The claims of randomized controlled trials to be the gold standard rest on the fact that the ideal RCT is a deductive method: if the assumptions of the test are met, a positive result implies the appropriate causal conclusion. This is a feature that RCTs share with a variety of other methods, which thus have equal claim to being a gold standard. This article describes some of these other deductive methods and also some useful non-deductive methods, including the hypothetico-deductive method. (...) It argues that with all deductive methods, the benefit that the conclusions follow deductively in the ideal case comes with a great cost: narrowness of scope. This is an instance of the familiar trade-off between internal and external validity. RCTs have high internal validity but the formal methodology puts severe constraints on the assumptions a target population must meet to justify exporting a conclusion from the test population to the target. The article reviews one such set of assumptions to show the kind of knowledge required. The overall conclusion is that to draw causal inferences about a target population, which method is best depends case-by-case on what background knowledge we have or can come to obtain. There is no gold standard. (shrink)

The facticity view of fundamental laws of physics takes them to state facts about reality. To preserve the facticity of laws in the face of complex phenomena with multiple intervening factors, composition of causes, often by vector addition, is invoked. However, this addition should be read only as a metaphor, for only the resultant force is real. The truth and the explanatory power of laws can both be preserved by viewing laws as describing causal powers that objects possess, but this (...) view would require a new account of explanation. (shrink)

What kinds of evidence reliably support predictions of effectiveness for health and social care interventions? There is increasing reliance, not only for health care policy and practice but also for more general social and economic policy deliberation, on evidence that comes from studies whose basic logic is that of JS Mill's method of difference. These include randomized controlled trials, case–control studies, cohort studies, and some uses of causal Bayes nets and counterfactual-licensing models like ones commonly developed in econometrics. The topic (...) of this paper is the 'external validity' of causal conclusions from these kinds of studies. We shall argue two claims. Claim, negative: external validity is the wrong idea; claim, positive: 'capacities' are almost always the right idea, if there is a right idea to be had. If we are right about these claims, it makes big problems for policy decisions. Many advice guides for grading policy predictions give top grades to a proposed policy if it has two good Mill's-method-of difference studies that support it. But if capacities are to serve as the conduit for support from a method-of-difference study to an effectiveness prediction, much more evidence, and much different in kind, is required. We will illustrate the complexities involved with the case of multisystemic therapy, an internationally adopted intervention to try to diminish antisocial behaviour in young people. (shrink)

This paper addresses the just distribution of vaccines against the SARS-CoV-2 virus and sets forth an ethical framework that prioritises frontline and essential workers, people at high risk of severe disease or death, and people at high risk of infection. Section I makes the case that vaccine distribution should occur at a global level in order to accelerate development and fair, efficient vaccine allocation. Section II puts forth ethical values to guide vaccine distribution including helping people with the greatest need, (...) reducing health disparity, saving the most lives and promoting narrow social utility. It also responds to objections which claim that earlier years have more value than later years. Section III puts forth a practical ethical framework to aid decision-makers and compares it with alternatives. (shrink)

With the development of increasingly sophisticated sociable robots, robot-human relationships are being transformed. Not only can sociable robots furnish emotional support and companionship for humans, humans can also form relationships with robots that they value highly. It is natural to ask, do robots that stand in close relationships with us have any moral standing over and above their purely instrumental value as means to human ends. We might ask our question this way, ‘Are there ways we can act towards robots (...) that would be wrong to the robot?’ To address this, Part I lays out standard approaches to moral standing: appealing to intrinsic properties, human responses, and values inhering in relationships. Part II explores the third, relational strategy in detail. Looking beyond Western analyses, it considers Eastern philosophy and the environmental philosophy of 'deep ecology' and extends these approaches to sociable robots. Part III examines practical implications for the case of Samantha, a sex robot that was allegedly raped. Part IV identifies and replies to objections. (shrink)

Should you wash your hands? -- Are workarounds ethical? -- Turfing, bending, and gaming -- Dirty hands and the semiclear conscience -- Problems of humanity -- Ethics without heroics : foreseeing moral problems in complex systems.

