For evidence-based practice and policy, randomised controlled trials (RCTs) are the current gold standard. But exactly why? We know that RCTs do not, without a series of strong assumptions, warrant predictions about what happens in practice. But just what are these assumptions? I maintain that, from a philosophical stance, answers to both questions are obscured because we don't attend to what causal claims say. Causal claims entering evidence-based medicine at different points say different things and, I would suggest, failure to (...) attend to these differences makes much current guidance about evidence for medical and social policy misleading. (shrink)

Approximately 20% of adult cancer patients are eligible to participate in a clinical trial, but only 2.5-9% do so. Accrual is even less for minority and medically underserved populations. As a result, critical life-saving treatments and quality of life services developed from research studies may not address their needs. This study questions the utility of the bioethical concern with therapeutic misconception (TM), a misconception that occurs when research subjects fail to distinguish between clinical research and ordinary treatment, and therefore attribute (...) therapeutic intent to research procedures in the safety net setting. This paper provides ethnographic insight into the ways in which research is discussed and related to standard treatment. (shrink)

This paper argues that we can see our lives as a snapshot happening now or as a moving picture extending across time. These dual ways of seeing our lives inform how we conceive of the problem of age group justice. A snapshot view sees age group justice as an interpersonal problem between distinct age groups. A moving picture view sees age group justice as a first-person problem of prudential choice. This paper explores these different ways of thinking about age group (...) justice and illustrates them using a principle of respect for human dignity, understood in terms of reasonable support for floor level central human capabilities at each stage of life. I argue that different frames are suitable for different kinds of decisions, and each provides a true, but partial, picture of aging and age group justice. (shrink)

Written in a direct and accessible, almost manifesto-like style, The Truth of Democracy presents a forceful plea that we rethink democracy not as one political regime or form among others but as that which opens up the very experience of ...

Philosophers of science have had little to say about ‘middle-range theory’ although much of what is done in science and of what drives its successes falls under that label. These lectures aim to spark an interest in the topic and to lay groundwork for further research on it. ‘Middle’ in ‘middle range’ is with respect to the level both of abstraction and generality. Much middle-range theory is about things that come under the label ‘mechanism’. The lectures explore three different kinds (...) of mechanism: struc tural mechanisms or underlying systems that afford causal pathways; causal-chain mechanisms that are represented in what in policy contexts are called ‘theories of change’ and for which I give an extended account following the causal process theory of Wesley Salmon; and middle-range-law mechanisms like those discussed by Jon Elster, which I claim are —and rightly are— rampant throughout the social sciences. The theory of the democratic peace, that democracies do not go to war with democracies, serves as a running example. The discussions build up to the start of, first, an argument that reliability in social (and natural) science depends not so much on evidence as it does on the support of a virtuous tangle of practices (without which there couldn’t even be evidence), and second, a defence of a community-practice centred instrumentalist understanding of many of the central basic principles that we use (often successfully) in social (and in natural) science for explanation, prediction and evaluation. (shrink)

A good many models used in physics and economics offer descriptions of imaginary situations, using a combination of mathematics and natural language. The descriptions are both thin - not much about the situation is filled in - and unrealistic - what is filled in is not true of many real situations. Yet we want to use the results of these models to inform our conclusions about a range of actually occurring situations. I propose we interpret many of these models as (...) fables. The actual happenings in the model are only one concrete instantiation of a lesson that is more widely applicable ‘when expressed in more abstract language.' A fable generally comes with the abstract lesson attached; parables, by contrast, usually require an interpretation from outside. Models, then, tend to be more like parables than fables. The right abstract interpretation is not supplied by the model itself. The central problem, then, is where shall it come from? (shrink)

It is widely appreciated today that injustices can arise on different scales — some are national, some regional, some global. Thus, the notion of a plurality of scales of justice is intuitively plausible. What may be less evident is the idea that some important injustices are best located not on any one single scale but rather at the intersection of several scales. This article argues that this is the case for one of the core characteristic injustices of the present era: (...) namely, ‘the social exclusion of the global poor’. (shrink)

