A theoretical structure for multiattribute decision making is presented, based on a dynamical system for interactions in a neural network incorporating affective and rational variables. This enables modeling of problems that elude two prevailing economic decision theories: subjective expected utility theory and prospect theory. The network is unlike some that fit economic data by choosing optimal weights or coefficients within a predetermined mathematical framework. Rather, the framework itself is based on principles used elsewhere to model many other cognitive and behavioral (...) data, in a manner approximating how humans perform behavioral functions. Different, interconnected modules within the network encode (a) attributes of objects among which choices are made, (b) object categories, (c) and goals of the decision maker. An example is utilized to simulate the actual consumer choice between old and new versions of Coca-Cola. Potential applications are also discussed to market decisions involving negotiations between participants, such as international petroleum traders. (shrink)

Records the papers and commentaries, with an edited discussion, presented at an international consultation convened by the Council for International Organizations of Medical Sciences (CIOMS) to guide revision of the CIOMS International Ethical Guidelines for Biomedical Research Involving Human Subjects. The Guidelines, first issued in 1982 and then revised in 1993, are being updated and expanded to address a number of new and especially challenging ethical issues. These include issues raised by international collaborative trials of drugs in developing countries, especially (...) expensive drugs, and the use of placebo controls in randomized clinical trials. Others arise from the complexity of research in human genetics, including stem-cell research, and in reproductive biology. Throughout, particular attention is given to the difficult questions that arose during the heated debate over trials in developing countries, of short-duration zidovudine (AZT) therapy to reduce perinatal transmission of HIV. The International Ethical Guidelines for Biomedical Research Involving Human Subjects set out a code of research ethics that is widely used by ethical review committees and other bodies responsible for reviewing and overseeing the ethical design of studies and conduct of research. The revision of the Guidelines is being coordinated by CIOMS, in collaboration with WHO. The consultation centered on seven specially commissioned papers, authored by international experts that explore some of the more difficult issues in depth. Each is followed by an invited commentary, often expressing opposing views, and a summary of the issues or conclusions that emerged during the subsequent debate. The first paper, on justice in international research, deals with the question of whether proposals for research to be conducted in a developing country should make provision for future access of the population involved to the interventions under investigation. Also considered are questions that arise when research uses populations in developing countries to investigate interventions that will be of exclusive benefit to the industrialized world. Case studies of recent drug trials and their research protocols are discussed to illustrate circumstances in which use of populations in developing countries is justified or constitutes exploitation. Ethical challenges of the randomized controlled trial are considered in the second paper, which includes a discussion on the equitable distribution of benefits and risks, the use of placebo for controls, and the obligation to ensure that the participation of controls does not compromise their medical care or endanger their health. A paper on informed consent in international health research considers how cultural factors influence communication and language in the informed-consent process and respect for privacy and confidentiality in the research. Subsequent papers address issues in genetics research and reproductive biology, including the moral status of fetuses and the use of embryos in research, and examine the contribution which international human rights instruments can make in the application of the general principles of ethics to research involving human subjects. The final paper gives an overview of capacity building and the role of communities in international biomedical research. (shrink)

:High-fidelity simulation is a relatively new teaching modality, which is gaining widespread acceptance in medical education. To date, dozens of studies have proven the usefulness of HFS in improving student, resident, and attending physician performance, with similar results in the allied health fields. Although many studies have analyzed the utility of simulation, few have investigated why it works. A recent study illustrated that permissive failure, leading to simulated mortality, is one HFS method that can improve long-term performance. Critics maintain, however, (...) that the use of simulated death is troubling and excessive. Given the controversy regarding simulated death, we consider the data about the educational value and the emotional harms associated with them, expecting that evidence could be useful in resolving the question. The goal of this narrative review is to explore the argument against simulated mortality and provide educators with an imperative as to why it can be safely utilized. (shrink)

Samuel J. Kerstein develops a new, broadly Kantian account of the ethical issues that arise when a person treats another merely as a means. He explores how Kantian principles on the dignity of persons shed light on pressing issues in modern bioethics, including the distribution of scarce medical resources and the regulation of markets in organs.

Philosophical Investigations, Volume 45, Issue 3, Page 320-333, July 2022.