This article agrees with Philip Kitcher that we should aim for a well-ordered science, one that answers the right questions in the right ways. Crucial to this is to address questions of use: Which scientific account is right for which system in which circumstances? This is a difficult question: evidence that may support a scientific claim in one context may not support it in another. Drawing on examples in physics and other sciences, this article argues that work on the warrant (...) of theories in philosophy of science needs to change. Emphasis should move from the warrant of theories in the abstract to questions of evidence for use. (shrink)

Significantly, Berkeley, in his Essay Towards a New Theory of Vision, leveled a sustained attack on just this geometrical theory of distance perception. At first glance it may seem, as it did to Berkeley, that Descartes’ geometrical theory is produced by a simple error: namely, by the idea that a physiological optics provides an adequate description of the psychological processes of judging distances. In truth, this is the weakest of Berkeley’s objections to Descartes’ theory. Obviously we do not see the (...) angles and lines of convergence when we focus on a distant object, nor are we aware of having used any geometrical rules in judging distance. And Descartes never claimed this. (shrink)

In 2022, the International Association of Bioethics (IAB) announced that the 17th World Congress of Bioethics would be held in Doha, Qatar. In response to ethical concerns expressed about the Qatar selection, the IAB Board of Directors developed and posted to the IAB website a response using a Q&A format. In this Letter, we (the IAB President and Vice President) address concerns about the ethics of bioethics conferencing raised in a 2023 Letter to the Editor of Bioethics by Van der (...) Graaf et al. We do not represent the Board of Directors, and this Letter expresses solely our own views. (shrink)

This paper gives an ethical argument for temporarily waiving intellectual property protections for COVID-19 vaccines. It examines two proposals under discussion at the World Trade Organization : the India/South Africa proposal and the WTO Director General proposal. Section I explains the background leading up to the WTO debate. Section II rebuts ethical arguments for retaining current IP protections, which appeal to benefiting society by spurring innovation and protecting rightful ownership. It sets forth positive ethical arguments for a temporary waiver that (...) appeal to standing in solidarity and holding companies accountable. After examining built-in exceptions to existing agreements and finding them inadequate, the paper replies to objections to a temporary waiver and concludes, in section III, that the ethical argument for temporarily waiving IP protection for COVID-19 vaccines is strong. There are no data in this work. (shrink)

People who lack decision‐making capacity may be able to communicate preferences, which can and should inform surrogate decision‐making on their behalf. It is unclear whether making a further distinction about “capacity for preferences,” as Jason Wasserman and Mark Navin propose in this issue of the Hastings Center Report, would improve the process of surrogate decision‐making. Anyone who is regularly involved in surrogate decision‐making or who has worked to articulate decision‐making standards and processes can think of cases in which a patient's (...) voice was ignored or his or her preferences and ability to communicate them overlooked. However, we can also think of cases in which it was unclear whether information provided by a patient, recently or in the past, should have been characterized as a preference relevant to a medical decision that the patient lacked the capacity to make. We should also recognize that clear preferences of a patient who lacks decision‐making capacity may conflict with the limits of another person or of a family's resources such that these preferences cannot guide a surrogate's decision. This patient will not get what he wants. A situation in which preferences are known and make sense but cannot be applied in a feasible way demonstrates the limits of the medical decision‐making framework concerning care that is not covered by medical insurance. (shrink)

Causation is in trouble—at least as it is pictured in current theories in philosophy and in economics as well, where causation is also once again in fashion. In both disciplines the accounts of causality on offer are either modelled too closely on one or another favoured method for hunting causes or on assumptions about the uses to which causal knowledge can be put—generally for predicting the results of our efforts to change the world. The first kind of account supplies no (...) reason to think that causal knowledge, as it is pictured, is of any use; the second supplies no reason to think our best methods will be reliable for establishing causal knowledge. So, if these accounts are all there is to be had, how do we get from method to use? Of what use is knowledge of causal laws that we work so hard to obtain? (shrink)

