Background: Due to the important role of depression in major illnesses, screening measures for depression are commonly used in medical research. The protocol for managing participants with positive screens is unclear and raises ethical concerns. The aim of this article is to identify and critically discuss the ethical issues that arise when a positive screen for depression is detected, and offer some guidance on managing these issues.DiscussionDeciding on whether to report positive screens to healthcare practitioners is both an ethical and (...) a pragmatic dilemma. Evidence suggests that reporting positive depression screens should only be considered in the context of collaborative care. Possible adverse effects, such as the impact of false-positive results, potentially inappropriate labelling, and potentially inappropriate treatment also need to be considered. If possible, the psychometric properties of the selected screening measure should be determined in the target population, and a threshold for depression that minimises the rate of false-positive results should be chosen. It should be clearly communicated to practitioners that screening scores are not diagnostic for depression, and they should be informed about the diagnostic accuracy of the measure. Research participants need to be made aware of the consequences of the detection of high scores on screening measures, and to be fully informed about the implications of the research protocol.SummaryFurther research is needed and the experiences of researchers, participants, and practitioners need to be collated before the value of reporting positive screens for depression can be ascertained. In developing research protocols, the ethical challenges highlighted should be considered. Participants must be agreeable to the agreed protocol and efforts should be made to minimise potentially adverse effects. (shrink)

Deep brain stimulation has been of considerable interest to bioethicists, in large part because of the effects that the intervention can occasionally have on central features of the recipient’s personality. These effects raise questions regarding the philosophical concept of authenticity. In this article, we expand on our earlier work on the concept of authenticity in the context of deep brain stimulation by developing a diachronic, value-based account of authenticity. Our account draws on both existentialist and essentialist approaches to authenticity, and (...) Laura Waddell Ekstrom’s coherentist approach to personal autonomy. In developing our account, we respond to Sven Nyholm and Elizabeth O’Neill’s synchronic approach to authenticity, and explain how the diachronic approach we defend can have practical utility, contrary to Alexandre Erler and Tony Hope’s criticism of autonomy-based approaches to authenticity. Having drawn a distinction between the authenticity of an individual’s traits and the authenticity of that person’s values, we consider how our conception of authenticity applies to the context of anorexia nervosa in comparison to other prominent accounts of authenticity. We conclude with some reflections on the prudential value of authenticity, and by highlighting how the language of authenticity can be invoked to justify covert forms of paternalism that run contrary to the value of individuality that seems to be at the heart of authenticity. (shrink)

In the United Kingdom, a number of National Health Service Clinical Commissioning Groups have proposed controversial measures to restrict elective surgery for patients who either smoke or are obese. Whilst the nature of these measures varies between NHS authorities, typically, patients above a certain Body Mass Index and smokers are required to lose weight and quit smoking prior to being considered eligible for elective surgery. Patients will be supported and monitored throughout this mandatory period to ensure their clinical needs are (...) appropriately met. Controversy regarding such measures has primarily centred on the perceived unfairness of targeting certain health states and lifestyle choices to save public money. Concerns have also been raised in response to rhetoric from certain NHS authorities, which may be taken to imply that such measures punitively hold people responsible for behaviours affecting their health states, or simply for being in a particular health state. In this paper, we examine the various elective surgery rationing measures presented by NHS authorities. We argue that, where obesity and smoking have significant implications for elective surgical outcomes, bearing on effectiveness, the rationing of this surgery can be justified on prognostic grounds. It is permissible to aim to maximise the benefit provided by limited resources, especially for interventions that are not urgently required. However, we identify gaps in the empirical evidence needed to conclusively demonstrate these prognostic grounds, particularly for obese patients. Furthermore, we argue that appeals to personal responsibility, both in the prospective and retrospective sense, are insufficient in justifying this particular policy. Given the strength of an alternative justification grounded in clinical effectiveness, rhetoric from NHS authorities should avoid explicit statements, which suggest that personal responsibility is the key justificatory basis of proposed rationing measures. (shrink)

When evidence-based policymaking is so often mired in disagreement and controversy, how can we know if the process is meeting its stated goals? We develop a novel mathematical model to study disagreements about adequate knowledge utilization, like those regarding wild horse culling, shark drumlines and facemask policies during pandemics. We find that, when stakeholders disagree, it is frequently impossible to tell whether any party is at fault. We demonstrate the need for a distinctive kind of transparency in evidence-based policymaking, which (...) we call transparency of reasoning. Such transparency is critical to the success of the evidence-based policy movement, as without it, we will be unable to tell whether in any instance a policy was in fact based on evidence. (shrink)

