumptions. The absence of a critical and sceptical spirit has resulted in little more than a dominant ideology. I focus on three key issues. First, that too often bioethics collapses into medical ethics. Second, that medical ethics itself is beset by a lack of self-reflection that I characterize here as a (...) commitment to three dogmas. Third, I offer a more positive perspective by suggesting how bioethics may benefit from looking towards public health ethics as a new source of inspiration and direction. (shrink)

This paper argues that qualitative research is both useful and necessary, as it provides an essential means of gaining a richer understanding of patients' perceptions, social processes and meanings. In their paper in this edition of Clinical Ethics, Hallowell and Lawton raise many issues relating to the way that qualitative research is treated by RECs in the UK. In this paper I discuss just three key topics stimulated by their paper: the way that methodology relates to ethics, the experience and (...) character of the researcher, and the normative/descriptive distinction. I strongly support Hallowell and Lawton's appeal for greater communication between qualitative researchers and RECs. In other respects, I would argue that they do not go far enough. The recent review of research ethics structures and the review process provides an opportunity to move away from the present 'one size fits all' approach to ethical review. I would argue that this change could only benefit qualitative research and researchers. (shrink)

The pipeline framework for identifying ethical issues in machine learning healthcare applications outlined by Char et al. is a very useful starting point for the systematic consideration...

Opens up new histories of freedom and republicanism by building on Quentin Skinner's ground-breaking Liberty before Liberalism nearly twenty five years after its initial publication. Leading historians and philosophers reveal the neo-Roman conception of liberty that Skinner unearthed as a normative and historical hermeneutic tool of enormous, ongoing power. The volume thinks with neo-Romanism to offer reinterpretations of individual thinkers, such as Montaigne, Grotius and Locke. It probes the role of neo-Roman liberty within hierarchies and structures beyond that of citizen (...) and state – namely, gender, slavery, and democracy. Finally, it reassesses the relationships between neo-Romanism and other languages in the history of political thought: liberalism, conservatism, socialism, and the human rights tradition. The volume concludes with a major reappraisal by Skinner himself. (shrink)

El artículo, tras validar la importancia de las organizaciones de derechos humanos y las de familiares de las víctimas en Chile, y del realce de este tema en los gobiernos de la Concertación, se centra en analizar el rol de las universidades frente a este tema, argumentando la necesidad de que estas desempeñen la noble tarea de formar profesionales ciudadanos, es decir personas con una formación basada en los derechos humanos. Para ello se focaliza en los objetivos y contenidos transversales (...) y postula un nuevo método pedagógico. (shrink)

Presentists believe that only present things exist. Their theories, at first glance, seem to offer many admirable features: a simple ontology, and a meaningful, objective status for key temporal phenomena, such as the present moment and the passage of time. So intuitive is this theory that, as John Bigelow puts it, presentism was “believed by everyone...until at least the nineteenth century”. Yet, in the last 200 years presentism has been beset by criticisms from both physicists and metaphysicians. One of the (...) most significant criticisms is that presentists cannot provide an acceptable system of truthmaking. If there is no past, how can there still be truths about the past? In this paper, I introduce a new theory of presentism, which addresses this problem in a novel way: by simply denying that there are any truths about the past. While prima facie an unintuitive position, I will argue that a sensible presentist philosophy of this kind can be described, so long as it is accompanied by an appropriate system of physics. I will also indicate at certain points that adopting presentism could allow us to understand fundamental physics in new, more intuitive ways. By the end of the paper, I hope to not only show that hard presentism is a defensible theory of time, but also that it could offer a number of advantages to the physicist and the philosopher alike. (shrink)

In September of 2002, without fanfare, Ivor Grattan-Guinness retired from the faculty of Middlesex University. His scholarly activity, however, has continued unabated, his time now no longer fetter...

In these twelve papers notable ethicists use the resources of ethical theory to illuminate important theoretical and practical topics, including the nature of public health, notions of community, population bioethics, the legitimate role of law, the use of cost-effectiveness as a methodology, vaccinations, and the nature of infectious disease.

In recent years, misogyny has become a central concept in philosophy as well as an established concept in public discourse and political policy. But where is misogyny’s supposed counterpart, namely, misandry? In this paper I argue for an ameliorative analysis of "misandry", arguing that it can be reformulated in an effort to reclaim it from its misogynistic weaponisation. The term "misandry" is used almost exclusively as a misogynistic rhetorical device for attributing unjust anger, hatred, or other similar emotions to a (...) speaker, thereby undermining their epistemic authority. Rather than dismissing the term as conceptually flawed and politically problematic, I argue that we ought to ameliorate misandry to instead refer to a felt anger, hostility, or fear toward the patriarchal social order and its valorisation and/or expression in misogynistic and machismo behaviour. To support these claims, I begin with a discussion of Kate Manne's analysis of misogyny before reflecting on how this can inform our understanding of misandry. I then demonstrate the various ways in which misandry is rhetorically deployed as a means of silencing speakers that express dissent against the patriarchy. Following this, I argue that we should ameliorate the term, not only to undermine these misogynistic practices, but also to articulate a legitimate affective and reactive attitude against the patriarchal imposition of a hierarchical gender binary. (shrink)

