Obtaining informed consent from patients prior to a medical or surgical procedure is a fundamental part of safe and ethical clinical practice. Currently, it is routine for a significant part of the consent process to be delegated to members of the clinical team not performing the procedure (eg, junior doctors). However, it is common for consent-taking delegates to lack sufficient time and clinical knowledge to adequately promote patient autonomy and informed decision-making. Such problems might be addressed in a number of (...) ways. One possible solution to this clinical dilemma is through the use of conversational artificial intelligence using large language models (LLMs). There is considerable interest in the potential benefits of such models in medicine. For delegated procedural consent, LLM could improve patients’ access to the relevant procedural information and therefore enhance informed decision-making.In this paper, we first outline a hypothetical example of delegation of consent to LLMs prior to surgery. We then discuss existing clinical guidelines for consent delegation and some of the ways in which current practice may fail to meet the ethical purposes of informed consent. We outline and discuss the ethical implications of delegating consent to LLMs in medicine concluding that at least in certain clinical situations, the benefits of LLMs potentially far outweigh those of current practices. (shrink)

In today’s evolving understanding of gender, questions arise about the future of the feminist movement. Using Simone de Beauvoir’s The Second Sex, Hugh Ryan's “Who's Afraid of Social Contagion,” and Ben Kesslen’s “How the Idea of a 'Transgender Contagion' Went Viral—and Caused Untold Harm,” this paper explores the concept of the Other to analyze social contagion and gender-based oppression. It argues that while feminism must adapt, its future lies in embracing the experiences of all classified as the Other. Through de (...) Beauvoir's work, historical definitions of gender, and social constructivism, this paper proposes a new idea for the future of feminism. (shrink)

Recently, Australia became the second jurisdiction worldwide to legalize the use of mitochondrial donation technology. The Mitochondrial Donation Law Reform (Maeve’s Law) Bill 2021 allows individuals with a family history of mitochondrial disease to access assisted reproductive techniques that prevent the inheritance of mitochondrial disease. Using inductive content analysis, we assessed submissions sent to the Senate Committee as part of a programme of scientific inquiry and public consultation that informed drafting of the Bill. These submissions discussed a range of bioethical (...) and legal considerations of central importance to the political debate. Significantly, submissions from those with a first-hand experience of mitochondrial disease, including clinicians and those with a family history of mitochondrial disease, were in strong support of this legislation. Those in support of the Bill commended the two-staged approach and rigorous licencing requirements as part of the Bill’s implementation strategy. Submissions which outlined arguments against the legislation either opposed the use of these techniques in general or opposed aspects of the implementation strategy in Australia. These findings offer a window into the ethical arguments and perspectives that matter most to those Australians who took part in the Senate inquiry into mitochondrial donation. The insights garnered from these submissions may be used to help refine policy and guidelines as the field progresses. (shrink)

This article explores chemical skin bleaching practices in urban Ghana to demonstrate the ways that particular racialized understandings of meaning are deployed in a contemporary postcolonial African society. I argue that the processes of racialization indexed by skin bleaching in Ghana must be contextualized within global racial formations; specifically, they can only be understood by examining the interlinked local and global ideologies and practices of race. In elaborating this argument, the essay also engages with contemporary African diaspora theorization that tends (...) to foreground diasporic identity and experience at the expense of contemporary continental processes. By bringing a postcolonial African society into a dialogue about race, processes of racialization, and the interlinked transnational construction of black identities, this essay offers one way out of the ambivalent relationship that I believe diaspora theorization has with Africa. (shrink)

This article argues that Judith Butler’s neglect of biopolitics in her reading of Michel Foucault’s work on sexuality leads her to propose a genealogy of gender ontology rather than conduct a genealogy of gender itself. Sex was not an effect of a cultural system for Foucault, but an apparatus of biopower that emerged in the eighteenth century for the administration of life. Butler, however, is interested in uncovering how something we call or identify as gender manifests itself in different times (...) and contexts, rather than asking what relations of power made necessary the emergence of gender as a discourse. After examining the theoretical configurations underpinning Butler’s engagement with Foucault’s Herculine Barbin, I suggest a more biopolitically informed reading of how the material body becomes captured by the discourses of sexuality and sex. Finally, the article sets out preliminary questions with which a more strictly Foucauldian genealogy of gender might be conducted. (shrink)

