This study takes as its point of departure a canvas by Rosa Bonheur containing a series of painted sketches of a lion cub, in order to approach her oeuvre from the perspective of animal biographies. The article focuses on the lion and lioness models frequented by the artist during her career. The aim is to shed light on the complexity of these relationships, starting from an analysis of the paintings and of the information about these animals to be found in (...) several early biographies of Bonheur. (shrink)

Rassemblant des écrits issus des domaines de l’histoire de l’art et des études littéraires et théâtrales, Femmes sauvages et ensauvagées dans les arts et les lettres propose une constellation de figures issues de l’imaginaire occidental du Moyen Âge jusqu’au xixe siècle. Les textes sont le prolongement des interventions du colloque éponyme organisé à l’université de Rennes les 13 et 14 octobre 2016 par le département d’histoire de l’art et le département dédié à la littérature, en écho au col...

Intellectualism is the claim that practical knowledge or ‘know-how’ is a kind of propositional knowledge. The debate over Intellectualism has appealed to two different kinds of evidence, semantic and scientific. This paper concerns the relationship between Intellectualist arguments based on truth-conditional semantics of practical knowledge ascriptions, and anti-Intellectualist arguments based on cognitive science and propositional representation. The first half of the paper argues that the anti-Intellectualist argument from cognitive science rests on a naturalistic approach to metaphysics: its proponents assume that (...) findings from cognitive science provide evidence about the nature of mental states. We demonstrate that this fact has been overlooked in the ensuing debate, resulting in inconsistency and confusion. Defenders of the semantic approach to Intellectualism engage with the argument from cognitive science in a way that implicitly endorses this naturalistic metaphysics, and even rely on it to claim that cognitive science support Intellectualism. In the course of their arguments, however, they also reject that scientific findings can have metaphysical import. We argue that this situation is preventing productive debate about Intellectualism, which would benefit from both sides being more transparent about their metaphilosophical assumptions. (shrink)

An indispensable and comprehensive resource for students and scholars of philosophy of religion.

Philosophy and Phenomenological Research, EarlyView.

Plain disjunctive sentences, such as _The mystery box contains a blue ball or a yellow ball_, typically imply that the speaker does not know which of the two disjuncts is true. This is known as an ignorance inference. We can distinguish between two aspects of this inference: the negated universal upper bound part (i.e., the speaker is uncertain about each disjunct), which we call uncertainty, and the existential lower bound part (i.e., the speaker considers each disjunct possible), which we call (...) possibility. In the traditional approach, uncertainty is derived as a primary implicature, from which possibility follows. In this paper, we report on two experiments using a sentence-picture verification task based on the mystery box paradigm that challenge the traditional implicature approach. Our findings show that possibility can arise without uncertainty, and we thus call for a reevaluation of the traditional view of disjunction and ignorance inferences. Our experimental findings are related to similar results involving disjunction in embedded contexts and pave the way for alternative theories that can account for the observed patterns of inference derivation in a unified fashion. We discuss how recent implicature and non-implicature theories can account for the derivation of existential lower bound inferences without the presence of negated universal upper bound inferences. (shrink)

This paper argues that if motivation by rightness de re is praiseworthy, then so is motivation by rightness de dicto. I argue that these two types of moral motivation have been unfairly compared, in light of a widespread failure to appreciate the structural similarities between them. These structural similarities become clear when we think more carefully about the nature of motivation and about moral metaphysics. I then argue that the two types of moral motivation are on a par by discussing (...) a series of minimal pairs. I argue that in good cases, in which the agent succeeds in doing what she is motivated to do, both motivations seem praiseworthy, and that bad cases, in which the agent fails, arise for motivation by rightness de re in precisely the same way as they do for motivation by rightness de dicto. I then offer a way to evaluate the unsuccessful agents, according to which someone's motivations can still be praiseworthy even if her actions and moral beliefs are both blameworthy, and someone can have certain praiseworthy motivations while lacking others. On my view, most of us are deeply flawed agents who nonetheless have some redeeming features—including our moral motivations. (shrink)

The aim of this study is to contribute to a conceptualization of organizational politics that underscores the possibility of developing positive political behavior at the workplace. In this respect, we seek to provide a context of re-evaluating the normative foundations of organizational politics. Normative issues are critically discussed in the context of mainstream ethical theories that illuminate the interaction of ethics and political behavior. More specifically, it is argued that a deontological framework is of particular importance for the proper management (...) of negative political behavior, whereas a virtue-ethics context can be employed so as to foster positive political behavior at the workplace. Finally, the implications of this approach for organizational life and HRM processes and practices are taken into consideration. (shrink)