This article examines the cross-generational continuity of community work performed by women living and working in low-income communities and demonstrates the complex ways in which gender, race-ethnicity, and class contribute to the social construction of mothering. The analysis of low-income women's community work challenges definitions of mothering that are limited to biological and legal expressions, thus neglecting the significance of community-based nurturing work for geographic communities and racial-ethnic and class-based groups. The analysis utilizes a broadened understanding of labor and contests (...) the divisions between paid and unpaid work traditionally used to discuss women's work. The article compares and contrasts the experiences of African-American and Latina community workers from low-income communities in New York City and Philadelphia. The findings of the research further demonstrate the ways that knowledge generated from the standpoint of women from different classes and racial-ethnic backgrounds transforms our understanding of politics, labor, and mothering. (shrink)

The paper frames interdisciplinary research as creating complex, distributed cognitive-cultural systems. It introduces and elaborates on the method of cognitive ethnography as a primary means for investigating interdisciplinary cognitive and learning practices in situ. The analysis draws from findings of nearly 20 years of investigating such practices in research laboratories in pioneering bioengineering sciences. It examines goals and challenges of two quite different kinds of integrative problem-solving practices: biomedical engineering (hybridization) and integrative systems biology (collaborative interdependence). Practical lessons for facilitating (...) research and learning in these specific fields are discussed and a preliminary set of interdisciplinary epistemic virtues are proposed as candidates for cultivation in interdisciplinary practices of these kinds more widely. (shrink)

Scientific data supporting rational arguments for human-made causes of climate and environmental changes might be persuasive in some contexts. Law, policy, activism and The Earth Charter similarly appear insufficient to change attitudes and behaviours. Even biblical and theological arguments fail to move some Christians beyond apathy and climate denial. Decades of ecological theology and calls for ecological conversion suggest that appeals to reason and facts are limited without an affective epistemology that join knowledge and experience to produce worldview transformation through (...) emotions, such as awe.Contribution: Departing from appeal to scientific data and arguments alone, the primary claim is that ecological conversion is not singularly a rational act. For broader engagement and action to mitigate climate and environmental degradation, experiential and affective encounter with nature promise wider participation and transformation. (shrink)

Is there any other activity as problematic as judgment? How is it possible that those who judge are at the same time judged by their own judgement, measured by the need to judge? This question splits into two subordinate problems that interact with each other. On the one side, the absence of law. This apparently negative condition translates into a positive requirement, the advantage of an obligation: we still need to find the law. On the other side, law does not (...) coincide with natural law: it concerns instead regulations that the faculty of judgement reflectively provides for itself. Juridical norms refer to a code, and the rules of games institute procedures: the first ones make reference to a preestablished system, while the others structure processes. The first ones, in order to be legitimated, should have a reason from which they depend; the others exist just for the sake of the game based on them. There is no need to establish a general, “first”, rule. But rules are necessary and have to be defined. This is the general “law of the laws”, a law that judges reason and refers to a more inclusive idea of judgement. (shrink)

This article offers a reconceptualization of “the political” from the standpoint of women working in and for low-income neighborhoods, with special emphasis on the contradictions between their actions as community workers and their understandings of the political aspects of their work. The author also examines how their gender and race identity influenced their political consciousness and practice. The date are drawn from in-depth interviews with forty-two perdominantly African American and Puerto Rican women from New York City and Philadelphia who were (...) hired in community action programs established by the Economic Opportunity Act of 1964. (shrink)

This paper defends the need for evidential diversity and the mix of methods that that can in train require. The focus is on causal claims, especially ‘singular’ claims about the effects of causes in a specific setting—either what will happen or what has happened. I do so by offering a template that categorises kinds of evidence that can support these claims. The catalogue is generated by considering what needs to happen for a causal process to carry through from putative cause (...) at the start to the targeted effect at the end. The usual call for mixed methods focusses on a single overall claim and argues that we increase certainty by the use of different methods with compensating strengths and weaknesses. My proposals instead focus on the evidence that supports the great many subsidiary claims that must hold if the overall one is to be true. As is typical for singular causal claims, the mix of methods that will generally be required to collect the kinds of evidence I urge will usually have little claim to the kind of rigour that is now widely demanded in evidencing causal claims, especially those for policy/treatment effectiveness. So I begin with an exploration of what seems to be intended by ‘rigour’ in such discussions, since it is seldom made clear just what makes the favoured methods especially rigorous. I then argue that the emphasis on rigour can be counterproductive. Rigour is often the enemy of evidential diversity, and evidential diversity—lots of it—can make for big improvements in the reliability of singular causal predictions and post hoc evaluations. I illustrate with the paragon of rigour for causal claims, randomised controlled trials (RCTs), rehearsing at some length what they can and cannot do to make it easier to assess the importance of rigour in warranting singular causal claims. (shrink)