Within barely a year, two school shootings shook Finland. The school shootings shocked Finnish society, forcing media, academics and experts, police and politicians alike to search for reasons behind the violent incidents. Focusing their analysis on the two main Finnish newspapers, Helsingin Sanomat and Hufvudstadsbladet, authoritative sources of information for Finland’s two language communities, the authors maintain that the Finnish case contributes to research on school shootings by evidencing the intimate linkages between the state, gender and violence. The authors argue (...) that violence is to be understood through different discourses about the Finnish state. In particular, they discern three discourses about the state that produce gendered discourses of violence: the welfare state, the realist state and the neoliberal state. The authors conclude that these discourses produce different notions of rational and irrational violence thereby providing different legitimizations for male-embodied/masculine violence. (shrink)

In this note we show that the classical modal technology of Sahlqvist formulas gives quick proofs of the completeness theorems in [8] (D. Gregory, Completeness and decidability results for some propositional modal logics containing “actually” operators, Journal of Philosophical Logic 30(1): 57–78, 2001) and vastly generalizes them. Moreover, as a corollary, interpolation theorems for the logics considered in [8] are obtained. We then compare Gregory's modal language enriched with an “actually” operator with the work of Arthur Prior now known under (...) the name of hybrid logic. This analysis relates the “actually” axioms to standard hybrid axioms, yields the decidability results in [8], and provides a number of complexity results. Finally, we use a bisimulation argument to show that the hybrid language is strictly more expressive than Gregory's language. (shrink)

A modal logic is developed to deal with finite ordered binary trees a they are used in linguistics. A modal language is introduced with operators for the ‘mother of’, ‘first daughter of’ and ‘second daughter of’ relations together with their transitive reflexive closures. The relevant class of tree models is defined and three linguistic applications of this language are discussed: context free grammars, command relations, and trees decorated with feature structures. An axiomatic proof system is given for which completeness is (...) shown with respect to the class of finite ordered binary trees. A number of decidability results follow. (shrink)

Pragmatists have traditionally been enemies of representationalism but friends of naturalism, when naturalism is understood to pertain to human subjects, in the sense of Hume and Nietzsche. In this volume Huw Price presents his distinctive version of this traditional combination, as delivered in his René Descartes Lectures at Tilburg University in 2008. Price contrasts his view with other contemporary forms of philosophical naturalism, comparing it with other pragmatist and neo-pragmatist views such as those of Robert Brandom and Simon Blackburn. (...) Linking their different 'expressivist' programmes, Price argues for a radical global expressivism that combines key elements from both. With Paul Horwich and Michael Williams, Brandom and Blackburn respond to Price in new essays. Price replies in the closing essay, emphasising links between his views and those of Wilfrid Sellars. The volume will be of great interest to advanced students of philosophy of language and metaphysics. (shrink)

The idea of combining logics, structures, and theories has recently been attracting interest in areas as diverse as constraint logic programming, theorem proving, verification, computational linguistics, artificial intelligence and indeed, various branches of logic itself. It would be an exaggeration to claim that these (scattered, and by-and-large independent) investigations have crystallized into an enterprise meriting the title "combined methods"; nonetheless, a number of interesting themes are emerging. This introduction notes some prominent ones and relates them to the papers in this (...) special issue. (shrink)

First published in 1877, this book analyses the laws that govern human relations with society and with the natural world.

The article challenges conventional assumptions regarding the question of incest survival within contemporary discourses. A textual analysis of Kathryn Harrison's autobiographical novel tracing her consensual sexual relationship with her father is used to address the issue of failed or unresolved mourning as a prototypically ‘modern’ cultural phenomenon. Psychoanalytically informed feminist literary criticism is used to explore the parallels between the cultural construction of femininity and failed or postponed mourning in western historical and philosophical traditions. Following the work of Juliana Schiesari (...) and Kathleen Woodward, the article contends that melancholia is a gendered discourse that has historically privileged male theorists and film-makers, such as Barthes and Fassbinder. The article suggests that contemporary women writers, such as Harrison, are engaged in a revisionary approach to the construction of loss within their writing. By situating themselves at the heart of the contemporary family narrative, instead of the ‘melancholic’ margins, they are able to produce a counter-discourse that dispels the conventional dynamics of the traditional family romance. By using the ‘writing cure’ to overcome ideological loss, the desiring daughter is able to challenge misogynist constructions of femininity within contemporary literature. (shrink)