The allocation of scarce health care resources such as flu treatment or organs for transplant presents stark problems of distributive justice. Persad, Wertheimer, and Emanuel have recently proposed a novel system for such allocation. Their “complete lives system” incorporates several principles, including ones that prescribe saving the most lives, preserving the most life-years, and giving priority to persons between 15 and 40 years old. This paper argues that the system lacks adequate moral foundations. Persad and colleagues' defense of giving priority (...) to those between 15 and 40 leaves them open to the charge that they discriminate unfairly against children. Second, the paper contends that the complete lives system fails to provide meaningful practical guidance in central cases, since it contains no method for balancing its principles when they conflict. Finally, the paper proposes a new method for balancing principles of saving the most lives and maximizing life-years. (shrink)

The threat of bioterrorism, the emergence of the SARS epidemic, and a recent focus on professionalism among physicians, present a timely opportunity for a review of, and renewed commitment to, physician obligations to care for patients during epidemics. The professional obligation to care for contagious patients is part of a larger "duty to treat," which historically became accepted when 1) a risk of nosocomial infection was perceived, 2) an organized professional body existed to promote the duty, and 3) the public (...) came to rely on the duty. Physicians' responses to epidemics from the Hippocratic era to the present suggests an evolving acceptance of the professional duty to treat contagious patients, reaching a long-held peak between 1847 and the1950's. There has been some professional retrenchment against this duty to treat in the last 40 years but, we argue, conditions favoring acceptance of the duty are met today. A renewed embrace of physicians' duty to treat patients during epidemics, despite conditions of personal risk, might strengthen medicine's relationship with society, improve society's capacity to prepare for threats such as bioterrorism and new epidemics, and contribute to the development of a more robust and meaningful medical professionalism. (shrink)

Following its determination of a finding of scientific misconduct the Office of Research Integrity (ORI) will seek redress for any injury sustained. Several remedies both administrative and statutory may be available depending on the strength of the evidentiary findings of the misconduct investigation. Pursuant to federal regulations administrative remedies are primarily remedial in nature and designed to protect the integrity of the affected research program, whereas statutory remedies including civil fines and criminal penalties are designed to deter and punish wrongdoers. (...) This commentary discusses the available administrative and statutory remedies in the context of a specific case, that of former University of Vermont nutrition researcher Eric Poehlman, and supplies a possible rationale for the legal result. (shrink)

Opponents of commerce in organs sometimes appeal to Kant’s Formula of Humanity to justify their position. Kant implies that anyone who sells an integral part of his body violates this principle and thereby acts wrongly. Although appeals to Kant’s Formula are apt, they are less helpful than they might be because they invoke the necessity of respecting the dignity of ends in themselves without specifying in detail what dignity is or what it means to respect it, and they cite the (...) wrongness of an agent’s treating another merely as a means without clarifying conditions under which this occurs. This paper crystallizes two different approaches to the Formula of Humanity and probes when, according to them, the principle would imply that it is wrong to engage in “live donor” transactions, in which someone chooses to undergo a kidney extraction in exchange for money. (shrink)

In the Paraplegia Case, we must choose either to preserve the life of a paraplegic for 10 years or that of someone in full health for the same duration. Non-consequentialists reject a benefit-maximising view, which holds that since the person in full health will have a higher quality of life, we ought to save him straightaway. In the Unequal Lifespan Case, we face a choice between saving one person for 5 years in full health and another for 25 years in (...) full health. Frances Kamm has recently unfurled an Equal Respect Argument in an effort to support the position that while we ought to give each person a 50% chance of being saved in the Paraplegia Case, we are morally permitted to save straightaway the person who would live longer in the Unequal Lifespan case. The article tries to show that a Kant-inspired account of the dignity of persons is far more successful than Kamm's argument in supporting this position. The Kant-inspired account owes this success to its conceiving of respect for persons not primarily as respect for their pursuit of what is of value for them, but rather as respect for the value in them. (shrink)

In Kant and Modern Political Philosophy, Katrin Flikschuh pursues two main aims. She tries to show that Kant’s theory of Right [Recht] is grounded in Kantian metaphysics. For example, we do not really understand Kant’s thought on property rights and cosmopolitanism unless we have in view its metaphysical underpinnings. Second, Flikschuh attempts to demonstrate the relevance of Kant’s theory of Right, especially as it is presented in Kant’s notoriously difficult Rechtslehre, to contemporary political concerns. In pursuing these aims she brings (...) to bear wide-ranging knowledge of scholarly work on Kant’s political and legal thought. (shrink)