Philosophers have largely ignored sleep, treating it as a useless negativity, mere repose for the body or at best a source for the production of unconscious signs out of the night of the soul.In an extraordinary theoretical investigation written with lyric intensity, The Fall of Sleep puts an end to this neglect by providing a deft yet rigorous philosophy of sleep. What does it mean to fallasleep? Might there exist something like a reasonof sleep, a reason at work in its (...) own form or modality, a modality of being in oneself, of return to oneself, without the waking selfthat distinguishes Ifrom youand from the world? What reason might exist in that absence of ego, appearance, and intention, in an abandon thanks to which one is emptied out into a non-place shared by everyone?Sleep attests to something like an equality of all that exists in the rhythm of the world. With sleep, victory is constantly renewed over the fear of night, an a confidence that we will wake with the return of day, in a return to self, to us--though to a self, an us, that is each day different, unforeseen, without any warning given in advance.To seek anew the meaning stirring in the supposed loss of meaning, of consciousness, and of control that occurs in sleep is not to reclaim some meaning already familiar in philosophy, religion, progressivism, or any other -ism. It is instead to open anew a source that is not the source of a meaning but that makes up the nature proper to meaning, its truth: opening, gushing forth, infinity.This beautiful, profound meditation on sleep is a unique work in the history of phenomenology--a lyrical phenomenology of what can have no phenomenology, since sleep shows itself to the waking observer, the subject of phenomenology, only as disappearance and concealment. (shrink)

In this paper we examine the pattern of conceptual change during scientific revolutions by using methods from cognitive psychology. We show that the changes characteristic of scientific revolutions, especially taxonomic changes, can occur in a continuous manner. Using the frame model of concept representation to capture structural relations within concepts and the direct links between concept and taxonomy, we develop an account of conceptual change in science that more adequately reflects the current understanding that episodes like the Copernican revolution are (...) not always abrupt. When concepts are represented by frames, the transformation from one taxonomy to another can be achieved in a piecemeal fashion not preconditioned by a crisis stage, and a new taxonomy can arise naturally out of the old frame instead of emerging separately from the existing conceptual system. This cognitive mechanism of continuous change demonstrates the constructive roles of anomaly and incommensurability in promoting the progress of science. (shrink)

This volume features new findings by nine interdisciplinary teams of researchers on the topics of self, motivation, and virtue. Nine chapters bringing together scholars from the fields of philosophy, psychology, neuroscience, and sociology advance our substantive understanding of these important topics, and showcase a variety of research methods of interdisciplinary interest. Essays on Buddhism and the self in the context of romantic relationships, the development of personal projects and virtue, the notion of self-distancing and its moral impact, virtues as self-integrated (...) traits, humility and the self in loving encounter, the importance of nation and faith in motivating virtue in western and non-western countries, roles for the self and virtue in eudaimonic growth, overcoming spiritual violence and sacramental shame in Christian communities, and an investigation into the moral self highlight the range and diversity of topics explored in this volume. The concept of deep integration also characterizes this work: each member of the interdisciplinary teams was fully and equally invested in their project from inception to completion. This approach invites teams to examine their disciplinary assumptions, rethink familiar concepts, and adjust methodologies in order to view their topics with fresh eyes. The result is not only new findings of substantive and methodological interest, but also an interesting glimpse into the thinking of the researchers as they sought interdisciplinary common ground in their research. Self, Motivation, and Virtue will be of interest to scholars in philosophy, moral psychology, neuroscience, and sociology who are working on these topics. (shrink)

This collection of original essays examines innovations in both the theory and practice of classical philology. The chapters address interdisciplinary methods in a variety of ways. Some apply theoretical insights derived from other disciplines, such as folklore studies, performance theory, feminist criticism, and the like, to classical texts. Others examine the relationships between classics and cultural studies, popular literature, film, art history, and other related disciplines. Others, again, look to the evolution of theoretical methods within the discipline of classics. Taken (...) together, the essays offer a spectrum of new approaches in the classics and their place within the profession. (shrink)

