Increasing ethical attention and debate is focusing on whether individuals who take part in clinical trials should be given access to post-trial care. However, the main focus of this debate has been upon drug trials undertaken in low-income settings. To broaden this debate, we report findings from interviews with individuals (n = 24) who participated in a clinical trial of a closed-loop system, which is a medical device under development for people with type 1 diabetes that automatically adjusts blood glucose (...) to help keep it within clinically recommended ranges. Individuals were recruited from UK sites and interviewed following trial close-out, at which point the closed-loop had been withdrawn. While individuals were stoical and accepting of the requirement to return the closed-loop, they also conveyed varying degrees of distress. Many described having relaxed diabetes management practices while using the closed-loop and having become deskilled as a consequence, which made reverting back to pre-trial regimens challenging. Participants also described unanticipated consequences arising from using a closed-loop. As well as deskilling, these included experiencing psychological and emotional benefits that could not be sustained after the closed-loop had been withdrawn and participants reevaluating their pre- and post-trial life in light of having used a closed-loop and now perceiving this life much more negatively. Participants also voiced frustrations about experiencing better blood glucose control using a closed-loop and then having to revert to using what they now saw as antiquated and imprecise self-management tools. We use these findings to argue that ethical debates about post-trial provisioning need to be broadened to consider potential psychological and emotional harms, and not just clinical harms, that may result from withdrawal of investigated treatments. We also suggest that individuals may benefit from information about potential nonclinical harms to help make informed decisions about trial participation. (shrink)

Hilary Kornblith presents a new account of mental reflection, and its importance for knowledge, reasoning, freedom, and normativity. He argues that reflection cannot solve the philosophical problems it has traditionally been thought to, and offers a more realistic, demystified view of its nature which draws on dual process approaches to cognition.

In 1922 Skolem delivered an address before the Fifth Congress of Scandinavian Mathematicians in which he pointed out what he called a "relativity of set-theoretic notions". This "relativity" has frequently been regarded as paradoxical; but today, although one hears the expression "the Lowenheim-Skolem Paradox", it seems to be thought of as only an apparent paradox, something the cognoscenti enjoy but are not seriously troubled by. Thus van Heijenoort writes, "The existence of such a 'relativity' is sometimes referred to as the (...) Lowenheim-Skolem Paradox. (shrink)

We report on the deliberations of an interdisciplinary group of experts in science, law, and philosophy who convened to discuss novel ethical and policy challenges in stem cell research. In this report we discuss the ethical and policy implications of safety concerns in the transition from basic laboratory research to clinical applications of cell-based therapies derived from stem cells. Although many features of this transition from lab to clinic are common to other therapies, three aspects of stem cell biology pose (...) unique challenges. First, tension regarding the use of human embryos may complicate the scientific development of safe and effective cell lines. Second, because human stem cells were not developed in the laboratory until 1998, few safety questions relating to human applications have been addressed in animal research. Third, preclinical and clinical testing of biologic agents, particularly those as inherently complex as mammalian cells, present formidable challenges, such as the need to develop suitable standardized assays and the difficulty of selecting appropriate patient populations for early phase trials. We recommend that scientists, policy makers, and the public discuss these issues responsibly, and further, that a national advisory committee to oversee human trials of cell therapies be established. **NB we did not reccommend a NAC, we think it might be appropriate**. (shrink)

The Dobbs v. Jackson Women’s Health Organization Supreme Court decision not only upended constitutional protections for abortion in the United States but also bolstered legislative and cultural int...