What is nontrivial digital computation? It is the processing of discrete data through discrete state transitions in accordance with finite instructional information. The motivation for our account is that many previous attempts to answer this question are inadequate, and also that this account accords with the common intuition that digital computation is a type of information processing. We use the notion of reachability in a graph to defend this characterization in memory-based systems and underscore the importance of instructional information for (...) digital computation. We argue that our account evaluates positively against adequacy criteria for accounts of computation. (shrink)

This is a paper about the nature of snobbery and the undermining import of a charge of snobbery. On my account, snobs sincerely attempt to identify and correctly evaluate the aesthetically relevant features of an object, but they get things wrong, and their getting things wrong is explained by the fact that they under-value that which they associate with being lower-class. We can see the need for this account by reflecting on examples, and can distinguish it from existing accounts of (...) snobbery by thinking about when and why evidence of snobbery constitutes higher-order evidence against one’s aesthetic judgements. Existing accounts either are consistent with snobs’ aesthetic judgements being flawless, and thus not undermined by evidence of snobbery, or they imply that the canonical reasoning-process for arriving at aesthetic judgements has been bypassed altogether. On my account, by contrast, snobbery does not bypass the canonical aesthetic reasoning-process but distorts it in systematic and predictable ways. (shrink)

In her paper “Radical Externalism”, Amia Srinivasan argues that externalism about epistemic justification should be preferred to internalism by those who hold a “radical” worldview (according to which pernicious ideology distorts our evidence and belief‐forming processes). I share Srinivasan's radical worldview, but do not agree that externalism is the preferable approach in light of the worldview we share. Here I argue that cases informed by this worldview can intuitively support precisely the internalist view that Srinivasan challenges, offer two such cases, (...) and explain away the externalist‐friendly intuitions that Srinivasan's cases solicit. I then articulate and defend a “radical” internalism, arguing that internalists’ aversion to epistemic hubris and emphasis on subjecting one's beliefs to critical scrutiny are especially attractive in realistic cases involving multiple intersecting axes of oppression—that is, precisely the sort of case that permeates our social world. I also argue that externalism's lack of interest in action‐guiding principles leaves it with little to offer us in the fight against epistemic oppression. (shrink)

Alex Worsnip argues that structural rationality is a unified phenomenon, given the constitutive facts about the natures of our mental states. He also argues that structural rationality is normatively significant, given the reasons to which its requirements give rise. This paper breaks bad news: these two parts of Worsnip’s picture are strange bedfellows, since the sequences of states and processes that would clearly count as transgressing the structural-rationality-based reasons that he describes are precisely those sequences that are ruled out by (...) the constitutive facts about our mental states that he also describes. As a result, it is hard to see what transgressing our structural-rationality-based reasons could amount to on Worsnip’s overall picture, and thus hard to see how these reasons could be normative in an interestingly robust way. The present paper spells out this puzzle and then discusses how Worsnip might respond and how far it might generalize. (shrink)

In 2022, students at North American universities with third-dose COVID-19 vaccine mandates risk disenrolment if unvaccinated. To assess the appropriateness of booster mandates in this age group, we combine empirical risk-benefit assessment and ethical analysis. To prevent one COVID-19 hospitalisation over a 6-month period, we estimate that 31 207–42 836 young adults aged 18–29 years must receive a third mRNA vaccine. Booster mandates in young adults are expected to cause a net harm: per COVID-19 hospitalisation prevented, we anticipate at least (...) 18.5 serious adverse events from mRNA vaccines, including 1.5–4.6 booster-associated myopericarditis cases in males (typically requiring hospitalisation). We also anticipate 1430–4626 cases of grade ≥3 reactogenicity interfering with daily activities (although typically not requiring hospitalisation). University booster mandates are unethical because they: (1) are not based on an updated (Omicron era) stratified risk-benefit assessment for this age group; (2) may result in a net harm to healthy young adults; (3) are not proportionate: expected harms are not outweighed by public health benefits given modest and transient effectiveness of vaccines against transmission; (4) violate the reciprocity principle because serious vaccine-related harms are not reliably compensated due to gaps in vaccine injury schemes; and (5) may result in wider social harms. We consider counterarguments including efforts to increase safety on campus but find these are fraught with limitations and little scientific support. Finally, we discuss the policy relevance of our analysis for primary series COVID-19 vaccine mandates. (shrink)