Do physicists believe that general relativity is true, and that electrons and phonons exist, and if so, in what sense? To what extent does the spectrum of positions among physicists correspond to philosophical positions like scientific realism, instrumentalism, or perspectivism? Does agreement with these positions correlate with demographic factors, and are realist physicists more likely to support research projects purely aimed at increasing knowledge? We conducted a questionnaire study to scrutinize the philosophical stances of physicists. We received responses from 384 (...) physicists and 151 philosophers. Our main findings are (1) On average, physicists tend toward scientific realism, and slightly more so than philosophers of science. (2) Physicists can be clustered into five groups. Three show variants of scientific realism, one is instrumentalist, and one seems undecided or incoherent. (3) Agreement with realism weakly correlates with approval of building a bigger particle collider. (4) Agreement with realism weakly correlates with the seniority of physicists. (5) We did not find correlations with other factors, such as whether physicists focus on theoretical or experimental research and whether they engage with applied or basic research. (shrink)

Dynamic Syntax (DS: Kempson et al. 2001; Cann et al. 2005) is an action-based grammar formalism which models the process of natural language understanding as monotonic tree growth. This paper presents an introduction to the notions of incrementality and underspecification and update, drawing on the assumptions made by DS. It lays out the tools of the theoretical framework that are necessary to understand the accounts developed in the other contributions to the Special Issue. It also represents an up-to-date account of (...) the framework, combining the developments that have previously remained distributed in a diverse body of literature. (shrink)

ExcerptCarl Schmitt (1888–1985) is known as the most consequential German legal and political mind of the twentieth century.1 Many crimes of the Nazi regime found support in his conceptual justifications, and Schmitt is called the “Crown Jurist” of the Third Reich with good reason. Historians, political scientists, and sociologists must grapple with the author in order to understand the course of totalitarianism in modernity. Whether literary historians should do so is far less settled, though he was fascinated by their object (...) of study. His writings on literary topics are said to reveal much about Schmitt’s person, politics, and period, but little about literature itself.2 This explains why his “Don Quijote und das Publikum” (“Don Quixote and the Public”), published in the arts and cultural journal Die Rheinlande in 1912, was almost unknown in literary studies for a century.3 Schmitt’s text on the novel by Miguel de Cervantes has not been reprinted, and until recently it had not been translated from the original German. Size has a role too. At under two thousand words, the text has probably escaped notice due to its small scale.4 Recent English and Italian translations in major humanistic journals may signal the end of its obscurity though.5 “Don Quixote and the Public” is at the door of literary studies. The question now is not whether to respond, but how. (shrink)

In this paper, Caitlin Murphy Brust and Hannah Widmaier begin with the assumption that highly selective institutions of higher education in the United States have a duty to promote civic equality. They employ Wendy Salkin's theory of informal political representation to examine how highly selective institutions should go about promoting civic equality. According to Salkin's theory, someone serves as an informal political representative (IPR) when they speak or act on behalf of others, without having been selected to do so (...) via a systematized selection procedure. Brust and Widmaier argue that as part of their civic educational missions, highly selective institutions should educate their students for informal political representation, and this includes equipping students to (1) serve as effective IPRs, (2) be responsible audience members to others' informal political representation, and (3) deliberate carefully and with open-mindedness about when they should or should not take on the role of IPR. Brust and Widmaier examine two types of injustice that students from marginalized communities face at highly selective institutions, and they explore how education for informal political representation might ameliorate those injustices. The authors conclude by offering some practical suggestions to institutional policymakers and educators. (shrink)

In the wake of the COVID-19 pandemic, many have become increasingly dissatisfied with how science funding is distributed. Traditional grant funding processes are seen as stifling the creativity of researchers, in addition to being bureaucratic, slow, and inefficient. Consequently, there have been increasing popular calls to make “fast funding” – fast, unbureaucratic grant applications – a new standard for scientific funding. Though this approach to funding, implemented by Fast Grants, has been successful as a pandemic response strategy, we believe there (...) are serious costs to its wide-scale adoption, particularly for transparency and equity, and that the purported benefits – increased creativity and efficiency – are unlikely to materialize. While traditional funding mechanisms are certainly not perfect, scientific communities should think twice before adopting fast funding as a new standard for funding. (shrink)

Although Hannah Arendt is considered one of the major contributors to social and political thought in the twentieth century, this is the first general anthology ...

Awarded the 1988 Johnsonian Prize in Philosophy. Published with the aid of a grant from the National Endowment for the Humanities.