Government have in the past embarked on many infrastructural programmes such as building of roads, hospitals, health centers in the rural areas, schools, etc for its citizens. A lot of projects have been carried out in the past years, there are institutions formed to carter for the implementation of such programmes, institutions like NEMA to check disasters, repair of roads, collapse buildings etc. NDDC was formed to take care of roads in the South East but many of these programmes and (...) institutions have not fared well in recent years because of corruption. Take for instance in the channels news of Tuesdays 16/6/2020 the new NDDC Director revealed how projects awarded to contractors in the past were all not carried out, funds meant for those purposes were all embezzled into private pockets. With the coming of Covid 19, governments have now found cover to say Covid 19 has attacked all revenue sources and so cannot carry out projects in the country. This is the burden of this work. Is it true that it is Covid 19 that halted the success of programme implementation in Nigeria? This is what this paper is out to ascertain. (shrink)

Hilary Kornblith argues for a naturalistic approach to investigating knowledge. Knowledge, he explains, is a feature of the natural world, and so should be investigated using scientific methods. He offers an account of knowledge derived from the science of animal behavior, and defends this against its philosophical rivals. This controversial and refreshingly original book offers philosophers a new way to do epistemology.

Ethics in Public Policy and Management: A global research companion showcases the latest research from established and newly emerging scholars in the fields of public management and ethics. This collection examines the profound changes of the last 25 years, including the rise of New Public Management, New Public Governance and Public Value; how these have altered practitioners' delivery of public services; and how academics think about those services. Drawing on research from a broad range of disciplines, Ethics in Public Policy (...) and Management looks to reflect on this changing landscape. With contributions from Asia, Australasia, Europe and the USA, the collection is grouped into five main themes: theorising the practice of ethics; understanding and combating corruption; managing integrity; ethics across boundaries; expanding ethical policy domains. This volume will prove thought-provoking for educators, administrators, policy makers and researchers across the fields of public management, public administration and ethics. (shrink)

If you thought you knew who you were, THINK AGAIN. Did you know that half your DNA isn't human? That somebody, somewhere has exactly the same face? Or that most of your memories are fiction? What about the fact that you are as hairy as a chimpanzee, various parts of your body don't belong to you, or that you can read other people's minds? Do you really know why you blush, yawn and cry? Why 90 per cent of laughter has (...) nothing to do with humour? Or what will happen to your mind after you die? You belong to a unique, fascinating and often misunderstood species. How to be Human is your guide to making the most of it. (shrink)

Integral Science's most distinctive effect is to shift the context of human interactions from competition against one another to seeking what is good for both one's self and the larger whole. The partnership environment it suggests creates a foundation of relationship that powerfully increases organizational intelligence. This simple switch creates the potential for both more humanistic and more effective organizations that are better able to meet the needs of the populations they serve.

General practitioners (GPs) have to negotiate a range of challenges when they suspect child abuse or neglect. This article details findings from a Delphi exercise that was part of a larger study exploring the conflicts of interest that arise for UK GPs in safeguarding children. The specific objectives of the Delphi exercise were to understand how these conflicts of interest are seen from the perspectives of an expert panel, and to identify best practice for GPs. The Delphi exercise involved four (...) iterative rounds with questionnaires completed by an expert panel. Results from each round were distilled and findings sent to panel members until consensus was reached. Panel members shared insights regarding their understanding of conflicts of interest in relation to GPs and safeguarding children and responses when conflicts of interests arise. Findings suggested a broader understanding of conflicts of interest (intrapersonal, interpersonal, interprofessional and interagency), the importance of professional judgement in uncertain situations when both action and inaction have potentially negative consequences and the importance of trust. The Delphi exercise was an effective means to bring together a wide range of professional and disciplinary perspectives on a complex topic. Findings caution against the oversimplification of the conceptual and practical issues, emphasise the importance of professional judgement, and support the development of open and trusting relationships with families and among professionals in health and social care agencies. (shrink)