In Remarks on the Foundations of Mathematics, Wittgenstein notes that he has ‘not yet made the role of miscalculating clear’ and that ‘the role of the proposition: “I must have miscalculated”…is really the key to an understanding of the “foundations” of mathematics.’ In this paper, I hope to get clear on how this is the case. First, I will explain Wittgenstein's understanding of a ‘foundation’ for mathematics. Then, by showing how the proposition ‘I must have miscalculated’ differentiates mathematics from the (...) physical sciences, we will see how this proposition is the key to understanding the foundations of mathematics. (shrink)

In recent scholarship, the science and religion debate has been historicized, revealing the novelty of the concepts of science and religion and their complex connections to secularization and the birth of modernity. This article situates this historicist turn in the history of philosophy and its connections to theology and Scripture, showing that the science and religion concept derives from philosophy's earlier tension with theology as it became an academic discipline centered in the medieval, then research university, with the centrality of (...) Scripture changing under the influence of historical criticism. Looking at Thomas Aquinas and Friedrich Schleiermacher on theology and Scripture's connection to science, it offers a new framework for theorizing science and religion as part of the history of philosophy. (shrink)

Out of a concern for keeping suicidal patients alive, some psychotherapists may use hard persuasion or coercion to keep them in treatment. However, more recent evidence-supported interventions have made respect for patient autonomy a cornerstone, showing that the effective interventions that promote the wellbeing of suicidal patients also prioritize respect for patient autonomy. This article details how psychotherapists can incorporate respect for patient autonomy in the effective treatment of suicidal patients by listening to them, explaining treatments to them, involving them (...) in decisions, and inviting evaluations from them on the process and progress of their treatment. It also describes how processes that respect patient autonomy can supplement interventions that directly address some of the drivers of suicide. (shrink)

This is a reply to ‘Defending Wittgenstein’, Piotr Dehnel's critique of my article, ‘Defending Wittgenstein's Remarks on Cantor from Putnam’. I first show that my position is much more in agreement with Felix Mühlhölzer than Dehnel takes it to be, and that his criticism of me is nothing more than a failure to recognize this. I then show how Dehnel incorrectly reads Wittgenstein as rejecting set theory as false. It is an overemphasis on and a much too narrow picture of (...) ‘applicability’ which leads him to this view. Finally, I conclude by rejecting Dehnel's view that Wittgenstein was a finitist about mathematics. (shrink)

My goals in this paper are twofold: to outline the refashioning of amateur and professional roles in life science in late Victorian Yorkshire, and to provide a revised historiography of the relationship between amateurs and professionals in this era. Some historical treatments of this relationship assume that amateurs were demoralized by the advances of laboratory science, and so ceased to contribute and were left behind by the autonomous "new biology." Despite this view, I show that many amateurs played a vital (...) part in the construction of a professional academic community in urban Yorkshire, and then continued to collaborate with the laboratory-based biologists. The key to any analysis of the relationship between amateurs and professionals is the great variety of amateur identities and practices in Victorian Yorkshire. The amateur-professional rift fallacy arose because laboratory biologists fashioned an identity in conscious opposition to a particular type of amateur: an ideal that belied an array of cooperative relationships. As naturalists refashioned their roles and identities in light of the changes within academe and without, debates about the practice and place of life science took place as often among amateurs as between professionals and amateurs. (shrink)

This paper concerns Kant's view of the relations between an actions's moral permissibility and its moral worth. In the Groundwork of the Metaphysics of Morals, Kant holds that only morally permissible actions can have moral worth. By restricting moral worth to morally permissible actions, Kant generates an asymmetrical account of how two kinds of failure affect an actions's moral worth. While failure to judge correctly whether one's action is morally permissible precludes it from having moral worth failure to attain the (...) end of one's action does not. I argue that this asymmetrical account is implausible. Kant, I claim, should acknowledge that morally permissible actions can have moral worth. After addressing objections to this claim, I consider Kant's position in a later work: the Metaphysics of Moreals. I argue that though he does not go far enough, Kant moves toward recognizing that some morally impermissible actions can have moral worth. (shrink)

This article probes the voucher program from an ethical perspective. It focuses mainly on an issue of inequity. A disparity exists in US kidney transplantation. Although African-Americans suffer far higher rates of ESRD than whites, African-Americans are much less likely than whites to get a transplant. The article explores the voucher program in light of this disparity. It motivates the view that, at least in the short term, more whites than African-Americans are likely to take advantage of the voucher program. (...) The program is, thus, likely to increase the gap in transplantation rates between the two groups. If this is correct, what impact does it have on the moral acceptability of the program? (shrink)

In this book, I give a topic-based, modular introduction to philosophy. The book has 16 chapters: 7 in theoretical philosophy and 9 in practical philosophy. Each topic is introduced by means of a concrete question; the main positions on this question are then developed and criticized in turn. I try to avoid taking sides; instead, I emphasize that students must think through the issues for themselves.