Within a year of each other, three one-volume general dictionaries of philosophy have recently appeared; when our future colleagues in philosophy look back on the 1990s they may well think of it as the decade of reference works. But however productive these years may prove to be in this genre, clearly visible somewhere around the top of the heap will be this handy, useful, entertaining, and instructive contribution from Simon Blackburn. Its two immediate competitors are the Cambridge Dictionary of (...) Philosophy, edited by Robert Audi, and the Oxford Companion to Philosophy, edited by Ted Honderich. No detailed comparison will be attempted here, but two points stand out as obviously giving Blackburn’s dictionary a rather different use and flavor from the others: while containing a closely comparable number of entries, it is distinctly shorter and handier in format; and it has all been written by a single author. (shrink)

The aim of this article is to discuss the role that victim groups and organizations may have in framing and supporting an accountability agenda, as well as their potential for endorsing a distributive justice agenda. The article explores two empirical cases where victims' rights have been introduced and applied by victim organizations to promote accountability—Colombia and Peru. It will be argued that if transitional justice in general and victim reparations in particular are to embark in a quest for distributive justice, (...) it cannot do so without considering victims as political actors, and putting forward demands in terms of victims’ rights. (shrink)

When making substituted judgments for incapacitated patients, surrogates often struggle to guess what the patient would want if they had capacity. Surrogates may also agonize over having the (sole) responsibility of making such a determination. To address such concerns, a Patient Preference Predictor (PPP) has been proposed that would use an algorithm to infer the treatment preferences of individual patients from population-level data about the known preferences of people with similar demographic characteristics. However, critics have suggested that even if such (...) a PPP were more accurate, on average, than human surrogates in identifying patient preferences, the proposed algorithm would nevertheless fail to respect the patient’s (former) autonomy since it draws on the ‘wrong’ kind of data: namely, data that are not specific to the individual patient and which therefore may not reflect their actual values, or their reasons for having the preferences they do. Taking such criticisms on board, we here propose a new approach: the Personalized Patient Preference Predictor (P4). The P4 is based on recent advances in machine learning, which allow technologies including large language models to be more cheaply and efficiently ‘fine-tuned’ on person-specific data. The P4, unlike the PPP, would be able to infer an individual patient’s preferences from material (e.g., prior treatment decisions) that is in fact specific to them. Thus, we argue, in addition to being potentially more accurate at the individual level than the previously proposed PPP, the predictions of a P4 would also more directly reflect each patient’s own reasons and values. In this article, we review recent discoveries in artificial intelligence research that suggest a P4 is technically feasible, and argue that, if it is developed and appropriately deployed, it should assuage some of the main autonomy-based concerns of critics of the original PPP. We then consider various objections to our proposal and offer some tentative replies. (shrink)

Provides a comprehensive introduction to the major philosophical theories attempting to explain the workings of language.

Simon Blackburn puts forward a compelling original philosophy of human motivation and morality. He maintains that we cannot get clear about ethics until we get clear about human nature. So these are the sorts of questions he addresses: Why do we behave as we do? Can we improve? Is our ethics at war with our passions, or is it an upshot of those passions? Blackburn seeks the answers in an exploration of guilt, shame, disgust, and other moral emotions; (...) he draws also on game theory and cognitive science in his account of the structures of human motivation. Many philosophers have wanted a naturalistic ethics a theory that integrates our understanding of human morality with the rest of our understanding of the world we live in. What is special about Blackburn's naturalistic ethics is that it does not debunk the ethical by reducing it to the non-ethical. At the same time he banishes the spectres of scepticism and relativism that have haunted recent moral philosophy. Ruling Passions sets ethics in the context of human nature: it offers a solution to the puzzle of how ethics can maintain its authority even though it is rooted in the very emotions and motivations that it exists to control. (shrink)

This volume collects some influential essays in which Simon Blackburn, one of our leading philosophers, explores one of the most profound and fertile of philosophical problems: the way in which our judgments relate to the world. This debate has centered on realism, or the view that what we say is validated by the way things stand in the world, and a variety of oppositions to it. Prominent among the latter are expressive and projective theories, but also a relaxed pluralism (...) that discourages the view that there are substantial issues at stake. The figure of the "quasi-realist" dramatizes the difficulty of conducting these debates. Typically philosophers thinking of themselves as realists will believe that they alone can give a proper or literal account of some of our attachments--to truth, to facts, to the independent world, to knowledge and certainty. The quasi-realist challenge, developed by Blackburn in this volume, is that we can have those attachments without any metaphysic that deserves to be called realism, so that the metaphysical picture that goes with our practices is quite idle. The cases treated here include the theories of value and knowledge, modality, probability, causation, intentionality and rule-following, and explanation. A substantial new introduction has been added, drawing together some of the central themes. The essays articulate a fresh alternative to a primitive realist/anti-realist opposition, and their cumulative effect is to yield a new appreciation of the delicacy of the debate in these central areas. (shrink)