I defend the normativity of meaning against recent objections by arguing for a new interpretation of the ‘ought’ relevant to meaning. Both critics and defenders of the normativity thesis have understood statements about how an expression ought to be used as either prescriptive or semantic. I propose an alternative view of the ‘ought’ as conveying the primitively normative attitudes speakers must adopt towards their uses if they are to use the expression with understanding.

In 1992, the Joint Commission on the Accreditation of Healthcare Organizations (JCAHO) passed a mandate that all its approved hospitals put in place a means for addressing ethical concerns.Although the particular process the hospital uses to address such concernsmay vary, the hospital or healthcare ethics committee (HEC) is used most often. In a companion study to that reported here, we found that in 1998 over 90% of U.S. hospitals had ethics committees, compared to just 1% in 1983, and that many (...) have some and a few have sweeping clinical powers in hospitals. (shrink)

Revolutions in semiconductor device miniaturization, bioelectronics, and applied neural control technologies are enabling scientists to create machine-assisted minds, science fiction's “cyborgs.” In a paper published in 1999, we sought to draw attention to the advances in prosthetic devices, to the myriad of artificial implants, and to the early developments of this technology in cochlear and retinal implants. Our concern, then and now, was to draw attention to the ethical issues arising from these innovations. Since that time, breakthroughs have occurred at (...) a breathtaking pace. Scientists, researchers, and engineers using differing methodologies are pursuing the possibilities of direct interfaces between brains and machines. Technological innovations as such are neither good nor evil; it is the uses devised for them that create moral implications. As there can be ethical problems inherent in the proper human uses of technologies and because brain chips are a very likely future technology, it is prudent to formulate policies and regulations that will mitigate their ill effects before the technologies are widespread. Unlike genetic technologies, which have received widespread scrutiny within the scientific community, national governments, and international forums, brain–machine interfaces have received little social or ethical scrutiny. However, the potential of this technology to change and significantly affect humans is potentially far greater than that of genetic enhancements, because genetic enhancements are inherently limited by biology and the single location of an individual, whereas hybrids of human and machine are not so restricted. Today, intense interest is focused on the development of drugs to enhance memory; yet, these drugs merely promise an improvement of normal memory, not the encyclopedic recall of a computer-enhanced mind combined with the ability to share information at a distance. The potential of brain chips for transforming humanity are astounding. This paper describes advances in hybrid brain–machine interfaces, offers some likely hypotheses concerning future developments, reflects on the implications of combining cloning and transplanted brain chips, and suggests some potential methods of regulating these technologies. (shrink)

Vann McGee; XIII*—Two Problems with Tarski's Theory of Consequence, Proceedings of the Aristotelian Society, Volume 92, Issue 1, 1 June 1992, Pages 273–292, htt.

A unique selection of the most significant interviews given by Hannah Arendt, including the last she gave before her death in 1975. Some are published here in English for the first time. Arendt was one of the most important thinkers of her time, famous for her idea of "the banality of evil" which continues to provoke debate. This collection provides new and startling insight into Arendt's thoughts about Watergate and the nature of American politics, about totalitarianism and history, and (...) her own experiences as an emigre. Hannah Arendt: The Last Interview and Other Conversations is an extraordinary portrait of one of the twentieth century's boldest and most original thinkers. As well as Arendt's last interview with French journalist Roger Errera, the volume features an important interview from the early 60s with German journalist Gunter Gaus, in which the two discuss Arendt's childhood and her escape from Europe, and a conversation with acclaimed historian of the Nazi period, Joachim Fest, as well as other exchanges. These interviews show Arendt in vigorous intellectual form, taking up the issues of her day with energy and wit. She offers comments on the nature of American politics, on Watergate and the Pentagon Papers, on Israel; remembers her youth and her early experience of anti-Semitism, and then the swift rise of the Hitler; debates questions of state power and discusses her own processes of thinking and writing. Hers is an intelligence that never rests, that demands always of her interlocutors, and her readers, that they think critically. As she puts it in her last interview, just six months before her death at the age of 69, "there are no dangerous thoughts, for the simple reason that thinking itself is such a dangerous enterprise.". (shrink)