In this paper I argue that there would be no obligatory maxims if the only standards for assessing maxims were Kant’s universalizability tests. The paper is divided into five sections. In the first, I clarify my thesis: I define my terms and disambiguate my thesis from other related theses for which one might argue. In the second, I confront the view that says that if a maxim passes the universalizability tests, then there is a positive duty to adopt that maxim; (...) I also confront a close relative of this view. In the third, I confront the view that says that if a maxim does not pass the universalizability tests, then there is a positive duty to adopt the contradictory of that maxim. In the fourth, I confront two variations of the view that says that if a maxim does not pass the universalizability tests and an agent is deliberating about the action in the maxim, then the agent has a positive duty to adopt the contrary of that maxim. In the fifth, I confront the view that says that if an agent has adopted a maxim of ends, then the agent has a positive duty to universalize that end. I then wrap up the paper with some concluding remarks. (shrink)

Many take Kantian ethics to founder when it comes to our duties to animals. In this paper, I advocate a novel approach to this problem. The paper is divided into three sections. In the first, I canvass various passages from Kant in order to set up the problem. In the second, I introduce a novel approach to this problem. In the third, I defend my approach from various objections. By way of preview: I advocate rejecting the premise that nonhuman animals (...) are nonrational. (shrink)

We routinely observe others’ choices and use them to guide our own. Whose choices influence us more, and why? Prior work has focused on the effect of perceived similarity between two individuals, such as the degree of overlap in past choices or explicitly recognizable group affiliations. In the real world, however, any dyadic relationship is part of a more complex social structure involving multiple social groups that are not directly observable. Here we suggest that human learners go beyond dyadic similarities (...) in choice behaviors or explicit group memberships; they infer the structure of social influence by grouping individuals based on choices, and they use these groups to decide whose choices to follow. We propose a computational model that formalizes this idea, and we test the model predictions in a series of behavioral experiments. In Experiment 1, we reproduce a well-established finding that people's choices are more likely to be influenced by someone whose past choices are more similar to their own past choices, as predicted by our model as well as dyadic similarity models. In Experiments 2–5, we test a set of unique predictions of our model by looking at cases where the degree of choice overlap between individuals is equated, but their choices indicate a latent group structure. We then apply our model to prior empirical results on infants’ understanding of others’ preferences, presenting an alternative account of developmental changes. Finally, we discuss how our model relates to classical findings in the social influence literature and the theoretical implications of our model. Taken together, our findings demonstrate that structure learning is a powerful framework for explaining the influence of social information on decision making in a variety of contexts. (shrink)

In this paper I defend the traditional interpretations of Kant’s Formula of a Law of Nature from recent attacks leveled by Faviola Rivera-Castro, James Furner, Ido Geiger, Pauline Kleingeld and Sven Nyholm. After a short introduction, the paper is divided into four main sections. In the first, I set out the basics of the three traditional interpretations, the Logical Contradiction Interpretation, the Practical Contradiction Interpretation and the Teleological Contradiction Interpretation. In the second, I examine the work of Geiger, Kleingeld and (...) Nyholm: these three commentators reject the traditional interpretations entirely, but I argue that this rejection is ill-founded. In the third and fourth, I take a detailed look at Furner’s work, work in which he seeks to revise (rather than reject) the traditional interpretations. I argue that, despite his more modest aims, Furner’s revision is also ill-founded. (shrink)

In this article, we review approaches to modeling a connection between spatial and mathematical thinking across development. We critically evaluate the strengths and weaknesses of factor analyses, meta-analyses, and experimental literatures. We examine those studies that set out to describe the nature and number of spatial and mathematical skills and specific connections between these abilities, especially those that included children as participants. We also find evidence of strong spatial-mathematical connections and transfer from spatial interventions to mathematical understanding. Finally, we map (...) out the kinds of studies that could enhance our understanding of the mechanisms by which spatial and mathematical processing are connected and the principles by which mathematical outcomes could be enhanced through spatial training in educational settings. (shrink)

In this article, I argue that Kant’s Categorical Imperative applies to maxim tokens rather than to maxim types. The article has three main parts. In the first, I explain my thesis. In the second, I argue for it. In the third, I argue, further, that, if my thesis is correct, then tokens of different maxim types can have different deontic statuses for different agents.