My thesis is that moral ignorance does not imply a failure to care adequately about what is in fact morally significant. I offer three cases: one in which someone is ignorant of the precise nature of what she cares about; one in which someone does not reflect on the significance of what she cares about in a particular set of circumstances, and one in which someone cares deeply about two morally significant considerations while being mistaken about their relative significance. I (...) argue that these agents all clearly care at least “adequately” about everything morally significant, including the very considerations that in fact make their acts wrong. This creates theoretical room for a way of thinking about culpable moral ignorance that respects the key concerns of those in the voluntarist tradition who have held that moral ignorance is typically blameless, within an approach to thinking about moral responsibility according to which we are blameworthy for that which manifests poor quality of will; caring adequately does not require moral omniscience, but motivated moral ignorance and moral ignorance that reflects indifference to things that matter morally are still blameworthy. My thesis also suggests a fruitful change of direction for quality-of-will theorists: we should articulate the nature and structure of the standards for adequate caring, i.e. those that specify what it is to care “adequately”. I close by offering an initial proposal as to what these standards might look like and identifying four promising avenues for further research on this topic. (shrink)

In a recent paper, Jack Woods advances an intriguing argument against expressivism based on Moore’s paradox. Woods argues that a central tenet of expressivism—which he, following Mark Schroeder, calls the parity thesis—is false. The parity thesis is the thesis that moral assertions express noncognitive, desire-like attitudes like disapproval in exactly the same way that ordinary, descriptive assertions express cognitive, belief-like attitudes. Most contemporary defenders of expressivism seem not only to accept the parity thesis but also to rely on it to (...) distinguish their view from subjectivism, so Woods’s argument against it poses a serious challenge to the view. In this paper, I argue that Woods’s argument is unsuccessful, but show that diagnosing precisely where it goes wrong raises interesting questions for expressivists—and metaethicists more generally—about the transparency of our moral attitudes. (shrink)

This article explores the extent to which consumers consider ethics in luxury goods consumption. In particular, it explores whether there is a significant difference between consumers’ propensity to consider ethics in luxury versus commodity purchase and whether consumers are ready to purchase ethical-luxury. Prior research in ethical consumption focuses on low value, commoditized product categories such as food, cosmetics and high street apparel. It is debatable if consumers follow similar ethical consumption patterns in luxury purchases. Findings indicate that consumers’ propensity (...) to consider ethics is significantly lower in luxury purchases when compared to commoditized purchases and explores some of the potential reasons for this reduced propensity to identify or act upon ethical issues in luxury consumption. (shrink)

It is often morally important that you have a choice between two options in the sense that each option is available to you and you are not coerced into choosing one or the other. Even when you have a choice, though, the presence of time constraints and other noncoercive influences can prevent you from taking the time you need to make up your mind and really choose for yourself. How are we to understand this latter phenomenon? In this essay, I (...) argue that while choosing for yourself seems, at first glance, to be an exercise in discovering your preferences, this is not the whole story. At least sometimes, choosing for yourself instead involves creating your preferences—and, in so doing, choosing what kind of person and valuer to be—through the exercise of what I call formative autonomy. I then explore some objections to this account and some implications for public health policy and clinical ethics. Throughout, I draw primarily on examples that involve choosing whether to continue or terminate a pregnancy and the regulations governing such choices. (shrink)

Normative judgments are practical: they bear a close connection to motivation. Noncognitivists often claim that they have a distinctive explanatory advantage accounting for this connection. After all, if normative judgments just are noncognitive, desire-like states, then it is no mystery why they bear an intimate connection to motivation: desire-like states motivate. In this paper, however, I argue that noncognitivism does not have this explanatory advantage after all. The problem is that noncognitivists cannot provide a characterization of the practicality of normative (...) judgment that allows them to retain this advantage. Noncognitivists either posit a strong and controversial connection between normative judgment and motivation that cognitivists have no trouble rejecting, or they posit a weaker connection that cognitivists can explain just as well. Either way, noncognitivists cannot argue from the practicality of normative judgments to their claim that normative judgments are noncognitive, desire-like states. The practicality of normative judgments does not support noncognitivism. (shrink)