The thesis of this article is that engagement and suffering are essential aspects of responsible caregiving. The sense of medical responsibility engendered by engaged caregiving is referred to herein as clinical phronesis, i.e. practical wisdom in health care, or, simply, practical health care wisdom. The idea of clinical phronesis calls to mind a relational or communicative sense of medical responsibility which can best be understood as a kind of virtue ethics, yet one that is informed by the exigencies of moral (...) discourse and dialogue, as well as by the technical rigors of formal reasoning. The ideal of clinical phronesis is not (necessarily) contrary to the more common understandings of medical responsibility as either beneficence or patient autonomy — except, of course, when these notions are taken in their disengaged form (reflecting the malaise of modern medicine). Clinical phronesis, which gives rise to a deeper, broader, and richer, yet also to a more complex, sense than these other notions connote, holds the promise both of expanding, correcting, and perhaps completing what it currently means to be a fully responsible health care provider. In engaged caregiving, providers appropriately suffer with the patient, that is, they suffer the exigencies of the patient's affliction (though not his or her actual loss) by consenting to its inescapability. In disengaged caregiving — that ruse Katz has described as the silent world of doctor and patient — provides may deny or refuse any given connection with the patient, especially the inevitability of the patient's affliction and suffering (and, by parody of reasoning, the inevitability of their own. When, however, responsibility is construed qualitatively as an evaluative feature of medical rationality, rather than quantitatively as a form of calculative reasoning only, responsibility can be viewed more broadly as not only a matter of science and will, but of language and communication as well — in particular, as the task of responsibly narrating and interpreting the patient's story of illness. In summary, the question is not whether phronesis can save the life of medical ethics — only responsible humans can do that! Instead, the question should be whether phronesis, as an ethical requirement of health care delivery, can prevent the death of medical ethics. (shrink)

In recent years, organisational theorists have been interested in the tensions faced by healthcare organisations. In this paper, these tensions are examined using the virtue approach to ethics of Alasdair MacIntyre. It is argued that although MacIntyre's framework shares many concerns with organisational studies, it supplements the analysis with a focus on moral content and evaluation. By providing moral evaluation of the stories told in organisations, an ethical analysis compels action on a basis that organisational studies does not. Nevertheless, it (...) is the analysis of stories in organisation studies that provides the tools for taking action. The analysis presented here provides an example of how ethics and organisational studies can be brought together to provide a stronger analysis of organisational phenomena. Indeed, it provides support for Nielsen's position that organisational theory and ethics are co‐dependent and suggests that greater attention should be paid to ethical concepts in the study of organisational phenomena. (shrink)

In a powerful and original contribution to the history of ideas, Hannah Dawson explores the intense preoccupation with language in early-modern philosophy, and presents a groundbreaking analysis of John Locke's critique of words. By examining a broad sweep of pedagogical and philosophical material from antiquity to the late seventeenth century, Dr Dawson explains why language caused anxiety in writers such as Montaigne, Bacon, Descartes, Hobbes, Gassendi, Nicole, Pufendorf, Boyle, Malebranche and Locke. Locke, Language and Early-Modern Philosophy demonstrates that (...) new developments in philosophy, in conjunction with weaknesses in linguistic theory, resulted in serious concerns about the capacity of words to refer to the world, the stability of meaning, and the duplicitous power of words themselves. Dr Dawson shows that language so fixated all manner of early-modern authors because it was seen as an obstacle to both knowledge and society. She thereby uncovers a novel story about the problem of language in philosophy, and in the process reshapes our understanding of early-modern epistemology, morality and politics. (shrink)

As initially envisioned, Gödel's Collected Works were to include transcriptions of material from his mathematical workbooks. In the end that material, as well as some other manuscript items from Gödel's Nachlass, had to be left out. This note describes some of the unpublished items in the Nachlass that are likely to attract the notice of scholars and surveys the extent of shorthand transcription efforts undertaken hitherto. Some examples of sources outside Gödel's Nachlass that may be of interest to Gödel scholars (...) are also indicated. (shrink)

In this paper, my aim is to develop a phenomenological understanding of discrimination from the perspective of the discriminator. Since early existential phenomenology, the phenomenon of discrimination has received a great deal of attention. While much of this work has focused on the experience of the discriminatee, recent scholarship has begun to reflect on the intentional structures on the side of the discriminator. In a contribution to this trend, I argue that our sense of what is (ab)normal plays a constitutively (...) significant role in the reiteration and reinforcement of harmful discriminatory practices. More specifically, I argue that Husserl's distinction between two forms of normality, namely, concordance-normality [Einstimmigkeit] and optimal-normality [Optimalität], is an important tool for illuminating otherwise overlooked aspects of the discriminator's experience. I achieve this by demonstrating how these two notions of normality play distinct constitutive roles when comparing deliberate acts of discrimination committed with malintent, compared with more primordial, habitual, and prereflective expectations which are already discriminatory in nucleo. I argue that at the heart of discriminatory practices there is a naïve, normalizing attempt to stabilize concordance at the expense of critical self-reflection, normative revisions, and enriched horizons of expectation. In doing so, this paper provides a novel and important contribution to philosophical discussions surrounding discrimination. (shrink)