In this article, I confront Jessica Flanigan’s recent attempt to show not merely that women have a right to commit prenatal injury, but also that women who act on this right are praiseworthy and should not be criticized for this injury. I show that Flanigan’s arguments do not work, and I establish presumptive grounds against any such right—namely, prenatal injury, by definition, involves intentional or negligent harm and, as such, may be subsumed under a wider class of actions that are (...) presumptively wrong. (shrink)

In reinforcement learning, a decision maker searching for the most rewarding option is often faced with the question: What is the value of an option that has never been tried before? One way to frame this question is as an inductive problem: How can I generalize my previous experience with one set of options to a novel option? We show how hierarchical Bayesian inference can be used to solve this problem, and we describe an equivalence between the Bayesian model and (...) temporal difference learning algorithms that have been proposed as models of RL in humans and animals. According to our view, the search for the best option is guided by abstract knowledge about the relationships between different options in an environment, resulting in greater search efficiency compared to traditional RL algorithms previously applied to human cognition. In two behavioral experiments, we test several predictions of our model, providing evidence that humans learn and exploit structured inductive knowledge to make predictions about novel options. In light of this model, we suggest a new interpretation of dopaminergic responses to novelty. (shrink)

This chapter contains sections titled: I II III IV V VI Bibliography.

This paper introduces the concept of moral residue to global health, and shows how its presence undermines crucial interventions and research, especially in the global south. Lingering feelings of anxiety, anger, blame or frustration often exist among local populations, where previous interventions or research have left traces of harm and/or exploitation. The existence of such feelings reflects the presence of moral residue, recognizing the moral experiences of epistemic injustices, which in turn undermines critical interventions and research through outright rejection or (...) passive non-compliance among affected populations. While such situations have been variously interpreted and relevant strategies developed to address the issues, little to no consideration is made on the implications of moral residue experiences in global health contexts and how to address them. This paper demonstrates the presence of moral residue in global health and proffers an African ethical approach, a harmony framework, for addressing moral residue issues, as part of a holistic approach towards tackling population health crises without compromising health gains for affected populations in the global south. (shrink)

According to the positive duties objection, it is not possible to derive positive duties from Kant’s Formula of Universal Law (FUL). However, in his recent “Deriving Positive Duties from Kant’s Formula of Universal Law”, Guus Duindam tries to answer this objection. More specifically, Duindam tries to show how both a duty of benevolence and a duty of self-perfection can be derived from the FUL. I critically examine Duindam’s arguments. I maintain that Duindam’s argument for the positive duty of benevolence is (...) ambiguous and that this ambiguity exposes him to a fatal dilemma: on one horn, Duindam faces the same objection that he concedes to be effective against other attempts to answer the positive duties objection; on the other horn, the procedure he recommends cannot be based on the FUL (because it does not evaluate actions on the basis of their corresponding maxims). In addition, I maintain that Duindam’s benevolence argument rests on a procedure that is, in general, intractable and, in this particular case, foredoomed (because it can be shown that there are no positive duties of the kind he tries to derive). From there, I turn to Duindam’s argument for the positive duty of self-perfection. I explain that Duindam’s derivation of the duty of self-perfection, even if successful, does not answer the positive duties objection. This is because Duindam never appeals to the FUL in his derivation of the duty of self-perfection (the derivation is based, rather, on instrumental reasoning from the second-order end to accomplish our first-order ends). I elaborate on this by comparing and contrasting Duindam’s argument with Oliver Sensen’s interpretation of how to apply the FUL in the latter’s recent “Universal Law and Poverty Relief”. (shrink)

According to Kant’s ethics, at least on one common interpretation, persons have a special worth or dignity that demands respect. But personhood is not coextensive with human life; for example, individuals can live in severe dementia after losing the capacities constitutive of personhood. Some philosophers, including David Velleman and Dennis Cooley, have suggested that individuals living after the loss of their personhood might offend against the Kantian dignity the individuals once possessed. Cooley has even argued that it is morally required (...) on Kantian grounds for those who realize that they will lose their personhood as a result of dementia (e.g. Alzheimer’s) to hasten their deaths (e.g. commit suicide). This article specifies circumstances in which post-personhood living might indeed involve an affront to the Kantian dignity of a person who once was. However, the article contends, Kant implies that it is neither morally required nor even morally permissible for someone in an early stage of Alzheimer’s to hasten their death to avoid such an affront, even if they have autonomously chosen to do so. The article adds an ethical perspective to debate on physician-assisted dying, in particular on the moral permissibility of the soon-to-be-demented ending their lives. (shrink)