As software developers design artificial agents , they often have to wrestle with complex issues, issues that have philosophical and ethical importance. This paper addresses two key questions at the intersection of philosophy and technology: What is deception? And when is it permissible for the developer of a computer artifact to be deceptive in the artifact’s development? While exploring these questions from the perspective of a software developer, we examine the relationship of deception and trust. Are developers using deception to (...) gain our trust? Is trust generated through technological “enchantment” warranted? Next, we investigate more complex questions of how deception that involves AAs differs from deception that only involves humans. Finally, we analyze the role and responsibility of developers in trust situations that involve both humans and AAs. (shrink)

BackgroundInaccurate, false or incomplete research publications may mislead readers including researchers and decision-makers. It is therefore important that such problems are identified and rectified promptly. This usually involves collaboration between the research institutions and academic journals involved, but these interactions can be problematic.MethodsThese recommendations were developed following discussions at World Conferences on Research Integrity in 2013 and 2017, and at a specially convened 3-day workshop in 2016 involving participants from 7 countries with expertise in publication ethics and research integrity. The (...) recommendations aim to address issues surrounding cooperation and liaison between institutions and journals about possible and actual problems with the integrity of reported research arising before and after publication.ResultsThe main recommendations are that research institutions should: develop mechanisms for assessing the integrity of reported research that are distinct from processes to determine whether individual researchers have committed misconduct;release relevant sections of reports of research integrity or misconduct investigations to all journals that have published research that was investigated;take responsibility for research performed under their auspices regardless of whether the researcher still works at that institution or how long ago the work was done;work with funders to ensure essential research data is retained for at least 10 years.Journals should: respond to institutions about research integrity cases in a timely manner;have criteria for determining whether, and what type of, information and evidence relating to the integrity of research reports should be passed on to institutions;pass on research integrity concerns to institutions, regardless of whether they intend to accept the work for publication;retain peer review records for at least 10 years to enable the investigation of peer review manipulation or other inappropriate behaviour by authors or reviewers.ConclusionsVarious difficulties can prevent effective cooperation between academic journals and research institutions about research integrity concerns and hinder the correction of the research record if problems are discovered. While the issues and their solutions may vary across different settings, we encourage research institutions, journals and funders to consider how they might improve future collaboration and cooperation on research integrity cases. (shrink)

This collection is a powerful statement about the many directions a post-metaphysical ethics might take.

The “beyond a reasonable doubt” standard of proof, currently used in criminal trials, is notoriously vague and undermotivated. This paper discusses two popular strategies for justifying our choice of a particular precise interpretation of the standard: the “ratio-to-standard strategy” identifies a desired ratio of trial outcomes and then argues that a certain standard is the one that we can expect to produce our desired ratio, while the “utilities-to-standard strategy” identifies utilities for trial outcomes and then argues that a certain standard (...) maximizes expected utility. I argue that both strategies fail on their own terms, by requiring us to perform calculations that we simply cannot perform. No version of either strategy can be performed by jurors or legislators in our actual epistemic position, in which, since we do not know which of the defendants in our trial system are genuinely innocent and which are genuinely guilty, we cannot determine the extent to which our trial system tends to produce evidence that misleadingly incriminates the innocent or misleadingly exonerates the guilty. But we would need to determine this in order to perform the calculations required by any possible version of the ratio-to-standard or utilities-to-standard strategies. I then suggest some empirical reasons to be pessimistic about the evidence produced by our actual trial system. The upshot is that the “beyond a reasonable doubt” standard lacks a clear interpretation and rationale, nor do we have a promising way to identify an alternative. This is the trouble with standards of proof. (shrink)