Can we reconcile the idea that we are free and responsible agents with the idea that what we do is determined according to natural laws? For centuries, philosophers have tried in different ways to show that we can. Hilary Bok takes a fresh approach here, as she seeks to show that the two ideas are compatible by drawing on the distinction between practical and theoretical reasoning.Bok argues that when we engage in practical reasoning--the kind that involves asking "what should (...) I do?" and sifting through alternatives to find the most justifiable course of action--we have reason to hold ourselves responsible for what we do. But when we engage in theoretical reasoning--searching for causal explanations of events--we have no reason to apply concepts like freedom and responsibility. Bok contends that libertarians' arguments against "compatibilist" justifications of moral responsibility fail because they describe human actions only from the standpoint of theoretical reasoning. To establish this claim, she examines which conceptions of freedom of the will and moral responsibility are relevant to practical reasoning and shows that these conceptions are not vulnerable to many objections that libertarians have directed against compatibilists. Bok concludes that the truth or falsity of the claim that we are free and responsible agents in the sense those conceptions spell out is ultimately independent of deterministic accounts of the causes of human actions.Clearly written and powerfully argued, Freedom and Responsibility is a major addition to current debate about some of philosophy's oldest and deepest questions. (shrink)

Interest in ethical leadership from academics and practitioners has grown enormously in recent years. This article addresses this literature through a framework that identifies three interlocking questions. First, who are ethical leaders and what are their characteristics? Second, how do ethical leaders do what they do? Third, why do leaders do as they do and what are the outcomes of ethical leadership? Different dimensions to ethical leadership are examined and presented as three interlocking circles; Virtues, Purposes and Practices. This framework (...) presents an integrated approach to ethical leadership and argues that future research take this holistic framework and apply it to different sectors or contexts. (shrink)

Hilary Kornblith presents an account of inductive inference that addresses both its metaphysical and epistemological aspects. He argues that inductive knowledge is possible by virtue of the fit between our innate psychological capacities and the causal structure of the world. Kornblith begins by developing an account of natural kinds that has its origins in John Locke's work on real and nominal essences. In Kornblith's view, a natural kind is a stable cluster of properties that are bound together in nature. (...) The existence of such kinds serves as a natural ground of inductive inference. Kornblith then examines two features of human psychology that explain how knowledge of natural kinds is attained. First, our concepts are structured innately in a way that presupposes the existence of natural kinds. Second, our native inferential tendencies tend to provide us with accurate beliefs about the world when applied to environments that are populated by natural kinds. (shrink)

This work traces the development of Western educational ideas from the Greek society of Socrates, Plato and Aristotle, to the ideas and ideologies behind some of the controversial issues in education today. The authors avoid the traditional "great thinkers" approach, and instead try to relate educational ideas to the political, social and economic development of the times, covering Greece and Rome, early Christianity, the Renaissance, the religious conflicts of the 15th and 16th centuries, the Enlightenment in the 18th century, and (...) Romanticism, as well as more familiar political issues in the 19th and 20th centuries. The book concludes with a brief discussion of the problem of values and education in the 21st century. The authors reject extreme versions of postmodernist thinking, and reassert the view that values and an expression of priorities within value systems are an essential aspect of educational planning at any time. (shrink)

This paper is not a study in the history of ideas; rather, it is an interpretation of the Phenomenology of Spirit, guided largely by the commentaries of Alexandre Kojeve and Jean Hyppolite, and written from the standpoint of an existential phenomenology. It opens with an exposition of Hegel’s concepts of consciousness and experience and a statement of his conception of the phenomenological method. Then, arguing that the Phenomenology of Spirit is a concrete idealism which offers a cogent philosophy of human (...) existence, the paper examines the closely related themes of death, freedom, intersubjectivity, action, and speech in Hegel’s phenomenology. Finally, it closes with remarks, suggested by Hegel’s analysis of action in the intersubjective world, on the interpretation of philosophical works. (shrink)

Hilary Putnam; X*—What Is “Realism”?, Proceedings of the Aristotelian Society, Volume 76, Issue 1, 1 June 1976, Pages 177–194, https://doi.org/10.1093/aristotel.