Sinnott-Armstrong's paper principally defends our inability to justify, philosophically, normal moral claims. In particular, we cannot justify them against other claims, especially the claim of moral nihilism. Moral nihilism is the doctrine that there are no moral obligations. This thesis ‘does not lie in meta-ethics. It is a universally quantified substantive moral claim’. Sinnott-Annstrong makes it clear that he does not actually believe this doctrine, but he believes that it is coherent, and that a variety of strategies philosophers might attempt (...) all fail to disprove it. And because of this, ordinary claims to obligation are philosophically unjustified. (shrink)

Abstract In this piece I take issue with Bernard Williams's interpretation of Herodotus as lacking something of our conception of time. I claim that there is nothing so unusual in the interleaving of myth or fiction and history that Williams finds in Herodotus. I also reflect on the difficulty of separating acceptance of truth from acceptance of myth, metaphor, and model, not only in history but also in science.

Hybrid languages are expansions of propositional modal languages which can refer to worlds. The use of strong hybrid languages dates back to at least [Pri67], but recent work has focussed on a more constrained system called $\mathscr{H}$. We show in detail that $\mathscr{H}$ is modally natural. We begin by studying its expressivity, and provide model theoretic characterizations and a syntactic characterization. The key result to emerge is that $\mathscr{H}$ corresponds to the fragment of first-order logic which is invariant for generated (...) submodels. We then show that $\mathscr{H}$ enjoys interpolation, provide counterexamples for its finite variable fragments, and show that weak interpolation holds for the sublanguage $\mathscr{H}$. Finally, we provide complexity results for $\mathscr{H}$ and other fragments and variants, and sharpen known undecidability results for $\mathscr{H}$. (shrink)

This modern, advanced textbook reviews modal logic, a field which caught the attention of computer scientists in the late 1970's.

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

In their simplest form, hybrid languages are propositional modal languages which can refer to states. They were introduced by Arthur Prior, the inventor of tense logic, and played an important role in his work: because they make reference to specific times possible, they remove the most serious obstacle to developing modal approaches to temporal representation and reasoning. However very little is known about the computational complexity of hybrid temporal logics.In this paper we analyze the complexity of the satisfiability problem of (...) a number of hybrid temporal logics: the basic hybrid language over transitive trees; nominal Until logic; and referential interval logic. We discuss the effects of including nominals, the @ operator, the somewhere modality E, and the difference operator D. Adding nominals to tense logic leads for several frame-classes to an increase in complexity of the satisfiability problem from PSPACE to EXPTIME. On transitive trees, however, the satisfiability problem for this language can be decided in PSPACE. Along the way we make a detour through hybrid propositional dynamic logic: we establish upper bounds for a number of temporal logics by generalizing results due to Passy and Tinchev [29] and De Giacomo [16]. We conclude with some remarks on the relevance of our results to description logic, and draw attention to the utility of the spypoint technique for proving upper and lower bounds. (shrink)

In this article we define a logical system called Hybrid Partial Type Theory ( $\mathcal {HPTT}$ ). The system is obtained by combining William Farmer’s partial type theory with a strong form of hybrid logic. William Farmer’s system is a version of Church’s theory of types which allows terms to be non-denoting; hybrid logic is a version of modal logic in which it is possible to name worlds and evaluate expressions with respect to particular worlds. We motivate this combination of (...) ideas in the introduction, and devote the rest of the article to defining, axiomatising, and proving a completeness result for $\mathcal {HPTT}$. (shrink)

We show that basic hybridization makes it possible to give straightforward Henkin-style completeness proofs even when the modal logic being hybridized is higher-order. The key ideas are to add nominals as expressions of type t, and to extend to arbitrary types the way we interpret \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$@_i$\end{document} in propositional and first-order hybrid logic. This means: interpret \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$@_i\alpha _a$\end{document}, where \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} (...) \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$\alpha _a$\end{document} is an expression of any type \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$a$\end{document}, as an expression of type \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$a$\end{document} that rigidly returns the value that \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$\alpha_a$\end{document} receives at the i-world. The axiomatization and completeness proofs are generalizations of those found in propositional and first-order hybrid logic, and we automatically obtain a wide range of completeness results for stronger logics and languages. Our approach is deliberately low-tech. We don’t, for example, make use of Montague’s intensional type s, or Fitting-style intensional models; we build, as simply as we can, hybrid logicover Henkin’s logic. (shrink)