Academic research is increasingly centering on interdisciplinary work. Strong interdisciplinary research (SIR), involving researchers from very different fields, such as scientists and humanists, is often encouraged, if not required, by funding agencies. I argue that two intellectual virtues, open-mindedness and intellectual humility, are crucial for overcoming obstacles to SIR and achieving success. In part I, I provide a primer on intellectual virtue and the two virtues in question. In part II, I distinguish SIR from weak interdisciplinary research (WIR), which involves (...) research teams from neighboring fields, such as physics and chemistry, and from disciplinary research (DR), which involves researchers from the same discipline. I also outline what counts as success in SIR, and explain why it’s more challenging to attain than in WIR and DR. In part III, I explain how both intellectual virtues are essential for achieving success in SIR and for overcoming obstacles that can arise in its pursuit. (shrink)

Baconian science, a tool for plundering nature, has impelled physicians to insist on medical treatment even when it is futile. The Hippocratic tradition of medicine teaches us instead to acknowledge nature's limits.

BackgroundCommunity engagement in research is valuable for instrumental and intrinsic reasons. Despite existing guidance on how to ensure meaningful CE, much of what it takes to achieve this goal differs across settings. Considering the emerging trend towards mandating CE in many research studies, this study aimed at documenting how CE is conceptualized and implemented, and then providing context-specific guidance on how researchers and research regulators in Uganda could think about and manage CE in research.MethodsWe conducted qualitative interviews and focus group (...) discussions involving forty-one respondents who were experienced in HIV/aids biomedical research involving CE. Thirty-eight of these were directly or indirectly associated with Uganda’s leading research institution in the field of HIV/aids. They included Principal Investigators, Community Liaisons Officers, Research Ethics Committee members and Community Advisory Board Members. Three respondents were from Uganda National Council for Science and Technology. Data were collected between August 2019 and August 2020, using audio-taped focus group discussions and key informant interviews, transcribed and analyzed manually to generate themes and subthemes.ResultsThree major themes emerged: goals or value of CE; the means of CE, and, the evaluation of CE. Goals or value of CE generated four subthemes representing the overarching goals of CE: Promote communities’ agency; Generate and sustain trust; Protect and promote communities’ rights and interests; and, Help studies optimize participation in the form of enrolment and retention of participants. What usually comes under the nomenclatures of methods, strategies, and approaches of CE, such as town-hall meetings, sports events, drama, and the like, should simply be understood as the means of CE, and it is not desirable to hold pre-conceived and fixed ideas about the best means to conduct CE in research since a lot depend on the context. Finally, the study found that despite CE’s critical importance, which suggests the need to track and evaluate it, CE is currently intermittently evaluated, and for inadequate motivations.ConclusionsExisting guidance on how to conduct robust CE in research is no substitute for creativity, flexibility, and reflexivity on the part of both researchers and research regulators. (shrink)

Genetic testing raises concerns that individuals will be denied health insurance (and thus, effectively, access to health care), or that employers will screen to eliminate potentially costly workers. Although we as a society do not yet concur on the degree to which private businesses have a responsibility to promote social justice, several different policy alternatives might allow us to weigh the interests of insurers, as businesses, against the interests of citizens in a responsible manner.

How should healthcare systems prepare to care for growing numbers and proportions of older people? Older people generally suffer worse health than younger people do. Should societies take steps to reduce age-related health inequalities? Some express concern that doing so would increase age-related inequalities in healthcare. This paper addresses this debate by presenting an argument in support of three principles for distributing scarce resources between age groups; framing these principles of age group justice in terms of life stages; and indicating (...) policy implications that merit further attention in light of rapidly aging societies. (shrink)

What is commonly called Reichenbach’s “Principle of the Common Cause” is not a general criterion for a common cause, as many philosophers nowadays suppose. Examples include W. Salmon in his accounts of causal processes and Bas van Fraassen in his new book on quantum mechanics, in which he argues that the quantum world has no causal structure. This does not matter for Reichenbach’s purposes. Indeed it should not be surprising from his point of view that in different situations we need (...) different criteria or different methods for testing for the same phenomenon. The third thesis begins from a question: Where do probabilistic criteria for causality come from? (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)

This is a much-needed new introduction to a field that has been transformed in recent years by exciting new subjects, ideas, and methods. It is designed for students in both philosophy and the social sciences. Topics include ontology, objectivity, method, measurement, and causal inference, and such issues as well-being and climate change.