While friend/enemy are commonly perceived to be mutually constitutive opposites, it is not so evident that hatred is the opposite of love. Hatred is oriented by two ideologies specific to European thought—‘nature’ as an illusory universal, and the ‘ego’, distinct from the ‘I’, as an irreducible expression of identity. The origins of racial hatred in naturalised hierarchical classification at the time of European colonial expansion demonstrates how naturalism and egoism combined to produce an over-valuation of one’s own self or group (...) as authentic or pure. Drawing on Pascal, Fanon and Derrida, this essay challenges the autonomous, self-loving and naturalised sense of self. It calls for education as a form of action against racial hatred, including hate-speech. It suggests that the dignity or absoluteness of each individual or group should be thought as a ‘sense’ which cannot be reduced to a meaning. This is in contrast to hatred which presupposes closed or solidified meanings. (shrink)

The precautionary principle is an emerging principle of international law but has only recently been proposed in North America as a new basis for environmental policy. On the surface it is a simple, common-sense proposition: in the face of possible harm, exercise precaution. But the enthusiasm the principle has stirred among public advocates suggests it has a deeper appeal. It is, in fact, based on values related to “forecaring for life” and the natural world. The principle cannot effectively be invoked (...) without stating these values up front. The principle makes it clear that decisions and developments in science and technology are based first of all on values and only secondarily on scientific and technological fact and process. Moreover, a precautionary approach is best carried out in the context of goals that embody the values of communities and societies. (shrink)

This article addresses the gap between what works in research and what works in practice. Currently, research in evidence-based education policy and practice focuses on randomized controlled trials. These can support causal ascriptions (“It worked”) but provide little basis for local effectiveness predictions (“It will work here”), which are what matter for practice. We argue that moving from ascription to prediction by way of causal generalization (“It works”) is unrealistic and urge focusing research efforts directly on how to build local (...) effectiveness predictions. We outline various kinds of information that can improve predictions and encourage using methods better equipped for acquiring that information. We compare our proposal with others advocating a better mix of methods, like implementation science, improvement science, and practice-based evidence. (shrink)

This article describes political discourse on domestic violence that obscures men's violence while placing the burden of responsibility on women. This perspective, which the author calls patriarchal resistance, challenges a feminist construction of the problem. Using a qualitative analysis of men's and political magazines, the author describes two main discursive strategies used in the resistance discourse: degendering the problem and gendering the blame. These strategies play a central role in resisting any attempts to situate social problems within a partiarchal framework. (...) It is argued that this is a political countermovement to the feminist constructions of domestic violence as opposed to a serious concern about women's violence and male victims. Three major implications this resistance discourse has are the normalization of intimate violence, the diversion of attention from men's responsibility and cultural and structural factors that foster violence, and the distortion of women's violence. (shrink)

Growing demand for direct care workers to assist care-dependent elderly people has created an opening for migrant workers from low- income nations to sell their services to middle and high-income nations. Using Singapore as a case example, we draw on capability theory to make the case that receiving nations that import direct care workers should be held to global justice standards that protect workers’ floor level human capabilities. Specifically, we (1) show that Singapore and other receiving nations fail to protect (...) human capabilities at a threshold level required by dignity; (2) identify specific human capabilities placed at risk; and (3) recommend standards for receiving nations that support central capabilities. As populations in both developed and developing nations are rapidly aging, these concerns could not be timelier. (shrink)

In “How the Neuroscience of Decision Making Informs Our Conception of Autonomy,” Gidon Felsen and Peter Reiner (2011) argue that decisions typically regarded as rational and autonomous are in fact...

As a population, people who self‐identify as lesbian, gay, bisexual, or transgender face significant risks to health and difficulty in obtaining medical and behavioral health care, relative to the general public. These issues are especially challenging in safety‐net health care institutions, which serve a range of vulnerable populations with limited access, limited options, and significant health disparities. Safety‐net hospitals, particularly public hospitals with fewer resources than academic medical centers and other nonprofit hospitals that also serve as safety nets, are under (...) immense financial pressures. However, with the introduction in 2011 of standards for LGBT inclusion by The Joint Commission, showing progress on LGBT health care has become a compliance issue for hospitals. And because the health care community itself has contributed to LGBT health disparities through prejudice, disrespect, or inadequate knowledge that have made it difficult for LGB and especially T people to seek care or to obtain the care they need, there is a moral case for allocating scarce resources to this population: we owe them some investment in righting wrongs that the health care system itself has produced.So, where to begin in the typical safety‐net hospital or clinic? Beyond staff training, which is essential and for which good models now exist, what does justice demand from a service‐utilization perspective? Given the range of health care services that an LGBT person in the safety net may need or want, how should we set priorities? And what can't we promise to do for this member of our community? (shrink)