Genetic counselors are on the front lines of the genetic revolution, presented with tests of varying predictive values and reliability, unfair testing distribution mechanisms, tests for conditions where no treatment exists, and companies that oversell the usefulness of their tests to physicians and nurses. Many scholars, both genetic testing task forces as well as the newly formed National Bioethics Advisory Commission, have all noted that genetic counseling programs and services are critical for adequate genetic testing. At the same time, in (...) our own work at the University of Pennsylvania we have encountered many requests for new materials for training genetic counselors in ethics and providing ethics resources for genetic counseling. One of us has noted elsewhere that it is crucial that resources from the Human Genome Project, the Centers for Disease Control, and other public agencies be devoted to providing better resources for genetic counselors facing difficult ethical issues. Although the American Board of Genetic Counseling requires that training programs include some formal coursework in ethics, many wonder whether enough is being done to prepare genetic counselors for an ever-tougher job, and in particular there has been much concern expressed about whether is an outmoded ideal that hampers this profession as it attempts to grow and identify the value of its practice. On the basis of many comments to us by genetic counselors and on the basis of our review of the current literature, we hypothesized that accredited genetic counseling training programs are poised at the turn of the century to begin planning a new approach toteaching the philosophy of genetic counseling, one that integrates philosophical, theoretical, and ethical training throughout thecurriculum in genetic counseling. (shrink)

Journal of Applied Philosophy, EarlyView.

Auf den ersten Blick haben Hannah Arendt und Michel Foucault kaum etwas gemein. Tatsächlich beziehen sie sich jedoch auf die identischen Topoi der Philosophiegeschichte - wenn ihre Auslegungen der Quellen auch denkbar verschieden sind. Als Grund hierfür bestimmt Hannah Holme die komplementären Perspektiven der beiden, die sie als Aneignungen des heideggerschen Sorgebegriffs deutet: die ethische Sorge um sich Foucaults und die politische Sorge um die Welt Arendts. Am Ende steht ein Plädoyer für eine Verbindung des machtkritischen Ethos der (...) Sorge um sich mit der Macht des politischen Handelns, das der Sorge um die Welt unterstellt ist. (shrink)

is the newest section of CambridgeQuarterly. Twice each year these pages will feature a colloquium on a breaking issue in bioethics.

The Perfect Baby is the most popular introduction to ethical issues in genetics. This new edition has been updated to discuss and debate advances in high tech reproduction, genetic testing, gene therapy, human cloning, and stem cell research. It includes a new epilogue by cloning pioneer Ian Wilmut and Glenn McGee.

Conceived as a solution to clinical dilemmas, and now required by organizations for hospital accreditation, ethics committees have been subject only to small-scale studies. The wide use of ethics committees and the diverse roles they play compel study. In 1999 the University of Pennsylvania Ethics Committee Research Group (ECRG) completed the first national survey of the presence, composition, and activities of U.S. healthcare ethics committees (HECs). Ethics committees are relatively young, on average seven years in operation. Eighty-six percent of ethics (...) committees report that they play a role in ongoing clinical decision making through clinical ethics consultation. All are engaged in developing institutional clinical policy. Although 4.5% of HECs write policy on managed care, 50% of HEC chairs feel inadequately prepared to address managed care. The power and activity of ethics committees parallels the composition of those committees and the relationship of members to their institutions. The role of ethics committees across the nation in making policies about clinical care is greater than was known, and ethics committees will likely continue to play an important role in the debate and resolution of clinical cases and clinical policies. (shrink)

Mathematical realism is the doctrine that mathematical objects really exist, that mathematical statements are either determinately true or determinately false, and that the accepted mathematical axioms are predominantly true. A realist understanding of set theory has it that when the sentences of the language of set theory are understood in their standard meaning, each sentence has a determinate truth value, so that there is a fact of the matter whether the cardinality of the continuum is א2 or whether there are (...) measurable cardinals, whether or not those facts are knowable by us. (shrink)

This is not an overly ambitious paper. What I would like to do is to take a thesis that most people would regard as wildly implausible, and convince you that it is, in fact, false. What's worse, the argument I shall give is by no means airtight, though I hope it's reasonably convincing. The thesis has to do with the fuzzy boundaries of terms that refer to familiar middle-sized objects, terms like ‘Kilimanjaro’ and ‘the tallest mountain in Africa.’ It is (...) intuitively clear that Kilimanjaro has a fuzzy boundary, so that there are some clods of earth at the base of the mountain for which there isn't anything, either in our practices in using the word ‘Kilimanjaro’ or in the facts of geography, that determines an answer to the question whether the clod is a part of Kilimanjaro. (shrink)

Tarski and Mautner proposed to characterize the "logical" operations on a given domain as those invariant under arbitrary permutations. These operations are the ones that can be obtained as combinations of the operations on the following list: identity; substitution of variables; negation; finite or infinite disjunction; and existential quantification with respect to a finite or infinite block of variables. Inasmuch as every operation on this list is intuitively "logical", this lends support to the Tarski-Mautner proposal.