Raanan Gillon is a noted defender of the four principles approach to healthcare ethics. His general position has always been that these principles are to be considered to be both universal and prima facie in nature. In recent work, however, he has made two claims that seem to present difficulties for this view. His first claim is that one of these four principles, respect for autonomy, has a special position in relation to the others: he holds that it is first (...) among equals. We argue that this claim makes little sense if the principles are to retain their prima facie nature. His second claim is that cultural variation can play an independent normative role in the construction of our moral judgments. This, he argues, enables us to occupy a middle ground between what he sees as the twin pitfalls of moral relativism and moral imperialism. We argue that there is no such middle ground, and while Gillon ultimately seems committed to relativism, it is some form of moral imperialism that will provide the only satisfactory construal of the four principles as prima facie universal moral principles. (shrink)

Phenomenological discussions of sociality have long been concerned with the relations between the I, the You, and the We. Recently, dialogue between phenomenology and analytic philosophical work on collective intentionality has given rise to a corpus of literature oriented around the first-person plural 'we'. In this paper, I demonstrate how these dominant accounts of the 'we' are not exhaustive of first-person plural experiences as such. I achieve these aims by arguing for a phenomenological distinction between an experience of being part (...) of a 'we' compared to an experience of being part of an 'us'. To have a 'we-experience' there must be a plurality of (unified) subjects sharing in an experience together such that the experience has the phenomenal character of being ours. An 'us-experience', on the other hand, requires the experiential salience of an external 'Third' in a way which is constitutively significant. Drawing on Sartrean social ontology, I argue that the 'us' is distinct from the 'we' on three levels, all of which pertain to the constitutive and unifying role of the Third. I then outline two forms of us-experiences: (1) the experience of being grouped and (2) the experience of apprehending one's seriality. (shrink)

The papers of Kurt Gödel were donated to the Institute for Advanced Study by his widow Adele shortly after his death in 1978. They were catalogued by the review.

Research ethics is an integral part of research, especially that involving human subjects. However, concerns have been expressed that research ethics has come to be seen as a procedural concern focused on a few well-established ethical issues that researchers need to address to obtain ethical approval to begin their research. While such prospective review of research is important, we argue that it is not sufficient to address all aspects of research ethics. We propose retrospective review as an important complement to (...) prospective review. We offer two arguments to support our claim that prospective review is insufficient. First, as currently practiced, research ethics has become for some a ‘tick box’ exercise to get over the ‘hurdle’ of ethics approval. This fails to capture much of what is important in ethics and does not promote careful reflection on the ethical issues involved. Second, the current approach tends to be rules-based and we argue that research ethics should go beyond this to develop people’s capacity to be sensitive to the relevant moral features of their research, their ethical decision-making skills and their integrity. Retrospective review of a project’s ethical issues, and how they were addressed, could help to achieve those aims better. We believe that a broad range of stakeholders should be involved in such retrospective review, including representatives of ethics committees, participating communities and those involved in the research. All stakeholders could then learn from others’ perspectives and experiences. An open and transparent assessment of research could help to promote trust and understanding between stakeholders, as well as identifying areas of agreement and disagreement and how these can be built upon or addressed. Retrospective review also has the potential to promote critical reflection on ethics and help to develop ethical sensitivity and integrity within the research team. Demonstrating this would take empirical evidence and we suggest that any such initiatives should be accompanied by research into their effectiveness. Our article concludes with a discussion of some possible objections to our proposal, and an invitation to further debate and discussion. (shrink)

Eyal et al have recently argued that researchers should consider conducting severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) human challenge studies to hasten vaccine development. We have conducted (J. L.) and overseen (L. D.) human challenge studies and agree that they can be useful in developing anti-infective agents. We also agree that adults can autonomously choose to undergo risks with no prospect of direct benefit to themselves. However, we disagree that SARS-CoV-2 challenge studies are ethically appropriate at this time, for (...) 3 reasons: (1) current scientific knowledge of SARS-CoV-2 infection is insufficient to manage risks; (2) autonomous decision making, while necessary, does not override concerns about risk; and (3) undertaking challenge studies now would imperil confidence in the research enterprise, potentially undermining the global response to the coronavirus disease 2019 (COVID-19) pandemic. (shrink)

Volume 20, Issue 10, October 2020, Page 39-41.

The general question to which this paper is addressed is whether knowledge and rationality carry within themselves the seeds of their own destruction. Some of those who set out in search of knowledge come to believe as a result of their inquiries that the object of their quest is not what they had taken it to be; seeking to discover the way the world actually is, they are led to conclude that all they can hope to find is a reflection (...) of their own needs and interests; the grail is but a beaker. Similarly, some of those whose aim is to formulate the principles of rational thought are led by reason to deny that any beliefs can be rationally justified; reasons are never reasons for believing but mere epiphenomena, produced by but not producing events whose only begetter is the passions; the quest is just another power struggle. The particular question I wish to ask is whether this picture is an accurate representation of social inquiry. (shrink)