There is limited knowledge about cancer patients' experiences of uncertainty while waiting for genome sequencing results, and whether prolonged uncertainty contributes to psychological factors in this context. To investigate uncertainty in patients with a cancer of likely hereditary origin while waiting for genome sequencing results, we collected questionnaire and interview data at baseline, and at three and 12 months follow up. Participants had negative attitudes towards uncertainty at baseline, and low levels of uncertainty at three and 12 months. Uncertainty about (...) genome sequencing did not change significantly over time [t = 0.660, p = 0.510]. Greater perceived susceptibility for cancer [r = 0.14, p < 0.01], fear of cancer recurrence [r = 0.19, p < 0.01], perceived importance of genome sequencing [r = 0.24, p < 0.01], intention to change behavior if a gene variant indicating risk is found [r = 0.29, p < 0.01], perceived ability to cope with results [r = 0.36, p < 0.01], and satisfaction with decision to have genome sequencing [r = 0.52, p < 0.01] were significantly correlated with negative attitudes towards uncertainty at baseline. Multiple primary cancer diagnoses [B = −2.364 [−4.238, −0.491], p = 0.014], lower perceived ability to cope with results [B = −0.1.881 [−3.403, −0.359], p = 0.016] at baseline, greater anxiety about genome sequencing [B = 0.347 [0.148, 0.546], p = 0.0012] at 3 months, and greater perceived uncertainty about genome sequencing [B = 0.494 [0.267, 0.721] p = 0.000] at 3 months significantly predicted greater perceived uncertainty about genome sequencing at 12 months. Greater perceived uncertainty about genome sequencing at 3 months significantly predicted greater anxiety about genome sequencing at 12 months [B = 0.291 [0.072, 0.509], p = 0.009]. Semi-structured interviews revealed that while participants were motivated to pursue genome sequencing as a strategy to reduce their illness and risk uncertainty, genome sequencing generated additional practical, scientific and personal uncertainties. Some uncertainties were consistently discussed over the 12 months, while others emerged over time. Similarly, some uncertainty coping strategies were consistent over time, while others emerged while patients waited for their genome sequencing results. This study demonstrates the complexity of uncertainty generated by genome sequencing for cancer patients and provides further support for the inter-relationship between uncertainty and anxiety. Helping patients manage their uncertainty may ameliorate psychological morbidity. (shrink)

In their important paper “Autonomous Agents”, Floridi and Sanders use “levels of abstraction” to argue that computers are or may soon be moral agents. In this paper we use the same levels of abstraction to illuminate differences between human moral agents and computers. In their paper, Floridi and Sanders contributed definitions of autonomy, moral accountability and responsibility, but they have not explored deeply some essential questions that need to be answered by computer scientists who design artificial agents. One such question (...) is, “Can an artificial agent that changes its own programming become so autonomous that the original designer is no longer responsible for the behavior of the artificial agent?” To explore this question, we distinguish between LoA1 (the user view) and LoA2 (the designer view) by exploring the concepts of unmodifiable, modifiable and fully modifiable tables that control artificial agents. We demonstrate that an agent with an unmodifiable table, when viewed at LoA2, distinguishes an artificial agent from a human one. This distinction supports our first counter-claim to Floridi and Sanders, namely, that such an agent is not a moral agent, and the designer bears full responsibility for its behavior. We also demonstrate that even if there is an artificial agent with a fully modifiable table capable of learning* and intentionality* that meets the conditions set by Floridi and Sanders for ascribing moral agency to an artificial agent, the designer retains strong moral responsibility. (shrink)

Managing the violent behaviour of mentally disordered offenders is challenging in all jurisdictions. We describe the ethical framework and practical management of MDOs in England and Wales in the context of the move to equivalence of healthcare between hospital and prison. We consider the similarities and differences between prison and hospital management of the violent and challenging behaviours of MDOs. We argue that both types of institution can learn from each other and that equivalence of care should extend to equivalence (...) of criminal proceedings in court and prisons for MDOs. We argue that any adjudication process in prison for MDOs is enhanced by the relevant involvement of mental health professionals and the articulation of the ethical principles underpinning health and criminal justice practices. (shrink)

Far from considering the phenomenon of disagreement across the board, the peer debate in epistemology solely focuses on cases of disagreements that are at least assumed to be genuine. What counts as a genuine disagreement is most of the times kept on the level of a pre-theoretical intuition according to which the peers disagree insofar as they hold incompatible doxastic attitudes with respect to a proposition P (King, 2012). Yet, the pre-theoretical intuition yields the wrong verdict when the bone of (...) contention is a proposition whose truth is relativized. In order to avoid these counter-intuitive results, the peer debate needs to replace the pre-theoretical intuition of genuine disagreement with a full-fledged account of it. In this essay I firstly put forth a possible candidate for the role coming from an ongoing discussion in philosophy of language. Then, I assess how well such an account fares in both an outright and a credal model of belief. (shrink)