In this comment I respond to the criticisms put forth by Muller et al. It is my assessment that the authors’ make useful suggestions for future analyses. However, their conclusion regarding the invalidity of my results are based on a misconception of the goals and data used in my article.

Sheryl Swoopes is an African American woman and a celebrity in the US Women’s National Basketball Association. In 2005, she announced she was in a seven-year relationship with a woman and received a six figure endorsement deal with a lesbian cruise line. Swoopes was also branded as a mother and married to a man — inferring heterosexuality. The article uses the ‘coming out’ to look at the interconnections of race, gender, class, sexual orientation, and celebrity identities. Using discourse analysis the (...) article examines both academic and popular discourse to raise the question: ‘Is Sheryl Swoopes a lesbian?’ When can she self-identify as a lesbian and become an insider in the queer community? The article argues for feminists to see oppressions as multiplicative, rather than using the adding-on approach. Identifying celebrity as a capitalist identity, the article shows the challenges of identity and discourse and how they continue to frame our theological method. (shrink)

Political Monsters and Democratic Imagination explores the democratic thought of Spinoza and its relation to the thought of William Blake, Victor Hugo, and James Joyce. As a group, these visionaries articulate: a concept of power founded not on strength or might but on social cooperation; a principle of equality based not on the identity of individuals with one another but on the difference between any individual and the intellectual power of society as a whole; an understanding of thought as a (...) process that operates between rather than within individuals; and a theory of infinite truth, something individuals only partially glimpse from their particular cultural situations. For Blake, God is the constellation of individual human beings, whose collective imagination produces revolutionary change. In Hugo's novel, Jean Valjean learns that the greatest truth about humanity lies in the sewer or among the lowest forms of social existence. For Joyce, Leopold and Molly Bloom are everybody and nobody, singular beings whose creative power and truth is beyond categories and social hierarchies. (shrink)

The increasing prevalence of ecologically sustainable products in consumer markets, such as organic produce, are generally assumed to curtail anthropogenic impacts on the environment. Here I intend to present an alternative perspective on sustainable production by interpreting the relationship between recent rises in organic agriculture and greenhouse gas emissions from agricultural production. I construct two time series fixed-effects panel regressions to estimate how increases in organic farmland impact greenhouse gas emissions derived from agricultural production. My analysis finds that the rise (...) of certified organic production in the United States is not correlated with declines in greenhouse gas emissions derived specifically from agricultural production, and on the contrary is associated positively overall agricultural greenhouse gas emissions. To make sense of this finding, I embed my research within the conventionalization thesis. As a result I argue that the recent USDA certification of organic farming has generated a bifurcated organic market, where one form of organic farming works as a sustainable counterforce to conventional agriculture and the other works to increase the economic accessibility of organic farming through weakening practice standards most conducive to reducing agricultural greenhouse gas output. Additionally, I construct my own theoretical framework known as the displacement paradox to further interpret my findings. (shrink)

This chapter presents a response to Chapter 1. The arguments put forward in that chapter attempted to drive us from the paradise created by Cantor’s theory of infinite number. The principal complaint is that Cantor’s proof that the subsets of a set are more numerous than its elements fails to yield an adequate diagnosis of Russell’s paradox. This chapter argues that Cantor’s proof was never meant to be a diagnosis of Russell’s paradox. Further, it argues that Cantor’s theory is fine (...) as it is. (shrink)

The essence of the correspondence between Arendt and Scholem can be said to lie in three things. Above all it provides an intimate account of how two great intellectuals try to come to terms with being both German and Jewish, and how to think about Germany before, during, and after the Holocaust. They also debate the issue of what it means to be Jewish in the post-Holocaust world whether in New York or in Jerusalem. Finally, the specter of Benjamin haunts (...) the work and in a sense the letters are as much about Benjamin as the other two questions since his life and tragic death epitomize them both. Arendt and Scholem's letters on these weighty questions are lightened by more routine exchanges: on travel itineraries, lunch or dinner parties where important people were present, and so forth. These daily details are woven throughout the correspondence and provide vivid biographical information about Arendt and Scholem that is unavailable in any other source. (shrink)

Hannah Ginsborg presents fourteen essays which establish Kant's Critique of Judgment as a central contribution to the understanding of human cognition. The papers bring out the significance of Kant's philosophical notion of judgment, and use it to address interpretive issues in Kant's aesthetics, theory of knowledge, and philosophy of biology.