Men do not want solely the obedience of women; they want their sentiments. All men, except the most brutish, desire to have, in the woman most nearly connected with them, not a forced slave but a willing one, not a slave merely, but a favourite. They have therefore put everything in practice to enslave their minds. The masters of all other slaves rely, for maintaining obedience, on fear; either fear of themselves, or religious fears. The masters of women wanted more (...) than simple obedience, and they turned the whole force of education to effect their purpose. All women are brought up from the very earliest years in the belief that their ideal of character is the very opposite to that of men; not self-will, and government by self-control, but submission, and yielding to the control of others. All the moralities tell them that it is the duty of women, and all the current sentimentalities that it is their nature, to live for others; to make complete abnegation of themselves, and to have no life but in their affections.— John Stuart Mill, The Subjection of Women. (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)

The essays in this volume provide rich fodder for reflection on topics that are of urgent interest to all thinking people. Each one suggests new ways to contemplate our own role(s) in the production and promotion of evil.

In two earlier papers, I began to explore how “ordinary people” acquire virtue. By “ordinary people,” I mean people, not specifically or directly concerned with becoming virtuous, who have goals or aims the pursuit of which requires them to develop virtue. E.g., parents acquire patience and generosity in the course of pursuing their goal to be good parents; those concerned with being peacemakers acquire tact and diplomacy in the pursuit of that goal, and so on. These virtues can be viewed (...) by those who seek them to be of instrumental and not intrinsic value, that is, needed for goal attainment but not necessarily valuable in their own right. Moreover, the virtues so acquired need not be substantially informed by reflective deliberation. Are there pathways by means of which possessors of ordinary virtue can develop Aristotelian virtue, by coming to view the virtues they possess as having intrinsic value; and developing their phronetic capacities such that their virtues become informed by practical wisdom? In this essay, I continue the exploration of ordinary virtue with an eye to revealing possible pathways by which ordinary virtue can indeed take on the characteristics of full Aristotelian virtue. In the spirit of empirical collaboration, I suggest these pathways of virtue development as testable hypotheses. (shrink)

Girolamo Cardano's writings on medicine reflect both the complexity and diversity of the Renaissance medical world and the breadth of his own interests. This book draws on selected themes of in Cardano's medical writings to explore the relation between medicine and Renaissance.

La création de la Commission de la santé et des services sociaux des Premières Nations du Québec et du Labrador (CSSSPNQL) date de 1994. L’Assemblée des Chefs des Premières Nations du Québec et du Labrador a entériné sa création afin de faire valoir le droit inhérent des Premières Nations de concevoir et de livrer des services de santé et sociaux culturellement convenables.L’Assemblée des Premières Nations du Québec et du Labrador (APNQL) est constituée de l’ensemble des Chefs des communautés..

Norman Daniels' and Daniel Callahan's recent work attempts to develop and deepen theories of justice in order to accommodate intergenerational moral issues. Elsewhere, I have argued that Callahan's arguments furnish inadequate support for the age rationing policy he accepts. This essay therefore examines Daniel's account of age rationing, together with the complex theory of age-group justice that buttresses it. Sections one and two trace the main features of Daniels' prudential lifespan approach. Section three calls into question the theory's conformity to (...) liberal tenets. The next section attempts to show that the outcome of the prudential approach fails to match our considered judgments. The brief final section offers a broader perspective on the task of articulating a liberal theory of age-group justice. Keywords: elderly, age-group justice, biomedical model of disease, rationing, liberalism, distributive justice CiteULike Connotea Del.icio.us What's this? (shrink)

In this presidential address, the author argues that being disabled is being a “misfit,” and that being a philosopher is often considered to be something like a disability, rendering philosophy, and philosophers, misfits as well. But not all disabilities are negative, and there are even cases in which disability can be something for which the disabled person and others can be grateful. Comparing her own physical disability that renders her a “misfit” to philosophy as a misfit discipline, the author argues (...) that there is a connection between gratitude as a virtue, disability, and philosophy as an academic discipline and as a way of life. (shrink)