My research focuses on the moral evaluation of people’s motivations. A popular recent view in Philosophy is that good people are motivated by the considerations that make actions morally right (the “right-making features”). For example, this view entails that a Black Lives Matter protester can be a good person if she is motivated to engage in protest by the thought that it will bring about equality, or justice, since this is what makes engaging in protest morally right. But this view (...) entails that the protester cannot be a good person if she engages in protest because it is morally right. I think that this is a serious mistake. My view is that it is good to be explicitly committed to acting rightly and motivated by the moral rightness of one’s actions. More specifically, I explore the nature and defend the value of a complex state that I call "trying to act rightly". This comprises (a) wanting to act rightly, (b) thinking about which actions are right, and (c) doing the things that you think are right, because they are right. The three papers of my Dissertation each make part of the case for trying to act rightly. My first paper, “Praiseworthy Motivations”, addresses the view that it is good to be motivated by the right-making features but not good to be motivated to act rightly. I argue that this view rests on poorly-drawn comparison cases that are not genuine minimal pairs, and that well-constructed cases show these two types of motivation to be equally good. I address the worry that trying to act rightly leads people with false moral beliefs to act wrongly, by noting that this also applies to motivation by right-making features, since people can be motivated by a right-making feature while being mistaken about which acts have this feature. I then argue that we should distinguish carefully between motivations, actions, and beliefs when evaluating these well-meaning but morally mistaken agents. The second paper, “We Can Have Our Buck and Pass It, Too”, addresses the view that the fact that an act is morally right is not a genuine reason to perform it, and that our reasons for action are instead provided by the right-making features. I argue that this view rests on a confused picture of moral metaphysics, which would rule out any case in which one reason to perform an act is partially metaphysically constituted by another fact that is also a reason to perform the same act – as, for example, when a salad both is healthy and contains vegetables. I then sketch an alternative picture of moral metaphysics, on which genuine reasons for action can be metaphysically related to one another. My third paper, “Accidentally Doing the Right Thing”, uses general reflections on the nature of deliberate action and its relationship to praiseworthiness to argue that someone is only praiseworthy for acting rightly if she was trying to act rightly. I apply this idea to the philosophical debate on moral worth, defending the Kantian view that actions have moral worth just in case they are instances of someone’s trying to act rightly and succeeding. This is a radical departure from the most popular contemporary view on moral worth, and requires a re-evaluation of the main case discussed in this literature: that of Huckleberry Finn. (shrink)

Synthetic biologists design and engineer organisms for a better and more sustainable future. While the manifold prospects are encouraging, concerns about the uncertain risks of genome editing affect public opinion as well as local regulations. As a consequence, biosafety and associated concepts, such as the Safe-by-design framework and genetic safeguard technologies, have gained notoriety and occupy a central position in the conversation about genetically modified organisms. Yet, as regulatory interest and academic research in genetic safeguard technologies advance, the implementation in (...) industrial biotechnology, a sector that is already employing engineered microorganisms, lags behind. The main goal of this work is to explore the utilization of genetic safeguard technologies for designing biosafety in industrial biotechnology. Based on our results, we posit that biosafety is a case of a changing value, by means of further specification of how to realize biosafety. Our investigation is inspired by the Value Sensitive Design framework, to investigate scientific and technological choices in their appropriate social context. Our findings discuss stakeholder norms for biosafety, reasonings about genetic safeguards, and how these impact the practice of designing for biosafety. We show that tensions between stakeholders occur at the level of norms, and that prior stakeholder alignment is crucial for value specification to happen in practice. Finally, we elaborate in different reasonings about genetic safeguards for biosafety and conclude that, in absence of a common multi-stakeholder effort, the differences in informal biosafety norms and the disparity in biosafety thinking could end up leading to design requirements for compliance instead of for safety. (shrink)

A grandfather clause is a provision whereby an old rule continues to apply to some existing situation while a new rule applies to all future cases. This paper focuses on the use of grandfather clauses in health technology appraisals (HTAs) issued by the National Institute for Health and Care Excellence (NICE) in the United Kingdom. NICE provides evidence‐based guidance on healthcare technologies and public health interventions that influence resource allocation decisions in the National Health Service (NHS) and the broader public (...) sector in England and Wales. In this context, a grandfather clause is included when NICE does not recommend treatment with a given technology. The grandfather clause provides an exemption from the general recommendation for patients who have already started treatment with the technology in question, before the publication of the NICE guidance. In this paper we first lay out the contexts in which grandfather clauses occur in NICE guidance, and then consider ethical arguments against and in support of grandfather clauses and the continuation of treatment. We argue that NICE’s current practice of automatic inclusion of a grandfather clause is ethically problematic and unfair. While the inclusion of a grandfather clause may be appropriate and justified in specific cases, we argue that inclusion of such a clause should be considered as part and parcel of the decision making process on a case by case basis, rather than adopted as the default. (shrink)