Obtaining prospective written consent from women to participate in trials when they are experiencing an obstetric emergency is challenging. Alternative consent pathways, such as gaining verbal consent at enrolment followed, later, by obtaining written consent, have been advocated by some clinicians and bioethicists but have received little empirical attention. We explored women’s and staff views about the consent procedures used during the internal pilot of a trial, where the protocol permitted staff to gain verbal consent at recruitment. Interviews with staff (...) and participating women. Data were analysed thematically and interviews were cross-compared to identify differences and similarities in participants’ views about the consent procedures used. Women and some staff highlighted benefits to obtaining verbal consent at trial enrolment, including expediting recruitment and reducing the burden on those left exhausted by their births. However, most staff with direct responsibility for taking consent expressed extreme reluctance to proceed with enrolment until they had obtained written consent, despite being comfortable using verbal procedures in their clinical practice. To account for this resistance, staff drew a strong distinction between research and clinical care and suggested that a higher level of consent was needed when recruiting into trials. In doing so, staff emphasised the need to engage women in reflexive decision-making and highlighted the role that completing the consent form could play in enabling and evidencing this process. While most staff cited their ethical responsibilities to women, they also voiced concerns that the absence of a signed consent form at recruitment could expose them to greater risk of litigation were an individual to experience a complication during the trial. Inexperience of recruiting into peripartum trials and limited availability of staff trained to take consent also reinforced preferences for obtaining written consent at recruitment. While alternative consent pathways have an important role to play in advancing emergency medicine research, and may be appreciated by potential recruits, they may give rise to unintended ethical and logistical challenges for staff. Staff would benefit from training and support to increase their confidence and willingness to recruit into trials using alternative consent pathways. This qualitative research was undertaken as part of the GOT-IT Trial. Date of registration 26/03/2014. (shrink)

This is the third volume of Hilary Putnam's philosophical papers, published in paperback for the first time. The volume contains his major essays from 1975 to 1982, which reveal a large shift in emphasis in the 'realist'_position developed in his earlier work. While not renouncing those views, Professor Putnam has continued to explore their epistemological consequences and conceptual history. He now, crucially, sees theories of truth and of meaning that derive from a firm notion of reference as inadequate.

This anthology edited by Mario De Caro and David Macarthur offers an insightful presentation of Hilary Putnam's philosophical method by collecting his reflections on many other philosophers, including such major figures as Richard Rorty, Jürgen Habermas, Bernard Williams, Ned Block, Michael Dummett, W.V. Quine, Hans Reichenbach, Tyler Burge, John McDowell, Charles Parsons, and Ian Hacking.

This is the first collective study of the thinking behind the effective altruism movement. This movement comprises a growing global community of people who organise significant parts of their lives around the two key concepts represented in its name. Altruism is the idea that if we use a significant portion of the resources in our possession—whether money, time, or talents—with a view to helping others then we can improve the world considerably. When we do put such resources to altruistic use, (...) it is crucial to focus on how much good this or that intervention is reasonably expected to do per unit of resource expended (as a gauge of effectiveness). We can try to rank various possible actions against each other to establish which will do the most good with the resources expended. Thus we could aim to rank various possible kinds of action to alleviate poverty against one another, or against actions aimed at very different types of outcome, focused perhaps on animal welfare or future generations. The scale and organisation of the effective altruism movement encourage careful dialogue on questions that have perhaps long been there, throwing them into new and sharper relief, and giving rise to previously unnoticed questions. In this volume a team of internationally recognised philosophers, economists, and political theorists present refined and in-depth explorations of issues that arise once one takes seriously the twin ideas of altruistic commitment and effectiveness. (shrink)

Firms located in communities in which people are, on average, more trusting enjoy some benefits in terms of the power of CEO contracts. We present two pieces of empirical evidence to support this claim: (1) higher average trust in a county is associated with “flatter” executive contracts and (2) when an exogenous shock occurs (such as a scandal involving an important social institution), both trust and contracting move in similar directions. We obtain the first result in a panel specification and (...) the second in a “difference-in-difference” specification that uses the revelation of sex scandals involving the Catholic Church across different U.S. localities. (shrink)