Our topic here is uncertainty, especially as this arises in medicine. We are concerned with the uncertainty of diagnosis and of prognosis, and about how this should be communicated and shared between a doctor and patient. We are concerned with the idea that the doctor might rightly take responsibility for some of that uncertainty, in the sense that they may manage it when the patient is unwilling or unable to do so. And we are concerned with the implications that this (...) has for informed consent, for shared decision making, and for other normative dimensions of the doctor–patient relationship. Most centrally we argue that it is best understood, not in terms of informed consent, but in terms of informed trust. (shrink)

Elinor Mason's Ways to be Blameworthy offers an interesting and potentially-fruitful distinction between varieties of blame and, correspondingly, between varieties of blameworthiness. The notion of "Grasping" Morality is central to her picture, distinguishing those who act subjectively wrongly and can be blamed in the ordinary way from those who only act objectively wrongly and can only be blamed in a detached way. Here I request more information about this central notion and pose a puzzle for Mason's account; I argue that (...) the various things Mason says about agents who grasp Morality appear inconsistent once we recognize that people can count as grasping Morality overall despite significant gaps in their understanding of it. (shrink)

Some philosophers think that if someone acts wrongly while falsely believing that her act is permissible, this moral mistake cannot excuse her wrongdoing. And some think that this is because it is morally blameworthy to fail to appreciate the moral significance of non‐moral facts of which one is aware, such that mistakenly believing that one's act is permissible when it is in fact wrong is itself morally blameworthy. Here I challenge the view that it is blameworthy to fail to appreciate (...) the moral significance of non‐moral facts of which one is aware. This view seems okay if we focus on examples of people mistakenly believing that their wrongful acts are permissible. But it is not remotely plausible when we consider other varieties of moral mistake – such as believing that one's action is required when it is in fact supererogatory, believing that one's action is wrong when it is in fact permissible, and believing false things about the moral properties of others’ actions and of merely possible actions. The upshot is that those who maintain that moral mistakes cannot excuse are sent back to the drawing board; we need a new explanation of why this would be the case. (shrink)

Receptor tyrosine kinases exhibit ligand‐induced activity and uptake into cells via endocytosis. In the case of epidermal growth factor (EGF) receptor (EGFR), the resulting endosomes are trafficked to the perinuclear region, where dephosphorylation of receptors occurs, which are subsequently directed to degradation. Traveling endosomes bearing phosphorylated EGFRs are subjected to the activity of cytoplasmic phosphatases as well as interactions with the endoplasmic reticulum (ER). The peri‐nuclear region harbors ER‐embedded phosphatases, a component of the EGFR‐bearing endosome‐ER contact site. The ER is (...) also emerging as a central player in spatiotemporal control of endosomal motility, positioning, tubulation, and fission. Past studies strongly suggest that the physical interaction between the ER and endosomes forms a reaction “unit” for EGFR dephosphorylation. Independently, endosomes have been implicated to enable quantization of EGFR signals by modulation of the phosphorylation levels. Here, we review the distinct mechanisms by which endosomes form the logistical means for signal quantization and speculate on the role of the ER. (shrink)

Placebo-controlled surgical trials can provide important information about the efficacy of surgical interventions. However, they are ethically contentious as placebo surgery entails the risk of harms to recipients, such as pain, scarring or anaesthetic misadventure. This has led to claims that placebo-controlled surgical trials are inherently unethical. On the other hand, without placebo-controlled surgical trials, it may be impossible to know whether an apparent benefit from surgery is due to the intervention itself or to the placebo effect.

Here we present the personal perspectives of two authors on the important and unfortunately frequent scenario of ambulance clinicians facing a deceased individual and family members who do not wish them to attempt cardiopulmonary resuscitation. We examine the professional guidance and the protection provided to clinicians, which is not matched by guidance to protect family members. We look at the legal framework in which these scenarios are taking place, and the ethical issues which are presented. We consider the interaction between (...) ethics, clinical practice and the law, and offer suggested changes to policy and guidance which we believe will protect ambulance clinicians, relatives and the patient. (shrink)